Psychooncology Unit, Hospital Duran I Reynals, Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain.
Palliat Support Care. 2010 Dec;8(4):455-60. doi: 10.1017/S1478951510000337. Epub 2010 Sep 28.
The purpose of this study was to assess the psychological care needs of cancer patients throughout the healthcare process: after diagnosis, after medical treatment (surgery, chemotherapy, radiotherapy) and during follow-up.
A total of 703 ambulatory cancer patients were assessed in this study. The inclusion period was from April 1, 2005 to April 30, 2007. The first psychological scales used were the 14-item Hospital Anxiety and Depression Scales (HADS), which has two sub-scales for anxiety (7 items) and for depression (7 items). All patients with a score ≥ 14 were assessed through the Structured Clinical Interview for Psychiatric Disorder (SCID-I) of the DSM-IV. All data were compared with sociodemographic and medical characteristics.
Of the 703 cancer patients in the study, 349 were men and 354 women, with a mean age of 53 years. The median time between the cancer diagnosis and our clinical interview was 6 months (range, 12 days to 190 months). Overall, the screening tools indicated that one in four patients needed psychological care. The most common psychiatric diagnosis was adjustment disorder (129 cases), whereas 10 patients were diagnosed with major depression. Using a HADS cut-off score of > 7 for anxiety and depression, 28% and 17% of patients, respectively, were classified as "possible clinical cases." Risk factors for distress included age < 65 years, asthenia, constipation, and a low performance status. However, chemotherapy treatment was found to be a protector against distress in cancer patients.
Chemotherapy treatment is interpreted by the patients as a protector against cancer, thereby reducing distress levels.
本研究旨在评估癌症患者在整个医疗过程中的心理护理需求：诊断后、治疗后（手术、化疗、放疗）和随访期间。
本研究共评估了 703 名门诊癌症患者。纳入期为 2005 年 4 月 1 日至 2007 年 4 月 30 日。首先使用的心理量表是 14 项医院焦虑抑郁量表（HADS），它有两个子量表，分别用于焦虑（7 项）和抑郁（7 项）。所有得分≥14 的患者均通过 DSM-IV 的精神疾病诊断定式访谈（SCID-I）进行评估。所有数据均与社会人口学和医学特征进行比较。
在研究中的 703 名癌症患者中，349 名男性和 354 名女性，平均年龄为 53 岁。癌症诊断和我们临床访谈之间的中位数时间为 6 个月（范围，12 天至 190 个月）。总体而言，筛查工具表明，四分之一的患者需要心理护理。最常见的精神科诊断是适应障碍（129 例），而 10 例被诊断为重度抑郁症。使用 HADS 焦虑和抑郁切点分数>7，分别有 28%和 17%的患者被归类为“可能的临床病例”。痛苦的危险因素包括年龄<65 岁、乏力、便秘和低表现状态。然而，化疗被认为是癌症患者痛苦的保护因素。
化疗被患者解释为对抗癌症的保护因素，从而降低了痛苦水平。
