Loughan Ashlee R, Aslanzadeh Farah J, Brechbiel Julia, Rodin Gary, Husain Mariya, Braun Sarah E, Willis Kelcie D, Lanoye Autumn
Virginia Commonwealth University, Department of Neurology, Division of Neuro-Oncology, Richmond, Virginia.
Massey Cancer Center, Richmond, Virginia.
Neurooncol Pract. 2020 Apr 10;7(5):498-506. doi: 10.1093/nop/npaa015. eCollection 2020 Oct.
A diagnosis of cancer may increase mortality salience and provoke death-related distress. Primary brain tumor (PBT) patients may be at particular risk for such distress given the certainty of tumor progression, lack of curative treatments, and poor survival rates. This study is the first to examine the prevalence of death-related distress and its correlates in PBT patients.
Adult PBT patients (N = 105) enrolled in this cross-sectional study and completed the Death Distress Scale (subscales: Death Depression, Death Anxiety, Death Obsession), Generalized Anxiety Disorder-7, and Patient Health Questionnaire-9. Prevalence and predictors of death-related distress, and the relationships of demographic variables to clusters of distress, were explored.
The majority of PBT patients endorsed clinically significant death-related distress in at least one domain. Death anxiety was endorsed by 81%, death depression by 12.5%, and death obsession by 10.5%. Generalized anxiety was the only factor associated with global death-related distress. Cluster analysis yielded 4 profiles: global distress, emotional distress, resilience, and existential distress. Participants in the resilience cluster were significantly further out from diagnosis than those in the existential distress cluster. There were no differences in cluster membership based on age, sex, or tumor grade.
PBT patients appear to have a high prevalence of death-related distress, particularly death anxiety. Further, 4 distinct profiles of distress were identified, supporting the need for tailored approaches to addressing death-related distress. A shift in clusters of distress based on time since diagnosis also suggest the need for future longitudinal assessment.
癌症诊断可能会增加死亡凸显性并引发与死亡相关的痛苦。原发性脑肿瘤（PBT）患者可能尤其容易遭受此类痛苦，因为肿瘤进展具有确定性、缺乏治愈性治疗方法且生存率较低。本研究首次调查了PBT患者中与死亡相关痛苦的患病率及其相关因素。
参与这项横断面研究的成年PBT患者（N = 105）完成了死亡痛苦量表（子量表：死亡抑郁、死亡焦虑、死亡执念）、广泛性焦虑障碍-7量表和患者健康问卷-9。探讨了与死亡相关痛苦的患病率和预测因素，以及人口统计学变量与痛苦集群的关系。
大多数PBT患者在至少一个领域认可具有临床意义的与死亡相关的痛苦。81%的患者认可死亡焦虑，12.5%的患者认可死亡抑郁，10.5%的患者认可死亡执念。广泛性焦虑是与整体死亡相关痛苦相关的唯一因素。聚类分析产生了4种类型：整体痛苦、情绪痛苦、心理韧性和存在性痛苦。心理韧性类型的参与者距离诊断时间明显比存在性痛苦类型的参与者更长。在年龄、性别或肿瘤分级方面，各类型成员没有差异。
PBT患者中与死亡相关的痛苦患病率似乎较高，尤其是死亡焦虑。此外，确定了4种不同的痛苦类型，这支持了需要采用针对性方法来解决与死亡相关痛苦的观点。基于诊断后时间的痛苦类型转变也表明需要进行未来的纵向评估。
