国立肿瘤研究所住院的成年实体瘤患者抑郁和焦虑的评估

Salman Bashar Al Ayub, M. H. Rahman, Muhammad Rafiqul Islam, N. Khatun
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引用次数: 0

摘要

背景:癌症是全球最常见的死亡和发病原因之一,2020年估计造成1000万人死亡。癌症的诊断是一个压力事件,会引起严重的心理困扰,最常见的是抑郁和焦虑,直接影响疾病的预后和生活质量。该研究的目的是评估患有实体瘤的成年患者的抑郁和焦虑水平,以及各种社会人口统计学和临床因素与之的关系。方法:在达卡国立癌症研究所和医院(NICRH)进行了为期12个月的横断面描述性研究。在满足纳入和排除标准后,共有405例组织学证实的成人实体瘤患者采用目的抽样纳入研究。采用半结构化问卷和孟加拉语版DASS-21量表对患者进行面对面访谈,收集数据。结果:本组调查对象平均年龄为47.4±16.5岁,以男性为主,男女比例约为3:2。最常见的是胃肠道癌症(27.4%),其次是肺癌(19.5%)、妇科(11.4%)、乳腺癌和肉瘤(均为9.4%)。大多数患者正在接受化疗(71.9%)和IV期疾病(64.4%),病程少于12个月(62%)。抑郁和焦虑症状在所有患者中的患病率分别为38.02%和42.96%。超过一半(53.3%)的成年实体瘤患者患有抑郁和/或焦虑。轻度抑郁占19.7%,中度抑郁占13.6%,重度抑郁占3.7%,极重度抑郁占1%,焦虑严重程度分别为17.3%、11.6%、9.4%和4.7%。住院患者中,女性患者抑郁程度显著高于男性(p<0.01),肺癌患者抑郁程度显著高于男性(p<0.01);相比之下,胃肠道癌症和合并症的存在更容易导致焦虑(p<0.05)。虽然治疗方式和疾病严重程度与抑郁或焦虑的患病率没有显著关系,但ECOG表现状态对这两种疾病都有显著影响。在对社会人口变量的分析中,文盲和低收入的人更容易患严重和极严重的抑郁症,另一方面,家庭主妇和较低的社会经济阶层的焦虑程度更高。结论:研究结果表明,在住院患者中,抑郁和焦虑症状的患病率较高;因此,心理健康的咨询、筛查和及时评估应成为肿瘤治疗标准方案的一部分。孟加拉国J医学2023;第34卷,第2(1)号补编:215-216
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Assessment of Depression and Anxiety Among Adult Patients With Solid Tumours Admitted in National Institute of Cancer Research & Hospital
Background: Cancer is one of the most common causes of mortality & morbidity globally, accounting for an estimated 10 million deaths in 2020. The diagnosis of cancer is a stressful event causing significant psychological distresses, most commonly depression and anxiety, directly interfering with disease outcome and quality of life. The aim of the study is to assess the level of depression and anxiety among adult patients with solid tumours as well as the association of various socio-demographic and clinical factors with them. Methods: This cross-sectional type of descriptive study was conducted at the National Institute of Cancer Research & Hospital (NICRH), Dhaka for a period of 12 months. A total of 405 histologically confirmed adult solid tumour patients were enrolled in the study using purposive sampling after fulfilling inclusion and exclusion criteria. Data were collected from the patients by face-to-face interviews using a semi-structured questionnaire and Bangla version of the DASS-21 scale. Results: In this study, the mean age of the respondents was 47.4 ± 16.5 years, the respondents were predominantly male with the male-tofemale ratio being 3:2 roughly. Gastrointestinal cancers (27.4%) were most prevalent, followed by lung (19.5%), gynaecological (11.4%), breast cancers and sarcomas (both 9.4%). The majority of the patients were undergoing chemotherapy (71.9%) and harbouring stage IV disease (64.4%) with duration of illness for less than twelve months (62% of respondents). The prevalence of depressive and anxious symptomatology among all patients was 38.02% and 42.96%, respectively. More than half (53.3%) of the adult patients with solid tumours were suffering from either of depression and/or anxiety. 19.7% had mild, 13.6% had moderate, 3.7% had severe and 1% had extremely severe levels of depression, while the percentages were 17.3%, 11.6%, 9.4% and 4.7% respectively, for severity of anxiety. In inpatient setting, depressive disorders were significantly higher in females than males (p<0.01) and among the lung cancer patients; in contrast, gastrointestinal cancer and the presence of co-morbidities predisposed more to anxiety (p<0.05). Although mode of treatment and severity of disease showed no significant relationship with the prevalence of depression or anxiety, ECOG performance status was found to have a significant impact on both of the disorders. On analysis of the socio-demographic variables, illiterate and low-income people were seen to suffer more with a severe and extremely severe level of depression, on the other hand, homemakers and lower socio-economic class had higher levels of anxiety. Conclusion: The study findings demonstrated a higher prevalence of depressive and anxious symptomatology in the inpatient setting; therefore, counselling, screening, and timely evaluation of mental health should be a part of the standard protocol of oncology care. Bangladesh J Medicine 2023; Vol. 34, No. 2(1) Supplement: 215-216
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