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食管癌患者治疗期间心理困扰的围手术期风险因素。

Perioperative risk factors of psychological distress in patients undergoing treatment for esophageal cancer.

机构信息

Section Division of Liaison Psychiatry and Palliative Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.

Department of Gastroenterological Surgery, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan.

出版信息

World J Surg Oncol. 2020 Dec 9;18(1):326. doi: 10.1186/s12957-020-02092-3.

Abstract

BACKGROUND

Esophageal cancer patients often feel depressed and are fearful of metastasis and death. The objective of this study was to clarify the characteristics of patients with psychological distress at all 5 time points compared with patients with no psychological distress especially from standpoints of personal coping styles and QOL.

METHODS

In total, 102 of 152 consecutive patients who attended the outpatient clinic at Toranomon Hospital between April 2017 and April 2019 met eligibility criteria for inclusion in this study. Questionnaires designed to identify psychological distress (HADS-scores) and assess QOL (EORTC QLQ C-30/OES18) were administered at 5 time points from the time of the first outpatient consultation to 3 months after esophagectomy. The questionnaire of coping strategies (MAC-scales) was administered at only time 1 point.

RESULTS

Based on the trends of HADS-scores, we defined two groups: "persistent high-HAD scores" and "persistent low-HADS scores." There are strong relationships between psychological distress and coping strategy, and psychological distress and QOL. The possibility that there are relationships between stress coping strategies and some QOL status depending on some point of treatment.

CONCLUSIONS

The psychological distress during the treatment course of esophageal cancer is significantly associated with the coping strategies and QOL influenced by esophagectomy. This study can provide baseline information for identifying patients in need of psychological management and paves the way for larger clinical studies in the future.

摘要

背景

食管癌患者常感到抑郁,担心转移和死亡。本研究旨在从个人应对方式和生活质量的角度,明确所有 5 个时间点存在心理困扰的患者与无心理困扰患者的特征。

方法

2017 年 4 月至 2019 年 4 月期间,152 名连续就诊于 Toranomon 医院门诊的患者中,共有 102 名符合纳入本研究的标准。在首次门诊就诊时,以及食管癌手术后 3 个月内的 5 个时间点,我们使用汉密尔顿焦虑量表(HADS)和欧洲癌症研究与治疗组织生活质量问卷核心模块 30 项(EORTC QLQ C-30)/食管癌量表 18 项(EORTC QLQ OES18)来评估心理困扰和生活质量,并在第 1 次就诊时使用医学应对方式问卷(MAC)评估应对策略。

结果

根据 HADS 评分的趋势,我们将患者分为“持续高 HADS 评分”和“持续低 HADS 评分”两组。心理困扰与应对策略、心理困扰与生活质量之间存在密切关系。在治疗过程中,患者的心理困扰与手术带来的应对策略和生活质量之间存在显著关联。

结论

食管癌患者治疗过程中的心理困扰与手术带来的应对策略和生活质量显著相关。本研究可为识别需要心理管理的患者提供基线信息,并为未来更大规模的临床研究铺平道路。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c323/7727175/6e000795c382/12957_2020_2092_Fig1_HTML.jpg

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