转移性结直肠癌一线系统治疗患者使用心理社会服务的预测因素。
Predictors for use of psychosocial services in patients with metastatic colorectal cancer receiving first line systemic treatment.
机构信息
Department of Medical Oncology, VU University medical center, Cancer Center Amsterdam, Amsterdam, the Netherlands.
Department of Psychiatry and Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, the Netherlands.
出版信息
BMC Cancer. 2019 Feb 1;19(1):115. doi: 10.1186/s12885-019-5318-9.
BACKGROUND
Patients with advanced disease experience high levels of psychological distress, yet there is low uptake of psychosocial services offered to patients who screened positive for distress. In this study we aimed to identify predictors for use of psychosocial services in patients with metastatic colorectal cancer (mCRC) receiving first line chemotherapy enrolled in a prospective cluster randomized trial (CRT).
METHODS
Patients completed measures on psychological distress, physical distress, and quality of life at baseline. Demographics, clinical characteristics at baseline and clinical events during treatment (e.g. severe adverse events, clinical benefit) were extracted from patient records. Patients reported psychosocial service utilization in- and outside the hospital after 10, 24 and 48 weeks of treatment. Multivariable logistic regression models were used to identify predictors for the use of psychosocial services.
RESULTS
Out of 349 patients, seventy patients (20.0%) used psychosocial support services during the follow-up period. Use of psychosocial services was associated with younger age, a higher educational level, presence of more pain (at baseline), and the expressed need to talk to a professional (at baseline). In addition, patients without progressive disease within the first ten weeks of treatment were more likely to use psychosocial services .
CONCLUSIONS
One in five patients with mCRC receiving first line palliative treatment used psychosocial services during this prospective longitudinal CRT. Sociodemographic factors (age, education), clinical factors (pain and no progressive disease) and the expressed need to talk to a professional predicted use of psychosocial services. Identification of these predictors may contribute to the understanding of factors that determine the need for psychosocial services.
TRIAL REGISTRATION
Netherlands Trial Register NTR4034 .
背景
患有晚期疾病的患者会经历高度的心理困扰，但对筛查出有困扰的患者提供的心理社会服务的利用率却很低。在这项研究中，我们旨在确定接受一线化疗的转移性结直肠癌（mCRC）患者使用心理社会服务的预测因素，这些患者是在一项前瞻性聚类随机试验（CRT）中筛选出来的。
方法
患者在基线时完成了心理困扰、身体困扰和生活质量的测量。从患者记录中提取了人口统计学、基线时的临床特征以及治疗期间的临床事件（如严重不良事件、临床获益）。患者在治疗的第 10、24 和 48 周后报告了医院内外的心理社会服务利用情况。使用多变量逻辑回归模型来确定使用心理社会服务的预测因素。
结果
在 349 名患者中，有 70 名（20.0%）在随访期间使用了心理社会支持服务。使用心理社会服务与年龄较小、教育程度较高、基线时存在更多疼痛以及表达与专业人士交谈的需求（基线时）有关。此外，在治疗的前 10 周内没有疾病进展的患者更有可能使用心理社会服务。
结论
在这项前瞻性纵向 CRT 中，接受一线姑息治疗的 mCRC 患者中，每五分之一的患者在治疗期间使用了心理社会服务。社会人口学因素（年龄、教育）、临床因素（疼痛和无疾病进展）以及表达与专业人士交谈的需求预测了心理社会服务的使用。识别这些预测因素可能有助于了解决定心理社会服务需求的因素。
试验注册
荷兰试验注册 NTR4034。
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