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癌症患者对癌症复发的焦虑和恐惧及其与支持性护理需求和医疗服务利用的关联。

Anxiety and fear of cancer recurrence and its association with supportive care needs and health-care service utilization in cancer patients.

作者信息

Sarkar Susanne, Sautier Leon, Schilling Georgia, Bokemeyer Carsten, Koch Uwe, Mehnert Anja

机构信息

Department and Outpatient Clinic of Medical Psychology, Center of Psychosocial Medicine, Hubertus Wald Tumorzentrum (University Cancer Center Hamburg), University Medical Center Hamburg-Eppendorf, Martinistr.52/W26, 20246, Hamburg, Germany.

Department of Psychiatry and Psychotherapy, University Medical Center Charité Berlin, Berlin, Germany.

出版信息

J Cancer Surviv. 2015 Dec;9(4):567-75. doi: 10.1007/s11764-015-0434-2. Epub 2015 Feb 13.

Abstract

PURPOSE AND METHODS

We investigated the relationship between fear of cancer recurrence (FCR), anxiety, supportive care needs, and utilization of health-care services in a mixed sample of 335 cancer patients. We used validated questionnaires including the Fear of Progression Questionnaire-Short Form (FoP-Q-SF), the General Anxiety Disorder Scale (GAD-7) and the Supportive Care Needs Survey (SCNS-SF34). Health-care services utilization was measured by a self-constructed questionnaire recording the use of 22 health and supportive care offers.

RESULTS

In our sample, 3.9% of patients were classified as having high anxiety and 5.1% had high FCR. Patients reported the highest unmet supportive care needs in the domain health system and information followed by psychological needs. Integrated care and complementary support services were the most frequently used (32%) followed by medical (31%), psychological (23%), spiritual and religious (8%) and other support services (9%). Whereas anxiety was related to both unmet psychological and physical/daily living needs (p < 0.01), FCR was associated with unmet supportive care needs in all five domains further including needs with regard to health system and information, patient care, and sexuality (p < 0.01). However, higher levels of anxiety and FCR were not related to higher utilization of health-care services.

CONCLUSION

Our findings show that FCR plays a significant role in unmet supportive care needs in cancer patients but not for health-care service utilization.

IMPLICATIONS FOR CANCER SURVIVORS

We recommend that clinicians monitor supportive care needs in patients struggling with FCR and anxiety.

摘要

目的与方法

我们在335名癌症患者的混合样本中,研究了癌症复发恐惧(FCR)、焦虑、支持性护理需求以及医疗服务利用之间的关系。我们使用了经过验证的问卷,包括《恐惧进展问卷简表》(FoP-Q-SF)、《广泛性焦虑障碍量表》(GAD-7)和《支持性护理需求调查》(SCNS-SF34)。通过一份自行编制的问卷来衡量医疗服务的利用情况,该问卷记录了22种健康和支持性护理服务的使用情况。

结果

在我们的样本中,3.9%的患者被归类为高度焦虑,5.1%的患者有高度癌症复发恐惧。患者报告在健康系统和信息领域未满足的支持性护理需求最高,其次是心理需求。综合护理和补充支持服务是最常用的(32%),其次是医疗服务(31%)、心理服务(23%)、精神和宗教服务(8%)以及其他支持服务(9%)。焦虑与未满足的心理需求以及身体/日常生活需求均相关(p<0.01),而癌症复发恐惧与所有五个领域未满足的支持性护理需求相关,进一步包括健康系统和信息、患者护理以及性方面的需求(p<0.01)。然而,更高水平的焦虑和癌症复发恐惧与更高的医疗服务利用率无关。

结论

我们的研究结果表明,癌症复发恐惧在癌症患者未满足的支持性护理需求中起重要作用,但与医疗服务利用无关。

对癌症幸存者的启示

我们建议临床医生监测有癌症复发恐惧和焦虑的患者的支持性护理需求。

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