Husson Olga, Zebrack Bradley J, Aguilar Christine, Hayes-Lattin Brandon, Cole Steve
Department of Medical Psychology, Radboud University Medical Center, Nijmegen, the Netherlands.
University of Michigan School of Social Work, Ann Arbor, Michigan.
Cancer. 2017 Jul 15;123(14):2743-2751. doi: 10.1002/cncr.30656. Epub 2017 Mar 20.
The objective of the current study was to examine social functioning among adolescents and young adults (AYAs) within the first 2 years after a cancer diagnosis and compare their scores with population norms and identify trajectories of social functioning over time and its correlates.
A multicenter, longitudinal study was conducted among 215 AYA patients with cancer aged 14 to 39 years. A total of 141 patients completed a self-report measure of social functioning within the first 4 months of diagnosis and again at 12 months and 24 months later.
AYA patients with cancer were found to have significantly worse social functioning scores around the time of diagnosis (52.0 vs 85.1; P<.001), at the 12-month follow-up (73.1 vs 85.1; P<.001), and at the 24-month follow-up (69.2 vs 85.1; P<.001) when compared with population norms. Significant improvements in social functioning from baseline to the 12-month follow-up were observed; however, social functioning levels remained stable thereafter. Among participants, 9% demonstrated consistently high/normal social functioning, 47% demonstrated improved social functioning, 13% were found to have worsening social functioning, and 32% demonstrated consistently low social functioning. AYA patients with cancer who had consistently low social functioning were more often off treatment at the time of follow-up, reported more physical symptoms and higher levels of distress at baseline and follow-up, and perceived less social support at baseline compared with the other 3 groups.
Although improved over time, social functioning still was found to be compromised 24 months after the primary diagnosis. Nearly one-third of these patients remain at risk of poor social functioning. Reducing physical symptoms and psychological distress and enhancing social support by interventions during the period after treatment may potentially help these young survivors to better reintegrate into society. Cancer 2017;123:2743-51. © 2017 American Cancer Society.
本研究的目的是调查癌症诊断后前两年青少年及青年成人（AYA）的社会功能，将他们的得分与总体标准进行比较，并确定社会功能随时间的变化轨迹及其相关因素。
对215名年龄在14至39岁的AYA癌症患者进行了一项多中心纵向研究。共有141名患者在诊断后的前4个月内完成了一份社会功能自评量表，并在12个月和24个月后再次进行了测评。
与总体标准相比，发现AYA癌症患者在诊断时（52.0对85.1；P<0.001）、12个月随访时（73.1对85.1；P<0.001）和24个月随访时（69.2对85.1；P<0.001）的社会功能得分明显更差。从基线到12个月随访期间，观察到社会功能有显著改善；然而，此后社会功能水平保持稳定。在参与者中，9%表现出持续较高/正常的社会功能，47%表现出社会功能改善，13%被发现社会功能恶化，32%表现出持续较低的社会功能。与其他三组相比，社会功能持续较低的AYA癌症患者在随访时更常停止治疗，在基线和随访时报告更多的身体症状和更高水平的痛苦，并且在基线时感知到的社会支持更少。
尽管随着时间推移有所改善，但在初次诊断24个月后，社会功能仍被发现受到损害。这些患者中近三分之一仍面临社会功能不佳的风险。在治疗后的时期通过干预措施减轻身体症状和心理痛苦并增强社会支持，可能有助于这些年轻幸存者更好地重新融入社会。《癌症》2017年；123:2743 - 51。©2017美国癌症协会。
