Department of Medical Psychology, Albert Schweitzer Hospital, Dordrecht, The Netherlands.
Department of Haematology, Albert Schweitzer Hospital, Dordrecht, The Netherlands.
Psychooncology. 2022 Feb;31(2):176-184. doi: 10.1002/pon.5800. Epub 2021 Aug 30.
There is growing evidence and awareness of the psychological impact of watch-and-wait in patients with indolent haematological malignancy. However, the need for supportive care is unknown. The aims of this study were to investigate prevalence of unmet needs, their psychological associates, and prevalence of anxiety and depressive symptomatology.
Adult patients with indolent haematological malignancy, during watch-and-wait (n = 122) were included in this cross-sectional single-centre study. Participants filled out questionnaires on anxiety (Generalised Anxiety Disorder), depression (Patient Health Questionnaire), coping (Acceptance and Action Questionnaire II), distress (distress thermometer), disease-specific quality of life (The European Organisation for Research and Treatment of Cancer quality of life questionnaire) and supportive care needs (Supportive care needs survey - Dutch short version). Multiple linear regression analyses were performed to identify patient-factors associated with unmet needs.
The prevalence of anxiety and depressive symptomatology were both 7.3%. Unmet needs were reported by 35% (n = 43) of patients. After controlling for covariates, higher levels of distress (β = 0.23, p = 0.05), depression (β = 0.41, p = 0.001), poorer coping (β = 0.35, p = 0.002) and younger age (β = -0.16, p = 0.05) were independently associated with more supportive care needs. The highest unmet needs were reported in domain health system, information & patient support (mean = 23.6 ± 23.0) and psychological domain (mean = 18.7 ± 21.8).
One third of indolent haematology patients during watch-and-wait report unmet supportive care needs. Screening for unmet needs and design of interventions is required. A joint approach focused on psychological care, especially on improving psychological flexibility, should be combined with promoting accessibility to health-services and optimising disease education.
越来越多的证据和意识表明，惰性血液病患者等待观察时存在心理影响。然而，支持性护理的需求尚不清楚。本研究的目的是调查未满足需求的患病率、其心理相关因素以及焦虑和抑郁症状的患病率。
本横断面单中心研究纳入了 122 名惰性血液病等待观察的成年患者。参与者填写了焦虑（广泛性焦虑障碍）、抑郁（患者健康问卷）、应对（接受与行动问卷 II）、痛苦（痛苦温度计）、疾病特异性生活质量（欧洲癌症研究与治疗组织生活质量问卷）和支持性护理需求（支持性护理需求调查-荷兰短版）的问卷。进行多元线性回归分析，以确定与未满足需求相关的患者因素。
焦虑和抑郁症状的患病率均为 7.3%。35%（n=43）的患者报告存在未满足的需求。在控制了协变量后，较高的痛苦程度（β=0.23，p=0.05）、抑郁程度（β=0.41，p=0.001）、较差的应对能力（β=0.35，p=0.002）和较年轻的年龄（β=-0.16，p=0.05）与更多的支持性护理需求独立相关。健康系统、信息和患者支持领域（均值=23.6±23.0）和心理领域（均值=18.7±21.8）的未满足需求最高。
三分之一的惰性血液病患者在等待观察时报告存在未满足的支持性护理需求。需要进行未满足需求的筛查和干预设计。一种联合的方法，侧重于心理护理，特别是改善心理灵活性，应与促进获取医疗服务和优化疾病教育相结合。
