Dominick Sally A, Natarajan Loki, Pierce John P, Madanat Hala, Madlensky Lisa
Moores UCSD Cancer Center, University of California, San Diego, La Jolla, CA, USA.
Psychooncology. 2014 Sep;23(9):1049-56. doi: 10.1002/pon.3510. Epub 2014 Feb 26.
Lymphedema is a distressing and chronic condition affecting up to 30% of breast cancer survivors. Using a cross-sectional study design, we examined the impact of self-reported lymphedema-related distress on psychosocial functioning among breast cancer survivors in the Women's Healthy Eating and Living Study. The Women's Healthy Eating and Living Study has a dataset that includes self-report data on lymphedema status, symptoms, and distress.
Chi-square tests and binary logistic regression models were used to examine how specific participant characteristics, including lymphedema-related distress, were associated with physical health and mental health as measured by the SF-36-Item Health Survey and depressive symptoms assessed by the Center for Epidemiologic Studies Depression Scale screening form.
Of the 2431 participants included in the current study population, 692 (28.5%) self-reported ever having lymphedema. A total of 335 (48.9%) women reported moderate to extreme distress as a result of their lymphedema and were classified as having lymphedema-related distress. The logistic regression models showed that women with lymphedema-related distress had 50% higher odds of reporting poor physical health (p = 0.01) and 73% higher odds of having poor mental health (p < 0.01) when compared with women without lymphedema. In contrast, even though lymphedema-related distress was significantly associated (p = 0.03) with elevated depressive symptoms in the bivariate analyses, it was not significant in the logistic regression models.
Breast cancer survivors with lymphedema-related distress had worse physical health and mental health outcomes than women with lymphedema who were not distressed and women with no lymphedema. Our findings provide further evidence of the relationship between lymphedema and psychosocial outcomes in breast cancer survivors.
淋巴水肿是一种令人痛苦的慢性疾病，影响着高达30%的乳腺癌幸存者。我们采用横断面研究设计，在女性健康饮食与生活研究中，考察了自我报告的淋巴水肿相关困扰对乳腺癌幸存者心理社会功能的影响。女性健康饮食与生活研究有一个数据集，其中包括关于淋巴水肿状态、症状和困扰的自我报告数据。
采用卡方检验和二元逻辑回归模型，以考察特定参与者特征（包括淋巴水肿相关困扰）与通过SF-36健康调查量表测量的身体健康和心理健康以及通过流行病学研究中心抑郁量表筛查表评估的抑郁症状之间的关联。
在本研究纳入的2431名参与者中，692人（28.5%）自我报告曾患淋巴水肿。共有335名（48.9%）女性报告因淋巴水肿而有中度至重度困扰，并被归类为有淋巴水肿相关困扰。逻辑回归模型显示，与没有淋巴水肿的女性相比，有淋巴水肿相关困扰的女性报告身体健康不佳的几率高50%（p = 0.01），心理健康不佳的几率高73%（p < 0.01）。相比之下，尽管在双变量分析中淋巴水肿相关困扰与抑郁症状升高显著相关（p = 0.03），但在逻辑回归模型中并不显著。
与没有困扰的淋巴水肿女性和没有淋巴水肿的女性相比，有淋巴水肿相关困扰的乳腺癌幸存者的身体健康和心理健康状况更差。我们的研究结果为淋巴水肿与乳腺癌幸存者心理社会结局之间的关系提供了进一步证据。
