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拉丁裔乳腺癌幸存者的抑郁症状:癌症筛查的障碍。

Depressive symptoms in Latina breast cancer survivors: a barrier to cancer screening.

机构信息

Institute of Health Promotion Research.

出版信息

Health Psychol. 2014 Mar;33(3):242-8. doi: 10.1037/a0032685. Epub 2013 Jun 3.

Abstract

OBJECTIVE

Depressed mood limits vigilance, risk avoidance or risk reduction. This may reflect inability to follow health care provider recommendations for screening for other cancers. We determined prevalence of depressive symptoms and its role in screening for other cancers in Latina breast cancer survivors.

METHOD

A convenience sample of 117 Latina breast cancer survivors completed a questionnaire including the Center for Epidemiologic Studies Depression scale (CES-D) and substantive barriers to following health care provider recommendations. A threshold score of 16 or greater on the CESD was considered elevated symptoms in the past week. Chi-square and T tests were used to evaluate bivariate associations and multiple logistic regression to identify barriers to compliance with recommendations regarding ovarian and colorectal screening.

RESULTS

The results showed 31.6% had CESD scores above the threshold, about three times the general population. Cancer screening rates were very low with only five women (4.2%) screened for both ovarian and colorectal cancer. Elevated symptoms were present in 38% of those without colorectal cancer screening and 42% of those without ovarian cancer screening. It is inversely related to screening for colorectal (aOR = 0.44, p = .04), ovarian (aOR = 0.44, p = .09), or either screening (aOR = 0.38, p = .035).

CONCLUSIONS

Depressive symptom rates are higher among breast cancer survivors than the general population; rates of screening for other cancers are low. This indicates general failure to comply with recommendations for screening for other cancers among breast cancer survivors. Depressive symptoms may be a barrier to screening. Affective components of survivorship must be addressed in order to make interventions more effective.

摘要

目的

抑郁情绪会限制警觉性、风险规避或降低风险。这可能反映出患者无法遵循医疗服务提供者关于筛查其他癌症的建议。我们确定了抑郁症状的患病率及其在拉丁裔乳腺癌幸存者其他癌症筛查中的作用。

方法

采用方便抽样法,对 117 名拉丁裔乳腺癌幸存者进行问卷调查,问卷内容包括流行病学研究中心抑郁量表(CES-D)和遵循医疗服务提供者建议的实质性障碍。CES-D 量表得分超过 16 分被认为是过去一周内出现了升高的抑郁症状。卡方检验和 T 检验用于评估二变量关联,多因素逻辑回归用于识别遵守卵巢和结直肠癌筛查建议的障碍。

结果

结果显示,有 31.6%的患者 CES-D 评分超过了阈值,是一般人群的三倍左右。癌症筛查率非常低,只有 5 名女性(4.2%)接受了卵巢和结直肠癌的筛查。未进行结直肠癌筛查的患者中,有 38%出现了升高的症状,未进行卵巢癌筛查的患者中,有 42%出现了升高的症状。它与结直肠癌(aOR=0.44,p=0.04)、卵巢癌(aOR=0.44,p=0.09)或两者的筛查(aOR=0.38,p=0.035)呈负相关。

结论

乳腺癌幸存者的抑郁症状发生率高于一般人群;其他癌症的筛查率较低。这表明乳腺癌幸存者普遍未能遵循筛查其他癌症的建议。抑郁症状可能是筛查的障碍。为了使干预措施更加有效,必须解决生存者的情感成分问题。

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