Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan.
Medical College, Aga Khan University Hospital, Karachi, Pakistan.
Psychooncology. 2021 Jun;30(6):882-891. doi: 10.1002/pon.5661. Epub 2021 Mar 10.
This study assessed resilience in brain tumor patients at a tertiary care hospital in Pakistan (a lower middle-income country; LMIC) and explored its relationship with patients' sociodemographic factors, clinical characteristics, social support, and mental health.
A cross-sectional survey was conducted amongst adult (≥18 years) patients with brain tumor at the Aga Khan University Hospital, Pakistan. Resilience was assessed by Wagnild and Young's Resilience Scale, and patients' psychosocial characteristics by the Hospital Anxiety and Depression Scale and the Enriched Social Support Instrument.
A total of 250 patients were included (mean age: 44 years; 68% males), with majority (97.6%) having high social support and only 4.4% and 2% having symptomatic depression and anxiety, respectively. On multivariable linear regression adjusted for covariates, lower resilience was associated with not being involved in household decision-making (Adjusted Beta Coefficient: 4.58 [95% Confidence Interval:-7.59, -1.56]), not currently working (-2.80 [-4.61, -0.99]), undergoing multiple neurosurgical interventions such as tumor biopsies or resections (-8.64 [-13.11, -4.16]), receiving chemotherapy (-5.17 [-9.51, -0.83]) or combination adjuvant therapy (-2.91 [-5.14, -0.67]), low social support (-7.77 [-13.73, 1.81]), mild depression (-13.00 [-17.00,-8.99]) or symptomatic depression (-19.79 [-24.69, -14.89]), and mild anxiety (-4.24 [-7.98, -0.50]).
Our study highlights the function of familial/household role and working status in mediating resilience, and demonstrates the well-known protective effect of resilience for mental health in brain tumor patients in Pakistan, a South-Asian LMIC. These findings are of clinical relevance with regards to the development of culture-specific evidence-based resilience-building interventions that may help patients with brain tumors to cope with the psychological distress of cancer.
本研究评估了巴基斯坦一家三级保健医院（中低收入国家）脑肿瘤患者的适应力，并探讨了其与患者社会人口统计学因素、临床特征、社会支持和心理健康的关系。
本横断面研究在巴基斯坦 Aga Khan 大学医院对成年（≥18 岁）脑肿瘤患者进行。使用 Wagnild 和 Young 的适应力量表评估适应力，使用医院焦虑和抑郁量表以及丰富社会支持量表评估患者的心理社会特征。
共纳入 250 例患者（平均年龄 44 岁；男性占 68%），大多数（97.6%）患者社会支持度较高，仅有 4.4%和 2%的患者分别存在症状性抑郁和焦虑。在校正了协变量后，多变量线性回归分析显示，适应力较低与不参与家庭决策（调整后的β系数：4.58 [95%置信区间：-7.59，-1.56]）、未就业（-2.80 [-4.61，-0.99]）、接受多次神经外科干预，如肿瘤活检或切除术（-8.64 [-13.11，-4.16]）、接受化疗（-5.17 [-9.51，-0.83]）或联合辅助治疗（-2.91 [-5.14，-0.67]）、社会支持度低（-7.77 [-13.73，1.81]）、轻度抑郁（-13.00 [-17.00，-8.99]）或症状性抑郁（-19.79 [-24.69，-14.89]）以及轻度焦虑（-4.24 [-7.98，-0.50]）相关。
本研究强调了家庭/家庭角色和工作状态在调节适应力方面的作用，并证实了适应力对巴基斯坦脑肿瘤患者心理健康的显著保护作用，这是南亚中低收入国家的一项研究结果。这些发现与开发基于文化的循证适应力增强干预措施具有临床相关性，这些干预措施可能有助于脑肿瘤患者应对癌症带来的心理困扰。
