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甲状腺癌幸存者的心理困扰和疾病认知:年龄重要吗?

Psychological Distress and Illness Perceptions in Thyroid Cancer Survivors: Does Age Matter?

机构信息

Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, United Kingdom.

Department of Psychosocial Research, Division of Psychosocial Research & Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.

出版信息

J Adolesc Young Adult Oncol. 2020 Jun;9(3):375-383. doi: 10.1089/jayao.2019.0153. Epub 2020 Jan 28.

Abstract

To examine the role of differentiated thyroid cancer (DTC) patients' age in illness perceptions and psychological distress, and the potential moderating role of age in the relationship between illness perceptions and psychological distress. We used the Netherlands Cancer Registry to select all patients diagnosed with thyroid cancer between 1990 and 2008 ( = 568). Patients filled out the Hospital Anxiety and Depression Scale (HADS) and Brief Illness Perception Questionnaire. Levels of psychological distress and illness perceptions were compared between the different DTC survivor age groups (adolescents and young adults [AYAs; 18-39 years], middle-aged adults [40-64 years], and older survivors [65-84 years]). Among 293 respondents with DTC, AYAs ( = 84) had more faith in the fact that their treatment can help them, and reported a stronger belief in understanding their illness compared to middle-aged ( = 172) and older adults ( = 37). No differences regarding age were seen on the other six illness perception subscales. AYAs did report significantly less distress (HADS caseness = 13.8%) compared to middle-aged (28.7%) and older adults (22.2%). Most illness perception subscales were associated with distress and the associations with age were mixed. AYAs and older patients who believed that their illness would continue for a long time reported more distress, but this association was not found for the middle-aged group. Illness perceptions play a key role in the experience of distress years after diagnosis and this is related to age. AYA and older cancer patients may be particularly vulnerable to distress related to maladaptive cancer-related beliefs/perceptions.

摘要

为了研究分化型甲状腺癌 (DTC) 患者年龄在疾病认知和心理困扰中的作用,以及年龄在疾病认知和心理困扰之间关系中的潜在调节作用。我们使用荷兰癌症登记处选择了 1990 年至 2008 年间诊断为甲状腺癌的所有患者(n=568)。患者填写了医院焦虑和抑郁量表 (HADS) 和简明疾病认知问卷。比较了不同 DTC 幸存者年龄组(青少年和年轻成人 [AYA;18-39 岁]、中年成人 [40-64 岁] 和老年幸存者 [65-84 岁])之间的心理困扰和疾病认知水平。在 293 名患有 DTC 的受访者中,AYA(n=84)对治疗能帮助他们的信念更强烈,并且与中年(n=172)和老年(n=37)患者相比,他们对疾病的理解程度的信念更强。在其他六个疾病认知子量表上,年龄没有差异。AYA 报告的困扰程度明显低于中年(HADS 病例率为 28.7%)和老年(HADS 病例率为 22.2%)。大多数疾病认知子量表与困扰有关,而与年龄的关联则各不相同。认为疾病会持续很长时间的 AYA 和老年患者报告的困扰更多,但中年组则没有这种关联。疾病认知在诊断多年后体验困扰中起着关键作用,而这与年龄有关。AYA 和老年癌症患者可能特别容易受到与适应不良的癌症相关信念/认知有关的困扰。

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