Department of Anesthesiology, Yokohama City University Hospital, Yokohama, Kanagawa, Japan.
Department of PeriAnesthesia Nursing, Graduate School of Medicine, Yokohama City University, Yokohama, Kanagawa, Japan.
J Perianesth Nurs. 2022 Oct;37(5):654-661. doi: 10.1016/j.jopan.2021.11.007. Epub 2022 May 17.
Perioperative depressive symptoms are associated with poor postoperative quality of life (QOL), leading to prolonged hospital stays, and delayed return to society. Previous studies show that physical and mental states change on the third day after surgery, and there is a correlation between quality of recovery (QoR) on this day and QOL at 3 months after surgery. QoR after surgery is an important indicator of postoperative QOL. However, there are no reports on the association between depressive symptoms, and postoperative QoR. Therefore, the study purpose was to clarify the relationship between depressive symptoms in perioperative cancer patients during the prehospitalization waiting period, and QoR on the third postoperative day.
This was a prospective cohort study.
We examined whether depressive symptoms during the prehospitalization waiting period were related to QoR on day 3 after surgery in perioperative cancer patients. Subjects were patients with primary tumors who underwent surgery under general anesthesia. Subjects completed self-administered questionnaires during the prehospitalization waiting period and on postoperative day 3. The presence and/or absence of depressive symptoms was measured using the Hospital Anxiety and Depression Scale. Subjects were divided into two groups: depressive symptoms or non-depressive symptoms. Postoperative QoR was determined using the QoR-40 questionnaire and we calculated the rate of change in QoR-40 global and dimension scores from preoperation to postoperation.
231 individuals met the inclusion criteria and agreed to participate in the study. Of these, 173 were included in the analysis. Only the rate of change in emotional state differed significantly between groups (P = .022). Both global and dimension QoR-40 scores were lower in the depressive symptoms group than in the non-depressive symptoms group.
These findings demonstrate the need to provide both psychological and physical support continuously from the preoperative to early postoperative stage for cancer patients with depressive symptoms in the prehospitalization waiting period.
围手术期抑郁症状与术后生活质量（QOL）较差相关，导致住院时间延长和社会回归延迟。先前的研究表明，患者在手术后第 3 天身心状态发生变化，这一天的恢复质量（QoR）与术后 3 个月的 QOL 相关。手术后的 QoR 是术后 QOL 的一个重要指标。然而，目前尚无围手术期癌症患者抑郁症状与术后 QoR 之间关联的报道。因此，本研究旨在阐明围手术期癌症患者在住院前等待期的抑郁症状与术后第 3 天 QoR 之间的关系。
这是一项前瞻性队列研究。
我们研究了住院前等待期的抑郁症状是否与围手术期癌症患者手术后第 3 天的 QoR 相关。研究对象为接受全身麻醉手术的原发性肿瘤患者。患者在住院前等待期和术后第 3 天完成了自我管理问卷。使用医院焦虑和抑郁量表（HADS）评估是否存在抑郁症状。患者分为有抑郁症状或无抑郁症状两组。使用 QoR-40 问卷评估术后 QoR，并计算 QoR-40 总分和维度评分从术前到术后的变化率。
共有 231 名符合纳入标准并同意参加研究的个体，其中 173 名纳入分析。只有情绪状态的变化率在两组之间有显著差异（P=.022）。抑郁症状组的 QoR-40 总分和各维度评分均低于无抑郁症状组。
这些发现表明，对于有抑郁症状的癌症患者，需要从术前到术后早期持续提供心理和身体支持。
