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使用患者报告结局问卷来评估近期癌症幸存者的癌症生存问题及心理社会结局。

The use of a patient-reported outcome questionnaire to assess cancer survivorship concerns and psychosocial outcomes among recent survivors.

作者信息

Palmer Steven C, Stricker Carrie T, DeMichele Angela M, Schapira Marilyn, Glanz Karen, Griggs Jennifer J, Jacobs Linda A

机构信息

Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA.

Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.

出版信息

Support Care Cancer. 2017 Aug;25(8):2405-2412. doi: 10.1007/s00520-017-3646-3. Epub 2017 Feb 23.

Abstract

PURPOSE

Survivor distress is well represented in the literature, but less is known about survivors' concerns and how these relate to adaptation. Using a newly designed Survivorship Concern Scale, we examined concerns and their relationship to psychosocial adaptation among recent breast cancer (BC) survivors.

METHODS

One hundred forty-three stage 0-III BC survivors completed an online assessment including the Survivorship Concern Scale (0-3 scale; alpha = 0.91), unmet needs, quality of life (QoL), and anxiety and depressive symptoms within 1 year of end of treatment.

RESULTS

Participants were predominately white (76%), middle-aged (51 years), married (70%), and college educated (79%). Eighty-two percent were stage I or II at diagnosis. Mean degree of survivorship concern was moderate (M = 1.75, SD = 0.70) though variable (range = 0.12-3.00). Survivorship concerns were not significantly related to disease, treatment, or demographic variables except income (p = 0.02). Degree of survivorship concern was significantly associated with all indices of psychosocial adaptation: unmet need (r = 0.50), physical and mental QoL (r = -0.32 and r = -0.32, respectively), depressive symptoms (r = 0.21), and anxiety symptoms (r = 0.51; all p < 0.001). Binary logistic regression suggested that each one-point increase in degree of average concern increased the odds for elevated depressive symptoms by 2.83 (p = 0.03) and increased the odds of elevated anxiety symptoms by 3.69 (p < 0.001).

CONCLUSIONS

Survivorship concerns in the year following treatment are moderate but variable. Concerns are associated with QoL, unmet need, and psychosocial adaptation. Adequately addressing concerns may be a way to improve psychosocial outcomes early in the survivorship trajectory.

摘要

目的

幸存者的痛苦在文献中有充分体现,但对于幸存者的担忧以及这些担忧与适应之间的关系,我们了解得较少。我们使用新设计的幸存者担忧量表,研究了近期乳腺癌(BC)幸存者的担忧及其与心理社会适应的关系。

方法

143名0 - III期乳腺癌幸存者在治疗结束后1年内完成了一项在线评估,包括幸存者担忧量表(0 - 3量表;α = 0.91)、未满足的需求、生活质量(QoL)以及焦虑和抑郁症状。

结果

参与者主要为白人(76%)、中年(51岁)、已婚(70%)且受过大学教育(79%)。82%在诊断时为I期或II期。尽管存在差异(范围 = 0.12 - 3.00),但平均幸存者担忧程度为中等(M = 1.75,SD = 0.70)。除收入外(p = 0.02),幸存者担忧与疾病、治疗或人口统计学变量无显著相关性。幸存者担忧程度与心理社会适应的所有指标均显著相关:未满足的需求(r = 0.50)、身体和心理健康生活质量(分别为r = -0.32和r = -0.32)、抑郁症状(r = 0.21)以及焦虑症状(r = 0.51;所有p < 0.001)。二元逻辑回归表明,平均担忧程度每增加1分,抑郁症状加重的几率增加2.83(p = 0.03),焦虑症状加重的几率增加

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