Objectives: According to the personality five-factor theory (FFT), this study explored a structural equation model for women with breast cancer involving variables, including extraversion and neuroticism, post-breast-cancer stress, demoralization, sleep disturbances, and psychological well-being (PWB). Methods: A total of 351 women with breast cancer were recruited from mid-Taiwan for the cross-sectional questionnaire survey. Results: In this model, extraversion had direct effects on demoralization (−0.21), sleep disturbances (−0.16), and PWB (0.36); neuroticism had direct effects on post-breast-cancer stress (0.28), demoralization (0.12), and sleep disturbances (0.19); post-breast-cancer stress had direct effects on demoralization (0.71) and PWB (0.38); demoralization had direct effects on sleep disturbances (0.33) and PWB (−0.75). Accordingly, extraversion had a higher direct influence on demoralization than neuroticism (−0.21 vs. 0.12); however, neuroticism correlated with demoralization more than extraversion with demoralization (0.36 vs. −0.28). Neuroticism had a higher direct influence on sleep disturbances than extraversion on sleep disturbances. With regards to indirect influences, post-breast-cancer stress partially mediated the path from neuroticism to demoralization. Demoralization completely mediated the path from post-breast-cancer stress to sleep disturbances and partially mediated the path from extraversion to sleep disturbances. Moreover, demoralization and post-breast-cancer stress together completely mediated the path from neuroticism to PWB. Furthermore, a suppression effect occurred, making the influence from post-breast-cancer stress to PWB positive, which seemed to characterize post-traumatic growth; meanwhile, the suppression enforced the negative effect of demoralization on PWB. Conclusions: Post-breast-cancer stress and demoralization play important roles in clinical counseling for survivors of women with breast cancer.
目的：基于人格五因素理论，本研究构建了一个针对乳腺癌女性的结构方程模型，该模型涉及外向性、神经质、乳腺癌后应激、失志、睡眠障碍及心理幸福感等变量。方法：在台湾中部地区招募351名乳腺癌女性进行横断面问卷调查。结果：模型中，外向性对失志（-0.21）、睡眠障碍（-0.16）及心理幸福感（0.36）产生直接影响；神经质对乳腺癌后应激（0.28）、失志（0.12）及睡眠障碍（0.19）产生直接影响；乳腺癌后应激对失志（0.71）和心理幸福感（0.38）产生直接影响；失志对睡眠障碍（0.33）和心理幸福感（-0.75）产生直接影响。具体而言，外向性对失志的直接影响强于神经质（-0.21对比0.12），但神经质与失志的相关性高于外向性与失志的相关性（0.36对比-0.28）。神经质对睡眠障碍的直接影响强于外向性对睡眠障碍的影响。在间接影响方面，乳腺癌后应激部分中介了神经质至失志的路径；失志完全中介了乳腺癌后应激至睡眠障碍的路径，并部分中介了外向性至睡眠障碍的路径。此外，失志与乳腺癌后应激共同完全中介了神经质至心理幸福感的路径。研究还发现抑制效应使乳腺癌后应激对心理幸福感的影响呈正向，这体现了创伤后成长特征；同时该抑制效应强化了失志对心理幸福感的负面影响。结论：乳腺癌后应激与失志在乳腺癌女性幸存者的临床心理干预中具有重要作用。
肿瘤(癌症)患者之家