Dalton Jo A, Higgins Melinda K, Miller Andrew H, Keefe Francis J, Khuri Fadlo R
*Nell Hodgson Woodruff School of Nursing Departments of †Psychiatry §Hematology and Medical Oncology, School of Medicine, Winship Cancer Institute, Emory University, Atlanta, GA ‡Department of Psychiatry, Division of Behavioral Medicine, Duke University Medical Center, Durham, NC.
Am J Clin Oncol. 2015 Oct;38(5):457-64. doi: 10.1097/COC.0b013e3182a79009.
To explore biopsychosocial factors (beliefs, depression, catastrophizing cytokines) in individuals newly diagnosed with lung cancer and no pain to determine their relationship at diagnosis and across time and to determine whether these factors contribute to pain intensity or pain interference with function at pain onset.
A longitudinal, exploratory, pilot study was implemented in a private medical center and a VA medical center in the southeast. Twelve subjects not experiencing pain related to cancer of the lung or its treatment were recruited. A Karnofsky status of 40% and hemoglobin of 8 g were required. Five questionnaires were completed and 10 mL of blood was drawn at baseline; 4 questionnaires and blood draws were repeated monthly for 5 months. One baseline questionnaire and a pain assessment were added at final. Demographic, clinical, and questionnaire data were summarized; standardized scale scores were calculated.
Biopsychosocial scores that were low at baseline increased from T1-T4 but decreased slightly T5-T6. Individuals with higher pain intensity and higher pain interference at final had higher psychosocial scores at baseline than individuals with lower pain intensity and lower pain interference at final.
Unrelated to disease stage, metastasis, or treatment, unique levels of biopsychosocial factors are observed in patients newly diagnosed with lung cancer who report higher levels of pain intensity and higher levels of pain interference at the time pain occurs. Replication studies are needed to validate this response pattern and determine the value of repeated individual assessments.
探讨新诊断为肺癌且无疼痛的个体的生物心理社会因素（信念、抑郁、灾难化思维、细胞因子），以确定它们在诊断时及随时间的关系，并确定这些因素是否会导致疼痛发作时的疼痛强度或功能受限。
在东南部的一家私立医疗中心和一家退伍军人医疗中心开展了一项纵向、探索性的试点研究。招募了12名未经历与肺癌或其治疗相关疼痛的受试者。要求卡氏评分40%且血红蛋白8g。在基线时完成5份问卷并抽取10mL血液；在5个月内每月重复进行4次问卷填写和血液抽取。最后增加一份基线问卷和一次疼痛评估。总结人口统计学、临床和问卷数据；计算标准化量表得分。
基线时较低的生物心理社会得分从T1到T4升高，但在T5到T6时略有下降。与最终疼痛强度较低和功能受限较低的个体相比，最终疼痛强度较高和功能受限较高的个体在基线时具有较高的心理社会得分。
与疾病分期、转移或治疗无关，在新诊断为肺癌且疼痛发作时报告较高疼痛强度和较高功能受限水平的患者中观察到独特水平的生物心理社会因素。需要进行重复研究以验证这种反应模式并确定重复个体评估的价值。
