Perceived stress is associated with a higher symptom burden in cancer survivors
Perceived stress is associated with a higher symptom burden in cancer survivors
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DOI：
10.1002/cncr.32477
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发表时间：
2019-12-15
期刊：
影响因子：
6.2
通讯作者：
Miaskowski, Christine
中科院分区：
文献类型：
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作者：
Mazor, Melissa;Paul, Steven M.;Miaskowski, Christine
背景虽然多种并发症状是癌症幸存者的一个重要问题，但据作者所知，关于与更高症状负担相关的表型特征知之甚少。本研究的目的是评估与32种症状相关的发生率、严重程度和痛苦，并检查与较高症状负担相关的表型和应激特征。方法对623名癌症幸存者进行了人口统计学问卷调查，以及功能状态、合并症、整体（感知压力量表）和癌症相关（事件影响量表修订版）压力的测量。采用记忆症状评定量表评价症状负担。多元线性回归分析用于确定与较高症状负荷相关的表型特征。结果平均症状数为9.1（+/- 5.2）。最常见、最严重和最令人痛苦的症状分别是精力不足、性兴趣/活动问题和脱发。患者的功能状态、合并症水平较高、有吸烟史以及较高的感知压力量表和事件影响量表修订版评分与较高的症状负担相关。总体模型解释了症状负担的约45.6%的方差。结论：尽管癌症幸存者报告了大量中度严重和痛苦的并发症状，但在目前的研究中，没有发现疾病或治疗特征与较高的症状负担相关。临床医生需要评估一般和特定疾病的压力源，并提供压力管理干预措施的推荐。未来的研究需要检查症状负担，功能状态和合并症水平之间的纵向关系，以及压力和症状负担之间的关联机制。
Background Although multiple co-occurring symptoms are a significant problem for cancer survivors, to the authors' knowledge little is known regarding the phenotypic characteristics associated with a higher symptom burden. The objectives of the current study were to evaluate the occurrence, severity, and distress associated with 32 symptoms and examine the phenotypic and stress characteristics associated with a higher symptom burden. Methods A total of 623 cancer survivors completed a demographic questionnaire, as well as measures of functional status, comorbidity, and global (Perceived Stress Scale) and cancer-related (Impact of Event Scale-Revised) stress. The Memorial Symptom Assessment Scale was used to evaluate symptom burden. Multiple linear regression analysis was used to determine the phenotypic characteristics associated with a higher symptom burden. Results The mean number of symptoms was 9.1 (+/- 5.2). The most common, severe, and distressing symptoms were lack of energy, problems with sexual interest/activity, and hair loss, respectively. Poorer functional status, a higher level of comorbidity, and a history of smoking as well as higher Perceived Stress Scale and Impact of Event Scale-Revised scores were associated with a higher symptom burden. The overall model explained approximately 45.6% of the variance in symptom burden. Conclusions Although cancer survivors report a high number of co-occurring symptoms of moderate severity and distress, in the current study, no disease or treatment characteristics were found to be associated with a higher symptom burden. Clinicians need to assess for general and disease-specific stressors and provide referrals for stress management interventions. Future studies need to examine the longitudinal relationships among symptom burden, functional status, and level of comorbidity, as well as the mechanisms that underlie the associations between stress and symptom burden.