Spirituality, patients' worry, and follow-up health-care utilization among cancer survivors.

Anthony J Cannon, Deborah L Darrington, Elizabeth C Reed, Fausto R Loberiza
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引用次数: 29

Abstract

Background: Spirituality may aid cancer survivors as they attempt to interpret the meaning of their experience.

Objective: We examined the relationship between spirituality, patient-rated worry, and health-care utilization among 551 cancer survivors with different malignancies, who were evaluated prospectively.

Methods: Baseline spirituality scores were categorized into low and high spirituality groups. Patient-rated worries regarding disease recurrence/progression, developing new cancer, and developing complications from treatment were collected at baseline and at 6 and 12 months. Follow-up health-care utilization was also examined at 6 and 12 months.

Results: Among the survivors, 271 (49%) reported low spirituality and 280 (51%) reported high spirituality. Of the cohort, 59% had some kind of worry regarding disease recurrence/progression, development of new cancers, and treatment complications. Highly spiritual survivors were less likely to have high levels of worries at both 6 and 12 months. Highly worried survivors were significantly more likely to place phone calls to their follow-up providers and had more frequent follow-up visits at 6 and 12 months. No interactions between spirituality and level of worry were noted to affect follow-up health-care utilization.

Conclusion: Given spirituality's effect on anxiety, spirituality-based intervention may have a role in addressing cancer survivors' worries but may not improve health-care utilization.

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癌症幸存者的精神、患者担忧和后续医疗保健利用
背景:当癌症幸存者试图解释他们经历的意义时,精神可能会帮助他们。目的:对551例不同恶性肿瘤的癌症幸存者进行前瞻性评估,探讨精神状态、患者自述焦虑和医疗保健利用之间的关系。方法:将基线灵性评分分为低灵性组和高灵性组。在基线、6个月和12个月时收集患者对疾病复发/进展、新癌症发生和治疗并发症的担忧程度。还在6个月和12个月时检查了后续保健利用情况。结果:在幸存者中,271(49%)报告低灵性,280(51%)报告高灵性。在队列中,59%的人对疾病复发/进展、新癌症的发展和治疗并发症有某种程度的担忧。高度灵性的幸存者在6个月和12个月时都不太可能有高度的担忧。高度担忧的幸存者更有可能给他们的后续服务提供者打电话,并在6个月和12个月时进行更频繁的随访。没有发现精神状态和担忧水平之间的相互作用会影响后续的医疗保健利用。结论:鉴于灵性对焦虑的影响,基于灵性的干预可能在解决癌症幸存者的担忧方面发挥作用,但可能不会提高医疗保健的利用率。
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