Author Affiliations: Instituto de Investigación Biosanitaria, ibs.GRANADA (Drs Petrova, Ubago-Guisado, Caparros-Gonzalez, and Sánchez, and Mr Rendondo-Sánchez), Granada; Escuela Andaluza de Salud Pública (Drs Petrova, Ubago-Guisado, and Sánchez, and Mr Rendondo-Sánchez), Granada; CIBER of Epidemiology and Public Health (Drs Petrova, Ubago-Guisado, Pérez-Gómez, and Sánchez, and Mr Rendondo-Sánchez), Madrid; University of Granada (Drs Garcia-Retamero, Catena, and Caparros-Gonzalez); National Center for Epidemiology, Health Institute Carlos III (Dr Pérez-Gómez), Madrid; and Departamento de Medicina Preventiva y Salud Pública, Universidad de Granada (Dr Sánchez), Spain.
Cancer Nurs. 2024;47(4):290-298. doi: 10.1097/NCC.0000000000001216. Epub 2023 Mar 15.
Individuals with cancer often experience stress throughout the cancer trajectory and have a high risk of experiencing depression.
The aim of this study was to examine the relationship between allostatic load (AL), a measure of cumulative stress-related physiologic dysregulation of different body systems, and symptoms of depression in cancer survivors.
Participants were 294 adult cancer survivors from the US National Health and Nutrition Examination Survey (NHANES 2007-2018). Allostatic load was measured using 14 indicators representing cardiometabolic risk, glucose metabolism, cardiopulmonary functioning, parasympathetic functioning, and inflammation. Depressive symptoms were measured with the Patient Health Questionnaire-9. The relationship between AL and depressive symptoms was investigated using multiple regression adjusted for diverse sociodemographic and diagnosis variables.
Higher AL was associated with higher depressive symptom scores. The higher risk of depression was concentrated among those survivors in the highest AL quartile, with 21% (95% confidence interval, 11%-32%) of survivors presenting a high risk of depression compared with 8% to 11% of survivors in the lower quartiles. In exploratory analyses, the relationship between AL and depressive symptoms was only significant among survivors with a lower income. In contrast, in survivors in the highest income group, depressive symptoms were lower and unrelated to AL.
High AL is associated with more depressive symptoms among cancer survivors.
Nurses have an important role in identifying psychological distress in cancer patients and survivors. Further research is needed to investigate the usefulness of AL as a marker in the context of cancer follow-up care and screening for psychological distress.
癌症患者在癌症病程中经常会经历压力，并且有很高的抑郁风险。
本研究旨在探讨全身性适应负荷（AL）与癌症幸存者抑郁症状之间的关系，AL 是一种衡量不同身体系统与压力相关的生理失调的累积指标。
参与者为来自美国国家健康和营养调查（NHANES 2007-2018）的 294 名成年癌症幸存者。使用代表心血管代谢风险、葡萄糖代谢、心肺功能、副交感神经功能和炎症的 14 个指标来衡量全身性适应负荷。使用患者健康问卷-9 来衡量抑郁症状。使用多元回归调整了多种社会人口学和诊断变量，来探讨 AL 与抑郁症状之间的关系。
较高的 AL 与较高的抑郁症状评分相关。在 AL 最高四分位数的幸存者中，抑郁风险较高，有 21%（95%置信区间，11%-32%）的幸存者存在较高的抑郁风险，而在较低四分位数的幸存者中，这一比例为 8%至 11%。在探索性分析中，AL 与抑郁症状之间的关系仅在收入较低的幸存者中显著。相比之下，在收入最高的幸存者中，抑郁症状较低且与 AL 无关。
高 AL 与癌症幸存者更多的抑郁症状相关。
护士在识别癌症患者和幸存者的心理困扰方面具有重要作用。需要进一步研究以探讨 AL 作为癌症随访护理和心理困扰筛查背景下的标志物的有用性。
