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癌症患者及其照顾者的痛苦、抑郁、焦虑和韧性。

Distress, depression, anxiety, and resilience in patients with cancer and caregivers.

机构信息

Department of Psychiatry and Behavioral Sciences.

Siteman Cancer Center.

出版信息

Health Psychol. 2022 Apr;41(4):246-255. doi: 10.1037/hea0001170.

Abstract

OBJECTIVE

Resilience is the ability to cope and function despite adversity, such as a cancer diagnosis, and has been conceptualized as the other end of a distress-resilience continuum. There are known associations among resilience, distress, depression, and anxiety-yet the nature of the associations is not well characterized. Less is known about the relationship among these variables for caregivers. We examined these associations in a convenience sample from a clinical setting with these hypotheses: (a) patients and nondyadic caregivers will report elevated, comparable levels of distress, depression, and anxiety, and (b) resilience will moderate the effect of distress on depression and anxiety.

METHOD

Participants were patients with a cancer diagnosis (n = 328) and nondyadic caregivers (n = 169). Participants completed a demographic/clinical questionnaire and self-report measures (National Comprehensive Cancer Network Distress Thermometer, Patient-Reported Outcomes Measurement Information System anxiety and depression measures, and Brief Resilience Scale). The statistical plan for this cross-sectional study included moderation analyses and various tests of association.

RESULTS

Patients and caregivers reported comparable levels of resilience and elevated distress; patients exhibited more severe depression and anxiety. There was no evidence for a moderating effect of resilience. For both groups, the model of distress predicting depression/anxiety exhibited improved fit when including resilience. Distress and resilience share variance in the prediction of depression/anxiety among patients.

CONCLUSIONS

Distress, depression, and anxiety are common in patients with cancer but also in cancer caregivers. Resilience appears to be an important variable to consider alongside distress and may enhance our understanding of the relationships among distress and depression/anxiety, especially for individuals with cancer. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

摘要

目的

韧性是一种在逆境中应对和发挥功能的能力,例如癌症诊断,并被概念化为困扰-韧性连续体的另一端。韧性、困扰、抑郁和焦虑之间存在已知的关联,但关联的性质尚未很好地描述。对于照顾者来说,关于这些变量之间的关系知之甚少。我们在一个临床环境中的便利样本中检验了这些关联,并提出了以下假设:(a)患者和非二元照顾者将报告更高、相当水平的困扰、抑郁和焦虑,(b)韧性将缓和困扰对抑郁和焦虑的影响。

方法

参与者包括癌症诊断患者(n=328)和非二元照顾者(n=169)。参与者完成了人口统计学/临床问卷和自我报告测量(国家综合癌症网络困扰温度计、患者报告的结果测量信息系统焦虑和抑郁测量以及简要韧性量表)。这项横断面研究的统计计划包括了调节分析和各种关联测试。

结果

患者和照顾者报告了相当水平的韧性和较高的困扰;患者表现出更严重的抑郁和焦虑。韧性没有表现出调节作用。对于两组,包括韧性在内,困扰预测抑郁/焦虑的模型拟合度更好。在预测患者的抑郁/焦虑时,困扰和韧性共享方差。

结论

困扰、抑郁和焦虑在癌症患者中很常见,但在癌症照顾者中也很常见。韧性似乎是一个重要的变量,需要与困扰一起考虑,这可能会增强我们对困扰和抑郁/焦虑之间关系的理解,特别是对于癌症患者。

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