樂觀與社會支持對乳癌倖存者心理社會衝擊之影響：以心理韌性為中介

Abstract

目的：本研究目的為探討乳癌倖存者正、負向心理衝擊與樂觀、感知社會支持及心理韌性之間的關係，並進一步探究心理韌性在樂觀、感知社會支持與正、負向心理社會衝擊之間扮演的中介角色。研究方法：研究對象為372名乳癌倖存者，平均被診斷年數5.49年。參與者須完成人口學變項、樂觀、感知社會支持、心理韌性及心理社會衝擊的問卷，用於施測的問卷分別為：中文版生活定向測驗、多向度感知社會支持量表、心理韌性量及PROMIS心理社會疾病衝擊量表。研究結果：樂觀(r = 0.57)、感知社會支持(r = 0.60)、心理韌性(r = 0.77)都與正向心理社會衝擊呈顯著正相關。樂觀(r = -0.59)、感知社會支持(r = -0.52)、心理韌性(r = -0.58) 都與負向心理社會衝擊呈顯著負相關。心理韌性為樂觀與正向心理社會衝擊的完全中介變項；為樂觀與負向心理社會衝擊的部分中介變項。心理韌性為感知社會支持與正向心理社會衝擊的部分中介變項；為感知社會支持與負向心理社會衝擊的完全中介變項。討論：本研究最有意義的發現是或許可以透過心理治療的介入提升心理韌性，增加乳癌倖存者的正向心理社會衝擊，並減少負向心理社會衝擊。

Purpose: This study aimed to investigate the occurrence of positive and negative psychosocial impacts among breast cancer survivors in association with optimism, perceived social support, and resilience. Furthermore, we assessed the mediation effect of resilience on the relationship between optimism and positive, negative psychosocial impact, as well as the mediation effect of resilience on the relationship between perceived social support and positive, negative psychosocial impact. Methods: This study was conducted with 372 breast cancer survivors, averaging 5.49 years after diagnosis. Participants completed questionnaires assessing socio-demographic characteristics, optimism, perceived social support, resilience, and psychosocial impact which were measured with the Chinese version of the revised Life Orientation Test (CLOT-R), Multidimensional Scale of Perceived Social Support (MSPSS), Connor-Davidson Resilience Scale (CD-RISC) and PROMIS Psychosocial Illness Impact Scale, respectively. Results: Optimism(r = 0.57), perceived social support (r = 0.60) and resilience (r = 0.77) were significantly positively correlated with positive psychosocial impact. Optimism(r = -0.59), perceived social support (r = -0.52), and resilience (r = -0.58) were significantly negatively correlated with negative psychosocial impact. Structural equation modeling analysis showed that resilience fully mediated the relationship between optimism and positive psychosocial impact in which the indirect effect of optimism and positive psychosocial impact through resilience was 0.505(p < .01). The resilience partially mediated the relationship between optimism and negative psychosocial impact in which the indirect effect of optimism and negative psychosocial impact through resilience was -0.149(p < .05). The resilience partially mediated the relationship between perceived social support and positive psychosocial impact in which the indirect effect of perceived social support and positive psychosocial impact through resilience was 0.174(p < .01). The resilience fully mediated the relationship between perceived social support and negative psychosocial impact in which the indirect effect of perceived social support and negative psychosocial impact through resilience was -0.051(p < .05). Conclusions: The most important implication of this study was that psycho-therapeutic intervention strategies might improve resilience to promoting positive psychosocial impact and reducing negative psychosocial impact among breast cancer survivors.