The Resilience And Its Influencing Factors In Postoperative Chemotherapy Of Breast Cancer

Objective To investigate the psychological resilience of patients with postoperative chemotherapy for breast cancer and to describe its trajectory in four periods,to explore the influencing factors of psychological resilience in four periods,and to analyze the relationship between psychological resilience and negative emotion level,body image,medical coping style and social support in different stages of chemotherapy.To provide a reference for the clinical formulation of targeted intervention programs.Methods From January 2016 to December 2018,150 postoperative patients undergoing chemotherapy in the Department of Oncology and General Surgery of the First and Second Affiliated Hospitals of Anhui Medical University were followed up for4.2 months.The disease information questionnaire was used to investigate the general sociodemographic and disease-related data of patients.The psychoelasticity scale(Resilience Scale-14,RS-14)was used to assess the patient's psychological resilience.The Hospital Anxiety and Depression was used.Scale,HADS)Investigate the patient's negative emotional level,use the Body Image Scale(BIS)to investigate the body's willingness during treatment,and use the Medical Coping Modes Questionnaire(MCMQ)to investigate the patient's medicine.Coping style,social support rating scale(SSRS)was used to investigate the social support of patients.The database was built using EpiData3.1,and the SPSS24.0 statistical software was used for statistical analysis.The scores of psychoelasticity in different stages of chemotherapy were analyzed by descriptive analysis and univariate analysis,and the levels of psychoelasticity and the changes of HADS,BIS,MCMQ,SSRS in four periods were compared by repeated measurement of variance.Pearson correlation analysis was used to analyze the correlation between RS-14 and HADS,BIS,MCMQ and SSRS in patients at four periods,and using the multiple linear regression method to analyze the influence factors ofpsychoelasticity in patients in four periods.Results 1.A total of 150 patients with breast cancer were investigated before the first chemotherapy,149 patients were investigated after the first chemotherapy,1 patient was not followed up,145 patients were investigated after the third chemotherapy,4 patients were missed,136 patients were investigated after the sixth chemotherapy,9 patients were missed.The rate of missing three visits was 0.66%,2.67% and 6.20% respectively.2.The scores of psychoelasticity were(58.43±9.34)before chemotherapy,(63.47 ±8.67)after the first chemotherapy,(61.84±8.75)after the third chemotherapy,(69.66 ±7.58)after the sixth chemotherapy.With the prolongation of the chemotherapy cycle,the psycho-elastic score of the patients showed an upward trend.There was a significant difference between the two groups(P < 0.05),and the score decreased during the third cycle of chemotherapy.One-way ANOVA analysis was carried out on the psycho-elastic score of 136 patients at four periods.The results showed that education was carried out in 136 patients.Degree,family location,occupation,family per capita monthly income,living condition,main caregiver,payment of medical expenses,disease stages and family disease history were the influencing factors of psycho-elasticity of patients.3.The scores of other variables in patients with breast cancer were as follows: before chemotherapy,1,3,6 times of chemotherapy,the HADS-A score was(13.76±2.59),(10.66±2.96),(14.45±3.17),(8.31±3.07);the HADS-D score was(11.15±5.53),(10.03 ± 3.25),(13.02 ± 3.43),(8.05 ± 3.36);the BIS score was(17.58 ± 2.76),(18.98 ±2.89),(16.15±3.02),(19.27±3.14);the score of MCMQ(face)was(19.10 ±4.14),(21.39±4.20),(20.55±4.27),(22.47±4.38);the SSRS scores were(40.43±5.41),(43.06±6.03),(42.37±4.43),(45.18±4.69).The HADS score after the sixth chemotherapy in patients with breast cancer was significantly lower than that before chemotherapy,the BIS score after the first and third chemotherapy was significantly lower than that before chemotherapy,and the SSRS score was significantly higher than that before chemotherapy,after the first and third times of chemotherapy,and the score of SSRSwas significantly higher than that before chemotherapy.The difference was statistically significant(P < 0.05).BIS score,MCMQ "face" score,SSRS score at the third stage of chemotherapy dropped,HADS score increased.4.The results of correlation analysis between psychoelasticity and other variables in different stages:Pearson correlation analysis showed that before chemotherapy,1,3,6times of chemotherapy,the score of psychoelasticity was correlated with HADS,BIS,MCMQ(face),SSRS score and negatively correlated with HADS score(r=-0.564,P=0.043),(r=-0.588,P=0.039),(r=-0.527,P=0.037),(r=-0.463,P=0.033).There was a positive correlation between BIS,MCMQ(r >0,P < 0.05)and SSRS score(r>0,P < 0.05).The correlation between psychoelasticity and BIS score was(r=0.521,P=0.048),(r=0.510,P=0.037),(r=0.459,P=0.026),(r=0.483,P=0.041).The correlation between psychoelasticity and MCMQ(face)score was(r=0.453,P=0.035),(r=0.498,P=0.021),(r=0.367,P=0.046),(r=0.476,P=0.036).The correlation between psychoelasticity and SSRS score was(r=0.472,P=0.025),(r=0.484,P=0.031),(r=0.406,P=0.044),(r=0.514,P=0.032).5.The results of multiple linear regression showed that:The significant variables in univariate analysis were incorporated into the multivariate linear regression analysis,and the results showed that:Before chemotherapy,the influencing factors of psychoelasticity included payment of medical expenses,stage of disease,and HADS,BIS,explained 59.9% of psychoelasticity;There were main caregivers after the first chemotherapy,and BIS,MCMQ,SSRS,explained 60.3% of the psychoelasticity;There were major caregivers after the third chemotherapy,and MCMQ,SSRS,explained 61.7% of the psychoelasticity;After the sixth chemotherapy,the average family income per month,HADS,MCMQ,SSRS,explained 62.9% of the psycho-elasticity.Conclusion The psychological and elastic scores of four time periods in the patients with breast cancer after operation were at medium level,and with the extension of thechemotherapy period,the level of the psychological elasticity was generally on the rise,and the score decreased in the third cycle of the chemotherapy;the development trajectory of the psychological elasticity was a dynamic curve with fluctuation.There is a negative correlation between the psychological elasticity and the anxiety and depression,which is positively related to the body image,the medical coping style(facing)and the social support.The influencing factors of psychological elasticity in patients with breast cancer at different stages of chemotherapy are different.With the prolongation of the course of disease and the increase of chemotherapy times,the main influencing factors of psychological elasticity are the main caregivers,medical coping style and social support.Exploring the influencing factors of different stages can provide scientific basis for the establishment of the overall structure of psychological elasticity in different stages and the targeted psychological elastic intervention.