van Stam Marie-Anne, van der Poel Henk G, Bosch J L H Ruud, Tillier Corinne N, Horenblas Simon, Mols Floor, Aaronson Neil K
Urology Department, University Medical Center Utrecht, Utrecht, The Netherlands; Urology Department, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
Urology Department, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
Urol Oncol. 2017 Aug;35(8):531.e1-531.e7. doi: 10.1016/j.urolonc.2017.03.028. Epub 2017 Apr 27.
The purpose of this study was to identify factors associated with mental health (MH) problems in prostate cancer (PC) survivors. Toward this end, we evaluated (1) differences in the prevalence of MH problems between PC survivors and age-matched men from the general population (GenPop) and (2) correlates of MH in PC survivors and the GenPop.
In this observational case-control study, we age-matched PC survivors (n = 644, alive≥5y after diagnosis of a stage I-IV carcinoma) recruited from Dutch community hospitals (Patient Reported Outcomes Following Initial treatment and Long-term Evaluation of Survivorship registry) with GenPop peers (n = 644) selected from a population-based sample recruited in general practices (NIVEL). MH was operationalized using the 5-item Mental Health Inventory of the Short Form Health Survey (SF-36). Potential correlates of MH included sociodemographic characteristics, health-related quality of life scores, and clinical characteristics (PC survivors only). We used analysis of (co)variance and chi-square tests to address the 2 research questions.
We observed clinically relevant MH symptoms in 14% of the PC survivors and 6% of the GenPop controls (P<0.01, odds ratio = 2.45 [1.66-3.62]). The most important correlates of lower MH scores in the PC survivors were being widowed, a lower educational level, lower general health perceptions, more bodily pain and urinary bother, and less sexual satisfaction. The most important correlates of lower MH scores in the GenPop were as follows: lower general health perceptions, more role limitations because of physical problems, and more bodily pain.
Our results indicate that long-term PC survivors have poorer MH, as assessed by the 5-item Mental Health Inventory questionnaire, than men of a comparable age from the GenPop without a history of PC. Attention to potentially modifiable factors associated with MH problems in PC survivors, such as urinary function and its related bother, bodily pain, and sexual satisfaction, may help to prevent or limit MH problems in this survivor population.
本研究旨在确定前列腺癌（PC）幸存者心理健康（MH）问题的相关因素。为此，我们评估了：（1）PC幸存者与年龄匹配的普通人群（GenPop）男性中MH问题患病率的差异；（2）PC幸存者和GenPop人群中MH的相关因素。
在这项观察性病例对照研究中，我们将从荷兰社区医院招募的PC幸存者（n = 644，确诊为I-IV期癌症后存活≥5年）与从普通实践中招募的基于人群样本中选取的GenPop同龄人（n = 644）进行年龄匹配（患者初始治疗后报告结局及长期生存评估登记处）。使用简短健康调查问卷（SF-36）的5项心理健康量表对MH进行量化。MH的潜在相关因素包括社会人口学特征、健康相关生活质量评分和临床特征（仅PC幸存者）。我们使用方差分析和卡方检验来解决这两个研究问题。
我们在14%的PC幸存者和6%的GenPop对照中观察到具有临床意义的MH症状（P<0.01，优势比 = 2.45 [1.66 - 3.62]）。PC幸存者中较低MH评分的最重要相关因素是丧偶、教育水平较低、总体健康认知较差、身体疼痛和泌尿问题较多以及性满意度较低。GenPop中较低MH评分的最重要相关因素如下：总体健康认知较差、因身体问题导致的角色限制较多以及身体疼痛较多。
我们的结果表明，通过5项心理健康量表问卷评估，长期PC幸存者的MH状况比无PC病史的同龄GenPop男性更差。关注PC幸存者中与MH问题相关的潜在可改变因素，如泌尿功能及其相关问题、身体疼痛和性满意度，可能有助于预防或限制该幸存者群体中的MH问题。
