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宫颈癌患者放疗期间的焦虑、抑郁及应对方式及其与疾病不确定感的相关性

Anxiety, depression, and coping styles among cervical cancer patients during radiotherapy and their correlations with uncertainty in illness.

作者信息

Ma Chen-Ying, Shang Jing, Zhang Lu, Chen Jie, Qian Ke-Yan, Zhou Ju-Ying

机构信息

Department of Radiation Oncology, The First Affiliated Hospital of Soochow University, Suzhou 215123, Jiangsu Province, China.

Department of Psychiatry, The First Affiliated Hospital of Soochow University, Suzhou 215123, Jiangsu Province, China.

出版信息

World J Psychiatry. 2025 Apr 19;15(4):103510. doi: 10.5498/wjp.v15.i4.103510.

Abstract

BACKGROUND

Currently, there is limited research examining the relationship between anxiety, depression, coping styles, and illness uncertainty in patients with cervical cancer (CC) undergoing radiotherapy. Addressing this gap could provide valuable insights and more reliable evidence for clinical practice targeting this patient population.

AIM

To analyze the anxiety, depression, and coping styles of patients with CC undergoing radiotherapy and explore their correlations with illness uncertainty.

METHODS

A total of 200 patients with CC undergoing radiotherapy at The First Affiliated Hospital of Soochow University between June 2018 and June 2022 were enrolled. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS), comprising subscales for anxiety (HADS-A) and depression (HADS-D). Coping styles were evaluated using the Jalowiec Coping Scale (JCS-60), comprising dimensions such as confrontive, evasive, optimistic, fatalistic, emotive, palliative, supportive, and self-reliant. Illness uncertainty was measured using the Mishel Uncertainty in Illness Scale (MUIS), encompassing ambiguity, complexity, information deficit, and unpredictability. Correlations among anxiety, depression, coping styles, and illness uncertainty were analyzed.

RESULTS

During radiotherapy, the mean scores were 7.12 ± 3.39 for HADS-A, 6.68 ± 3.49 for HADS-D, 1.52 ± 0.23 for JCS-60, and 93.40 ± 7.44 for MUIS. Anxiety (HADS-A ≥ 8) was present in 39.5% of patients, depression (HADS-D ≥ 8) in 41.0%, and both in 14.0%. Anxiety was significantly positively correlated with ambiguity, unpredictability, and total MUIS score ( < 0.05). Depression was significantly positively correlated with ambiguity, information deficit, unpredictability, and total MUIS score ( < 0.05). Most patients adopted an optimistic coping style, whereas the emotive style was least utilized. Evasive, fatalistic, and emotive coping styles were significantly positively correlated with illness uncertainty, whereas the self-reliant style was significantly negatively correlated with unpredictability ( < 0.05).

CONCLUSION

Anxiety, depression, and coping styles in patients with CC undergoing radiotherapy correlate significantly with their level of illness uncertainty. Medical staff should address patients' psychological status and coping strategies by providing targeted information to reduce negative emotions, foster adaptive coping styles, and decrease illness uncertainty.

摘要

背景

目前,关于接受放疗的宫颈癌(CC)患者焦虑、抑郁、应对方式与疾病不确定性之间关系的研究有限。填补这一空白可为针对该患者群体的临床实践提供有价值的见解和更可靠的证据。

目的

分析接受放疗的CC患者的焦虑、抑郁和应对方式,并探讨它们与疾病不确定性的相关性。

方法

选取2018年6月至2022年6月在苏州大学附属第一医院接受放疗的200例CC患者。使用医院焦虑抑郁量表(HADS)评估焦虑和抑郁,该量表包括焦虑分量表(HADS - A)和抑郁分量表(HADS - D)。使用贾洛维茨应对量表(JCS - 60)评估应对方式,该量表包括对抗、回避、乐观、宿命、情感、姑息、支持和自力更生等维度。使用疾病不确定感量表(MUIS)测量疾病不确定性,该量表包括模糊性、复杂性、信息缺乏和不可预测性。分析焦虑、抑郁、应对方式与疾病不确定性之间的相关性。

结果

放疗期间,HADS - A的平均分为7.12±3.39,HADS - D的平均分为6.68±3.49,JCS - 60的平均分为1.52±0.23,MUIS的平均分为93.40±7.44。39.5%的患者存在焦虑(HADS - A≥8),41.0%的患者存在抑郁(HADS - D≥8),14.0%的患者两者皆有。焦虑与模糊性、不可预测性和MUIS总分显著正相关(<0.05)。抑郁与模糊性、信息缺乏、不可预测性和MUIS总分显著正相关(<0.05)。大多数患者采用乐观应对方式,而情感应对方式使用最少。回避、宿命和情感应对方式与疾病不确定性显著正相关,而自力更生应对方式与不可预测性显著负相关(<0.05)。

结论

接受放疗的CC患者的焦虑、抑郁和应对方式与他们的疾病不确定程度显著相关。医护人员应通过提供有针对性的信息来关注患者的心理状态和应对策略,以减少负面情绪,培养适应性应对方式,并降低疾病不确定性。

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