Division of Pulmonary Diseases, Department of Internal Medicine, Sir Mortimer B. Davis Jewish General Hospital, 3755 Cote Ste Catherine, Montreal, QC, H3T 1E2, Canada.
Support Care Cancer. 2009 Dec;17(12):1493-7. doi: 10.1007/s00520-009-0614-6. Epub 2009 Apr 3.
Distress is defined by the National Comprehensive Cancer Network as a multifactorial unpleasant emotional experience of a psychological, social, and/or spiritual nature that may interfere with the ability to cope effectively with cancer. We investigated the prevalence and associated symptoms of distress in newly diagnosed lung cancer patients.
Between November 2005 and July 2007, 98 newly diagnosed lung cancer patients completed an assessment. The Distress Thermometer (DT) and Edmonton Symptom Assessment Scale (ESAS) were used as screening tools.
Fifty (51%) patients reported clinically significant distress (>or=4) on the DT. Of those, 26 (52%) patients reported high levels of depression, nervousness, or both on ESAS. The remaining 24 (48%) patients had elevated levels of distress but no significant depression or nervousness. A correlation between the DT and the total ESAS score was observed (Pearson correlation = 0.46). The ten items of the ESAS together explained 46% of the variability in DT scores. The depression and nervousness ESAS items were significant predictors of DT score (p < 0.01 for both items). However, once the two psychosocial items, depression and nervousness, were removed from the total ESAS score, leaving only physical symptoms and the sleeplessness item, the predictive power of the model decreased to R(2) = 0.12.
The prevalence of distress in lung cancer patients is high. The DT appears to discriminate between physical and emotional distress. This easily measured score may determine which patients require further intervention for emotional distress.
美国国家综合癌症网络将痛苦定义为一种多因素的不愉快的情绪体验,具有心理、社会和/或精神性质,可能会干扰患者有效应对癌症的能力。我们调查了新诊断的肺癌患者的痛苦发生率及其相关症状。
在 2005 年 11 月至 2007 年 7 月期间,98 例新诊断的肺癌患者完成了评估。使用痛苦温度计(DT)和埃德蒙顿症状评估量表(ESAS)作为筛查工具。
50 例(51%)患者在 DT 上报告有临床显著的痛苦(>或=4)。其中,26 例(52%)患者在 ESAS 上报告有较高水平的抑郁、紧张或两者兼有。其余 24 例(48%)患者的痛苦程度升高,但无明显的抑郁或紧张。DT 与 ESAS 总分之间存在相关性(Pearson 相关系数=0.46)。ESAS 的十个项目共同解释了 DT 评分的 46%。ESAS 的抑郁和紧张两个项目是 DT 评分的显著预测因素(两个项目的 p 值均<0.01)。然而,一旦将 ESAS 的两个社会心理项目,即抑郁和紧张,从总分中去除,只留下身体症状和失眠项目,模型的预测能力下降到 R(2)=0.12。
肺癌患者的痛苦发生率较高。DT 似乎可以区分身体和情绪痛苦。这个易于测量的评分可能可以确定哪些患者需要进一步干预情绪痛苦。