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乳腺癌患者的癌症相关认知障碍:心理变量的影响

Cancer-Related Cognitive Impairment in Breast Cancer Patients: Influences of Psychological Variables.

作者信息

Yang Yesol, Hendrix Cristina C

机构信息

Division of Health Systems and Analytics, School of Nursing, Duke University, Geriatric Research, Education and Clinical Center, Durham Veterans Affairs Medical Center, Durham, NC, USA.

出版信息

Asia Pac J Oncol Nurs. 2018 Jul-Sep;5(3):296-306. doi: 10.4103/apjon.apjon_16_18.

Abstract

Approximately 3.1 million women in the US are living with breast cancer and up to 75% of these women experience cancer-related cognitive impairment (CRCI). CRCI is described as impairments in memory, verbal fluency, thought processes, and attention span. Despite the high prevalence of breast cancer, only a few studies have been published on CRCI and most of these studies primarily focused on its pathophysiological mechanism. However, recent evidence has demonstrated that breast cancer patients with CRCI are more likely to have high level of psychologic distress, suggesting a possible relationship between CRCI and psychologic distress. This review aims to examine existing literature that describes CRCI in relation to psychological distress among breast cancer patients. One thousand four hundred and ninety-eight articles were searched using PubMed, CINAHL, and PsycINFO. Thirteen studies met inclusion criteria, and one article was additionally pulled from article reference lists. Of these19 studies, psychologic distress has been operationalized in varied ways such as anxiety ( = 3), depression ( = 2), both anxiety and depression ( = 4), stress ( = 4), worry ( = 2), mental fatigue ( = 1), and undefined psychological distress ( = 2). Except for six studies designed as a longitudinal study, the rest of studies used a cross-sectional design. Twelve studies used both subjective and objective measures to assess cognitive function. We found that the patients with high psychological distress displayed lower performance on cognitive function tests. Our finding indicates that psychological variables contributed to CRCI that breast cancer patients experienced. Areas for further investigation are proposed that will advance the care of breast cancer patients with CRCI.

摘要

美国约有310万女性患有乳腺癌,其中高达75%的女性经历过癌症相关的认知障碍(CRCI)。CRCI被描述为记忆、语言流畅性、思维过程和注意力广度方面的障碍。尽管乳腺癌的患病率很高,但关于CRCI的研究却很少,而且这些研究大多主要集中在其病理生理机制上。然而,最近的证据表明,患有CRCI的乳腺癌患者更有可能出现高度的心理困扰,这表明CRCI与心理困扰之间可能存在关联。本综述旨在研究现有文献中描述的乳腺癌患者CRCI与心理困扰之间的关系。通过PubMed、CINAHL和PsycINFO检索到1498篇文章。13项研究符合纳入标准,另外从文章参考文献列表中选取了1篇文章。在这19项研究中,心理困扰的定义方式各不相同,如焦虑(3项)、抑郁(2项)、焦虑和抑郁(4项)、压力(4项)、担忧(2项)、精神疲劳(1项)以及未明确的心理困扰(2项)。除了6项设计为纵向研究的研究外,其余研究均采用横断面设计。12项研究使用主观和客观测量方法来评估认知功能。我们发现,心理困扰程度高的患者在认知功能测试中的表现较差。我们的研究结果表明,心理变量导致了乳腺癌患者经历的CRCI。本文还提出了有待进一步研究的领域,以推进对患有CRCI的乳腺癌患者的护理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6132/5996591/3e87512a1d95/APJON-5-296-g002.jpg

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