初诊晚期非小细胞肺癌患者的疾病感知特征与心理和生理症状。
Illness perception profiles and psychological and physical symptoms in newly diagnosed advanced non-small cell lung cancer.
机构信息
Department of Physical Medicine and Rehabilitation, University of Michigan.
Department of Internal Medicine, Division of Medical Oncology, The Ohio State University Comprehensive Cancer Center.
出版信息
Health Psychol. 2022 Jun;41(6):379-388. doi: 10.1037/hea0001192.
OBJECTIVE
Of all cancers, advanced nonsmall cell lung cancer (NSCLC) is associated with the highest burden on mental and physical health-related quality of life (HRQoL). Patients' subjective beliefs about their cancer (i.e., illness perceptions) may influence coping responses and treatment decisions and affect health. To identify cognitive and emotional perceptions and their association with patient characteristics and illness circumstances, the relationship between illness perception schemas and psychological and physical responses and symptoms were studied.
METHOD
Patients newly diagnosed with stage IV NSCLC (N = 186) enrolled in a prospective cohort study (NCT03199651) completed measures of illness perceptions; anxiety, depression, and physical symptoms; and health status. Latent profile analysis identified illness perception profiles. Hierarchical linear regressions tested profile assignment as a correlate of responses and symptoms.
RESULTS
A three-profile solution was optimal. Patients with a "struggling" profile (n = 83; 45%) reported the most negative perceptions; patients with a "coping" profile (n = 41; 22%) reported relatively positive perceptions; and patients with a "coping but concerned" profile (n = 62; 33%) endorsed high illness concern but relatively positive perceptions otherwise. Patients with a "struggling" profile reported the highest levels of anxiety and depression symptoms, overall physical symptoms, cough, dyspnea, and pain, and the poorest self-rated health.
CONCLUSIONS
New data add to the clinical portrayal of patients coping with NSCLC since the availability of new therapies and survival improvements. Other disease groups have reported a predominance of positive perceptions, rather than ones of significant cognitive and emotional struggles found here. Illness perception data may provide content-rich resources for intervention tailoring. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
目的
在所有癌症中，晚期非小细胞肺癌（NSCLC）与精神和身体健康相关生活质量（HRQoL）的负担最高。患者对癌症的主观信念（即疾病认知）可能会影响应对反应和治疗决策，并影响健康。为了确定认知和情感认知及其与患者特征和疾病情况的关系，研究了疾病认知模式与心理和生理反应以及症状之间的关系。
方法
新诊断为 IV 期 NSCLC 的患者（N=186）参加了一项前瞻性队列研究（NCT03199651），完成了疾病认知、焦虑、抑郁和身体症状以及健康状况的测量。潜在剖面分析确定了疾病认知模式。分层线性回归测试了模式分配作为反应和症状的相关因素。
结果
三模式解决方案是最佳的。具有“挣扎”模式（n=83；45%）的患者报告了最消极的认知；具有“应对”模式（n=41；22%）的患者报告了相对积极的认知；具有“应对但担忧”模式（n=62；33%）的患者则对疾病高度关注，但其他方面的认知相对积极。具有“挣扎”模式的患者报告的焦虑和抑郁症状、总体身体症状、咳嗽、呼吸困难和疼痛程度最高，自我评估的健康状况最差。
结论
新数据增加了对新疗法和生存改善后 NSCLC 患者应对的临床描述。其他疾病群体报告了更积极的认知，而不是这里发现的显著认知和情感挣扎。疾病认知数据可能为干预定制提供内容丰富的资源。
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