Voigt Kelly R, Wullaert Lissa, van Driel M H Elise, Goudberg Max, Doornebosch Pascal G, Schreinemakers Jennifer M J, Verseveld Maria, Peeters Koen C M J, Verhoef Cornelis, Husson Olga, Grünhagen Dirk J
Department of Surgical Oncology and Gastrointestinal Surgery, Erasmus MC Cancer Institute, Doctor Molewaterplein 40, 3015 GD, Rotterdam, Netherlands.
Department of Surgery, IJsselland Hospital, Capelle aan den IJssel,, The Netherlands.
Support Care Cancer. 2024 Aug 1;32(8):564. doi: 10.1007/s00520-024-08758-y.
Amidst the rising number of cancer survivors and personnel shortages, optimisation of follow-up strategies is imperative, especially since intensive follow-up does not lead to survival benefits. Understanding patient preferences and identifying the associated patient profiles is crucial. Coping style may be a key determinant in achieving this. Our study aims to evaluate preferences, identify coping styles and their associated factors, and explore the association between coping style and patients' preferences in colorectal cancer (CRC) follow-up.
In a prospective multicentre implementation study, patients completed the Threatening Medical Situations Inventory (TMSI) to determine their coping style. Simultaneously patients choose their follow-up preferences for the CRC trajectory regarding frequency of tumour marker determination, location of blood sampling, and manner of contact.
A total of 188 patients completed the TMSI questionnaire after inclusion. A more intensive follow-up was preferred by 71.5% of patients. Of all patients, 52.0% had a coping style classified as 'blunting' and 34.0% as 'monitoring'. Variables such as a younger age, female gender, higher educational level, and lower ASA scores were associated with having higher monitoring scores. However, there were no significant associations between follow-up preferences and patients' coping styles.
This study suggests that none of the provided options in a patient-led follow-up are unsuitable for patients who underwent curative surgery for primary CRC, based on coping style determined at baseline. Low-intensity surveillance after curative resection of CRC may, therefore, be suitable for a wide range of patients independent of coping styles.
在癌症幸存者数量不断增加和人员短缺的背景下，优化随访策略势在必行，尤其是因为强化随访并不能带来生存益处。了解患者偏好并确定相关的患者特征至关重要。应对方式可能是实现这一目标的关键决定因素。我们的研究旨在评估偏好、确定应对方式及其相关因素，并探讨应对方式与结直肠癌（CRC）随访中患者偏好之间的关联。
在一项前瞻性多中心实施研究中，患者完成了威胁性医疗情境量表（TMSI）以确定其应对方式。同时，患者就CRC病程的随访偏好做出选择，包括肿瘤标志物测定频率、采血地点和联系方式。
共有188例患者在纳入研究后完成了TMSI问卷。71.5%的患者倾向于更密集的随访。在所有患者中，52.0%的应对方式被归类为“钝化”，34.0%为“监测”。年龄较小、女性、教育水平较高和ASA评分较低等变量与较高的监测得分相关。然而，随访偏好与患者的应对方式之间没有显著关联。
本研究表明，基于基线时确定的应对方式，在患者主导的随访中提供的任何选项都不适用于接受原发性CRC根治性手术的患者。因此，CRC根治性切除术后的低强度监测可能适用于广泛的患者，而与应对方式无关。
