Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio.
Department of Urology, School of Medicine, Case Western Reserve University, Cleveland, Ohio.
Palliat Support Care. 2012 Dec;10(4):279-86. doi: 10.1017/S1478951511000861. Epub 2012 Mar 22.
This study examined general and cancer-related stressors of depression that are unique to African-American cancer patients.
The study used cohort design and mixed methods. Seventy-four breast and prostate cancer survivors including 34 depressed and 23 non-depressed African-Americans and 17 depressed whites were interviewed. Qualitative data analysis identified themes. The thematic codes were converted to a SPSS data set numerically. The Fisher's exact test was performed to examine group differences in the experience of stress.
Significantly more depressed African-Americans experienced a dramatic reaction to a cancer diagnosis (p = 0.03) or had concerns about functional decline (p = 0.01), arguments with relatives or friends (p = 0.02), and unemployment status (p = 0.03) than did non-depressed African-Americans, who reacted to the cancer diagnosis as a matter of reality (p = 0.02). Significantly more depressed African-Americans talked about feeling shocked by a cancer diagnosis (p = 0.04) and being unable to do things that they used to do (p = 0.02) than did depressed whites. Qualitative analysis shed light on the extent of such group differences.
Distress from the initial cancer diagnosis and functional decline were likely to have triggered or worsened depression in African-American cancer patients. This study highlighted racial differences in this aspect. It is critical to screen African-American cancer patients for depression at two critical junctures: immediately after the disclosure of a cancer diagnosis and at the onset of functional decline. This will enhance the chance of prompt diagnosis and treatment of depression in this underserved population.
本研究考察了非裔美国癌症患者特有的与抑郁相关的一般和癌症相关压力源。
该研究采用队列设计和混合方法。对 74 名乳腺癌和前列腺癌幸存者进行了访谈，其中包括 34 名抑郁和 23 名非抑郁的非裔美国人和 17 名抑郁的白人。定性数据分析确定了主题。主题代码被转换为 SPSS 数据集中的数字。采用 Fisher 精确检验检验组间应激体验的差异。
与非抑郁的非裔美国人相比，更多的抑郁非裔美国人对癌症诊断（p = 0.03）或对功能下降的担忧（p = 0.01）、与亲戚或朋友争吵（p = 0.02）和失业状态（p = 0.03）的反应更剧烈，而非抑郁的非裔美国人将癌症诊断视为现实问题（p = 0.02）。与抑郁的白人相比，更多的抑郁非裔美国人表示感到震惊（p = 0.04）和无法做以前做过的事情（p = 0.02）。定性分析揭示了这种群体差异的程度。
癌症诊断和功能下降带来的痛苦可能引发或加重非裔美国癌症患者的抑郁。本研究强调了这方面的种族差异。在两个关键节点对非裔美国癌症患者进行抑郁筛查至关重要：癌症诊断后立即和功能下降开始时。这将提高在这个服务不足的人群中及时诊断和治疗抑郁的机会。
