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辅助性乳腺癌内分泌治疗期间疾病认知与抑郁的纵向趋势:一项前瞻性观察研究。

Longitudinal Trends in Illness Perception and Depression during Adjuvant Breast Cancer Endocrine Therapy: A Prospective Observational Study.

作者信息

Park Seul Ki, Min Yul Ha, Lee Sae Byul

机构信息

Red Cross College of Nursing, Chung-Ang University, Seoul 06974, Korea.

College of Nursing, Kangwon National University, Chuncheon-si 24341, Korea.

出版信息

Healthcare (Basel). 2021 Sep 16;9(9):1223. doi: 10.3390/healthcare9091223.

Abstract

This study aimed to identify the changes in the illness perceptions and depression of women with breast cancer, undergoing AET, at three time points (i.e., before initiating AET, 3 months follow-up, and 12 months follow-up). We investigated the interaction effects of their demographic and clinical characteristics on illness perception changes over time. Furthermore, factors including the patient's characteristics and illness perceptions associated with depressive symptoms 1 year after starting AET were explored. Illness perception and depressive symptoms were assessed with the brief illness perception questionnaire and the Center for Epidemiologic Studies Depression Scale, in a prospective study of 150 women. The changes in illness perceptions and depression between the three time points were analyzed using repeated measures ANOVA. The factors associated with depressive symptoms were identified using regression analysis. Illness perception improved overall over the 12 months. However, more patients perceived their illness as chronic, experienced more symptoms, and developed negative beliefs that treatment could not control their disease. Patients' depressive symptoms decreased significantly. Depression at the baseline, cancer stage, and the perception of personal control were highly associated with depression after 12 months. These findings suggest that healthcare providers should offer appropriate interventions to patients, for managing symptoms, having a positive belief that treatment can control their disease, and preventing long-term depressive symptoms.

摘要

本研究旨在确定接受辅助内分泌治疗(AET)的乳腺癌女性在三个时间点(即开始AET前、随访3个月和随访12个月)的疾病认知和抑郁状况的变化。我们调查了她们的人口统计学和临床特征对疾病认知随时间变化的交互作用。此外,还探讨了包括患者特征和与开始AET 1年后抑郁症状相关的疾病认知等因素。在一项对150名女性的前瞻性研究中,使用简短疾病认知问卷和流行病学研究中心抑郁量表对疾病认知和抑郁症状进行评估。使用重复测量方差分析来分析三个时间点之间疾病认知和抑郁状况的变化。使用回归分析来确定与抑郁症状相关的因素。在12个月内,疾病认知总体上有所改善。然而,更多患者认为自己的疾病是慢性的,经历了更多症状,并产生了治疗无法控制疾病的消极信念。患者的抑郁症状显著减轻。基线时的抑郁状况、癌症分期和个人控制感与12个月后的抑郁状况高度相关。这些发现表明,医疗服务提供者应向患者提供适当的干预措施,以管理症状,树立治疗可以控制疾病的积极信念,并预防长期抑郁症状。

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