Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
Department of Oncology, Hematology and Bone Marrow Transplantation with Section of Pneumology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
Medicina (Kaunas). 2021 Sep 20;57(9):993. doi: 10.3390/medicina57090993.
Despite a generally good prognosis, testicular cancer can be a life-altering event. We explored perceived positive and negative life changes after testicular cancer in terms of frequency, demographic and disease-related predictors, and associations with depression and anxiety. All testicular cancer survivors receiving follow-up care at two specialized outpatient treatment facilities were approached at follow-up visits or via mail. We assessed a total of = 164 patients (66% participation rate, mean time since diagnosis: 11.6 years, SD = 7.4) by the Posttraumatic Growth Inventory (PTGI, modified version assessing positive and negative changes for each of 21 items), Patient-Health-Questionnaire-9 (PHQ-9), and Generalized-Anxiety-Disorder-Scale-7 (GAD-7). We conducted controlled multivariate regression analyses. Most survivors (87%) reported at least one positive change (mean number: 7.2, SD = 5.0, possible range: 0-21). The most frequent perceived positive changes were greater appreciation of life (62%), changed priorities in life (62%), and ability rely on others (51%). At least one negative change was perceived by 33% (mean number of changes: 1.1, SD = 2.5). Negative changes were most frequent for decreases in self-reliance (14%), personal strength (11%), and ability to express emotions (9%). A higher socioeconomic status was associated with more positive changes (β = 0.25, 95% CI 0.08 to 0.42); no other association with demographic and disease-related predictors emerged. While positive life changes were not associated with depression (β = -0.05, 95% CI -0.17 to 0.07) and anxiety (β = 0.00, 95% CI -0.13 to 0.13), more negative life changes were significantly associated with higher depression (β = 0.15, 95% CI -0.03 to 0.27) and anxiety (β = 0.23, 95% CI 0.11 to 0.36). There was no significant interaction of positive and negative changes on depression or anxiety. Although positive life changes after testicular cancer are common, a significant number of survivors perceive negative changes in life domains that have been primarily investigated in terms of personal growth. Early identification of and psychosocial support for patients who perceive predominantly negative changes may contribute to prevention of prolonged symptoms of anxiety and depression.
尽管总体预后良好，但睾丸癌可能会改变人的一生。我们探讨了睾丸癌患者在经历后的生活中感知到的积极和消极变化，包括频率、人口统计学和疾病相关预测因素，以及与抑郁和焦虑的关联。所有在两家专门的门诊治疗机构接受随访护理的睾丸癌幸存者，在随访时或通过邮件被联系到。我们通过创伤后成长量表（PTGI，修改版，评估 21 项中的积极和消极变化）、患者健康问卷 9 项（PHQ-9）和广泛性焦虑症 7 项（GAD-7）对 164 名患者（66%的参与率，平均诊断后时间：11.6 年，SD=7.4）进行了评估。我们进行了控制多元回归分析。大多数幸存者（87%）报告至少有一个积极变化（平均数量：7.2，SD=5.0，可能范围：0-21）。最常见的感知到的积极变化是更加珍惜生命（62%）、改变生活重点（62%）和依靠他人的能力（51%）。33%的人感知到至少有一个消极变化（平均变化数量：1.1，SD=2.5）。最常见的消极变化是自我依赖下降（14%）、个人力量下降（11%）和表达情感的能力下降（9%）。较高的社会经济地位与更多的积极变化相关（β=0.25，95%CI 0.08-0.42）；没有发现与人口统计学和疾病相关预测因素的其他关联。积极的生活变化与抑郁（β=-0.05，95%CI-0.17-0.07）和焦虑（β=0.00，95%CI-0.13-0.13）无关，而更多的消极生活变化与更高的抑郁（β=0.15，95%CI-0.03-0.27）和焦虑（β=0.23，95%CI 0.11-0.36）显著相关。积极和消极变化对抑郁或焦虑没有显著的交互作用。尽管睾丸癌后积极的生活变化很常见，但仍有相当数量的幸存者感知到生活领域的消极变化，这些变化主要是在个人成长方面进行研究的。早期识别和为感知到主要消极变化的患者提供社会心理支持，可能有助于预防焦虑和抑郁症状的持续存在。
