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胰腺癌患者及其照料者的焦虑、抑郁与生活质量

Anxiety, depression and quality of life in people with pancreatic cancer and their carers.

作者信息

Janda Monika, Neale Rachel E, Klein Kerenaftali, O'Connell Dianne L, Gooden Helen, Goldstein David, Merrett Neil D, Wyld David K, Rowlands Ingrid J, Beesley Vanessa L

机构信息

Institute for Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia.

Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia.

出版信息

Pancreatology. 2017 Mar-Apr;17(2):321-327. doi: 10.1016/j.pan.2017.01.008. Epub 2017 Jan 20.

Abstract

BACKGROUND

People with pancreatic cancer have high levels of anxiety and depression and reduced quality of life (QoL), but few studies have assessed these outcomes for patient-carer dyads. We therefore investigated these issues in an Australian population-based study.

METHODS

Patients with pancreatic cancer (n = 136) and many of their carers (n = 84) completed the Hospital Anxiety and Depression Scale (HADS) and Functional Assessment of Cancer Therapy QoL questionnaire at a median of three months after diagnosis. Overall QoL and well-being subscales (physical, social, emotional, functional) were compared with general population norms. Intraclass correlation coefficients were used to compare anxiety, depression and QoL scores of patients and their respective carers.

RESULTS

Fifteen percent of patients and 39% of carers had HADS scores indicative of anxiety and 15% of patients and 14% of carers of depression, respectively. Overall, 70% of patients and 58% of carers had QoL scores below the Queensland population average. Patients' anxiety, depression, overall QoL, social, emotional and functional wellbeing scores were significantly related to those scores in their carers. Among patients and carers, accessing psychological help was associated with elevated anxiety. Not receiving chemotherapy was associated with elevated depression among patients and younger age was associated with poorer outcomes in carers.

CONCLUSIONS

More carers had symptoms of anxiety than patients with pancreatic cancer, but symptoms of depression were similarly common in patients and carers. Further research is needed to assess whether interventions to reduce patients' distress could also improve QoL among carers, or whether carer-focussed interventions are required.

摘要

背景

胰腺癌患者焦虑和抑郁水平较高,生活质量(QoL)下降,但很少有研究评估患者 - 照顾者二元组的这些结果。因此,我们在一项基于澳大利亚人群的研究中调查了这些问题。

方法

胰腺癌患者(n = 136)及其许多照顾者(n = 84)在诊断后中位三个月时完成了医院焦虑抑郁量表(HADS)和癌症治疗生活质量功能评估问卷。将总体生活质量和幸福子量表(身体、社会、情感、功能)与一般人群规范进行比较。使用组内相关系数比较患者及其各自照顾者的焦虑、抑郁和生活质量得分。

结果

分别有15%的患者和39%的照顾者HADS得分表明有焦虑,15%的患者和14%的照顾者有抑郁。总体而言,70%的患者和58%的照顾者生活质量得分低于昆士兰人群平均水平。患者的焦虑、抑郁、总体生活质量、社会、情感和功能幸福得分与他们照顾者的得分显著相关。在患者和照顾者中,获得心理帮助与焦虑升高有关。未接受化疗与患者抑郁升高有关,年龄较小与照顾者预后较差有关。

结论

与胰腺癌患者相比,更多的照顾者有焦虑症状,但抑郁症状在患者和照顾者中同样常见。需要进一步研究以评估减轻患者痛苦的干预措施是否也能改善照顾者的生活质量,或者是否需要以照顾者为重点的干预措施。

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