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神经肿瘤患者术后的心理社会障碍筛查。

Postsurgical screening for psychosocial disorders in neurooncological patients.

出版信息

Acta Neurochir (Wien). 2013 Dec;155(12):2255-61. doi: 10.1007/s00701-013-1884-9.

DOI:10.1007/s00701-013-1884-9
PMID:24078064
Abstract

BACKGROUND

The diagnosis of a brain tumor can cause severe psychosocial distress, which can have a variety of negative consequences on patients' physical and mental well-being. The detection of psychosocial distress in daily clinical routine is difficult and subsequent referral to mental health professionals is rare. The aim of this study was to determine the incidence of psychological disorders of patients early postoperatively and to investigate both the Hornheide Screening Instrument (HSI) and Distress Thermometer (DT) as screening tools in neurooncological practice.

METHODS

One hundred and thirty-four patients with brain tumors of different histology were postoperatively evaluated by the Distress Thermometer and Hornheide Screening Instrument. Additionally, correlation to gender, age, localization of the tumor, Karnofsky performance score and tumor entity were analyzed.

RESULTS

After initial surgery 36 patients (26.9 %) showed pathologic results in the HSI and 50 patients (36.7 %) were severely distressed (DT Score≥6). Women had the highest rate of psychological disorders, followed by patients suffering from gliomas and meningiomas. Further highlighting the results of both tests, over 80 % of those patients who scored pathologically in both tests were in need of professional psychiatric help due to depression.

CONCLUSION

Both the DT and HSI are suitable instruments for identifying patients in psychological distress after brain tumor surgery in neurooncological routine. Our results confirm that nearly one third of patients are unable to overcome the difficulties facing the diagnosis of a brain tumor in this early situation and should be supported by mental health professionals.

摘要

背景

脑肿瘤的诊断会导致严重的心理社会困扰,这会对患者的身心健康产生各种负面影响。在日常临床实践中,心理社会困扰的检测较为困难,随后向心理健康专业人员转介的情况也很少见。本研究的目的是确定术后早期患者心理障碍的发生率,并研究 Hornheide 筛查工具(HSI)和痛苦温度计(DT)在神经肿瘤学实践中的筛查作用。

方法

134 名不同组织学类型的脑肿瘤患者在术后接受了痛苦温度计和 Hornheide 筛查工具的评估。此外,还分析了性别、年龄、肿瘤部位、卡诺夫斯基表现评分和肿瘤实体与这两种测试的相关性。

结果

初次手术后,36 名患者(26.9%)HSI 结果异常,50 名患者(36.7%)严重痛苦(DT 评分≥6)。女性心理障碍发生率最高,其次是患有胶质瘤和脑膜瘤的患者。进一步强调了这两种测试的结果,在这两种测试中都表现出病理结果的患者中,超过 80%的患者因抑郁需要专业的精神卫生帮助。

结论

DT 和 HSI 都是神经肿瘤学常规中识别脑肿瘤手术后心理困扰患者的合适工具。我们的研究结果证实,近三分之一的患者在这种早期情况下无法克服诊断脑肿瘤所面临的困难,应得到心理健康专业人员的支持。

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