Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1414, Houston, TX, 77030, USA.
Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Support Care Cancer. 2019 Jan;27(1):139-145. doi: 10.1007/s00520-018-4298-7. Epub 2018 Jun 9.
The literature suggests that psychological distress and quality of life are interdependent in couples coping with cancer. The current study seeks to extend these findings to physical symptom burden, examining differences in symptom self-rating and perception of partner symptoms.
Couples were approached while waiting for an integrative oncology service. Fifty patients and their partners completed the Edmonton Symptom Assessment Scale (ESAS-FS; twelve symptoms, scores 0-10, 10 worst possible) and a Global Health measure (PROMIS10). Patient and partner each also completed the ESAS-FS as it related to their perception of the other's symptoms. ESAS distress subscales analyzed included Global (GDS), Psychosocial (PSS), and Physical (PHS). Analyses included paired t tests to examine all measures.
Fifty-eight percent of patients were female with most common cancer diagnoses of breast (22%), gastrointestinal (16%), and thoracic/H&N (16%). For ESAS-FS self-ratings, patients had significantly higher physical distress than partners, with a no significant difference in psychosocial distress. For PROMIS10 self-ratings, patients reported significantly lower global health and physical health, (p's < 0.001); no differences were found for mental health between patients and caregivers. Patient rating of partner physical distress (PHS, p = 0.01) was significantly higher than partner self-rating, with no significant difference observed in ratings for psychosocial distress. Partner rating of patient psychosocial distress (PSS, p < 0.001) and physical distress (PHS, p = 0.001) was significantly higher than that of patient self-rating.
Our findings suggest that both patients and partners perceive physical distress of the other higher than self; however, patients may be more sensitive to psychosocial distress in their partners.
文献表明，在应对癌症的夫妇中，心理困扰和生活质量是相互依存的。本研究旨在将这些发现扩展到身体症状负担，检查症状自评和对伴侣症状感知的差异。
在等待综合肿瘤服务时，对夫妇进行了接触。五十名患者及其伴侣完成了埃德蒙顿症状评估量表（ESAS-FS；十二项症状，评分 0-10，10 分为最严重）和 PROMIS10 全球健康量表。患者和伴侣还各自完成了与他们对对方症状的感知相关的 ESAS-FS。分析了 ESAS 困扰子量表，包括总体（GDS）、心理社会（PSS）和身体（PHS）。分析包括配对 t 检验以检查所有指标。
58%的患者为女性，最常见的癌症诊断为乳腺癌（22%）、胃肠道癌（16%）和胸部/H&N 癌（16%）。对于 ESAS-FS 自评，患者的身体困扰明显高于伴侣，而心理困扰无显著差异。对于 PROMIS10 自评，患者报告的总体健康和身体健康明显较低（p<0.001）；患者和照顾者的心理健康无差异。患者对伴侣身体困扰（PHS，p=0.01）的评分明显高于自我评分，而对心理困扰的评分无显著差异。伴侣对患者心理社会困扰（PSS，p<0.001）和身体困扰（PHS，p=0.001）的评分明显高于患者自评。
我们的研究结果表明，患者和伴侣都认为对方的身体困扰高于自身，但患者可能对伴侣的心理社会困扰更为敏感。
