Psycho-Oncology Service, Calvary Mater Newcastle, Waratah, NSW, Australia.
Psychooncology. 2011 Dec;20(12):1334-41. doi: 10.1002/pon.1854. Epub 2010 Sep 27.
This analysis sought to determine whether patient self-report measures were associated with disruption to radiation therapy sessions due to anxiety among cancer patients undergoing radiation therapy to the head and neck region.
A cohort of patients undergoing radiation therapy to the head and neck region at a major regional radiation oncology treatment centre (ROTC) in Australia completed self-report measures of anxiety, history of panic and fears relevant to use of an immobilising mask. The treating Radiation Therapist (RT) rated the level of session disruption due to patient anxiety during the Computerised Tomography/Simulation (CT/Sim) (baseline) session and first treatment session.
Complete data were obtained for 90 patients. RTs rated 11 and 24% of patients as having some level of session disruption session due to anxiety at baseline and Treatment 1, respectively. Five factors were significantly associated with session disruption at baseline in bivariate analyses: currently taking psycho-active medication (p=0.008); fear of enclosed spaces (p=0.006); fear of face being covered up (p=0.006); fear of movement restriction (p=0.041) and ever had an anxiety attack (p=0.034). Sensitivity ranged from 0.57 to 0.75 and specificity ranged from 0.68 to 0.90. Only session disruption at baseline predicted disruption at Treatment 1 (p<0.01).
This study offers some preliminary insights into the prevalence of patient anxiety severe enough to cause session disruption and patient self-report measures which might be used to flag patients for prophylactic treatment. Further development and replication in a larger sample is warranted before introduction of these measures into routine practice.
本分析旨在确定癌症患者在接受头颈部放射治疗时,患者的自我报告测量值是否与因焦虑而导致放射治疗中断有关。
在澳大利亚一家主要地区放射肿瘤治疗中心(ROTC)接受头颈部放射治疗的患者队列完成了焦虑、恐慌史以及与使用固定面罩相关的恐惧的自我报告测量。治疗放射治疗师(RT)在计算机断层扫描/模拟(CT/Sim)(基线)治疗期间和首次治疗期间,评估患者焦虑引起的治疗中断程度。
90 名患者获得了完整的数据。RT 分别将 11%和 24%的患者评定为在基线和治疗 1 时存在某种程度的治疗中断。在单变量分析中,有 5 个因素与基线时的治疗中断显著相关:目前正在服用精神药物(p=0.008);害怕封闭空间(p=0.006);害怕脸部被遮住(p=0.006);害怕运动受限(p=0.041)和曾经有过焦虑发作(p=0.034)。灵敏度范围为 0.57 至 0.75,特异性范围为 0.68 至 0.90。只有基线时的治疗中断预测了治疗 1 时的中断(p<0.01)。
这项研究初步探讨了导致治疗中断的严重程度足以引起治疗中断的患者焦虑的患病率,以及可能用于为预防性治疗标记患者的自我报告测量。在将这些措施引入常规实践之前,需要在更大的样本中进一步开发和复制。