Medical Oncology Unit, "San Giovanni di Dio" Hospital, ASL Napoli 2 Nord, Frattamaggiore, Italy.
Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy; Molecular Oncology and Precision Medicine Laboratory, Fondazione Biogem, Ariano Irpino, Italy.
Chin Clin Oncol. 2023 Aug;12(4):35. doi: 10.21037/cco-23-54.
Psychological distress has been associated with greater physical symptom severity, suffering, and mortality in cancer patients. For this reason, today, psychological care represents a fundamental tool for improving the quality of life of cancer patients.
From September 2021 to May 2022, 170 newly diagnosed cancer patients, were enrolled in the observational study at Medical Oncology Unit, "San Giovanni di Dio" Hospital. Before the start of oncological treatment, they were subjected to the Kessler 10 (K10) test, a validated measure of non-specific symptoms of psychological distress of the past 4 weeks. On the basis of the score, they were divided into three groups: low [10-19], moderate [20-29] and high [30-50] distress. After 3 months of psychological therapy, they repeated the test.
Majority of patients were female (74.1%), aged <70 years (78.2%). The most represented tumours were breast (47.6%), colon (15.3%), urothelial (10.6%) and lung (7.6%) cancer and most patients started intravenous chemotherapy treatment (74.7%) rather than oral therapy. The previous remote pathological history and the family cancer history of the patients were also evaluated. Finally, marital status, schooling and employment status were recorded. At baseline we found 55, 72, and 43 patients with a low, moderate and high psychological distress, respectively. After the 3 months of psychotherapy, we re-administered the K10 test and we found a radical improvement in the degree of psychological distress (96 patients had a low score, 62 with a moderate score and just 12 patients with a high score). The great reduction in the score in K10 was statistically significant with a P value of <0.0001. The reduction of the K10 score was observed indiscriminately in all subgroups analysed. A statistically significant difference was observed between patients with different education levels (low 56% vs. high 32% of reduction in K10 score). Furthermore, the improvement in psychological health was greater in unemployed patients than in workers.
The use of the K10 test is helpful in monitoring the degree of psychological distress of patients facing the diagnosis of cancer and who are about to start oncological treatment. Psychotherapy is effective in reducing the distress of these patients just a few months after starting treatment.
心理困扰与癌症患者更严重的身体症状严重程度、痛苦和死亡率有关。因此，如今，心理护理是提高癌症患者生活质量的重要工具。
从 2021 年 9 月到 2022 年 5 月，170 名新诊断的癌症患者在“圣乔瓦尼·迪·迪奥”医院肿瘤医学科参加了观察性研究。在开始肿瘤治疗之前，他们接受了 Kessler 10（K10）测试，这是一种过去 4 周非特异性心理困扰症状的有效测量方法。根据分数，他们被分为三组：低（10-19）、中（20-29）和高（30-50）困扰。在心理治疗 3 个月后，他们重复了测试。
大多数患者为女性（74.1%），年龄<70 岁（78.2%）。最常见的肿瘤是乳腺癌（47.6%）、结肠癌（15.3%）、尿路上皮癌（10.6%）和肺癌（7.6%），大多数患者开始静脉化疗治疗（74.7%）而非口服治疗。还评估了患者以前的远程病史和家族癌症史。最后，记录了婚姻状况、教育程度和就业状况。在基线时，我们发现 55、72 和 43 名患者的心理困扰程度分别为低、中、高。在 3 个月的心理治疗后，我们重新进行了 K10 测试，发现心理困扰程度有了显著改善（96 名患者评分较低，62 名患者评分中度，仅有 12 名患者评分较高）。K10 评分的大幅下降具有统计学意义（P 值<0.0001）。在所有分析的亚组中，K10 评分的下降都具有统计学意义。在不同教育程度的患者之间观察到统计学显著差异（低水平组 K10 评分下降 56%，高水平组下降 32%）。此外，与在职人员相比，失业人员的心理健康改善更大。
使用 K10 测试有助于监测面临癌症诊断和即将开始肿瘤治疗的患者的心理困扰程度。心理治疗在治疗开始后仅几个月就能有效减轻这些患者的困扰。
