Deimling Gary T, Bowman Karen F, Sterns Samantha, Wagner Louis J, Kahana Boaz
Department of Sociology, Case Western Reserve University, 10900 Euclid Ave., Cleveland, OH 44106-7124, USA.
Psychooncology. 2006 Apr;15(4):306-20. doi: 10.1002/pon.955.
While long-term survivors (5 years+) do not face the stressors of diagnosis and treatment, they continue to face the uncertainties that survivorship brings: recurrence, other cancers, late effects of treatment, and the potential of a shortened life expectancy. This research focuses on the cancer-related health worries of older adult, long-term cancer survivors, the factors that predict these worries, and their link to traditional measures of psychological distress. Specifically, a model is proposed that identifies the personal (including race and gender) and illness/treatment characteristics of survivors that are significantly associated with cancer-related health worries and their effects on anxiety and depression. Descriptive and multivariate analyses of a random sample of 321 long-term survivors in a major cancer center tumor registry are used to address these issues. About one-third of survivors continue to report worries about recurrence, worries about a second cancer, and worries that symptoms they experience may be from cancer. The regression analyses show that cancer-related health worries is a significant predictor of both depression (beta=0.36) and anxiety (beta=0.21). Race is a significant predictor; being African American is related to fewer cancer-related health worries (beta=-0.22). Having more symptoms during treatment is also a predictor of having more cancer-related health worries (beta=0.20). The most consistent predictor of psychosocial distress is dispositional optimism/pessimism, with more optimistic individuals reporting fewer cancer-related health worries (beta=-0.27), lower levels of both anxiety (beta=-0.16) and depression (beta=-0.23). Overall, for many older adult, long-term survivors, the legacy of cancer continues in terms of cancer-related health worries. In spite of these, for most survivors, their quality of life is not dramatically compromised either physically or psychologically.
虽然长期存活者（存活5年以上）不再面临诊断和治疗带来的压力，但他们仍要面对癌症存活所带来的不确定性：癌症复发、患其他癌症、治疗的晚期效应以及预期寿命缩短的可能性。本研究聚焦于老年长期癌症存活者与癌症相关的健康担忧、预测这些担忧的因素以及它们与传统心理困扰指标之间的联系。具体而言，提出了一个模型，该模型确定了与癌症相关健康担忧及其对焦虑和抑郁影响显著相关的存活者个人特征（包括种族和性别）以及疾病/治疗特征。利用对某大型癌症中心肿瘤登记处321名长期存活者的随机样本进行的描述性和多变量分析来解决这些问题。约三分之一的存活者继续报告对癌症复发的担忧、对患第二种癌症的担忧以及对自身所经历症状可能由癌症引起的担忧。回归分析表明，与癌症相关的健康担忧是抑郁（β=0.36）和焦虑（β=0.21）的显著预测因素。种族是一个显著预测因素；非裔美国人与较少的癌症相关健康担忧有关（β=-0.22）。治疗期间出现更多症状也是癌症相关健康担忧更多的一个预测因素（β=0.20）。心理社会困扰最一致的预测因素是性格乐观/悲观，更乐观的个体报告的癌症相关健康担忧较少（β=-0.27），焦虑（β=-0.16）和抑郁水平（β=-0.23）也较低。总体而言，对于许多老年长期存活者来说，与癌症相关的健康担忧方面，癌症的影响仍在持续。尽管如此，对大多数存活者来说，他们的生活质量在身体或心理上并未受到显著损害。
