Harris Carolyn S, Conley Yvette P, Rosenzweig Margaret Q, Erickson Kirk I, Cooper Bruce A, Bender Catherine M
Author Affiliations: School of Nursing, University of Pittsburgh, Pennsylvania (Drs Harris, Conley, Rosenzweig, and Bender); Neuroscience Institute, AdventHealth Research Institute, Orlando, Florida (Dr Erickson); School of Nursing, University California, San Francisco, California (Dr Cooper).
Cancer Nurs. 2024 Dec 2. doi: 10.1097/NCC.0000000000001423.
Although common, the severity of the psychological symptom cluster (PSC) (ie, co-occurrence of anxiety, depression, fatigue, sleep disturbance) varies among women with breast cancer. In addition, the impact of various types of stress and other risk factors on its severity are understudied, and the influence of the PSC on quality of life (QOL) outcomes remains poorly characterized.
To identify subgroups of postmenopausal women with breast cancer with distinct PSC severity profiles following surgery and evaluate whether these subgroups differed in terms of demographic and clinical characteristics, symptoms, social and posttraumatic stress, and QOL.
Following surgery, 159 postmenopausal women with early-stage, hormone receptor-positive breast cancer completed assessments of anxiety, depression, fatigue, sleep disturbance, cognitive function, physical symptoms, stress, and QOL. Latent profile analysis was used to identify subgroups of women based on the severity of the prespecified PSC. Parametric and nonparametric tests were used to evaluate for subgroup differences.
Three distinct PSC severity subgroups were identified (ie, Lower [71.7%], Moderate [23.9%], Higher [4.4%]). Compared with the Lower subgroup, the Moderate subgroup was less likely to have received prior radiation, and the Moderate and Higher subgroups had worse perceived cognitive function, higher symptom burden, higher posttraumatic stress, and lower QOL. Clinically relevant sleep disturbance was common across PSC subgroups.
PSC severity is associated with higher posttraumatic stress and poorer QOL following breast surgery. Sleep disturbance is a common problem and may be undertreated.
Assessments of posttraumatic stress and sleep disturbance are needed for timely intervention.
心理症状群（PSC）（即焦虑、抑郁、疲劳、睡眠障碍同时出现）在乳腺癌女性患者中很常见，但其严重程度因人而异。此外，各类压力及其他风险因素对其严重程度的影响研究不足，且PSC对生活质量（QOL）结果的影响仍未得到充分描述。
识别绝经后乳腺癌女性患者术后具有不同PSC严重程度特征的亚组，并评估这些亚组在人口统计学和临床特征、症状、社会及创伤后应激以及QOL方面是否存在差异。
术后，159名绝经后早期激素受体阳性乳腺癌女性患者完成了焦虑、抑郁、疲劳、睡眠障碍、认知功能、身体症状、应激及QOL的评估。采用潜在剖面分析根据预先设定的PSC严重程度识别女性亚组。使用参数检验和非参数检验评估亚组差异。
识别出三个不同的PSC严重程度亚组（即低严重程度组[71.7%]、中等严重程度组[23.9%]、高严重程度组[4.4%]）。与低严重程度组相比，中等严重程度组接受过先前放疗的可能性较小，中等严重程度组和高严重程度组的认知功能自评较差、症状负担较重、创伤后应激较高且QOL较低。临床相关的睡眠障碍在各PSC亚组中均很常见。
PSC严重程度与乳腺癌术后较高的创伤后应激及较差的QOL相关。睡眠障碍是一个常见问题，可能未得到充分治疗。
需要对创伤后应激和睡眠障碍进行评估以便及时干预。
