Hermann Myriel, Goerling Ute, Hearing Charis, Mehnert-Theuerkauf Anja, Hornemann Beate, Hövel Peter, Reinicke Sabrina, Zingler Hanna, Zimmermann Tanja, Ernst Jochen
Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin, Germany.
Comprehensive Cancer Center, University Clinic Center Dresden, Dresden, Germany.
Psychooncology. 2024 Dec;33(12):e70038. doi: 10.1002/pon.70038.
Cancer places a psychological burden on both patients and their relatives. Perceived social support influences the extent of psychological distress. Our aim was to investigate associations between positive support, detrimental interactions, depression and anxiety in patient-relative dyads in the initial period after diagnosis.
Patients with a solid tumor and their relatives participated in this prospective, multicenter observational study. Participants answered validated measures including the Illness-specific Social Support Scale (SSUK-8), the Patient Health Questionnaire (PHQ-9) and the General Anxiety Disorder Scale (GAD-7). We analyzed cross-sectional data from the initial time following diagnosis with paired t-tests and actor-partner interdependence models.
A total of 347 dyads of patients (mean age 59.9 years) and their relatives (mean age 56.7 years) participated. Compared to their relatives, patients reported significantly higher levels of depression (patients: M = 6.31, SD = 4.94; relatives: M = 5.44, SD = 4.77) and lower levels of anxiety (patients: M = 4.40, SD = 4.10; relatives: M = 4.98, SD = 4.47) as well as more positive support (patients: M = 14.31, SD = 2.07; relatives: M = 12.46, SD = 3.29) and a lower frequency of detrimental interactions (patients: M = 3.21, SD = 2.97; relatives: M = 3.66, SD = 2.93). Intrapersonal effects: Positive support was associated with lower distress only for relatives, whereas detrimental interactions were associated with higher distress for both patients and relatives (all p < 0.05). Interpersonal effects: More positive support and fewer detrimental interactions experienced by relatives were associated with lower patient distress (all p < 0.05).
Better support for relatives may not only reduce their own distress, but also patients' distress. Relatives experience similar levels of distress and poorer social support than patients.
癌症给患者及其亲属都带来了心理负担。感知到的社会支持会影响心理困扰的程度。我们的目的是调查诊断后初期患者 - 亲属二元组中积极支持、有害互动、抑郁和焦虑之间的关联。
实体瘤患者及其亲属参与了这项前瞻性、多中心观察性研究。参与者回答了经过验证的量表，包括疾病特异性社会支持量表（SSUK - 8）、患者健康问卷（PHQ - 9）和广泛性焦虑障碍量表（GAD - 7）。我们使用配对t检验和actor - partner相互依赖模型分析了诊断后初始时间的横断面数据。
共有347对患者（平均年龄59.9岁）及其亲属（平均年龄56.7岁）参与。与亲属相比，患者报告的抑郁水平显著更高（患者：M = 6.31，SD = 4.94；亲属：M = 5.44，SD = 4.77），焦虑水平更低（患者：M = 4.40，SD = 4.10；亲属：M = 4.98，SD = 4.47），积极支持更多（患者：M = 14.31，SD = 2.07；亲属：M = 12.46，SD = 3.29），有害互动频率更低（患者：M = 3.21，SD = 2.97；亲属：M = 3.66，SD = 2.93）。个体内部效应：积极支持仅与亲属较低的困扰相关，而有害互动与患者和亲属较高的困扰相关（所有p < 0.05）。人际效应：亲属获得更多积极支持和更少有害互动与患者较低的困扰相关（所有p < 0.05）。
对亲属更好的支持不仅可能减轻他们自身的困扰，还可能减轻患者的困扰。亲属经历的困扰水平与患者相似，但社会支持比患者更差。
