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Li J, Ma C. Anxiety and depression during 3-year follow-up period in postoperative gastrointestinal cancer patients: prevalence, vertical change, risk factors, and prognostic value. Ir J Med Sci 2023; 192:2621-2629. [PMID: 36862310 DOI: 10.1007/s11845-023-03318-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 02/13/2023] [Indexed: 03/03/2023]
Abstract
BACKGROUND Anxiety and depression are common issues in gastrointestinal cancer, bringing negative impacts on patients' quality of life and long-term prognosis. This study aimed to identify the prevalence, longitudinal variation, risk factors, and prognostic value of anxiety and depression in postoperative gastrointestinal cancer patients. METHODS A total of 320 gastrointestinal cancer patients after surgical resection (210 colorectal cancer (CRC) patients and 110 gastric cancer (GC) patients) were enrolled in this study. During the 3-year follow-up period, Hospital Anxiety and Depression Scale (HADS)-anxiety (HADS-A) and HADS-depression (HADS-D) scores were determined at baseline, 12th month (M12), 24th month (M24), and 36th month (M36). RESULTS The prevalence of anxiety and depression at baseline was 39.7% and 33.4% in postoperative gastrointestinal cancer patients, respectively. Female (vs. male), single/divorced/widowed (vs. married), CRC (vs. GC), hypertension, higher TNM stage, neoadjuvant chemotherapy, and postoperative complications were independent risk factors of anxiety or depression in patients with gastrointestinal cancer (all P < 0.050). Furthermore, anxiety (P = 0.014) and depression (P < 0.001) were associated with shortened overall survival (OS); after further adjustment, depression was independently linked with shortened OS (P < 0.001), while anxiety was not. During the follow-up period, HADS-A score (from 7.78 ± 3.180 to 8.57 ± 2.854, P < 0.001), HADS-D score (from 7.23 ± 2.711 to 8.01 ± 2.786, P < 0.001), anxiety rate (from 39.7 to 49.2%, P = 0.019), and depression rate (from 33.4 to 42.6%, P = 0.023) were all gradually increased from baseline to M36. CONCLUSION Anxiety and depression gradually exacerbate and relate to poor survival in postoperative gastrointestinal cancer patients.
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Affiliation(s)
- Jiaying Li
- Department of Colorectal Cancer Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150086, China
| | - Chongyi Ma
- Department of Cardiovascular Surgery, The Second Affiliated Hospital of Harbin Medical University, No. 246 Xuefu Road, Nangang District, Harbin, Heilongjiang, 150086, China.
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Zucca A, Mansfield E, Sanson-Fisher R, Wyse R, Johnston SA, Fakes K, Robinson S, Smith S. Perceived Provision of Perioperative Information and Care by Patients Who Have Undergone Surgery for Colorectal Cancer: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15249. [PMID: 36429966 PMCID: PMC9690373 DOI: 10.3390/ijerph192215249] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/11/2022] [Accepted: 11/15/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Active patient participation in preparation and recovery from colorectal cancer surgery can be facilitated by timely information and care and may improve patient wellbeing and reduce hospitalizations; Methods: We aimed to identify gaps in perioperative information and care by asking colorectal cancer surgical patients to retrospectively report on their perceptions of care via a cross-sectional survey; Results: Overall, 179 (64% consent rate) patients completed one of two 64-item surveys exploring their views of 'optimal care' or their experiences of 'actual care'. In total, 41 (64%) aspects of care were endorsed as optimal. Of these, almost three-quarters (73%) were received by most patients (80% or more). Gaps in care were identified from discrepancies in the endorsement of optimal versus actual survey items. Of the 41 items identified as representing 'optimal care', 11 items were received by fewer than 80% of patients, including the provision of information about the impact of surgical wait-times on cancer cure (69%); pre-habilitation behaviors to improve health (75%); the type of questions to ask the health care team (74%); impact of pain medications on bowel movements (73%); how to obtain medical supplies for self-care at home (67%); dietary or exercise advice after discharge (25-31%); and emotional advice after discharge (44%). CONCLUSIONS These gaps represent patient-centered priorities and targets for supportive interventions.
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Affiliation(s)
- Alison Zucca
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, NSW 2308, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Newcastle, NSW 2308, Australia
| | - Elise Mansfield
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, NSW 2308, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Newcastle, NSW 2308, Australia
| | - Rob Sanson-Fisher
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, NSW 2308, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Newcastle, NSW 2308, Australia
| | - Rebecca Wyse
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, NSW 2308, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Newcastle, NSW 2308, Australia
| | - Sally-Anne Johnston
- Department of Colorectal Surgery, Division of Surgery, John Hunter Hospital, New Lambton Heights, NSW 2305, Australia
| | - Kristy Fakes
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, NSW 2308, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Newcastle, NSW 2308, Australia
| | - Sancha Robinson
- Department of Anaesthesia, John Hunter Hospital, New Lambton Heights, NSW 2305, Australia
- Department of Anaesthesia, Calvary Mater Newcastle Hospital, Newcastle, NSW 2298, Australia
| | - Stephen Smith
- Department of Colorectal Surgery, Division of Surgery, John Hunter Hospital, New Lambton Heights, NSW 2305, Australia
- Department of Surgery, Calvary Mater Newcastle Hospital, Newcastle, NSW 2298, Australia
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Zhang X, Xu W, Sang G, Yu D, Shi Q. A measure for perioperative anxiety symptoms in patients with FUAS - treated uterine fibroids: development and validation. Int J Hyperthermia 2022; 39:525-529. [PMID: 35300541 DOI: 10.1080/02656736.2022.2051612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVE To develop a scale that measured the perioperative anxiety symptoms of uterine fibroids (PASM-UF) treated with focused ultrasound ablation surgery (FUAS). METHODS A panel of gynecologists, nurses, and patient-reported outcome (PRO) experts created a draft of the PASM-UF scale. Women who underwent FUAS for uterine fibroids were recruited for its psychometric validation. Assessments were conducted during admission, before surgery, and at discharge. The Symptom Checklist-90 (SCL-90) was administered to assess criterion validity. We assessed the relationship between the developed PASM-UF and the SCL-90 via a correlation analysis. Cronbach's alpha was used to assess internal consistency for reliability. RESULTS We included five items, pain, lack of appetite, fatigue (tiredness), disturbed sleep, and anxiety, in the final version of the PASM-UF. Data were collected from 228 patients. Cronbach's alpha was 0.745, whereas the correlation coefficient between SCL-90 and PASM-UF was 0.345 (p < 0.001). The total PASM-UF scores were significantly higher in patients whose SCL-90 scores were ≥160 compared to those with <160 (9.85 ± 9.07 vs. 4.01 ± 5.15, p = .002). Those who did not complete the SCL-90 reported lower PASM-UF scores than those who did (2.33 ± 3.27 vs. 4.67 ± 5.99, p = .006). Patients reported significantly lower PASM-UF scores postoperatively than preoperatively (2.95 ± 4.18 vs. 3.92 ± 4.90, p = .002). CONCLUSIONS The PASM-UF is a valid, reliable, and sensitive scale for assessing perioperative anxiety levels among women with uterine fibroids. Statistical analysis suggests that it is also an effective instrument for scientific research.Key MessageWe developed a brief scale to assess anxiety in perioperative patients with uterine fibroids. In addition, the scale monitored the anxiety levels at multiple frequencies and did not increase burden on the patients. The scale has been proven to be effective, reliable, and highly sensitive.
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Affiliation(s)
- Xin Zhang
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China
| | - Wei Xu
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Guowei Sang
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China
| | - Dan Yu
- Chongqing Haifu Hospital, Chongqing, China
| | - Qiuling Shi
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China.,School of Public Health and Management, Chongqing Medical University, Chongqing, China
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Taha A, Taha-Mehlitz S, Staartjes VE, Lunger F, Gloor S, Unger I, Mungo G, Tschuor C, Breitenstein S, Gingert C. Association of a prehabilitation program with anxiety and depression before colorectal surgery: a post hoc analysis of the pERACS randomized controlled trial. Langenbecks Arch Surg 2021; 406:1553-1561. [PMID: 33782738 DOI: 10.1007/s00423-021-02158-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 03/24/2021] [Indexed: 12/12/2022]
Abstract
PURPOSE Hospital-associated anxiety and depression are major preoperative stressors and common in colorectal cancer surgery and major abdominal surgery. The prehabilitation Enhanced Recovery After Colorectal Surgery (pERACS) study is a single-center, single-blinded randomized controlled trial (RCT) evaluating the effect of a structured prehabilitation program. We evaluate within this RCT the association of a prehabilitation program with anxiety and depression before colorectal surgery. METHODS Treatment allocation randomized and single-blinded. Regardless of group allocation, patients were treated according to our institutional Enhanced Recovery After Surgery (ERAS) protocol. Inclusion criteria consisted of adult patients suffering from colorectal disease requiring surgical treatment and who were treated according to the ERAS protocol. Anxiety and depression scores were assessed at baseline and at admission according to the Hospital Anxiety and Depression Scale (HADS), with its subcomponents for depression (HADS-D) and for anxiety (HADS-A). RESULTS A total of 23 patients randomized to prehabilitation (mean age: 64.8±11.5 years) and 25 patients randomized to the control group (64.0±11.9 years) were included. There was no statistically significant difference in HADS-Anxiety improvement (Prehabilitation: -1.7±2.8 points vs. control: -0.4±3.4 points, p=0.132). Similarly, the difference in HADS-Depression improvement among the prehabilitation (1.0±2.4 points) and control (-0.3 ± 4.0 points) groups (p = 0.543) was non-significant. Clinically meaningful improvement in anxiety (60.9%/40.0%, p=0.149) and depression (34.8%/20.0%, p=0.250) was similar among the groups. CONCLUSION In a post hoc analysis of a randomized trial, prehabilitation had no effect on preoperative reduction of anxiety and depression measures. TRIAL REGISTRATION NUMBER Clinicaltrials.gov NCT02746731. Date of registration: April 21, 2016.
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Affiliation(s)
- Anas Taha
- Department of Visceral and Thoracic Surgery, Cantonal Hospital Winterthur, Brauerstrasse 15, CH-8401, Winterthur, Switzerland.
| | - Stephanie Taha-Mehlitz
- Clarunis, Department of Visceral Surgery, University Centre for Gastrointestinal and Liver Diseases, St. Clara Hospital and University Hospital Basel, Postfach, CH-4002, Basel, Switzerland
| | - Victor E Staartjes
- Faculty of Medicine, University of Zurich, Rämistrasse 71, CH-8006, Zurich, Switzerland
| | - Fabian Lunger
- Department of Visceral Surgery and Medicine, Berne University Hospital, Freiburgstrasse 18, CH-3010, Berne, Switzerland
| | - Severin Gloor
- Department of Visceral Surgery and Medicine, Berne University Hospital, Freiburgstrasse 18, CH-3010, Berne, Switzerland
| | - Ines Unger
- Institute for Therapies and Rehabilitation, Cantonal Hospital Winterthur, Brauerstrasse 15, CH-8401, Winterthur, Switzerland
| | - Giuseppe Mungo
- Institute for Therapies and Rehabilitation, Cantonal Hospital Winterthur, Brauerstrasse 15, CH-8401, Winterthur, Switzerland
| | - Christoph Tschuor
- Division of Visceral Surgery and Transplantation, University Hospital Zurich, Rämistrasse 100, CH-8091, Zurich, Switzerland.,Department of Surgery, Atrium Health, Carolinas Medical Center, Charlotte, NC, USA
| | - Stefan Breitenstein
- Department of Visceral and Thoracic Surgery, Cantonal Hospital Winterthur, Brauerstrasse 15, CH-8401, Winterthur, Switzerland
| | - Christian Gingert
- Department of Visceral and Thoracic Surgery, Cantonal Hospital Winterthur, Brauerstrasse 15, CH-8401, Winterthur, Switzerland
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Casarin J, Cromi A, Sgobbi B, Di Siena A, Serati M, Bolis ME, Ghezzi F. Music Therapy for Preoperative Anxiety Reduction in Women Undergoing Total Laparoscopic Hysterectomy: A Randomized Controlled Trial. J Minim Invasive Gynecol 2021; 28:1618-1624.e1. [PMID: 33549732 DOI: 10.1016/j.jmig.2021.02.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 01/26/2021] [Accepted: 02/02/2021] [Indexed: 12/23/2022]
Abstract
STUDY OBJECTIVE To assess the superiority of a music therapy intervention (Music) vs usual care (Control) in reducing the preoperative anxiety of patients undergoing total laparoscopic hysterectomy (TLH) with nononcologic indications. DESIGN This was a 1:2 (Music vs Control) randomized controlled study. SETTING A teaching hospital. PATIENTS One hundred patients were available for the analysis: 30 and 70 in the Music and Control arms, respectively. INTERVENTIONS Perioperative music therapy pathway in patients undergoing TLH for benign disease. MEASUREMENTS AND MAIN RESULTS Anxiety was evaluated with the State-Trait Anxiety Inventory Y Form (STAI-Y) at different time points: at baseline and during preoperative, early postoperative, and late postoperative periods. Pathologic anxiety was defined as STAI-Y state >45. Postoperative pain was registered using the visual analog scale. Women in the Music arm experienced lower anxiety levels (median STAI-Y scores 38.0 vs 41.0; p = .002) during the preoperative period. STAI-Y scores did not vary significantly by intervention at each subsequent time point. A significant difference between the groups (Music vs Control) was found in the proportion of women with pathologic anxiety during the preoperative (16.7% vs 37.2%; p = .04) and early postoperative periods (0% vs 12.9%; p = .04), whereas no significant difference between the groups was registered during the late postoperative period (6.6% vs 7.1%; p = .93). Postoperative pain intensity did not significantly differ between the groups at 1, 3, and 6 hours after surgery. CONCLUSIONS Music therapy might be a viable complementary modality to usual surgical care in the gynecologic setting for its ability to significantly decrease preoperative anxiety in women undergoing TLH for benign conditions.
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Affiliation(s)
- Jvan Casarin
- Department of Obstetrics and Gynecology, Women's and Children's Del Ponte Hospital, University of Insubria, Varese, Italy (all authors).
| | - Antonella Cromi
- Department of Obstetrics and Gynecology, Women's and Children's Del Ponte Hospital, University of Insubria, Varese, Italy (all authors)
| | - Barbara Sgobbi
- Department of Obstetrics and Gynecology, Women's and Children's Del Ponte Hospital, University of Insubria, Varese, Italy (all authors)
| | - Anna Di Siena
- Department of Obstetrics and Gynecology, Women's and Children's Del Ponte Hospital, University of Insubria, Varese, Italy (all authors)
| | - Maurizio Serati
- Department of Obstetrics and Gynecology, Women's and Children's Del Ponte Hospital, University of Insubria, Varese, Italy (all authors)
| | - Maria Elena Bolis
- Department of Obstetrics and Gynecology, Women's and Children's Del Ponte Hospital, University of Insubria, Varese, Italy (all authors)
| | - Fabio Ghezzi
- Department of Obstetrics and Gynecology, Women's and Children's Del Ponte Hospital, University of Insubria, Varese, Italy (all authors)
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Zhou Z, Wang Y, Niu Y, He Z, Huang M, Zhou Y, Lv W, Hu J. How we assess the perioperative anxiety of surgical patients with pulmonary nodules: the revision of state-trait anxiety inventory. J Cardiothorac Surg 2020; 15:324. [PMID: 33115530 PMCID: PMC7592361 DOI: 10.1186/s13019-020-01338-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Accepted: 09/22/2020] [Indexed: 01/17/2023] Open
Abstract
PURPOSE The aim of the study was to develop a short form of State-Trait Anxiety Inventory (STAI) and calculate the norms for the assessment of anxiety in surgical patients in mainland China. METHODS Patients who were scheduled to carry out pulmonary surgery in our department were included. The sinicized 40-item STAI Form-Y was used to assess the anxiety on the surgery eve. Then the coefficient of variation, coefficient of correlation, stepwise regression analysis, principal component analysis, and structural equation model were successively to filter the items. The reliability and validity of the revised STAI was estimated and the norms were computed. RESULTS 445 intact replies were collected. A 13-item STAI with 6 items in state subscale and 7 items in trait subscale produced similar scores with the full version of STAI. The Cronbach alpha coefficients for the state and trait subscales were 0.924 and 0.936, respectively. The determinant coefficients were 0.781 and 0.822, respectively. Moreover, the norms of both state subscale and trait subscale are provided according to the age and gender. CONCLUSIONS The revised short form of STAI has good reliability and validity. It is likely to be more acceptable by reducing the fatigue effects, and is suitable for follow-up study on the assessment and intervention of perioperative anxiety of surgical patients with pulmonary nodules.
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Affiliation(s)
- Zhenyu Zhou
- Department of Thoracic Surgery, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, China
| | - Ying Wang
- Operation Room, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, China
| | - Yuequn Niu
- Department of Thoracic Surgery, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, China
| | - Zhehao He
- Department of Thoracic Surgery, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, China
| | - Manli Huang
- Department of Psychiatry, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, China
| | - Yuqiong Zhou
- Operation Room, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, China
| | - Wang Lv
- Department of Thoracic Surgery, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, China
| | - Jian Hu
- Department of Thoracic Surgery, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, China.
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Williams H, Jajja MR, Baer W, Balch GC, Maithel SK, Patel AD, Patel D, Patel SG, Stetler JL, Winer JH, Gillespie TW, Kooby DA. Perioperative anxiety and depression in patients undergoing abdominal surgery for benign or malignant disease. J Surg Oncol 2019; 120:389-396. [DOI: 10.1002/jso.25584] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Revised: 04/23/2019] [Accepted: 05/24/2019] [Indexed: 11/11/2022]
Affiliation(s)
| | - Mohammad Raheel Jajja
- Department of SurgeryEmory University Atlanta Georgia
- Winship Cancer Institute, Emory University Atlanta Georgia
| | - Wendy Baer
- Winship Cancer Institute, Emory University Atlanta Georgia
- Department of PsychiatryEmory University Atlanta Georgia
| | - Glen C. Balch
- Department of SurgeryEmory University Atlanta Georgia
- Winship Cancer Institute, Emory University Atlanta Georgia
| | - Shishir K. Maithel
- Department of SurgeryEmory University Atlanta Georgia
- Winship Cancer Institute, Emory University Atlanta Georgia
| | | | - Dipan Patel
- Department of SurgeryEmory University Atlanta Georgia
| | | | | | - Joshua H. Winer
- Department of SurgeryEmory University Atlanta Georgia
- Winship Cancer Institute, Emory University Atlanta Georgia
| | - Theresa W. Gillespie
- Department of SurgeryEmory University Atlanta Georgia
- Winship Cancer Institute, Emory University Atlanta Georgia
| | - David A. Kooby
- Department of SurgeryEmory University Atlanta Georgia
- Winship Cancer Institute, Emory University Atlanta Georgia
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