Gynaecological Cancers Group, Queensland Institute of Medical Research, Herston, QLD, Australia.
Psychooncology. 2013 Jul;22(7):1565-71. doi: 10.1002/pon.3169. Epub 2012 Aug 31.
The objective of this paper is to determine changes in supportive care needs after first-line treatment for ovarian cancer and identify risk factors for future unmet needs.
Two hundred and nineteen women with ovarian cancer were asked to complete a baseline survey 6-12 months after diagnosis then follow-up surveys every 6 months for up to 2 years. The validated Supportive Care Needs Survey-Short Form measured 34 needs across five domains. Logistic regression identified baseline variables associated with future needs.
At baseline, standardized median scores (possible range 0-100, least-to-greatest need) within the psychological, system/information, physical, patient care and sexuality need domains were 25, 20, 15, 15 and 8, respectively. The most frequently reported moderate-to-high unmet needs at baseline were needing help with fear about cancer spreading (25%), concerns about worries of those close (20%), being informed about things to help get well (20%), uncertainty about future (19%) and lack of energy (18%). All except the item about being informed were still reported as unmet needs by ≥ 15% of women 2 years later. Median health system/information, patient care and sexuality need scores decreased over 2 years (p<0.05), whereas psychological and physical scores remained constant. Risk factors for having ≥ 1 moderate-to-high unmet overall, psychological or physical need 1-2 years after baseline included older age, advanced disease, unmet need, anxiety, depression, insomnia and less social support at baseline.
Women with ovarian cancer report needing ongoing assistance to deal with psychological and physical needs over the first 2 years after first-line treatment. Targeting individuals at risk of future unmet needs should be prioritized.
本文旨在确定卵巢癌一线治疗后支持性护理需求的变化,并确定未来未满足需求的风险因素。
219 名卵巢癌患者在诊断后 6-12 个月完成基线调查,然后每 6 个月进行一次随访调查,最长可达 2 年。经过验证的支持性护理需求调查-短表测量了五个领域的 34 项需求。逻辑回归确定了与未来需求相关的基线变量。
基线时,心理、系统/信息、身体、患者护理和性需求领域的标准化中位数评分(可能范围为 0-100,需求最低到最高)分别为 25、20、15、15 和 8。基线时报告的最常见中度至高度未满足需求是需要帮助应对癌症扩散的恐惧(25%)、对亲近者担忧的关注(20%)、了解有助于康复的信息(20%)、对未来的不确定性(19%)和缺乏精力(18%)。除了关于获得信息的项目外,所有项目在 2 年后仍有≥15%的女性报告未满足需求。中位数健康系统/信息、患者护理和性需求评分在 2 年内下降(p<0.05),而心理和身体评分保持不变。基线时存在≥1 项中度至高度未满足的整体、心理或身体需求 1-2 年后的风险因素包括年龄较大、疾病晚期、未满足的需求、焦虑、抑郁、失眠和较少的社会支持。
卵巢癌患者在一线治疗后头 2 年报告需要持续帮助来应对心理和身体需求。应优先针对未来有未满足需求风险的个体。