Department of Psychiatry and Psychotherapy, University Freiburg - Medical Center, Freiburg, Germany.
Psychooncology. 2013 Sep;22(9):1972-8. doi: 10.1002/pon.3238. Epub 2013 Jan 3.
The purpose of this study was to explore the impact of self-efficacy for coping with cancer (SECC) on physical fatigue and depressive symptoms in melanoma patients, in comparison with objective factors, such as treatment with interferon-alpha (IFN-α) and medical and sociodemographic variables. Current literature shows that psychological distress in melanoma patients is generally moderate, that they experience high quality of life, and that symptoms of depression and fatigue have been mostly associated with adjuvant IFN-α treatment
A total of 175 melanoma patients, stages Ib-IIIc with and without low-dose IFN-α therapy, completed surveys on SECC, depression, and fatigue. Two hierarchical regression analyses were conducted to explore the predictive role of objective factors (first step: tumor stage, time since diagnosis, and current IFN-α treatment; second step: age and gender) in conjunction with the subjective factor of SECC (third step) on physical fatigue and depression.
Regression analysis revealed no significant effect of IFN-α treatment upon depression. Current IFN-α treatment was predictive of higher fatigue scores, however. The highest predictive effect by far was obtained for SECC, indicating higher fatigue and depression in patients with lower SECC.
The findings suggest that the treatment with IFN-α is mainly accompanied by physical fatigue in melanoma patients rather than by mood changes. Most notably, the potential influence of increased SECC on reducing both physical fatigue and depression is suggested by the data, indicating the importance of self-efficacy enhancing interventions in the psycho-oncological support of melanoma patients.
本研究旨在探讨应对癌症自我效能感(SECC)对黑色素瘤患者身体疲劳和抑郁症状的影响,并与干扰素-α(IFN-α)治疗等客观因素以及医学和社会人口学变量进行比较。目前的文献表明,黑色素瘤患者的心理困扰通常处于中等水平,他们的生活质量较高,且抑郁和疲劳症状主要与辅助 IFN-α 治疗相关。
共 175 名 I b 期至 IIIc 期黑色素瘤患者,接受或未接受低剂量 IFN-α 治疗,完成了应对癌症自我效能感、抑郁和疲劳的调查。采用分层回归分析,探讨客观因素(肿瘤分期、诊断后时间和当前 IFN-α 治疗;第二步:年龄和性别)与主观因素 SECC(第三步)对身体疲劳和抑郁的预测作用。
回归分析显示 IFN-α 治疗对抑郁无显著影响。然而,当前 IFN-α 治疗可预测更高的疲劳评分。到目前为止,SECC 的预测效果最高,表明 SECC 较低的患者疲劳和抑郁程度更高。
这些发现表明,IFN-α 治疗主要伴随黑色素瘤患者的身体疲劳,而不是情绪变化。数据表明,SECC 增加可能会降低身体疲劳和抑郁,这表明增强自我效能感的干预措施对黑色素瘤患者的心理肿瘤支持非常重要。