Ascencio-Huertas Leticia, Allende-Pérez Silvia Rosa, Pastrana Tania
Servicio de Cuidados Paliativos, Instituto Nacional de Cancerologia, Mexico City, Mexico.
Department of Palliative Medicine, Medical Faculty, RWTH Aachen University, Aachen, Germany.
Palliat Support Care. 2021 Aug;19(4):447-456. doi: 10.1017/S1478951520001066.
The objective of this study was to assess the psychosocial distress and associated factors in advanced cancer patients consulting at the outpatient Palliative Care Unit at the National Cancer Institute in Mexico City.
A retrospective study was conducted using electronic records (June 2015 to December 2016).
A total of 646 patients with advanced cancer during their first visit to the outpatient palliative care unit at the National Cancer Institute in Mexico were evaluated using the Distress Thermometer (DT) and ECOG performance status scores.
Overall, 62% were women, with a median age of 57 years, and married (54.8%). The most frequent diagnosis was gastrointestinal cancer (28.6%), and 38.9% had a functional performance status of ECOG 2. The median DT score was 4.0 (IQR = 2-6), with 56% reporting DT scores ≥4. The three most frequent problems ≥4 were sadness (82.6%), feeling weak (81.2%), worry (79.6%), and <4 were feeling weak (57.7%), fatigue (55.6%), and financial security (52.1%). The variables associated with distress according to the multiple logistic regression analysis were problems with housing (OR = 2.661, 95% CI = 1.538-4.602), sadness (OR = 2.533, 95% CI = 1.615-3.973), transportation (OR = 1.732, 95% CI = 1.157-2.591), eating (OR = 1.626, 95% CI = 1.093-2.417), nervousness (OR = 1.547, 95% CI = 1.014-2.360), and sleep (OR = 1.469, 95% CI = 1.980-2.203).
The principal factors were related to distress levels, housing problems, transportation issues, and emotional problems such as sadness, nervousness, lower functionality, and younger age. Therefore, psychosocial support is of considerable relevance in palliative care. These findings will help clinicians understand the distress of patients with advanced cancer in palliative care in Latin American countries.
本研究的目的是评估在墨西哥城国家癌症研究所门诊姑息治疗科就诊的晚期癌症患者的心理社会困扰及相关因素。
采用电子记录进行回顾性研究（2015年6月至2016年12月）。
对墨西哥国家癌症研究所门诊姑息治疗科首次就诊的646例晚期癌症患者，使用苦恼温度计（DT）和东部肿瘤协作组（ECOG）体能状态评分进行评估。
总体而言，62%为女性，中位年龄57岁，已婚（54.8%）。最常见的诊断是胃肠道癌（28.6%），38.9%的患者ECOG体能状态为2级。DT评分中位数为4.0（四分位间距=2-6），56%的患者报告DT评分≥4。DT评分≥4的三个最常见问题是悲伤（82.6%）、感觉虚弱（81.2%）、担忧（79.6%），<4的问题是感觉虚弱（57.7%）、疲劳（55.6%）和经济保障（52.1%）。根据多因素逻辑回归分析，与困扰相关的变量有住房问题（比值比[OR]=2.661，95%置信区间[CI]=1.538-4.602）、悲伤（OR=2.533，95%CI=1.615-3.973）、交通问题（OR=1.732，95%CI=1.157-2.591）、饮食问题（OR=1.626，95%CI=1.093-2.417）、紧张（OR=1.547，95%CI=1.014-2.360）和睡眠问题（OR=1.469，95%CI=1.980-2.203）。
主要因素与困扰程度、住房问题、交通问题以及悲伤、紧张、功能较低和年龄较轻等情绪问题有关。因此，心理社会支持在姑息治疗中具有相当重要的意义。这些研究结果将有助于临床医生了解拉丁美洲国家姑息治疗中晚期癌症患者的困扰情况。
