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新冠疫情相关治疗变化是否会影响乳腺癌患者对癌症复发的恐惧、焦虑和抑郁?

Do COVID-19-Related Treatment Changes Influence Fear of Cancer Recurrence, Anxiety, and Depression in Breast Cancer Patients?

机构信息

Author Affiliations: College of Nursing (Ms Kim) and Mo-Im Kim Nursing Research Institute (Dr Kim), College of Nursing, Yonsei University, Seoul, South Korea.

出版信息

Cancer Nurs. 2022;45(2):E628-E638. doi: 10.1097/NCC.0000000000000937.

DOI:10.1097/NCC.0000000000000937
PMID:33654008
Abstract

BACKGROUND

The worldwide spread of the coronavirus disease 2019 (COVID-19) has impacted the treatment of cancer patients. Treatment changes can negatively affect patients' prognosis and may be psychologically burdensome.

OBJECTIVE

The aim of this study was to explore whether COVID-19-related treatment changes (delays, cancellations, changes) influenced fear of cancer recurrence, anxiety, and depression in breast cancer patients.

METHODS

A convenience sample (n = 154) of patients who were diagnosed with breast cancer no longer than 2 years ago was obtained from an online community and social network site. The survey content included COVID-19-related treatment experiences and psychological status. The data were analyzed using descriptive statistics, χ2 test, independent t test, and analysis of variance.

RESULTS

Twenty-nine patients (18.8%) had experienced COVID-19-related treatment changes, and changes of the treatment plan had a significant correlation with depression (t = 2.000, P = .047). Fear of cancer recurrence was high (mean score, 84.31 ± 24.23). Fifteen percent had moderate to severe levels of anxiety, and 24.7% had moderate to severe levels of depression. Narrative reports also identified COVID-19-related unforeseen costs.

CONCLUSION

In the midst of the COVID-19 pandemic, breast cancer patients experienced treatment changes, and changes in treatment plans were significantly associated with depression. Fear of recurrence, anxiety, and depression were found at high levels.

IMPLICATIONS FOR PRACTICE

Oncology nurses should assess the psychological status of cancer patients in the early survivorship phase who appear to be especially vulnerable during the COVID-19 pandemic. Oncology nurses can also monitor whether patients are receiving timely supportive care to alleviate fears and anxiety and assess financial needs for COVID-19-related costs.

摘要

背景

2019 年冠状病毒病(COVID-19)在全球范围内的传播影响了癌症患者的治疗。治疗的改变可能会对患者的预后产生负面影响,并且可能会带来心理负担。

目的

本研究旨在探讨 COVID-19 相关的治疗改变(延迟、取消、改变)是否会影响乳腺癌患者对癌症复发的恐惧、焦虑和抑郁。

方法

从一个在线社区和社交网站上获得了一组不超过 2 年前被诊断患有乳腺癌的患者的方便样本(n=154)。调查内容包括与 COVID-19 相关的治疗经历和心理状况。使用描述性统计、卡方检验、独立 t 检验和方差分析对数据进行分析。

结果

29 名患者(18.8%)经历了与 COVID-19 相关的治疗改变,治疗计划的改变与抑郁有显著相关性(t=2.000,P=.047)。对癌症复发的恐惧程度较高(平均得分为 84.31±24.23)。15%的患者有中度至重度焦虑,24.7%的患者有中度至重度抑郁。叙述性报告还确定了与 COVID-19 相关的意外费用。

结论

在 COVID-19 大流行期间,乳腺癌患者经历了治疗改变,治疗计划的改变与抑郁显著相关。恐惧复发、焦虑和抑郁的发生率较高。

实践意义

肿瘤护士应评估早期生存阶段癌症患者的心理状况,这些患者在 COVID-19 大流行期间似乎特别脆弱。肿瘤护士还可以监测患者是否正在接受及时的支持性护理,以减轻恐惧和焦虑,并评估与 COVID-19 相关费用的财务需求。

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