Povezanost depresije i stigme u oboljelih od raka pluća

Branka Aukst Margetić, Suzana Kukulj, Kristina Galić, Belma Šarić Zolj

Uvod: Rak pluća je povezan s visokom učestalošću depresije i stigme. I depresija i stigma povezane su s lošijim ishodima u dijagnostici i liječenju raka pluća te je potrebno njihovo daljnje istraživanje i uključivanje u terapiju. Cilj: Istraživanje je imalo za cilj ispitati prisutnost depresije i stigme u uzorku oboljelih od raka pluća i njihovu međusobnu povezanost. Metode: Sedamdeset šest pacijenta iz dviju sveučilišnih bolnica s dijagnozom nesitnostaničnog raka pluća uključeno je konsekutivno u istraživanje. Pacijente smo ispitali samoprocjenjujućim ljestvicama, a sociodemografski podatci i podatci o stadiju bolesti prikupljeni su iz povijesti bolesti. Depresija je ispitana primjenom Ljestvice za depresiju Centra za epidemiološka istraživanja (Center for Epidemiological Study – Depression Scale – CES-D), a prisutnost stigme u uzorku ispitana je Cataldovom ljestvicom stigme u raku pluća (Cataldo Lung Cancer Stigma Scale – CLCSS). Istraživanje je također ispitalo povezanost depresije i stigme s pušenjem i sociodemografskim varijablama (dob, spol) te stadijem tumora prema TNM klasifikaciji. Rezultati: Depresija je bila prisutna u 38,7% ispitanika. Depresija i stigma su bile međusobno značajno povezane (r=0,365). Nije nađena njihova povezanost s pušenjem, sociodemografskim varijablama i stadijem bolesti. Stigma je bila jedini značajan prediktor depresije u logističkoj regresijskoj analizi. Zaključak: Depresija i stigma su u pacijenata s rakom pluća povezane te, s obzirom na implikacije koje imaju na prognozu liječenja, trebaju pozornost kliničara u svakodnevnom radu.

Introduction: Lung cancer is often associated with high prevalence of depression and stigma of self- inflicted disease. Both depression and stigma are associated with poor outcomes in diagnostics and treatment and should be detected and managed. Aim: The aim of the study was to assess the prevalence of depression and stigma in the sample of lung cancer patients and the associations between depression and stigma. Methods: Seventy-six patients from two university clinics with diagnosis of non-small cell lung cancer were consecutively included in the study. The self-report scales were used for the assessment of depression and stigma and sociodemographic data and clinical data were taken from patients’ clinical charts. Depression was assessed with Center for Epidemiological Study-Depression scale (CES-d) and the presence of stigma using Cataldo Lung Cancer Stigma Scale (CLCSS). The research also assessed the associations between stigma, depression, smoking and sociodemographic variables (age and gender) and tumor stage according to TNM classification. Results: Depression was present in 38.7% of the participants. Depression and stigma were significantly correlated (r=0.365). Stigma and depression were not associated with smoking and other measured sociodemographic variables. Stigma was the sole predictor of depression in logistic regression analysis. Conclusion: Depression and stigma are interconnected in patients with lung cancer, and considering their impact on the illness outcome, they need to be addressed in clinical work.