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接受食物口服免疫疗法的患者及其家庭的心理需求与支持

Psychological needs and support among patients and families undergoing food oral immunotherapy.

作者信息

Polloni Laura, Muraro Antonella, Bonaguro Roberta, Toniolo Alice, Ballin Anna, Guarnaccia Alberto, Lazzarotto Francesca

机构信息

Department of Women's and Children's Health Food Allergy Referral Centre, Veneto Region Padua University Hospital Padua Italy.

Psychology Unit Padua University Hospital Padua Italy.

出版信息

Clin Transl Allergy. 2022 Feb 3;12(2):e12078. doi: 10.1002/clt2.12078. eCollection 2022 Feb.

Abstract

BACKGROUND

Oral immunotherapy (OIT) is a promising treatment for food allergy (FA) however it is a challenging process for patients and parents. Induction can generate stress and anxiety. This may in turn affect their motivation and ability to cope with OIT challenges.

OBJECTIVE

This study aimed to investigate psychological needs and support to patients/parents undergoing food OIT assessing participants' main characteristics, reasons for seeking psychological support, OIT phase and related psychological difficulties, type and timing of treatments and patients' perception of the effectiveness of the intervention.

METHODS

This is an observational, retrospective study. 50 psychological interventions required for OIT related problems were selected consecutively in a Referral Centre in North-Eastern Italy. All patients had a medical diagnosis of FA and were undergoing OIT or had just discontinued it. Data were collected from hospital records. A descriptive statistical analysis was performed.

RESULTS

66% of patients asked for psychological support for the initial phase (e.g., oral food challenge, first maintenance doses), 20% during the up-dosing phase, 8% during maintenance and 6% after discontinuation. 70% of treatments were required mainly because of emotional problems including dysfunctional anxiety and mood disorders, increased distress and excessive worry and/or fear related to OIT; 20% because of difficulties in managing OIT; 10% because of eating difficulties; 50% of patients reported recent anaphylaxis. All patients reported improvement and felt the psychological intervention was helpful.

CONCLUSION

It is recommended to evaluate the psychological needs in profiling patients and families suitable to OIT and offer specific psychological support when needed.

摘要

背景

口服免疫疗法(OIT)是一种很有前景的食物过敏(FA)治疗方法,但对患者及其家长来说是一个具有挑战性的过程。诱导阶段可能会产生压力和焦虑。这反过来可能会影响他们应对OIT挑战的动力和能力。

目的

本研究旨在调查接受食物OIT的患者/家长的心理需求和支持情况,评估参与者的主要特征、寻求心理支持的原因、OIT阶段及相关心理困难、治疗类型和时间以及患者对干预效果的感知。

方法

这是一项观察性回顾性研究。在意大利东北部的一个转诊中心,连续选取了50例因OIT相关问题而需要的心理干预案例。所有患者均有FA的医学诊断,正在接受OIT或刚刚停止。数据从医院记录中收集。进行了描述性统计分析。

结果

66%的患者在初始阶段(如口服食物激发试验、首次维持剂量)寻求心理支持,20%在剂量增加阶段,8%在维持阶段,6%在停止后。70%的治疗主要是因为情绪问题,包括功能失调性焦虑和情绪障碍、与OIT相关的痛苦增加以及过度担忧和/或恐惧;20%是因为管理OIT有困难;10%是因为进食困难;50%的患者报告近期有过敏反应。所有患者均报告症状改善,并认为心理干预有帮助。

结论

建议在评估适合OIT的患者及其家庭时评估心理需求,并在需要时提供特定的心理支持。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7135/8811642/9630e4533d62/CLT2-12-e12078-g002.jpg

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