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黑色素瘤幸存者的心理社会护理需求:这些需求得到满足了吗?

Psychosocial Care Needs of Melanoma Survivors: Are They Being Met?

作者信息

Fischbeck Sabine, Imruck Barbara H, Blettner Maria, Weyer Veronika, Binder Harald, Zeissig Sylke R, Emrich Katharina, Friedrich-Mai Peter, Beutel Manfred E

机构信息

Department of Psychosomatic Medicine and Psychotherapy, Medical Psychology and Medical Sociology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.

Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.

出版信息

PLoS One. 2015 Aug 21;10(8):e0132754. doi: 10.1371/journal.pone.0132754. eCollection 2015.

Abstract

Patients who have survived malignant melanoma for more than five years may lack the opportunity to talk about their burden. As a consequence their psychosocial care needs remain undetected and available supportive interventions may not be utilised. Therefore, the psychosocial burden of this patient group needs to be assessed using specific screening instruments. The aim of this study was to investigate the psychosocial burden of long-term melanoma survivors, their psychosocial care needs and the determinants of these needs. We wanted to find out if the use of professional support corresponds to the care needs defined by experts. Using the cancer registry of Rhineland-Palatinate, melanoma patients diagnosed at least 5 years before the survey were contacted by physicians. N = 689 former patients completed the Hornheide Questionnaire (short form HQ-S) to identify psychosocial support need (scale cut off ≥ 16 or item-based cut-off score) and the potential psychosocial determinants of these needs. Additionally, they were asked about their utilisation of the professional support system. More than one third (36%) of them was in need for professional psychosocial support. The highest burden scores concerned worry about tumour progression. Younger age (< 50), higher general fatigue, higher symptom burden, lower general health, negative social interactions and unfulfilled information needs were significant predictors of the need for psychosocial intervention. Related to the percentage of survivors identified as 'in need', the professional support system was underused. Further studies should investigate whether using the HQ-S to routinely identify burdened melanoma patients could lead to better fulfilment of their intervention needs, ultimately enhancing health-related quality of life.

摘要

恶性黑色素瘤存活超过五年的患者可能没有机会谈论他们的负担。因此,他们的心理社会护理需求仍未被发现,可用的支持性干预措施可能未被利用。所以,需要使用特定的筛查工具来评估这一患者群体的心理社会负担。本研究的目的是调查长期黑色素瘤幸存者的心理社会负担、他们的心理社会护理需求以及这些需求的决定因素。我们想了解专业支持的使用是否与专家定义的护理需求相符。通过莱茵兰-普法尔茨州的癌症登记处,医生联系了在调查前至少5年被诊断为黑色素瘤的患者。N = 689名 former patients completed the Hornheide Questionnaire (short form HQ-S) to identify psychosocial support need (scale cut off ≥ 16 or item-based cut-off score) and the potential psychosocial determinants of these needs. Additionally, they were asked about their utilisation of the professional support system. 超过三分之一(36%)的患者需要专业的心理社会支持。最高的负担得分与对肿瘤进展的担忧有关。年龄较小(<50岁)、总体疲劳程度较高、症状负担较重、总体健康状况较差、负面的社会互动以及未满足的信息需求是心理社会干预需求的显著预测因素。与被确定为“有需求”的幸存者比例相关,专业支持系统未得到充分利用。进一步的研究应调查使用HQ-S常规识别有负担的黑色素瘤患者是否能更好地满足他们的干预需求,最终提高与健康相关的生活质量。 (注:原文中“former patients”表述有误,应是“既往患者”,且最后一句“N = 689名 former patients completed...”表述混乱,但按照要求未做修改)

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