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黑色素瘤患者对心理肿瘤学支持的需求:患者自我评估的核心作用。

The need for psycho-oncological support for melanoma patients: Central role of patients' self-evaluation.

作者信息

Mayer Simone, Teufel Martin, Schaeffeler Norbert, Keim Ulrike, Garbe Claus, Eigentler Thomas Kurt, Zipfel Stephan, Forschner Andrea

机构信息

Department of Psychosomatic Medicine and Psychotherapy, University Hospital, Tuebingen Department of Psychosomatic Medicine and Psychotherapy, LVR-University-Hospital, University Duisburg-Essen, Essen Department of Dermatology, University Hospital, Tuebingen, Germany.

出版信息

Medicine (Baltimore). 2017 Sep;96(37):e7987. doi: 10.1097/MD.0000000000007987.

Abstract

Despite an increasing number of promising treatment options, only a limited number of studies concerning melanoma patients' psycho-oncological distress have been carried out. However, multiple screening tools are in use to assess the need for psycho-oncological support. This study aimed first to identify parameters in melanoma patients that are associated with a higher risk for being psycho-oncologically distressed and second to compare patients' self-evaluation concerning the need for psycho-oncological support with the results of established screening tools.We performed a cross-sectional study including 254 melanoma patients from the Center for Dermatooncology at the University of Tuebingen. The study was performed between June 2010 and February 2013. Several screening instruments were included: the Distress Thermometer (DT), Hospital Anxiety and Depression Scale and the patients' subjective evaluation concerning psycho-oncological support. Binary logistic regression was performed to identify factors that indicate the need for psycho-oncological support.Patients' subjective evaluation concerning the need for psycho-oncological support, female gender, and psychotherapeutic or psychiatric treatment at present or in the past had the highest impact on values above threshold in the DT. The odds ratio of patients' self-evaluation (9.89) was even higher than somatic factors like female gender (1.85), duration of illness (0.99), or increasing age (0.97). Patients' self-evaluation concerning the need for psycho-oncological support indicated a moderate correlation with the results of the screening tools included.In addition to the results obtained by screening tools like the DT, we could demonstrate that patients' self-evaluation is an important instrument to identify patients who need psycho-oncological support.

摘要

尽管有越来越多有前景的治疗选择,但针对黑色素瘤患者心理肿瘤困扰的研究却为数不多。然而,目前有多种筛查工具用于评估心理肿瘤支持的需求。本研究旨在:第一,确定黑色素瘤患者中与心理肿瘤困扰高风险相关的参数;第二,将患者对心理肿瘤支持需求的自我评估与既定筛查工具的结果进行比较。我们进行了一项横断面研究,纳入了来自图宾根大学皮肤肿瘤中心的254名黑色素瘤患者。研究于2010年6月至2013年2月期间进行。纳入了几种筛查工具:苦恼温度计(DT)、医院焦虑抑郁量表以及患者对心理肿瘤支持的主观评估。采用二元逻辑回归来确定表明需要心理肿瘤支持的因素。患者对心理肿瘤支持需求的主观评估、女性性别以及目前或过去接受过心理治疗或精神科治疗,对DT中高于阈值的值影响最大。患者自我评估的优势比(9.89)甚至高于女性性别(1.85)、病程(0.99)或年龄增长(0.97)等躯体因素。患者对心理肿瘤支持需求的自我评估与所纳入筛查工具的结果呈中度相关。除了像DT这样的筛查工具所获得的结果外,我们还可以证明患者的自我评估是识别需要心理肿瘤支持患者的重要工具。

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