Cantor Center for Research in Nursing and Patient Care Services, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.
Department of Physiological Nursing, School of Nursing, University of California, San Francisco, California, USA.
Semin Oncol Nurs. 2023 Aug;39(4):151431. doi: 10.1016/j.soncn.2023.151431. Epub 2023 May 8.
In a sample of patients with gynecologic cancers who are receiving chemotherapy, subgroups of patients with distinct state anxiety profiles were identified, and differences among the subgroups in demographic and clinical characteristics, stress, exposure to stressful life events, resilience, and coping behaviors were evaluated.
Patients (n = 230) completed questionnaires six times over two chemotherapy cycles. State anxiety was measured using the Spielberger State Anxiety Inventory. Subgroups of patients with distinct state anxiety profiles were identified using latent profile analysis. Differences among the classes were assessed using parametric and nonparametric tests.
Three distinct state anxiety profiles were identified: low (55.2%), moderate (38.3%), and very high (6.5%). Compared with the low class, persons in the other two classes had lower functional status, more comorbidities, higher perceived stress, and lower resilience and were more likely to report a history of depression and to use disengagement coping strategies. Compared with the low class, the very high class was more likely to report childcare responsibilities; have a history of lung disease, stomach disease, or low back pain; have experienced physical neglect, serious money problems, a serious disaster, or foster care; or were a caregiver for someone with a severe disability.
Nearly 45% of patients reported clinically meaningful levels of state anxiety that persisted over two cycles of chemotherapy. Experiences with a variety of stressors may be risk factors for higher levels of anxiety during chemotherapy. Clinicians need to perform comprehensive social histories and assess for anxiety in patients receiving chemotherapy.
在接受化疗的妇科癌症患者样本中，确定了具有不同状态焦虑特征的患者亚组，并评估了亚组在人口统计学和临床特征、压力、应激性生活事件暴露、适应力和应对行为方面的差异。
患者（n=230）在两个化疗周期内完成了六次问卷调查。使用 Spielberger 状态焦虑量表测量状态焦虑。使用潜在剖面分析确定具有不同状态焦虑特征的患者亚组。使用参数和非参数检验评估类之间的差异。
确定了三种不同的状态焦虑特征：低（55.2%）、中（38.3%）和非常高（6.5%）。与低焦虑组相比，其他两组的功能状态较低、合并症较多、感知压力较高、适应力较低，更有可能报告抑郁病史和采用回避应对策略。与低焦虑组相比，非常高焦虑组更有可能报告照顾儿童的责任；患有肺病、胃病或腰痛；经历过身体忽视、严重的经济问题、严重灾害或寄养；或照顾严重残疾的人。
近 45%的患者报告了持续两个化疗周期的具有临床意义的状态焦虑水平。各种压力源的经历可能是化疗期间焦虑水平较高的风险因素。临床医生需要对接受化疗的患者进行全面的社会病史评估和焦虑评估。
