Department of Gastrointestinal Surgery, Stavanger University Hospital, Stavanger, Norway.
Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.
Eur J Cancer Care (Engl). 2021 Sep;30(5):e13437. doi: 10.1111/ecc.13437. Epub 2021 Mar 9.
To describe the severity of treatment burden in surgically treated colorectal cancer (CRC) patients and examine associations between treatment burden and demographic and clinical variables.
This cross-sectional study recruited 134 patients diagnosed with Dukes' stage A-C CRC between 2016 and 2018 who underwent curative surgery. The Patient Experience with Treatment and Self-management (PETS) questionnaire assessed treatment burden domains of 'workload', 'stressors' and 'impact' between 6 weeks and 18 months after primary surgery.
Highest scores were observed for difficulty with healthcare services (median score 33.3), physical and mental fatigue (median score 30.0) and medical information (median score 26.8). Younger age, low education level or no cohabitants were significantly associated with higher workload PETS scores (p < 0.05, 0.013, p = 0.047, respectively). Higher PETS stressors scores were significantly associated with younger age (p = 0.006), lower education level (p = 0.016), and high comorbidity (p = 0.013). Higher PETS impact scores were significantly associated with the female sex (p = 0.050), younger age (p = <0.001-0.003), lower education (p = 0.003), no cohabitants (p = 0.003), high comorbidity (p = 0.003) and cancer stage Dukes A (p = 0.004).
A seamless and supportive healthcare system beyond hospitalisation targeting CRC subpopulations in danger of high treatment burden may improve patients' self-management experience.
描述接受手术治疗的结直肠癌（CRC）患者的治疗负担严重程度，并检验治疗负担与人口统计学和临床变量之间的关联。
本横断面研究纳入了 2016 年至 2018 年间接受根治性手术治疗的 Dukes' A-C 期 CRC 患者 134 例。在初次手术后 6 周至 18 个月期间，采用治疗体验与自我管理问卷（Patient Experience with Treatment and Self-management，PETS）评估患者治疗负担的“工作量”、“压力源”和“影响”三个领域。
患者在医疗服务困难（中位数 33.3 分）、身心疲劳（中位数 30.0 分）和医疗信息（中位数 26.8 分）方面的评分最高。年龄较小、受教育程度较低或无同居者与更高的工作量 PETS 评分显著相关（p 值分别为<0.05、0.013 和 0.047）。更高的 PETS 压力源评分与年龄较小（p=0.006）、受教育程度较低（p=0.016）和合并症较高（p=0.013）显著相关。更高的 PETS 影响评分与女性（p=0.050）、年龄较小（p<0.001-0.003）、受教育程度较低（p=0.003）、无同居者（p=0.003）、合并症较高（p=0.003）和 Dukes A 期癌症（p=0.004）显著相关。
针对有较高治疗负担风险的 CRC 亚人群，建立一个无缝且支持性的院外医疗体系，可能会改善患者的自我管理体验。
