Sato Takashi, Fujisawa Daisuke, Arai Daisuke, Nakachi Ichiro, Takeuchi Mari, Nukaga Shigenari, Kobayashi Keigo, Ikemura Shinnosuke, Terai Hideki, Yasuda Hiroyuki, Kawada Ichiro, Sato Yasunori, Satomi Ryosuke, Takahashi Saeko, Hashiguchi Mizuha Haraguchi, Nakamura Morio, Oyamada Yoshitaka, Terashima Takeshi, Sayama Koichi, Saito Fumitake, Sakamaki Fumio, Inoue Takashi, Naoki Katsuhiko, Fukunaga Koichi, Soejima Kenzo
Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan.
Department of Medicine, Keiyu Hospital, Yokohama, Japan.
Palliat Med. 2021 May;35(5):943-951. doi: 10.1177/02692163211001721. Epub 2021 Mar 24.
Both advanced cancer patients and their family caregivers experience distress and have a range of concerns after cancer diagnosis. However, longitudinal studies on this topic have been lacking.
To investigate concerns in both patients with advanced lung cancer and their family caregivers longitudinally from diagnosis.
A multi-center prospective questionnaire-based study.
SETTING/PARTICIPANTS: We recruited patients with newly diagnosed advanced lung cancer and their family caregivers at 16 hospitals in Japan. We prospectively assessed the prevalence of their concerns using the Concerns Checklist and investigated the associations between their concerns and mental status as well as quality of life until 24 months after diagnosis.
A total of 248 patients and their 232 family caregivers were enrolled. The prevalence of serious concerns was highest at diagnosis (patients: 68.3%, family caregivers: 65.3%). The most common serious concern was concern about the future in both groups at diagnosis (38.2% and 40.5%, respectively) and this remained high in prevalence over time, while the high prevalence of concern about lack of information improved 3 months after diagnosis in both groups. Approximately one-third of patient-family caregiver dyads had discrepant reports of serious concerns. The presence of serious concerns was significantly associated with anxiety and depression continuously in both groups.
The majority of advanced lung cancer patients and their family caregivers have serious concerns from diagnosis, which is associated with their psychological distress. The spectrum of concerns alters over the disease trajectory, warranting efficient tailored care and support for both groups immediately after diagnosis.
晚期癌症患者及其家庭照顾者在癌症诊断后都会经历痛苦并存在一系列担忧。然而,关于这一主题的纵向研究一直缺乏。
从诊断开始纵向调查晚期肺癌患者及其家庭照顾者的担忧。
一项多中心前瞻性问卷调查研究。
地点/参与者:我们在日本的16家医院招募了新诊断的晚期肺癌患者及其家庭照顾者。我们使用担忧清单前瞻性评估他们担忧的发生率,并调查他们的担忧与心理状态以及生活质量之间的关联,直至诊断后24个月。
共纳入248例患者及其232名家庭照顾者。严重担忧的发生率在诊断时最高(患者:68.3%,家庭照顾者:65.3%)。两组在诊断时最常见的严重担忧都是对未来的担忧(分别为38.2%和40.5%),且随着时间推移其发生率一直居高不下,而两组中对信息缺乏的担忧发生率在诊断后3个月有所改善。约三分之一的患者-家庭照顾者二元组在严重担忧方面的报告存在差异。两组中严重担忧的存在均与焦虑和抑郁持续显著相关。
大多数晚期肺癌患者及其家庭照顾者从诊断开始就有严重担忧,这与他们的心理痛苦有关。担忧的范围在疾病进程中会发生变化,因此在诊断后应立即为两组提供有效的个性化护理和支持。