4.7 Article

Posttraumatic stress disorder symptoms in patients with acute myeloid leukemia

期刊

CANCER
卷 127, 期 14, 页码 2500-2506

出版社

WILEY
DOI: 10.1002/cncr.33524

关键词

acute leukemia; coping; distress; hematologic malignancy; hypervigilance; posttraumatic stress; posttraumatic stress disorder; psychological well-being; traumatic stress

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资金

  1. National Cancer Institute [K08CA251654]

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Patients with acute myeloid leukemia (AML) receiving intensive chemotherapy face significant PTSD symptoms related to coping, quality of life, and other factors, highlighting the importance of supportive oncology interventions.
BACKGROUND Patients with acute myeloid leukemia (AML) receiving intensive chemotherapy face a life-threatening illness, isolating hospitalization, and substantial physical and psychological symptoms. However, data are limited regarding risk factors of posttraumatic stress disorder (PTSD) symptoms in this population. METHODS The authors conducted a secondary analysis of data from 160 patients with high-risk AML who were enrolled in a supportive care trial. The PTSD Checklist-Civilian Version was used to assess PTSD symptoms at 1 month after AML diagnosis. The Brief COPE and the Functional Assessment of Cancer Therapy-Leukemia were to assess coping and quality of life (QOL), respectively. In addition, multivariate regression models were constructed to assess the relation between PTSD symptoms and baseline sociodemographic factors, coping, and QOL. RESULTS Twenty-eight percent of patients reported PTSD symptoms, describing high rates of intrusion, avoidance, and hypervigiliance. Baseline sociodemographic factors significantly associated with PTSD symptoms were age (B = -0.26; P = .002), race (B = -8.78; P = .004), and postgraduate education (B = -6.30; P = .029). Higher baseline QOL (B = -0.37; P <= .001) and less decline in QOL during hospitalization (B = -0.05; P = .224) were associated with fewer PTSD symptoms. Approach-oriented coping (B = -0.92; P = .001) was associated with fewer PTSD symptoms, whereas avoidant coping (B = 2.42; P <= .001) was associated with higher PTSD symptoms. CONCLUSIONS A substantial proportion of patients with AML report clinically significant PTSD symptoms 1 month after initiating intensive chemotherapy. Patients' baseline QOL, coping strategies, and extent of QOL decline during hospitalization emerge as important risk factors for PTSD, underscoring the need for supportive oncology interventions to reduce the risk of PTSD in this population.

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