Physical Functioning and Depression Among Older Persons with Cancer

Margot E. Kurtz ph d, J. C. Kurtz ph d, Manfred Stommel ph d, Charles W. Given ph d, Barbara Given ph d, rn, faan
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引用次数: 64

Abstract

Purpose: The purpose of this study was to help identify factors to assess which elderly patients are likely to experience problems with physical and psychological functioning in association with cancer or its treatment.

description of Study: A study was undertaken with a sample of 420 patients with cancer who were between the ages of 65 and 98 years and had received an incident diagnosis of breast, colon, lung, or prostate cancer. An analysis of covariance technique was used to determine how cancer site, treatment type, stage of disease, gender, age, comorbidity, symptom severity, and prediagnosis levels of physical functioning were related to physical functioning deficit, and how all of these in turn influenced patient depressive symptomatology.

Results: Prediagnosis physical functioning, symptom severity, and days since surgery were significant predictors of physical functioning deficit. Patients who had been treated only with surgery experienced greater physical functioning deficits than did patients who had received both surgery and adjuvant therapy. This apparent anomaly was partly explained by the time interval from surgery to interview. Higher levels of symptom severity, lower levels of prior physical functioning, and greater physical functioning deficits all predicted higher levels of depressive symptomatology.

clinical Implications: In the care of elderly patients with cancer, it is important for healthcare providers to consider the prediagnosis levels of physical functioning of patients with cancer to understand and anticipate the physical and psychological consequences of cancer and its treatment. Equally important is the proper management of patient symptoms in maximizing both the physical and psychological quality of life.

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老年癌症患者的身体功能与抑郁
目的:本研究的目的是帮助确定因素,以评估哪些老年患者可能经历与癌症或其治疗相关的身体和心理功能问题。研究描述:本研究对420名年龄在65至98岁之间的癌症患者进行了研究,这些患者曾被诊断为乳腺癌、结肠癌、肺癌或前列腺癌。采用协方差分析技术确定癌症部位、治疗类型、疾病分期、性别、年龄、合并症、症状严重程度和身体功能的诊断前水平与身体功能缺陷之间的关系,以及所有这些因素如何反过来影响患者的抑郁症状。结果:诊断前躯体功能、症状严重程度和手术后天数是躯体功能缺陷的重要预测因素。仅接受手术治疗的患者比同时接受手术和辅助治疗的患者有更大的身体功能缺陷。这种明显的异常部分是由于从手术到面谈的时间间隔。症状严重程度越高,先前身体功能水平越低,身体功能缺陷越严重,都预示着抑郁症状的程度越高。临床意义:在老年癌症患者的护理中,医疗保健提供者考虑癌症患者身体功能的诊断前水平,以了解和预测癌症及其治疗的生理和心理后果是很重要的。同样重要的是对患者症状的适当管理,以最大限度地提高身体和心理生活质量。
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