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韩国癌症患者的焦虑、无助/绝望和“渴望速死”。

Anxiety, helplessness/hopelessness and 'desire for hastened death' in Korean cancer patients.

机构信息

Department of Psychology, Catholic University of Daegu, Gyeongsan, Gyeongbuk, South Korea.

出版信息

Eur J Cancer Care (Engl). 2011 May;20(3):395-402. doi: 10.1111/j.1365-2354.2010.01202.x.

Abstract

Despite a relatively high rate of suicide associated with cancer, this issue has not been explored in Korean patients. This study investigates the prevalence and factors related to 'the desire for hastened death' (DHD) in Korean cancer patients. A cross-sectional survey using standardised measures, including the Schedule of Attitudes toward Hastened Death and the Hospital Anxiety and Depression Scale, was performed with 131 patients with different types of cancer. 13.7% of the participants experienced moderate DHD (Schedule of Attitudes toward Hastened Death scores 5-9) and 1.7% experienced high DHD (≥10). Socio-demographic and disease-associated factors of the DHD included age, overall health and shortness of breath. The majority of psychosocial variables such as sadness, distress, 'helplessness/hopelessness' and 'anxious preoccupation' had a moderate association with DHD. Patients with a clinically significant level of anxiety or depression reported higher levels of DHD. Other significant correlates included 'meaning/peace', a sense of burdening family, dignity impairment and suicidal thoughts after diagnosis. Helplessness/hopelessness and anxiety were the strongest predictors of DHD in multivariate analysis. In view of significant role of helplessness/hopelessness and anxiety in the DHD of cancer patients, careful monitoring and management of these factors should be an integral part of cancer care to reduce the occurrence of DHD.

摘要

尽管癌症相关的自杀率相对较高,但这一问题在韩国患者中尚未得到探讨。本研究调查了韩国癌症患者中“加速死亡愿望”(DHD)的流行率和相关因素。采用包括态度量表和医院焦虑抑郁量表在内的标准化测量方法对 131 名不同类型癌症患者进行了横断面调查。参与者中有 13.7%经历了中度 DHD(态度量表得分 5-9),1.7%经历了高度 DHD(≥10)。DHD 的社会人口统计学和疾病相关因素包括年龄、整体健康状况和呼吸急促。大多数心理社会变量,如悲伤、痛苦、“无助/无望”和“焦虑困扰”与 DHD 中度相关。有临床显著焦虑或抑郁水平的患者报告了更高水平的 DHD。其他显著相关因素包括“意义/平静”、对家庭的负担感、尊严受损和诊断后自杀念头。无助/无望和焦虑是多变量分析中 DHD 的最强预测因素。鉴于无助/无望和焦虑在癌症患者 DHD 中的重要作用,应将这些因素的仔细监测和管理作为癌症治疗的一个组成部分,以降低 DHD 的发生。

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