癌症患者的心理困扰与诊断、当前治疗或残疾程度有关吗？来自澳大利亚一项大型研究的结果。

Is psychological distress in people living with cancer related to the fact of diagnosis, current treatment or level of disability? Findings from a large Australian study.

机构信息

National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT.

出版信息

Med J Aust. 2010 Sep 6;193(S5):S62-7. doi: 10.5694/j.1326-5377.2010.tb03931.x.

DOI:10.5694/j.1326-5377.2010.tb03931.x

PMID:21542449

Abstract

OBJECTIVE

To investigate whether the observed elevated levels of psychological distress in cancer survivors relate specifically to aspects of cancer diagnosis, to treatment or to disability.

DESIGN, PARTICIPANTS AND SETTING: Self-reported questionnaire data on demographic, health and lifestyle factors and mental health from 89574 Australian men and women aged 45 years or older, sampled from the Medicare database for the 45 and Up Study from 1 February 2006 to 30 April 2008. Logistic regression was used to examine the risk of high levels of psychological distress in relation to cancer diagnosis and disability, adjusting for age, sex, income and education.

MAIN OUTCOME MEASURE

High psychological distress (Kessler Psychological Distress Scale score > or = 22).

RESULTS

Overall, 7.5% of participants had high levels of psychological distress. Among cancer survivors, the median time since diagnosis was 7.3 years. Compared with people without cancer, the odds ratios (95% CIs) for psychological distress were: 1.17 (1.09-1.26) in people reporting having had any cancer apart from non-melanoma skin cancer; 1.34 (1.08-1.67) in those with cancer diagnosed in the previous year; 1.53 (1.33-1.76) for those reporting treatment for cancer in the previous month and 1.11 (1.03-1.19) for those with cancer but without recent treatment. Using individuals with neither cancer nor disability as the reference group, the adjusted odds ratio (95% CI) for psychological distress was 6.51 (5.95-7.12) in those reporting significant disability but no cancer, 1.14(1.04-1.24) in those without disability but with cancer and 5.81(4.88-6.91) in those with both cancer and disability.

CONCLUSION

The risk of psychological distress in individuals with cancer relates much more strongly to their level of disability than it does to the cancer diagnosis itself.

摘要

目的

探讨癌症幸存者中观察到的心理困扰水平升高是否与癌症诊断、治疗或残疾的具体方面有关。

设计、参与者和设置：来自澳大利亚医疗保险数据库的自我报告问卷数据，涉及人口统计学、健康和生活方式因素以及心理健康，样本来自 2006 年 2 月 1 日至 2008 年 4 月 30 日期间参加 45 岁及以上研究的 89574 名年龄在 45 岁或以上的男性和女性。使用逻辑回归来研究与癌症诊断和残疾相关的高水平心理困扰的风险，同时调整年龄、性别、收入和教育因素。

主要结果衡量标准

高水平的心理困扰（Kessler 心理困扰量表得分≥22）。

结果

总体而言，7.5%的参与者存在高水平的心理困扰。在癌症幸存者中，诊断后中位数时间为 7.3 年。与没有癌症的人相比，癌症报告者的心理困扰比值比（95%置信区间）为：除非黑色素瘤皮肤癌外，任何其他癌症（1.17，1.09-1.26）；前一年诊断出癌症的患者（1.34，1.08-1.67）；前一个月接受癌症治疗的患者（1.53，1.33-1.76）；没有接受最近治疗但患有癌症的患者（1.11，1.03-1.19）。使用既没有癌症也没有残疾的个体作为参考组，报告有显著残疾但没有癌症的个体的调整后心理困扰比值比（95%置信区间）为 6.51（5.95-7.12），没有残疾但患有癌症的个体为 1.14（1.04-1.24），既患有癌症又患有残疾的个体为 5.81（4.88-6.91）。