Mao Jun J, Palmer Steve C, Straton Joseph B, Cronholm Peter F, Keddem Shimrit, Knott Kathryn, Bowman Marjorie A, Barg Frances K
Department of Family Medicine and Community Health, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA.
J Cancer Surviv. 2008 Jun;2(2):116-24. doi: 10.1007/s11764-008-0052-3. Epub 2008 Apr 15.
Despite advancements in cancer care, cancer survivors continue to experience a substantial level of physical and emotional unmet needs (UMN). This study aims to determine the relationship between patients' perceived UMN and their use of complementary and alternative medicine (CAM) to help with cancer problems during and after treatment.
A mailed, cross-sectional survey was completed by 614 cancer survivors identified through the Pennsylvania Cancer Registry 3.5 to 4 years from initial diagnosis. Relationships among UMN and CAM use along with clinical and socio-demographic factors were examined.
Respondents who identified any UMN were 63% more likely to report CAM use than those without UMN (58% vs. 36%), p < 0.001. UMN remained the only independent predictor (adjusted odds ratio = 2.30, 95% confidence interval = 1.57-3.36, p < 0.001) of CAM use in a multivariate logistic regression model that included age, sex, marital status, education, previous chemotherapy and radiotherapy. Adjusted for covariates, UMN in domains of emotional, physical, nutritional, financial, informational, treatment-related, employment-related, and daily living activities were all related to CAM use, whereas UMN in transportation, home care, medical staff, family and spirituality were not related to CAM use. Patients who experienced multiple types of unmet needs were also more likely to use multiple types of CAM (p < 0.001 for model).
Cancer survivors who experienced unmet needs within the existing cancer treatment and support system were more likely to use CAM to help with cancer problems. Research is needed to determine if appropriate CAM use decreases unmet needs among cancer survivors.
尽管癌症治疗取得了进展,但癌症幸存者仍持续面临大量未得到满足的身体和情感需求(UMN)。本研究旨在确定患者感知到的UMN与他们在治疗期间及治疗后使用补充和替代医学(CAM)来帮助解决癌症问题之间的关系。
通过宾夕法尼亚癌症登记处确定了614名癌症幸存者,他们在初次诊断后3.5至4年完成了一项邮寄的横断面调查。研究了UMN与CAM使用之间的关系以及临床和社会人口统计学因素。
报告存在任何UMN的受访者使用CAM的可能性比没有UMN的受访者高63%(58%对36%),p<0.001。在包含年龄、性别、婚姻状况、教育程度、既往化疗和放疗的多因素逻辑回归模型中,UMN仍然是CAM使用的唯一独立预测因素(调整后的优势比=2.30,95%置信区间=1.57 - 3.36,p<0.001)。经协变量调整后,情感、身体、营养、财务、信息、治疗相关、就业相关和日常生活活动领域的UMN均与CAM使用有关,而交通、家庭护理、医务人员、家庭和精神领域的UMN与CAM使用无关。经历多种未满足需求类型的患者也更有可能使用多种类型的CAM(模型p<0.001)。
在现有的癌症治疗和支持系统中存在未满足需求的癌症幸存者更有可能使用CAM来帮助解决癌症问题。需要开展研究以确定适当使用CAM是否能减少癌症幸存者未满足的需求。