Wang Changying, Wang Jin, Zhang Yunwei, Wang Yi, Yang Ya, Ding Hansheng
Shanghai Health Development Research Center (Shanghai Medical Information Center), Shanghai, China.
Dahua Hospital, Xuhui District, Shanghai, China.
Support Care Cancer. 2025 Jul 16;33(8):695. doi: 10.1007/s00520-025-09740-y.
There has been increasing attention on negative emotions in advanced cancer patients. The correlative factors of negative emotions (anger/agitation) and the role of spousal care in older adults with advanced cancer remain limited.
This study was based on large cross-sectional sample data; a total of 117,396 individuals were included, who were conscious, cognitively intact home-dwelling older adults. Multivariable logistic regression analyses were conducted on the correlative factors of anger/agitation and the correlation between anger/agitation and spousal care.
Among home-dwelling older adults with advanced cancer, 8.3% reported more feelings of anger/agitation in the past week, which was significantly lower than the results previously reported for other negative emotions (depression and anxiety). It was found that significant positive correlates of anger/agitation in older adults with advanced cancer included education level, receiving formal care, and the number of chronic diseases. Significant negative correlates included advanced age (≥ 80 years), 1-12 outpatient visits, and 1-6 inpatient services in the past year. Emotional expressions among cancer patients may differ markedly between cultural contexts. Spousal care played a positive role in providing emotional support to older adults with advanced cancer and chronic diseases.
Older adults with higher education levels were more likely to experience anger/agitation; it is suggested that strategies are tailored to educational levels. Home-dwelling older adults had a reduced likelihood of experiencing anger/agitation. At the end-of-life stage, those who received spousal care, the likelihood of experiencing anger/agitation in both the advanced cancer group and the chronic diseases group was found to be significantly reduced. It was recommended to focus on socioeconomic disparities among older adults with advanced cancer in end-of-life care and to improve home-based palliative care. There is a need to consider the specific type of emotions under different cultural surroundings. Culturally adapted hierarchical strategies are critical for China's aging cancer population on government, community, and technological levels.
晚期癌症患者的负面情绪日益受到关注。负面情绪（愤怒/激动）的相关因素以及配偶照顾在老年晚期癌症患者中的作用仍然有限。
本研究基于大型横断面样本数据；共纳入117396名个体，他们是意识清醒、认知完整的居家老年人。对愤怒/激动的相关因素以及愤怒/激动与配偶照顾之间的相关性进行多变量逻辑回归分析。
在居家老年晚期癌症患者中，8.3%的人报告在过去一周有更多愤怒/激动情绪，这显著低于先前报告的其他负面情绪（抑郁和焦虑）的结果。研究发现，老年晚期癌症患者愤怒/激动的显著正相关因素包括教育水平、接受正规护理以及慢性病数量。显著负相关因素包括高龄（≥80岁）、过去一年1 - 12次门诊就诊以及1 - 6次住院服务。癌症患者的情绪表达在不同文化背景下可能存在显著差异。配偶照顾在为老年晚期癌症和慢性病患者提供情感支持方面发挥了积极作用。
教育水平较高的老年人更容易出现愤怒/激动情绪；建议根据教育水平制定相应策略。居家老年人出现愤怒/激动情绪的可能性降低。在生命末期阶段，接受配偶照顾的患者中，晚期癌症组和慢性病组出现愤怒/激动情绪的可能性均显著降低。建议在临终关怀中关注老年晚期癌症患者的社会经济差异，并改善居家姑息治疗。需要考虑不同文化背景下特定的情绪类型。在政府、社区和技术层面，针对中国老年癌症患者的文化适应性分层策略至关重要。
