PDF(Pubmed)
Abstract：
OBJECTIVE: This longitudinal study investigated distress rates in patients with advanced ovarian cancer during the COVID-19 pandemic and examined whether time, illness representations, and coping strategies predicted distress levels.
METHODS: UK patients with stage 3 or 4 ovarian cancer were recruited between September 2020 and March 2021. Data were collected at baseline (T0), 2 months (T1), and 4 months (T2) post-enrolment. Validated questionnaires assessed distress (anxiety, depression, PTSD, fear of progression) and predictors (coping strategies and illness perceptions), analysed via multilevel modelling.
RESULTS: Seventy-two participants returned a questionnaire at T0, decreasing to 49 by T2. High distress was observed, with over 50% of participants experiencing anxiety and depression consistently. Nearly 60% reported clinical levels of fear of progression at some point. PTSD rates resembled the general population. Although distress levels remained stable over time, some individual variability was observed. Time had minimal effect on distress. Coping strategies and illness perceptions remained stable. Threatening illness perceptions consistently predicted distress, while specific coping strategies such as active coping, acceptance, self-blame, and humour predicted various aspects of distress. Together, these factors explained up to half of the distress variance.
CONCLUSIONS: The findings have implications for routine screening for distress and the inclusion of psychological treatment pathways in advanced ovarian cancer care. Addressing illness representations is crucial, with attention to informational support. Future research should explore the long-term effects of heightened distress and the effectiveness of interventions targeting illness perceptions. This study informs current clinical practice and future pandemic preparedness in cancer care.
METHODS: UK patients with stage 3 or 4 ovarian cancer were recruited between September 2020 and March 2021. Data were collected at baseline (T0), 2 months (T1), and 4 months (T2) post-enrolment. Validated questionnaires assessed distress (anxiety, depression, PTSD, fear of progression) and predictors (coping strategies and illness perceptions), analysed via multilevel modelling.
RESULTS: Seventy-two participants returned a questionnaire at T0, decreasing to 49 by T2. High distress was observed, with over 50% of participants experiencing anxiety and depression consistently. Nearly 60% reported clinical levels of fear of progression at some point. PTSD rates resembled the general population. Although distress levels remained stable over time, some individual variability was observed. Time had minimal effect on distress. Coping strategies and illness perceptions remained stable. Threatening illness perceptions consistently predicted distress, while specific coping strategies such as active coping, acceptance, self-blame, and humour predicted various aspects of distress. Together, these factors explained up to half of the distress variance.
CONCLUSIONS: The findings have implications for routine screening for distress and the inclusion of psychological treatment pathways in advanced ovarian cancer care. Addressing illness representations is crucial, with attention to informational support. Future research should explore the long-term effects of heightened distress and the effectiveness of interventions targeting illness perceptions. This study informs current clinical practice and future pandemic preparedness in cancer care.
摘要：
目的：这项纵向研究调查了COVID-19大流行期间晚期卵巢癌患者的痛苦发生率，疾病陈述，应对策略预测了困境水平。
方法：在2020年9月至2021年3月之间招募了英国3期或4期卵巢癌患者。数据在基线（T0）收集，2个月（T1），和注册后4个月（T2）。经过验证的问卷评估了痛苦(焦虑，抑郁症,创伤后应激障碍,对进展的恐惧)和预测因素(应对策略和疾病感知)，通过多层次建模进行分析。
结果：72名参与者在T0时返回了问卷，到T2时减少到49。观察到高度痛苦，超过50%的参与者持续经历焦虑和抑郁。近60%的人报告了在某些时候对进展的恐惧的临床水平。PTSD的发生率与普通人群相似。尽管痛苦水平随着时间的推移保持稳定，观察到一些个体差异。时间对痛苦的影响很小。应对策略和疾病认知保持稳定。威胁疾病的感知始终预测痛苦，而具体的应对策略，如积极应对，接受,自责,幽默预测了痛苦的各个方面。一起,这些因素解释了高达一半的困境差异。
结论：这些发现对于在晚期卵巢癌治疗中常规筛查痛苦和纳入心理治疗途径具有重要意义。应对疾病陈述至关重要，关注信息支持。未来的研究应该探讨痛苦加剧的长期影响以及针对疾病感知的干预措施的有效性。这项研究为癌症护理的当前临床实践和未来大流行准备提供了信息。
方法：在2020年9月至2021年3月之间招募了英国3期或4期卵巢癌患者。数据在基线（T0）收集，2个月（T1），和注册后4个月（T2）。经过验证的问卷评估了痛苦(焦虑，抑郁症,创伤后应激障碍,对进展的恐惧)和预测因素(应对策略和疾病感知)，通过多层次建模进行分析。
结果：72名参与者在T0时返回了问卷，到T2时减少到49。观察到高度痛苦，超过50%的参与者持续经历焦虑和抑郁。近60%的人报告了在某些时候对进展的恐惧的临床水平。PTSD的发生率与普通人群相似。尽管痛苦水平随着时间的推移保持稳定，观察到一些个体差异。时间对痛苦的影响很小。应对策略和疾病认知保持稳定。威胁疾病的感知始终预测痛苦，而具体的应对策略，如积极应对，接受,自责,幽默预测了痛苦的各个方面。一起,这些因素解释了高达一半的困境差异。
结论：这些发现对于在晚期卵巢癌治疗中常规筛查痛苦和纳入心理治疗途径具有重要意义。应对疾病陈述至关重要，关注信息支持。未来的研究应该探讨痛苦加剧的长期影响以及针对疾病感知的干预措施的有效性。这项研究为癌症护理的当前临床实践和未来大流行准备提供了信息。
