Menzies School of Health Research, Charles Darwin University, 147 Wharf St Spring Hill, Brisbane, QLD, 4000, Australia.
School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Ave, Kelvin Grove, Brisbane, QLD, 4059, Australia.
Support Care Cancer. 2018 Jun;26(6):1737-1746. doi: 10.1007/s00520-017-3995-y. Epub 2017 Dec 14.
The purpose of this study is to identify the level of and factors associated with distress in 155 Indigenous Australian cancer survivors approximately 6 months post-diagnosis.
The distress thermometer (DT) was used to assess clinically significant distress (defined as having a DT score ≥ 4). Logistic regression was used to identify sociodemographic and clinical factors associated with clinically significant distress.
The mean distress score was 2.7 (SD 2.9), with about one in three Indigenous cancer survivors reporting clinically significant distress (35%; n = 54). After adjusting for age and sex, clinically significant distress was more likely among those who were separated/divorced/widowed than those who were married (odds ratio (OR) = 2.99, 95% confidence intervals (95% CI) 1.21-7.35, p = 0.017) and less likely among those residing in remote areas than those in major cities (OR = 0.23, 95% CI 0.08-0.71, p = 0.001) and in those receiving non-surgical treatment only compared with surgery only (OR = 0.24, 95% CI 0.08-0.68, p = 0.008).
Despite increased screening for distress in cancer care, this is, to our knowledge, the first published assessment of distress among Indigenous Australian cancer survivors. The characteristics of Indigenous cancer survivors associated with greater likelihood of clinically significant distress indicate at-risk subgroups who would benefit from screening and early intervention. Further research is required to identify the specific aetiologies of distress. Our findings indicate a need to identify psychological distress and for survivorship care to include culturally sensitive and tailored psychological support for Indigenous cancer survivors.
本研究旨在确定 155 名澳大利亚原住民癌症幸存者在诊断后约 6 个月时的痛苦水平及其相关因素。
使用痛苦温度计（DT）评估临床显著痛苦（定义为 DT 得分≥4）。使用逻辑回归来确定与临床显著痛苦相关的社会人口统计学和临床因素。
平均痛苦评分 2.7（标准差 2.9），约三分之一的澳大利亚原住民癌症幸存者报告有临床显著痛苦（35%；n=54）。在调整年龄和性别后，与已婚者相比，离异/丧偶者更有可能出现临床显著痛苦（优势比（OR）=2.99，95%置信区间（95%CI）1.21-7.35，p=0.017），与居住在偏远地区者相比，居住在主要城市者更有可能出现临床显著痛苦（OR=0.23，95%CI 0.08-0.71，p=0.001），与仅接受非手术治疗者相比，仅接受手术治疗者更有可能出现临床显著痛苦（OR=0.24，95%CI 0.08-0.68，p=0.008）。
尽管在癌症护理中增加了对痛苦的筛查，但这是我们所知的第一个对澳大利亚原住民癌症幸存者进行的痛苦评估。与临床显著痛苦更相关的澳大利亚原住民癌症幸存者的特征表明存在处于风险中的亚组，他们需要进行筛查和早期干预。需要进一步研究以确定痛苦的具体病因。我们的研究结果表明，需要识别心理痛苦，并为癌症幸存者提供有文化敏感性和针对性的心理支持。
