Mehnert A, Lehmann C, Graefen M, Huland H, Koch U
Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistr., Hamburg, Germany.
Eur J Cancer Care (Engl). 2010 Nov;19(6):736-45. doi: 10.1111/j.1365-2354.2009.01117.x.
The aim of this study is to identify anxiety, depression and post-traumatic stress disorder in prostate cancer patients and to investigate the association with social support and health-related quality of life. A total of 511 men who had undergone prostatectomy were surveyed during ambulatory follow-up care for an average of 27 months after surgery using standardised self-report measures (e.g. Hospital Anxiety and Depression Scale, Posttraumatic Stress Disorder Checklist--Civilian Version, Illness-Specific Social Support Scale, Short-Form Health Survey). Seventy-six per cent of patients evaluated their disease as 'not' or a 'little threatening'. The cancer diagnosis and uncertainty were most frequently reported as 'distressing', while medical treatment and doctor-patient interaction were most frequently evaluated as 'most helpful'. The number of patients reporting increased levels of psychological distress was 16%, with 6% demonstrating signs of having severe mental health problems'. No higher levels of anxiety and depression were observed in cancer patients compared with age-adjusted normative comparison groups. Lack of positive support, detrimental interactions and perceived threat of cancer were found to be predictors of psychological co-morbidity (P < 0.001). Lack of positive support, detrimental interactions, threat of cancer, disease stage and age significantly predicted mental health (P < 0.001), whereas the impact of social support on physical health was rather weak. Findings emphasise the need for routine psychosocial screening.
本研究的目的是识别前列腺癌患者的焦虑、抑郁和创伤后应激障碍，并调查其与社会支持及健康相关生活质量的关联。共有511名接受了前列腺切除术的男性在术后平均27个月的门诊随访中接受了调查，采用标准化的自我报告测量方法（如医院焦虑抑郁量表、创伤后应激障碍检查表——平民版、疾病特异性社会支持量表、简短健康调查问卷）。76%的患者将他们的疾病评估为“无”或“有一点威胁”。癌症诊断和不确定性最常被报告为“令人痛苦”，而医疗治疗和医患互动最常被评估为“最有帮助”。报告心理困扰水平增加的患者人数为16%，其中6%表现出有严重心理健康问题的迹象。与年龄调整后的正常对照组相比，癌症患者中未观察到更高水平的焦虑和抑郁。发现缺乏积极支持、有害互动和感知到的癌症威胁是心理共病的预测因素（P<0.001）。缺乏积极支持、有害互动、癌症威胁、疾病阶段和年龄显著预测心理健康（P<0.001），而社会支持对身体健康的影响相当微弱。研究结果强调了常规心理社会筛查的必要性。
