Epidemiology and Health Services Research Unit CMN Siglo XXI, Mexican Institute of Social Security, Mexico City, Mexico.
Division of Social Protection and Health, Jamaica Country Office, Interamerican Development Bank, Jamaica.
Psychooncology. 2021 Apr;30(4):591-601. doi: 10.1002/pon.5608. Epub 2020 Dec 8.
To compare the prevalence of depression, supportive care needs (SC-needs), and quality of patient-centered cancer care (PCC-quality) between women with breast cancer and women with cervical cancer and to assess the association of SC-needs and PCC-quality with depression.
We conducted a cross-sectional survey in a public oncology hospital in Mexico City with 247 breast cancer and 165 cervical cancer ambulatory patients aged ≥18 years with at least one hospitalization and ≤5 years since diagnosis. Participants completed the short-form Supportive Care Needs Survey, the Patient-Centered Quality of Cancer Care Questionnaire, and the Hospital Anxiety and Depression Scale. We performed multiple logistic regression analyses to evaluate the association between SC-needs, PCC-quality, and probable presence of depression.
Nearly all women reported SC-needs-mainly health system and information needs, followed by physical and psychological needs. PCC-quality was substandard in both groups. PCC-quality was lowest when addressing biopsychosocial needs, followed by information for treatment decision-making needs. Cervical cancer patients had probable depression more often (41.2%) than those with breast cancer (29.5%). Having unmet psychological and care needs was associated with increased odds of probable depression, while high-quality timely care was associated with reduced odds of probable depression.
In Mexico, women with cervical and breast cancer face unmet SC-needs, probable depression, and substandard PCC-quality, pointing to priority areas for improvements in cancer care.
比较乳腺癌女性和宫颈癌女性的抑郁、支持性护理需求(SC-需求)和以患者为中心的癌症护理质量(PCC-质量)的患病率,并评估 SC-需求和 PCC-质量与抑郁的关系。
我们在墨西哥城的一家公立肿瘤医院进行了一项横断面调查,共纳入了 247 名乳腺癌和 165 名宫颈癌门诊患者,年龄均≥18 岁,至少有一次住院治疗,且距诊断时间不超过 5 年。参与者完成了简短的支持性护理需求调查、以患者为中心的癌症护理质量问卷和医院焦虑和抑郁量表。我们进行了多项逻辑回归分析,以评估 SC-需求、PCC-质量与可能存在的抑郁之间的关系。
几乎所有女性都报告存在 SC-需求,主要是医疗体系和信息需求,其次是身体和心理需求。两组的 PCC-质量都不达标。在满足生物心理社会需求方面,PCC-质量最低,其次是治疗决策信息需求。宫颈癌患者的抑郁可能性(41.2%)高于乳腺癌患者(29.5%)。存在未满足的心理和护理需求与抑郁可能性增加有关,而高质量的及时护理与抑郁可能性降低有关。
在墨西哥,宫颈癌和乳腺癌女性面临着未满足的 SC-需求、可能的抑郁和不达标的 PCC-质量,这表明癌症护理需要优先改善。