Gastrointestinal Medicine and Surgery Department, Guy's and St Thomas's NHS Foundation Trust, Westminster Bridge Road, London, SE1 7EH, UK.
Gastrointestinal Medicine and Surgery Department, Guy's and St Thomas's NHS Foundation Trust, Westminster Bridge Road, London, SE1 7EH, UK.
Eur J Surg Oncol. 2024 Jun;50(6):108046. doi: 10.1016/j.ejso.2024.108046. Epub 2024 Feb 22.
Despite significant surgical advancements in the treatment of oesophago-gastric cancer (OGC), patients often experience a considerable decline in health-related quality of life postoperatively. Psychological factors, such as hypervigilance and symptom-specific anxiety, may contribute to this. This study aimed to investigate the prevalence and trend of hypervigilance and symptom-specific anxiety in OGC survivors across treatment stages.
103 patients with either gastric or oesophageal cancer, treated with surgery (and/or neoadjuvant chemotherapy), completed a specialist measure of oesophageal hypersensitivity (Oesophageal Anxiety and Hypervigilance Scale) at five time-points: spanning from diagnostic clinics to 6 months post-hospital discharge.
The results indicate a trend of rising symptom-specific anxiety and hypervigilance scores over time post-hospital discharge. Total scores showed variations over time; elevated at diagnosis, decreasing between pre-operative assessment and 2-4 weeks post-hospital discharge, and rising again at between 3 and 6 months post-discharge, exceeding the average score at diagnosis. The patterns for the subscale scores for symptom-specific anxiety and hypervigilance followed a similar trend, though anxiety scores consistently exceeded hypervigilance scores at previous time-points.
In noting the presence and variations of symptom-specific anxiety and hypervigilance in patients with OGC, this study directs attention to the previously unexplored significant psychological distress. Although specific conclusions from the data are restricted due to the study's design, it indicates the importance of assessing and addressing these psychological factors for effective management of patients with OGC.
尽管在治疗食管胃结合部癌(OGC)方面取得了重大的手术进展,但患者术后通常会经历相当大的生活质量下降。心理因素,如过度警觉和症状特异性焦虑,可能对此有所贡献。本研究旨在调查 OGC 幸存者在治疗各阶段过度警觉和症状特异性焦虑的患病率和趋势。
103 名胃或食管癌症患者接受了手术(和/或新辅助化疗)治疗,在五个时间点完成了一项食管高敏度的专业测量(食管焦虑和过度警觉量表):从诊断诊所到出院后 6 个月。
结果表明,出院后时间推移,症状特异性焦虑和过度警觉评分呈上升趋势。总评分随时间变化;在诊断时升高,在术前评估和出院后 2-4 周之间下降,然后在出院后 3-6 个月再次升高,超过诊断时的平均评分。症状特异性焦虑和过度警觉的子量表评分模式也呈现出类似的趋势,尽管焦虑评分在前几个时间点始终超过过度警觉评分。
本研究注意到 OGC 患者存在且变化的症状特异性焦虑和过度警觉,并将注意力引向以前未被探索的显著心理困扰。尽管由于研究设计的限制,数据的具体结论受到限制,但它表明评估和处理这些心理因素对于有效管理 OGC 患者的重要性。