Longitudinal Study Between Rumination,Coping Style And Subjective Well-Being In Patients With Breast Cancer

Objective?1?To explore the dynamic changes of rumination,coping styles and subjective well-being of breast cancer patients at different time points.?2?Analyze the effects of rumination and coping styles on subjective well-being in breast cancer patients at different time points.MethodsThis study used convenience sampling method to select patients with primary breast cancer from November 2018 to October 2019 in the First Affiliated Hospital of Dalian Medical University.Patients who received surgery and chemotherapy after operative were recruited.A longitudinal survey was used to collect questionnaires for patients who met the criteria for admission.The study consists of four tools:self-designed general information questionnaire,Chinese Event-Related Rumination Inventory?C-ERRI?,Medical Coping Modes Questionnaire?MCMQ?,General Well-being Schedule?GWB?.We refined and improved of the research plan during the pre-investigation process.The overall condition of the patient is evaluated before each investigation.The evaluation time points were on the day of admission?T₁?,the 1 month after surgery?T₂?,the 3 month after surgery?T₃?,and the 6 month after surgery?T₄?.On the day of admission?T₁?,patients was introduced to the hospital and the department environment,the responsible doctor and nurse to alleviate anxiety.At the same time,we explained the procedures of postoperative limb function exercises and encouraged preoperative practice.Then we introduced the purpose and significance of this study,obtained patient consent,signed the informed consent form and distribute scales.After the T₂,T₃,and T4evaluations,we communicated with patients by telephone to confirm time of hospitalization or admission check.After evaluating the patient's condition,a questionnaire was issued.After obtaining the questionnaire,we input the data by double it in time.Using SPSS19.0 to analysis datas,methods included:normal test,descriptive statistical analysis,repeated ANOVA,pearson correlation analysis,multiple linear regression equation and so on.Results1 Dynamic changes of rumination in breast cancer patientsT₁:total score of rumination was?28.85±8.90?points,intrusive rumination score was?14.38±6.63?points,objective rumination score was?14.46±6.08?points;T₂:total score of rumination was?29.37±6.64?points,intrusive rumination score was?17.68±6.14?points,objective rumination score was?11.70±5.16?points;T₃:total score of rumination was?25.13±5.55?points,intrusive rumination score was?10.80±4.95?points,objective rumination score was?14.33±3.92?points;T₄:total score of rumination was?22.57±3.83?points,intrusive rumination score was?7.74±3.23?points,objective rumination score was?14.83±3.63?points.The data outcome of repeated ANOVA showed that difference is significant?P<0.001?.The changes in the total score of rumination in breast cancer patients with different educational background and different chemotherapy cycles were statistically significant in both time and interaction effects?P<0.05?.2 Dynamic changes of coping styles in breast cancer patientsThe confrontation,avoidance and yield of breast cancer patients are different at different time points.Confrontation:the highest score at T₄was?2.46±0.49?points;Avoidance:the highest score at T₂was?2.24±0.31?points;Yield:the highest score at T₂was?2.11±0.81?points.The data outcome of repeated ANOVA showed that difference is significant?P<0.001?.The mean scores of breast cancer patients with per capita monthly income from different families were statistically significant in terms of time and interaction effects?P<0.05?.3 Dynamic changes of subjective well-being in breast cancer patients.Subjective well-being scores of breast cancer patients at different time points is T₁:?98.39±15.64?points;T₂:?80.91±19.64?points;T₃:?90.07±12.75?points;T₄:?96.77±13.88?points.The total score of subjective well-being shows a trend of decreasing first and then rising,and the subjective well-being score will be higher over time after surgery.The score of T₂is lowest.The data outcome of repeated ANOVA showed that difference is significant?P<0.001?.4 Correlation analysis of rumination,coping styles and subjective well-being in breast cancer patientsPearson correlation analysis showed that:subjective well-being in breast cancer has a negative correlation with intrusive rumination,avoidance and yield,has a positive correlation with objective rumination and confrontation?P<0.05?.The results of multiple linear regression showed that intrusive rumination,avoidance and yield can negatively predict subjective well-being,objective rumination and confrontation can positively predict subjective well-being?P<0.05?.Conclusion1 The rumination in breast cancer patients at 6 months after surgery showed dynamic changes.The types of rumination at different time points were different.The frequency of rumination was highest at 1 month after surgery,mainly intrusive rumination.Later,the total score of rumination showed a decreasing trend and the objective rumination showed an increasing trend over time.The effects of per capita monthly income and chemotherapy cycle on ruminant rumination in breast cancer patients were different in different families.2 The coping styles in breast cancer patients at 6 months after surgery showed dynamic changes.Confrontation is a decreasing trend and then an increasing trend,the score was the lowest at 1 month after surgery;Avoidance is a increasing trend and then an decreasing trend;Yield is a increasing trend and then an decreasing trend.The per capita monthly income of different families has different influence on the coping style of patients.3 The subjective well-being in breast cancer patients at 6 months after surgery showed dynamic changes.Total scores is a decreasing trend and then an increasing trend,the score was the lowest at 1 month after surgery.At 6 months after surgery,it recovered to the preoperative level,and the change trend of energy dimension and mood of depression or happiness was more obvious in each dimension.4 Intrusive rumination,yield,and avoidance at different time points are negatively correlated with subjective well-being,objective rumination and confrontation are positively correlated with subjective well-being.Intrusive rumination,avoidance and yield can negatively predict subjective well-being,objective rumination and confrontation can positively predict subjective well-being.