Psychological Distress in Long-term Survivors of Adult-Onset Cancer Results From a National Survey
Psychological Distress in Long-term Survivors of Adult-Onset Cancer Results From a National Survey
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DOI：
10.1001/archinternmed.2009.179
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发表时间：
2009-07-27
影响因子：
--
通讯作者：
Ng, Andrea K.
中科院分区：
文献类型：
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作者：
Hoffman, Karen E.;McCarthy, Ellen P.;Ng, Andrea K.
背景资料：随着癌症筛查和治疗的进步，癌症长期幸存者的数量增加，了解癌症经历的长期心理后遗症非常重要。方法：4636名受访者认为自己是成人-在2002年至2006年的全国健康访谈调查中，确定了5年或更长时间的初发癌症患者和122220名从未被诊断为癌症的受访者。在这项以人群为基础的研究的主要结果是严重的心理困扰（SPD）定义为K6量表（一种有效的筛选工具，精神疾病）得分为13或以上。结果：在幸存者中，诊断时的中位年龄为50岁，在采访时的年龄为66岁，自诊断以来的时间为12年。长期癌症幸存者的SPD患病率显著高于从未被诊断为癌症的受访者（5.6% vs 3.0%; P <0.001）。在对临床和社会人口统计学变量（年龄、性别、种族、关系状况、教育程度、保险状况、合并症、吸烟史和进行工具性日常生活活动的能力）进行调整后，幸存者仍然更有可能经历SPD（调整后的比值比，1.4; 95%置信区间，1.2-1.7）。调整后的其他临床和社会人口统计学变量，长期幸存者谁是年轻的，未婚，有不到高中教育，没有保险，有更多的合并症，或有困难进行日常生活的工具activities更有可能体验SPD.Conclusions：长期幸存者的成年发病癌症的心理困扰的风险增加。这项研究确定了与SPD相关的几个临床和社会人口因素，这些因素可能有助于针对高危幸存者进行心理筛查和支持。
Background: As advances in cancer screening and treatment increase the number of long-term cancer survivors, it is important to understand the long-term psychological sequelae of the cancer experience.Methods: The 4636 respondents who identified themselves as survivors of adult-onset cancer of 5 years or more and 122 220 respondents who were never diagnosed as having cancer were identified in the 2002 to 2006 National Health Interview Survey. The primary outcome in this population-based study was serious psychological distress (SPD) defined as a K6 scale (a validated screening tool for mental illness) score of 13 or more.Results: Among survivors, the median age at diagnosis was 50 years, the age at interview was 66 years, and the time since diagnosis was 12 years. The prevalence of SPD was significantly higher among long-term cancer survivors than among respondents who were never diagnosed as having cancer (5.6% vs 3.0%; P < .001). After adjustment for clinical and sociodemographic variables (age, sex, race, relationship status, educational attainment, insurance status, comorbidities, smoking history, and ability to perform instrumental activities of daily living), survivors remained significantly more likely to experience SPD (adjusted odds ratio, 1.4; 95% confidence interval, 1.2-1.7). After adjustment for other clinical and sociodemographic variables, long-term survivors who were younger, were unmarried, had less than a high school education, were uninsured, had more comorbidities, or had difficulty performing instrumental activities of daily living were more likely to experience SPD.Conclusions: Long-term survivors of adult-onset cancer are at increased risk for psychological distress. This study identifies several clinical and sociodemographic factors associated with SPD that may help target high-risk survivors for psychological screening and support.