参加遗传性乳腺癌和卵巢癌患者小组教育课程的女性的焦虑和抑郁症状
Anxiety and depression symptoms among women attending group-based patient education courses for hereditary breast and ovarian cancer.
作者信息
Listøl Wenche, Høberg-Vetti Hildegunn, Eide Geir Egil, Bjorvatn Cathrine
机构信息
Western Norway Familial Cancer Center, Haukeland University Hospital, Bergen, Norway ; Center for Medical Genetics and Molecular Medicine, Haukeland University Hospital, Bergen, Norway.
Centre of Clinical Research, Haukeland University Hospital, Bergen, Norway ; Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
出版信息
Hered Cancer Clin Pract. 2017 Jan 11;15:2. doi: 10.1186/s13053-016-0062-5. eCollection 2017.
BACKGROUND
Women carrying -mutations are facing significant challenges, including decision making regarding surveillance and risk-reducing surgery. They often report that they are left alone with these important decisions. In order to enhance the genetic counselling session we organized a group-based patient education (GPE) course for women with -mutations. The study aims were to characterize women attending a group-based patient education (GPE) course for hereditary breast and ovarian cancer, consider the usefulness of the course, evaluate symptoms of anxiety and depression among the participants, and finally investigate whether their levels of anxiety and depression changed from before to after the course session.
METHODS
A prospective study was conducted. Two weeks before (T1) and 2 weeks after (T2) attending the GPE-course the participants received questionnaires by mail. We collected information on demographic- and medical variables, anxiety and depression using Hospital Anxiety and Depression Scale (HADS), self-efficacy using The Bergen Genetic Counseling Self-Efficacy scale (BGCSES) and coping style using the Threatening Medical Situations Inventory (TMSI). A total of = 100 (77% response rate) women participated at baseline and 75 (58% response rate) also completed post-course assessment.
RESULTS
The mean level of anxiety symptoms was elevated among participants but decreased significantly during follow-up. Lower anxiety symptom levels were associated with "longer time since disclosure of gene test result", "higher levels of self-efficacy" and having experienced "loss of a close relative due to breast or ovarian cancer". Lower depression symptom levels were associated with "higher levels of education" and "loss of a close relative due to breast or ovarian cancer".
CONCLUSION
The women in this study seemed to benefit from the GPE course. Women newly diagnosed with a mutation who reported lower levels of self-efficacy and lower levels of education were more vulnerable. These women need special attention.
背景
携带BRCA1/2突变的女性面临着重大挑战，包括关于监测和降低风险手术的决策。她们经常表示在做出这些重要决策时感到孤立无援。为了加强遗传咨询环节，我们为携带BRCA1/2突变的女性组织了一次基于小组的患者教育（GPE）课程。本研究的目的是描述参加遗传性乳腺癌和卵巢癌基于小组的患者教育（GPE）课程的女性特征，考量该课程的实用性，评估参与者的焦虑和抑郁症状，最后调查她们的焦虑和抑郁水平在课程前后是否发生变化。
方法
进行了一项前瞻性研究。在参加GPE课程前两周（T1）和课程结束后两周（T2），参与者通过邮件收到问卷。我们收集了关于人口统计学和医学变量、使用医院焦虑和抑郁量表（HADS）评估的焦虑和抑郁、使用卑尔根遗传咨询自我效能量表（BGCSES）评估的自我效能以及使用威胁性医疗情境量表（TMSI）评估的应对方式的信息。共有100名女性（回复率77%）在基线时参与，75名（回复率58%）也完成了课程后评估。
结果
参与者的焦虑症状平均水平较高，但在随访期间显著下降。较低的焦虑症状水平与“基因检测结果披露后时间较长”、“较高的自我效能水平”以及经历过“因乳腺癌或卵巢癌失去近亲”有关。较低的抑郁症状水平与“较高的教育水平”和“因乳腺癌或卵巢癌失去近亲”有关。
结论
本研究中的女性似乎从GPE课程中受益。新诊断出携带BRCA1/2突变且自我效能水平较低和教育水平较低的女性更易受影响。这些女性需要特别关注。
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