Renovanz Mirjam, Hechtner Marlene, Janko Mareile, Kohlmann Karoline, Coburger Jan, Nadji-Ohl Minou, König Jochem, Ringel Florian, Singer Susanne, Hickmann Anne-Katrin
Department of Neurosurgery, University Medical Center, Johannes-Gutenberg-University Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany.
Division of Epidemiology and Health Services Research, Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center, Johannes-Gutenberg-University Mainz, Mainz, Germany.
J Neurooncol. 2017 Jul;133(3):653-662. doi: 10.1007/s11060-017-2484-y. Epub 2017 May 19.
Objective of this study aimed at assessing glioma patients' supportive care needs in a neurosurgical outpatient setting and identifying factors that are associated with needs for support. In three neuro-oncological outpatient departments, glioma patients were assessed for their psychosocial needs using the Supportive Care Needs Survey short-form (SCNS-SF34-G). Associations between clinical, sociodemographic, treatment related factors as well as distress (measured with the distress thermometer) and supportive care needs were explored using multivariable general linear models. One-hundred and seventy three of 244 eligible glioma patients participated, most of them with primary diagnoses of a high-grade glioma (81%). Highest need for support was observed in 'psychological needs' (median 17.5, range 5-45) followed by 'physical and daily living needs' (median 12.5, range 0-25) and 'health system and information needs' (median 11.3, range 0-36). Needs in the psychological area were associated with distress (R = 0.36) but not with age, sex, Karnofsky performance status (KPS), extend of resection, currently undergoing chemotherapy and whether guidance during assessment was offered. Regarding 'health system and information needs', we observed associations with distress, age, currently undergoing chemotherapy and guidance (R = 0.31). In the domain 'physical and daily living needs' we found associations with KPS, residual tumor, as well as with distress (R = 0.37). Glioma patients in neuro-oncological departments report unmet supportive care needs, especially in the psychological domain. Distress is the factor most consistently associated with unmet needs requiring support and could serve as indicator for clinical neuro-oncologists to initiate support.
本研究旨在评估神经外科门诊环境下胶质瘤患者的支持性护理需求，并确定与支持需求相关的因素。在三个神经肿瘤门诊科室，使用支持性护理需求调查简表（SCNS-SF34-G）对胶质瘤患者的心理社会需求进行评估。使用多变量一般线性模型探讨临床、社会人口统计学、治疗相关因素以及痛苦（用痛苦温度计测量）与支持性护理需求之间的关联。244名符合条件的胶质瘤患者中有173名参与，其中大多数患者的初步诊断为高级别胶质瘤（81%）。在“心理需求”方面观察到最高的支持需求（中位数为17.5，范围为5 - 45），其次是“身体和日常生活需求”（中位数为12.5，范围为0 - 25）和“卫生系统和信息需求”（中位数为11.3，范围为0 - 36）。心理领域的需求与痛苦相关（R = 0.36），但与年龄、性别、卡氏功能状态（KPS）、切除范围、当前是否正在接受化疗以及评估期间是否提供指导无关。关于“卫生系统和信息需求”，我们观察到与痛苦、年龄、当前是否正在接受化疗以及指导相关（R = 0.31）。在“身体和日常生活需求”领域，我们发现与KPS、残留肿瘤以及痛苦相关（R = 0.37）。神经肿瘤科室的胶质瘤患者报告了未满足的支持性护理需求，尤其是在心理领域。痛苦是与未满足的支持需求最一致相关的因素，可作为临床神经肿瘤学家启动支持的指标。
