Utility of routine psychological screening in the childhood cancer survivor clinic
Utility of routine psychological screening in the childhood cancer survivor clinic
复制标题
DOI：
10.1200/jco.2003.05.158
复制
发表时间：
2003-03-01
影响因子：
45.3
通讯作者：
Diller, L
中科院分区：
文献类型：
--
作者：
Recklitis, C;O'Leary, T;Diller, L
目的：本研究通过评估患者接受度、比较受试者的症状与标准数据、检验特定测试的有效性以及确定与心理问题相关的危险因素，来检验常规心理筛查在儿童癌症幸存者诊所中的作用。方法：在每年的临床访问中，101名成年癌症幸存者(中位年龄，25岁)完成了症状自评量表(SCL-90)、简明36(SF-36)、贝克抑郁量表(RDI)，以及一个附加的自杀问题。结果：大多数受试者(80%)在30分钟内完成筛查，报告的痛苦很少(15%)或没有(84%)。64%的人认为这会对了解他们有“很大”或“适度”的帮助，35%的人认为这会有“轻微”帮助。在SCL-90中，有32名(31.7%)被试的筛查结果为阳性，表明存在明显的心理困扰。所有在BDI和SF-36心理健康量表上有明显临床症状的受试者均为SCL-90中的病例(病例阳性)。有自杀症状者占13.9%，均为SCL-90病例。在Logistic回归模型中，受试者对外貌不满意、身体健康状况不佳、接受头颅放射治疗与心理痛苦相关。结论：常规心理筛查可以成功地整合到癌症幸存者诊所，并可能有效地识别出需要进一步评估的有重大痛苦的幸存者。
Purpose: This study examined the utility of routine psychologic screening in a childhood cancer survivor clinic by evaluating patient acceptance, comparing subjects' symptoms to normative data, examining the utility of specific tests, and identifying risk factors associated with psychological distress.Methods: During their annual clinic visit, 101 adult survivors of childhood cancer (median age, 25 years) completed the Symptom Checklist 90 Revised (SCL-90), as well as the Short Form 36 (SF-36), Beck Depression Inventory (RDI), and one additional suicide question. Psychological distress was operationally defined according to the published SCL-90 clinical case rule, classifying subjects with a consistent pattern of symptom elevations as clinical cases.Results: The majority of subjects (80%) completed the screening in less than 30 minutes and reported little (15%) or no (84%) distress. Sixty-four percent believed it would help "very much" or "moderately" in getting to know them, and 35% thought it would help "slightly." On the SCL-90, 32 subjects (31.7%) had a positive screen, indicating significant psychological distress. All subjects with clinically significant symptoms on the BDI and SF-36 Mental Health Scale were cases on the SCL-90 (case-positive). Suicidal symptoms were reported in 13.9% of the sample, all of whom were SCL-90 cases. In a logistic regression model, subjects' dissatisfaction with physical appearance, poor physical health, and treatment with cranial radiation were associated with psychological distress.Conclusion: Results demonstrate that routine psychological screening can be successfully integrated into the cancer survivor clinic and may be effective in identifying those survivors with significant distress who require further evaluation.