| [Objective]Clarify the change track of social anxiety(SA)in postoperative breast cancer patients,analyze the influence factors of the change track,explore the predictive effects of different types of rumination on the change track of social anxiety in breast cancer patients,to provide reference for relevant clinical nursing practices.[Methods]1.Longitudinal study of the trajectory of social anxiety(SA)changes in breast cancer patientsThe Interaction Anxiety Scale(IAS)was used to measure the social anxiety level of breast cancer patients at four times(one day before surgery,seven days after surgery,one month after surgery,and three months after surgery).Repeated measures ANOVA was used to clarify the overall change trend of SA in breast cancer patients,and then the Growth Mixture Model(GMM)was used to analyze the potential categories of the trajectory of social anxiety change in breast cancer patients after surgery.2.Analysis of factors influencing the potential categories of postoperative social anxiety(SA)trajectories in breast cancer patientsPreoperatively,general and disease data were collected from patients,nonfactor analysis and logistic regression were applied to explore the final influencing factors of SA change track.3.Effects of different types of rumination on potential categories of social anxiety(SA)change trajectories in breast cancer patientsThe Positive and Negative Rumination Scale was used to measure patients’ levels of rumination preoperatively,cluster analysis was applied to classify the types of rumination in breast cancer patients,and finally logistic regression was used to analyze which type of rumination affects patients’ social anxiety levels after breast cancer surgery.[Results]1.Longitudinal study of the trajectory of social anxiety(SA)changes in breast cancer patientsSocial anxiety levels of breast cancer patients showed a trend of rising,then slightly decreasing,finally rising;five potential categories were identified by GMM analysis,including mild social anxiety group(37.9%),mild social anxiety rising group(7.2%),moderate social anxiety group(31%),moderate social anxiety rising group(15.2%)and severe social anxiety group(8.8%).2.Analysis of factors influencing potential categories of change track in social anxiety(S A)in breast cancer patients after surgeryThe results showed that age,whether the spouse cares about the present image,chemotherapy regimen and the surgical procedure affect the potential categories of the change track in social anxiety in breast cancer patients after surgery.Using the mild social anxiety group as a reference,postoperative breast cancer patients with younger age and chemotherapy regimen of paclitaxel-based drugs were more likely to develop their social anxiety track into the moderate social anxiety rising group;and patients who believed that their spouse cared about their present image were more likely to develop into the mild social anxiety rising group,moderate social anxiety rising group,moderate social anxiety group and severe social anxiety group;patients whose surgical modality was breast-conserving surgery would develop into the mild social anxiety group.3.The effect of different types of ruminative thinking on potential categories of changes in the trajectory of social anxiety in postoperative breast cancer patientsCluster analysis was used to classify the rumination into three types,positive ruminator,negative ruminator,and low ruminator,and after nonfactor analysis.Using the moderate social anxiety group as a reference,breast cancer patients whose rumination type is negative will develop their postoperative social anxiety levels into the mild social anxiety rising group,moderate social anxiety rising group and severe social anxiety group,less likely to develop into the mild social anxiety group.[Conclusion]1.The overall level of social anxiety in postoperative breast cancer patients showed a trend of rising,then slightly decreasing,finally rising again,and there were different groups of potential categories of their change trajectories.Through GMM we identified five groups with different change trends,and nearly half of the postoperative breast cancer patients had a rising trend and persistent severe social anxiety level,we should pay more clinical attention to the social anxiety of such people.2.In social anxiety interventions for postoperative breast cancer patients,more attention should be paid to breast cancer patients who are young,whose spouse care about their present image,whose chemotherapy regimen is paclitaxel-based,and whose surgical options are modified radical surgery and radical surgery.3.The three types of rumination in breast cancer patients are positive,negative and low type.More attention should be paid to the negative type of rumination in clinical work,the level of social anxiety in this group is more likely to be elevated in the postoperative period. |
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