乳腺癌患者心理护理有关中重度负性情绪倾向发生率的指标应用分析

目的 探讨中重度负性情绪倾向（焦虑、抑郁）发生率指标在乳腺癌患者中应用的效果。方法 将基于德尔菲法构建的“中重度负性情绪倾向（焦虑、抑郁）发生率”设为乳腺科护理质量指标,进行心理护理质量控制与评价。将2019年7月至12月江苏省肿瘤医院收治的90例乳腺癌患者设为观察组,构建并实施乳腺科标准化心理护理活动;另以同年1月至6月收治的给予乳腺癌常规心理护理的90例患者为对照组。于两组患者术前及出院时用广泛性焦虑量表（GAD-7）评价患者焦虑程度（界定GAD-7≥10分为中重度焦虑）,健康问卷抑郁症状群量表（PHQ-9）评价患者抑郁程度（界定PHQ-9≥10分为中重度抑郁）,获得中重度负性情绪倾向发生率,并以心理弹性量表（CD-RISC）评价患者心理弹性水平。结果 观察组术前中重度负性情绪倾向发生率为35.6%,心理弹性（56.61±10.76）分;出院时中重度负性情绪倾向发生率10.0%,心理弹性（67.43±12.53）分。对照组术前中重度负性情绪倾向发生率38.89%,心理弹性（57.18±11.88）分;出院时中重度负性情绪倾向发生率23.33%,心理弹性（53.98±10.46）分,差异均有统计学意义(均P<0.05）。结论 中重度负性情绪倾向（焦虑、抑郁）发生率护理质量指标的应用,有助提高乳腺癌患者负性情绪的改善,提高患者心理弹性水平,同时为乳腺科护理质控及评价提供了规范指引。     

Not all negative emotions are equal: the role of emotional expression in online support groups for women with breast cancer

The repression/suppression of negative emotions has long been considered detrimental for breast cancer (BC) patients, leading to poor coping, progression of symptoms, and general lower quality of life. Therapies have focused on encouraging the expression of negative emotions. While group therapies have proven to be successful for BC patients, no study has looked at the role of expressing negative emotions during the therapeutic interaction. We examined written expressed emotions by women participating in a common form of psychosocial support, Internet based bulletin boards (BBs). Fifty-two new members to BC BBs were studied. They completed measures of quality of life and depression. After 6 months the measures were again assessed and messages during that time were collected and analyzed for emotional content. For the 52 women, results showed that greater expression of anger was associated with higher quality of life and lower depression, while the expression of fear and anxiety was associated with lower quality of life and higher depression. The expression of sadness was unrelated to change scores. Our results serve to challenge the commonly held belief that the expression of all negative emotions are beneficial for BC patients. Instead, expressing specific negative emotions are beneficial, while others are not.     

Prospective investigation of emotional control and cancer risk in men (the Zutphen Elderly Study) (The Netherlands)

Objectives: Emotional control is hypothesized to increase cancer incidence and cancer mortality risk. We tested the hypothesis prospectively on all cancers in elderly men. Methods: The Zutphen Elderly Study on lifestyle and chronic diseases started in 1985. The total sample consisted of 939 men born between 1900 and 1920 and living in Zutphen (response 74%). In 1985, emotional control was measured by questionnaire with the Courtald Emotional Control Scale (CECS). The CECS consists of three dimensions (anger, anxiety and depression). Emotional control scores were grouped in tertiles. Information on cancer incidence and mortality was collected until December 1994 through general practitioners and hospital administration (119 incidence cases, and 71 deaths from cancer). Cox proportional hazards analyses were performed, adjusted for sociodemographic, psychosocial, and lifestyle-related factors. Results: Overall emotional control and emotional control of anger and of anxiety were not convincingly related to cancer risk. Intermediate control of depression was related to cancer incidence (fully adjusted RR = 1.7, 95% CI = 1.0–2.8). Both intermediate and high control of depression were related to cancer mortality (RR = 2.2, 95% CI = 1.1–4.6 and RR = 2.1, 95% CI = 1.0–4.3, respectively). Conclusion: Our findings provide evidence that control of depression is related to cancer risk.     

中晚期乳腺癌患者家属负性情绪及压力及照护能力的调查分析

目的 探讨中晚期乳腺癌患者家属的负性情绪、压力及照护能力.方法 选取2015年4月至2019年12月间陕西省肿瘤医院收治的160例乳腺癌患者家属,采用焦虑、抑郁自评量表、照顾者压力量表(CBI)及自制照护能力量表对家属进行调查,分析家属一般资料对上述结果 的影响.结果 家属的文化程度和家庭平均月收入与其焦虑和抑郁评分有...     

Economic stress among low-income women with cancer: effects on quality of life

BACKGROUND: Attention to the economic consequences of cancer has grown as the number of cancer survivors is increasing. Although prevalent among low-income minority survivors, the impact of economic stress on quality of life (QOL) remains largely unexplored. METHODS: Data are reported for 487 predominantly Hispanic low-income women with a primary diagnosis of breast or gynecological cancer and undergoing active treatment or follow-up. Cross-sectional and longitudinal analyses examined the effects of economic concerns on QOL, depression, and anxiety. RESULTS: Rates of unemployment, medical cost and wage concerns, and financial stress were high in this study population, at baseline, respectively, 70%, 68%, 47%, and 49%. The proportions reporting unemployed status and medical cost concerns stayed flat from baseline to 6 months, followed by a pronounced drop at 12 months. Patient reported rates of lost wage worries increased from baseline to 6 months, followed by a moderate decrease. Functional, emotional, physical, and social-family well-being and depression and anxiety scores exhibited consistent linear improvement from baseline to 12 months. Over 12 months, patients reporting economic concerns had significantly poorer functional, emotional, and affective well-being. CONCLUSIONS: Economic stress is negatively associated with QOL, highlighting the importance of addressing economic stress in low-income women with cancer.     

手术方式对乳腺癌患者不同阶段生活质量的影响

背景与目的：随着医学模式的转变,肿瘤患者术后生活质量(quality of life)已成为评价整体治疗的重要标准之一。本研究旨在探讨不同手术方式对乳腺癌患者治疗和康复各阶段的生活质量的影响。方法：对2012年4月—2013年4月在北京同仁医院肿瘤中心手术后复查以及首次接受手术的乳腺癌患者共207例进行生活质量评定,其中保留乳房的乳腺癌切除术61例,全乳切除即刻乳房重建术60例,乳腺癌改良根治术86例,通过配对设计方法,使用量表进行调查,并进行统计学分析。结果：围手术期时,接受保乳手术或全乳切除即刻乳房重建手术的患者与接受改良根治术的患者主要在生理、情感和焦虑、抑郁等不良情绪水平方面差异有统计学意义(P<0.05),而在生活质量方面差异无统计学意义(P>0.05);术后2年和术后5年,接受保乳手术或全乳切除即刻乳房重建手术的患者与接受改良根治术的患者在生活质量方面差异有统计学意义(P<0.05),而在生理、情感和焦虑、抑郁等不良情绪水平方面差异无统计学意义(P>0.05)。结论：保留乳房的乳腺癌切除术和全乳切除即刻乳房重建手术较乳腺癌改良根治术可明显降低乳腺癌患者在围手术期焦虑、抑郁等不良情绪,并可不同程度提高患者的远期生活质量。     

Psychosocial Impact of Lymphoedema After Breast Surgery

Lymphoedema (LE) secondary to cancer is the side effect of cancer treatments and may appear on breast cancer (BC) survivors’ upper limb post-surgery. Several symptoms other than swelling have been reported. LE onset adversely affects the emotional and psychological state of BC survivors, leading to anxiety, depression, body image issues and altered psychological quality of life (QoL). In sufficient informational support, physical limitations, compression garments, LE symptoms and age are associated with the emotional and psychological sequelae. Social impact of LE, such as social confidence, job security and sexuality and relationship with partners, has also been reported. The visibility of LE, its association with BC and compression garments are associated with LE-related social sequelae. Several studies aiming at both LE prevention and QoL improvement have been conducted. However, their efficacy, especially in minimising psychosocial sequelae among BC survivors with LE, remains to be confirmed.     

Gynecological Cancer Survivors: Assessment of Psychological Distress and Unmet Supportive Care Needs

This study highlights psychosocial needs of gynecological cancer survivors, contributing to evaluation of the Cancer Survivors Unmet Needs measure. Of the 45 participants, 28.9% reported clinical anxiety, 20.0% mild-to-severe depression, and 15.6% had probable posttraumatic stress disorder. Strength of unmet needs was associated with anxiety, depression, posttraumatic stress, poorer quality of life, younger age, and greater time since diagnosis. Linear regressions showed clinical measures, quality of life, optimism, and self-blaming coping style explained 56.4% of strength of unmet needs. Anxiety, functional well-being, posttraumatic stress, and emotional well-being accounted for 40.7% of variance in fear of recurrence, with emotional well-being the strongest predictor.     

急诊护理干预对肿瘤合并上消化道出血患者心理状态及营养指标的影响

目的 探讨急诊护理干预对肿瘤合并上消化道出血患者心理状态及营养指标的影响.方法 选取2018年6月至2021年6月间海警医院收治的90例肿瘤合并上消化道出血患者,采用随机数表法分为观察组和对照组,每组45例.观察组患者采用急诊护理干预,对照组患者采用常规护理干预,比较两组患者干预后的护理效果、满意度、营养指标和负性情绪...     

Gynecological cancer survivors: assessment of psychological distress and unmet supportive care needs

This study highlights psychosocial needs of gynecological cancer survivors, contributing to evaluation of the Cancer Survivors Unmet Needs measure. Of the 45 participants, 28.9% reported clinical anxiety, 20.0% mild-to-severe depression, and 15.6% had probable posttraumatic stress disorder. Strength of unmet needs was associated with anxiety, depression, posttraumatic stress, poorer quality of life, younger age, and greater time since diagnosis. Linear regressions showed clinical measures, quality of life, optimism, and self-blaming coping style explained 56.4% of strength of unmet needs. Anxiety, functional well-being, posttraumatic stress, and emotional well-being accounted for 40.7% of variance in fear of recurrence, with emotional well-being the strongest predictor.     

Psychosocial characteristics associated with breast cancer survivors' intimate partners' needs for information and support after primary breast cancer treatment

This study examines which psychosocial characteristics are associated with breast cancer survivors' partners' posttreatment needs for information and support. Eighty-four partners completed measures of coping, social support, illness representations, perceived stress, self-efficacy, anxiety, depression, and marital malfunctioning. Partners in need reported higher anxiety and depression, emotional illness representations, and emotion-oriented coping than partners without needs. Moreover, partners needing information and support took a more negative view on the timeline and consequences of their spouse's posttreatment condition. Interventions aimed at enhancing partners' posttreatment adjustment should focus on partners responding emotionally as well as perceiving their spouse's condition as a chronic condition.     

Psychosocial and sexual functioning of survivors of breast cancer

The literature documents that the majority of breast cancer survivors have adjusted well after their first 2 years since diagnosis. However, there is a subset of survivors reporting psychological distress, including depression and anxiety, involving approximately 30% by 4 years post-treatment, but widely ranging from 5% to 50%, depending on when diagnosed and time since treatment completion. Further, a large proportion of survivors report cancer-related problems long after treatment completion, including cancer-related distress involving body image, fear of recurrence, post-traumatic stress disorder (PTSD), and sexual problems. Those with long-term medical sequelae, such as lymphedema, have worse adjustment compared to those who do not. Future research directions are suggested.     

术后乳腺癌患者焦虑、抑郁及生活质量分析

[目的]评价术后乳腺癌患者焦虑、抑郁和生活质量状况。[方法]采用一般调查问卷、生活质量测定量表、焦虑自评量表和抑郁自评量表对116例术后乳腺癌患者进行问卷调查。[结果]术后乳腺癌患者生活质量偏低,社会状况、情感状况、关注状况和生理状况得分均偏低。年龄、教育程度、婚姻状况、职业、家庭收入、病程、医疗费用等均与乳腺癌患者生活质量总分呈正相关,而肿瘤分期、焦虑总分、抑郁总分等与乳腺癌患者生活质量总分呈负相关。[结论]乳腺癌患者术后焦虑、抑郁情绪越严重,其生活质量越差。建议医护人员对乳腺癌患者加强疾病宣教、情绪疏导,促进其社会支持、提高乳腺癌患者的生活质量。     

家庭有氧运动对胃癌患者负性情绪和生活质量的影响

目的探讨家庭有氧运动对胃癌患者焦虑抑郁情绪和生活质量的影响。方法选取2011年1月至2012年12月治疗的98例胃癌患者为研究对象,常规组患者仅给予常规护理,干预组增加家庭有氧运动,比较两组患者焦虑抑郁情绪和生活质量。结果 3个月后,干预组患者焦虑标准分为(42.46±3.51)分,抑郁标准分为(42.37±3.21)分,明显低于常规组,差异有统计学意义(P<0.05)。干预组患者除共性症状及副作用维度差异无统计学意义外,其他各维度得分及其总分明显优于常规组,差异有统计学意义(P<0.05)。结论家庭有氧运动能够明显降低胃癌患者焦虑抑郁情绪程度,提高患者生活质量。     

Impact of Caregiver’s Psychological Aspects towards Quality of Life of Children with Acute Lymphoblastic Leukemia (ALL)

Background: Families who have children with Acute Lymphoblastic Leukemia (ALL) are at high risk of experiencing stress. Stress on the family can cause the formation of negative communication in children so that families tend to spend more time in dealing with negative emotions through negative actions. This study aimed to analyze the correlation between stress, anxiety, and depression in caregiver with pediatric ALL outcome. Methods: A cross sectional study was conducted on children with ALL and their caregivers at the Pediatric Ward, Dr. Soetomo Hospital, Surabaya. Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI) questionnaire were used to measure anxiety and depression in caregivers. Previous stressful experiences in children and caregivers were assessed by The Perceived Stress Scale (PSS), Children quality of life was assessed by pediatric quality of life inventory (PedsQL™) questionnaire. Pearson and Spearman correlation strength test was performed for the statistical analysis. Results: There is no significant correlation between stress level of caregivers with the quality of life of children with ALL (P > 0.05). There is negative correlation between the level of anxiety and depression in caregivers with the quality of life of children (P < 0.05). There is negative correlation between children stress level with the quality of life of children (P < 0.05). Conclusion: The psychological condition of the caregiver affects the quality of life of children. The higher the level of anxiety and depression in caregivers, the lower the quality of life of children.     

60例癌症患者的心理状态调查

目的：研究癌症住院患者的心理状况。方法：焦虑自评量表（SAS）、抑郁自评量表（SDS）评定癌症组、糖尿病组及健康对照组各60例的心理状况。结果：癌症组的SAS标准分、SDS标准分高于糖尿病组和健康组（P〈0.01）。结论：癌症患者存在明显的焦虑抑郁症状,心身状况较差,因此,在恶性肿瘤进行手术、放疗、化疗、中医药治疗的同时,应加强患者的心理治疗,改善患者的生存质量。     

Relationship of psychological characteristics and self‐efficacy in gastrointestinal cancer survivors

To characterize gastrointestinal cancer survivors' ability to psychologically adjust, we examined the relationship between psychological characteristics (quality of life (QOL), anxiety, depression, and post‐traumatic stress symptoms) and self‐efficacy (perceived ability to initiate coping strategies). Forty‐seven subjects (32 males and 15 females) were recruited from outpatient clinics or general surgical wards after readmission for therapy unrelated to cancer. All had undergone treatment for gastrointestinal cancer. Japanese version of the Functional Assessment of Cancer Therapy—General (FACT‐G), Japanese version of Hospital Anxiety and Depression Scale (HADS), Japanese version of Impact of Event Scale—Revised (IES‐R), and The Self‐Efficacy Scale for Advanced Cancer (SEAC) were administered. Correlation analyses revealed a statistically significant positive correlation between three subscales of SEAC and QOL (total of FACT‐G value) and a significant negative correlation between anxiety, depression (the total of HADS value), post‐traumatic stress symptoms (the total of IES‐R value), and SEAC. In multiple regression analysis, the influence from Affect Regulation Efficacy (subscale of SEAC) was the largest in anxiety and post‐traumatic stress symptoms while the influence from Activities of Daily Living Efficacy (subscale of SEAC) was the largest in QOL and depression. Our findings revealed that a strong relationship between self‐efficacy and psychological adjustment, and that there should be several psychological intervention forms performed at various treatment stages to enhance self‐efficacy in this population of gastrointestinal cancer survivors. These results also imply the effectiveness of interventions on self‐efficacy for gastrointestinal cancer survivors and the influence of psychological factors such as QOL, anxiety, depression, and post‐traumatic stress symptoms. Copyright © 2009 John Wiley & Sons, Ltd.     

肺癌患者合并情绪障碍的临床分析

目的:探讨肺癌患者的情绪障碍。方法:采用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HA-MA)对72例肺癌患者和72例同期住院的普通内科病人进行比较,比较两组的情绪障碍。结果:肺癌患者与对照组相比存在明显的抑郁症状和焦虑症状,抑郁程度和焦虑程度越高,情绪障碍越明显,差异有统计学意义。结论:肺癌患者存在着明显的情绪障碍,其抑郁和焦虑症状均较明显。     

肺癌患者合并情绪障碍的临床分析

目的：探讨肺癌患者的情绪障碍。方法：采用汉密尔顿抑郁量表（HAMD）、汉密尔顿焦虑量表（HA-MA）对72例肺癌患者和72例同期住院的普通内科病人进行比较,比较两组的情绪障碍。结果：肺癌患者与对照组相比存在明显的抑郁症状和焦虑症状,抑郁程度和焦虑程度越高,情绪障碍越明显,差异有统计学意义。结论：肺癌患者存在着明显的情绪障碍,其抑郁和焦虑症状均较明显。     

Gender and online cancer support groups: Issues facing male cancer patients

Background. Men are underrepresented in cancer support groups. They emphasize information seeking rather than emotional support and are less likely to express negative emotion critical for change. Three hypotheses were tested; men compared to women express fewer negative emotions, especially about their cancer, and men experience more fear and apprehension. Method. Four online professionally led groups were sampled. Assessments of emotions and fears used 3 text analysis programs. Results. Women expressed more negative emotions. these differences were more pronounced when discussing their cancer. Men experienced greater anxiety/fear, which may explain their under representation. Conclusions. The dual dilemma of attracting men to support groups and directing them to emotional issues represents a challenge to health providers.