Longitudinal Study Between Health Locus Of Control And Subjective Well-being In Elderly Breast Cancer Patients

ObjectiveThe purpose of this study was to investigate the dynamic changes of the health locus of control and subjective well-being of elderly breast cancer patients,and to explore the relationship between the health locus of control and subjective well-being of elderly breast cancer patients in different time periods,and to develop intervention programs related to subjective well-being provide a theoretical basis.MethodsThe research method adopted in this study was a longitudinal study.From October2018 to October 2019,this study used a convenient sampling method to select 108 elderly breast cancer patients in a tertiary first-class hospital in Dalian,and researched health locus of control and subjective well-being of elderly breast cancer patients in different periods.The 6-month longitudinal survey was conducted on the day of admission(T0),1 month after surgery(T1),3 months(T2),and 6 months(T3).The survey tools were general information,Multidimentional Health Locus of Control Scale,and General Well-being schedule.Statistical analysis was performed using Excel input data and SPSS17.0 statistical software.Statistical analysis methods were: descriptive analysis,repeated ANOVAs,Pearson correlation analysis.P<0.05 was considered statistically significant.Results1 Scores and trends of health locus of control in elderly patients with breast cancer from T0 to T3The dimensional score of health locus of control in elderly patients with breast cancer during T0 period: internal health locus of control were(25.49 ± 3.81)points,powerful others health locus of control were(25.36 ± 2.73)points,and chance health locus of control were(20.04 ± 4.28)points;The scores of the dimensions of the patient's health locus of control during T1 period: internal health locus of control were(23.42±3.60)points,powerful others health locus of control were(28.26±2.07)points,and chance health locus of control were(20.83±2.95)points;The scores of the dimensions of the patient's health locus of control during T2 period: internal health locus of control were(25.33±2.88)points,powerful others health locus of control were(25.71±2.05)points,and chance health locus of control were(18.92±2.51)points;The scores of the dimensions of the patient's health locus of control during T3 period:internal health locus of control were(25.21±2.52)points,powerful others health locus of control were(25.71±2.05)points,and chance health locus of control were(18.92±2.51)points.The results of repeated ANOVAs showed that there were statistically significant differences in the scores of health locus of control among elderly breast cancer patients during the period from T0 to T3(P <0.01).The internal health locus of control of patient reached the lowest level at 1 month after operation,and 3After one month,it showed an upward trend.The powerful others health locus of control and chance health locus of control reached the highest level within one month after operation,and it decreased after three months.2 Subjective well-being scores and trends of elderly breast cancer patients from T0 to T3The total score of subjective well-being of elderly patients with breast cancer at T0 period was(79.97 ± 10.57)points,the total score of subjective well-being of patients at T1 period was(71.27 ± 9.18)points,and the total subjective happiness of patients at T2 period was(75.91 ± 8.94)points,the total subjective well-being of patients during T3 period was(79.62 ± 9.09)points.The results of repeated ANOVAs showed that there was a statistically significant difference in subjective well-being scores of elderly breastcancer patients from T0 to T3 period(P <0.01).Patients' subjective well-being reached a minimum at 1 month after surgery,and showed an upward trend after 3 months.3 Analysis of repeated ANOVAs of the health locus of control of elderly breast cancer patients in different groupsThe results showed that under the grouping of per capita monthly income of families and whether had chemotherapy,the powerful others health locus of control in the time effect,group and time interaction effect,all showed statistical significance(P<0.05).It showed that with the extension of time,there was a difference in the trend of changes in the scores of powerful others health locus of control among patients with different monthly incomes per capita and whether they received chemotherapy.From T0 to T1,patients with family monthly income of 4001 to 6000 yuan per capita have the largest increase in the powerful others health locus of control.During T1 to T3,patients with family monthly income of 2000 yuan or less per,the powerful others health locus of control have a decrease in the score.In other monthly income groups,the decline is slowing down from fast.During the period from T1 to T3,the decline in the powerful others health locus of control of chemotherapy patients was slower than that of non-chemotherapy patients.4 Analysis of repeated ANOVAs of the subjective well-being of elderly breast cancer patients in different groupsThe results showed that under different clinical stages and with or without chemotherapy,the patients' subjective well-being had statistical differences in time effect,group and time interaction effect(P <0.05).This indicated that there was a difference in the change trend of subjective well-being score between patients with different clinical stages and whether they received chemotherapy.From T0 to T1,patients with clinical stage 2 had the largest decrease in subjective well-being,and patients with stage 3 had a smaller decrease in subjective well-being.From T1 to T3,patients with stage 0 had a larger increase in subjective well-being than other patients,and stage 2 rises more slowly,and overall,the higher the clinical stage,the lower thepatient's subjective well-being level.From T0 to T1,the subjective well-being of chemotherapy patients decreased more than non-chemotherapy patients.From T1 to T3,the subjective well-being of chemotherapy patients increased more slowly than non-chemotherapy patients.5 Correlation analysis of health locus of control and subjective well-being of elderly breast cancer patients from T0 to T3In each period of T0 ? T3,the internal health locus of control of elderly breast cancer patients was positively correlated with the total score of subjective well-being,and the powerful others health locus of control,chance health locus of control and the total score of subjective well-being were all negatively correlated(P <0.05).The higher the level of internal health locus of control,the higher the level of subjective well-being.The lower the level of powerful others health locus of control and the chance health locus of control,the higher the level of subjective well-being.Conclusion1 The level of health locus of control of elderly breast cancer patients changes dynamically with the postoperative time.The internal health locus of control was at the lowest level after 1 month,and the powerful others health locus of control and chance health locus of control were at the highest level after 1 month.Medical staff should pay attention to the level of health locus of control at early postoperative,and communicate with patients,understand patients' psychological experience of disease or treatment,explain the treatment of breast cancer patients and treatment rehabilitation cases,increase patients self-confidence in overcoming disease,and makes them actively face the disease.2 The level of subjective well-being of elderly breast cancer patients changes dynamically with the prolongation of postoperative time,and it is at the lowest level at1 month after surgery.Medical staff should pay close attention to the patient's subjective well-being in the early postoperative period,conduct psychological evaluation early in the post-operative period,and intervene early to discover the patient's psychologicalproblems in a timely manner,help channel and resolve their negative emotions,and improve their subjective well-being.3 There were differences in the trend of changes in the powerful others health locus of control among elderly breast cancer patients with different monthly family incomes.Patients with lower family monthly incomes continue to rely on medical staff and others more than one month after surgery.This suggests that medical staff should increase the number of diseases related knowledge guidance or psychological counseling,and gradually help them build confidence in recovery.There was a difference in the trend of changes in the powerful others health locus of control among patients with chemotherapy.The frequency of postoperative hospitalization of patients with chemotherapy is higher.They are in the role of patients for a long time,and their self-recovery awareness is less,so they rely more on the care of medical staff and family members.This suggests that at this stage,medical staff should give more successful cases to explain the end of safe chemotherapy,increase awareness of self-rehabilitation,and actively participate in social activities.4 There were differences in the trend of subjective well-being scores among elderly breast cancer patients with different clinical stages.The higher the clinical stage of patients,the higher the degree of malignancy and the poorer prognosis.It should be guided step by step to help patients release their emotions and maintain a positive and optimistic attitude.There was a difference in the trend of subjective well-being scores among patients receiving chemotherapy.Chemotherapy patients are hospitalized more frequently and the side effects of treatment are more obvious.It is necessary to pay close attention to the level of subjective well-being of chemotherapy patients and give psychological counseling in time to help pass the chemotherapy period.5 There is a positive correlation between the internal health locus of control of elderly breast cancer patients and their subjective well-being,and a negative correlation between powerful others health locus of control,chance health locus of control and subjective well-being.By improving the internal health locus of control of patients andreducing the level of powerful others health locus of control and the chance health locus of control,the level of patient's subjective well-being can be improved.