Ramos Katherine, King Heather A, Gladney Micaela N, Woolson Sandra L, Coffman Cynthia, Bosworth Hayden B, Porter Laura S, Hastings S Nicole
Department of Psychiatry and Behavioral Sciences, Duke University Medical Center.
Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System.
Psychol Serv. 2024 Nov;21(4):773-783. doi: 10.1037/ser0000839. Epub 2024 Mar 4.
Psychological distress while coping with cancer is a highly prevalent and yet underrecognized and burdensome adverse effect of cancer diagnosis and treatment. Left unaddressed, psychological distress can further exacerbate poor mental health, negatively influence health management behaviors, and lead to a worsening quality of life. This multimethod study primarily focused on understanding veterans' psychological distress and personal experiences living with lung cancer (an underrepresented patient population). In a sample of 60 veterans diagnosed with either nonsmall cell lung cancer (NSCLC) or small cell lung cancer (SCLC), we found that distress is common across clinical psychology measures of depression (37% [using the Patient Health Questionnaire, PHQ-9 measure]), anxiety (35% [using the Generalized Anxiety Disorder, GAD-7 measure]), and cancer-related posttraumatic stress (13% [using the Posttraumatic Stress Symptom Checklist measure]). A total of 23% of the sample endorsed distress scores on two or more mental health screeners. Using a broader cancer-specific distress measure (National Comprehensive Cancer Network), 67% of our sample scored above the clinical cutoff (i.e., ≥ 3), and in the follow-up symptom checklist of the National Comprehensive Cancer Network measure, a majority endorsed feeling sadness (75%), worry (73%), and depression (60%). Qualitative analysis with a subset of 25 veterans highlighted that psychological distress is common, variable in nature, and quite bothersome. Future research should (a) identify veterans at risk for distress while living with lung cancer and (b) test supportive mental health interventions to target psychological distress among this vulnerable veteran population. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
在应对癌症过程中的心理困扰是癌症诊断和治疗中一种非常普遍但却未得到充分认识且负担沉重的不良影响。如果不加以解决，心理困扰会进一步加剧心理健康问题，对健康管理行为产生负面影响，并导致生活质量下降。这项多方法研究主要聚焦于了解退伍军人的心理困扰以及患肺癌（一个代表性不足的患者群体）后的个人经历。在一个由60名被非非非小细胞肺癌（NSCLC）或小细胞肺癌（SCLC）退伍军人组成的样本中，我们发现，在抑郁（37%[使用患者健康问卷，PHQ - 9量表]）、焦虑（35%[使用广泛性焦虑障碍，GAD - 7量表]）以及癌症相关创伤后应激（13%[使用创伤后应激症状清单量表]）的临床心理学测量中，困扰都很常见。共有23%的样本在两项或更多心理健康筛查中认可存在困扰得分。使用更广泛的癌症特异性困扰测量工具（美国国立综合癌症网络），我们样本中的67%得分高于临床临界值（即≥3），并且在国立综合癌症网络测量工具的后续症状清单中，大多数人认可感到悲伤（75%）、担忧（73%）和抑郁（60%）。对其中25名退伍军人进行的定性分析突出表明，心理困扰很常见，性质多样，且相当令人烦恼。未来的研究应该（a）识别出患肺癌退伍军人中存在困扰风险的人群，以及（b）测试针对这一脆弱退伍军人群体心理困扰的支持性心理健康干预措施。（PsycInfo数据库记录（c）2024美国心理学会，保留所有权利）
