Senkpeil Ryan R, Olson Julie S, Fortune Erica E, Zaleta Alexandra K
Research and Training Institute, Cancer Support Community, Philadelphia, PA, USA.
J Patient Exp. 2022 Nov 1;9:23743735221134733. doi: 10.1177/23743735221134733. eCollection 2022.
Advances in diagnostics and therapeutics have improved prognosis for metastatic breast cancer (MBC). Yet, treatment and disease burden-including experiences of pain and nausea-present practical and emotional challenges. To better support patients and enhance quality of life, deeper understanding of the pathways linking physical and psychological health is needed. To this end, we examined associations of pain and nausea with depression and anxiety among women with MBC. In doing so, we highlighted social function as a potentially important mechanism in this relationship. This observational, cross-sectional study included 148 predominantly non-Hispanic White, highly educated women living with MBC. Multivariate regression models demonstrated that more intense pain and nausea were significantly associated with higher levels of depression and anxiety ( < .001). Causal mediation analyses confirmed significant indirect effects whereby decreases in social function associated with pain and nausea contributed to depression and anxiety. Thus, our findings illustrate decreased social function as one pathway through which pain and nausea contribute to escalation of depression and anxiety. Our results, therefore, underscore the importance of supporting social function among women with MBC to potentially reduce psychological sequelae of pain and nausea.
诊断和治疗方面的进展改善了转移性乳腺癌(MBC)的预后。然而,治疗和疾病负担,包括疼痛和恶心的经历,带来了实际和情感上的挑战。为了更好地支持患者并提高生活质量,需要更深入地了解连接身心健康的途径。为此,我们研究了MBC女性中疼痛和恶心与抑郁和焦虑之间的关联。在此过程中,我们强调社会功能是这种关系中一个潜在的重要机制。这项观察性横断面研究纳入了148名主要为非西班牙裔白人、受过高等教育的MBC女性。多变量回归模型表明,更强烈的疼痛和恶心与更高水平的抑郁和焦虑显著相关(<0.001)。因果中介分析证实了显著的间接效应,即与疼痛和恶心相关的社会功能下降导致了抑郁和焦虑。因此,我们的研究结果表明社会功能下降是疼痛和恶心导致抑郁和焦虑加剧的一条途径。所以,我们的结果强调了支持MBC女性社会功能对于潜在减轻疼痛和恶心的心理后遗症的重要性。