Jim Heather S, Andrykowski Michael A, Munster Pamela N, Jacobsen Paul B
Health Outcomes and Behavior Program, H. Lee Moffitt Cancer Center, University of South Florida, Tampa, FL 33612, USA.
Ann Behav Med. 2007 Oct;34(2):200-8. doi: 10.1007/BF02872674.
Studies suggest that the period following completion of treatment can be distressing for cancer patients. One potentially important predictor of distress is physical symptoms/side effects during treatment.
A longitudinal, observational design was used to examine whether the number of physical symptoms/side effects experienced during treatment was a correlate of cancer-related distress and general distress 4 months after treatment completion, as measured by the Impact of Events Scale and the Mental Health subscale of the Short Form-36, respectively.
Participants were 151 women who had completed chemotherapy and/or radiotherapy for ductal carcinoma in situ or stage 1 or 2 breast cancer. Hierarchical multiple regression was conducted with relevant sociodemographic, clinical, and psychiatric variables entered as controls.
Greater physical symptoms/side effects predicted greater total cancer-related distress, intrusive thoughts, and general distress. Physical symptoms/side effects did not significantly predict avoidance. Follow-up analyses indicated that the relationship between physical symptoms/side effects and general distress was mediated by both total cancer-related distress and intrusive thoughts.
These results suggest that patients who experience greater physical symptoms/side effects during treatment are at greater risk for later cancer-related distress and, in turn, general distress. Future research should evaluate whether early intervention with these patients is effective in preventing or reducing distress in the posttreatment period.
研究表明,治疗结束后的一段时间对癌症患者来说可能会很痛苦。痛苦的一个潜在重要预测因素是治疗期间的身体症状/副作用。
采用纵向观察设计,以分别通过事件影响量表和简短健康调查问卷-36的心理健康分量表测量的治疗结束后4个月时与癌症相关的痛苦和一般痛苦为指标,研究治疗期间经历的身体症状/副作用数量是否与之相关。
参与者为151名完成了原位导管癌或1期或2期乳腺癌化疗和/或放疗的女性。进行分层多元回归分析,将相关的社会人口统计学、临床和精神科变量作为对照纳入。
更多的身体症状/副作用预示着更高的与癌症相关的痛苦总分、侵入性思维和一般痛苦。身体症状/副作用对回避没有显著预测作用。随访分析表明,身体症状/副作用与一般痛苦之间的关系由与癌症相关的痛苦总分和侵入性思维共同介导。
这些结果表明,在治疗期间经历更多身体症状/副作用的患者在后期出现与癌症相关的痛苦进而出现一般痛苦的风险更高。未来的研究应评估对这些患者进行早期干预是否能有效预防或减轻治疗后阶段的痛苦。