Department of Gynecology and Obstetrics, University Hospital of Schleswig-Holstein, Campus Luebeck, 23538, Lübeck, Germany.
Department of Cardiac Surgery, University Innsbruck, 6020, Innsbruck, Austria.
Arch Gynecol Obstet. 2019 Oct;300(4):993-1005. doi: 10.1007/s00404-019-05253-2. Epub 2019 Jul 23.
The aim of the present study was to determine the levels of anxiety of partners of breast cancer patients and to evaluate the differences of anxiety levels between patients and partners according to the stage of treatment, age and education level.
57 spouses or domestic partners of breast cancer patients and 148 breast cancer patients participated in this prospective cohort study and filled out the questionnaires including the Spielberger state-trait-anxiety-inventory, as well as questions based on stress-triggering procedures during breast cancer diagnosis and therapy.
State anxiety levels of partners were highest in partners who accompanied their patients when presenting for examinations and operations and tumorboard decisions (Mean State-Scores 52, 45 and 46.5). Anxiety scores were lowest at the stage of ongoing chemotherapy or follow-up. The 25% quartile of partners with the highest state anxiety levels had a significantly higher educational level (p = 0.023). Young men aged 18-35 years showed the highest levels of both trait and state anxiety. Partners showed significantly higher levels of anxiety than the patients for anesthetic complications (p < 0.001), e.g., fear of not waking up from general anesthetic and postoperative pain (p < 0.001). Patients showed significantly higher levels of anxiety for hairloss (p < 0.001), weight gain during chemotherapy (p < 0.001) and postoperative scars (p = 0.027).
Breast cancer patients are much more concerned about body image issues than their male partners. As these body image-associated concerns often arise from the fear of loosing attraction to their partner, these fears might be reduced by speaking about them openly. Partners are mostly concerned about surgery and anesthetic-related complications. Therefore, preoperative medical information to the partner is mandatory. Partners of breast cancer patients should be included in psycho-oncological support and medical briefings. Probably high anxiety levels of both partners and patients should be taken into account (due to younger age, lower educational level and procedures causing distress). These partners and patients should receive extra careful (clarification) counselling and (treatment support such as a psycho-oncologist) involvement of a psyco-oncologist.
本研究旨在确定乳腺癌患者伴侣的焦虑水平，并根据治疗阶段、年龄和教育水平评估患者和伴侣的焦虑水平差异。
57 名乳腺癌患者的配偶或伴侣以及 148 名乳腺癌患者参加了这项前瞻性队列研究，并填写了包括 Spielberger 状态-特质焦虑量表在内的问卷，以及基于乳腺癌诊断和治疗期间应激触发程序的问题。
当伴侣陪同患者进行检查、手术和肿瘤委员会决策时，伴侣的状态焦虑水平最高（平均状态得分分别为 52、45 和 46.5）。在接受化疗或随访阶段，焦虑评分最低。状态焦虑水平最高的 25%四分位数的伴侣具有更高的教育水平（p=0.023）。18-35 岁的年轻男性表现出最高的特质和状态焦虑水平。与患者相比，伴侣对麻醉并发症的焦虑程度显著更高（p<0.001），例如，担心无法从全身麻醉中醒来和术后疼痛（p<0.001）。患者对脱发（p<0.001）、化疗期间体重增加（p<0.001）和术后疤痕（p=0.027）的焦虑程度显著更高。
乳腺癌患者比男性伴侣更关心自身形象问题。由于这些与身体形象相关的担忧通常源于担心失去对伴侣的吸引力，因此通过公开谈论这些问题可以减轻这些担忧。伴侣主要关注手术和麻醉相关的并发症。因此，必须向伴侣提供术前医疗信息。应将乳腺癌患者的伴侣纳入心理肿瘤学支持和医疗简报中。可能需要考虑到伴侣和患者的高焦虑水平（由于年龄较小、教育水平较低以及引起困扰的程序）。这些伴侣和患者应接受特别仔细的（澄清）咨询和（治疗支持，如心理肿瘤学家）心理肿瘤学家的参与。
