The impact of depression on disease prognosis in patient with esophageal cancer

• Main Authors: Yang Hsin Yi, 楊馨怡
• Other Authors: Chen Mei Ling
• Format: Others
• Language: zh-TW
• Published: 2003
• Online Access: http://ndltd.ncl.edu.tw/handle/81792338753525338264

碩士 === 長庚大學 === 護理學研究所 === 91 === A prospective study design was used. The purposes of this were to understand the long-term changes of depression status, and examine the impact of depression status on disease prognosis in patient with esophageal cancer. One hundred- nineteen esophageal cancer patients were recruited from a medical center in Northern Taiwan with convenient sampling, then two years follow-up to collect data. Data were analyzed by descriptive statistics, Generalized Estimating Equations, Kaplan-Meier survival analysis, Cox’s proportional hazard model. The major findings of this study were: (1) Ninety patients were died in two years follow-up time, median survival time was 12 month, 1 and 2 year cumulative survival rate was 48.27% and 23.45%; (2) Among eighty-nine patients finished therapy, thirty-three patients had tumor recurrence in two years follow-up time, 1 and 2 year cumulative non recurrence survival rate was 63.42% and 51.57%; (3) Base on each measure time had different patients, depression in the Geriatric Depression Scale (GDS) prevalence rate was 15.7%-21.1% in each measure time, in the Hospital Anxiety and Depression Scale-Depression( HADS-D) was 17.4%-41.6% in each measure time. Compared with baseline date, the depression status did not change with time; (4) Univariate analysis showed that body weights loss level, functional status of diagnosis, functional status of 6th month, functional status of 12th month, depression status of 4th month, 6th month, 12th month in the GDS and HADS-D was significantly related to survival. Only depression status of 6th month in the GDS was significantly related to tumor recurrence; (5) Multivariate analysis, when other relevant covariates were controlled, if patient can survival 4 month, depression status of 4th month in the GDS and HADS-D was significantly related to survival, the increased risk of death during follow-up for the GDS and HADS-D category of depression, relative hazard ration was 1.7489-3.3115. If patient can survival 6 month, depression status of 6th month in the HADS-D was significantly related to survival, the increased risk of death during follow-up for the HADS-D category of depression, relative hazard ration was 2.7145; (6) if patient can survival 6 month, depression status of 6th month in the GDS was significantly related to tumor recurrence, the increased risk of tumor recurrence during follow-up for the GDS category of depression, relative hazard ration was 2.6044. The findings of this study can help nurses understand the long-term changes of depression status and it’s impact on disease prognosis in esophageal cancer patients. Suggest nurses should assess depression status in esophageal cancer patients, especially 4th month and 6th month after diagnosis, find the depression patient, appropriate nursing interventions to help them improve patient’s depression status in order to increasing survival time and non recurrence survival time. Key word: Depression status, Esophageal cancer, Disease prognosis