School of Psychology, Deakin University, 221 Burwood Highway, Burwood, Victoria, 3125, Australia.
Cancer Council Victoria, 615 St Kilda Rd, Melbourne, Victoria, 3004, Australia.
J Cancer Surviv. 2020 Dec;14(6):826-833. doi: 10.1007/s11764-020-00895-7. Epub 2020 Jun 8.
To examine variations in anxiety and longitudinal associations between unmet supportive care needs and elevated anxiety in young women (< 50 years) within 13 months of their breast cancer diagnosis.
Two hundred and nine women recruited through Victorian Cancer Registry completed questionnaires at study entry (T1) (average 7 months post-diagnosis) then 3 (T2) and 6 months later (T3). Women completed the Hospital Anxiety and Depression Scale (HADS) and Supportive Care Needs Survey-Breast Cancer (SCNS-Breast) at each time point. Primary outcome was anxiety with six domains of SCNS-Breast (physical daily living, information, psychological, health system information, peer support, patient care and miscellaneous needs) the key predictors. Generalised estimating equations examined longitudinal associations.
Over the 6 months, the proportion of young women with elevated anxiety decreased (T1, 41% to T3, 35%; p = .06) as did the proportion with any moderate or high unmet needs (T1, 88%; T3, 74%; p < .01). While psychological needs and peer needs were positively associated with anxiety levels in multivariable cross-sectional analyses, in multivariable longitudinal analysis, only informational needs were associated with higher levels of anxiety (p < .001) with this association holding after adjusting for baseline anxiety levels.
While reducing over time, a third of young women treated for breast cancer enter early survivorship with elevated anxiety and unmet supportive care needs.
As informational needs were positively associated with future levels of anxiety, addressing needs in this domain may decrease the risk of anxiety in younger women with breast cancer.
在乳腺癌诊断后 13 个月内,检查年轻女性(<50 岁)焦虑的变化以及未满足的支持性护理需求与焦虑升高之间的纵向关联。
通过维多利亚癌症登记处招募了 298 名女性,她们在研究开始时(T1)(平均诊断后 7 个月)、3 个月(T2)和 6 个月(T3)后完成了问卷调查。女性在每个时间点都完成了医院焦虑和抑郁量表(HADS)和乳腺癌支持性护理需求量表(SCNS-Breast)。主要结局是焦虑,SCNS-Breast 的六个领域(身体日常生活、信息、心理、卫生系统信息、同伴支持、患者护理和杂项需求)是关键预测因素。广义估计方程检查了纵向关联。
在 6 个月内,患有焦虑症的年轻女性比例下降(T1,41%至 T3,35%;p=0.06),中度或高度未满足需求的比例也下降(T1,88%;T3,74%;p<0.01)。虽然心理需求和同伴需求与多变量横断面分析中的焦虑水平呈正相关,但在多变量纵向分析中,只有信息需求与较高的焦虑水平相关(p<0.001),在调整基线焦虑水平后,这种关联仍然存在。
虽然随着时间的推移,接受乳腺癌治疗的年轻女性中有三分之一在进入早期生存时伴有焦虑和未满足的支持性护理需求。
由于信息需求与未来的焦虑水平呈正相关,因此在这个领域满足需求可能会降低患有乳腺癌的年轻女性焦虑的风险。