Wang Xiaoxuan, Zou Wenjie, Du Qianqian, Xie Jingyue, Zhong Mengjiao, Li Xinxin, Wu Xiaodan, Zhang Meifen
School of Nursing, Sun Yat-sen University, Guangzhou, China.
Hengrui Pharmaceutical, Wuhan, China.
J Adv Nurs. 2025 Jul;81(7):3929-3942. doi: 10.1111/jan.16585. Epub 2024 Nov 19.
To identify the longitudinal trajectories of psychological distress and to explore the predictive factors of different trajectories among young and middle-aged colorectal cancer patients from diagnosis to 6 months postoperation.
A longitudinal study was conducted, guided by the STROBE checklist.
A total of 214 patients were recruited from July 2021 to May 2022 at a cancer hospital in Guangzhou, China. Data were collected from diagnosis to 6 months post-surgery, using the Brief Symptom Inventory-18, Distress Disclosure Index, Connor-Davidson Resilience Scale and Social Support Rating Scale. We also collected socio-demographic and clinical characteristics at baseline. General estimation equation (GEE) was used to analyse the overall trend of psychological distress. To identify distinct distress trajectories, growth mixture modelling (GMM) and latent class growth modelling (LCGM) were both used.
Longitudinal trajectories of psychological distress: the average score of psychological distress at different time points were 12.02 ± 9.87, 17.40 ± 9.73, 15.91 ± 10.05, 16.28 ± 11.24 and 16.31 ± 11.66. GEE showed four unique trajectories of psychological distress: chronic distress, no distress, steady increase and significantly increased. With reference to resilient group, multinomial logistic regression showed that education level, monthly income, minor offspring, stoma, residence, self-disclosure and psychological resilience were predictive factors of chronic distress class or increase-distress class.
From diagnosis to 6 months post-surgery, psychological distress increased at discharge, gradually stabilising thereafter. Meanwhile, results revealed heterogeneity in this population. To effectively alleviate distress, it is crucial to identify high-risk individuals through predictive factors and implement tailored interventions.
IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: This study offers the trajectory and predictors of psychological distress in the process of diagnosis and treatment, and can be used in the clinical identification and monitoring of high-risk patients.
The findings suggest that healthcare providers should regularly monitored and identified the psychological distress of patients, and took individualised intervention measures.
This study is reported using the STROBE guidelines.
No patient or public engagement.
确定心理困扰的纵向轨迹，并探讨中青年结直肠癌患者从诊断到术后6个月不同轨迹的预测因素。
采用STROBE清单指导进行纵向研究。
2021年7月至2022年5月在中国广州一家癌症医院招募了214例患者。从诊断到术后6个月收集数据，使用简明症状量表-18、苦恼披露指数、康纳-戴维森心理韧性量表和社会支持评定量表。我们还在基线时收集了社会人口学和临床特征。采用广义估计方程（GEE）分析心理困扰的总体趋势。为了确定不同的苦恼轨迹，同时使用了增长混合模型（GMM）和潜在类别增长模型（LCGM）。
心理困扰的纵向轨迹：不同时间点心理困扰的平均得分分别为12.02±9.87、17.40±9.73、15.91±10.05、16.28±11.24和16.31±11.66。GEE显示心理困扰有四种独特轨迹：慢性困扰、无困扰、稳步增加和显著增加。以心理韧性组为参照，多项逻辑回归显示教育水平、月收入、未成年子女、造口、居住地、自我表露和心理韧性是慢性困扰组或增加困扰组的预测因素。
从诊断到术后6个月，心理困扰在出院时增加，此后逐渐稳定。同时，结果显示该人群存在异质性。为有效缓解困扰，通过预测因素识别高危个体并实施针对性干预至关重要。
对专业和/或患者护理的意义：本研究提供了诊断和治疗过程中心理困扰的轨迹和预测因素，可用于临床识别和监测高危患者。
研究结果表明，医疗服务提供者应定期监测和识别患者的心理困扰，并采取个体化干预措施。
本研究采用STROBE指南进行报告。
未涉及患者或公众参与。
