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错失筛查机会——癌症患者心理肿瘤支持服务延迟利用的预测因素及其对痛苦评估和管理的影响。

Falling off the screening grid-Predictors for postponed utilization of psycho-oncological support in cancer patients and its implications for distress assessment and management.

机构信息

Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital, University of Duisburg-Essen, Essen, Germany.

West German Cancer Center, University Hospital Essen, Essen, Germany.

出版信息

Psychooncology. 2023 Nov;32(11):1727-1735. doi: 10.1002/pon.6226. Epub 2023 Oct 3.

DOI:10.1002/pon.6226
PMID:37789593
Abstract

OBJECTIVE

Distress assessment of cancer patients is considered state-of-the-art. In addition to distress scores, individual care needs are an important factor for the initiation of psycho-oncological interventions. In a mono-centric, observational study, we aimed for characterization of patients indicating a subjective need but declining to utilize support services immediately to facilitate implementation of adapted screenings.

METHODS

This study analyzed retrospective data from routine distress screening and associated data from hospital records. Descriptive, variance and regression analyses were used to assess characteristics of postponed support utilization in patients with mixed cancer diagnoses in different treatment settings.

RESULTS

Of the total sample (N = 1863), 13% indicated a subjective need but postponed support utilization. This subgroup presented as being as burdened by symptoms of depression (p < 0.001), anxiety (p < 0.001) and distress (p < 0.001) as subjectively distressed patients with intent to directly utilize support. Time periods since diagnosis were shorter (p = 0.007) and patients were more often inpatients (p = 0.045).

CONCLUSIONS

Despite high heterogeneity among the subgroups, this study identified distress-related factors and time since diagnosis as possible predictors for postponed utilization of psycho-oncological interventions. Results suggest the necessity for time-individualized support which may improve utilization by distressed patients.

摘要

目的

评估癌症患者的痛苦程度被认为是最先进的方法。除了痛苦评分外,个体护理需求也是启动心理肿瘤干预的一个重要因素。在一项单中心、观察性研究中,我们旨在描述那些表示有主观需求但拒绝立即利用支持服务的患者的特征,以便为实施适应性筛查提供便利。

方法

本研究分析了常规痛苦筛查的回顾性数据以及来自医院记录的相关数据。采用描述性、方差和回归分析方法,评估了不同治疗环境下混合癌症诊断患者推迟支持利用的特征。

结果

在总样本(N=1863)中,有 13%的患者表示有主观需求但推迟了支持的利用。与有直接利用支持意向的主观痛苦患者相比,这一下属群体表现出与抑郁(p<0.001)、焦虑(p<0.001)和痛苦(p<0.001)症状一样严重的负担。诊断后时间间隔较短(p=0.007),患者更多地是住院患者(p=0.045)。

结论

尽管亚组之间存在高度异质性,但本研究确定了与痛苦相关的因素和诊断后时间可作为推迟心理肿瘤干预利用的预测因素。结果表明,需要进行个体化的时间支持,这可能会提高痛苦患者的利用率。

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