首诊鼻咽癌患者焦虑抑郁现状及其与恐惧疾病进展的关系

doi:10.16460/j.issn1008-9969.2024.20.067

摘要/Abstract

摘要： 目的分析首诊鼻咽癌患者抑郁、焦虑等心理问题的现况及其与恐惧疾病进展的关系。方法选择我院放疗科2023年3月—2024年4月就诊的鼻咽癌患者中存在中度及以上抑郁症状的患者作为研究对象,采用一般情况调查表、抑郁焦虑量表、恐惧疾病进展量表及社会支持量表进行调查,采用多因素Logistic回归分析恐惧疾病进展水平与抑郁、焦虑的相关关系。结果本研究共调查90例患者,中度及以上焦虑的比例为54%,同时存在中重度抑郁和中重度焦虑的患者比例为14%。恐惧疾病进展与焦虑（r=0.381,P<0.001）、抑郁（r=0.587,P<0.001）呈正相关（P<0.001）。恐惧疾病进展高水平组的中重度抑郁、中重度焦虑的比例均显著高于低水平组（P<0.001）。校正多因素的分析显示,相对于恐惧疾病进展低水平组,高水平组患者发生中重度及以上焦虑的风险增加16.34倍（95%CI：2.57~103.93,P=0.003）、中重度以上抑郁和焦虑共患病的风险增加6.9倍（95%CI：1.34~35.60;P=0.021）。结论抑郁和焦虑存在显著的共患病情况。相对于恐惧疾病进展的低水平组,高水平组患者发生焦虑以及同时出现抑郁和焦虑的风险显著增加。

关键词: 鼻咽癌, 抑郁, 焦虑, 恐惧疾病进展

Abstract: Objective To analyze the current status of psychological problems including depression, anxiety, etc., in newly diagnosed nasopharyngeal carcinoma patients and their relationship with fear of disease progression. Methods Patients with nasopharyngeal carcinoma who were treated in Department of Radiotherapy in our hospital from March 2023 to April 2024 and had moderate or severe depressive symptoms were selected as research subjects. They were surveyed using the General Information Questionnaire, Depression and Anxiety Scale, Fear of Disease Progression Scale and Social Support Scale. Multivariate logistic regression analysis was used to analyze the relationship between fear of disease progression level and depression and anxiety. Results Ninety patients were investigated. The proportion of patients with moderate or severe anxiety was 54%. The proportion of patients with comorbid moderate or severe depression and anxiety was 14%. Fear of disease progression was positively correlated with anxiety (r=0.381, P<0.001) and depression (r=0.587, P<0.001, P<0.001). The proportion of moderate or severe depression and anxiety in the high fear of disease progression group was significantly higher than that in the low group(P<0.001). After adjusting for multiple factors, the risk of moderate or severe anxiety in the high fear of disease progression group increased 16.34 times (95%CI: 2.57~103.93, P=0.003) when compared with that in the low group, and the risk of comorbid moderate or severe depression and anxiety increased 6.9 times (95%CI: 1.34~35.60; P=0.021). Conclusion There is a significant comorbidity of depression and anxiety. Compared with that in the low fear of disease progression group, the risk of anxiety and comorbid depression and anxiety increases significantly in the high group.

Key words: nasopharyngeal carcinoma, depression, anxiety, fear of disease progression

中图分类号:

R473.76

祁丽萍, 王文煊, 侯敏, 郑粤豪, 冯惠霞, 李济宾. 首诊鼻咽癌患者焦虑抑郁现状及其与恐惧疾病进展的关系[J]. 护理学报, 2024, 31(20): 67-72.

QI Li-ping, WANG Wen-xuan, HOU Min, ZHENG Yue-hao, FENG Hui-xia, LI Ji-bin. Current status of depression and anxiety in newly diagnosed nasopharyngeal carcinoma patients and their relationship with fear of disease progression[J]. Journal of Nursing, 2024, 31(20): 67-72.

参考文献

[1] Zhang Y, Rumgay H, Li M, et al.Nasopharyngeal cancer incidence and mortality in 185 countries in 2020 and the projected burden in 2040: population-based global epidemiological profiling[J]. JMIR Public Health Surveill, 2023,9:e49968. DOI: 10.2196/49968.
[2] 邱丽燕, 杨丽, 廖婷婷, 等. 鼻咽癌出院5年患者症状群与生活质量的相关性研究[J]. 护理学杂志, 2021,36(3):38-41. DOI:10.3870/j.issn.1001-4152.2021.03.038.
[3] McDowell LJ, Rock K, Xu W, et al. Long-term late toxicity, quality of life, and emotional distress in patients with nasopharyngeal carcinoma treated with intensity modulated radiation therapy[J]. Int J Radiat Oncol Biol Phys, 2018,102(2):340-352.DOI: 10.1016/j.ijrobp.2018.05.060.
[4] 李颖斐, 刘玉瑶, 魏洁丽, 等. 鼻咽癌患者癌症复发恐惧水平及影响因素分析[J]. 中华全科医学, 2019,17(9):1443-1446.DOI:10.16766/j.cnki.issn.1674-4152.000965.
[5] 马飞飞,彭鹏,劳家辉,等. 基于SEER数据库分析癌症患者自杀率的长期趋势[J]. 中华肿瘤防治杂志, 2022,29(4):248-252. DOI:10.16073/j.cnki.cjcpt.2022.04.03.
[6] Kroenke K, Spitzer RL, Williams JB.The PHQ-9: validity of a brief depression severity measure[J]. J Gen Intern Med, 2001,16(9):606-613.DOI:10.1046/j.1525-1497.2001.016009606.x.
[7] 闵宝权, 周爱红, 梁丰, 等. 病人健康问卷抑郁自评量表(PHQ-9)的临床应用[J]. 神经疾病与精神卫生, 2013,13(6):569-572. DOI:10.3969/j.issn.1009-6574.2013.06.009.
[8] Garcia-Campayo J, Zamorano E, Ruiz MA, et al.Cultural adaptation into Spanish of the generalized anxiety disorder-7 (GAD-7) scale as a screening tool[J]. Health Qual Life Outcomes, 2010,8:8. DOI: 10.1186/1477-7525-8-8.
[9] 吕兰竹, 周月英, 苏泳诗. GAD-7和PHQ-9调查分析综合医院住院患者焦虑抑郁状况[J].中国现代医药杂志, 2017,19(3):47-49. DOI:10.3969/j.issn.1672-9463.2017.03.013.
[10] Mehnert A, Herschbach P, Berg P, et al.Fear of progression in breast cancer patients-validation of the short form of the Fear of Progression Questionnaire (FoP-Q-SF)[J]. Z Psychosom Med Psychother, 2006,52(3):274-288. DOI: 10.13109/zptm.2006.52.3.274.
[11] 吴奇云, 叶志霞, 李丽, 等. 癌症患者恐惧疾病进展简化量表的汉化及信效度分析[J]. 中华护理杂志, 2015,50(12):1515-1519. DOI:10.3761/j.issn.0254-1769.2015.12.021.
[12] Zimet GD, Powell SS, Farley GK, et al.Psychometric characteristics of the Multidimensional Scale of Perceived Social Support[J]. J Pers Assess, 1990, 55(3/4): 610-617. DOI: 10.1080/00223891.1990.9674095.
[13] Sung H, Ferlay J, Siegel RL, et al.Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2021,71(3):209-249. DOI: 10.3322/caac.21660.
[14] 姜华, 吕俭霞, 牟文轩, 等. 中国鼻咽癌患者抑郁症状发生率的Meta分析[J].广州医科大学学报, 2021,49(6):18-25. DOI:10.3969/j.issn.2095-9664.2021.06.04.
[15] Pinquart M, Duberstein PR.Depression and cancer mortality: a Meta-analysis[J]. Psychol Med, 2010, 40(11):1797-1810. DOI: 10.1017/S0033291709992285.
[16] Granek L, Nakash O, Ben-David M, et al.Oncologists' treatment responses to mental health distress in their cancer patients[J]. Qual Health Res, 2018,28(11):1735-1745. DOI: 10.1177/1049732318786479.
[17] Li R, Su L, Hua Y, et al.Anxiety and depression status prior to radiotherapy in patients with nasopharyngeal carcinoma and its effect on acute radiation toxicities[J]. Eur J Cancer Care (Engl), 2021,30(6):e13487. DOI: 10.1111/ecc.13487.
[18] 王乾沙, 魏清风, 钟清玲, 等. 肺癌患者癌症复发恐惧现状及影响因素研究[J].中国护理管理, 2020,20(10):1596-1600. DOI:10.3969/j.issn.1672-1756.2020.10.034.
[19] Kulpa M, Zietalewicz U, Kosowicz M, et al.Anxiety and depression and cognitive coping strategies and health locus of control in patients with ovary and uterus cancer during anticancer therapy[J]. Contemp Oncol (Pozn), 2016,20(2):171-175. DOI: 10.5114/wo.2016.60074.
[20] Hanprasertpong J, Geater A, Jiamset I, et al.Fear of cancer recurrence and its predictors among cervical cancer survivors[J]. J Gynecol Oncol, 2017,28(6):e72. DOI: 10.3802/jgo.2017.28.e72.
[21] 王盼盼, 从恩朝, 罗斌, 等. 肿瘤相关性抑郁焦虑的研究进展[J]. 现代肿瘤医学, 2023,31(15):2922-2925. DOI:10.3969/j.issn.1672-4992.2023.15.030.
[22] Podina IR, Todea D, Fodor LA.Fear of cancer recurrence and mental health: a comprehensive Meta-analysis[J]. Psychooncology, 2023,32(10):1503-1513. DOI: 10.1002/pon.6205.
[23] 郭婷婷, 邢伟, 张苇, 等. 郑州市某三甲医院中青年妇科癌症患者恐惧疾病进展现状及影响因素分析[J]. 现代预防医学, 2019,46(14):2607-2611.
[24] 崔静萍,蒋燕,赵姗姗.衰弱和抑郁在肺癌化疗患者恐惧疾病进展与生活质量间的链式中介作用[J].护理学报,2023,30(18):65-70.DOI:10.16460/j.issn1008-9969.2023.18.065.
[25] Dankert A, Duran G, Engst-Hastreiter U, et al.Fear of progression in patients with cancer, diabetes mellitus and chronic arthritis[J]. Rehabilitation (Stuttg), 2003,42(3):155-163. DOI: 10.1055/s-2003-40094.
[26] Mutsaers B, Butow P, Dinkel A, et al.Identifying the key characteristics of clinical fear of cancer recurrence: an international Delphi study[J]. Psychooncology, 2020,29(2):430-436. DOI:10.1002/pon.5283.
[27] Koch L, Bertram H, Eberle A, et al.Fear of recurrence in long-term breast cancer survivors-still an issue. Results on prevalence, determinants, and the association with quality of life and depression from the cancer survivorship-a multi-regional population-based study[J]. Psychooncology, 2014,23(5):547-554.DOI:10.1002/pon.3452.

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