Risberg Terje, Kolstad Arne, Cassileth Barrie R
a From the University Hospital of Tromso, Norway (T. Risberg, A. Kolstad) and the Memorial SloanKettering Cancer Center, Integrative Medicine Centre, New York, USA (B.R. Cassileth).
Acta Oncol. 2002;41(7-8):646-651. doi: 10.1080/028418602321028265.
The purpose of this study was to investigate the relationship between the use of alternative medicine (AM) by cancer patients' and the level of self-perceived mental distress. One hundred and fifty-seven cancer patients were included in a longitudinal questionnaire-based study 12 months after their first contact with the Department of Oncology, University Hospital of Tromsø, during the period 1990 to 1991. Eligible patients received follow-up questionnaires after 24 and 60 months recording their use of AM and measuring their perceived mental distress (GHQ-20). A total of 64 (41%) of the 157 patients who completed at least one questionnaire reported using AM one or more times during follow-up (ever-use). Between 65% and 79% of patients who were eligible at each point of the study completed the GHQ questionnaire. After 60 months of follow-up, 104 patients were still alive and 54 patients (52% of the survivors) had completed all the questionnaires. At inclusion in the study, significantly more AM users reported mental distress (57%) than non-users (20%) (p=0.001). After 24 and 60 months, the corresponding figures were 42% versus 29% (p=0.18), and 30% versus 10% (p=0.02), respectively. When adjusted for sex, age and disease progression, use of AM was found to be an independent factor highly associated with mental distress at 12 months (OR=5.5, 95% CI 2.1-14.4). Later in the study, progression/relapse of cancer proved to be a more important predictor of mental distress. These findings suggest that, in North Norway, seeking alternative treatment is more common among mentally distressed cancer patients.
本研究的目的是调查癌症患者使用替代医学(AM)与自我感知的心理困扰程度之间的关系。1990年至1991年期间,157名癌症患者在首次与特罗姆瑟大学医院肿瘤科接触12个月后,被纳入一项基于问卷的纵向研究。符合条件的患者在24个月和60个月后收到后续问卷,记录他们使用替代医学的情况,并测量他们感知到的心理困扰(一般健康问卷-20项,GHQ-20)。在完成至少一份问卷的157名患者中,共有64名(41%)报告在随访期间使用过一次或多次替代医学(曾经使用)。在研究的每个时间点符合条件的患者中,65%至79%完成了GHQ问卷。随访60个月后,104名患者仍然存活,54名患者(占幸存者的52%)完成了所有问卷。在纳入研究时,报告有心理困扰的替代医学使用者(57%)明显多于非使用者(20%)(p=0.001)。24个月和60个月后,相应的数字分别为42%对29%(p=0.18)和30%对10%(p=0.02)。在对性别、年龄和疾病进展进行调整后,发现使用替代医学是与12个月时的心理困扰高度相关的独立因素(比值比=5.5,95%置信区间2.1-14.4)。在研究后期,癌症的进展/复发被证明是心理困扰更重要的预测因素。这些发现表明,在挪威北部,寻求替代治疗在心理困扰的癌症患者中更为常见。