Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Psychooncology. 2013 Aug;22(8):1766-73. doi: 10.1002/pon.3211. Epub 2012 Oct 29.
We examined differences in distress levels and Distress Thermometer (DT) cutoff scores between different cancer types. The effect of socio-demographic and illness-related variables on distress was also examined.
One thousand three hundred fifty patients (response = 51%) completed questions on socio-demographic and illness-related variables, the Dutch version of the DT and Problem List, and the Hospital Anxiety and Depression Scale. Receiver operating characteristics analyses were performed to determine cancer specific cutoff scores. Univariate and multivariate effects of socio-demographic and illness-related variables (including cancer type) on distress were examined.
Prostate cancer patients reported significantly lower DT scores (M = 2.5 ± 2.5) and the cutoff score was lower (≥ 4) than in patients with most other cancer types (M varied between 3.4 and 5.1; cutoff ≥ 5). Multivariate analyses (F = 10.86, p < .001, R(2) = 0.08) showed an independent significant effect of four variables on distress: intensive treatment (β = .10, any (combination of) treatment but surgery only and 'wait and see'); a non-prostate cancer type (β = -.17); the interaction between gender and age (β = -.12, highest distress in younger women as compared with older women and younger and older men); and the interaction between cancer type and treatment intensity (β = .08, lowest scores in prostate cancer patients receiving non-intensive treatment as compared with their counterparts).
Distress and cutoff score in prostate cancer patients were lower than in patients with other cancer types. Additionally, younger women and patients receiving treatment other than surgery only or 'wait and see' are at risk for higher distress. These results can help identify patients possibly in need of referral to professional psychosocial and/or allied health care.
我们研究了不同癌症类型患者的痛苦水平和痛苦温度计（DT）截断分数的差异。还研究了社会人口统计学和疾病相关变量对痛苦的影响。
1350 名患者（应答率=51%）完成了社会人口统计学和疾病相关变量、荷兰版 DT 和问题清单以及医院焦虑和抑郁量表的问题。进行了接收者操作特征分析，以确定特定于癌症的截断分数。检查了社会人口统计学和疾病相关变量（包括癌症类型）对痛苦的单变量和多变量影响。
前列腺癌患者报告的 DT 分数明显较低（M=2.5±2.5），截断值较低（≥4），而大多数其他癌症类型的患者的分数（M 在 3.4 到 5.1 之间；截断值≥5）。多变量分析（F=10.86，p<0.001，R2=0.08）显示，有四个变量对痛苦有独立的显著影响：强化治疗（β=0.10，任何（组合）治疗但仅手术和“等待和观察”）；非前列腺癌类型（β=-0.17）；性别和年龄之间的相互作用（β=-0.12，年轻女性比老年女性和年轻男性和老年男性的痛苦更高）；以及癌症类型和治疗强度之间的相互作用（β=0.08，接受非强化治疗的前列腺癌患者的分数最低，与他们的对应者相比）。
前列腺癌患者的痛苦和截断分数低于其他癌症类型的患者。此外，年轻女性和接受除手术或“等待和观察”以外的治疗的患者更有可能出现较高的痛苦。这些结果可以帮助识别可能需要转介给专业心理社会和/或联合医疗保健的患者。
