The changeable nature of patients' fears regarding chemotherapy: Implications for palliative care
The changeable nature of patients' fears regarding chemotherapy: Implications for palliative care
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DOI：
10.1016/s0885-3924(00)00249-9
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发表时间：
2001-02-01
影响因子：
4.7
通讯作者：
Theobald, DE
中科院分区：
文献类型：
--
作者：
Passik, SD;Kirsh, KL;Theobald, DE
化疗的副作用是癌症患者在开始治疗时的恐惧。在这项研究中，我们调查了患者对化疗的预期恐惧。然后，我们在最初的采访后三到六个月重新评估了这些恐惧，这些恐惧是在那段时间接受化疗的患者。我们还检查了这些时间间隔的症状困扰。脱发、呕吐;感染，恶心和体重减轻被列为癌症治疗的最可怕的副作用，因为他们开始治疗。开始化疗的患者经常或强烈地感到疲劳，担心未来，疼痛和睡眠问题。在基于性别、年龄或教育水平的症状报告中没有发现差异。虽然在研究期间症状困扰的变化并不明显，但对化疗的恐惧的变化很有趣。在治疗经历后，最可怕的症状被重新排序。恶心、呕吐、脱发、食欲不振等症状明显减少。报告呕吐是他们最害怕的副作用之一的化疗患者减少了35%;报告呕吐是他们最害怕的副作用之一的止吐药患者减少了45%。有效的治疗方法，例如那些已经开发出来的治疗急性化疗相关呕吐的方法，可以减轻患者对治疗的恐惧。我们的结论是，病人对治疗的恐惧是流动的和可塑的。患者对化疗治疗相关痛苦的恐惧随着提供适当管理而改变。我们讨论了这些研究结果的姑息治疗教育的影响。(C)美国癌症疼痛缓解委员会，2001年。
The side effects of chemotherapy are feared by cancer patients as they begin their treatment In this study, we investigated patients' anticipatory fears about chemotherapy. We then re-assessed these fears three to six months after the initial interview for patients who received chemotherapy during that time. We also examined symptom distress at these intervals. Hair loss, vomiting; infection, nausea, and weight loss were ranked as the most feared side effects of cancer treatment for the group as they began treatment. Patients beginning chemotherapy endorsed frequent or intense levels of fatigue, worrying about the future, pain, and sleep problems. No differences were found in the reporting of symptoms based on gender, age, or educational level. While changes in symptom distress over the study period were unremarkable, changes in fears about chemotherapy were of interest. The most feared symptoms were re-ordered following the treatment experience. The endorsement of nausea and vomiting; alopecia, and loss of appetite decreased significantly. Thirty-five percent fewer chemotherapy patients reported vomiting as one of their most feared side effects; 45% fewer patients who received anti-emetics reported vomiting as one of their most feared side effects. Effective treatments, such as those that have been developed to treat acute chemotherapy-related emesis, can relieve the fears of patients on treatment. We conclude that patients' fears about treatment are fluid and malleable. Patients' fears of suffering related to chemotherapy treatment change in response to the provision of adequate management. We discuss the implications of these findings for palliative care education. (C) U.S. Cancer Pain Relief Committee, 2001.