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对接受心理肿瘤治疗的癌症患者饮酒情况的纵向分析。

A longitudinal analysis on alcohol consumption in patients with cancer undergoing psycho-oncological treatment.

作者信息

Kiefer Paulina, Lebherz Lisa, Freitag Janina, Schulz Holger, Bleich Christiane, Bokemeyer Carsten, Bokemeyer Frederike

机构信息

Department of Medical Psychology, University Medical Center Hamburg Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.

Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Freiburg, Hauptstraße 8, 79104, Freiburg, Germany.

出版信息

Sci Rep. 2025 Jun 20;15(1):20137. doi: 10.1038/s41598-025-04849-w.

Abstract

The negative impact of alcohol consumption on cancer development and progression is well-established in oncologic research, yet it receives surprisingly little attention from patients with cancer, the public, and even oncology professionals. A cancer diagnosis can lead to significant psychological distress, including high levels of depression and anxiety. For patients with cancer experiencing high levels of psychological burden, psycho-oncological care is available to help manage these symptoms and the overall impact of their condition. Alcohol consumption can serve as a coping mechanism for psychological stress. However, there is limited knowledge about the alcohol consumption patterns among this particularly vulnerable group of patients with cancer, as well as the patient- and disease-related factors associated with drinking. Patients with cancer are particularly susceptible to the harmful effects of alcohol. The aim of this study is to investigate the prevalence of potentially risky alcohol consumption among patients with cancer receiving psycho-oncological care over a six-month period and to identify sociodemographic, health-related, and psychosocial factors that may predict alcohol consumption after a cancer diagnosis. We conducted a secondary analysis using data from 300 patients with cancer (72 % female, mean age 52.74 years) treated at the outpatient clinic of the University Medical Center Hamburg-Eppendorf in Germany. Between 2013 and 2021 demographic, medical, and psychosocial information was collected using self-report questionnaires. A generalized longitudinal linear mixed model was used to determine the prevalence of risky and potentially harmful drinking behavior (AUDIT-C ≥ 2 for women and ≥ 3 for men) among patients with cancer as well as to identify patient characteristics associated with alcohol consumption. The results show that approximately 70% of the patients continued drinking after their cancer diagnosis, despite the known detrimental effects of alcohol on prognosis. At both time points, around 40 to 50% of female and male patients reported potentially harmful drinking behaviors (T0 (beginning of psychosocial treatment): 49.1% of female, 38.1% of male patients; T1 (6 months later): 41.2% of female and 42.9% of male patients). A higher number of comorbidities (OR = 0.707; 95% CI: 0.567-0.883), older age (OR = 0.983, 95% CI: 0.967-0.999, and higher levels of depressive symptoms (OR = 0.952, 95% CI: 0.907-0.998) were significantly associated with lower odds of risky alcohol consumption over the six-month period. In contrast, higher anxiety levels (OR = 1.075, 95% CI: 1.021-1.132) were associated with an increased likelihood of risky drinking. The significant proportion of patients with cancer consuming alcohol at levels that may worsen their cancer prognosis highlights the need for improved patient education and guidelines. The results can help identify high-risk patients who require close monitoring of their drinking behaviors during their survival period, and inform the implementation of better alcohol control measures in cancer care. By understanding alcohol consumption patterns and associated factors, we aim to promote healthier behaviors and improve treatment outcomes for patients with cancer in psycho-oncological care.

摘要

饮酒对癌症发生和发展的负面影响在肿瘤学研究中已得到充分证实,但令人惊讶的是,癌症患者、公众甚至肿瘤学专业人员对其关注甚少。癌症诊断可能导致严重的心理困扰,包括高度的抑郁和焦虑。对于心理负担较重的癌症患者,可提供心理肿瘤学护理以帮助管理这些症状及其病情的整体影响。饮酒可以作为应对心理压力的一种机制。然而,对于这一特别脆弱的癌症患者群体的饮酒模式,以及与饮酒相关的患者和疾病因素,我们了解有限。癌症患者尤其容易受到酒精有害影响。本研究的目的是调查在接受为期六个月心理肿瘤学护理的癌症患者中存在潜在风险饮酒行为的患病率,并确定可能预测癌症诊断后饮酒情况的社会人口学、健康相关和心理社会因素。我们使用来自德国汉堡 - 埃彭多夫大学医学中心门诊治疗的300名癌症患者(72%为女性,平均年龄52.74岁)的数据进行了二次分析。在2013年至2021年期间,通过自我报告问卷收集了人口统计学、医学和心理社会信息。使用广义纵向线性混合模型来确定癌症患者中危险和潜在有害饮酒行为(女性酒精使用障碍鉴定测试 - 消费项目评分(AUDIT - C)≥2,男性≥3)的患病率,并确定与饮酒相关的患者特征。结果显示,尽管已知酒精对预后有不利影响,但约70%的患者在癌症诊断后仍继续饮酒。在两个时间点,约40%至50%的女性和男性患者报告有潜在有害饮酒行为(T0(心理社会治疗开始时):49.1%的女性、38.1%的男性患者;T1(6个月后):41.2%的女性和42.9%的男性患者)。更多的合并症(比值比(OR)=0.707;95%置信区间(CI):0.567 - 0.883)、年龄较大(OR = 0.983,95% CI:0.967 - 0.999)以及更高水平的抑郁症状(OR = 0.952,95% CI:0.907 - 0.998)与六个月期间危险饮酒几率较低显著相关。相比之下,更高的焦虑水平(OR = 1.075,95% CI:1.021 - 1.132)与危险饮酒可能性增加相关。相当比例的癌症患者饮酒量可能会恶化其癌症预后,这凸显了加强患者教育和制定指南的必要性。这些结果有助于识别在生存期需要密切监测饮酒行为的高危患者,并为在癌症护理中实施更好的酒精控制措施提供依据。通过了解饮酒模式及相关因素,我们旨在促进更健康的行为,并改善接受心理肿瘤学护理的癌症患者的治疗效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc80/12181269/d8fcb11d9ffc/41598_2025_4849_Fig1_HTML.jpg

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