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首页> 外文期刊>Psychosomatic Medicine: Journal of the American Psychosomatic Society >Psychological distress and pain significantly increase before death in metastatic breast cancer patients.
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Psychological distress and pain significantly increase before death in metastatic breast cancer patients.

机译：转移性乳腺癌患者死亡前的心理困扰和痛苦明显增加。

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OBJECTIVE: This study was designed to examine the course of psychological distress and pain from study entry to death in 59 women with metastatic breast cancer participating in a randomized trial of the effects of group psychotherapy on psychosocial outcomes and survival. It was hypothesized that psychological distress would increase significantly before death independent of changes in pain. METHOD: Data were collected as part of a larger study (N = 125). Analyses were based on data from a subset of women who had died and for whom we had data from at least three assessments. Mean levels of mood, trauma symptoms, depression symptoms, well-being, and pain over three time points were examined: at baseline (T1), the second-to-last assessment before death (T2), and the last assessment before death (T3). RESULTS: Results indicate that while psychological distress remained relatively constant or declined from T1 to T2, means on all measures significantly changed in the hypothesized direction from T2 to T3. Neither self-reported pain, nor the passage of time, appeared to account for these changes. Additionally, participation in group psychotherapy did not have a significant impact on this change in distress proximal to death. CONCLUSIONS: Results suggest that specialized end-stage clinical interventions are particularly needed for cancer patients as they approach death. Moreover, intervention studies for patients with deteriorating illnesses may need to take this "spike" in psychological distress and pain proximal to death into account to avoid Type II errors in evaluations of psychological outcomes.
机译：目的：本研究旨在研究参加集体心理治疗对心理社会结局和生存的影响的随机试验的59名转移性乳腺癌妇女从研究进入死亡的心理困扰和痛苦过程。据推测，死亡前的心理困扰将显着增加，而与疼痛的变化无关。方法：收集数据作为一项较大研究的一部分（N = 125）。分析基于死亡妇女的子集数据，而我们从至少三项评估中获得了这些数据。检查了三个时间点的平均情绪，外伤症状，抑郁症状，幸福感和疼痛水平：基线（T1），死前倒数第二次评估（T2）和死前倒数第二次评估（T2） T3）。结果：结果表明，尽管心理困扰从T1到T2保持相对稳定或下降，但意味着所有措施在从T2到T3的假设方向上均发生了显着变化。自我报告的疼痛或时间的流逝似乎都不能解释这些变化。此外，参加团体心理治疗对死亡临近的痛苦变化没有重大影响。结论：结果表明，癌症患者在接近死亡时特别需要特殊的临床后期干预。此外，对病情恶化的患者进行的干预研究可能需要考虑这种心理困扰和临近死亡的“尖刺”，以避免在心理结果评估中出现II型错误。

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