文章：

结直肠癌腹膜转移术后患者生物心理社会远期效应的心理干预——可行性研究

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

原文发布日期：27 March 2025

DOI: 10.3390/cancers17071127

类型: Article

开放获取: 是

英文摘要：

Background: 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.Methods: 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.Results: 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 (p= 0.003, Hedges’s g 1.54), (2) the secondary LE (p< 0.001, Hedges’s g 1.65), and (3) general wellbeing (p= 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%).Conclusions: Screening for LEs and conducting an MDT can provide a personalized intervention plan, which patients are able to complete and may benefit from.

摘要翻译： 

背景：高达80%的结直肠癌腹膜转移患者在术后一年仍受晚期效应影响。本研究旨在评估针对此类晚期效应的治疗策略的可行性及临床效果。 方法：2021年1月至2023年5月期间，对丹麦地区接受结直肠癌腹膜转移手术的患者进行生物心理社会晚期效应筛查（包括焦虑、抑郁、癌症复发恐惧、失眠、认知障碍、疼痛及疲劳）。达到临床阈值的患者被转介至多学科团队会议。会议由患者、外科医生、护士及心理学家共同参与，通过识别核心问题制定个体化干预方案。干预前后采用"自我评估困扰与健康状态"量表，使用7级李克特量表对两项最困扰的晚期效应及整体健康状况进行评估。 结果：在28例符合条件患者中，13例（平均年龄59岁，女性占85%）接受转介并参与多学科团队会议，获得个体化干预方案。其中11例完成全部干预。干预后1个月，三项评估指标均显示显著改善：（1）主要晚期效应（p=0.003，Hedges's g=1.54）；（2）次要晚期效应（p<0.001，Hedges's g=1.65）；（3）整体健康状况（p=0.005，Hedges's g=1.09）。此改善效果在干预后6个月仍持续存在。15例未参与者普遍年龄较大（平均66岁，男性占73%）。 结论：晚期效应筛查及多学科团队会议可制定个体化干预方案，患者能够完成该方案并从中获益。

原文链接：

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