疫情封锁期间妇科和乳腺癌患者治疗方案改变的心理影响。
The psychological impact of therapeutic changes during the COVID-19-lockdown for gynaecological and breast cancer patients.
机构信息
Department of Obstetrics and Gynaecology Surgery, Femme Mère Enfant University Hospital, Hospices Civils de Lyon, Bron, France; University of Lyon, Université Claude Bernard Lyon 1, Lyon, France.
Department of Obstetrics and Gynaecology Surgery, Femme Mère Enfant University Hospital, Hospices Civils de Lyon, Bron, France; University of Lyon, Université Claude Bernard Lyon 1, Lyon, France.
出版信息
J Gynecol Obstet Hum Reprod. 2022 Mar;51(3):102311. doi: 10.1016/j.jogoh.2022.102311. Epub 2022 Jan 7.
OBJECTIVE
The exceptional health situation related to the Coronavirus 2019 (COVID-19) pandemic has required an in-depth and immediate reorganisation of gynaecological cancer care. The main objective was to assess the psychological impact of such treatment modifications during the lockdown period for gynaecological and breast cancer patients.
PATIENTS AND METHODS
A multicentre prospective study was conducted in three university gynaecological cancer wards (Hospices Civils de Lyon, France) during the French first lockdown (16th March to 11th May 2020). All patients with non-metastatic breast cancer or gynaecological cancer were included. Data was collected regarding treatment modifications (delay, cancellation, change of therapeutic plan). The psychological impact of treatment modifications during and after the lockdown was assessed by validated questionnaires (SF-12, EORTC-QLQ-C30, HADS).
RESULTS
A total of 205 consecutive patients were included, aged 60.5 ± 1.0 years. Seven patients (3.4%) presented a SARS-CoV-2 infection, and two patients died. Treatment was maintained for 122 (59.5%) patients, postponed for 72 (35.1%) and cancelled for 11 (5.4%). During the lockdown, 35/118 (29.7%) patients suffered from confirmed anxiety and the mean fatigue-EORTC score was 48.00 ± 2.51; it was 38.64 ± 2.33 (p = 0.02) after the lockdown. After the lockdown and compared to the lockdown period, the mental SF-12 score and overall health status EORTC score were significantly higher (45.03 ± 1.06 vs 41.71 ± 1.15, p = 0.02 and 64.58 ± 1.66 vs 57.44 ± 2.02, p = 0.0007, respectively). The number of confirmed-anxiety cases was significantly higher amongst patients for whom treatment was delayed or cancelled (40.5% vs 23.7%, p = 0.04).
CONCLUSION
This study quantified the treatment modifications of gynaecological cancer patients during the COVID-19 lockdown and revealed a poorer psychological state and quality of life during this period, even for patients whose treatment plan was not actually modified. Anxiety was more significant in patients with a delayed or cancelled treatment.
目的
与 2019 年冠状病毒病（COVID-19）大流行相关的特殊健康状况需要对妇科癌症治疗进行深入和即时的重新组织。主要目的是评估封锁期间妇科和乳腺癌患者治疗修改的心理影响。
患者和方法
在法国第一次封锁期间（2020 年 3 月 16 日至 5 月 11 日），在三个大学妇科癌症病房（里昂民事医院，法国）进行了一项多中心前瞻性研究。所有非转移性乳腺癌或妇科癌症患者均纳入研究。收集了有关治疗修改（延迟、取消、治疗计划改变）的数据。通过经过验证的问卷（SF-12、EORTC-QLQ-C30、HADS）评估封锁期间和之后治疗修改的心理影响。
结果
共纳入 205 例连续患者，年龄 60.5±1.0 岁。7 例（3.4%）患者出现 SARS-CoV-2 感染，2 例患者死亡。122 例（59.5%）患者维持治疗，72 例（35.1%）患者延迟治疗，11 例（5.4%）患者取消治疗。在封锁期间，35/118（29.7%）名患者患有确诊焦虑症，EORTC 疲劳评分平均为 48.00±2.51；封锁后为 38.64±2.33（p=0.02）。封锁后与封锁期间相比，精神 SF-12 评分和整体健康状况 EORTC 评分明显更高（45.03±1.06 与 41.71±1.15，p=0.02 和 64.58±1.66 与 57.44±2.02，p=0.0007，分别）。治疗延迟或取消的患者中确诊焦虑症的病例数明显更高（40.5%与 23.7%，p=0.04）。
结论
本研究量化了 COVID-19 封锁期间妇科癌症患者的治疗修改，并揭示了在此期间心理状态和生活质量较差，即使对于其治疗计划未实际修改的患者也是如此。焦虑在治疗延迟或取消的患者中更为明显。
Zotero 插件