Thorsteinsdottir Thordis, Valdimarsdottir Heiddis, Hauksdottir Arna, Stranne Johan, Wilderäng Ulrica, Haglind Eva, Steineck Gunnar
Division of Clinical Cancer Epidemiology, Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
Faculty of Nursing, School of Health Sciences, University of Iceland, Reykjavík, Iceland.
Psychooncology. 2017 Nov;26(11):1749-1757. doi: 10.1002/pon.4359. Epub 2017 Feb 10.
Negative intrusive thoughts about one's prostate cancer have been associated with depressive mood and impaired quality of life among prostate cancer patients. However, little is known about possible predictors for negative intrusive thoughts among this group. We aimed to identify health- and care-related predictors for such thoughts among a population of men newly diagnosed with prostate cancer and undergoing radical prostatectomy.
In the LAPPRO-trial, 3154 men (80%) answered study-specific questionnaires at admission and 3 months after surgery. Questions concerned socio-demographics, health, uncertainty, preparedness for symptoms, and the outcome-negative intrusive thoughts. Associations between variables were analyzed by log-binominal and multivariable approach.
The strongest predictor of negative intrusive thoughts at admission to surgery was uncertainty of cure, followed by binge drinking, poor physical health, antidepressant medication, not being prepared for urinary symptoms, age under 55, and physical pain. Reporting it not probable to obtain urinary symptoms after surgery lowered the odds. Negative intrusive thoughts before surgery were the strongest predictor for such thoughts 3 months later followed by uncertainty of cure, physical pain, younger age, living alone, and poor self-reported physical health.
Our findings showed an association of preoperative uncertainty of cure as well as low preparedness for well-known surgery-induced symptoms with higher occurrence of negative intrusive thoughts about prostate cancer. Future studies should examine if interventions designed to have healthcare professionals inform patients about their upcoming prostatectomy reduce patients' negative intrusive thoughts and thereby, improve their psychological well-being.
前列腺癌患者脑海中出现的消极侵入性想法与抑郁情绪及生活质量受损有关。然而，对于该群体中消极侵入性想法的可能预测因素知之甚少。我们旨在确定新诊断为前列腺癌并接受根治性前列腺切除术的男性群体中与健康和护理相关的此类想法的预测因素。
在LAPPRO试验中，3154名男性（80%）在入院时和术后3个月回答了特定研究问卷。问题涉及社会人口统计学、健康状况、不确定性、症状准备情况以及结果——消极侵入性想法。通过对数二项式和多变量方法分析变量之间的关联。
手术入院时消极侵入性想法的最强预测因素是治愈的不确定性，其次是酗酒、身体健康状况差、服用抗抑郁药物、对泌尿症状未做好准备、年龄在55岁以下以及身体疼痛。报告术后不太可能出现泌尿症状可降低几率。术前的消极侵入性想法是3个月后此类想法的最强预测因素，其次是治愈的不确定性、身体疼痛、年龄较小、独居以及自我报告的身体健康状况差。
我们的研究结果表明，术前治愈的不确定性以及对手术引起的常见症状准备不足与前列腺癌消极侵入性想法的较高发生率相关。未来的研究应探讨旨在让医疗保健专业人员告知患者即将进行的前列腺切除术的干预措施是否能减少患者的消极侵入性想法，从而改善他们的心理健康。
