Yang Guiping, Shen Sen, Zhang Jiajia, Gu Yan
Department of Neurosurgery, Affiliated Hospital of Nantong University, Nantong, China.
Transl Cancer Res. 2022 May;11(5):1219-1229. doi: 10.21037/tcr-22-732.
Psychological resilience has played an increasingly important role in the treatment of different diseases and many glioma patients will experience adverse emotional reactions after being diagnosed. However, it remains unclear whether psychological resilience is related to the adverse events and quality of life of patients with glioma.
Patients with glioma between March 2016 and July 2020 were included in this retrospective cohort study. Psychological resilience was evaluated by the Connor-Davidson resilience scale (CD-RISC) 1 day before surgery. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ)-C30 and EORTC QLQ-BN20 were used for the quality of life (QoL) assessment of the included patients. The relationships between psychological resilience and postoperative adverse events/QoL were determined using multivariable logistic and linear regression analysis, respectively. Some patients were evaluated again after admission, and the patients were divided into an increased resilience group and decreased resilience group for subgroup analysis according to the changes between the two CD-RISC scores. All included patients were followed up for at least 6 months.
Ninety-seven patients were included in the high resilience group and 284 patients were included in the low resilience group. More neurological complications occurred in the low resilience group than in the high resilience group (18.7% 8.2%, P=0.016). Also, a higher Karnofsky performance scale score and higher psychological resilience contributed to less adverse events. Patients in the high resilience group had higher postoperative global health status scores than those in the low resilience group. Higher educational level, Karnofsky performance scale score, and psychological resilience acted as a protective factor for postoperative QoL. Subgroup analysis showed that the incidence of neurological complications was significantly higher in the decreased resilience group compared to the increased resilience group (22.9% 3.8%, P=0.039). Lastly, better global health status, physical functioning, and role functioning were observed in glioma patients with increased resilience.
The incidence of postoperative adverse events and QoL of glioma patients are closely related to their level of preoperative psychological resilience. Psychological counseling may also be a part of improving the prognosis of glioma patients.
心理弹性在不同疾病的治疗中发挥着越来越重要的作用，许多胶质瘤患者在被诊断后会经历不良情绪反应。然而，心理弹性是否与胶质瘤患者的不良事件和生活质量相关仍不清楚。
本回顾性队列研究纳入了2016年3月至2020年7月期间的胶质瘤患者。术前1天采用康纳-戴维森心理弹性量表（CD-RISC）评估心理弹性。使用欧洲癌症研究与治疗组织生活质量问卷（EORTC QLQ）-C30和EORTC QLQ-BN20对纳入患者的生活质量（QoL）进行评估。分别采用多变量逻辑回归和线性回归分析确定心理弹性与术后不良事件/QoL之间的关系。部分患者入院后再次进行评估，并根据两次CD-RISC评分的变化将患者分为心理弹性增强组和心理弹性降低组进行亚组分析。所有纳入患者至少随访6个月。
高心理弹性组纳入97例患者，低心理弹性组纳入284例患者。低心理弹性组发生的神经并发症多于高心理弹性组（18.7%对8.2%，P=0.016）。此外，较高的卡氏功能状态评分和较高的心理弹性导致较少的不良事件。高心理弹性组患者术后总体健康状况评分高于低心理弹性组。较高的教育水平、卡氏功能状态评分和心理弹性是术后QoL的保护因素。亚组分析显示，心理弹性降低组的神经并发症发生率显著高于心理弹性增强组（22.9%对3.8%，P=0.039）。最后，心理弹性增强的胶质瘤患者的总体健康状况、身体功能和角色功能更好。
胶质瘤患者术后不良事件的发生率和QoL与其术前心理弹性水平密切相关。心理咨询也可能是改善胶质瘤患者预后的一部分。
