Emotional distress and psychosocial needs in patients with breast cancer in British Columbia: younger versus older adults
Emotional distress and psychosocial needs in patients with breast cancer in British Columbia: younger versus older adults
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DOI：
10.1007/s10549-019-05468-6
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发表时间：
2019-10-19
影响因子：
3.8
通讯作者：
Ho, Cheryl
中科院分区：
文献类型：
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作者：
Naik, Hiten;Leung, Bonnie;Ho, Cheryl
目的：本研究评估了年轻成年人（YA，年龄18-39岁）乳腺癌患者与老年患者相比，在诊断时的情绪困扰和心理社会需求的患病率。方法通过全省范围内的计划，BC癌症患者完成癌症修订的心理社会扫描（PSSCAN-R）问卷，该问卷筛选焦虑和抑郁症状的存在，并使用加拿大问题清单（CPC）评估心理社会需求。研究人群包括2011年至2016年期间在癌症诊断后6个月内完成问卷的所有乳腺癌患者。从电子健康记录中回顾性收集临床信息。采用X-2、Fisher精确检验和逻辑回归进行单变量和多变量分析，以比较患者年龄组。结果该队列包括10，734例乳腺癌患者：中位年龄62岁，4%为YA，99%为女性，96%为非转移性疾病。在调整临床和人口统计学变量后，YA患者比老年患者更容易报告抑郁（33.6% vs. 25.5%，OR 1.47，p = 0.001）和焦虑症状（58.6% vs. 35.7%，OR 2.49，p < 0.001）。关于工作/学校（OR 3.79，p < 0.001），亲密/性（OR 2.82，p < 0.001）和财务（OR 2.78，p < 0.001）的社会心理需求在YA中比老年人更常见。结论乳腺癌诊断后，与老年患者相比，YAs有更高水平的情绪困扰。具体的心理社会需求的差异可能反映了这些年龄组之间生活阶段的差异。这些数据表明，YAs值得特别关注的早期心理社会评估和量身定制的干预。
Purpose This study evaluates the prevalence of emotional distress and psychosocial needs in young adult (YA, age 18-39) patients at the time of their breast cancer diagnosis compared to older patients. Methods Through a province-wide program, BC Cancer patients complete the PsychoSocial Scan for CANcer-Revised (PSSCAN-R) questionnaire, which screens for the presence of symptoms of anxiety and depression and assesses psychosocial needs using the Canadian Problem Checklist (CPC). The study population comprised all breast cancer patients who completed the questionnaire within 6 months of their cancer diagnosis between 2011 and 2016. Clinical information was retrospectively collected from electronic health records. Univariate and multivariate analyses using the X-2, Fisher's exact test, and logistical regression were used to compare patient age groups. Results The cohort included 10,734 breast cancer patients: median age 62, 4% YA, 99% female, and 96% presented with non-metastatic disease. After adjusting for clinical and demographic variables, YA patients were more likely to report depression (33.6% vs. 25.5%, OR 1.47, p = 0.001) and anxiety symptoms (58.6% vs. 35.7%, OR 2.49, p < 0.001) than older patients. Psychosocial needs regarding work/school (OR 3.79, p < 0.001), intimacy/sexuality (OR 2.82, p < 0.001), and finances (OR 2.78, p < 0.001) were more common among YA than older adults. Conclusions After a breast cancer diagnosis, YAs have higher levels of emotional distress compared to older patients. Differences in specific psychosocial needs likely reflect differences in life stage between these age groups. The data suggest that YAs warrant specific attention with respect to early psychosocial assessment and tailored intervention.