Prevalence of Psychological Symptoms in Patients Undergoing Pancreatoduodenectomy and Results of a Distress Management System: A Clinic-Based Study
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose: Patients undergoing pancreatoduodenectomy are a high-risk group that requires psychosocial support. This study retrospectively reviewed the prevalence of psychological symptoms in patients undergoing pancreatoduodenectomy for periampullary neoplasm and the psychosocial referral rate after implementing full screening and triage algorithm for administering a distress management protocol based on the integrated supportive care system established in 2010. Materials and methods: From September 2010 to December 2018, insomnia, anxiety, and depression were screened on the first day of admission (T1) and on the 10th postoperative day (T2). Patients with clinical levels of distress were referred to a mental health clinic for appropriate aftercare. Results: The adherence rate to routine screening was 82.7% (364/440). Among the 364 patients, the prevalence of insomnia, anxiety, and depression increased from 22.0% (T1) to 32.6% (T2, p=0.001), 29.1% to 33.6% (p=0.256), and 18.4% to 27.6% (p=0.001), respectively. Less than 45% of those with psychological symptoms expressed their needs for psychological supportive care. Among those with psychological symptoms at T2, clinical insomnia, anxiety, and depression were detected via in-depth evaluations among 77.2%, 38.1%, and 82.5% of patients, respectively. Patients who had two or more symptoms at T2 had a longer postoperative hospital stay, as compared to those with one or no symptoms (a median of 20.5 days vs. 18.0 days, p=0.006). Psychiatric consultation rate was 72.8% among patients with clinical psychological symptoms, and 74% of the consulted patients completed psychiatric intervention before discharge. Conclusion: Over one-third of the patients had psychological symptoms before and after pancreatoduodenectomy. Implementing a routine psychological symptoms screening with a systematic psychiatric referral protocol enhanced surgeons' responsiveness to patients' psychological symptoms.
Abstract
Purpose: Patients undergoing pancreatoduodenectomy are a high-risk group that requires psychosocial support. This study retrospectively reviewed the prevalence of psychological symptoms in patients undergoing pancreatoduodenectomy for periampullary neoplasm and the psychosocial referral rate after implementing full screening and triage algorithm for administering a distress management protocol based on the integrated supportive care system established in 2010. Materials and methods: From September 2010 to December 2018, insomnia, anxiety, and depression were screened on the first day of admission (T1) and on the 10th postoperative day (T2). Patients with clinical levels of distress were referred to a mental health clinic for appropriate aftercare. Results: The adherence rate to routine screening was 82.7% (364/440). Among the 364 patients, the prevalence of insomnia, anxiety, and depression increased from 22.0% (T1) to 32.6% (T2, p=0.001), 29.1% to 33.6% (p=0.256), and 18.4% to 27.6% (p=0.001), respectively. Less than 45% of those with psychological symptoms expressed their needs for psychological supportive care. Among those with psychological symptoms at T2, clinical insomnia, anxiety, and depression were detected via in-depth evaluations among 77.2%, 38.1%, and 82.5% of patients, respectively. Patients who had two or more symptoms at T2 had a longer postoperative hospital stay, as compared to those with one or no symptoms (a median of 20.5 days vs. 18.0 days, p=0.006). Psychiatric consultation rate was 72.8% among patients with clinical psychological symptoms, and 74% of the consulted patients completed psychiatric intervention before discharge. Conclusion: Over one-third of the patients had psychological symptoms before and after pancreatoduodenectomy. Implementing a routine psychological symptoms screening with a systematic psychiatric referral protocol enhanced surgeons' responsiveness to patients' psychological symptoms.
참고문헌 (24)
- Clark KL, "Psychological distress in patients with pancreatic cancer : an understudied group", Psychooncology, 19, pp.1313~1320 (2010)
- Linden W, "Anxiety and depression after cancer diagnosis : prevalence rates by cancer type, gender, and age", J Affect Disord, 141, pp.343~351 (2012)
- Reilly CM, "A literature synthesis of symptom prevalence and severity in persons receiving active cancer treatment", Support Care Cancer, 21, pp.1525~1550 (2013)
- Bubis LD, "Symptom burden in the first year after cancer diagnosis : an analysis of patient-reported outcomes", J Clin Oncol, 36, pp.1103~1111 (2018)
- Mitchell AJ, "Screening for cancer-related distress : when is implementation successful and when is it unsuccessful?", Acta Oncol, 52, pp.216~224 (2013)
- Cloyd JM, "Impact of pancreatectomy on long-term patient-reported symptoms and quality of life in recurrence-free survivors of pancreatic and periampullary neoplasms", J Surg Oncol, 115, pp.144~150 (2017)
- Petzel MQ, "Fear of cancer recurrence after curative pancreatectomy : a cross-sectional study in survivors of pancreatic and periampullary tumors", Ann Surg Oncol, 19, pp.4078~4084 (2012)
- Beesley VL, "A tsunami of unmet needs : pancreatic and ampullary cancer patients’ supportive care needs and use of community and allied health services", Psychooncology, 25, pp.150~157 (2016)
- Lounis L, "Psychological outcomes and quality of life in relation to pancreatectomy : a systematic review", Pancreas, 48, pp.471~479 (2019)
- Tung S, "Population-level symptom assessment following pancreaticoduodenectomy for adenocarcinoma", JAMA Surg, 154, pp.e193348~ (2019)
- Yu ES, "Development of guidelines for distress management in Korean cancer patients", Psychooncology, 21, pp.541~549 (2012)
- Shim EJ, "Development and validation of the National Cancer Center Psychological Symptom Inventory", Psychooncology, 26, pp.1036~1043 (2017)
- Bastien CH, "Validation of the Insom-nia Severity Index as an outcome measure for insomnia research", Sleep Med, 2, pp.297~307 (2001)
- 조용원, "Validation of a Korean Version of the Insomnia Severity Index", Journal of Clinical Neurology, 10(3), pp.210~215 (2014), 대한신경과학회[DOI]
- Spielberger CD, "Manual for the State-Trait Anxiety Inventory" (1970), Consulting Psychologists Press
- Kim JT, "A study of the relationship between trait anxiety and social tendency", J Human Underst Couns, 1, pp.16~26 (1978)
- Beck AT, "An inventory for measuring depression", Arch Gen Psychiatry, 4, pp.561~571 (1961)
- Lee YH, "A study of the reliability and the validity of the BDI, SDS, and MMPI-D scales", Korean J Clin Psychol, 10, pp.98~113 (1991)
- Jiyoung Kim, "Surgical impact on anxiety of patients with breast cancer: 12-month follow-up prospective longitudinal study", Annals of Surgical Treatment and Research, 98(5), pp.215~223 (2020), 대한외과학회[DOI]
- Lee HJ, "Psycho-oncology in Korea : past, present and future", Biopsychosoc Med, 11, pp.12~ (2017)
- Zebrack B, "Psychosocial distress screening implementation in cancer care : an analysis of adherence, responsiveness, and acceptability", J Clin Oncol, 33, pp.1165~1170 (2015)
- Prodinger B, "Improving quality of care through patient-reported outcome measures(PROMs) : expert interviews using the NHS PROMs Programme and the Swedish quality registers for knee and hip arthroplasty as examples", BMC Health Serv Res, 18, pp.87~ (2018)
- van Rijssen LB, "Core Set of Patient-reported Outcomes in Pancreatic Cancer(COPRAC) : an international delphi study among patients and health care providers", Ann Surg, 270, pp.158~164 (2019)
- Cherkaoui Z, "A standard set of value-based patient-centered outcomes for pancreatic carcinoma : an international delphi survey", Ann Surg Oncol, 28, pp.1069~1078 (2021)