Ise Masato, Nakata Eiji, Katayama Yoshimi, Hamada Masanori, Kunisada Toshiyuki, Fujiwara Tomohiro, Nakahara Ryuichi, Takihira Shouta, Sato Kohei, Akezaki Yoshiteru, Senda Masuo, Ozaki Toshifumi
Department of Orthopaedic Surgery, Okayama University Hospital, Okayama 700-8558, Japan.
Department of Rehabilitation Medicine, Okayama University Hospital, Okayama 700-8558, Japan.
Healthcare (Basel). 2021 May 11;9(5):566. doi: 10.3390/healthcare9050566.
Psychological distress is common in patients with soft tissue and bone tumors. We first investigated its frequency and the associated risk factors in patients with pre-operative bone and soft tissue tumors. Participants included 298 patients with bone and soft tissue tumors who underwent surgery in our institution between 2015 and 2020. Psychological distress was evaluated by the Distress and Impact Thermometer (DIT) that consists of two types of questions (questions about the severity of the patient's distress (DIT-D) and its impact (DIT-I)). We used a cut-off point of 4 on the DIT-D and 3 on the DIT-I for screening patients with psychological distress. We therefore investigated: (1) the prevalence of psychological distress as assessed with DIT or distress thermometer (DT), which can be decided by DIT-D ≥ 4, (2) what are the risk factors for the prevalence of psychological distress, and (3) what is the number of patients who consulted a psychiatrist for psychological distress in patients with pre-operative bone and soft tissue tumors. With DIT and DT, we identified 64 patients (21%) and 95 patients (32%), respectively, with psychological distress. Multivariate logistic regression revealed that older age, sex (female), malignancy (malignant or intermediate tumor), a lower Barthel Index, and higher numeric rating scale were risk factors for psychological distress. Two patients (3%) consulted a psychiatrist after surgery. In conclusion, careful attention to psychological distress is needed, especially for female patients, older patients, and those with malignant soft or bone tissue tumors who have more than moderate pain.
心理困扰在软组织和骨肿瘤患者中很常见。我们首先调查了术前骨和软组织肿瘤患者心理困扰的发生率及其相关危险因素。研究对象包括298例2015年至2020年在我院接受手术的骨和软组织肿瘤患者。采用由两类问题（关于患者困扰严重程度的问题（DIT-D）及其影响的问题（DIT-I））组成的困扰与影响温度计（DIT）评估心理困扰。我们将DIT-D≥4和DIT-I≥3作为筛查心理困扰患者的临界值。因此，我们调查了：（1）用DIT或困扰温度计（DT）评估的心理困扰患病率（可由DIT-D≥4确定），（2）心理困扰患病率的危险因素有哪些，以及（3）术前骨和软组织肿瘤患者中因心理困扰咨询精神科医生的患者人数。使用DIT和DT，我们分别确定了64例（21%）和95例（32%）有心理困扰的患者。多因素逻辑回归显示，年龄较大、女性、恶性肿瘤（恶性或中间型肿瘤）、较低的巴氏指数以及较高的数字评定量表是心理困扰的危险因素。两名患者（3%）术后咨询了精神科医生。总之，需要特别关注心理困扰，尤其是对于女性患者、老年患者以及那些患有恶性软组织或骨组织肿瘤且疼痛超过中度的患者。
