年轻女性癌症患者生育忧虑现状及其影响因素分析

目的调查年轻女性癌症患者生育忧虑现状,并分析其影响因素。方法采用一般资料调查表及中文版癌症后生育忧虑量表对380名年轻女性癌症患者进行调查分析。结果年轻女性癌症患者生育忧虑总分为(57.26±8.340)分;年轻女性癌症患者的文化程度、子女数、生育意愿及癌症类型进入生育忧虑的回归方程,能够解释总变异的35.0%;其中回归分析显示,癌症类型的3个虚拟变量中,甲状腺癌患者与乳腺癌患者相比,其生育忧虑水平为低(β=-0.151,t=-2.499,P=0.013);而妇科恶性肿瘤及大肠癌患者与乳腺癌患者的生育忧虑水平无差异。结论年轻女性癌症患者的生育忧虑水平较高,个体文化程度、子女数、生育意愿及癌症类型是影响生育忧虑的重要因素,医务人员应针对影响因素采取有效的心理干预策略。     

中文版感知社会支持量表在老年癌症患者中的信效度分析

目的 检验中文版感知社会支持量表（the multidimensional scale of perceived social support, MSPSS）在老年癌症患者中应用的信效度。方法 采用整群抽样的方法,使用中文版感知社会支持量表对老年癌症患者进行调查,并对结果进行信效度检验。结果 共收到有效问卷520份,中文版感知社会支持量表的Cronbach α系数为0.877;探索性因子中共提取出公因子3个,累积方差贡献率为69.5%;通过验证性因子分析得出GFI、CFI、IFI指标范围在0.855～0.921之间。结论 中文版社会支持量表在老年癌症患者中应用具有良好的信效度,可用于评估该人群感知社会支持水平。     

年轻女性癌症患者生育忧虑与抑郁的相关性研究——以乌鲁木齐市某三级甲等医院为例

目的 调查年轻女性癌症患者抑郁现状,并分析与生育忧虑之间的关系。方法 选取397名年轻女性癌症患者,患者填写中文版癌症后生育忧虑量表及病人健康问卷-9进行调查。结果 研究对象中轻度及无抑郁者92例(23.20%),中度抑郁者197例(49.60%),重度及极重度抑郁者108例(27.20%)。调整婚姻状况、文化程度、职业、家庭月收入和癌症类型等混杂因素后,生育忧虑仍是抑郁的危险因素(OR=2.423,95%CI:1.824~3.219);6个生育忧虑维度(担忧生育能力、担忧配偶知情、不孕接受度、担忧自身健康、担忧子女健康、担忧备孕)均与抑郁存在关联。结论 年轻女性癌症患者的抑郁程度较高,且生育忧虑为其风险因素,医务人员应针对个体忧虑状况采取有效的心理干预策略。     

添加糖摄入与妇科癌症发病关系的研究进展

妇科恶性肿瘤是全球女性癌症的常见类型，也是全球女性癌症死亡的主要原因，其中宫颈癌、子宫内膜癌、卵巢癌作为主要的妇科癌症类型，对全球女性健康构成严重威胁。研究表明，饮食在妇科癌症的发生发展中发挥着重要作用，而添加糖因其食物来源特点以及相关生物学效应，可能是宫颈癌、子宫内膜癌、卵巢癌等主要妇科癌症的影响因素。就添加糖摄入与子宫内膜癌、卵巢癌以及宫颈癌等妇科癌症发病关系研究进展予以综述，以期为妇科癌症的积极预防提供参考。     

妇科癌症与元素医学食疗

乳腺癌、宫颈癌、卵巢癌为妇科常见的恶性肿瘤,是严重威胁女性健康和生命的i大杀手,确切病因迄今尚未阐明;元素平衡医学认为妇科癌症主要是患者体内多种元素代谢失衡所致,用元素医学食疗法,治疗妇科癌症取得成功。     

正念减压疗法对年轻女性癌症患者生育忧虑及复发恐惧的影响

目的 探索正念减压疗法对年轻女性癌症患者生育忧虑、复发恐惧的效果。方法 将72例年轻女性癌症患者分为试验组和对照组,每组各36例。两组均进行常规护理,试验组接受6周的正念减压疗法,在干预前后及干预后3个月,均采用癌症后生育忧虑量表、疾病恐惧进展量表对两组的生育忧虑、复发恐惧进行测量。结果 6周正念减压干预后,两组的配偶知情、接受度、怀孕能力、自身健康、子女健康维度得分及生育忧虑总得分的组间效应差异有统计学意义(P<0.05);两组生育忧虑各维度得分及生育忧虑总分时间效应差异有统计学意义(P<0.05);两组的复发恐惧各维度得分及复发恐惧总分的组间效应、时间效应差异具有统计学意义(P<0.05);结论 正念减压疗法能有效减轻年轻女性癌症患者生育忧虑、复发恐惧的心理。     

育龄甲状腺癌女性患者生育忧虑现状及影响因素分析

目的了解育龄甲状腺癌女性患者生育忧虑现状及其影响因素,为临床工作提供基础。方法于2017年10月至2018年10月选取在温州医科大学附属第二医院头颈外科就诊的甲状腺患者200例为研究对象。采用一般资料调查表及中文版癌症后生育忧虑量表进行问卷调查。采用SPSS 19.0进行t检验、方差分析和多元线性回归分析。结果最终纳入分析的育龄甲状腺癌女性患者有效例数为193例,生育忧虑总分为(52.98±13.60)分,配偶知情维度得分为(10.44±3.39)分,备孕能力维度得分为(10.10±3.47)分,不孕接受度维度得分为(10.23±3.19)分,怀孕能力维度得分为(11.44±2.64)分,自身健康维度得分为(9.86±3.41)分,子女健康维度得分为(11.35±2.37)分。单因素分析结果显示,18～30岁的患者生育忧虑总得分高于31～40岁者,初高中文化程度的患者得分高于大专及以上文化程度者,未婚患者得分高于已婚、离异患者,无子女的患者得分高于1或2个子女者,有生育意愿的患者得分高于无生育意愿者,差异均有统计学意义(P0.01)。多元线性回归分析结果显示,年龄(β=-0.114)、文化程度(β=-0.348)与生育忧虑得分呈负相关,有生育意愿与生育忧虑得分呈正相关(β=0.728),均有统计学意义(P0.05,P0.01)。结论育龄甲状腺癌女性患者存在不同程度的生育忧虑,年龄、文化程度、生育意愿是可能的影响因素。     

青年女性乳腺癌患者生育忧虑水平及影响因素的研究

目的：了解青年女性乳腺癌患者生育忧虑水平,并分析其影响因素。方法：选取本院2022年1月-2023年6月收治的青年女性乳腺癌患者为研究对象。采用一般资料调查表、癌症后生育忧虑量表、社会支持评定量表进行调查。采用单因素及多重线性回归模型分析影响青年女性乳腺癌患者生育忧虑水平的相关因素。结果：青年女性乳腺癌患者生育忧虑量表得分为(63.9±11.5)分,社会支持得分为(40.7±5.3)分,社会支持与生育忧虑呈负相关(r=-0.479,P<0.001)。多重线性回归分析显示,年龄(β=-0.105)、家庭经济收入(β=-0.196)、子女数量(β=-0.230)、疾病病程(β=0.118)、手术方式(β=0.184)、社会支持水平(β=-0.219)是青年女性乳腺癌患者生育忧虑的影响因素。结论：低龄、低收入、无子女、病程较长、术后乳房缺失的青年女性乳腺癌患者生育忧虑水平较高。增加社会支持,对患者生育忧虑具有保护作用。建议主动为患者提供生育咨询,制定个体化的治疗计划和生育保留方案,并鼓励患者主动寻求和利用社会支持缓解疾病压力,以降低生育忧虑。     

青少年冒险问卷-冒险行为量表(ARQ-RB)的测量等同性检验

目的以青少年冒险问卷-冒险行为量表为工具,运用多组验证性因子分析检验,考查ARQ-RB中文版在不同经济水平地区青少年群体间的测量等同性。方法以安徽和宁夏初一到高三的2250名青少年为被试,以青少年冒险问卷-冒险行为量表为工具进行施测。结果(1)ARQ-RB包括刺激寻求、鲁莽、叛逆和反社会四个维度,问卷的因子结构具有跨样本稳定性,皖组和宁组的累计方差贡献率分别为52.15%和52.17%;不同地区样本群体的结构效度良好,且具有良好的交互效度;(2)ARQ-RB在安徽和宁夏地区青少年样本中存在完全弱等值性(TRd=9.85,P0.05);同时,两组不同地区青少年样本数据支持部分强等值(TRd=6.66,P0.05)和因子方差-协方差等值(TRd=66.41,P0.05)。结论 ARQ-RB中文版在不同地区样本中具有一定的等值性,其所得分数能够进行跨组间比较;对不同经济社会和文化背景下的冒险行为特征进行比较前的测量等值性检验是有必要的。     

亚健康量表中医生和护士的测量不变性

目的检验亚健康量表在医生和护士人群调查中的测量不变性,并比较两组职业人群的亚健康状态。方法采用多阶段分层整群抽样方法对1832名医护人员进行亚健康量表测量。采用多组验证性因子分析检验量表在两组间的测量不变性。结果亚健康量表在医生和护士两组间具有严格不变性(ΔCFI0.01),条目的均数和变异的组间差异将可以完全反映亚健康各维度的均数和变异的组间差异。护士的亚健康得分略高于医生,但差异无统计学意义(4个潜因子均值分别为0.029、0.050、0.054和0.010,P值分别为0.385、0.168、0.092和0.753)。结论亚健康量表对医护人员亚健康状态的测量有着普遍适用性。     

2005-2014年中国甲状腺癌死亡及疾病负担时间趋势分析

目的 分析我国2005-2014年甲状腺癌死亡及疾病负担的时间趋势，为甲状腺癌的预测和防控工作提供参考。 方法 根据我国2008-2017年《中国肿瘤登记年报》中甲状腺癌的资料，计算其伤残调整寿命年（disability adjusted life year, DALY），并通过jointpoint回归模型计算年度变化百分比（Annual change percentage，APC）进行时间趋势分析。 结果 1、2005-2014年中国甲状腺癌死亡率呈上升趋势（APC=3.32%，P<0.05），城市高于村、女性高于男性（P均<0.05），同时城市甲状腺癌死亡率上升速度较农村明显（APC分别为4.76%和3.63%，P均<0.05），女性速度高于男性（APC分别为3.54%和2.80%，P均<0.05）。2、2005-2014年，中国甲状腺癌的死亡率随年龄升高而升高，其中35~39岁年龄组死亡率上升最快（APC=16.64%, P<0.05）。3、2005-2014年中国甲状腺癌的DALY率呈上升趋势（APC=8.42%, P<0.05），城市高于农村，女性高于男性。 结论 2005-2014年中国甲状腺癌死亡率及疾病负担均在增长，且以女性为主，应给予重点关注。     

Confirmatory Factor Analysis and Sample Invariance of the Chinese Patient Satisfaction Questionnaire (ChPSQ-9) among Patients with Breast and Lung Cancer

Objectives:  Previous exploratory factor analysis of the 9-item Chinese Patient Satisfaction Questionnaire (ChPSQ-9) identified two dominant factors: doctor and nurse. The present study employed confirmatory factor analysis (CFA) to examine the factorial invariance of the ChPSQ-9 between and within samples of Chinese patients with breast or lung cancer.
Methods:  Longitudinal data were analyzed from Chinese breast and lung cancer patients who had completed the ChPSQ-9 during their first outpatient visit, at 3 months, and at 6 months after baseline. CFAs tested the fit of a one-factor model, a hierarchical model that comprised a general latent factor and two first-order factors, and a correlated model that comprised two correlated first-order factors to the data. The factorial invariance of the ChPSQ-9 between six independent samples across time was investigated using multigroup CFAs.
Results:  The CFA's results demonstrated a better fit of the correlated model over the one-factor model and the hierarchical model in the breast and lung cancer samples. The correlated model showed evidence of cross-sample and longitudinal factorial invariance. Patients were generally satisfied with services provided by doctors and nurses. Internal consistency of the scale was also good for both cancer samples across time.
Conclusions:  The ChPSQ-9 is a valid and reliable instrument to be employed among breast and lung cancer patients, in clinical settings or intervention research, to evaluate group differences in patient satisfaction and its association with intervention effectiveness.     

单胎产妇妊娠期糖尿病发病情况及影响因素分析

目的 了解妊娠糖尿病（GDM）的发病情况，探讨其影响因素，为制定GDM的防控措施提供科学依据。方法 选取2015-2018年北京某地区分娩的5659例孕妇为研究对象，收集北京市妇幼保健信息系统中相关围产资料，采用SPSS 18.0统计软件进行〖XC小五号.EPS;P〗分析、多因素logistic回归分析GDM发病情况及影响因素。结果 研究对象共纳入5659人，其中GDM发病人数为858人，发病率为15.2%。不同户籍、年龄的孕妇GDM的发病率差异有统计学意义（〖XC小五号.EPS;P〗分别为26.66、76.0, P<0.01）。多因素分析结果显示，外地户籍是GDM发病的保护因素(OR=0.76,95%CI:0.64~0.90)；高龄(OR=1.72,95%CI:1.44~2.06)、孕前BMI超重(OR=1.96,95%CI:1.60~2.39)和肥胖(OR=3.41,95%CI:2.18~5.32)、有糖尿病家族史(OR=2.05,95%CI:1.42~2.96)、瘢痕子宫(OR=1.25,95%CI:1.03~1.52)、孕期甲状腺功能异常(OR=1.50,95%CI:1.22~1.84)、妊娠高血压疾病(OR=1.73,95%CI:1.17~2.57)均为GDM发病的危险因素（P<0.05)。结论 本地区GDM的发病率与相关研究报道结果不尽相同，它是多种因素作用的结果，做好孕前健康教育和孕中早发现、早干预，能降低GDM的发病率，改善母婴结局。     

Measurement equivalence of the CES-D 8 in the general population in Belgium: a gender perspective

International research consistently finds gender differences in depression, but do women genuinely experience more complaints or are the findings contaminated by group-specific elements unrelated to depression but affecting its measurement? The study of gender differences in depression depends on the measurement quality of the instrument used to evaluate depression. In the present study we test the measurement equivalence of a shorter version of a commonly used instrument in mental health research, the Center for Epidemiologic Studies - Depression Scale (CES-D), using data from the Belgian sample of the third round of the European Social Survey (N = 1794). Evidence for measurement invariance can be established within the multigroup confirmatory factor analysis framework. This method allows us to evaluate a nested hierarchy of hypotheses to test different levels of cross-group measurement invariance: configural, metric, scalar and residual invariance, and clarifies under what conditions meaningful comparisons between the male and female respondents can be made. The best fitting factor model is then used to estimate the ''true'' prevalence of depressive symptoms for both groups. In our study measurement equivalence is established at all levels, indicating that the current depression scale allows defensible quantitative gender comparisons. Our data also confirm the epidemiological finding that women report more complaints of depression than men.     

Exploring measurement invariance by gender in the profile of mood states depression subscale among cancer survivors

Purpose

The Profile of Mood States-Short Form (POMS-SF) is a well-validated tool commonly used in medical/clinical research. Less attention has been paid to the measurement invariance of the POMS—the degree to which the structure and items behave similarly for different groups (e.g., women and men). This study investigated the measurement invariance of the POMS Depression subscale across gender groups in a sample of cancer survivors.

Methods

The POMS Depression subscale has 8 items (Unhappy, Sad, Blue, Hopeless, Discouraged, Miserable, Helpless, and Worthless). Invariance was measured using multigroup confirmatory factor analysis. This study used data from American Cancer Society Studies of Cancer Survivors-II, a population-based survey of adult cancer survivors (n = 9170).

Results

We found factor structures and factor loadings were invariant for gender groups, but moderate differential item functioning (DIF) in the question containing the word blue.

Conclusion

With regard to cancer survivors’ gender, we found the Depression subscale of the POMS-SF had configural invariance, and partial metric and scalar invariance. This suggests that results should be interpreted with caution, especially when gender is considered important. More broadly, our finding suggests that questions with the word blue may introduce DIF into other measures of depressive mood. More research is needed to replicate these findings in other samples and with other instruments.

     

Measuring the psychological consequences of breast cancer screening: a confirmatory factor analysis of the Psychological Consequences Questionnaire

Objectives

To use confirmatory factor analysis (CFA) to test the proposed factor structure of the Psychological Consequences Questionnaire (PCQ), a measure of the psychological impact of breast cancer screening. A further aim was to examine the robustness of the proposed factor structure across key demographic and clinical variables.

Method

Following visits to breast cancer screening clinics, women who received a false-positive diagnosis and a matched sample of women who had received all-clear diagnoses were sent a questionnaire package containing the PCQ and a demographics measure. A total of 220 women returned completed questionnaires. CFA was used to test the factor structure and multiple indicator–multiple cause (MIMIC) models were used to test the robustness of the factor structure across the test result group, age, and family history of breast cancer diagnosis.

Results

The CFA results suggested support for both a three- and a one-factor model; a one-factor model was preferred, however, due to the very high covariance between the three latent factors in the three-factor model. A CFA MIMIC model suggested that the test result impacted on the latent factor: women who initially received a false-positive diagnosis showed significantly higher levels of psychological dysfunction after screening.

Conclusions

The PCQ appears to be a promising tool for assessing psychological dysfunction after breast cancer screening; however, a one-factor model received more support than the initially proposed three-factor model. There was little evidence of differential item functioning across key demographic and clinical variables for the PCQ.     

Psychometric properties of the Center for Epidemiologic Studies Depression Scale (CES-D) in French clinical and nonclinical adults

BackgroundPrevious research on the Center for Epidemiologic Studies Depression Scale (CES-D) has five main limitations. First, no study provided evidence of the factorial equivalence of this instrument across samples of depressive and community participants. Second, only one study included systematic tests of measurement invariance based on confirmatory factor analyses (CFA), and this study did not consider the higher-order factor structure of depression, although it is the CES-D global scale score that is most often used in the context of epidemiological studies. Third, few studies investigated the screening properties of the CES-D in non-English-language samples and their results were inconsistent. Fourth, although the French version of the CES-D has been used in several previous studies, it has never been systematically validated among community and/or depressed adults. Finally, very few studies have taken into account the ordered-categorical nature of the CES-D answer scale. The purpose of the study reported herein was therefore to examine the construct validity (i.e., factorial, reliability, measurement invariance, latent mean invariance, convergence, and screening properties) of the CES-D in a French sample of depressed patients and community adults.MethodsA total sample of 469 participants, comprising 163 clinically depressed patients and 306 community adults, was involved in this study. The factorial validity, and the measurement and latent mean invariance of the CES-D across gender and clinical status, were verified through CFAs based on ordered-categorical items. Correlation and receiver operator characteristic curves were also used to test the convergent validity and screening properties of the CES-D.ResultsThe present results: (i) provided support for the factor validity and reliability of a second-order measurement model of depression based on responses to the CES-D items; (ii) revealed the full measurement invariance of the first- and second-order measurement models across gender; (iii) showed the partial strict measurement invariance (four uniquenesses had to be freely estimated, but the factor variance–covariance matrix also proved fully invariant) of the first-order factor model and the complete measurement invariance of the second-order model across patients and community adults; (iv) revealed a lack of latent mean invariance across gender and across clinical and community subsamples (with women and patients reporting higher scores on all subscales and on the full scale); (v) confirmed the convergent validity of the CES-D with measures of depression, self-esteem, anxiety, and hopelessness; and (vi) demonstrated the efficacy of the screening properties of this instrument among clinical and nonclinical adults.ConclusionThis instrument may be useful for assessing depressive symptoms or for the screening of depressive disorders in the context of epidemiological studies targeting French patients and community men and women with a background similar to those from the present study.     

A reduced factor structure for the PROQOL–HIV questionnaire provided reliable indicators of health-related quality of life

ObjectivesTo identify a simplified factor structure for the PROQOL–human immunodeficiency virus (HIV) questionnaire to improve the measurement of the health-related quality of life (HRQL) of HIV-positive patients in clinical care and research settings.Study Design and SettingHRQL data were collected using the eight-dimension PROQOL-HIV questionnaire from 2,537 patients (VESPA2 study). Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) validated a simpler four-factor structure and assessed measurement invariance (MI). Multigroup analysis assessed the effect of sex, age, and antiretroviral therapy (ART) on the resulting factor scores. Correlations with symptom and Short Form (SF)-12 self-reports assessed convergent validity.ResultsItem analysis, EFA, and CFAs confirmed the validity [comparative fit index (CFI), 0.948; root mean square error of approximation, 0.064] and reliability (α's ≥ 0.8) of four dimensions: physical health and symptoms, health concerns and mental distress, social and intimate relationships, and treatment-related impact. Strong MI was demonstrated across sex and age (decrease in CFI <0.01). A multiple-cause multiple-indicator model indicated that HRQL correlated as expected with sex, age, and the ART status. Correlations of HRQL, symptom reports, and SF-12 scores evidenced convergent validity criterion.ConclusionThe simplified factor structure and scoring scheme for PROQOL-HIV will allow clinicians to monitor with greater reliability the HRQL of patients in clinical care and research settings.     

Gynecological and breast cancer in the department of Somme

BACKGROUND: Breast and gynecological tumors are the most common cancers in women. The aim of this study was to show the epidemiologic features of gynecological and breast cancers in the French administrative district of La Somme. METHODS: This study focused on the 1982-1999 period. Incidence, mortality and survival rates were calculated. RESULTS: In 1997-1999, the world standardized breast incidence and mortality rates were 81.6 and 20.2 per 100,000 females per year. Breast and genital tract cancers accounted for 47% of all cancers in women. The incidence and mortality of uterine cervix cancers showed a clear decline over the past 10 years, whereas the trend of breast cancers was dominated by continuing increase. However, mortality was stable for breast cancers. Five year relative survival rates were respectively 80% for breast cancers, and 68%, 76%, 38%, for uterine cervix, uterine body and ovary cancers respectively. Incidence and mortality rates in Somme were in the middle risk range of other cancer French registries. CONCLUSION: The results of this study indicate that genital tract and breast cancers constitute a serious public health problem pointing out the importance of screening activities in the Somme area.     

Examination of the construct validity of the Swedish version of Hospital Anxiety and Depression Scale in breast cancer patients

Purpose

To examine the construct validity of the Swedish version of Hospital Anxiety and Depression Scale (HAD) in women with breast cancer.

Method

Acquired data on HAD from 727 women who recently had breast cancer surgery, were aged 20–63 years and worked before diagnosis, and had no previous breast cancer (n = 725) were subjected to confirmatory factor analysis examining the viability of three hypothesized measurement models.

Results

The analysis showed adequate fit to the data for both bi-dimensional and three-factorial models of HAD. The single-factorial model, however, was shown to have inferior fit to the data. Substantive correlations were found between anxiety and depression in the bi-dimensional model, and negative affectivity and anxiety in the three-factorial model of HAD.

Conclusions

The findings support the utility of scoring procedure based on the original bi-dimensional model, but add indication of co-occurrence of anxiety and depression in this patient population. The discriminant validity of a third factor of negative affectivity in a three-factorial model, however, remains unclear.