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癌症幸存者的焦虑和抑郁:与情绪支持信息源互动的作用。

Anxiety and depression among cancer survivors: the role of engagement with sources of emotional support information.

机构信息

Center of Excellence in Cancer Communication Research, University of Pennsylvania, Philadelphia, PA 19104, USA.

出版信息

Health Commun. 2013;28(4):389-96. doi: 10.1080/10410236.2012.690329. Epub 2012 Jul 18.

Abstract

This study explores cancer survivors' engagement with information about emotional support from doctors, interpersonal sources, and the media and examines to what extent such engagement affects subsequent self-reported anxiety and depression. Patients with colorectal, breast, or prostate cancer (n = 1,128) were surveyed over 3 years following diagnosis. Using lagged logistic regression, we predicted the odds of experiencing anxiety or depression based on earlier engagement with sources of emotional support, adjusting for prior symptoms and confounders. Among those reporting anxiety or depression (n = 476), we also asked whether information engagement affected the severity of those symptoms. Participants obtained information about emotional support from multiple sources, but most often from physicians. Discussions with physicians about emotional support increased the odds of cancer survivors subsequently reporting anxiety or depression by 1.58 times (95% CI: 1.06 to 2.35; p = 0.025), adjusted for prior symptoms and confounders. Scanning from media sources was also significantly associated with increased odds of reporting emotional symptoms (OR=1.72; 95% CI: 1.03 to 2.87; p = 0.039). However, among those who reported symptoms, doctor-patient engagement predicted slightly reduced interference of these symptoms with daily activities (B = -0.198; 95% CI: -0.393 to -0.003; p = 0.047). Important implications for health communication research and practice are discussed.

摘要

本研究探讨了癌症幸存者获取医生、人际和媒体提供的情绪支持信息的情况,并考察了这种信息获取对后续自我报告的焦虑和抑郁程度的影响。研究对象为接受过结直肠癌、乳腺癌或前列腺癌治疗的患者(n=1128),在诊断后随访了 3 年。使用滞后逻辑回归,我们根据早期情绪支持信息获取情况预测出现焦虑或抑郁的几率,同时调整了先前的症状和混杂因素。在报告出现焦虑或抑郁症状的患者(n=476)中,我们还询问了信息获取是否会影响这些症状的严重程度。参与者从多个来源获取情绪支持信息,但最常从医生那里获取。与医生讨论情绪支持会使癌症幸存者随后报告出现焦虑或抑郁的几率增加 1.58 倍(95%CI:1.06 至 2.35;p=0.025),同时调整了先前的症状和混杂因素。从媒体来源获取信息也与报告情绪症状的几率增加显著相关(OR=1.72;95%CI:1.03 至 2.87;p=0.039)。然而,在报告有症状的患者中,医患互动可预测这些症状对日常生活活动的干扰略有减少(B=-0.198;95%CI:-0.393 至-0.003;p=0.047)。讨论了对健康传播研究和实践的重要启示。

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