肺癌患者及其家庭照顾者在患癌第一年所经历的痛苦。

Distress experienced by lung cancer patients and their family caregivers in the first year of their cancer journey.

作者信息

Aubin Michèle, Vézina Lucie, Verreault René, Simard Sébastien, Hudon Éveline, Desbiens Jean-François, Fillion Lise, Dumont Serge, Tourigny André, Daneault Serge

机构信息

Department of Family Medicine and Emergency Medicine, Université Laval, Québec, QC, Canada.

Research Centre of the Institut de cardiologie et de pneumologie de Québec (IUCPQ), Québec, QC, Canada.

出版信息

Palliat Support Care. 2022 Feb;20(1):15-21. doi: 10.1017/S1478951521000377.

DOI:10.1017/S1478951521000377

PMID:33899723

Abstract

OBJECTIVES

Diagnosis of cancer is emotionally threatening not only for patients but also for their family caregivers (FC) who witness and share much of the illness experience. This study compares distress experienced by lung cancer patients and their FC during the year following the diagnosis.

METHODS

A prospective cohort study of 206 patients recently diagnosed with inoperable lung cancer (participation rate 79.5%) and 131 FC (participation rate 63.6%) was conducted in an ambulatory oncology clinic in Quebec City (Canada). They completed validated questionnaires regarding their personal and psychological characteristics (Hospital and Anxiety Depression Scale-HADS), in the first months after the diagnosis of lung cancer and after 6 and 12 months. Univariate, bivariate, and linear mixed models were conducted to compare patient and FC distress.

RESULTS

At baseline, 7.8% of patients reported distress (HADS total score >15) and their mean distress score was 7.0 ± 4.9 (range 0-42). In contrast, 33.6% of FC presented significant distress and their mean distress score was 12.0 ± 7.2 (P < 0.0001). Proportions of patients and FC with distress remained relatively stable at 6 and 12 months, and at every time point, FC reported higher levels of distress compared to their relative with cancer (P < 0.0001). Comparable trends were found when looking at the mean scores of distress, anxiety, and depression throughout the study.

SIGNIFICANCE OF RESULTS

Being diagnosed with lung cancer and going through its different phases seems to affect more FC than patients. The psychological impact of such diagnosis appears early after the diagnosis and does not significantly change over time. These findings reinforce the importance for oncology teams, to include FC in their systematic distress screening program, in order to help them cope with their own feelings and be able to play their role in patient support and care throughout the cancer journey.

摘要

目的

癌症诊断不仅对患者而言在情感上具有威胁性，对于见证并共同经历许多疾病体验的家庭护理者（FC）也是如此。本研究比较肺癌患者及其家庭护理者在诊断后的一年中所经历的痛苦程度。

方法

在加拿大魁北克市的一家门诊肿瘤诊所，对206例近期被诊断为无法手术的肺癌患者（参与率79.5%）和131名家庭护理者（参与率63.6%）进行了一项前瞻性队列研究。他们在肺癌诊断后的最初几个月以及6个月和12个月后，完成了关于其个人和心理特征的有效问卷（医院焦虑抑郁量表-HADS）。采用单变量、双变量和线性混合模型来比较患者和家庭护理者的痛苦程度。

结果

在基线时，7.8%的患者报告有痛苦（HADS总分>15），其平均痛苦评分为7.0±4.9（范围0-42）。相比之下，33.6%的家庭护理者表现出明显痛苦，其平均痛苦评分为12.0±7.2（P<0.0001）。在6个月和12个月时，患者和家庭护理者有痛苦的比例相对稳定，并且在每个时间点，家庭护理者报告的痛苦程度均高于其患癌症的亲属（P<0.0001）。在整个研究过程中，观察痛苦、焦虑和抑郁的平均得分时也发现了类似趋势。