Nixon Jodie L, Brown Bena, Pigott Amanda E, Turner Jane, Brown Elizabeth, Bernard Anne, Wall Laurelie R, Ward Elizabeth C, Porceddu Sandro V
Occupational Therapy Department, Princess Alexandra Hospital, Brisbane, Australia.
School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.
J Med Radiat Sci. 2019 Sep;66(3):184-190. doi: 10.1002/jmrs.346. Epub 2019 Jul 25.
Distress related to wearing an immobilisation mask for radiotherapy treatment (RT) is a common experience for the person undergoing RT for head and neck cancer (HNC). Described as 'mask anxiety', there is little known about the patterns of this distress through the course of the treatment or what strategies are being used by people to help alleviate mask anxiety.
The study used a prospective cohort design to examine the patterns of patient-reported mask anxiety during the course of RT, using a modified Distress Thermometer (DT) and a survey to explore strategies patients used to assist their mask anxiety.
Thirty-five participants, who identified as experiencing mask anxiety, were followed throughout RT treatment. At baseline, females were more likely to experience higher mask anxiety (P = 0.03). Across the course of treatment, mask anxiety significantly (P < 0.001) reduced within the total cohort. In 72% of participants, the level of initial distress was found to reduce over time. Only 22% experienced mask anxiety that remained constant. Few (6%) experienced an increase in mask anxiety across the course of RT. Participants reported relying on intervention from health professionals, self-taught strategies, music, visualisation and medication to manage their mask anxiety.
Due to its high prevalence and variable patterns over time, it is recommended that routine screening for mask anxiety be implemented as standard care throughout the course of RT for HNC. Multiple, diverse strategies are being used by patients and studies are needed to develop effective interventions for managing mask anxiety.
对头颈部癌（HNC）患者进行放射治疗（RT）时，佩戴固定面罩所带来的困扰是常见经历。这种困扰被描述为“面罩焦虑”，但对于整个治疗过程中这种困扰的模式，或者人们使用何种策略来缓解面罩焦虑，了解甚少。
本研究采用前瞻性队列设计，使用改良的痛苦温度计（DT）检查患者报告的放疗过程中面罩焦虑模式，并通过一项调查探究患者用于缓解面罩焦虑的策略。
35名自认为有面罩焦虑的参与者在整个放疗过程中接受了跟踪。基线时，女性更有可能经历更高程度的面罩焦虑（P = 0.03）。在整个治疗过程中，整个队列中的面罩焦虑显著降低（P < 0.001）。在72%的参与者中，最初的困扰程度随时间降低。只有22%的人经历的面罩焦虑保持不变。很少有人（6%）在放疗过程中面罩焦虑增加。参与者报告依靠医疗专业人员的干预、自学策略、音乐、想象和药物来管理面罩焦虑。
由于其高发生率和随时间变化的模式，建议在HNC放疗全过程中将面罩焦虑的常规筛查作为标准护理措施实施。患者正在使用多种不同的策略，需要开展研究以开发管理面罩焦虑的有效干预措施。
