Nipp Ryan D, El-Jawahri Areej, Fishbein Joel N, Eusebio Justin, Stagl Jamie M, Gallagher Emily R, Park Elyse R, Jackson Vicki A, Pirl William F, Greer Joseph A, Temel Jennifer S
Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital Cancer Center and Harvard Medical School, Boston, Massachusetts.
Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
Cancer. 2016 Jul 1;122(13):2110-6. doi: 10.1002/cncr.30025. Epub 2016 Apr 18.
Patients with incurable cancer face many physical and emotional stressors, yet little is known about their coping strategies or the relationship between their coping strategies, quality of life (QOL), and mood.
As part of a randomized trial of palliative care, this study assessed baseline QOL (Functional Assessment of Cancer Therapy-General), mood (Hospital Anxiety and Depression Scale), and coping (Brief COPE) in patients within 8 weeks of a diagnosis of incurable lung or gastrointestinal cancer and before randomization. To examine associations between coping strategies, QOL, and mood, we used linear regression, adjusting for patients' age, sex, marital status, and cancer type.
There were 350 participants (mean age, 64.9 years), and the majority were male (54.0%), were married (70.0%), and had lung cancer (54.6%). Most reported high utilization of emotional support coping (77.0%), whereas fewer reported high utilization of acceptance (44.8%), self-blame (37.9%), and denial (28.2%). Emotional support (QOL: β = 2.65, P < .01; depression: β = -0.56, P = .02) and acceptance (QOL: β = 1.55, P < .01; depression: β = -0.37, P = .01; anxiety: β = -0.34, P = .02) correlated with better QOL and mood. Denial (QOL: β = -1.97, P < .01; depression: β = 0.36, P = .01; anxiety: β = 0.61, P < .01) and self-blame (QOL: β = -2.31, P < .01; depression: β = 0.58, P < .01; anxiety: β = 0.66, P < .01) correlated with worse QOL and mood.
Patients with newly diagnosed, incurable cancer use a variety of coping strategies. The use of emotional support and acceptance coping strategies correlated with better QOL and mood, whereas the use of denial and self-blame negatively correlated with these outcomes. Interventions to improve patients' QOL and mood should seek to cultivate the use of adaptive coping strategies. Cancer 2016;122:2110-6. © 2016 American Cancer Society.
患有无法治愈癌症的患者面临许多身体和情感上的压力源，但对于他们的应对策略，以及这些应对策略、生活质量（QOL）和情绪之间的关系却知之甚少。
作为姑息治疗随机试验的一部分，本研究在诊断为无法治愈的肺癌或胃肠道癌的患者随机分组前8周内，评估了他们的基线生活质量（癌症治疗功能评估通用版）、情绪（医院焦虑抑郁量表）和应对方式（简易应对方式问卷）。为了研究应对策略、生活质量和情绪之间的关联，我们使用线性回归，并对患者的年龄、性别、婚姻状况和癌症类型进行了校正。
共有350名参与者（平均年龄64.9岁），大多数为男性（54.0%），已婚（70.0%），患有肺癌（54.6%）。大多数人报告高度使用情感支持应对方式（77.0%），而较少人报告高度使用接受（44.8%）、自责（37.9%）和否认（28.2%）。情感支持（生活质量：β = 2.65，P <.01；抑郁：β = -0.56，P =.02）和接受（生活质量：β = 1.55，P <.01；抑郁：β = -0.37，P =.01；焦虑：β = -0.34，P =.02）与更好的生活质量和情绪相关。否认（生活质量：β = -1.97，P <.01；抑郁：β = 0.36，P =.01；焦虑：β = 0.61，P <.01）和自责（生活质量：β = -2.31，P <.01；抑郁：β = 0.58，P <.01；焦虑：β = 0.66，P <.01）与较差的生活质量和情绪相关。
新诊断为无法治愈癌症的患者使用多种应对策略。情感支持和接受应对策略的使用与更好的生活质量和情绪相关，而否认和自责的使用与这些结果呈负相关。改善患者生活质量和情绪的干预措施应致力于培养适应性应对策略的使用。《癌症》2016年；122：2110 - 6。©2016美国癌症协会。
