The Study Of Psychological Distress Status And Its Relevant Factors Among Breast Cancer Patients

Part 1:A meta-analysis of psychological distress in breast cancer patients screened by DTObjectives: Distress thermometer(DT)has been widely used in the screening of psychological distress among breast cancer patients.However,the prevalence of psychological distress screened out was significantly different between different studies.Therefore,this study performed a meta-analysis of psychological distress in breast cancer patients screened by DT,and obtained the summarized estimate of distress prevalence.Methods: We conducted a systematic search from Pub Med,EMBASE and Cochrane Library.All studies identifying distress of breast cancer patients through DT were included.After extracting demographic characteristics,distress prevalence and other information of included studies,the pooled meta-analysis was completed by Stata12.0 software.We also performed the sensitivity analysis,subgroup analysis and the test of publication bias.Results: After searching and screening all related studies,13 studies describing 2659 breast cancer patients were included in final meta-analysis.The prevalence of distress in breast cancer patients varied from 25.3% to 64.7% among the included studies.The pooled prevalence of distress was 45%(95% confidence interval(CI)39%–50%)for the overall sample.Base on the different cut-off value of DT,the pooled prevalence of distress were38%(95% CI 30%–47%),44%(95% CI 35%–54%)and 53%(95% CI 44%–62%)in DT≥7,DT ≥5 and DT ≥4 subgroup,respectively.Subgroup analysis was conducted according to the disease stage,average age and country of patients.And it found that the prevalence in newly diagnosed breast cancer patients was lower than that in mixed patients with different stages,the prevalence in young patients was significantly higher than that in older patients,and the prevalence in developed countries was slightly lower than that in developing countries.Conclusions: This study found the distress prevalence was high in breast cancer patients.Clinical practice should pay more attention to the psychological distress and try to develop routine screening for the distress among breast cancer patients,so as to take further intervention and management.Part 2:The study of psychological distress status and its relevant factors among inpatients with breast cancerObjectives: This study was aimed to evaluate the psychological distress using the distress thermometer(DT)among inpatients with breast cancer,and explore its relevant factors,so as to provide the basis for the establishment of effective interventions.Methods: The psychological distress and related problems of breast cancer patients were investigated by distress score chart and problem list(PL)of DT.The clinical data of patients were collected by reading electronic medical records.All data were analyzed by SPSS software(version 20.0).Results: 172 breast cancer patients were included in this study finally.The average score of psychological distress was 3.56(±2.25),and 49.4% of them had psychological distress.Among the 40 problems of PL,the top five problems were fatigue(45.9%),economy(42.4%),sleeping(39.5%),worry(37.8%)and pain(36.6%).Among the five dimensions of PL,the response items of emotional problems were the most,accounting for 21.4%(332 /1548),followed by practical problems(17.5%,181 / 1032).Multivariate logistic regression analysis showed that age(odds ratio(OR)=0.311,95% confidence interval(CI)0.140-0.689),tumor stage(OR=3.007,95% CI 1.801-5.021),disease course(OR=0.374,95% CI 0.248-0.563)and income(OR=0.358,95% CI 0.202-0.636)were related factors of psychological distress.Conclusion: The prevalence of psychological distress was higher in breast cancer patients.The patients with younger age,later tumor stage,shorter disease course and less income were more likely to have psychological distress.Clinicians should pay attention to the factors related to psychological distress,so as to avoid the occurrence and development of psychological distress.