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根治性膀胱切除术治疗膀胱癌患者的支持性护理需求和利用情况:一项纵向研究。

Supportive care needs and utilization of bladder cancer patients undergoing radical cystectomy: A longitudinal study.

机构信息

Department of Human Structure and Repair, Ghent University, Ghent, Belgium.

Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.

出版信息

Psychooncology. 2022 Feb;31(2):219-226. doi: 10.1002/pon.5795. Epub 2021 Aug 27.

Abstract

OBJECTIVES

Investigating supportive care (SC) needs and utilization/willingness to use SC services from diagnosis to one year after radical cystectomy in bladder cancer (BC) patients. MATERIALS & METHODS: A longitudinal cohort study was conducted in 90 BC patients at Ghent/Leuven University Hospitals between April 2017 and December 2020. The Supportive Care Needs Survey-short form (SCNS-SF34) was used before radical cystectomy, one, three, six and 12 months after radical cystectomy. Additional questions assessed utilization/willingness to use SC services. Linear mixed models were performed.

RESULTS

The majority of BC patients report at least one moderate or high SC need at diagnosis (82%), month 1 (84%), month 3 (86%), month 6 (64%), and month 12 (60%). Significant decreases over time were seen for all domains (p < 0.001), except for sexuality (p = 0.275). From baseline to month 1, physical needs first significantly increased (p = 0.001) after which they decreased. Psychological (e.g. fears about the future) and informational (e.g. information on how to get better) needs were most common at baseline whereas physical (e.g. lack of energy) and informational needs were more common in the early postoperative phases. The majority of patients (ranging from 81% (month 1) to 91% (month 12)) did not make use of SC services and the majority of the patients (ranging from 81% (month 1) to 88% (month 12)) did not wish to talk about their problems to someone. Those willing to talk to someone preferred their physician.

CONCLUSIONS

A clear gap exists between the large proportion of SC needs experienced by BC patients undergoing radical cystectomy and the low use of SC services.

摘要

目的

调查膀胱癌(BC)患者从诊断到根治性膀胱切除术后一年期间的支持性护理(SC)需求以及 SC 服务的利用/意愿。

材料与方法

2017 年 4 月至 2020 年 12 月期间,在根格特/鲁汶大学医院对 90 例 BC 患者进行了一项纵向队列研究。在根治性膀胱切除术前、根治性膀胱切除术后 1、3、6 和 12 个月时使用简短版支持性护理需求调查(SCNS-SF34)。还询问了 SC 服务的利用/意愿。采用线性混合模型进行分析。

结果

大多数 BC 患者在诊断时(82%)、术后 1 个月(84%)、术后 3 个月(86%)、术后 6 个月(64%)和术后 12 个月(60%)至少报告有一项中度或高度的 SC 需求。所有领域的需求都随着时间的推移而显著降低(p<0.001),除了性生活(p=0.275)。从基线到术后 1 个月,身体需求首先显著增加(p=0.001),之后下降。心理需求(如对未来的恐惧)和信息需求(如了解如何康复)在基线时最为常见,而身体需求(如缺乏精力)和信息需求在术后早期更为常见。大多数患者(术后 1 个月为 81%,术后 12 个月为 91%)未利用 SC 服务,大多数患者(术后 1 个月为 81%,术后 12 个月为 88%)不希望与他人谈论自己的问题。那些愿意与他人交谈的患者更倾向于与医生交谈。

结论

接受根治性膀胱切除术的 BC 患者的 SC 需求比例很高,但 SC 服务的利用率很低,两者之间存在明显差距。

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