Miles Anne, McClements Paula L, Steele Robert J C, Redeker Claudia, Sevdalis Nick, Wardle Jane
Department of Psychological Sciences, Birkbeck, University of London, London, UK.
Information Services Division, NHS National Services Scotland, Edinburgh, UK.
Psychooncology. 2017 Jan;26(1):29-36. doi: 10.1002/pon.4093. Epub 2016 Feb 11.
This study aimed to examine the effect of perceived diagnostic delay on cancer-related distress and determine whether fear of cancer-recurrence and quality of life mediate this relationship.
Cross-sectional study in which 311 colorectal cancer (CRC) survivors in Scotland completed a survey, which included questions on cancer-related distress (IES-R), perceived diagnostic delay, quality of life (trial outcome index of the FACT-C: FACT-C TOI) and fear of cancer recurrence. Fifteen patients withheld consent to data matching with medical records, leaving a sample size of 296. Participants were an average of 69 years old (range 56 to 81) and between 3.5 and 12 years post-diagnosis. Multiple regressions were used to test predictors of distress and regression and bootstrapping to test for mediation.
Perceived diagnostic delay was correlated with higher cancer-related distress, while objective markers of diagnostic delay (disease stage at diagnosis and treatment received) were not. Some of the relationship between perceived diagnostic delay and cancer-related distress was mediated by quality of life, but not by fear of cancer recurrence.
Perceived diagnostic delay was associated with higher cancer-related distress among CRC survivors. While poorer quality of life partly explained such associations, fear of cancer recurrence, stage at diagnosis and treatment did not. The exact features of diagnostic delay that are associated with cancer-related distress remain unclear. Future research should examine the experiences patients go through prior to diagnosis that may increase distress, in an effort to improve our understanding of the factors affecting emotional wellbeing among CRC survivors. Copyright © 2016 John Wiley & Sons, Ltd.
本研究旨在探讨感知到的诊断延迟对癌症相关困扰的影响，并确定对癌症复发的恐惧和生活质量是否介导了这种关系。
一项横断面研究，苏格兰的311名结直肠癌（CRC）幸存者完成了一项调查，其中包括有关癌症相关困扰（IES-R）、感知到的诊断延迟、生活质量（FACT-C试验结果指数：FACT-C TOI）和对癌症复发的恐惧的问题。15名患者拒绝同意将数据与医疗记录匹配，最终样本量为296。参与者平均年龄为69岁（范围56至81岁），诊断后3.5至12年。使用多元回归来测试困扰的预测因素，并使用回归和自抽样法来测试中介作用。
感知到的诊断延迟与较高的癌症相关困扰相关，而诊断延迟的客观指标（诊断时的疾病阶段和接受的治疗）则不然。感知到的诊断延迟与癌症相关困扰之间的部分关系由生活质量介导，但不由对癌症复发的恐惧介导。
在结直肠癌幸存者中，感知到的诊断延迟与较高的癌症相关困扰有关。虽然较差的生活质量部分解释了这种关联，但对癌症复发的恐惧、诊断阶段和治疗并未如此。与癌症相关困扰相关的诊断延迟的确切特征仍不清楚。未来的研究应检查患者在诊断前经历的可能增加困扰的情况，以努力增进我们对影响结直肠癌幸存者情绪健康的因素的理解。版权所有© 2016约翰威立父子有限公司。
