Unit of Oncological Psychology, Centro di Riferimento Oncologico National Cancer Institute, Aviano, Italy.
Support Care Cancer. 2010 Feb;19(2):291-5. doi: 10.1007/s00520-010-0818-9. Epub 2010 Feb 5.
The diagnosis of cancer marks an immediate passage from a condition of health to one characterized by uncertainty, threat of death, and changes. The psychological distress is recognized as a peculiar component in the process of disease adjustment and it seems to change over time together with needs. In the present study, both psychological distress and needs were assessed twice (i.e., after the diagnosis and later during treatments) in a sample of hospitalized cancer patients.
Eighty-five consecutive adult patients from the same Cancer Institute in North-east Italy were involved in the research. Participants were requested to fill out both a distress (i.e., the Hospital Anxiety and Depression Scale) and needs (i.e., Needs Evaluation Questionnaire) self-reported measure within a month of diagnosis (diagnostic phase) and 3-6 months from diagnosis (therapeutic phase).
In the diagnostic phase, the prevalence of probable psychological morbidity due to anxiety was 23.5% and 14.1% due to depression. When the inpatients identified as possible cases were included, the respective proportions were 56.5% and 36.5%. Progressing from diagnostic to therapeutic phase, anxiety seems to decrease, while no statistically significant difference has been found in depression levels. In both phases, the most frequently mentioned needs were the informative ones; although the decrement in time is significant only for this type of needs.
The implications both for the quality of care and the disease adjustment by cancer patients are discussed together with study limitations.
癌症的诊断标志着患者从健康状态立即转变为不确定、面临死亡威胁和发生变化的状态。心理困扰被认为是疾病调整过程中的一个特殊组成部分,它似乎随着时间的推移以及需求的变化而变化。在本研究中,对住院癌症患者样本进行了两次评估(即诊断后和治疗期间),分别评估了心理困扰和需求。
意大利东北部同一癌症研究所的 85 名连续成年患者参与了该研究。要求参与者在诊断后一个月内(诊断阶段)和诊断后 3-6 个月(治疗阶段)填写两次自我报告的困扰(即医院焦虑和抑郁量表)和需求(即需求评估问卷)。
在诊断阶段,焦虑导致可能存在心理困扰的比例为 23.5%,抑郁为 14.1%。当将被确定为可能病例的住院患者包括在内时,相应的比例分别为 56.5%和 36.5%。从诊断阶段到治疗阶段,焦虑似乎有所减轻,而抑郁水平没有统计学上的显著差异。在两个阶段,最常提到的需求都是信息需求;尽管这种需求在时间上的减少仅对这种类型的需求具有统计学意义。
讨论了癌症患者的护理质量和疾病调整的影响,同时也讨论了研究的局限性。