Psychological distress in patients and caregivers over the course of radiotherapy for head and neck Cancer
Psychological distress in patients and caregivers over the course of radiotherapy for head and neck Cancer
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DOI：
10.1016/j.oraloncology.2014.07.003
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发表时间：
2014-10-01
期刊：
影响因子：
4.8
通讯作者：
Posner, Marshall
中科院分区：
文献类型：
--
作者：
Badr, Hoda;Gupta, Vishal;Posner, Marshall
目的：头颈部癌症患者和他们的照顾者报告心理困扰的比例很高。高利率的身体症状的负担和增加的需要，家庭成员在治疗过程中提供的adveriving可能会导致这种distress.Methods：本研究探讨的轨迹，病人和照顾者的痛苦在放疗过程中的头部和颈部癌症，以及病人和照顾者如何影响对方的痛苦。49名头颈癌患者-护理人员配对完成了6次每周一次的身体症状（MDASI-HN）和痛苦（例如，结果：在治疗过程中，患者和护理人员的痛苦稳步增加，在第5周达到峰值;患者（82%男性; 69%第4阶段）和护理人员（90%女性）在77%的情况下报告了显着的痛苦。以患者-护理人员二元组为分析单位的线性混合模型显示，患者评定的头部和颈部特异性身体症状的增加对患者和护理人员的痛苦具有显著的（p <0.05）时变效应。增加一个二分体成员的痛苦水平也显着相关，随着时间的推移，在其他的痛苦水平下降。结论：研究结果突出了患者的身体症状在放疗期间对患者和照顾者的痛苦的不利影响。他们还支持一种二元应对模式，即病人和照顾者作为一个单位一起管理他们的痛苦。总的来说，在头颈部癌症中迫切需要注重控制患者身体症状并解决患者和护理者痛苦的二元支持性护理干预。(C)2014爱思唯尔有限公司版权所有。
Objectives: Head and neck cancer patients and their caregivers report high rates of psychological distress. High rates of physical symptom burden and the increased need for family members to provide caregiving during treatment may contribute to this distress.Methods: This study examined trajectories of patient and caregiver distress over the course of radiotherapy for head and neck cancer as well as how patients and caregivers influence each other's distress. Forty-nine head and neck cancer patient-caregiver dyads completed 6 weekly assessments of physical symptoms (MDASI-HN) and distress (e.g., NCCN distress thermometer) over the course of radiotherapy.Results: Patient and caregiver distress increased steadily over the course of treatment, peaking at week 5; patients (82% male; 69% Stage 4) and caregivers (90% female) reported significant distress in 77% of cases. Linear mixed models with the patient-caregiver dyad as the unit of analysis showed that increases in patient-rated head and neck specific physical symptoms had a significant (p < .05) time-varying effect on both patient and caregiver distress. Increases in one dyad member's distress levels were also significantly associated with decreases in the other's distress levels over time.Conclusion: Findings highlight the adverse impact of patient physical symptoms during radiotherapy on both patient and caregiver distress. They also support a dyadic coping model whereby patients and caregivers manage their distress together as a unit. Overall, dyadic supportive care interventions that focus on controlling patient physical symptoms and that address both patient and caregiver distress are sorely needed in head and neck cancer. (C) 2014 Elsevier Ltd. All rights reserved.