Stein Kevin D, Kaw Chiewkwei, Crammer Corinne, Gansler Ted
Behavioral Research Center, American Cancer Society, Atlanta, Georgia 30303, USA.
Cancer. 2009 Sep 15;115(18 Suppl):4397-408. doi: 10.1002/cncr.24591.
The medical and demographic correlates of complementary and alternative medicine (CAM) use among cancer survivors have been well documented. However, the role of psychological functioning in cancer survivors' CAM use and the degree to which such factors apply to survivors of colorectal cancer require additional study. In addition, sex differences in CAM use and its correlates among colorectal cancer survivors are not well understood.
By using data from a large-scale national population-based study of quality of life and health behaviors among cancer survivors, the authors examined the prevalence and psychological correlates of CAM use among 252 male and 277 female colorectal cancer survivors.
Use of CAM was more common among women, those with more education, and recipients of chemotherapy and radiation therapy. Several psychological factors predicted increased use of CAM among female colorectal cancer survivors, including anxiety, fear of cancer recurrence, fatigue, vigor, anger, mental confusion, and overall emotional distress. Depression was associated with decreased CAM use among female survivors, both for overall CAM use and across several standard CAM domains. In contrast, psychological functioning had little impact on male colorectal cancer survivors' CAM use. The only nonmedical/demographic variable associated with men's use of CAM was fatigue, which predicted use only of biologically based practices, such as diet and nutritional supplements.
Psychological functioning has a significant impact on CAM use among female colorectal cancer survivors. Decreased use of CAM among women with depressive symptoms was unexpected and warrants additional investigation.
癌症幸存者使用补充替代医学(CAM)的医学及人口统计学相关因素已有充分记录。然而,心理功能在癌症幸存者使用CAM方面所起的作用以及这些因素在多大程度上适用于结直肠癌幸存者,仍需进一步研究。此外,结直肠癌幸存者在使用CAM及其相关因素方面的性别差异尚不清楚。
通过一项基于全国大规模人群的癌症幸存者生活质量和健康行为研究的数据,作者调查了252名男性和277名女性结直肠癌幸存者使用CAM的患病率及其心理相关因素。
女性、受教育程度较高者以及接受化疗和放疗者更常使用CAM。几个心理因素预示着女性结直肠癌幸存者使用CAM的增加,包括焦虑、对癌症复发的恐惧、疲劳、活力、愤怒、精神错乱和总体情绪困扰。抑郁与女性幸存者总体CAM使用及多个标准CAM领域的CAM使用减少有关。相比之下,心理功能对男性结直肠癌幸存者使用CAM的影响很小。与男性使用CAM相关的唯一非医学/人口统计学变量是疲劳,它仅预示着使用基于生物学的方法,如饮食和营养补充剂。
心理功能对女性结直肠癌幸存者使用CAM有显著影响。抑郁症状女性CAM使用减少出乎意料,值得进一步调查。