Department of General Practice, Center of Expertise Palliative Care-Utrecht, Julius Center for Healthcare Sciences and Primary Care, University of Utrecht, Utrecht, The Netherlands.
Department of General Practice, Center of Expertise Palliative Care-Utrecht, Julius Center for Healthcare Sciences and Primary Care, University of Utrecht, Utrecht, The Netherlands.
J Pain Symptom Manage. 2020 Sep;60(3):522-530.e1. doi: 10.1016/j.jpainsymman.2020.04.005. Epub 2020 Apr 16.
Anxiety in patients with cancer is highly prevalent; yet it remains underestimated and inadequately assessed. Little is known about predictors for anxiety in hospitalized patients with cancer. Insight in predictors should improve recognition and enable a targeted approach.
To determine the prevalence of anxiety and predictors for anxiety in hospitalized patients with cancer at different stages of disease.
A cross-sectional analysis of patients with cancer admitted to the Utrecht University Medical Center in 2015-2018 was conducted. The Utrecht Symptom Diary, an adapted Dutch version of the Edmonton Symptom Assessment System, was used to assess symptom burden on a numeric rating scale (0 = no symptom and 10 = worst possible symptom). Scores ≥4 were considered clinically relevant. All patients completed the Utrecht Symptom Diary as part of routine care. The first questionnaire after admission was selected. Using multivariable linear regression, the predictive value of potential predictors on anxiety was analyzed.
In total, 2144 patients were included, of which 22% reported clinically relevant anxiety. The prevalence of anxiety was highest (36%) in patients receiving symptom-directed palliation only. In the total group, female gender, younger age, depressed mood, sleeping problems, dyspnea, and cancer of the head and neck were predictive of anxiety. Throughout all stages of disease, depressed mood was consistently the strongest predictor.
We found a high prevalence of anxiety in hospitalized patients with cancer. It is recommended to explore anxiety in hospitalized patients with cancer, in particular when they experience depressed mood. Structural use of a symptom diary during hospitalization facilitates the recognition of anxiety and concurrent symptoms.
癌症患者的焦虑症发病率很高；然而，这种情况仍被低估且评估不足。对于癌症住院患者中焦虑的预测因素知之甚少。了解这些预测因素有助于提高识别率，并能够采取针对性的治疗方法。
确定不同疾病阶段的癌症住院患者中焦虑症的发病率和焦虑症的预测因素。
对 2015 年至 2018 年期间入住乌得勒支大学医学中心的癌症患者进行了横断面分析。采用经过改编的荷兰版埃德蒙顿症状评估系统（Utrecht Symptom Diary），通过数字评分量表（0=无症状，10=症状最严重）来评估症状负担。得分≥4 被认为具有临床意义。所有患者都完成了 Utrecht Symptom Diary，作为常规护理的一部分。选择入院后的第一份问卷。使用多变量线性回归分析，评估潜在预测因素对焦虑的预测价值。
共纳入 2144 例患者，其中 22%报告有临床相关的焦虑症。仅接受症状导向姑息治疗的患者焦虑症发病率最高（36%）。在总人群中，女性、年龄较小、情绪低落、睡眠问题、呼吸困难和头颈部癌症是焦虑的预测因素。在所有疾病阶段，情绪低落都是最强的预测因素。
我们发现癌症住院患者中焦虑症的发病率很高。建议对癌症住院患者进行焦虑症的评估，尤其是当他们出现情绪低落时。在住院期间有结构地使用症状日记可以帮助识别焦虑症和伴随的症状。
