Williams Kate, Jackson Sarah E, Beeken Rebecca J, Steptoe Andrew, Wardle Jane
Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, UK.
Psychobiology Group, Department of Epidemiology and Public Health, University College London, London, UK.
Psychooncology. 2016 Jun;25(6):626-32. doi: 10.1002/pon.3998. Epub 2015 Oct 1.
Little is known about the trajectory of health and well-being from before to after a cancer diagnosis. This study aimed to examine changes in health and well-being across three time points (0-2 years before a cancer diagnosis, 0-2 years post-diagnosis and 2-4 years post-diagnosis) in individuals receiving a new cancer diagnosis, and at matched time points in a cancer-free comparison group.
Data were from waves 1-6 of the English Longitudinal Study of Ageing. Repeated-measures ANOVAs were used to examine differences in self-rated health, mobility impairments, activities of daily living impairments, quality of life, depressive symptoms and life satisfaction by group and time, and group-by-time interactions.
Of the 4565 participants with data from three time points, 444 (9.7%) reported a new cancer diagnosis. Those in the cancer group reported poorer self-rated health (p < .001), quality of life (p < .001) and life satisfaction (p < .01) than participants in the comparison group, and a higher proportion reported depressive symptoms (p < .001) and impairments in mobility (p < .001) and activities of daily living (p < .001). All markers of health and well-being worsened significantly over time. The group-by-time interaction was significant for self-rated health (p < .001), with a greater decline in health over time in the cancer group.
Cancer survivors in this sample had poorer health and well-being than those with no diagnosis, and self-rated health deteriorated more rapidly following a cancer diagnosis. Screening for these factors around the time of a cancer diagnosis could allow for interventions to be targeted effectively and improve the health and well-being of cancer survivors. © 2015 The Authors. Psycho-Oncology published by John Wiley & Sons Ltd.
对于癌症诊断前后健康与幸福状况的轨迹了解甚少。本研究旨在调查新确诊癌症个体在三个时间点(癌症诊断前0 - 2年、诊断后0 - 2年以及诊断后2 - 4年)的健康与幸福状况变化,并与无癌症对照组在相匹配时间点的情况进行比较。
数据来自英国老龄化纵向研究的第1 - 6轮调查。采用重复测量方差分析来检验按组和时间划分的自评健康、行动能力障碍、日常生活活动障碍、生活质量、抑郁症状和生活满意度的差异,以及组与时间的交互作用。
在4565名有三个时间点数据的参与者中,444人(9.7%)报告新确诊癌症。癌症组的参与者自评健康状况(p < 0.001)、生活质量(p < 0.001)和生活满意度(p < 0.01)比对照组差,且报告有抑郁症状(p < 0.001)、行动能力障碍(p < 0.001)和日常生活活动障碍(p < 0.001)的比例更高。所有健康与幸福指标随时间均显著恶化。组与时间的交互作用在自评健康方面显著(p < 0.001),癌症组健康状况随时间下降幅度更大。
本样本中的癌症幸存者健康与幸福状况比未确诊者差,且癌症诊断后自评健康状况恶化更快。在癌症诊断时筛查这些因素可使干预措施更具针对性,从而改善癌症幸存者的健康与幸福状况。© 2015作者。《心理肿瘤学》由约翰·威利父子有限公司出版