Feldstain Andrea, Lebel Sophie, Chasen Martin R
Department of Psychosocial and Rehabilitation Oncology, Tom Baker Cancer Centre, 2202 2nd st. SW, Calgary, AB, T2S 3C1, Canada.
School of Psychology, Faculty of Social Sciences, University of Ottawa, 136 Jean-Jacques Lussier, Vanier Hall Ottawa, Ottawa, ON, K1N 6N5, Canada.
Qual Life Res. 2017 Jul;26(7):1809-1818. doi: 10.1007/s11136-017-1531-7. Epub 2017 Feb 24.
Patients with advanced cancer have increased life expectancy but suffer from ongoing burden. Depressive symptomatology is their most common mental health concern. The Ottawa Palliative Rehabilitation Program (PRP) offers rehabilitation for this population. It offers 8 weeks of individualized interdisciplinary rehabilitation, post cancer treatment. Interventions include medical (physician and nurse), physiotherapy, occupational therapy, dietary, and social work using a general self-efficacy framework. Pilot data suggest benefits in a range of domains, including ratings of feeling "depressed." We examined whether reduced symptomatology was maintained 3 months after PRP completion.
Participants with advanced heterogeneous cancers who completed the PRP were mailed the Hospital Anxiety and Depression Scale (among others) 3-month post-PRP (n = 44). Demographic and medical information were obtained from patient files.
There was a significant linear trend (mean T1: 6.79 ± 2.29; T2: 5.23 ± 3.06; T3: 4.59 ± 3.34; p = 0.007) with statistically and clinically significant decreases in reported depressive symptomatology between T1 and T2 (p = 0.042) and T1 and T3 (p = 0.007). There was a significant decreases in number of cases reporting symptomatology scores in the clinical range from T1 to T3 (p = 0.038).
Patients who undergo a palliative rehabilitation program may experience relief of mild depressive symptomatology, maintainable 3-month post-PRP. The sample was exhibiting mild symptomatology and these results may not be generalizable to those with higher scores; a lack of specialized psychosocial clinician may have affected the acquired sample. Experimental designs are needed to more thoroughly compare these findings to independent rehabilitation interventions.
晚期癌症患者预期寿命延长，但仍承受持续负担。抑郁症状是他们最常见的心理健康问题。渥太华姑息康复项目（PRP）为这一人群提供康复服务。它提供为期8周的个体化多学科康复服务，在癌症治疗后进行。干预措施包括医疗（医生和护士）、物理治疗、职业治疗、饮食和社会工作，采用一般自我效能框架。试点数据表明，该项目在一系列领域都有好处，包括对“抑郁”感觉的评分。我们研究了PRP结束3个月后，症状减轻的情况是否得以维持。
向完成PRP的晚期异质性癌症患者在PRP结束3个月后邮寄医院焦虑抑郁量表（以及其他量表）（n = 44）。从患者档案中获取人口统计学和医疗信息。
存在显著的线性趋势（平均T1：6.79±2.29；T2：5.23±3.06；T3：4.59±3.34；p = 0.007），在T1和T2之间（p = 0.042）以及T1和T3之间（p = 0.007），报告的抑郁症状在统计学和临床上均有显著下降。从T1到T3，报告症状评分处于临床范围的病例数显著减少（p = 0.038）。
接受姑息康复项目的患者可能会缓解轻度抑郁症状，且在PRP结束3个月后仍可维持。样本表现出轻度症状，这些结果可能不适用于得分较高的患者；缺乏专业的心理社会临床医生可能影响了所获取的样本。需要进行实验设计，以便更全面地将这些发现与独立的康复干预措施进行比较。
