Simon A E, Thompson M R, Flashman K, Wardle J
Department of Epidemiology and Public Health, Health Behavior Research Centre, University College London, London, UK.
Colorectal Dis. 2009 Jan;11(1):19-25. doi: 10.1111/j.1463-1318.2008.01501.x. Epub 2008 Mar 18.
Disease stage is a strong predictor of cancer survival and is therefore assumed to influence psychosocial outcomes. However, existing findings are inconsistent, perhaps reflecting limited sample sizes, especially among patients with advanced disease. There has also been an emphasis on breast cancer, resulting in a focus on outcomes among women. The present study investigated associations between disease stage and psychosocial wellbeing in 128 patients (52% male, 48% female) diagnosed with colorectal cancer.
Patients diagnosed within the past year in a single hospital were invited to participate in a questionnaire study and give permission for staging information to be obtained from their medical records. The questionnaire included measures of anxiety, depression, quality of life, social support, social difficulties and quality of medical interactions.
Patients with more advanced disease were more anxious (P < 0.01) and depressed (P < 0.001), perceived their social support as lower (P < 0.01), and had a worse quality of life (P < 0.01). Women with advanced disease had more severe colorectal symptoms (P < 0.01), and worse physical (P < 0.01) and emotional (P < 0.05) quality of life than men.
Patients with advanced colorectal cancer have unmet psychosocial needs. Women may be more strongly affected by advanced disease than men.
疾病分期是癌症生存率的一个重要预测指标，因此被认为会影响心理社会结局。然而，现有研究结果并不一致，这可能反映出样本量有限，尤其是在晚期疾病患者中。此外，以往研究主要集中在乳腺癌，导致重点关注女性患者的结局。本研究调查了128例（52%为男性，48%为女性）确诊为结直肠癌患者的疾病分期与心理社会幸福感之间的关联。
邀请在一家医院过去一年内确诊的患者参与问卷调查，并允许从其病历中获取分期信息。问卷包括焦虑、抑郁、生活质量、社会支持、社交困难和医疗互动质量等方面的测量。
疾病进展程度较高的患者更焦虑（P < 0.01）、抑郁（P < 0.001），感觉自己获得的社会支持更少（P < 0.01），生活质量更差（P < 0.01）。疾病进展程度较高的女性结直肠症状更严重（P < 0.01），身体（P < 0.01）和情感（P < 0.05）生活质量比男性更差。
晚期结直肠癌患者存在未满足的心理社会需求。女性可能比男性更容易受到晚期疾病的强烈影响。
