Department of Gastroenterology and Hepatology, Amsterdam UMC, University of Amsterdam, Boelelaan 1117, 1118, 1081HV Amsterdam, The Netherlands.
Department of Medical Psychology, Amsterdam UMC, University of Amsterdam, Boelelaan 1117, 1118, 1081HV Amsterdam, The Netherlands.
Dis Esophagus. 2024 Nov 28;37(12). doi: 10.1093/dote/doae067.
Prior research has shown that patients with early Barrett's neoplasia treated endoscopically report at least the same level of fear for cancer recurrence as patients treated surgically for a more advanced disease stage. The aim of this qualitative study was to gain insight into the reasons why endoscopically treated patients fear or not fear cancer recurrence. Patients treated endoscopically for T1 esophageal adenocarcinoma participated in a semi-structured interview. Patients were asked open questions about their fear of cancer recurrence and presented an a priori list of possible reasons for experiencing or not experiencing fear of cancer recurrence. Data saturation was reached with 12 patients who added 7 new reasons. Reasons that induced fear of cancer recurrence were related to physical symptoms, if cancer was diagnosed as an accidental finding and experiences with cancer in close relations. Endoscopic surveillance was mentioned as a reason for not experiencing fear of cancer recurrence. Patients reduced their fear of cancer recurrence by talking to close relations and seeking distraction. Caregivers reduced patients fear of cancer recurrence by giving adequate information and by showing photo of the treatment and the results of the treatment. According to patients with early Barrett's neoplasia, receiving comprehensible information about the risk of recurrence and potential symptoms that may or may not be indicative of cancer recurrence, and continuing endoscopic surveillance, reduced fear of cancer recurrence. We recommend that healthcare providers discuss fear of cancer recurrence with their patients to enable tailoring information provision to their needs.
先前的研究表明,接受内镜治疗的早期 Barrett 肿瘤患者对癌症复发的恐惧程度至少与接受更晚期疾病阶段手术治疗的患者相同。本定性研究的目的是深入了解内镜治疗患者恐惧或不恐惧癌症复发的原因。接受 T1 食管腺癌内镜治疗的患者参加了半结构化访谈。患者被问及对癌症复发的恐惧,并提出了一系列可能导致或不导致对癌症复发恐惧的原因。12 名患者提出了 7 个新的原因,达到了数据饱和。引起对癌症复发恐惧的原因与身体症状、癌症是否被诊断为偶然发现以及与密切关系中的癌症经历有关。内镜监测被认为是不恐惧癌症复发的一个原因。患者通过与亲密关系交谈和寻求分散注意力来减轻对癌症复发的恐惧。护理人员通过提供充分的信息以及展示治疗过程和治疗结果来减轻患者对癌症复发的恐惧。根据早期 Barrett 肿瘤患者的说法,提供有关复发风险和潜在症状的可理解信息,以及继续进行内镜监测,可以减轻对癌症复发的恐惧。我们建议医疗保健提供者与患者讨论对癌症复发的恐惧,以便根据患者的需求调整信息提供。
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