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对癌症症状的了解和焦虑会影响不同癌症部位患者寻求诊断的延迟情况。

Knowledge of cancer symptoms and anxiety affect patient delay in seeking diagnosis in patients with heterogeneous cancer locations.

作者信息

Chojnacka-Szawłowska Gabriela, Majkowicz Mikołaj, Basiński Krzysztof, Zdun-Ryżewska Agata, Wasilewko Iwona, Pankiewicz Piotr

机构信息

Psychology Department, University of Finance and Management, Warsaw, Poland.

Department of Quality of Life Research, Medical University of Gdansk, Gdañsk, Poland; Public Health Department, Pomeranian University in Słupsk, Słupsk, Poland.

出版信息

Curr Probl Cancer. 2017 Jan-Feb;41(1):64-70. doi: 10.1016/j.currproblcancer.2016.10.001. Epub 2016 Oct 31.

Abstract

PURPOSE

This research was aimed at identifying factors that predict patient delay in treatment initiation in patients with suspected cancer disease. We sought to determine the differences between delaying and nondelaying patients with reference to their knowledge of cancer symptoms, sociodemographic variables, and the levels of state anxiety and trait anxiety.

METHODS

The study involved 301 randomly selected patients with suspected cancer disease before their first oncology appointment at a regional oncology center in Poland. Data were collected by means of a semistructured interview conducted by a trained psychologist. To evaluate the knowledge of cancer symptoms, the symptoms mentioned by subjects were compared to the list of symptoms from cancer awareness measure. Anxiety levels were assessed using the State-Trait Anxiety Inventory.

RESULTS

In the course of logistic regression analysis a model was developed, in which knowledge of cancer symptoms and state anxiety allowed to predict patient delay. Knowledge of every additional cancer symptom decreased the chance of patient delay by 16.4% point [95% CI: 1.4-29.2]. An increase in state anxiety for every point of the scale decreased the chance of delay by 2.5% points [95% CI: 0.2-4.6]. Trait anxiety and the studied sociodemographic variables proved to be nonsignificant predictors of patient delay.

CONCLUSIONS

Knowledge of cancer symptoms and the level of state anxiety allowed to predict patient delay in the initiation of treatment. Owing to the heterogeneity of the tumor locations within the sample, the obtained model can be used in large scale prevention programs designed for the whole population.

摘要

目的

本研究旨在确定预测疑似癌症患者治疗开始延迟的因素。我们试图参照患者对癌症症状的了解、社会人口统计学变量以及状态焦虑和特质焦虑水平,来确定延迟治疗和未延迟治疗的患者之间的差异。

方法

该研究纳入了波兰一家地区肿瘤中心301名在首次肿瘤门诊就诊前随机选取的疑似癌症患者。数据通过由一名经过培训的心理学家进行的半结构化访谈收集。为评估对癌症症状的了解,将受试者提到的症状与癌症认知测量中的症状列表进行比较。使用状态-特质焦虑量表评估焦虑水平。

结果

在逻辑回归分析过程中建立了一个模型,其中对癌症症状的了解和状态焦虑能够预测患者延迟。每多了解一种癌症症状,患者延迟的几率降低16.4个百分点[95%置信区间:1.4 - 29.2]。状态焦虑量表每增加一分,延迟的几率降低2.5个百分点[95%置信区间:0.2 - 4.6]。特质焦虑和所研究的社会人口统计学变量被证明不是患者延迟的显著预测因素。

结论

对癌症症状的了解和状态焦虑水平能够预测患者治疗开始的延迟。由于样本中肿瘤位置的异质性,所获得的模型可用于为整个人口设计的大规模预防项目。

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