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癌症患者的应对策略和抑郁症状。

Coping strategies and depressive symptoms in cancer patients.

机构信息

Department of Medical Oncology, Hospital Universitario La Paz, Madrid, Spain.

Department of Medical Oncology, Hospital Universitario Central de Asturias, Oviedo, Spain.

出版信息

Clin Transl Oncol. 2020 Mar;22(3):330-336. doi: 10.1007/s12094-019-02123-w. Epub 2019 May 10.

Abstract

INTRODUCTION

Depression in cancer patients is prevalent and negatively impacts their quality of life. Likewise, it correlates with lower overall survival. The aim of this work is to analyze whether different coping strategies, as well as sociodemographic and clinical factors are associated with the presence of depressive symptoms in individuals with a resected, non-metastatic neoplasm about to initiate adjuvant chemotherapy.

METHODS

NEOcoping is a cross-sectional, prospective, observational, multicenter study. Clinical (tumor site and stage, time to diagnosis, risk of recurrence, and type of adjuvant treatment) and sociodemographic characteristics (age, gender, marital status, educational level, occupational sector, and employment status), coping strategies (Mini-MAC scale), and depressive symptoms (BSI scale) were collected. A two-block linear regression model was performed to determine the predictive variables of depressive symptoms.

RESULTS

524 adults with resected, non-metastatic cancer were recruited. Twenty-six percent of patients have clinically significant depressive symptoms. Being female, < 40 years of age, having breast and stomach cancer, and > 50% chance of recurrence were associated with increased risk of depression. Likewise, depression was associated with greater helplessness and anxious preoccupation, and less fighting spirit. Age, gender, and risk of recurrence accounted for only 7% of the variance in depressive symptoms. Including coping strategies in the regression analysis significantly increased the variance explained (48.5%).

CONCLUSION

Early psychological intervention in patients with maladaptive coping strategies may modulate the onset of depressive symptoms, especially in those at higher risk for depression.

摘要

简介

癌症患者中抑郁的发病率较高,对其生活质量产生负面影响。同样,它与整体生存率降低相关。本研究旨在分析在即将开始辅助化疗的、切除的非转移性肿瘤个体中,不同的应对策略以及社会人口学和临床因素是否与抑郁症状的存在相关。

方法

NEOcoping 是一项横断面、前瞻性、观察性、多中心研究。收集了临床(肿瘤部位和分期、诊断时间、复发风险和辅助治疗类型)和社会人口学特征(年龄、性别、婚姻状况、教育程度、职业领域和就业状况)、应对策略(Mini-MAC 量表)和抑郁症状(BSI 量表)。采用两阶段线性回归模型来确定抑郁症状的预测变量。

结果

共招募了 524 名接受过切除的非转移性癌症治疗的成年人。26%的患者存在临床显著的抑郁症状。女性、年龄<40 岁、患有乳腺癌和胃癌、复发风险>50%与抑郁风险增加相关。同样,抑郁与更大的无助感和焦虑性关注以及较少的斗志有关。年龄、性别和复发风险仅解释了抑郁症状的 7%的方差。将应对策略纳入回归分析显著增加了可解释的方差(48.5%)。

结论

对具有适应不良应对策略的患者进行早期心理干预可能会调节抑郁症状的发生,尤其是对那些抑郁风险较高的患者。

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