Song Haifeng, He Fengyi, Zhang Xiaoling
Department of Urology, Lu'an Hospital of Anhui Medical University, 237005 Lu'an, Anhui, China.
Actas Esp Psiquiatr. 2025 Aug;53(4):791-801. doi: 10.62641/aep.v53i4.1921.
A decreased quality of life is commonly observed in elderly patients with prostate cancer (PCa), and psychological changes in these patients require particular attention. This study aimed to investigate factors influencing depression, death anxiety, and quality of life in elderly PCa patients and to explore the mediating role of depression in the relationship between death anxiety and quality of life.
A total of 120 valid questionnaires from PCa patients at Lu'an Hospital of Anhui Medical University were collected between October 2021 and July 2024. The Templer Death Anxiety Scale (T-DAS), Zung Self-Rating Depression Scale (SDS), and Functional Assessment of Cancer Therapy for PCa (FACT-P) were used to assess death anxiety, depression, and quality of life, respectively. Influencing factors and the mediating role of depression between death anxiety and quality of life were analyzed.
(1) Patients had a mean SDS score of 56.93 ± 4.47, T-DAS score of 44.83 ± 7.18 and FACT-P score of 103.52 ± 6.22; (2) Univariate analyses showed that patients' depression levels were associated with occupational status, average monthly income, length of illness, primary caregiver, and number of chronic illnesses (p < 0.05); death anxiety levels were associated with age, length of illness, primary caregiver, and number of chronic illnesses (p < 0.05); and quality of life was associated with age, BMI, and number of primary caregivers and chronic illnesses (p < 0.05); (3) Correlation analysis showed that depression was negatively correlated with quality of life (ρ = -0.360, p < 0.001), death anxiety was negatively correlated with quality of life (ρ = -0.456, p < 0.001), and death anxiety was positively correlated with depression (ρ = 0.493, p < 0.001); (4) Death anxiety had a significant negative effect on quality of life, with a direct effect of -0.262 and a total effect of -0.429. Depression significantly mediated the relationship between death anxiety and quality of life, with a mediating effect of -0.167 (95% CI: -0.331 to -0.045).
Depressive symptoms and death anxiety are prevalent among elderly PCa patients. Death anxiety directly impacts the quality of life of patients and also mediates an indirect effect through depression, further reducing patients' quality of life.
老年前列腺癌（PCa）患者的生活质量普遍下降，这些患者的心理变化需要特别关注。本研究旨在调查影响老年PCa患者抑郁、死亡焦虑和生活质量的因素，并探讨抑郁在死亡焦虑与生活质量关系中的中介作用。
2021年10月至2024年7月期间，收集了安徽医科大学六安医院120份PCa患者的有效问卷。分别使用坦普勒死亡焦虑量表（T-DAS）、zung自评抑郁量表（SDS）和前列腺癌的癌症治疗功能评估量表（FACT-P）来评估死亡焦虑、抑郁和生活质量。分析了影响因素以及抑郁在死亡焦虑与生活质量之间的中介作用。
（1）患者的SDS平均得分为56.93±4.47，T-DAS平均得分为44.83±7.18，FACT-P平均得分为103.52±6.22；（2）单因素分析显示，患者的抑郁水平与职业状况、月平均收入、病程、主要照顾者和慢性病数量有关（p<0.05）；死亡焦虑水平与年龄、病程、主要照顾者和慢性病数量有关（p<0.05）；生活质量与年龄、BMI、主要照顾者数量和慢性病数量有关（p<0.05）；（3）相关性分析显示，抑郁与生活质量呈负相关（ρ=-0.360，p<0.001），死亡焦虑与生活质量呈负相关（ρ=-0.456，p<0.001），死亡焦虑与抑郁呈正相关（ρ=0.493，p<0.001）；（4）死亡焦虑对生活质量有显著的负向影响，直接效应为-0.262，总效应为-0.429。抑郁显著介导了死亡焦虑与生活质量之间的关系，中介效应为-0.167（95%CI：-0.331至-0.045）。
抑郁症状和死亡焦虑在老年PCa患者中普遍存在。死亡焦虑直接影响患者的生活质量，还通过抑郁介导间接效应，进一步降低患者的生活质量。
