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乳腺癌检测方式对压力和痛苦的影响。

The effect of mode of detection of breast cancer on stress and distress.

作者信息

Gibbons Andrea, Groarke AnnMarie, Curtis Ruth, Groarke Jenny

机构信息

Health Psychology Research Unit, Royal Holloway, University of London, Egham, Surrey, UK.

School of Psychology, National University of Ireland, Galway, Ireland.

出版信息

Psychooncology. 2017 Jun;26(6):787-792. doi: 10.1002/pon.4227. Epub 2016 Aug 12.

Abstract

OBJECTIVE

The number of women with screen-detected breast cancer is increasing, but it is not clear if these women experience the same levels of distress as women with symptomatic breast cancer. The current study compared stress and distress in women with screen-detected or symptomatic breast cancer at diagnosis and 12 months post-diagnosis.

METHODS

Ninety-two women with screen-detected breast cancer and 129 women with symptomatic breast cancer completed measures of perceived stress, anxiety, and depression at diagnosis and 12 months post-diagnosis. Women also completed a measure of cancer-related stress 12 months post-diagnosis.

RESULTS

Both groups reported similar levels of perceived stress, anxiety, and depression at diagnosis. A third of women in both groups reported clinical levels of anxiety at diagnosis, which decreased over time. There were no differences in depression. Analyses revealed that at 12 months post-diagnosis, the symptomatic group reported a significant reduction in anxiety, but the screen-detected group reported a nonsignificant trend for a reduction over time. The screen-detected group reported significantly higher cancer-related stress at 12 months than the symptomatic group.

CONCLUSIONS

Screen-detected women report similar distress at diagnosis but may be more at risk for greater distress requiring further psychological support 1 year after diagnosis. Future interventions that focus on preparation for screening may help to reduce ongoing levels of anxiety and cancer-related stress for this group.

摘要

目的

通过筛查发现患有乳腺癌的女性数量正在增加,但尚不清楚这些女性所经历的痛苦程度是否与有症状的乳腺癌女性相同。本研究比较了通过筛查发现或有症状的乳腺癌女性在确诊时及确诊后12个月的压力和痛苦程度。

方法

92名通过筛查发现患有乳腺癌的女性和129名有症状的乳腺癌女性在确诊时及确诊后12个月完成了感知压力、焦虑和抑郁的测量。女性在确诊后12个月还完成了一项癌症相关压力的测量。

结果

两组在确诊时报告的感知压力、焦虑和抑郁水平相似。两组中三分之一的女性在确诊时报告有临床水平的焦虑,且随着时间推移有所下降。抑郁方面没有差异。分析显示,在确诊后12个月,有症状组报告焦虑显著减轻,但筛查发现组报告随时间有不显著的减轻趋势。筛查发现组在12个月时报告的癌症相关压力显著高于有症状组。

结论

通过筛查发现的女性在确诊时报告有相似的痛苦,但在确诊后1年可能面临更大痛苦的风险,需要进一步的心理支持。未来侧重于筛查准备的干预措施可能有助于降低该群体持续的焦虑水平和癌症相关压力。

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