Rapoport Y, Kreitler S, Chaitchik S, Algor R, Weissler K
Nose-Ear-and-Throat Department, Tel Aviv University, Israel.
Ann Oncol. 1993 Jan;4(1):69-73. doi: 10.1093/oxfordjournals.annonc.a058365.
Little is known about the psychosocial effects of cancer survivors especially after the first stage of adjustment. The study was designed to provide information about the major psychological problems of head-and-neck cancer patients and their change with time since diagnosis.
The subjects were 55 head-and-neck cancer patients, 40 men and 15 women with disease stages I to IV, grade of tumors G1 to G3-4, and disease duration in the range of 3 months to 21 years. A questionnaire with multiple-choice and open-ended questions assessing adjustment in 14 domains (e.g., fears and worries concerning health, functioning in the family) was administered to patients and their partners or closest relatives as well as scales assessing anxiety, anger and depression.
The results showed that the domains that were most problem-laden included coping with health problems, fears, communication with the partner and social relations. Comparing the problems of patients in different time periods (0.5-1.5 years after diagnosis, 1.5-5 years, and over 5 years) showed that many medical problems decreased with time but most psychological ones including anxiety and anger deteriorated markedly.
Head-and-neck cancer patients suffer from a broad range of psychosocial problems that become exacerbated with time. The deterioration in quality of life may reflect 'patient burnout' which could be decreased by acquiring adequate coping skills.
对于癌症幸存者的心理社会影响，尤其是在第一阶段适应之后，人们知之甚少。本研究旨在提供有关头颈癌患者主要心理问题及其自确诊以来随时间变化的信息。
研究对象为55名头颈癌患者，其中男性40名，女性15名，疾病分期为I至IV期，肿瘤分级为G1至G3 - 4级，病程在3个月至21年之间。向患者及其伴侣或近亲发放了一份包含多项选择题和开放式问题的问卷，用于评估14个领域的适应情况（例如，对健康的恐惧和担忧、家庭功能），同时还发放了评估焦虑、愤怒和抑郁的量表。
结果显示，问题最多的领域包括应对健康问题、恐惧、与伴侣的沟通以及社会关系。比较不同时间段（确诊后0.5 - 1.5年、1.5 - 5年以及5年以上）患者的问题发现，许多医疗问题随时间减少，但大多数心理问题，包括焦虑和愤怒，却明显恶化。
头颈癌患者存在广泛的心理社会问题，且这些问题会随着时间加剧。生活质量的下降可能反映了“患者倦怠”，通过获得足够的应对技巧，这种情况可能会得到缓解。
