Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
Department of Surgery, Dentistry, Pediatrics and Gynecology, University of Verona, Verona, Italy.
Psychooncology. 2021 Apr;30(4):455-462. doi: 10.1002/pon.5607. Epub 2020 Dec 15.
(1) To determine the prevalence and type of depressive symptoms at day-hospital clinical evaluation, before undergoing major surgery in patients diagnosed with pancreatic neoplasm. (2) To analyze the association between depression and sociodemographic, clinical, and psychosocial variables. (3) To understand how coping strategies, perceived social support, and self-efficacy might affect depressive symptoms in this cohort of patients.
Secondary data analysis collected during the baseline phase of a randomized controlled trial performed at the Pancreas Institute of the University Hospital of Verona, Italy, between June 2017 and June 2018.
18.5% of pancreatic patients had a PHQ-9 score ≥10 (cut-off). Depressed patients were basically more often female (p = 0.07), younger (p = 0.06), and married/with a partner (p = 0.02). Depression was associated to high trait anxiety (p < 0.01), the use of anxiolytics (p < 0.01), sleep-inducing drugs (p < 0.01), and painkillers (p < 0.01). Among psychosocial variables, depressed patients showed lower perceived self-efficacy (p < 0.01) and family and friends' social support (p < 0.01) and used significantly more often dysfunctional coping strategies (p < 0.01), compared to nondepressed. A logistic multivariate model using psychosocial variables as explanatory and depression as dependent was calculated and post hoc analyses were conducted to describe the contribution of each psychosocial variable on depression.
Our study advocates the need for screening for distress and depression in cancer surgery units and recommends to strengthen patients' adaptive coping, social support, and sense of effectiveness in facing the challenges related to the medical condition and treatment process.
(1) 确定在被诊断为胰腺肿瘤的患者接受大手术前,日间医院临床评估时的抑郁症状发生率和类型。(2) 分析抑郁与社会人口统计学、临床和心理社会变量之间的关系。(3) 了解在这一患者队列中,应对策略、感知到的社会支持和自我效能感如何影响抑郁症状。
这是对意大利维罗纳大学医院胰腺研究所于 2017 年 6 月至 2018 年 6 月期间进行的一项随机对照试验的基线阶段收集的二级数据分析。
18.5%的胰腺患者 PHQ-9 评分≥10(临界值)。抑郁患者基本更常为女性(p=0.07)、更年轻(p=0.06)和已婚/有伴侣(p=0.02)。抑郁与高特质焦虑(p<0.01)、使用抗焦虑药(p<0.01)、助眠药(p<0.01)和止痛药(p<0.01)相关。在心理社会变量中,与非抑郁患者相比,抑郁患者感知到的自我效能感(p<0.01)和家庭及朋友的社会支持(p<0.01)较低,且更常使用功能失调的应对策略(p<0.01)。使用心理社会变量作为解释变量,抑郁作为因变量,计算了一个逻辑多元模型,并进行了事后分析,以描述每个心理社会变量对抑郁的贡献。
我们的研究主张在癌症手术单位中需要筛查痛苦和抑郁,并建议加强患者的适应性应对、社会支持和应对与病情和治疗过程相关挑战的效能感。