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结直肠癌伴腹膜转移手术后具有生物心理社会迟发效应患者的心理干预——一项可行性研究

Psychological Intervention for Patients with Biopsychosocial Late Effects Following Surgery for Colorectal Cancer with Peritoneal Metastases-A Feasibility Study.

作者信息

Balachandran Rogini, Thaysen Henriette Vind, Christensen Peter, Nissen Eva Rames, O'Toole Mia Skytte, Knutzen Sofie Møgelberg, Buskbjerg Cecilie Dorthea Rask, Wu Lisa Maria, Tauber Nina, Amidi Ali, Danielsen Josefine Tingdal Taube, Zachariae Robert, Iversen Lene Hjerrild

机构信息

Department of Surgery, Aarhus University Hospital, 8200 Aarhus, Denmark.

Department of Clinical Medicine, Aarhus University, 8000 Aarhus, Denmark.

出版信息

Cancers (Basel). 2025 Mar 27;17(7):1127. doi: 10.3390/cancers17071127.

Abstract

: Up to 80% of patients experience late effects (LE) one year after surgery for peritoneal metastases (PM) from colorectal cancer (CRC). We tested the feasibility and outcome of a treatment strategy to address LEs. : During January 2021-May 2023, patients who had undergone surgery for CRC-PM in Denmark were screened for biopsychosocial LEs (anxiety, depression, fear of cancer recurrence, insomnia, cognitive impairment, pain, fatigue). Patients scoring according to clinical cut-offs were referred to a Multi-Disciplinary Team conference (MDT). The patients, surgeon(s), nurse(s), and psychologists participated in the MDT, identified key concerns and proposed a personalized intervention. Pre- and post-intervention, patients completed a "Measure Yourself Concerns and Wellbeing" (MYCaW) questionnaire, rating the two most distressing LEs and general wellbeing on a 7-point Likert scale. : Of 28 eligible patients, 13 (59 years (mean), 85% women) accepted referral, participated in the MDT, and were offered a personalized intervention. The intervention was completed by 11 patients. Improvement in MYCaW score was observed 1 month postintervention for all three items: (1) the primary LE ( = 0.003, Hedges's g 1.54), (2) the secondary LE ( < 0.001, Hedges's g 1.65), and (3) general wellbeing ( = 0.005, Hedges's g 1.09). This improvement was sustained 6 months postintervention. The 15 non-participants were, in general, older (66 years (mean), men 73%). : Screening for LEs and conducting an MDT can provide a personalized intervention plan, which patients are able to complete and may benefit from.

摘要

高达80%的患者在接受结直肠癌(CRC)腹膜转移(PM)手术后一年会出现迟发效应(LE)。我们测试了一种针对迟发效应的治疗策略的可行性和效果。:在2021年1月至2023年5月期间,对丹麦接受CRC-PM手术的患者进行了生物心理社会迟发效应(焦虑、抑郁、癌症复发恐惧、失眠、认知障碍、疼痛、疲劳)筛查。根据临床临界值评分的患者被转介到多学科团队会议(MDT)。患者、外科医生、护士和心理学家参加了MDT,确定了关键问题并提出了个性化干预措施。干预前后,患者完成了一份“自我评估关注与幸福感”(MYCaW)问卷,在7点李克特量表上对两个最令人苦恼的迟发效应和总体幸福感进行评分。:在28名符合条件的患者中,13名(平均59岁,85%为女性)接受了转介,参加了MDT,并接受了个性化干预。11名患者完成了干预。干预后1个月,观察到MYCaW评分在所有三个项目上均有改善:(1)主要迟发效应(P = 0.003,Hedges's g = 1.54),(2)次要迟发效应(P < 0.001,Hedges's g = 1.65),以及(3)总体幸福感(P = 0.005,Hedges's g = 1.09)。这种改善在干预后6个月持续存在。15名未参与者一般年龄较大(平均66岁,73%为男性)。:筛查迟发效应并开展MDT可以提供个性化干预计划,患者能够完成该计划并可能从中受益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/beb4/11987789/51a8d44ef4de/cancers-17-01127-g001.jpg

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