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低级别胶质瘤患者的心理困扰:一项单中心研究。

Psychooncological distress in low-grade glioma patients-a monocentric study.

机构信息

Department of Neurosurgery, Heinrich-Heine-University, Moorenstr. 5, 40225, Duesseldorf, Germany.

出版信息

Acta Neurochir (Wien). 2022 Mar;164(3):713-722. doi: 10.1007/s00701-021-04863-7. Epub 2021 Jun 22.

Abstract

BACKGROUND

Patients diagnosed with low-grade glioma (LGG) must live with constant knowledge of an upcoming malignant tumor transformation which may lead to increased anxiety and reduced quality of life. Here, we (1) analyzed the prevalence and risk factors for distress in LGG patients using (2) different screening tools to subsequently (3) evaluate their need for psychological support.

METHOD

Patients with LGG-suspicious findings in MRI studies as well as patients with histopathological confirmed LGG were screened using three established self-assessment instruments (Hospital Anxiety and Depression Scale, Distress Thermometer, EORTC-QLQ-C30-BN20). Screening results were correlated with sociodemographic factors.

RESULTS

One hundred forty-nine patients (74 men and 75 women) were prospectively included. Patients were further divided into different subgroups regarding the time of screening and diagnosis. An increased level of distress was observed in 20.8% (mean score 1.21, 95% CI 1.15-1.28) of all patients screened by HADS. Significant associated factors were pre-existing psychiatric disorders (p = 0.003) and psychotropic medication (p = 0.029). HRQoL (p = 0.022) and global health item (p = 0.015), as well as future uncertainty (p = 0.047), assessed by the EORTC-QLQ-C30-BN20 were significantly higher in those patients without histopathological diagnosis. Increased distress was significantly correlated with results in chosen sub-items of the HRQoL questionnaire (p < 0.001).

CONCLUSIONS

Our results demonstrate the need for frequent distress screening. If specific tools are not available, HRQoL questionnaires can also be used. Patients with pre-existing psychological stress should be offered additional psychooncological support, irrespectively of the time of screening or tumor diagnosis.

CLINICAL TRIAL REGISTRATION NUMBER

摘要

背景

被诊断为低级别胶质瘤(LGG)的患者必须时刻了解即将发生的恶性肿瘤转化,这可能导致焦虑增加和生活质量下降。在这里,我们(1)使用(2)不同的筛查工具分析 LGG 患者的困扰发生率和风险因素,随后(3)评估他们对心理支持的需求。

方法

对 MRI 研究中疑似 LGG 的患者以及组织病理学确诊为 LGG 的患者进行了三种已建立的自我评估工具(医院焦虑抑郁量表、痛苦温度计、EORTC-QLQ-C30-BN20)的筛查。筛查结果与社会人口学因素相关。

结果

前瞻性纳入了 149 例患者(74 名男性和 75 名女性)。根据筛查和诊断时间,患者进一步分为不同亚组。使用 HADS 筛查的所有患者中,有 20.8%(平均得分 1.21,95%CI 1.15-1.28)存在焦虑程度增加。有显著相关性的因素是先前存在的精神疾病(p=0.003)和精神药物治疗(p=0.029)。EORTC-QLQ-C30-BN20 评估的 HRQoL(p=0.022)和总体健康项目(p=0.015)以及未来不确定性(p=0.047)在没有组织病理学诊断的患者中显著更高。选择的 HRQoL 问卷子项的得分越高,患者的困扰程度就越显著(p<0.001)。

结论

我们的结果表明需要频繁进行困扰筛查。如果没有特定的工具,也可以使用 HRQoL 问卷。无论筛查时间或肿瘤诊断如何,都应向有预先存在心理压力的患者提供额外的心理肿瘤支持。

临床试验注册号

4087。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2460/8913453/ab5826f8cfeb/701_2021_4863_Fig1_HTML.jpg

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