评估新诊断的非小细胞肺癌患者的心理社会需求:识别与痛苦相关的因素。
Assessing the psychosocial needs of newly diagnosed patients with nonsmall cell lung cancer: Identifying factors associated with distress.
机构信息
Department of Medical Oncology, BC Cancer, Vancouver, British Columbia.
Department of Medicine, University of British Columbia, Vancouver, British Columbia.
出版信息
Psychooncology. 2019 Apr;28(4):815-821. doi: 10.1002/pon.5025. Epub 2019 Feb 27.
OBJECTIVE
The Psychosocial Screen for Cancer (PSSCAN-R) questionnaire is a validated screening tool used to identify the psychosocial needs of patients with cancer. It assesses patients' perceived social supports and psychosocial needs, and the presence of symptoms of depression and anxiety. The study goals were to assess the prevalence and factors associated with distress in patients with newly diagnosed nonsmall cell lung cancer (NSCLC).
METHODS
All patients with NSCLC referred to BC Cancer centers from 2011 to 2015, who completed a prospective PSSCAN-R questionnaire at the time of their first visit, were included in the study. Demographics and baseline disease characteristics were collected retrospectively. The chi-squared test, Fisher exact test, and logistical regression analysis were used to compare factors associated with the presence of distress based on sex, age, stage of disease, and performance status (PS).
RESULTS
A total of 4281 NSCLC patients completed the PSSCAN-R questionnaire. Baseline characteristics: 70% were greater than or equal to 65, 50% female, 52% metastatic disease, 47% Eastern Cooperative Oncology Group (ECOG) greater than or equal to two. Patients who were female, less than 65, have metastatic disease and poor PS were more likely to report subclinical or clinical symptoms of anxiety. Symptoms of depression were associated with younger, female, poor PS patients, and social isolation.
CONCLUSIONS
Newly diagnosed patients with NSCLC are likely to report clinical symptoms of anxiety and depression and have a high number of concerns in multiple psychosocial domains. Resource development for lung cancer patients should be based on their care needs with careful consideration of patients' age, gender, stage, and social situation to optimally support their psychosocial needs during treatment and follow-up.
目的
癌症心理社会筛查问卷(PSSCAN-R)是一种经过验证的筛查工具,用于识别癌症患者的心理社会需求。它评估患者感知的社会支持和心理社会需求,以及抑郁和焦虑症状的存在。研究目的是评估新诊断的非小细胞肺癌(NSCLC)患者的困扰发生率和相关因素。
方法
本研究纳入了 2011 年至 2015 年间在不列颠哥伦比亚癌症中心就诊、首次就诊时完成前瞻性 PSSCAN-R 问卷的所有 NSCLC 患者。回顾性收集患者的人口统计学和基线疾病特征。采用卡方检验、Fisher 确切检验和逻辑回归分析,比较了性别、年龄、疾病分期和体能状态(PS)与困扰存在相关的因素。
结果
共 4281 例 NSCLC 患者完成了 PSSCAN-R 问卷。基线特征:70%患者年龄≥65 岁,50%为女性,52%为转移性疾病,47%东部肿瘤协作组(ECOG)评分≥2。女性、年龄<65 岁、患有转移性疾病和 PS 差的患者更有可能报告亚临床或临床焦虑症状。抑郁症状与年轻、女性、PS 差和社会隔离相关。
结论
新诊断的 NSCLC 患者可能会报告出焦虑和抑郁的临床症状,并且在多个心理社会领域存在大量的担忧。为肺癌患者开发资源时,应根据患者的年龄、性别、分期和社会状况,仔细考虑患者的治疗需求,以优化他们在治疗和随访期间的心理社会需求的支持。