Head and neck cancer patients want us to support them psychologically in the posttreatment period: Survey results
Head and neck cancer patients want us to support them psychologically in the posttreatment period: Survey results
复制标题
DOI：
10.1017/s1478951513000771
复制
发表时间：
2014-12-01
影响因子：
2.2
通讯作者：
Hier, Michael
中科院分区：
文献类型：
--
作者：
Henry, Melissa;Habib, Laura-Anne;Hier, Michael
目的：没有研究系统地调查了一般头颈部癌症患者的支持性护理需求，使用有效的措施。这些需求包括身体和日常生活需求、卫生系统和信息需求、病人护理和支持需求、心理需求和性需求。确定头颈部癌症患者未满足的需求是改善我们为头颈部肿瘤诊所患者提供护理的必要第一步。加拿大抗癌伙伴关系的泛加拿大临床实践指南建议将其作为干预措施开发的第一步（见豪厄尔，2009年）。本研究旨在确定：（1）满足和未满足的支持性护理需求的头部和颈部癌症患者，和（2）根据人口统计学，疾病变量，痛苦的水平，和quality of life domains.Methods的需求的变化：参与者被招募从耳鼻咽喉头颈外科诊所的两所大学教学医院。自我管理的问卷调查包括社会人口学和医疗问题，以及验证措施，如支持性护理需求调查简表（SCNS-SF 34），医院焦虑和抑郁量表（HADS），功能评估癌症治疗一般（FACT-G）和头颈部模块（FACT-H&N）（生活质量的措施）。其中68%的人经历了未满足的需求，25%的人在HADS上显示出临床显著的痛苦水平。未满足的需求最多的是心理需求（前10项需求中有7项）。多元线性回归表明，当患者离婚，焦虑程度高，（HADS子量表），身体状况不佳，或情绪生活质量下降（FACT-G分量表）。结果的意义：这项研究的结果突出了头颈部癌症患者未满足的心理需求的压倒性存在，并强调了实施干预措施，以解决患者认为重要的这些领域。根据医院的资源分配和成本效益，还可以考虑筛查高度焦虑的患者，以及离婚和身体健康水平较低的目标患者，因为这些患者可能有更多的整体需求需要满足。
Objectives: No study systematically has investigated the supportive care needs of general head and neck cancer patients using validated measures. These needs include physical and daily living needs, health system and information needs, patient care and support needs, psychological needs, and sexuality needs. Identifying the unmet needs of head and neck cancer patients is a necessary first step to improving the care we provide to patients seen in our head and neck oncology clinics. It is recommended as the first step in intervention development in the Pan-Canadian Clinical Practice Guideline of the Canadian Partnership Against Cancer (see Howell, 2009). This study aimed to identify: (1) met and unmet supportive care needs of head and neck cancer patients, and (2) variability in needs according to demographics, disease variables, level of distress, and quality-of-life domains.Methods: Participants were recruited from the otolaryngology-head and neck surgery clinics of two university teaching hospitals. Self-administered questionnaires included sociodemographic and medical questions, as well as validated measures such as the Supportive Care Needs Survey-Short Form (SCNS-SF34), the Hospital Anxiety and Depression Scale (HADS), and the Functional Assessment of Cancer Therapy-General (FACT-G) and Head and Neck Module (FACT-H&N) (quality of life measures).Results: One hundred and twenty-seven patients participated in the survey. 68% of them experienced unmet needs, and 25% revealed a clinically significant distress level on the HADS. The highest unmet needs were psychological (7 of top 10 needs). A multiple linear regression indicated a higher level of overall unmet needs when patients were divorced, had a high level of anxiety (HADS subscale), were in poor physical condition, or had a diminished emotional quality of life (FACT-G subscales).Significance of results: The results of this study highlight the overwhelming presence of unmet psychological needs in head and neck cancer patients and underline the importance of implementing interventions to address these areas perceived by patients as important. In line with hospital resource allocation and cost-effectiveness, one may also contemplate screening patients for high levels of anxiety, as well as target patients who are divorced and present low levels of physical well-being, as these patients may have more overall needs to be met.