Wang Jing, Chen Ting, Li Wen, Wang Maosha, Yang Hua, Liu Feng
School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China.
Department of Gastroenterology, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, China.
J Thorac Dis. 2024 Oct 31;16(10):7063-7071. doi: 10.21037/jtd-24-1567. Epub 2024 Oct 28.
After endoscopic submucosal dissection (ESD) for early esophageal cancer, elderly patients generally have a fear of cancer recurrence (FCR), which may affect the effectiveness of treatment and the quality of life of patients. This study sought to investigate the FCR in elderly patients after ESD for early esophageal cancer and to analyze the factors associated with this fear.
Elderly patients with early esophageal cancer who underwent ESD at a general hospital in Nanjing, Jiangsu Province, were enrolled in this study. Survivors were evaluated using measures of FCR [Fear of Progression Questionnaire-Short Form (FoP-Q-SF)], disease perception (Brief Illness Perception Questionnaire), and coping styles (Medical Coping Modes Questionnaire) one month after surgery. Multivariate stepwise linear analysis is carried out.
A total of 162 patients participated in the study. The total FoP-Q-SF score of the elderly patients after ESD for early esophageal cancer was 34.38±4.1, the physical health dimension score was 19.96±2.78, and the social-family dimension score was 14.40±2.23, which exceeded the average level (≥34) in 98 cases (60.5%). The multiple stepwise regression analysis showed that literacy (β=-0.132, P=0.02), esophageal stenosis (β=0.132, P=0.02), the disease perception score (β=0.385, P<0.001), and the resignation dimension score (β=0.469, P<0.001) were the main factors influencing the FCR in elderly patients after ESD for early esophageal cancer.
The FCR is high in elderly patients after ESD for early esophageal cancer. Healthcare professionals should implement personalized disease-related health education programs to help patients reduce their fear of the disease, guide patients to adopt positive and effective coping styles, and improve the confidence and ability of patients to deal with disease-related problems to reduce the level of FCR.
早期食管癌内镜下黏膜剥离术（ESD）后，老年患者普遍存在癌症复发恐惧（FCR），这可能影响治疗效果及患者生活质量。本研究旨在调查老年早期食管癌患者ESD术后的FCR情况，并分析与这种恐惧相关的因素。
选取在江苏省南京市某综合医院接受ESD治疗的老年早期食管癌患者纳入本研究。术后1个月，采用癌症进展恐惧问卷简表（FoP-Q-SF）、疾病认知问卷（简明疾病感知问卷）及应对方式问卷（医学应对方式问卷）对幸存者进行评估。进行多因素逐步线性分析。
共有162例患者参与研究。老年早期食管癌患者ESD术后FoP-Q-SF总分34.38±4.1，身体健康维度得分19.96±2.78，社会家庭维度得分14.40±2.23，98例（60.5%）超过平均水平（≥34）。多因素逐步回归分析显示，文化程度（β=-0.132，P=0.02）、食管狭窄（β=0.132，P=0.02）、疾病认知得分（β=0.385，P<0.001）及听天由命维度得分（β=0.469，P<0.001）是影响老年早期食管癌患者ESD术后FCR的主要因素。
老年早期食管癌患者ESD术后FCR较高。医护人员应实施个性化的疾病相关健康教育计划，帮助患者减轻对疾病的恐惧，引导患者采取积极有效的应对方式，提高患者应对疾病相关问题的信心和能力，以降低FCR水平。
