Institute of Cognitive Psychology, Vocational and Social Development, Faculty of Psychology and Educational Sciences, University of Coimbra, Portugal.
Eur J Cancer Care (Engl). 2012 Jan;21(1):41-51. doi: 10.1111/j.1365-2354.2011.01269.x. Epub 2011 Aug 4.
The present study examined change on emotional distress of sarcoma patients from the diagnostic to treatment phases, the distinct trajectories of adjustment and the influence of demographic, clinical and coping variables on anxiety and depression. Thirty-six sarcoma patients completed questionnaires on emotional distress (Hospital Anxiety and Depression Scale) and coping strategies (Brief Cope) at time of diagnosis, and again during treatment. No significant change in emotional distress levels was found from diagnostic to treatment phase, with mean anxiety and depression scores remaining below the clinical range. Over time, 52.8% and 66.7% of patients maintained non-clinical anxious and depressive symptoms respectively, and 25% and 11.1% remained with clinical anxiety and depression. Living with partner, less use of humour and more denial were associated with high emotional distress at time of diagnosis and during treatments, and high levels of distress at baseline were predictive of poorer emotional adjustment during treatments. Although sarcoma patients, in general, seem to exhibit good psychological adjustment, there is a significant minority that requires mental health services in order to help decrease their emotional distress following the diagnosis, and prevent psychological difficulties during treatments. Our findings are an important contribution to understanding the psychological adjustment of patients with a specific and rare type of cancer.
本研究考察了肉瘤患者从诊断到治疗阶段情绪困扰的变化、调整的不同轨迹以及人口统计学、临床和应对变量对焦虑和抑郁的影响。36 名肉瘤患者在诊断时和治疗期间完成了情绪困扰（医院焦虑和抑郁量表）和应对策略（简要应对量表）的问卷。从诊断到治疗阶段，情绪困扰水平没有显著变化，平均焦虑和抑郁得分仍低于临床范围。随着时间的推移，52.8%和 66.7%的患者分别保持非临床焦虑和抑郁症状，25%和 11.1%的患者保持临床焦虑和抑郁。与伴侣一起生活、较少使用幽默和更多否认与诊断时和治疗期间的高情绪困扰有关，基线时的高情绪困扰预示着治疗期间情绪调整较差。尽管肉瘤患者总体上表现出良好的心理适应，但仍有相当一部分患者需要心理健康服务，以帮助他们在诊断后减轻情绪困扰，并预防治疗期间的心理困难。我们的研究结果对理解特定和罕见类型癌症患者的心理适应具有重要贡献。
