Factors associated with depression symptoms in women after breast cancer

ABSTRACT OBJECTIVE: To analyze the factors associated with the presence of depression symptoms in women after breast cancer. METHODS: Cross-sectional study with 181 women with breast cancer, aged 57.0 years (SD = 9.5), who were undergoing treatment or after treatment in the Oncology Research Center in Florianópolis, state of Santa Catarina, Brazil. The questionnaire comprised items addressing general and health information, economic level, anthropometric measures, depression symptoms (Beck Depression Inventory), self-esteem (Rosenberg Self-Esteem Scale), and body image (Body Image After Breast Cancer Questionnaire). Descriptive and inferential statistical analysis were performed by chi-square and Fisher's exact tests to verify association, Mann-Whitney U test to compare the groups and Poisson regression to identify the prevalence ratio of the factors associated with presence of depression symptoms (p < 0.05). RESULTS: We found an association between the presence of depression symptoms and the group of younger women (aged 40–60 years), those who had another disease besides cancer, those who had mastectomy surgery, those who suffered from lymphedema, and those who presented low–medium self-esteem. Less educated women presented more depressive symptoms, as did women with worse body image on the subscales of limitations, transparency, and arm concerns. CONCLUSIONS: Age, educational attainment, diagnosis of other diseases, type of surgery, lymphedema, self-esteem, and body image were factors associated with the presence of depression symptoms in Brazilian women after breast cancer. Health professionals should be aware of these relationships and try to detect depression symptoms earlier and improve the care they provide to these women.

摘要：
【目的】分析巴西圣卡塔琳娜州弗洛里亚诺波利斯市肿瘤研究中心内，接受乳腺癌治疗或已完成治疗的女性群体中，与抑郁症状发生相关的影响因素。
【方法】本研究为横断面研究，共纳入181名乳腺癌女性患者，平均年龄57.0岁，标准差（SD）=9.5，所有受试者均在该中心接受治疗或已完成抗肿瘤治疗。调查问卷涵盖一般与健康信息、经济水平、人体测量学指标、抑郁症状（贝克抑郁量表(Beck Depression Inventory)）、自尊（罗森伯格自尊量表(Rosenberg Self-Esteem Scale)）以及乳腺癌术后身体意象（乳腺癌术后身体意向量表(Body Image After Breast Cancer Questionnaire)）相关条目。统计分析采用描述性与推断性统计方法：以卡方检验、Fisher确切概率法验证变量间关联，以Mann-Whitney U检验开展组间比较，以泊松回归分析抑郁症状相关因素的患病率比（p<0.05）。
【结果】本研究发现，抑郁症状的发生与以下群体显著相关：40~60岁的年轻女性、合并其他疾病的乳腺癌患者、接受乳房切除术者、出现淋巴水肿者以及低-中等自尊水平者。受教育程度较低的女性抑郁症状发生率更高，在身体意象维度中活动受限、身体透明度及手臂不适维度评分较差的女性亦存在更高的抑郁症状风险。
【结论】年龄、受教育程度、合并其他疾病诊断、手术类型、淋巴水肿、自尊水平以及身体意象，均与巴西乳腺癌术后女性的抑郁症状发生存在显著关联。医疗卫生从业者应重视上述关联，尽早识别抑郁症状并优化对该群体女性的照护服务。