Procena mentalnog zdravlja kod bolesnika sa malignim bolestima u primarnoj zdravstvenoj zaštiti

Abstract

Uvod: Cilj ove studije je istraživanje povezanosti simptoma depresivnosti i anksioznosti kod pacijenata sa malignim bolestima u primarnoj zdravstvenoj zaštiti. Metod: Prospektivna opservaciona studija je obuhvatila odrasle korisnike primarne zdravstvene zaštite u Domu zdravlja Trstenik, Centralna Srbija, starosti 19 i više godina, oba pola, sa dijagnozom onkološke bolesti. Kao instrument istraživanja za procenu simptoma depresivnosti korišćen je upitnik PHQ-9 (The Patient Health Questionnaire), izveden iz PRIME MD-and (The Primary Care Evaluation of Mental Disorders), i Beck Anxiety Scale (BAI) za registrovanje prisustva određenih simptoma anksioznosti. Rezultati: Najveći procenat pacijenata imao je simptome blage (27,2%) ili umerene depresije (22%), dok je 18% prijavilo simptome velike depresije. Svi ispitanici su okarakterisani kao osobe sa teškom anksioznošću (skor 26-63). Nivo depresije i anksioznosti je veći kod starijih ispitanika, u prisustvu hroničnih bolesti sa većim ograničenjima i prisustvom poteškoća u obavljanju svakodnevnih aktivnosti, sa izraženijim dejstvom bola na aktivnost, prisustvo stresa. Zaključak: Briga o mentalnom zdravlju pacijenata obolelih od malignih bolesti mora zauzimati značajan deo nacionalne zdravstvene politike svake zemlje.

Background: The aim of this study is to research the association of cancer with the presence of symptoms of depression and anxiety in primary health care patients. Methods: The prospective observational study which included adult users of health care at the Health Center Trstenik, Central Serbia, aged 19 and over, both sexes, with a diagnosis of oncological disease. A research instrument to assess depressive symptoms is used PHQ-9 (The Patient Health Questionnaire) questionnaire, derived from PRIME MD-and (The Primary Care Evaluation of Mental Disorders), and the Beck Anxiety Scale (BAI) to register the presence of certain anxiety symptoms. Results: The largest percentage of patients had symptoms of mild (27.2%) or moderate depression (22%), while 18% reported symptoms of major depression.All subjects were characterized as persons with severe anxiety (score 26-63). The level of depression and anxiety is higher in older subjects, in the presence of chronic diseases with greater limitations of activity and the presence of difficulties in performing daily activities, with a more pronounced effect of pain on activity, the presence of stress. Conclusion: Caring for the mental health of cancer patients must occupy a significant part of each country's national health policy.