Objective:Recent research has documented psychological distress in advanced breast cancer(ABC)patients,but few studies have examined how death anxiety is affected by the symptom burden.Therefore,this study aims to exp...Objective:Recent research has documented psychological distress in advanced breast cancer(ABC)patients,but few studies have examined how death anxiety is affected by the symptom burden.Therefore,this study aims to explore the association among symptom burden,death anxiety and psychological distress(depression and anxiety)in ABC patients.Methods:This cross-sectional study used the Death and Dying Anxiety Scale(DADDS),9-item Patient Health Questionnaire(PHQ-9),General Anxiety Disorder-7(GAD-7)and MD Anderson Symptom Inventory(MDASI)to assess death anxiety,depression,anxiety,and symptom burden,respectively.Bias-corrected bootstrapping methods were used to estimate indirect effects and 95%confidence intervals.Results:Two hundred ABC patients completed the questionnaires.All of the respondents were females,with a mean age of 50±10 years.Initial correlation analyses revealed significant associations of death anxiety with depression(r=0.57,P<0.001),anxiety(r=0.60,P<0.001)and symptom burden(r=0.43,P<0.001).Moreover,depression(r=0.53,P<0.001)and anxiety(r=0.45,P<0.001)were significantly correlated with symptom burden.An analysis using Hayes’PROCESS macro revealed the partial effecting role of death anxiety in the relationship between depression and symptom burden,and between anxiety and symptom burden(contributions to the total effect of 0.247 and 0.469,respectively).Conclusions:This study provides insight into the relationship between death anxiety and symptom burden.The results suggest that interventions addressing death anxiety may be more effective for alleviating the depression and anxiety experienced by ABC patients with a symptom burden.展开更多
Background The aims of this study were to evaluate insomnia status in advanced cancer patients been served for 4 weeks symptom management in psycho-oncology service,and to explore predictors for the persistent or wors...Background The aims of this study were to evaluate insomnia status in advanced cancer patients been served for 4 weeks symptom management in psycho-oncology service,and to explore predictors for the persistent or worsen insomnia.Methods This was a real world longitudinal study among advanced cancer patients been referred to the psychooncology symptom management clinic in Peking University Cancer Hospital.Patients repeatedly completed the Insomnia Severity Index(ISI),Hospital Anxiety and Depression Scale(HADS),and MD Anderson Symptom Inventory(MDASI)on Day 0(baseline),Day 14,and Day 28 by using an electronic patient-reported outcomes(ePRO)system.Results At baseline,50.6%of the sample(78/161)had moderate to severe insomnia(>14 on ISI).Totally 111(68.9%)patients had completed the assessments at all 3 time points.The patients with insomnia and pain(66.7%)were more symptomatic with fatigue,distress,shortness of breath,drowsiness,dry mouth,and numbness(all P<0.05)at baseline.While observed 21%patients with significantly alleviated insomnia by Day 28(P<0.001),more severe disturbed sleep on MDASI(>=6)at baseline is a predictor for 30%of patients who had significant insomnia on Day 28(P<0.001).Conclusions Half of referred patients for symptom management consultation in psycho-oncology service reported moderate to severe insomnia,while 30%had significant insomnia after 4 weeks symptom management,highlighted the needs for routine insomnia monitoring in the clinic.Insomnia with pain is more symptomatic than insomnia without pain.More severe disturbed sleep at baseline is a predictor to persist or worsen insomnia.展开更多
基金the Beijing Municipal Health and Scientific and Technological Achievements and Appropriate Technology Promotion Projects in China(No.2018-TG-48)。
文摘Objective:Recent research has documented psychological distress in advanced breast cancer(ABC)patients,but few studies have examined how death anxiety is affected by the symptom burden.Therefore,this study aims to explore the association among symptom burden,death anxiety and psychological distress(depression and anxiety)in ABC patients.Methods:This cross-sectional study used the Death and Dying Anxiety Scale(DADDS),9-item Patient Health Questionnaire(PHQ-9),General Anxiety Disorder-7(GAD-7)and MD Anderson Symptom Inventory(MDASI)to assess death anxiety,depression,anxiety,and symptom burden,respectively.Bias-corrected bootstrapping methods were used to estimate indirect effects and 95%confidence intervals.Results:Two hundred ABC patients completed the questionnaires.All of the respondents were females,with a mean age of 50±10 years.Initial correlation analyses revealed significant associations of death anxiety with depression(r=0.57,P<0.001),anxiety(r=0.60,P<0.001)and symptom burden(r=0.43,P<0.001).Moreover,depression(r=0.53,P<0.001)and anxiety(r=0.45,P<0.001)were significantly correlated with symptom burden.An analysis using Hayes’PROCESS macro revealed the partial effecting role of death anxiety in the relationship between depression and symptom burden,and between anxiety and symptom burden(contributions to the total effect of 0.247 and 0.469,respectively).Conclusions:This study provides insight into the relationship between death anxiety and symptom burden.The results suggest that interventions addressing death anxiety may be more effective for alleviating the depression and anxiety experienced by ABC patients with a symptom burden.
文摘Background The aims of this study were to evaluate insomnia status in advanced cancer patients been served for 4 weeks symptom management in psycho-oncology service,and to explore predictors for the persistent or worsen insomnia.Methods This was a real world longitudinal study among advanced cancer patients been referred to the psychooncology symptom management clinic in Peking University Cancer Hospital.Patients repeatedly completed the Insomnia Severity Index(ISI),Hospital Anxiety and Depression Scale(HADS),and MD Anderson Symptom Inventory(MDASI)on Day 0(baseline),Day 14,and Day 28 by using an electronic patient-reported outcomes(ePRO)system.Results At baseline,50.6%of the sample(78/161)had moderate to severe insomnia(>14 on ISI).Totally 111(68.9%)patients had completed the assessments at all 3 time points.The patients with insomnia and pain(66.7%)were more symptomatic with fatigue,distress,shortness of breath,drowsiness,dry mouth,and numbness(all P<0.05)at baseline.While observed 21%patients with significantly alleviated insomnia by Day 28(P<0.001),more severe disturbed sleep on MDASI(>=6)at baseline is a predictor for 30%of patients who had significant insomnia on Day 28(P<0.001).Conclusions Half of referred patients for symptom management consultation in psycho-oncology service reported moderate to severe insomnia,while 30%had significant insomnia after 4 weeks symptom management,highlighted the needs for routine insomnia monitoring in the clinic.Insomnia with pain is more symptomatic than insomnia without pain.More severe disturbed sleep at baseline is a predictor to persist or worsen insomnia.
