Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Department of Research, CancerCare, New York, NY, USA.
Qual Life Res. 2024 Nov;33(11):2975-2985. doi: 10.1007/s11136-024-03760-7. Epub 2024 Aug 20.
This study examined the relationship between multidimensional patient concerns and anxiety and depression in a national sample of older adults with cancer (OACs ≥ 65 years) and the buffering effect of visiting providers across disciplines (e.g., oncology, allied health, primary care, mental health) on these relationships.
Participants completed a cross-sectional survey through the Cancer Support Community's Cancer Experience Registry (CER), an online community-based research initiative. Eligible participants were 65 years and older and diagnosed with cancer in the past five years. Participants completed self-report measures of (1) the severity of their concerns across multiple domains, (2) anxiety and depression, and (3) whether they received care for "symptoms and side effects" from various providers.
The sample consisted of 277 OACs; 45% endorsed elevated anxiety and 31% endorsed elevated depression. The most severe concerns were in the domains of body image and healthy lifestyle and symptom burden and impact. More severe concerns were associated with higher levels of anxiety and depression. The relationship between concern severity and distress was weaker in OACs who saw a palliative care, mental health, physical or occupational therapy provider, pharmacist, or primary care provider relative to OACs who did not. A visit with an oncology provider did not moderate most relationships between concerns and distress.
The relationship between OACs' concerns and distress was attenuated by treatment with a specialty provider. Interdisciplinary team care may be a vital component of comprehensive patient-centered care for OACs.
本研究考察了多维患者关注与癌症老年患者（≥65 岁）的焦虑和抑郁之间的关系，以及跨学科（例如肿瘤学、联合健康、初级保健、心理健康）就诊对这些关系的缓冲作用。
参与者通过癌症支持社区的癌症体验登记处（CER）完成了一项横断面调查，该登记处是一项基于在线社区的研究倡议。合格的参与者年龄在 65 岁及以上，并且在过去五年内被诊断出患有癌症。参与者完成了自我报告的多项措施，包括（1）他们在多个领域的关注的严重程度，（2）焦虑和抑郁，以及（3）他们是否从各种提供者那里获得了“症状和副作用”的护理。
该样本包括 277 名癌症老年患者；45%的人焦虑程度升高，31%的人抑郁程度升高。最严重的问题出现在身体形象和健康生活方式以及症状负担和影响领域。更严重的问题与更高水平的焦虑和抑郁有关。与未就诊的患者相比，就诊于姑息治疗、心理健康、物理或职业治疗、药剂师或初级保健提供者的患者，关注严重程度与痛苦之间的关系较弱。肿瘤学就诊并不能缓和大多数关注与痛苦之间的关系。
癌症老年患者的关注与痛苦之间的关系因接受专业治疗而减弱。跨学科团队护理可能是癌症老年患者全面以患者为中心护理的重要组成部分。
