Coping and Perception of Prognosis in Patients With Indolent Non-Hodgkin's Lymphoma.

Autor: Newcomb, Richard A, Johnson, P Connor, Yang, Daniel, Holmbeck, Katherine, Choe, Joanna, Nabily, Anisa, Lark, Porsha, Dhawale, Tejaswini, Amonoo, Hermioni L, El-Jawahri, Areej
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Zdroj: Oncologist; May2024, Vol. 29 Issue 5, p441-449, 9p
Abstrakt: Background Indolent non-Hodgkin's lymphomas (iNHL) are a heterogenous group of mostly incurable diseases with prolonged illness courses and prognostic uncertainty. Yet, studies evaluating coping and perception of prognosis are limited. Methods We conducted a cross-sectional study of adults newly diagnosed with iNHL in the past 3 months at a single academic center. We assessed quality of life (QOL: Functional Assessment of Cancer Therapy—General), psychological symptoms (Hospital Anxiety and Depression Scale), coping (Brief-COPE), and perception of prognosis (Prognosis Awareness Impact Scale). Results We enrolled 70.6% (48/68) of eligible patients. Patients had older age (mean = 66.9,sd = 10.5), were female (60.4%), predominantly identified as White (85.4%), and had at least received a college degree (75%). Chronic lymphocytic leukemia (39.6%) and follicular lymphoma (33.3%) were the most common diagnoses. Overall, 27.1% and 14.6% of patients reported clinically significant anxiety and PTSD symptoms, respectively. Patients highly utilized acceptance (56.2%), seeking emotional support (47.9%), and denial (47.9%) as coping strategies at diagnosis. While 66.7% of patients recalled their oncologist assessment of illness as incurable, only 35.4% reported that the illness is unlikely to be cured. Overall, 45.8% indicated that they were worried about prognosis and 31.2% reported perseverating on their prognosis. Higher emotional coping with prognosis was associated with fewer anxiety (B  = −0.6, SE  = 0.2, P  < .001), depression (B  = −0.3, SE  = .1, P  = .005), and PTSD (B  = −1.3, SE  = 0.4, P  < .001) symptoms and better QOL (B  = 1.7, SE  = 0.4, P  < .001). Discussion Patients with iNHL report substantial psychological distress, a diversity of coping strategies, and complex cognitive understanding of their prognosis. Interventions, which address prognostic uncertainty and promote positive emotional coping with prognosis, may ameliorate psychological distress in this population. [ABSTRACT FROM AUTHOR]
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