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致死的疾患における有効な心理的取り組み方(コーピング)に関する研究-prospective study-

致命疾病有效心理应对方法研究-前瞻性研究-

基本信息

批准号：
09770769
负责人：
明智龍男
金额：
$ 1.28万
依托单位：
National Cancer Center Research Institute and Research Center for Innovative Oncology, National Cancer Center Hospital East
依托单位国家：
日本
项目类别：
Grant-in-Aid for Encouragement of Young Scientists (A)
财政年份：
1998
资助国家：
日本
起止时间：
1998 至 1999
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-09770769/
关键词：
難治がんコーピング前向き悲観精神的負担うつ病

项目摘要

難治がん患者の有効なコーピングを明らかにする目的で、国立がんセンター東病院呼吸器科に新規入院した進行非小細胞肺がん患者を対象として、コーピングと感情状態の関連をprospectiveに検討した。適格症例のうち129名から初回調査参加への同意が得られたが、告知後6ヶ月時点の追跡調査が施行できた症例は84名であった。84症例の背景(告知後の初回調査時)は、平均年齢61+9(SD)歳、男性69%、10年以上の教育経験を有するもの54%、雇用状況は退職者が30%と最も多く、91%が既婚・再婚者であった。医学的背景(告知後の初回調査時)は、腺がんが71%と最も多く、臨床病期はIV期が51%、performance Statusは1以上(何らかの身体的機能障害を有する)の患者が88%で、痛みを有する患者が54%、呼吸困難感を有する患者が52%であった。初回調査は告知後初期治療前に行われ、病名告知から初回調査までの平均期間は18+12(SD)日であった。病名告知から2ヶ月後追跡調査までの平均期間は71+15(SD)日、6ヶ月後追跡調査までの平均期間は177+16(SD)日であった。初回調査時のコーピングと2ヶ月後追跡調査時の感情状態との関連を検討したところ、Fighting spirit(前向き)のみが抑うつおよび不安と有意な逆相関p<0.01)を示した一方で、抑うつ、不安と最も高い正相関を示したコーピングはHelplessness/Hopelessness(悲観)であった(p<0.05)。同様に、初回調査時のコーピングと6ヶ月後追跡調査時の感情状態との関連を検討しても同様の結果が得られた。また、初回調査時における年齢、教育経験、日常生活上の身体的機能の状態(Performance status)、疼痛の程度および呼吸困難感の程度を調整しても、これらの結果はほぼ同様であった。本結果より、進行非小細胞肺がん患者においては、Fighting spiritが高く、Helplessness/Hopelessnessが低いコーピングが安定した感情状態と関連していることが示され、がん告知後のコーピングはその後の精神的苦痛の予測因子となりうることが示唆された。

For patients with refractory diseases, the Department of Respiratory Medicine of the National People's Hospital conducted a prospective study on the relationship between the disease and emotional status. 129 eligible cases participated in the initial review, 84 cases participated in the follow-up survey 6 months after notification The background of 84 cases (initial review after notification) was 61+9(SD) years old, 69% male, 54% female with more than 10 years of education, 30% female with retired employment status, and 91% female with remarriage. 71% of patients had medical background (initial review after notification), 51% had clinical stage IV, 88% had performance status 1 or higher, 54% had pain, and 52% had dyspnea. The average duration of initial correction was 18+12(SD) days after notification and before initial treatment. The average duration of follow-up survey after 2 months was 71+15(SD) days, and the average duration of follow-up survey after 6 months was 177+16(SD) days. The relationship between emotional state and relationship in the initial correction survey was discussed in the first two months, and the relationship between emotional state and relationship was discussed in the second month. The relationship between emotional state and relationship was discussed in the third month. The relationship between emotional state and relationship was discussed in the second month. The relationship between emotional state and relationship was discussed in the third month. The relationship between emotional state was discussed in the second month. The relationship between emotional state and relationship was discussed The results of the same analysis were obtained by tracing the emotional state and relationship between the two groups at the time of the initial and follow-up surveys six months later. Also, during the initial review, the age, education, performance status of the body in daily life, the degree of pain, and the degree of dyspnea were adjusted, and the results were the same. The results showed that the patients with NSCLC had high Fighting spirit, low Helplessness/Hopelessness, stable emotional state and correlation, and predictive factors of mental pain after notification.