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820例连续黑色素瘤患者的痛苦及其决定因素

Distress and Its Determinants in 820 Consecutive Melanoma Patients.

作者信息

Reitmajer Markus, Riedel Petra, Garbe Claus, Schäffeler Norbert, Eigentler Thomas K, Forschner Andrea

机构信息

Department of Dermatology, University Hospital Tuebingen, Tuebingen, Germany.

Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany.

出版信息

Cancer Med. 2025 Mar;14(6):e70820. doi: 10.1002/cam4.70820.

Abstract

BACKGROUND

Psycho-oncological burden not only affects patients' mental health but can also decrease treatment compliance and impair outcomes. The Distress Thermometer (DT) is a widely used screening tool in real-world medical care for identifying and monitoring psychological distress. Patients with melanoma presenting in oncologic outpatient departments comprise a wide range of characteristics. Although young adults may face challenges related to pivotal life stages, such as career responsibilities or parenting, older adults often contend with mobility issues, preexisting comorbidities, or age-related physical limitations.

METHODS

We conducted a retrospective evaluation of DT data from 820 patients with melanoma treated at our outpatient department between July and September 2016. These patients underwent routine DT screening and completed the associated National Comprehensive Cancer Network (NCCN) Problem List. The study aimed to identify factors influencing DT values above the threshold (≥ 5), further characterizing the patients' complaints according to the NCCN Problem List.

RESULTS

A total of 820 patients with melanoma underwent psycho-oncological screening. More than 40% had DT values above the threshold. Significant factors associated with DT values over the threshold included female gender, younger age, and advanced melanoma stages III-IV. Analysis of the NCCN Problem List revealed complaints such as fear, sleep issues, tingling in hands and feet, feeling swollen, problems at work or school, concerns regarding God, and loss of faith.

CONCLUSION

The results indicate a high need for psycho-oncological support for patients with melanoma. Particular attention should be given to patients with the identified factors that are associated with exceeding the DT threshold.

摘要

背景

心理肿瘤负担不仅会影响患者的心理健康,还会降低治疗依从性并损害治疗效果。苦恼温度计(DT)是现实医疗护理中广泛用于识别和监测心理困扰的筛查工具。在肿瘤门诊就诊的黑色素瘤患者具有广泛的特征。虽然年轻人可能面临与关键人生阶段相关的挑战,如职业责任或育儿问题,但老年人往往要应对行动不便、既有合并症或与年龄相关的身体限制。

方法

我们对2016年7月至9月在我院门诊接受治疗的820例黑色素瘤患者的DT数据进行了回顾性评估。这些患者接受了常规DT筛查,并完成了相关的美国国立综合癌症网络(NCCN)问题清单。该研究旨在确定影响DT值高于阈值(≥5)的因素,并根据NCCN问题清单进一步描述患者的主诉。

结果

共有820例黑色素瘤患者接受了心理肿瘤筛查。超过40%的患者DT值高于阈值。与DT值超过阈值相关的显著因素包括女性、年轻以及黑色素瘤III-IV期。对NCCN问题清单的分析揭示了诸如恐惧、睡眠问题、手脚刺痛、感觉肿胀、工作或学校问题、对上帝的担忧以及失去信仰等主诉。

结论

结果表明黑色素瘤患者对心理肿瘤支持的需求很高。应特别关注具有与超过DT阈值相关的已确定因素的患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/684f/11931323/55759fa576a7/CAM4-14-e70820-g002.jpg

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