Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University, Halle, Germany.
BMC Cancer. 2019 Aug 27;19(1):836. doi: 10.1186/s12885-019-6007-4.
Depression is a common co-morbid, disabling disorder that affects 10-25% of cancer patients. It causes substantial functional impairment and lowers survival rate of breast cancer patients. Therefore, the aim of this study is to determine the magnitude of depression and its association with social support among breast cancer patients in Addis Ababa, Ethiopia.
A cross-sectional study which included 428 breast cancer patients was conducted in seven health facilities in Addis Ababa, Ethiopia. Depression and Social Support were assessed using standard tools Patient Health Questionnaire 9 (PHQ 9) and Multidimensional Scale of Perceived Social Support (MSPSS) respectively. Descriptive statistics were done based on the standard PHQ9 cut off points (0-4, 5-9, 10-14, 15-19 and ≥ 20). Mann-Whitney and Kruskal Wallis tests were employed to compare MSPSS score among depressed and non-depressed patients and across the different levels of depression. Bivariate and multivariate logistic regression was done to identify factors associated with depression.
The prevalence of depression among breast cancer patients was 25% (107/428), andaccording to the PHQ9 score categorization, 70/428 (16.4%), 30/428 (7.01%) and 7/428 (1.64%) of these patients were having moderate, moderately severe and severe depression respectively. Age, occupation, type of health facility treated, severity of pain, hormonal therapy and having problem with employer/ family were significantly associated with depression. The participants' MSPSS total score was overall found to be high (70.35 ± 16.81). Those women who had moderate and severe depression had lower mean MSPSS scores compared to women with none/ minimal depression (P = 0.002).
This study found that one in four breast cancer patients had depression. Depression is associated with poor social support given by family, friends and significant others. Therefore, screening for depression and psychosocial service should be integrated in the routine breast cancer care in Ethiopia.
抑郁症是一种常见的合并症,致残性疾病,影响 10-25%的癌症患者。它会导致严重的功能障碍,并降低乳腺癌患者的生存率。因此,本研究旨在确定埃塞俄比亚亚的斯亚贝巴乳腺癌患者中抑郁症的严重程度及其与社会支持的关系。
本研究采用横断面研究设计,在埃塞俄比亚亚的斯亚贝巴的 7 家医疗机构中纳入了 428 名乳腺癌患者。使用标准工具 PHQ-9 和 MSPSS 分别评估抑郁和社会支持。根据 PHQ-9 的标准截断点(0-4、5-9、10-14、15-19 和≥20)进行描述性统计。采用 Mann-Whitney 和 Kruskal Wallis 检验比较抑郁和非抑郁患者以及不同抑郁程度之间的 MSPSS 评分。采用单变量和多变量逻辑回归分析确定与抑郁相关的因素。
乳腺癌患者的抑郁患病率为 25%(107/428),根据 PHQ-9 评分分类,70/428(16.4%)、30/428(7.01%)和 7/428(1.64%)的患者分别患有中度、中重度和重度抑郁症。年龄、职业、治疗的医疗机构类型、疼痛严重程度、激素治疗和与雇主/家人的问题与抑郁显著相关。参与者的 MSPSS 总分总体较高(70.35±16.81)。与无/轻度抑郁的女性相比,患有中重度抑郁的女性 MSPSS 平均得分较低(P=0.002)。
本研究发现,四分之一的乳腺癌患者患有抑郁症。抑郁与来自家庭、朋友和重要他人的不良社会支持有关。因此,在埃塞俄比亚,应该将抑郁症筛查和心理社会服务纳入乳腺癌常规护理中。