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乳腺癌女性的焦虑与抑郁:社会和临床决定因素以及社会网络与社会支持的影响(DAMA队列研究)

Anxiety and depression in women with breast cancer: Social and clinical determinants and influence of the social network and social support (DAMA cohort).

作者信息

Puigpinós-Riera R, Graells-Sans A, Serral G, Continente X, Bargalló X, Domènech M, Espinosa-Bravo M, Grau J, Macià F, Manzanera R, Pla M, Quintana M J, Sala M, Vidal E

机构信息

Agència de Salut Pública de Barcelona (ASPB), Barcelona, Catalonia; CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Institut de Recerca Biomèdica Sant Pau (IIB St. Pau), Barcelona, Catalonia.

Agència de Salut Pública de Barcelona (ASPB), Barcelona, Catalonia; Campus Docent Sant Joan de Déu-Fundació Privada, Barcelona, Catalonia; Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra (UPF), (Experimental and Health Sciences Department, Pompeu Fabra University), Barcelona, Catalonia.

出版信息

Cancer Epidemiol. 2018 Aug;55:123-129. doi: 10.1016/j.canep.2018.06.002. Epub 2018 Jun 22.

Abstract

BACKGROUND

Anxiety and depression are the most prevalent mental health pathologies among women with breast cancer. Social, clinical and contextual variables may influence emotional stress among women with breast cancer. The aim of this work is to study anxiety and depression in a cohort of women diagnosed with breast cancer between 2003 and 2013 in Barcelona. We evaluate social and clinical determinants.

METHODS

We performed a mixed cohort study (prospective and retrospective) using a convenience sample of women diagnosed with breast cancer. The information sources were the Hospital Anxiety and Depression questionnaire and hospital medical records. Dependent variables were anxiety and depression; independent variables were social class, age, employment status, tumour stage at diagnosis, time since diagnosis, social network and social support. We performed a descriptive analysis, a bivariate analysis, and a multivariate logistic regression analysis.

RESULTS

A total of 1086 (48.6%) women had some degree of anxiety-related problem. As for depression. In the case of depression, 225 (15%) women had some degree of depression-related problem. Low emotional support and social isolation were clear risk factors for having more anxiety and depression. Low social class was also a risk factor, and age also played a role.

DISCUSSION

Our results show that women long period of cancer survival have high prevalences of anxiety than depression, and this prevalence of anxiety is higher than the general population. In addition, we found inequalities between social classes and the isolation and social support are worse too in low social class.

摘要

背景

焦虑和抑郁是乳腺癌女性中最常见的心理健康问题。社会、临床和环境变量可能会影响乳腺癌女性的情绪压力。这项研究的目的是调查2003年至2013年在巴塞罗那被诊断为乳腺癌的女性队列中的焦虑和抑郁情况。我们评估社会和临床决定因素。

方法

我们采用便利抽样法,对被诊断为乳腺癌的女性进行了一项混合队列研究(前瞻性和回顾性)。信息来源为医院焦虑和抑郁问卷以及医院病历。因变量为焦虑和抑郁;自变量为社会阶层、年龄、就业状况、诊断时的肿瘤分期、确诊后的时间、社交网络和社会支持。我们进行了描述性分析、双变量分析和多变量逻辑回归分析。

结果

共有1086名(48.6%)女性存在某种程度的焦虑相关问题。至于抑郁,有225名(15%)女性存在某种程度的抑郁相关问题。情感支持不足和社交孤立是导致更多焦虑和抑郁的明显风险因素。低社会阶层也是一个风险因素,年龄也起到了一定作用。

讨论

我们的研究结果表明,癌症长期存活的女性中焦虑的患病率高于抑郁,且这种焦虑患病率高于一般人群。此外,我们发现社会阶层之间存在不平等,低社会阶层的孤立和社会支持情况也更差。

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