School of Nursing, University of California, San Francisco, California, USA.
School of Nursing, University of California, San Francisco, California, USA.
J Pain Symptom Manage. 2020 Nov;60(5):e25-e34. doi: 10.1016/j.jpainsymman.2020.08.037. Epub 2020 Sep 2.
No information is available on oncology patients' level of stress and symptom burden during the coronavirus disease 2019 (COVID-19) pandemic.
To evaluate for differences in demographic and clinical characteristics, levels of social isolation and loneliness, and the occurrence and severity of common symptoms between oncology patients with low vs. high levels of COVID-19 and cancer-related stress. In addition, to determine which of these characteristics were associated with membership in the high-stressed group.
Patients were 18 years and older; had a diagnosis of cancer; and were able to complete an online survey.
Of the 187 patients in this study, 31.6% were categorized in the stressed group (Impact of Event Scale-Revised [score of ≥24]). Stressed group's Impact of Event Scale-Revised score exceeds previous benchmarks in oncology patients and equates with probable post-traumatic stress disorder. In this stressed group, patients reported occurrence rates for depression (71.2%), anxiety (78.0%), sleep disturbance (78.0%), evening fatigue (55.9%), cognitive impairment (91.5%), and pain (75.9%). Symptom severity scores equate with clinically meaningful levels for each symptom.
We identified alarmingly high rates of stress and an extraordinarily high symptom burden among patients with cancer, exceeding those previously benchmarked in this population and on par with noncancer patients with post-traumatic stress disorder. Given that the COVID-19 pandemic will likely impact cancer care for an indefinite period, clinicians must exhibit increased vigilance in their assessments of patients' level of stress and symptom burden. Moreover, an increase in referrals to appropriate supportive care resources must be prioritized for high-risk patients.
目前尚无关于癌症患者在 2019 年冠状病毒病（COVID-19）大流行期间的压力和症状负担水平的信息。
评估癌症患者中 COVID-19 和癌症相关压力的低水平与高水平之间在人口统计学和临床特征、社会隔离和孤独程度以及常见症状的发生和严重程度方面的差异。此外，确定这些特征中哪些与高压力组的成员有关。
患者年龄在 18 岁及以上；有癌症诊断；能够完成在线调查。
在这项研究的 187 名患者中，31.6%的患者被归类为有压力的患者（修订后的事件影响量表[评分≥24]）。有压力的患者的修订后的事件影响量表评分超过了以前癌症患者的基准，并与可能的创伤后应激障碍相当。在这个有压力的患者组中，患者报告的抑郁发生率（71.2%）、焦虑发生率（78.0%）、睡眠障碍发生率（78.0%）、傍晚疲劳发生率（55.9%）、认知障碍发生率（91.5%）和疼痛发生率（75.9%）。症状严重程度评分与每个症状的临床有意义水平相当。
我们发现癌症患者的压力和症状负担率高得惊人，超过了该人群以前的基准，与创伤后应激障碍的非癌症患者相当。鉴于 COVID-19 大流行可能在不确定的时期内影响癌症护理，临床医生必须在评估患者的压力和症状负担水平方面更加警惕。此外，必须优先为高危患者增加向适当的支持性护理资源的转介。
