妇科癌症手术住院期间的心理困扰、身体形象和营养状况：一项前瞻性观察研究。

Psychological distress, body image, and nutritional status during hospitalization for gynecological cancer surgery: a prospective observational study.

作者信息

Lafuenti Letizia, Ciccarone Francesca, De Paola Rebecca, Sicco Svetlana, Sani Livia, Belella Daniela, Liberati Luca, Ferrarese Daniele, Massaroni Valentina, Fagotti Anna, Chieffo Daniela Pia Rosaria

机构信息

Clinical Psychology Unit, Health Management, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 1, Rome, 00168, Italy.

Gynecologic Oncology Unit, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, 00168, Italy.

出版信息

Support Care Cancer. 2025 Aug 21;33(9):802. doi: 10.1007/s00520-025-09862-3.

DOI:10.1007/s00520-025-09862-3

PMID:40836028

Abstract

BACKGROUND

Hospitalization for gynecological cancer surgery represents a critical window for assessing and addressing psychological and nutritional vulnerabilities. This prospective observational study investigated changes in emotional distress, anxiety, depression, body-image dissatisfaction, orthorexic tendencies, and nutritional status from admission to discharge, and explored associations between psychological and nutritional variables.

METHODS

A total of 220 women hospitalized for surgical treatment of gynecological cancer were enrolled, with 181 (82.3%) completing both baseline (T0) and discharge (T1) assessments. Psychological outcomes were evaluated using the Distress Thermometer (DT), Hospital Anxiety and Depression Scale (HADS), Body-Image Scale (BIS), and Teruel Orthorexia Scale (TOS). Nutritional status was assessed through the Mini Nutritional Assessment (MNA). Changes between T0 and T1 were analyzed using paired t-tests. Pearson's correlations examined associations between psychological and nutritional variables. A multivariable logistic regression identified predictors of clinically relevant distress (DT ≥ 4) at discharge.

RESULTS

Significant improvements were observed in anxiety (p < 0.001), depression (p < 0.001), emotional distress (p < 0.001), and orthorexic tendencies (p < 0.001) between admission and discharge. Conversely, body-image dissatisfaction increased significantly (p < 0.001). Nutritional risk remained high throughout hospitalization, with no statistically significant change (p = 0.221). Higher body-image dissatisfaction at admission predicted a greater likelihood of clinically relevant distress at discharge (p = 0.003).

CONCLUSIONS

Hospitalization offers a pivotal opportunity to identify and address emotional and nutritional needs in women with gynecological cancers. Integrated, multidisciplinary supportive care models targeting both psychological and nutritional vulnerabilities are crucial to promote holistic recovery during and beyond the surgical course.

摘要

背景

妇科癌症手术住院是评估和解决心理及营养脆弱性的关键时期。这项前瞻性观察性研究调查了从入院到出院期间情绪困扰、焦虑、抑郁、身体形象不满、正食癖倾向和营养状况的变化，并探讨了心理和营养变量之间的关联。

方法

共有220名因妇科癌症手术治疗而住院的女性入组，其中181名（82.3%）完成了基线（T0）和出院（T1）评估。使用苦恼温度计（DT）、医院焦虑抑郁量表（HADS）、身体形象量表（BIS）和特鲁埃尔正食癖量表（TOS）评估心理结果。通过微型营养评定法（MNA）评估营养状况。使用配对t检验分析T0和T1之间的变化。Pearson相关性检验心理和营养变量之间的关联。多变量逻辑回归确定出院时临床相关苦恼（DT≥4）的预测因素。

结果

入院和出院之间，焦虑（p<0.001）、抑郁（p<0.001）、情绪困扰（p<0.001）和正食癖倾向（p<0.001）有显著改善。相反，身体形象不满显著增加（p<0.001）。整个住院期间营养风险仍然很高，无统计学显著变化（p=0.221）。入院时较高的身体形象不满预示着出院时临床相关苦恼的可能性更大（p=0.003）。