Department of Medical Oncology, Hospital Universitario de Canarias, Tenerife, Spain.
Department of Oncology Medical, Hospital Universitario La Paz, Madrid, Spain.
BMC Geriatr. 2022 Sep 5;22(1):732. doi: 10.1186/s12877-022-03423-7.
Most cancers occur in older individuals, who are more vulnerable due to functional impairment, multiple comorbidities, cognitive impairment, and lack of socio-familial support. These can undermine patients' sense of dignity. This study seeks to compare dignity scores in older patients with advanced cancer on sociodemographic and clinical variables and analyze the predictive value of anxiety, depression, functional limitations, and social support on dignity scores.
A prospective, multicenter, observational study conducted with participation of 15 hospitals in Spain from February 2020 to October 2021. Patients with newly-diagnosed, advanced cancer completed the dignity (PPDS), anxiety and depression (BSI), Social Support (Duke-UNC-11), and functional limitations (EORTC-C30) scales. Lineal regression analyses explored the effects of anxiety, depression, functional status, and social support on dignity, adjusting for sociodemographic and clinical variables.
A total of 180 subjects participated in this study. The results of the correlation analysis revealed that dignity correlated negatively with anxiety, depression, and sex, and positively with social support, functional status, and longer estimated survival. Thus, women, and more anxious and depressed individuals scored lower on the dignity scale, whereas patients with more social support, fewer functional limitations, and longer estimated survival scored higher.
In conclusion, being female, having a lower educational level, lower estimated survival, depression, anxiety, less social support, and limited functionality are correlated with less dignity in the elderly with advanced cancer. It is a priority to manage both physical and psychological symptoms in patients with unresectable advanced cancer to mitigate psychological distress and increase their sense of dignity.
大多数癌症发生在老年人中，由于功能障碍、多种合并症、认知障碍和缺乏社会家庭支持，他们更容易受到影响。这些因素可能会损害患者的尊严感。本研究旨在比较晚期癌症老年患者在社会人口统计学和临床变量方面的尊严评分，并分析焦虑、抑郁、功能限制和社会支持对尊严评分的预测价值。
这是一项前瞻性、多中心、观察性研究，于 2020 年 2 月至 2021 年 10 月在西班牙的 15 家医院进行。新诊断为晚期癌症的患者完成了尊严（PPDS）、焦虑和抑郁（BSI）、社会支持（Duke-UNC-11）和功能限制（EORTC-C30）量表。线性回归分析探讨了焦虑、抑郁、功能状态和社会支持对尊严的影响，同时调整了社会人口统计学和临床变量。
共有 180 名患者参与了这项研究。相关性分析的结果表明，尊严与焦虑、抑郁和性别呈负相关，与社会支持、功能状态和更长的预计生存期呈正相关。因此，女性以及更焦虑和抑郁的个体在尊严量表上的得分较低，而具有更多社会支持、较少功能限制和更长预计生存期的患者得分较高。
总之，女性、教育程度较低、预计生存期较短、抑郁、焦虑、较少的社会支持和功能受限与晚期癌症老年患者的尊严较低相关。管理无法切除的晚期癌症患者的身体和心理症状是优先事项，以减轻心理困扰并提高他们的尊严感。
