晚期肺癌或结直肠癌患者的长期应对策略:国际 ACTION 研究的启示。

IF 3.3 2区 医学 Q2 ONCOLOGY
Psycho‐Oncology Pub Date : 2024-10-01 DOI:10.1002/pon.9315
K L Luu, P Mager, D Nieboer, F E Witkamp, L J Jabbarian, S Payne, M Groenvold, K Pollock, G Miccinesi, L Deliens, J J M van Delden, A van der Heide, I J Korfage, J A C Rietjens
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引用次数: 0

摘要

目的:全面了解晚期疾病患者的应对策略有助于提供符合患者需求的支持性护理。然而,人们对这一人群的应对策略如何随着时间的推移而发展还缺乏深入了解。我们研究了晚期癌症患者随着时间推移的应对策略,并确定了不同的轨迹及其预测因素:分析了 ACTION 群组随机试验对照组 675 名患者的数据。来自六个欧洲国家(比利时、丹麦、意大利、荷兰、斯洛文尼亚和英国)的肺癌或结直肠癌患者在基线、12周和20周时填写了调查问卷。测量指标包括否认、接受和以问题为中心的应对(COPE,简要 COPE 清单;每个量表 4-16 分)。我们使用线性混合模型来分析数据,并使用潜类混合模型来确定稳定的(患者内部变化的)结果:基线时,患者对否认的使用率较低(6.6),而对接受(12.6)和问题应对(12.2)的使用率较高。这些分数变化不大。我们发现,在使用否认策略方面有四种不同的轨迹,在使用接受策略方面有三种不同的轨迹,在使用以问题为中心的应对策略方面有五种不同的轨迹。在 513 名(77%)患者中,否认型应对策略的使用轨迹比较稳定;在 645 名(96%)患者中,接受型应对策略的使用轨迹比较稳定;在 602 名(91%)患者中,问题型应对策略的使用轨迹比较稳定。447名患者(68%)的所有应对策略都保持稳定,181名患者(28%)的两种应对策略保持稳定:总体而言,大多数晚期癌症患者使用的应对策略比较稳定。结论:总体而言,大多数晚期癌症患者使用的应对策略比较稳定,但是,对于每种应对策略,都有亚群患者报告了波动的应对轨迹。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Coping Strategies of Patients With Advanced Lung or Colorectal Cancer Over Time: Insights From the International ACTION Study.

Objective: A comprehensive understanding of coping strategies of patients with advanced diseases can contribute to providing supportive care that meets patients' needs. However, insight into how coping of this population develops over time is lacking. We examined coping strategies of patients with advanced cancer over time and identified distinct trajectories and their predictors.

Methods: Data from 675 patients of the control group from the ACTION cluster-randomized trial were analyzed. Patients with lung or colorectal cancer from six European countries (Belgium, Denmark, Italy, the Netherlands, Slovenia and the United Kingdom) completed questionnaires at baseline, 12 and 20 weeks. Measures included Denial, Acceptance, and Problem-focused coping (COPE, Brief COPE inventory; scores 4-16 per scale). We used linear mixed models to analyze the data and latent class mixed models to identify stable (within patient change < 2) coping strategies.

Results: At baseline, patients reported low use of Denial (6.6) and greater use of Acceptance (12.6) and Problem-Focused coping (12.2). These scores did not significantly change. We found four distinct trajectories for the use of Denial, three for Acceptance and five for Problem-Focused coping strategies. Stable trajectories were found in 513 (77%) patients for Denial, 645 (96%) for Acceptance and 602 (91%) for Problem-Focused coping. All coping strategies were stable in 447 (68%) patients and two were stable in 181 patients (28%).

Conclusions: Overall, the use of coping strategies was rather stable in the majority of patients with advanced cancer. However, for each of the coping strategies subgroups of patients reported fluctuating coping trajectories.

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来源期刊
Psycho‐Oncology
Psycho‐Oncology 医学-心理学
CiteScore
6.30
自引率
8.30%
发文量
220
审稿时长
3-8 weeks
期刊介绍: Psycho-Oncology is concerned with the psychological, social, behavioral, and ethical aspects of cancer. This subspeciality addresses the two major psychological dimensions of cancer: the psychological responses of patients to cancer at all stages of the disease, and that of their families and caretakers; and the psychological, behavioral and social factors that may influence the disease process. Psycho-oncology is an area of multi-disciplinary interest and has boundaries with the major specialities in oncology: the clinical disciplines (surgery, medicine, pediatrics, radiotherapy), epidemiology, immunology, endocrinology, biology, pathology, bioethics, palliative care, rehabilitation medicine, clinical trials research and decision making, as well as psychiatry and psychology. This international journal is published twelve times a year and will consider contributions to research of clinical and theoretical interest. Topics covered are wide-ranging and relate to the psychosocial aspects of cancer and AIDS-related tumors, including: epidemiology, quality of life, palliative and supportive care, psychiatry, psychology, sociology, social work, nursing and educational issues. Special reviews are offered from time to time. There is a section reviewing recently published books. A society news section is available for the dissemination of information relating to meetings, conferences and other society-related topics. Summary proceedings of important national and international symposia falling within the aims of the journal are presented.
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