Verma Dhruv, Kwok Karl K, Wu Bechien U
From the Center for Pancreatic Care, Department of Gastroenterology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA.
Pancreas. 2017 Mar;46(3):352-357. doi: 10.1097/MPA.0000000000000756.
The aim of this study was to determine how patient anxiety, knowledge, and cancer worry influence preferences for management of pancreatic cysts.
We performed a prospective, cross-sectional study using a disease-specific survey instrument. We included patients older than 18 years who were diagnosed with a pancreatic cyst. A telephone survey instrument was developed to assess baseline anxiety using the Hospital Anxiety and Depression Scale (HADS), knowledge regarding pancreatic cysts, cancer worry, and patient preferences using a standard gamble.
Of the 100 studied participants (median age, 65 years; 72% women), median Hospital Anxiety and Depression Scale score was 4 (normal range). In terms of knowledge, 96% of the patients were not aware of their specific cyst type, and 58% were unaware of the possibility of any cyst-related malignancy. Overall, 8% of respondents had some degree of cancer worry. Respondents were more willing to undergo magnetic resonance imaging surveillance compared with endoscopic ultrasound or surgery. Knowledge of cyst type was a significant predictor of willingness to undergo invasive testing.
There is a significant gap in patient knowledge with respect to pancreatic cysts. Greater emphasis on patient education can help patients make informed decisions regarding cyst management.
本研究旨在确定患者的焦虑、知识水平和对癌症的担忧如何影响胰腺囊肿管理偏好。
我们使用特定疾病调查工具进行了一项前瞻性横断面研究。纳入了年龄大于18岁且被诊断为胰腺囊肿的患者。开发了一种电话调查工具,使用医院焦虑抑郁量表(HADS)评估基线焦虑,使用标准博弈法评估有关胰腺囊肿的知识、对癌症的担忧以及患者偏好。
在100名研究参与者中(中位年龄65岁;72%为女性),医院焦虑抑郁量表的中位得分为4分(正常范围)。在知识方面,96%的患者不知道自己囊肿的具体类型,58%的患者不知道囊肿有发生任何相关恶性病变的可能性。总体而言,8%的受访者有一定程度的癌症担忧。与内镜超声或手术相比,受访者更愿意接受磁共振成像监测。囊肿类型的知识是接受侵入性检查意愿的重要预测因素。
患者在胰腺囊肿知识方面存在显著差距。更加强调患者教育有助于患者就囊肿管理做出明智决策。