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妇科癌症患者从初次诊断到术后未满足的护理需求、社会支持及痛苦的变化:一项纵向研究。

Changes in unmet care needs, social support and distress from initial diagnosis to post-surgery in patients with gynecological cancer: A longitudinal study.

作者信息

Adamakidou Theodoula, Menti Konstantina, Charalambous Andreas, Tsiou Chrysoula, Vlachou Eugenia, Govina Ourania

机构信息

Nursing Department, Postgraduate Program of Μanagement of Chronic Diseases, University of West Attica, Athens, Greece.

Nursing Department, Postgraduate Program of Μanagement of Chronic Diseases, University of West Attica, Athens, Greece; Agios Savvas Anticancer Hospital, Athens, Greece.

出版信息

Eur J Oncol Nurs. 2023 Oct;66:102358. doi: 10.1016/j.ejon.2023.102358. Epub 2023 Jun 10.

DOI:10.1016/j.ejon.2023.102358
PMID:37572628
Abstract

PURPOSE

This study aimed to explore the changes in unmet care needs, perceived social support, and levels of distress experienced by newly diagnosed Greek patients with gynecological cancer during the phase after diagnosis and before surgical treatment (T0), and 4 months after surgical treatment at the first postoperative follow-up visit (T1).

METHODS

This was a prospective, longitudinal, descriptive study based on the framework of stress and coping theory. The Needs Evaluation Questionnaire, Depression, Anxiety and Stress Scale (DASS-21), Multidimensional Scale of Perceived Social Support (MSPSS), and a demographic and clinical data questionnaire were distributed to a convenience sample of 86 patients.

RESULTS

A convenience sample of 86 patients newly diagnoised with gynecological cancer participated in the study. The mean age of the participants was 60.7 years (SD = 10.9 years) while 57.6% of them were married. Overall, patients' needs and social support had significantly decreased at T1 compared to T0 (p = 0.005 and p = 0.029, respectively). DASS-21 subscale scores did not change significantly at T1, whereas anxiety levels were significantly lower at follow-up (p = 0.048). Changes in anxiety levels were associated with changes in needs related to family (p < 0.001), need for assistance/care (p = 0.013) and support (p = 0.004), and total needs (p = 0.004).

CONCLUSION

The phase following cancer diagnosis and awaiting surgery is a high-risk period for the mental health of women with gynecological cancer, and one that requires special attention from healthcare professionals. By identifying unmet needs, addressing anxiety and providing appropriate social support, healthcare professional can contribute significantly to improving patients' quality of life throughout their cancer journey.

摘要

目的

本研究旨在探讨希腊新诊断的妇科癌症患者在诊断后至手术治疗前阶段(T0)以及术后首次随访4个月(T1)时未满足的护理需求、感知到的社会支持和痛苦程度的变化。

方法

这是一项基于压力与应对理论框架的前瞻性、纵向、描述性研究。向86例患者的便利样本发放了需求评估问卷、抑郁、焦虑和压力量表(DASS-21)、感知社会支持多维量表(MSPSS)以及一份人口统计学和临床数据问卷。

结果

86例新诊断为妇科癌症的患者便利样本参与了本研究。参与者的平均年龄为60.7岁(标准差 = 10.9岁),其中57.6%已婚。总体而言,与T0相比,患者在T1时的需求和社会支持显著下降(分别为p = 0.005和p = 0.029)。DASS-21分量表得分在T1时无显著变化,而随访时焦虑水平显著降低(p = 0.048)。焦虑水平的变化与家庭相关需求的变化(p < 0.001)、对帮助/护理的需求(p = 0.013)、支持需求(p = 0.004)以及总需求(p = 0.004)相关。

结论

癌症诊断后等待手术的阶段是妇科癌症女性心理健康的高风险期,需要医护人员给予特别关注。通过识别未满足的需求、解决焦虑问题并提供适当的社会支持,医护人员可以在患者整个癌症治疗过程中显著提高其生活质量。

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