| Purpose To explore the psychological experience and status quo of posttraumatic growth of Chinese patients with breast cancer under early chemotherapy,to explore the mental and psychological characteristics of patients under the influence of traditional Chinese culture and the influencing factors of patients' posttraumatic growth,in order to provide guidance for the clinical psychological nursing of patients with breast cancer,Then,to explore the applicability and effection of Mindfulness-Based Stress Reduction in Chinese patients with breast cancer under early chemotherapy,providing a basis for the localization of Mindfulness-Based Stress Reduction.Methods The first part(qualitative study):We used the phenomenological method of qualitative research to explore the experience and feelings of the patients' posttraumatic growth after the disease.According to purposive sampling,16 cases of patients with breast cancer under early chemotherapy were interviewed by semi structural interview.and the interview records were analyzed according to the Claizzi analysis procedure.The second part(cross-sectional study):We used cross-sectional study to investigate the social demographic data,disease related data and psychological data of patients with breast cancer under early chemotherapy.According to purposive sampling,193 cases of patients with breast cancer under early chemotherapy in two hospitals in Jiangsu province were selected to test The self-made general data questionnaire,The Posttraumatic Growth Inventory(PTGI),Self-rating Anxiety Scale(SAS),Self-rating Depression Scale(SDS),Perceived Social Support Scale(PSSS)and The Chinese version of Cognitive Emotion Regulation Questionnaire(CERQ-C),and the data were statistically analyzed by SPSS 21.0.The third part(randomized controlled trial):101 cases of patients with breast cancer under the first chemotherapy were randomly divided into the intervention group and the waiting control group.The two groups of patients was given usual care,and Mindfulness-Based Stress Reduction was added to test patients in intervention group on this basis.Mindfulness-Based Stress Reduction is a 8 week course with 2 hours per course,course content includes mindfulness breathing training,mindfulness meditation,body scan and mindfulness yoga courses.We used PTGI,SAS,SDS,PSSS,CERQ-C and The Functional Assessment of Cancer Therapy-Breast Cancer(FACT-B)to all patients before and after the intervention,and the data were statistically analyzed by SPSS 21.0.Results The first part(qualitative study):The posttraumatic growth experience of patients with breast cancer under early chemotherapy mainly includes five aspects:doubting the individual strength,remolding individual strength,paying attention to the relationship with others,the sense of responsibility driving patients to face life actively and the spiritual world and new possibility of patients were relatively single.The second part(cross-sectional study):The average post traumatic growth of patients with breast cancer under early chemotherapy was(58.510±13.835),the scores of the five dimensions were:Relating to others(17.910±4.258),Personal strength(15.670±3.887),New possibilities(8.400 ±3.331),Spiritual change(2.970± 2.043),and Appreciation of life(14.060±4.836).The results of single factor analysis showed that there were correlations between posttraumatic growth levels of patients with breast cancer under early chemotherapy and teir occupation,educational level,family per capita monthly income,religious belief,tumor stage,operation mode,anxiety,depression,perceived social support,cognitive emotion regulation strategies(P<0.05).Multiple stepwise linear regression analysis showed that perceived social support,anxiety,cognitive emotion regulation strategies,family monthly income and tumor stage were main influencing factors of posttraumatic growth in patients with breast cancer under early chemotherapy.The third part(randomized controlled trial):The general data,PTGI,SAS,SDS,PSSS,CERQ-C and FACT-B of the two groups were not statistically significant before intervention(P>0.05).After intervention,anxiety,depression of patients with breast cancer in intervention group were significantly decreased(P<0.01),The total score of posttraumatic growth and the scores of all dimensions except the Spiritual change,the total score of understanding social support and the score of all dimensions,the score of acceptance dimension,the score of positive reappraisal,the score of positive refocusing,the total score of quality of life and the scores of all dimensions were significantly higher than those in the waiting control group(P<0.05).The scores of anxiety,depression,negative cognitive emotion regulation strategies,self censure dimension,disastrous dimension score and reproach dimension score were significantly lower than those in the waiting control group(P<0.05).compared with the waiting control group,the posttraumatic growth,perceived social support,positive cognitive emotion regulation strategies and quality of life of patients with breast cancer in intervention group were all in significantly improved(P<0.05).Conclusion Patients with breast cancer under early chemotherapy can experience posttraumatic growth,mainly in the affirmation of personal strength,attention to interpersonal relationship,and active face to life.It is suggested that medical professionals should enhance their professional support to promote their posttraumatic growth level.The average post traumatic growth of patients with breast cancer under early chemotherapy was at a medium level,and the main influencing factors include perceived social support,anxiety,cognitive emotion regulation strategies,family per capita monthly income and tumor staging.There was a significant negative correlation between post traumatic growth and anxiety,negative cognitive emotion regulation strategies and tumor staging(P<0.05),which was positively correlated with perceived social support,positive cognitive emotion regulation strategies and family per capita monthly income(P<0.05).The application of Mindfulness-Based Stress Reduction in patients with breast cancer in China is good.It can effectively improve the posttraumatic growth,perceived Social Support,positive cognitive emotion regulation strategies and quality of life in patients with breast cancer under early chemotherapy,and significantly reduce the patient's anxiety,depression and negative cognitive emotion regulation strategies,and help the patients adjusting their mental state,promoting the positive psychological and positive change of the patient,to improve their posttraumatic growth and the quality of life. |
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