Associations with worry about dying and hopelessness in ambulatory ovarian cancer patients.
Associations with worry about dying and hopelessness in ambulatory ovarian cancer patients.
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DOI：
10.1017/s1478951509990228
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发表时间：
2009-09
影响因子：
2.2
通讯作者：
Basen-Engquist K
中科院分区：
文献类型：
--
作者：
Shinn EH;Taylor CL;Kilgore K;Valentine A;Bodurka DC;Kavanagh J;Sood A;Li Y;Basen-Engquist K
患有卵巢癌的妇女面临着预后不良，治疗时间延长，但身体功能水平相对较高。他们对死亡前景的想法和感受是复杂的，尚未得到充分的研究。各种人口，医疗和心理社会因素进行了检查，以确定他们的独立协会与死亡和绝望的恐惧在一个横截面设计。254名卵巢癌患者在开始新的化疗方案时接受了评估。对死亡和失去希望的担忧进行了单独的logistic回归分析。对于每一项分析，在人口统计学和医学变量之后输入社会心理变量，以确定社会心理变量是否与各自的结果独立相关。55%的人承认害怕死亡，31.6%的人承认在与疾病的斗争中失去了希望。在控制了模型中的所有其他变量后，年轻（p = 0.001）、非西班牙裔白色种族（p = 0.026）和身体健康状况较差（p = 0.000）与担心死亡显著相关。关于失去希望，抑郁症状（p = .002），缺乏社会支持/幸福感（p = .001）和治疗次数（p = .04）是显著的。这是在晚期癌症患者样本中检查生命终结问题的最大研究之一。我们的研究结果强调了人口统计学和心理社会变量在卵巢癌患者临终关怀检查中的重要性。他们的恐惧和关切应该得到公开承认，即使临床重点仍然是治愈性治疗。
Women with ovarian cancer face a poor prognosis, with prolonged periods of treatment but relatively high levels of physical functioning. Their thoughts and feelings regarding the prospect of dying are complex and have not been adequately studied. Various demographic, medical and psychosocial factors were examined to determine their independent associations with fear of dying and hopelessness in a cross-sectional design. Two hundred fifty-four ovarian cancer patients were assessed at the beginning of a new chemotherapy regimen. Separate logistic regressions were performed for worry about dying and loss of hope. For each analysis, psychosocial variables were entered after the demographic and medical variables to determine whether the psychosocial variables had an independent association with the respective outcome. Fifty-five percent of the sample acknowledged fear of dying, and 31.6% acknowledged loss of hope in the fight against their illness. Being younger (p = .001), being of non-Hispanic White ethnicity (p = .026), and having poorer physical well-being (p = .000) were significantly associated with worry about dying after controlling for all other variables in the model. Regarding loss of hope, depressive symptoms (p = .002), lack of social support/well-being (p = .001), and number of treatments (p = .04) were significant. This is one of the largest studies to examine end-of-life concerns in a sample of advanced cancer patients. Our results underscore the importance of demographic and psychosocial variables in the examination of ovarian cancer patients’ end-of-life concerns. Their fears and concerns should be openly acknowledged, even when the clinical focus is still on curative treatment.