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晚期实体肿瘤癌症患者的精神健康状况与精神疾病共病情况

Spiritual wellbeing and psychiatric comorbidity among patients with advanced-stage solid tumor cancer.

作者信息

Mahato Apurba N, Swami Mukesh K, Pareek Puneet, Nebhinani Naresh

机构信息

Departments of Psychiatry and Radiation-Oncology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.

出版信息

Indian J Psychiatry. 2025 Jun;67(6):591-599. doi: 10.4103/indianjpsychiatry.indianjpsychiatry_867_24. Epub 2025 May 16.

Abstract

BACKGROUND

The physical and psychological suffering of advanced-stage cancer patients has received attention recently, but the role of spiritual wellbeing (SpWB) in psychiatric morbidity is not adequately explored in the Indian context. Understanding this dimension may improve the quality of care among these patients.

AIM

The present study aimed to identify the correlates of SpWB and its association with psychiatric comorbidity among patients with advanced-stage solid tumor cancer.

METHODOLOGY

This cross-sectional study was conducted in the Radiation-oncology department of a tertiary-care hospital after obtaining ethical approval. Patients with advanced-stage solid tumors (n = 102) were assessed with clinical interview and rating scales [Generalised Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and Functional Assessment of Chronic Illness Therapy - Spiritual Wellbeing 12 Item Scale (FACIT-Sp-12)]. The Chi-square test, Spearman's correlation, and logistic regression were used to examine the association of SpWB with psychiatric morbidity.

RESULTS

Out of 102 patients, 36.27% had a psychiatric diagnosis, the most frequent being adjustment disorder. SpWB had a significant negative correlation with anxiety (ρ = -0.78) and depressive symptoms (ρ = -0.70). The family income (U = 848; = 0.012) and belief about cancer prognosis (χ = 12.94, = 0.002) were associated with psychiatric morbidity. In logistic regression, SpWB (OR = 0.834) was significantly associated with psychiatric comorbidity, and among its domains, only 'Meaning' was significantly associated.

CONCLUSION

A higher level of SpWB is linked with lesser depressive and anxiety symptoms and is associated with psychiatric morbidity among advanced-stage cancer patients. The finding suggests a possible role of interventions facilitating spirituality and meaning in preventing psychiatric morbidity.

摘要

背景

晚期癌症患者的身心痛苦近来受到了关注,但在印度背景下,精神健康(SpWB)在精神疾病发病率中的作用尚未得到充分探讨。了解这一方面可能会提高这些患者的护理质量。

目的

本研究旨在确定晚期实体肿瘤癌症患者中SpWB的相关因素及其与精神疾病共病的关联。

方法

本横断面研究在一家三级医院的放射肿瘤科进行,研究获得了伦理批准。对晚期实体肿瘤患者(n = 102)进行了临床访谈和评定量表评估[广泛性焦虑障碍量表-7(GAD-7)、患者健康问卷-9(PHQ-9)以及慢性病治疗功能评估-精神健康12项量表(FACIT-Sp-12)]。采用卡方检验、斯皮尔曼相关性分析和逻辑回归来检验SpWB与精神疾病发病率之间的关联。

结果

102名患者中,36.27%有精神疾病诊断,最常见的是适应障碍。SpWB与焦虑(ρ = -0.78)和抑郁症状(ρ = -0.70)呈显著负相关。家庭收入(U = 848;P = 0.012)和对癌症预后的信念(χ² = 12.94,P = 0.002)与精神疾病发病率相关。在逻辑回归中,SpWB(OR = 0.834)与精神疾病共病显著相关,在其各个维度中,只有“意义”维度显著相关。

结论

较高水平的SpWB与较少的抑郁和焦虑症状相关,并且与晚期癌症患者的精神疾病发病率有关。该发现表明,促进精神性和意义的干预措施在预防精神疾病发病率方面可能发挥作用。

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