Asen M J, Dietz A, Meister E F, Hinz A, Meyer A
Abteilung für Medizinische Psychologie und Medizische Soziologie, Universitätsklinikum Leipzig AöR, Leipzig.
Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Plastische Operationen, Universität Leipzig, Leipzig.
Laryngorhinootologie. 2015 Oct;94(10):681-9. doi: 10.1055/s-0034-1398521. Epub 2015 Apr 22.
Fear of recurrence (FoR) is a common problem in cancer patients. However, it is quite unknown in which extent patients who underwent a PL have FoR. This pilot study examines the extent of FoR and coping strategies in cancer patients after PL as well as associations between FoR and medical, treatment-related, psychosocial and demographic parameters.
In a multicentre cross-sectional study, data was taken from 154 cancer patients after PL. Data was collected in personal interviews and with standardised questionnaires (e. g., PA-F; HADS; EORTC H&N-C35).
The study participants had a low level of FoR (MW=6.67; SD=2.43) and a high level of coping strategies (MW=3.24; SD=0.83). FoR was higher in young patients (r=-0.265; p=0.002) and in users of medical rehabilitation programs (U=1 480; p=0.025). Patients who thought smoking (r=0.197; p=0.029) or/and inner conflicts (r=0.177; p=0.050) was/were the reason(s) for their cancer and who reported more swallowing problems, had a significantly higher level of FoR (r=0.496; p<0.001). There was a negative correlation between the extent of FoR and time passing by since the last surgery of the larynx (r=- 0.322; p<0.001).
Frequently occurring swallowing problems as well as internal causal attributions for the development of cancer as smoking increase the level of FoR. Since internal causal attributions may cause feelings of guilt, psycho-oncological treatment can be indicated for patients with higher levels of FoR. Furthermore, younger individuals and patients with more swallowing problems need more attention by physicians and therapists.
对复发的恐惧（FoR）是癌症患者中常见的问题。然而，对于接受过喉部分切除术（PL）的患者，其恐惧复发的程度尚不清楚。这项初步研究旨在调查接受喉部分切除术后癌症患者的恐惧复发程度、应对策略，以及恐惧复发与医学、治疗相关、心理社会和人口统计学参数之间的关联。
在一项多中心横断面研究中，收集了154例接受喉部分切除术后癌症患者的数据。数据通过个人访谈和标准化问卷（如PA-F；HADS；EORTC H&N-C35）收集。
研究参与者的恐惧复发水平较低（中位数=6.67；标准差=2.43），应对策略水平较高（中位数=3.24；标准差=0.83）。年轻患者的恐惧复发程度更高（r=-0.265；p=0.002），以及使用医疗康复项目的患者也是如此（U=1480；p=0.025）。认为吸烟（r=0.197；p=0.029）或/和内心冲突（r=0.177；p=0.050）是其患癌原因，且报告有更多吞咽问题的患者，恐惧复发程度显著更高（r=0.496；p<0.001）。恐惧复发程度与自上次喉部手术以来的时间呈负相关（r=-0.322；p<0.001）。
频繁出现的吞咽问题以及将吸烟等癌症发生的内在原因归咎于自身，会增加恐惧复发的程度。由于内在原因归因可能会导致内疚感，对于恐惧复发程度较高的患者，可考虑进行心理肿瘤学治疗。此外，年轻个体和有更多吞咽问题的患者需要医生和治疗师给予更多关注。
