喉癌患者对疾病进展恐惧的影响因素

Influencing factors of fear of disease progression in patients with laryngeal cancer

目的:评估喉癌患者疾病进展恐惧(fear of disease progression,FoP)的患病率及其与临床病理特征的相关性。方法:在这项横断面研究中,共招募了185名喉癌患者,所有参与者被要求填写一份个人信息表、医院抑郁焦虑问卷(Hospital Anxiety and Depression Scale,HADS)、社会支持评定问卷(Social Support Rating Scale,SSRS)、生活质量问卷(European Organization for Reasearch and Treatment of Cancer,Quality of Life Questionnare-Core 30,EORTC-QLQ-C30)和疾病进展恐惧问卷(Fear of Disease Progression Questionnaire Short Form,FoP-Q-SF)。采用描述性统计等多种统计方法对数据进行分析。结果:60例患者(32%)出现高FoP(FoP-Q-SF≥34分)。在FoP-Q-SF的12个项目中,他们最担心的是项目11"我担心如果我发生什么事情,家庭会怎么样"、项目9"我担心疾病过程中会有一些重大的治疗"和项目10"我担心药物会损害我的身体"。我们发现女性、高教育水平、癌症家族史阴性的患者更容易出现高FoP。此外,焦虑、抑郁、社会支持越低、生活质量更差的患者更容易出现高FoP。进一步的Logistic分析发现,癌症家族史阴性、焦虑、抑郁、社会支持、生活质量是影响FoP的独立预测因子。结论:FoP是常见的,对喉癌患者具有重要的临床意义。因此,我们建议对喉癌患者进行FoP的常规筛查,在早期发现高度痛苦的患者,并提供针对性的支持。

Objective:To assess the prevalence of fear of disease progression(FoP)and its clinical relevance in patients with laryngeal cancer.Methods:In this cross-sectional study,one hundred and eighty-five laryngeal cancer patients were recruited.All participants were asked to complete a personal information sheet,the Hospital Anxiety and Depression Scale(HADS),the Social Support Rating Scale(SSRS),Quality of Life(EORTC-QLQ-C30)and Fear of Disease Progression Questionnaire Short Form(FoP-Q-SF).Descriptive statistics and other multiple statistical methods were conducted to analyze the data.Results:Sixty patients(32%)suffered from high FoP(FoP-Q-SF≥34 scores).According to the 12 items of the FoP-Q-SF,the three greatest fears were item 11"Worrying about what will happen to the family if something should happen to the patient",item 9"Being afraid of severe medical treatments in course of the illness"and item 10"Worrying that medications could damage the body".We found that female,those with a high level of education,and those with a negative family history of cancer were more likely to have high FoP.In addition,patients with more anxiety,more depression,lower social support and poorer quality of life were more likely to have high FoP.Further Logistic regression analysis showed that a negative family history of cancer,anxiety,depression,social support,QOL were identifified as independent predictors for FoP.Conclusion:FoP is frequent and of major clinical importance for laryngeal cancer patients.Hence,we recommend that laryngeal cancer patients undergo routine screening for FoP,to identify highly distressed patients at an early stage,and to offer targeted support.