Levkovich Inbar, Cohen Miri, Pollack Shimon, Drumea Karen, Fried Georgeta
Department of Gerontology,Faculty of Social Welfare and Health Sciences,University of Haifa,Haifa,Israel.
Department of Gerontology and School of Social Work,Faculty of Social Welfare and Health Sciences,University of Haifa,Haifa,Israel.
Palliat Support Care. 2015 Oct;13(5):1141-51. doi: 10.1017/S147895151400087X. Epub 2014 Sep 9.
Symptoms of depression and cancer-related fatigue (CRF) are common among breast cancer patients postchemotherapy and may seriously impair quality of life (QoL). This study aimed to assess the relationship between depression and CRF in breast cancer patients postchemotherapy and to examine their relationships to optimism and to threat and challenge appraisals.
Participants included 95 breast cancer patients (stages 1-3) 1 to 6 months after completion of chemotherapy. Patients submitted personal and medical details and completed the following: physical symptom questionnaires (EORTC QLQ-C30, and QLQ-BR23), a symptoms of depression questionnaire (CES-D), the Fatigue Symptom Inventory (FSI), the Life Orientation Test (LOT-R), and a stress appraisals questionnaire.
We found levels of depression, CRF, and appraisals of cancer as a threat to bemoderate and levels of optimism and appraisals of cancer as a challenge to be high. Depression and CRF were positively associated. A multivariate regression analysis revealed that 51% of the CRF variancewas explained; physical symptoms and threat appraisal were significantly associated with CRF. A 67% of the CRF variance of depression was explained; challenge and threat appraisals were significantly associated with depression [corrected].
Although CRF and depression were often experienced simultaneously and both were found to be higher among individuals who gave higher appraisals of cancer as a threat, only depression was related to optimism and challenge appraisals, while CRF was related mainly to intensity of physical symptoms. The different pattern of associations between optimism and appraisals warrants further clinical attention as well as future study.
抑郁症状和癌症相关疲劳（CRF）在乳腺癌化疗后患者中很常见，可能严重损害生活质量（QoL）。本研究旨在评估乳腺癌化疗后患者抑郁与CRF之间的关系，并检验它们与乐观主义以及威胁和挑战评估之间的关系。
参与者包括95例完成化疗1至6个月后的乳腺癌患者（1 - 3期）。患者提交个人和医疗细节并完成以下内容：身体症状问卷（欧洲癌症研究与治疗组织核心问卷QLQ - C30和乳腺癌特异性问卷QLQ - BR23）、抑郁症状问卷（流调中心用抑郁量表CES - D）、疲劳症状量表（FSI）、生活取向测试（LOT - R）以及压力评估问卷。
我们发现抑郁水平、CRF水平以及将癌症视为威胁的评估为中等程度，而乐观主义水平以及将癌症视为挑战的评估为高水平。抑郁与CRF呈正相关。多元回归分析显示，51%的CRF变异得到了解释；身体症状和威胁评估与CRF显著相关。抑郁的CRF变异的67%得到了解释；挑战和威胁评估与抑郁显著相关[校正后]。
尽管CRF和抑郁常常同时出现，且在将癌症评估为威胁程度较高的个体中两者都更高，但只有抑郁与乐观主义和挑战评估相关，而CRF主要与身体症状的强度相关。乐观主义与评估之间不同的关联模式值得进一步的临床关注以及未来研究。
