Screening for psychological distress in follow-up care to identify head and neck cancer patients with untreated distress
Screening for psychological distress in follow-up care to identify head and neck cancer patients with untreated distress
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DOI：
10.1007/s00520-015-3053-6
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发表时间：
2016-06-01
影响因子：
3.1
通讯作者：
Verdonck-de Leeuw, Irma M.
中科院分区：
文献类型：
--
作者：
Krebber, Anne-Marie H.;Jansen, Femke;Verdonck-de Leeuw, Irma M.
目的 本研究的目的是调查随访护理中的筛查，以识别患有未经治疗的心理困扰的头颈癌 (HNC) 患者。 方法 从 2009 年 11 月至 2012 年 12 月，我们调查了 Onco-Quest（一种触摸屏计算机系统，用于监测心理困扰（医院焦虑和抑郁量表 (HADS)）和生活质量（HRQOL；EORTC QLQ-C30 和 H&N35 模块）在常规随访中的使用情况筛选出心理困扰呈阳性的患者（HADS-T > 14、HADS-A > 7 或 HADS-D > 7）被询问是否接受心理或精神治疗。 结果 在 37 个月的研究期间，720 名个体 HNC 患者使用了 OncoQuest，其中 714 名患者有完整的 HADS 数据。根据标准（n = 137），25 人接受了心理治疗（18%），接受心理治疗与 HADS 总量表得分较高（19.6 对比 16.9；p = 0.019）、EORTC QLQ-C30 情绪功能量表得分较低（较差）（46.0 对比 58.6；p = 0.023）、较高得分显着相关。 （更差）疲劳得分（58.2 vs. 46.4；p = 0.032）、性问题（44.1 vs. 34.4；p = 0.043）、口腔疼痛（43.8 vs. 28.8；p = 0.011）和言语问题（37.0 vs. 25.3；p = 0.042）。 结论OncoQuest 是有益的，因为在未接受精神治疗的 HNC 患者中，有 82% 的痛苦程度较高，但接受治疗的患者报告了更多的痛苦和更差的生活质量，这可能是因为问题更严重的患者可能更倾向于寻求帮助，或者可能更容易被护理人员发现并更频繁地转诊至支持性护理。
Purpose The purpose of the study is to investigate screening in follow-up care to identify head and neck cancer (HNC) patients with untreated psychological distress.Methods From November 2009 until December 2012, we investigated the use of Onco-Quest (a touch screen computer system to monitor psychological distress (Hospital Anxiety and Depression Scale (HADS)) and quality of life (HRQOL; EORTC QLQ-C30 and H&N35 module) in routine follow-up care. Patients who screened positive for psychological distress (HADS-T > 14, HADS-A > 7, or HADS-D > 7) were asked whether they received psychological or psychiatric treatment.Results During the study period of 37 months, OncoQuest was used by 720 individual HNC patients, of whom 714 had complete HADS data. Psychological distress was present in 206 patients (29 %). Of those patients who fulfilled in-and exclusion criteria (n = 137), 25 received psychological treatment (18 %). Receipt of psychological treatment was significantly related to a higher score on the HADS total scale (19.6 vs. 16.9; p = 0.019), a lower (worse) score on the EORTC QLQ-C30 scale emotional functioning (46.0 vs. 58.6; p = 0.023), a higher (worse) score on fatigue (58.2 vs. 46.4; p = 0.032), problems with sexuality (44.1 vs. 34.4; p = 0.043), oral pain (43.8 vs. 28.8; p = 0.011) and speech problems (37.0 vs. 25.3; p = 0.042).Conclusions Screening for psychological distress via OncoQuest is beneficial because 82 % of HNC patients identified with an increased level of distress who do not yet receive mental treatment were identified. Patients who did receive treatment reported more distress and worse quality of life, which may be explained because patients with more severe problems maybe more inclined to seek help or might be detected easier by caregivers and referred to supportive care more often.