Yang Min, Ma Fei, Lan Bo, Cai Jianqiang, Sun Xiaoying, Xu Binghe
Comprehensive Oncology Department, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
Chin J Cancer Res. 2020 Aug;32(4):476-484. doi: 10.21147/j.issn.1000-9604.2020.04.05.
Family caregivers (FCs) of breast cancer patients play a vital role throughout the treatment process. Psychological distress of FCs is common and often ignored. A simple and effective instrument for screening psychological distress would help in selecting those FCs requiring special attention and intervention. Here, the validity of distress thermometer (DT) in FCs of Chinese breast cancer patients receiving postoperative chemotherapy was assessed, and the prevalence of anxiety and depression was evaluated.
We recruited 200 FCs of hospitalized breast cancer patients in this cross-sectional descriptive study. Before the first cycle of adjuvant chemotherapy, the levels of anxiety and depression among FCs were assessed using DT and Hospital Anxiety and Depression Scale (HADS). In total, 191 valid cases were analyzed. HADS was used as the diagnostic standard to assess the effectiveness of DT as a screening tool for anxiety and depression as well as to analyze the diagnostic efficiency of DT at various cutoff points.
The definitive prevalence of both anxiety and depression was 8.90%. The mean level of anxiety and depression among FCs was 5.64±3.69 and 5.09±3.85, respectively, both of which were significantly higher than corresponding Chinese norms (P<0.01). The areas under receiver operating characteristic curves of DT for the diagnoses of FCs' anxiety and depression were 0.904 and 0.885, respectively. A cutoff value of 5 produced the best diagnostic effects of DT for anxiety and depression.
The levels of both anxiety and depression were higher in the FCs of Chinese breast cancer patients receiving postoperative chemotherapy than the national norm. DT might be an effective tool to initially screen psychological distress among FCs. This process could be integrated into the palliative care of breast cancer patients and warrant further research.
乳腺癌患者的家庭照顾者在整个治疗过程中发挥着至关重要的作用。家庭照顾者的心理困扰很常见且常常被忽视。一种简单有效的心理困扰筛查工具将有助于挑选出那些需要特别关注和干预的家庭照顾者。在此，评估了 distress thermometer（DT）在中国接受术后化疗的乳腺癌患者家庭照顾者中的有效性，并评估了焦虑和抑郁的患病率。
在这项横断面描述性研究中，我们招募了200名住院乳腺癌患者的家庭照顾者。在辅助化疗的第一个周期之前，使用DT和医院焦虑抑郁量表（HADS）评估家庭照顾者的焦虑和抑郁水平。总共分析了191例有效病例。以HADS作为诊断标准，评估DT作为焦虑和抑郁筛查工具的有效性，并分析DT在不同临界值下的诊断效率。
焦虑和抑郁的确诊患病率均为8.90%。家庭照顾者的焦虑和抑郁平均水平分别为5.64±3.69和5.09±3.85，均显著高于相应的中国常模（P<0.01）。DT用于诊断家庭照顾者焦虑和抑郁的受试者工作特征曲线下面积分别为0.904和0.885。临界值为5时，DT对焦虑和抑郁的诊断效果最佳。
接受术后化疗的中国乳腺癌患者家庭照顾者的焦虑和抑郁水平均高于全国常模。DT可能是初步筛查家庭照顾者心理困扰的有效工具。这一过程可纳入乳腺癌患者的姑息治疗中，值得进一步研究。
