Nerenz D R, Leventhal H, Love R R
Cancer. 1982 Sep 1;50(5):1020-7. doi: 10.1002/1097-0142(19820901)50:5<1020::aid-cncr2820500534>3.0.co;2-j.
Recent studies have demonstrated that patients receiving cancer chemotherapy are more likely to have a successful treatment outcome if they receive optimal doses of drug continually. The current study was designed as a first step toward discovering factors that are associated with emotional distress during treatment and subsequent decisions by patients to delay, reduce, or terminate treatment. Interviews were conducted with 61 patients receiving chemotherapy for malignant lymphoma. Patients reported on side effects of treatment and their efforts to control them, their knowledge and beliefs about their illness, their strategies for monitoring the effectiveness of treatment, and the extent to which they had been prepared for the experiences of chemotherapy. Ratings of emotional distress were obtained on an 11-point self-report scale, and information about treatment schedules was obtained from medical records. The number of side effects experienced, but not the duration or severity, was positively correlated with distress. Vague, diffuse side effects such as tiredness and pain were more likely to be associated with distress than were acute, specific side effects such as nausea and vomiting. Patients who reported either unsuccessful attempts to cope with side effects or no attempts at all had greater distress than those who were coping successfully. Patients who developed conditioned nausea during treatment reported higher distress than those who did not.
近期研究表明，接受癌症化疗的患者若持续接受最佳剂量的药物治疗，更有可能获得成功的治疗效果。本研究旨在迈出第一步，探寻与治疗期间情绪困扰以及患者随后决定延迟、减少或终止治疗相关的因素。对61名接受恶性淋巴瘤化疗的患者进行了访谈。患者报告了治疗的副作用以及他们控制副作用的努力、对自身疾病的了解和信念、监测治疗效果的策略，以及他们为化疗经历所做准备的程度。通过11点自我报告量表获得情绪困扰评分，并从病历中获取治疗方案的信息。经历的副作用数量与困扰呈正相关，但副作用的持续时间或严重程度与困扰无关。诸如疲劳和疼痛等模糊、弥漫性的副作用比恶心和呕吐等急性、特定的副作用更有可能与困扰相关。报告应对副作用尝试未成功或根本未尝试应对的患者比成功应对的患者有更大的困扰。在治疗期间出现条件性恶心的患者比未出现的患者报告有更高的困扰。
