目的 探讨乳腺癌失眠患者在失眠过程中所采取的应对策略及其效果.方法 采用质性研究方法,以半结构式的开放性访谈问卷对31例乳腺癌失眠患者进行深入访谈,并运用内容分析法进行资料分析.结果 乳腺癌失眠患者的显性失眠应对策略主要包括饮食调整、行为调整、改善睡眠环境、睡眠时间调整和寻求专业帮助等.患者针对具体的应对策略形成了自己独特的条件有效或条件无效的应对策略认知.对于应对策略信息的实践主要与该信息来源的权威性、初次实践的成效以及以往的经验有关.结论 乳腺癌失眠患者在失眠过程中经历了反复的失眠应对策略摸索阶段.医护人员应了解乳腺癌失眠患者在自行应对失眠过程中所采取过的应对策略及其对失眠的认知和态度,以促进对失眠患者的早期发现和正确指导.

AIMS AND OBJECTIVES:This study aimed to explore the experiences and factors associated with insomnia in Chinese breast cancer survivors.BACKGROUND:Insomnia is a common and significant symptom in breast cancer survivors. Quantitative studies are unable to describe the experience of insomnia and the sleep-associated factors from a personal point of view. A profound understanding of the experience of insomnia in breast cancer survivors can provide information for health workers and caregivers to allow them to provide more effective support.DESIGN:A descriptive qualitative research was adopted.METHODS:In-depth interviews were conducted with 22 insomniac breast cancer survivors. A qualitative content analysis was used to analyse the data.RESULTS:Three themes emerged concerning the experiences of insomnia, including sleep neglect, insomnia perception and insomnia anxiety. Participants reported their own opinions on three insomnia-associated factors, including factors associated with hospitalisation, factors associated with breast cancer and the therapies and too much attention placed on sleep.CONCLUSIONS:Survivors would neglect their sleep problems in the early stage after diagnosis. When they became aware of their sleep problems, they were inclined to worry too much and sought help from traditional Chinese medicine. Anticipatory sleep anxiety, excessive negative cognitive activities and insomnia became a vicious circle for insomniac breast cancer survivors.RELEVANCE TO CLINICAL PRACTICE:The findings provide detailed information to help nurses understand the experiences of breast cancer survivors with insomnia. Nurses could provide proper care to help prevent insomnia or improve sleep.

PURPOSE:Due to the rapid increase in the number of breast cancer survivors in China, it is important to have a valid instrument to assess their posttraumatic growth. We carried out a study to validate the psychometric testing of the Simplified Chinese Version of the Posttraumatic Growth Inventory (PTGI-SC) in breast cancer survivors.METHODS AND SAMPLE:A convenience sampling method was used to collect data from 1227 breast cancer survivors at eight tertiary hospitals and some anticancer groups in Beijing between April 2010 and April 2012. We tested the item discrimination, content validity, construct validity, and internal consistency of the PTGI-SC.KEY RESULTS:The difficulties of the items ranged from 0.432 to 0.737, and their discrimination correlation coefficients ranged from 0.324 to 0.721. The content validity index of the inventory was 0.98. Five factors were extracted using exploratory factor analysis, and their cumulative contribution was determined to be 68.3%. The results of the confirmatory factor analysis include χ(2)/df=3.912, SRMR = 0.046, RMSEA = 0.055, IFI = 0.932, CFI = 0.932, and Cronbach's α = 0.90.CONCLUSION:The validity and reliability of the PTGI-SC support its use for evaluating Chinese breast cancer survivors. This reliable and valid inventory can be used in practice to measure PTG in breast cancer survivors and provide information about their psychological adjustment. It can also facilitate further psychological research among Chinese breast cancer survivors.

目的 调查乳腺癌术后患者的自我形象与经验性回避状况,并探讨二者之间的相关性.方法 采用乳腺癌患者生活质量测定量表、接纳与行动问卷对112例乳腺癌术后患者进行调查.结果 乳腺癌术后患者自我形象得分为(77.01±16.86)分,经验性回避得分为(15.95±8.90)分.经验性回避、家庭人均月收入、复发或转移为乳腺癌术后患者自我形象的影响因素.结论 医护人员应采取相应的心理干预措施,促进患者减少经验性回避行为,提高自我形象水平,同时积极治疗家庭人均月收入较低、复发或转移的患者.

Purpose The factors that affect posttraumatic growth (PTG) in breast cancer survivors have been discussed for many years, but it remains unclear which are most influential. The purpose of this study was to determine the level of PTG and identify associated socio-demographic and clinical factors in Chinese breast cancer survivors. Methods and sample A descriptive research design with a convenience sampling method was employed to collect data using the simplified Chinese version of the Posttraumatic Growth Inventory (PTGI-SC). This questionnaire was administered to 1227 participants recruited from eight tertiary hospitals and cancer survivor groups in Beijing between April 2010 and April 2012. Key results PTG is present in Chinese breast cancer survivors, with an average PTGI-SC score of 70.18 ± 15.85. There were five variables in the regression model: exercise, other chronic disease, income, education level, and work status. Exercise showed the strongest positive association with PTG after breast cancer. Household income and educational level also positively influenced PTG. Survivors with other accompanying chronic diseases had lower PTG. Retired survivors had the highest PTG, those working had moderate PTG, and those on sick leave had the lowest PTG. Conclusions PTG is common among Chinese breast cancer survivors. It is positively associated with exercise, income, education, and retirement, and negatively associated with the presence of other chronic diseases and working. The results may provide information on how to promote the development of PTG while nursing breast cancer survivors.

目的 探讨康复期乳腺癌患者创伤后成长状况及其影响因素,以便更好地指导临床护理工作.方法 采用创伤后成长量表对153例康复期乳腺癌患者进行问卷调查.结果 康复期乳腺癌患者创伤后成长量表得分为(75.42±3.20)分,分数转化后发现,患者欣赏生活维度得分最高,精神改变维度得分最低.经多元线性逐步回归分析,病程、人均月收入、疾病分期和其他慢性病为康复期乳腺癌患者创伤后成长的影响因素.结论 医护人员应采用各种心理干预方式尽可能帮助患者度过疾病诊断后的早期阶段,促进创伤后成长的发展,为乳腺癌患者建立战胜疾病的信心,同时积极治疗患者合并的其他慢性病.

Objective To understand the illness behavior and its influencing factors in hospitalized prostate hyperplasia patients so as to guide clinical nursing.Methods One hundred and five hospitalized prostate hyperplasia patients were surveyed by the illness behavior questionnaire.Results One hundred and five questionnaires were issued and 100 questionnaires were responsive with an effective response rate of 95.2％.The scores of psychological orientation,disease conviction and wondering index were respectively (1.66 ±1.01),(5.82 ± 2.15),(5.82 ± 2.47).There were respectively 43.0％,39.0％ and 36.0％ participants abnormal in psychological orientation,disease conviction and wondering index.Multiple regression analysis showed that educational level was associated with psychological orientation (P ＜ 0.05),self-care degree and other chronic diseases were correlated with disease assurance (P ＜ 0.05),and exercise frequency was the influencing factor of hypochondriac index (P ＜ 0.05).Conclusions Health workers should strengthen disease education,help patients express their negative emotions and treat the disease actively.We should encourage patients to care themselves and exercise moderately step by step in order to relieve their "disease feeling" and thereby promote disease rehabilitation and improve the prognosis.

ObjectiveTo describe the dynamic changes in posttraumatic growth (PTG) and psychological distress in hospitalized early-stage breast cancer (BC) survivors over a 6-month period.MethodsA longitudinal study design was adopted. The PTG inventory (PTGI) and distress management screening measure were used 3months after diagnosis, then again at 6 and 9months after diagnosis. For baseline data, 155 BC patients who were receiving chemotherapy were selected from four first-class tertiary hospitals in Beijing from April 2010 to March 2011 using a purposive sampling method. Of these, 120 BC patients completed the follow-up investigation. A repeated measures analysis of variance, followed by least significant difference post-hoc analysis, was used to compare PTG and psychological distress.ResultsThe total score of the PTGI was 62.7214.66 in BC survivors at 3months after diagnosis. There was a weak negative relationship between PTG and psychological distress (r=-0.282, p<0.001). PTG increased and psychological distress decreased from 3 to 9months after diagnosis. The PTGI scores were 63.24 +/- 14.21, 68.26 +/- 15.29, and 70.29 +/- 16.07 at 3, 6, and 9months after diagnosis, respectively, with distress thermometer scores of 3.62 +/- 1.98, 2.59 +/- 2.00, and 2.51 +/- 1.00, respectively.ConclusionsAt 3months after diagnosis, BC survivors develop PTG at a low level while they are receiving chemotherapy. PTG showed a weak negative association with psychological distress. The level of PTG shows an increasing tendency, whereas the degree of psychological distress exhibits a downward trend in the 9months after diagnosis. Copyright (c) 2013 John Wiley & Sons, Ltd.