Soloff Michelle A, Keel Trey, Nizam Aaron, Goldberg Gary L, Sakaris Antoinette, Diefenbach Michael A, DePeralta Danielle K, Frimer Marina
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Northwell Health, Zucker School of Medicine at Hofstra/Northwell, 270-05 76 Avenue, Queens, NY 11040, United States.
Zucker School of Medicine at Hofstra/Northwell, 500 Hofstra Blvd, Hempstead, NY 11549, United States.
Gynecol Oncol Rep. 2023 Jul 13;48:101245. doi: 10.1016/j.gore.2023.101245. eCollection 2023 Aug.
Amid the height of the COVID-19 pandemic in the US, the US Surgeon General ordered hospitals and healthcare systems to stop all elective surgical procedures. The aim of our study was to evaluate the additional mental health impact of surgical delay on patients awaiting surgery for benign, pre-malignant and malignant conditions within the context of the COVID-19 pandemic.
All patients over the age of 18 awaiting surgery for benign, pre-malignant or malignant conditions within the gynecologic oncology, surgical oncology and colorectal services across Northwell Health were eligible for participation. Upon successful enrollment, participants completed a baseline questionnaire consisting of the Generalized Anxiety Disorder Questionnaire, the Penn State Worry Questionnaire, and Brief-Illness Patient Questionnaire.
The surgical delay was considered moderately to extremely concerning by 72 % of survey respondents, with one third indicating the highest (10/10) level of concern. Fifty-five percent of patients with a pre-operatively suspected/confirmed cancer or pre-malignant condition demonstrated mild to severe anxiety in their completion of the GAD-7 scale. The average time awaiting surgery was 117 days (range 8-292); and 63 % of respondents indicated that the delay had a moderate to severe impact on their daily life.
Patients awaiting surgery for confirmed, suspected or pre-malignant conditions expressed decreased sense of control and increased levels of distress compared to patients awaiting procedures for benign conditions (p < 0.05, 95 % CI [-2.65, -0.08]). Future research will focus on the effects of COVID-19 related delays in operative care on clinical outcomes, including cancer morbidity and mortality.
在美国新冠疫情高峰期，美国卫生局局长下令医院和医疗系统停止所有择期外科手术。我们研究的目的是评估在新冠疫情背景下，手术延迟对等待良性、癌前和恶性疾病手术患者心理健康的额外影响。
在诺斯韦尔健康中心的妇科肿瘤、外科肿瘤和结直肠科服务部门中，所有年龄超过18岁、等待良性、癌前或恶性疾病手术的患者均符合参与条件。成功入组后，参与者完成一份基线问卷，该问卷包括广泛性焦虑障碍问卷、宾夕法尼亚州立大学忧虑问卷和简短疾病患者问卷。
72%的调查受访者认为手术延迟令人中度至极度担忧，三分之一的受访者表示担忧程度最高（10分制中的10分）。55%术前疑似/确诊患有癌症或癌前病变的患者在完成GAD - 7量表时表现出轻度至重度焦虑。等待手术的平均时间为117天（范围8 - 292天）；63%的受访者表示延迟对他们的日常生活有中度至重度影响。
与等待良性疾病手术的患者相比，等待确诊、疑似或癌前疾病手术的患者表现出控制感下降和痛苦程度增加（p < 0.05，95%置信区间[-2.65, -0.08]）。未来的研究将聚焦于新冠疫情相关的手术护理延迟对临床结局的影响，包括癌症发病率和死亡率。
