Department of Obstetrics, Gynecology, and Reproductive Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
Cancer. 2010 Apr 1;116(7):1810-9. doi: 10.1002/cncr.24954.
: The authors explored associations between anxiety disorders and advanced cancer patients' physical performance status, physician-patient relationships, end-of-life (EOL) treatment preferences and outcomes, and quality of death.
: The Coping with Cancer study was a National Cancer Institute/National Institute of Mental Health-sponsored, prospective, longitudinal, multicenter cohort study of patients with advanced cancer. Six hundred thirty-five patients completed the anxiety disorders module of the Structured Clinical Interview for the Diagnostic Statistical Manual IV. The results were compared with patients' baseline physical performance status, treatment preferences, perceptions of the physician-patient relationship, and advance care planning (ACP).
: Approximately 7.6% of patients met criteria for an anxiety disorder. Patients who were diagnosed with an anxiety disorder were more likely to be women and younger and to have a worse physical performance status. Although there were no significant differences in patients' EOL treatment preferences or care, ACP, hospice enrollment, or patients' location of death, there were significant differences in how patients with anxiety disorders perceived the physician-patient relationship. Patients with anxiety disorders had less trust in their physicians, felt less comfortable asking questions about their health, and felt less likely to understand the clinical information that their physicians presented. They also were more likely to believe that their physicians would offer them futile therapies and would not adequately control their symptoms.
: Women, patients who were more physically impaired, and younger patients with advanced cancer were more likely to meet criteria for an anxiety disorder. Patients with advanced cancer who had an anxiety disorder were more likely to experience greater challenges to the physician-patient relationship. Cancer 2010. (c) 2010 American Cancer Society.
作者探讨了焦虑障碍与晚期癌症患者的身体功能状态、医患关系、临终（EOL）治疗偏好和结局以及死亡质量之间的关联。
Coping with Cancer 研究是一项由美国国立癌症研究所/美国国立精神卫生研究所赞助的前瞻性、纵向、多中心队列研究，纳入了晚期癌症患者。635 例患者完成了《精神障碍诊断与统计手册第四版》结构临床访谈焦虑障碍模块。结果与患者的基线身体功能状态、治疗偏好、对医患关系的看法以及预先医疗指示（ACP）进行了比较。
约 7.6%的患者符合焦虑障碍的标准。被诊断为焦虑障碍的患者更可能是女性和年轻人，且身体功能状态更差。尽管患者的 EOL 治疗偏好或护理、ACP、临终关怀入院或患者死亡地点没有显著差异，但焦虑障碍患者对医患关系的看法存在显著差异。焦虑障碍患者对医生的信任度较低，询问自己健康问题时感到不自在，并且不太可能理解医生提供的临床信息。他们也更有可能认为医生会提供无效的治疗，并且无法充分控制他们的症状。
女性、身体功能障碍更严重的患者以及年轻的晚期癌症患者更有可能符合焦虑障碍的标准。患有焦虑障碍的晚期癌症患者更有可能面临医患关系的挑战。癌症 2010。（c）2010 年美国癌症协会。
