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癌症治疗结束后患者的支持性护理需求:一项前瞻性、纵向调查。

Patients' supportive care needs beyond the end of cancer treatment: a prospective, longitudinal survey.

机构信息

Nightingale School of Nursing and Midwifery, Division of Health and Social Care Research, King's College London, Rm 3.21, James Clerk Maxwell Bldg, 57 Waterloo Rd, London SE1 8WA.

出版信息

J Clin Oncol. 2009 Dec 20;27(36):6172-9. doi: 10.1200/JCO.2009.22.5151. Epub 2009 Nov 2.

Abstract

PURPOSE

To estimate prevalence and severity of patients' self-perceived supportive care needs in the immediate post-treatment phase and identify predictors of unmet need.

PATIENTS AND METHODS

A multicenter, prospective, longitudinal survey was conducted. Sixty-six centers recruited patients for 12 weeks. Patients receiving treatment for the following cancers were recruited: breast, prostate, colorectal, and gynecologic cancer and non-Hodgkin's lymphoma. Measures of supportive care needs, anxiety and depression, fear of recurrence, and positive and negative affect were completed at the end of treatment (T0) and 6 months later (T1).

RESULTS

Of 1,850 patients given questionnaire packs, 1,425 (79%) returned questionnaires at T0, and 1,152 (62%) returned questionnaires at T1. Mean age was 61 years; and most respondents were female (69%) and had breast cancer (57%). Most patients had no or few moderate or severe unmet supportive care needs. However, 30% reported more than five unmet needs at baseline, and for 60% of these patients, the situation did not improve. At both assessments, the most frequently endorsed unmet needs were psychological needs and fear of recurrence. Logistic regression revealed several statistically significant predictors of unmet need, including receipt of hormone treatment, negative affect, and experiencing an unrelated significant event between assessments.

CONCLUSION

Most patients do not express unmet needs for supportive care after treatment. Thirty percent reported more than five moderate or severe unmet needs at both assessments. Unmet needs were predicted by hormone treatment, negative mood, and experiencing a significant event. Our results suggest that there is a proportion of survivors with unmet needs who might benefit from the targeted application of psychosocial resources.

摘要

目的

评估患者在治疗后即刻阶段自我感知的支持性护理需求的普遍性和严重程度,并确定未满足需求的预测因素。

方法

进行了一项多中心、前瞻性、纵向调查。66 个中心招募了 12 周的患者。招募了接受以下癌症治疗的患者:乳腺癌、前列腺癌、结直肠癌和妇科癌症以及非霍奇金淋巴瘤。在治疗结束时(T0)和 6 个月后(T1)完成支持性护理需求、焦虑和抑郁、复发恐惧以及积极和消极情绪的测量。

结果

在收到问卷包的 1850 名患者中,有 1425 名(77%)在 T0 时返回了问卷,1152 名(62%)在 T1 时返回了问卷。平均年龄为 61 岁;大多数受访者为女性(69%),患有乳腺癌(57%)。大多数患者没有或只有少数中度或重度未满足的支持性护理需求。然而,30%的患者在基线时报告了超过五个未满足的需求,其中 60%的患者情况并未改善。在两次评估中,最常被认可的未满足需求是心理需求和对复发的恐惧。逻辑回归显示,有几个统计学上显著的未满足需求预测因素,包括接受激素治疗、负面情绪以及在评估之间经历无关的重大事件。

结论

大多数患者在治疗后不表达对支持性护理的未满足需求。30%的患者在两次评估中都报告了超过五个中度或重度未满足的需求。未满足的需求由激素治疗、负面情绪和经历重大事件预测。我们的结果表明,有一部分未满足需求的幸存者可能受益于针对性地应用心理社会资源。

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