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[急性医院中恶性肿瘤患者伴发精神障碍的患病率及对心理社会帮助的需求]

[Prevalence of concomitant psychiatric disorders and the desire for psychosocial help in patients with malignant tumors in an acute hospital].

作者信息

Singer S, Bringmann H, Hauss J, Kortmann R-D, Köhler U, Krauss O, Schwarz R

机构信息

Abteilung Sozialmedizin, Universität Leipzig, Leipzig, Deutschland.

出版信息

Dtsch Med Wochenschr. 2007 Oct;132(40):2071-6. doi: 10.1055/s-2007-985643.

Abstract

BACKGROUND AND OBJECTIVE

A diagnosis of cancer can overpower a patient's ability to cope and thus can increase the prevalence of psychiatric disorders in this group of patients. It was the aim of this study to estimate that prevalence in tumor patients during their acute treatment.

PATIENTS AND METHODS

689 patients with malignancies were interviewed using the structure clinical interview connected with the Diagnostic and Statistical Manual of Mental Disorders IV [SCID]) DSM-IV during their first days of inpatient treatment. The patients' wishes for psychosocial support by the oncological team were assessed.

RESULTS

32 % of the patients were diagnosed having a psychiatric disorder, e. g. depression. Prevalence was greater among female and/or young patients, those who had little money, were receiving chemotherapy and those who had not yet been diagnosed with cancer but in whom it was suspected. Some types of tumor were more likely to be associated with a mental disorder, for instance gynecological and head-and-neck malignancies. 83 % of the patients asked for psychosocial help from the treating physician, 44 % from the social worker, 30 % from the clinical psychologist, and 8 % from a spiritual adviser. Support was especially needed by patients who felt sad or depressed, and in those who lacked social support: these needs were unrelated to tumor stage and time since diagnosis.

CONCLUSIONS

Inpatient cancer patients frequently suffer from a psychiatric disorder. The majority of them would like to get psychosocial support, especially from their treating physician. It should be recognized that it is not only palliative care patients with advanced disease who need psychosocial treatment and support.

摘要

背景与目的

癌症诊断可能会削弱患者的应对能力,从而增加这类患者中精神障碍的患病率。本研究的目的是评估肿瘤患者在急性治疗期间的患病率。

患者与方法

689例恶性肿瘤患者在住院治疗的头几天接受了与《精神疾病诊断与统计手册》第四版(DSM-IV)相关的结构化临床访谈(SCID)。评估了患者对肿瘤治疗团队提供心理社会支持的意愿。

结果

32%的患者被诊断患有精神障碍,如抑郁症。女性和/或年轻患者、经济条件差的患者、正在接受化疗的患者以及尚未被诊断出癌症但疑似患有癌症的患者中患病率更高。某些类型的肿瘤更有可能与精神障碍相关,例如妇科和头颈恶性肿瘤。83%的患者向主治医生寻求心理社会帮助,44%向社会工作者寻求帮助,30%向临床心理学家寻求帮助,8%向精神顾问寻求帮助。感到悲伤或抑郁的患者以及缺乏社会支持的患者尤其需要支持:这些需求与肿瘤分期和诊断后的时间无关。

结论

住院癌症患者经常患有精神障碍。他们中的大多数人希望获得心理社会支持,尤其是来自主治医生的支持。应该认识到,不仅晚期疾病的姑息治疗患者需要心理社会治疗和支持。

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