Ye Yingjun, Wang Jin, Cai Shuping, Fu Xiaowei, Ji Yongling
The Cancer Hospital of the University of Chinese Academy of Sciences & Zhejiang Cancer Hospital, Hangzhou, China.
Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, China.
Psychooncology. 2022 Sep;31(9):1607-1615. doi: 10.1002/pon.5946. Epub 2022 May 10.
The currents study sought to explore the impact of treatment delay on the mental health for patients with cancer during the 2019 coronavirus disease (COVID-19) pandemic.
Travel restrictions were imposed in most areas of the country between 23 January 2020 and 25 February 2020 owing to the COVID-19 epidemic. Travel restrictions were lifted from 26 February 2020 to 12 March 2020. The number of new confirmed cases significantly reduced after 12 March 2020. Study participants, comprised of individuals from three distinct groups: (1) 835 cancer patients who attended Zhejiang Cancer Hospital between 26 February 2020 and 12 March 2020; (2) 185 healthy volunteers recruited between 26 February 2020 and 12 March 2020; (3) 168 cancer patients who attended the hospital during the non-epidemic period (after 12 March 2020). Two outcome measures including patients' posttraumatic stress responses and general psychological distress (GPD) were assessed using the Chinese versions of the Impact of Events Scale-Revised and the Kessler Psychological Distress Scale (K10). Treatment delay was assessed via counting the time interval from diagnosis to treatment initiation, or from planned treatment date to actual date of therapy. Communication satisfaction was evaluated via a self-report questionnaire. An independent sample t-test or Wilcoxon rank sum test was used for comparison. Statistical analysis included Chi-square test, Mann-Whitney test and multivariate logistic regression.
All 1188 participants (835 patients with cancer and 185 controls during the outbreak, and 168 patients with cancer during the non-epidemic period) completed and submitted the questionnaires. A positive association was observed between treatment delays and increased GPD levels (OR 1.716; 95% confidence interval ,CI 1.254-2.348; p = 0.001) as well as posttraumatic stress disorder (PTSD) symptoms (OR: 1.545, 95% CI: (1.166-2.047), p = 0.002). Patients who reported good communication with their doctors showed a significantly lower risk of GPD (OR: 0.526, 95% CI (0.348-0.794), p = 0.002) and PTSD (OR: 0.683, 95% CI (0.490-0.951), p = 0.024) compared with patients who reported unsatisfactory communication or had no contact with their doctors. Multivariate logistic regression analysis showed that treatment at a local hospital, treatment delays and unsatisfactory or no communication with cancer-care professionals were significantly correlated with severe GPD and PTSD symptoms of patients (all p ≤ 0.05).
The findings indicate that cancer patients who underwent treatment delays during the COVID-19 pandemic may become vulnerable to psychological distress. The results showed that effective communication with doctors and cancer-care professionals during outbreak significantly reduces GPD levels and PTSD symptoms.
本研究旨在探讨2019年冠状病毒病（COVID-19）大流行期间治疗延迟对癌症患者心理健康的影响。
由于COVID-19疫情，2020年1月23日至2020年2月25日期间该国大部分地区实施了旅行限制。2020年2月26日至2020年3月12日解除了旅行限制。2020年3月12日之后新确诊病例数显著减少。研究参与者由三个不同组的个体组成：（1）2020年2月26日至2020年3月12日期间在浙江省肿瘤医院就诊的835名癌症患者；（2）2020年2月26日至2020年3月12日期间招募的185名健康志愿者；（3）非疫情期间（2020年3月12日之后）在该医院就诊的168名癌症患者。使用中文版的事件影响量表修订版和凯斯勒心理困扰量表（K10）评估了两个结果指标，包括患者的创伤后应激反应和一般心理困扰（GPD）。通过计算从诊断到治疗开始的时间间隔，或从计划治疗日期到实际治疗日期来评估治疗延迟。通过一份自我报告问卷评估沟通满意度。采用独立样本t检验或Wilcoxon秩和检验进行比较。统计分析包括卡方检验、Mann-Whitney检验和多因素逻辑回归。
所有1188名参与者（疫情期间的835名癌症患者和185名对照，以及非疫情期间的168名癌症患者）完成并提交了问卷。观察到治疗延迟与GPD水平升高（比值比1.716；95%置信区间，CI 1.254 - 2.348；p = 0.001）以及创伤后应激障碍（PTSD）症状（比值比：1.545，95% CI：（1.166 - 2.047），p = 0.002）之间存在正相关。与报告沟通不满意或未与医生接触的患者相比，报告与医生沟通良好的患者出现GPD（比值比：0.526，95% CI（0.348 - 0.
