Nuclear Medicine, IRCCS CROB, Referral Cancer Center of Basilicata, Rionero in Vulture, Italy.
Psycho-oncology, IRCCS CROB, Referral Cancer Center of Basilicata, Rionero in Vulture, Italy.
Sci Prog. 2024 Jul-Sep;107(3):368504241253715. doi: 10.1177/00368504241253715.
This feasibility study evaluated the psychological status of patients with differentiated thyroid cancer (DTC) before, during, and 40 days after administration of I-131 radionuclide therapy (RAI). We investigated the appropriateness of providing patient a comprehensive psychological assessment in an isolation ward. Thirty consecutive patients (Study Group; SG) who received RAI were enrolled. The tools used were the Hospital Anxiety and Depression Scale (HADS) at three different moments, and the Coping Responses Inventory (CRI) at baseline for each patient. A supportive approach was also implemented. Data were collected at the first specialist visit, at the day of admission, and at 40 days follow-up visit. A matched cohort of patients (Control Group; CG), who did not receive psycho-oncological counseling, was retrospectively studied only about their medical needs and requests. Staff exposure to radiation was also compared during SG and CG hospitalization, to assess a possible reduction of radiological risk for them. A significant difference between the basal, intermediate, and final psychological status was observed (p < 0.0001), which was found to be irrespective of the induced hypothyroidism. Patients showed a significant worsening of their status in terms of anxiety and depression after the consent, but it improved 40 days after treatment. Repeated measures analysis showed a similar trend in patients' psychological status over this period. At hospital discharge, patients showed indirect signs of increased well-being. CG required more nursing and medical interventions. Staff exposure was significantly lower during hospitalization of SG as compared to CG. This study demonstrates that timed psychological evaluation and appropriate support may help to reduce anxiety and depression of patients receiving a diagnosis of cancer and undergoing RAI. Moreover, an improvement of workplace safety was recorded.
这项可行性研究评估了分化型甲状腺癌 (DTC) 患者在接受碘-131 放射性核素治疗 (RAI) 前后 40 天的心理状态。我们研究了在隔离病房为患者提供全面心理评估的适宜性。连续招募了 30 例接受 RAI 的患者（研究组，SG）。使用的工具包括三个不同时间点的医院焦虑和抑郁量表 (HADS)，以及每位患者基线时的应对反应量表 (CRI)。还实施了支持性方法。数据在第一次专科就诊时、入院当天和 40 天随访时收集。还回顾性地研究了一组未接受心理肿瘤学咨询的匹配患者（对照组，CG），仅研究他们的医疗需求和要求。还比较了 SG 和 CG 住院期间工作人员的辐射暴露情况，以评估他们可能降低的放射风险。观察到基础、中间和最终心理状态之间存在显著差异（p<0.0001），且与诱导性甲状腺功能减退无关。患者在同意后，在焦虑和抑郁方面的状况明显恶化，但在治疗后 40 天有所改善。重复测量分析显示，在此期间患者的心理状态呈相似趋势。出院时，患者表现出幸福感增强的间接迹象。CG 需要更多的护理和医疗干预。与 CG 相比，SG 住院期间工作人员的暴露明显降低。这项研究表明，定时心理评估和适当的支持可能有助于减轻接受癌症诊断和接受 RAI 治疗的患者的焦虑和抑郁。此外，还记录了工作场所安全性的提高。
