School of Social Work, University of Michigan, Ann Arbor, MI 48109-1106, USA.
Psychooncology. 2013 Aug;22(8):1798-806. doi: 10.1002/pon.3217. Epub 2012 Nov 8.
Post-traumatic stress symptoms (PTSS) have been identified as a meaningful indicator of distress in cancer survivors. Distinct from young adult survivors of childhood cancer, young people diagnosed with cancer as adolescents and young adults (AYAs) face unique psychosocial issues; however, there is little published research of PTSS in the AYA population. This study examines prevalence and predictors of PTSS among AYAs with cancer.
As part of a longitudinal study of AYAs with cancer, 151 patients aged 15-39 years completed mailed surveys at 6 and 12 months post-diagnosis. Severity of PTSS was estimated at 6 and 12 months post-diagnosis. Multiple regression analyses were conducted to investigate the predictive effects of socio-demographic and clinical characteristics on changes in PTSS over time.
At 6 and 12 months, respectively, 39% and 44% of participants reported moderate to severe levels of PTSS; 29% had PTSS levels suggestive of post-traumatic stress disorder. No significant differences in severity of PTSS between 6 and 12 months were observed. Regression analyses suggested that a greater number of side effects were associated with higher levels of PTSS at 6 months. Currently receiving treatment, having surgical treatment, diagnosis of a cancer type with a 90-100% survival rate, remaining unemployed/not in school, and greater PTSS at 6 months were associated with higher levels of PTSS at 12 months.
Post-traumatic stress symptoms were observed as early as 6 months following diagnosis and remained stable at 12-month follow-up. The development of early interventions for reducing distress among AYA patients in treatment is recommended.
创伤后应激症状(PTSS)已被确定为癌症幸存者痛苦的有意义指标。与儿童癌症的年轻成年幸存者不同,被诊断为青少年和年轻成人(AYAs)的癌症患者面临独特的心理社会问题;然而,关于 AYA 人群中 PTSS 的研究甚少。本研究调查了癌症 AYA 患者中 PTSS 的患病率和预测因素。
作为 AYA 癌症纵向研究的一部分,151 名年龄在 15-39 岁的患者在诊断后 6 个月和 12 个月时通过邮件完成了调查。在诊断后 6 个月和 12 个月时分别评估了 PTSS 的严重程度。进行了多元回归分析,以研究社会人口统计学和临床特征对 PTSS 随时间变化的预测作用。
分别有 39%和 44%的参与者在诊断后 6 个月和 12 个月报告了中度至重度的 PTSS;29%的患者 PTSS 水平提示患有创伤后应激障碍。在 6 个月和 12 个月之间,PTSS 的严重程度没有显著差异。回归分析表明,更多的副作用与 6 个月时更高水平的 PTSS 相关。目前正在接受治疗、接受手术治疗、诊断为存活率为 90-100%的癌症类型、失业/未上学、以及 6 个月时更高的 PTSS 与 12 个月时更高的 PTSS 水平相关。
早在诊断后 6 个月就观察到创伤后应激症状,并且在 12 个月的随访中保持稳定。建议为正在接受治疗的 AYA 患者开发早期干预措施以减少其痛苦。