Li Feifei, Xu Jing, He Yueyuan, Zhang Shanhong
Department of Nursing, The Second Hospital of Dalian Medical University, Dalian, China.
Front Oncol. 2024 Nov 22;14:1380916. doi: 10.3389/fonc.2024.1380916. eCollection 2024.
To explore the dynamic changes of psychological distress among patients with gynecological cancers across their treatment journey and identify the characteristics of subgroups of patients with distinct trajectories.
This study included a convenience sample of 132 patients with cervical cancer, ovarian cancer or endometrial cancer who received surgery and adjuvant chemotherapy in the gynecological department of a Grade III and Class A general hospital in Liaoning Province between November 2022 and October 2023. Patients' mean age was 55.46 ± 11.12 years. Psychological distress was measured with the Distress Thermometer and Problem List 1 day before surgery, before the first chemotherapy session, at the third chemotherapy session, and at the end of the last chemotherapy session. A latent class growth model (LCGM) was used to identify trajectories of psychological distress and explore influencing factors.
The LCGM identified three different trajectories of psychological distress in patients with gynecological cancers, including Class 1, "high level decline " (37.4%), Class 2, "no psychological distress" (24.1%), and Class 3, "high level stable" (38.5%). Multinomial logistic regression analysis showed monthly per capita household income, disease type, positive coping style and temperament type were significant predictors of trajectory of psychological distress in patients with gynecological cancers.
This study showed heterogeneity in the trajectory of psychological distress among patients with gynecological cancers. These findings should raise awareness among healthcare providers of the need to implement screening measures and timely psychological interventions in this patient population.
探讨妇科癌症患者在整个治疗过程中心理困扰的动态变化，并确定具有不同轨迹的患者亚组特征。
本研究纳入了2022年11月至2023年10月期间在辽宁省某三级甲等综合医院妇科接受手术及辅助化疗的132例宫颈癌、卵巢癌或子宫内膜癌患者的便利样本。患者的平均年龄为55.46±11.12岁。在手术前1天、第一次化疗前、第三次化疗时以及最后一次化疗结束时，使用苦恼温度计和问题清单对心理困扰进行测量。采用潜在类别增长模型（LCGM）来确定心理困扰的轨迹并探索影响因素。
LCGM确定了妇科癌症患者心理困扰的三种不同轨迹，包括第1类，“高水平下降”（37.4%），第2类，“无心理困扰”（24.1%），以及第3类，“高水平稳定”（38.5%）。多项逻辑回归分析表明，人均月家庭收入、疾病类型、积极应对方式和气质类型是妇科癌症患者心理困扰轨迹的显著预测因素。
本研究显示妇科癌症患者心理困扰轨迹存在异质性。这些发现应提高医疗服务提供者对在该患者群体中实施筛查措施和及时心理干预必要性的认识。
