Department of Psychology, University of Sheffield, Sheffield, UK.
Psychooncology. 2011 Nov;20(11):1202-10. doi: 10.1002/pon.1835. Epub 2010 Sep 7.
Gender differences in perceived vulnerability to late effects and views about follow-up among cancer survivors have received little attention. As lymphoma affects both genders similarly, we compared the consequences of cancer (late effects, perceived vulnerability and quality of life (health-related quality of life (HRQoL)), and satisfaction with clinic visits between genders.
A cohort of 115 younger adults (18-45 years, >5 years disease-free survival), who had been treated for lymphoma participated. Questionnaires (n = 91) were completed before and after (n = 62) routine consultant-led appointments. Survivors (n = 24) without appointments were recruited by post. Questionnaires included HRQoL, late effects, perceived vulnerability, issues survivors wanted to discuss and reported discussing in clinic, time waiting in clinic and consultation satisfaction.
There were no gender differences in number of self-reported late effects or perceived vulnerability. Men with more late effects reported worse psychological HRQoL (r = 0.50, p<0.001). While men wanted to discuss more topics than they did, women were able to discuss the topics they wanted (ANOVA, p = 0.01). Multiple regression analyses showed a shorter wait in clinic (r = -0.46, p = 0.009) and discussing more topics (r = 0.34, p = 0.06) explained 30.6% of the variance in consultation satisfaction for men.
Issues surrounding follow-up provision are increasingly important given the length of survival in young adults following treatment for lymphoma. Men may experience poor psychological well-being due to distress about unanswered concerns. Consideration of their concerns should be prioritised, given that satisfaction and ultimately continued attendance at clinic and HRQoL may be dependent on the extent to which follow-up meets survivors' expectations.
癌症幸存者对晚期效应的感知脆弱性和对随访的看法存在性别差异,但这一问题尚未得到充分关注。由于淋巴瘤对两性的影响相似,我们比较了两性癌症(晚期效应、感知脆弱性和生活质量(健康相关生活质量(HRQoL))的后果,以及对就诊的满意度。
我们招募了 115 名年龄在 18-45 岁(无病生存时间>5 年)的淋巴瘤年轻幸存者参与该队列研究。在常规顾问主导的就诊前(n=91)和就诊后(n=62)完成了问卷调查。通过邮寄问卷招募了没有就诊的幸存者(n=24)。调查问卷包括 HRQoL、晚期效应、感知脆弱性、幸存者希望讨论的问题以及报告在就诊时讨论的问题、在诊所的等待时间和咨询满意度。
报告的晚期效应或感知脆弱性数量在两性之间没有差异。自我报告的晚期效应较多的男性报告心理 HRQoL 更差(r=0.50,p<0.001)。虽然男性希望讨论的话题比实际讨论的话题多,但女性能够讨论她们希望讨论的话题(方差分析,p=0.01)。多元回归分析显示,在诊所等待时间较短(r=-0.46,p=0.009)和讨论更多话题(r=0.34,p=0.06)可以解释男性咨询满意度变化的 30.6%。
考虑到淋巴瘤治疗后年轻幸存者的生存时间延长,围绕随访提供的问题变得越来越重要。男性可能会因未解决的问题而感到痛苦,从而导致心理健康状况不佳。鉴于满足幸存者的期望可能会影响满意度和最终继续到诊所就诊和 HRQoL,应优先考虑他们的担忧。