Trajectories of Depressive Symptoms Among Patients Undergoing Chemotherapy for Breast, Gastrointestinal, Gynecological, or Lung Cancer.

IF 2.4 3区 医学 Q1 NURSING
Johanna A Suskin, Steven M Paul, Ashley R Stuckey, Yvette P Conley, Jon D Levine, Marilyn J Hammer, Christine Miaskowski, Laura B Dunn
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引用次数: 0

Abstract

Background: Individuals who undergo chemotherapy for cancer are at elevated risk of developing depressive symptoms, yet substantial interindividual variation exists in trajectories of these symptoms.

Objective: To examine interindividual variations in trajectories of depressive symptoms during 2 cycles of chemotherapy and to evaluate associations between demographic and clinical characteristics, symptom severity scores, psychological adjustment characteristics (eg, stress and coping), and initial levels and trajectories of depressive symptoms.

Methods: Patients (n = 1323) diagnosed with breast, gynecologic, lung, or gastrointestinal cancer completed the Center for Epidemiological Studies-Depression Scale 6 times, over 2 cycles of chemotherapy. At enrollment, patients provided demographic information and completed a broad range of symptom, stress, and coping measures. Hierarchical linear modeling was used to identify characteristics associated with initial levels and trajectories of depressive symptoms.

Results: Interindividual differences in initial levels of depressive symptoms were associated with marital status, functional status, level of comorbidity, chemotherapy toxicity, sleep disturbance, morning fatigue, cognitive function, global and cancer-related stress, and coping characteristics (ie, sense of coherence, venting, behavioral disengagement, and self-blame). Interindividual differences in depression trajectories were associated with education, cancer type, chemotherapy toxicity, sleep disturbance, evening energy, evening fatigue, cognitive function, global and cancer-related stress, and self-blame.

Conclusions: We present new findings concerning the trajectories and predictors of depressive symptoms during chemotherapy.

Implications for practice: Modifiable risk factors (eg, stress and coping) are important targets for intervening to address depressive symptoms in oncology patients.

乳腺癌、胃肠道癌、妇科癌或肺癌化疗患者的抑郁症状轨迹。
背景:接受癌症化疗的患者出现抑郁症状的风险较高:接受癌症化疗的患者出现抑郁症状的风险较高,但这些症状的变化轨迹存在很大的个体差异:研究两个化疗周期中抑郁症状轨迹的个体间差异,并评估人口统计学和临床特征、症状严重程度评分、心理调节特征(如压力和应对)以及抑郁症状初始水平和轨迹之间的关联:被诊断为乳腺癌、妇科癌症、肺癌或胃肠道癌症的患者(n = 1323)在两个化疗周期内完成了 6 次流行病学研究中心抑郁量表。在注册时,患者提供了人口统计学信息,并完成了一系列症状、压力和应对措施的测量。研究人员采用层次线性模型来确定与抑郁症状初始水平和轨迹相关的特征:抑郁症状初始水平的个体间差异与婚姻状况、功能状况、合并症程度、化疗毒性、睡眠障碍、晨起疲劳、认知功能、整体压力和癌症相关压力以及应对特征(即一致性感、发泄、行为脱离和自责)有关。抑郁轨迹的个体间差异与教育程度、癌症类型、化疗毒性、睡眠障碍、晚间精力、晚间疲劳、认知功能、整体和癌症相关压力以及自责有关:我们提出了有关化疗期间抑郁症状的轨迹和预测因素的新发现:可改变的风险因素(如压力和应对)是干预肿瘤患者抑郁症状的重要目标。
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来源期刊
Cancer Nursing
Cancer Nursing 医学-护理
CiteScore
4.80
自引率
3.80%
发文量
244
审稿时长
6-12 weeks
期刊介绍: Each bimonthly issue of Cancer Nursing™ addresses the whole spectrum of problems arising in the care and support of cancer patients--prevention and early detection, geriatric and pediatric cancer nursing, medical and surgical oncology, ambulatory care, nutritional support, psychosocial aspects of cancer, patient responses to all treatment modalities, and specific nursing interventions. The journal offers unparalleled coverage of cancer care delivery practices worldwide, as well as groundbreaking research findings and their practical applications.
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