目的 探讨年轻女性乳腺癌患者术后化疗期间身体意象的动态变化轨迹,并识别其关键影响因素,为制订相关心理支持策略提供参考依据。方法 2023年1月至2025年1月,采用便利抽样法选取某三级甲等医院乳腺癌术后拟行化疗患者200例为研究对象,采用医学应对问卷(medical coping modes questionnaire,MCMQ)、乳腺癌患者体象自评问卷(body image self-rating questionnaire for breast cancer,BISQ-BC)等对其调查,使用潜变量增长混合模型识别轨迹类别,多元有序Logistic回归分析影响因素。结果 200例乳腺癌患者MCMQ总分为(52.70±9.58)分,而BISQ-BC评分呈“先降低后升高”趋势(均P<0.05),可识别出持续障碍组(74例,37.00%)、短期适应组(96例,48.00%)与延迟障碍组(30例,15.00%)3类轨迹。3类患者在家庭人均月收入、癌症TNM分期、手术类型及应对方式上的差异均有统计学意义(均P<0.05)。多元回归显示,家庭人均月收入≤3000元、TNM分期Ⅲ期、乳房切除术及回避/屈服应对方式是患者身体意象持续障碍的影响因素(均P<0.05)。结论 年轻乳腺癌术后化疗患者身体意象具有异质性,有15%存在持续障碍。医护人员要关注年轻乳腺癌术后化疗患者身体意象的主要影响因素,并制订相应干预措施。

Objective To explore the dynamic change trajectory of body image among young female breast cancer patients during postoperative chemotherapy,and identify its key influencing factors,so as to provide evidence for formulating targeted psychological support strategies.Methods From January 2023 to January 2025,a total of 200 breast cancer patients scheduled for postoperative chemotherapy in a tertiary A hospital were enrolled by the convenience sampling method.The Medical Coping Modes Questionnaire (MCMQ) and Body Image Self-rating Questionnaire for Breast Cancer (BISQ-BC) were adopted for investigation.Latent growth mixture model was used to classify trajectory subtypes,and multivariate ordinal Logistic regression was applied to analyze influencing factors.Results The total MCMQ score of 200 patients was (52.70±9.58).The BISQ-BC scores presented a trend of decreasing first and then increasing (P<0.05).Three trajectory types were identified,including persistent disturbance group (74,37.00%),short-term adaptation group (96,48.00%)and delayed disturbance group (30,15.00%).There were statistically significant differences in family per capita monthly income,cancer TNM stage,surgical type and coping styles among the three groups (all P<0.05).Multivariate regression analysis indicated that family per capita monthly income ≤3000 yuan,stage Ⅲ TNM staging,mastectomy,as well as avoidance and resignation coping styles were independent influencing factors for persistent body image disturbance (all P<0.05).Conclusions Heterogeneity exists in body image status of young breast cancer patients receiving postoperative chemotherapy,and 15% of them suffer from long-term persistent disturbance.Medical staff should attach importance to the major influencing factors of body image disturbance and carry out targeted intervention measures.

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