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疼痛和应对策略是肺癌患者营养不良风险的决定因素:一项横断面研究。

Pain and Coping Strategies as Determinants of Malnutrition Risk in Lung Cancer Patients: A Cross-Sectional Study.

机构信息

Department of Internal and Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, 50-556 Wrocław, Poland.

Faculty of Medicine, Wrocław University of Science and Technology, 50-376 Wrocław, Poland.

出版信息

Nutrients. 2024 Jul 10;16(14):2193. doi: 10.3390/nu16142193.

Abstract

Progressive cachexia and malnutrition severely impact the physical and mental condition of cancer patients. Pain is a prognostic factor for shorter survival in cancer patients, and coping strategies are crucial for adapting to treatment and dietary regimens. This study assessed pain levels, pain-related beliefs, and coping strategies as factors increasing malnutrition risk in 257 lung cancer patients. Sociodemographic and clinical data were collected from medical records. The Mini Nutritional Assessment (MNA), Visual Analog Scale (VAS), Beliefs about Pain Control Questionnaire (BPCQ), and Coping Strategies Questionnaire (CSQ) were used. Overall, 42.8% of patients were at risk of malnutrition, and 17.5% were malnourished. Nutritional status negatively correlated with CSQ domains: reinterpretation of pain (RP: rho = -0.194; = 0.002), catastrophizing (CP: rho = -0.414; = 0.001), ignoring pain (IP: rho = -0.198; = 0.001), praying/hoping (PH: rho = -0.253; < 0.001), and coping self-statements (CS: rho = -0.172; = 0.006); and BPCQ domains: the power of doctors (PD: rho = -0.196; = 0.002) and VAS (rho = -0.451; < 0.001). Nutritional status positively correlated with CSQ domains: pain control (PC: rho = 0.499; < 0.001) and the ability to reduce pain (AR: rho = 0.512; < 0.001). In multivariate regression analysis, a better nutritional status was associated with a younger age (β = -0.094; < 0.001), non-small-cell lung cancer (NSCLC) (β = 1.218; = 0.037), a greater ability to reduce pain (CSQ-AR) (β = 0.901; < 0.001), lower catastrophizing (CSQ-CP) (β = -0.165; = 0.001), and lower pain perceived (VAS) (β = 0.639; < 0.001). Statistical analyses included Spearman's correlation and multivariate regression with a significance level of < 0.05. Patients with a normal nutritional status had reduced doctor involvement in pain control, less frequent negative coping strategies, and more common positive coping strategies. A normal nutritional status correlates with lower perceived pain. A better nutritional status is linked to a younger age, NSCLC, lower pain levels, greater pain reduction ability, and lower scores in pain catastrophizing.

摘要

进行性恶病质和营养不良严重影响癌症患者的身心状况。疼痛是癌症患者生存时间更短的预后因素,应对策略对于适应治疗和饮食方案至关重要。本研究评估了 257 名肺癌患者的疼痛水平、与疼痛相关的信念和应对策略,这些因素增加了营养不良的风险。从病历中收集了社会人口统计学和临床数据。使用了迷你营养评估量表(MNA)、视觉模拟量表(VAS)、疼痛控制信念问卷(BPCQ)和应对策略问卷(CSQ)。总体而言,42.8%的患者有营养不良风险,17.5%的患者营养不良。营养状况与 CSQ 各领域呈负相关:对疼痛的重新解释(RP:rho = -0.194; = 0.002)、灾难化(CP:rho = -0.414; = 0.001)、忽略疼痛(IP:rho = -0.198; = 0.001)、祈祷/希望(PH:rho = -0.253; < 0.001)和应对自我陈述(CS:rho = -0.172; = 0.006);以及 BPCQ 各领域:医生的力量(PD:rho = -0.196; = 0.002)和 VAS(rho = -0.451; < 0.001)。营养状况与 CSQ 各领域呈正相关:疼痛控制(PC:rho = 0.499; < 0.001)和减轻疼痛的能力(AR:rho = 0.512; < 0.001)。在多变量回归分析中,更好的营养状况与更年轻的年龄(β = -0.094; < 0.001)、非小细胞肺癌(NSCLC)(β = 1.218; = 0.037)、更大的减轻疼痛能力(CSQ-AR)(β = 0.901; < 0.001)、更低的灾难化(CSQ-CP)(β = -0.165; = 0.001)和更低的疼痛感知(VAS)(β = 0.639; < 0.001)相关。统计分析包括 Spearman 相关性和多变量回归,显著性水平为 < 0.05。营养状况正常的患者医生在疼痛控制方面的参与度降低,负面应对策略的频率降低,而常见的积极应对策略增加。正常的营养状况与疼痛感知降低相关。更好的营养状况与更年轻的年龄、非小细胞肺癌、更低的疼痛水平、更大的疼痛缓解能力和更低的疼痛灾难化评分有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/01a3/11279586/50936b716a05/nutrients-16-02193-g001.jpg

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