Reijsenbach de Haan, R. (Romee) (2015) Psychological Distress During Waiting Time for Treatment of a Tumor in the Head and Neck Region. thesis, Medicine.
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Abstract
Introduction: Head and neck tumors (HNT) are the sixth most common tumor in the world with a mortality rate of over 50%. As HNT progress aggressively, rapid treatment is recommended for better prognosis. HNT have high symptom burden with loss of quality of life (QoL). HNT-patients are associated with mood disorders such as anxiety and depression. Pre-treatment psychological distress, measured in anxiety and depression, is associated with decreased QoL and worse clinical outcomes. This prospective cohort study investigates the course of distress and QoL during the interval between the first appointment and start of initial treatment at the Netherlands Cancer Institute (NCI). Furthermore, we explored possible correlations between the above parameters and patient characteristics. Methods: Patients were invited to participate during the first outpatient clinic consultation. Only patients with primary HNT intended to treat curatively were included. Current malignancy, prior HNT and psychological comorbidity were exclusion criteria. Participants and partners completed several questionnaires measuring psychological distress and Health-related quality of life (HRQoL): The Hospital Anxiety and Depression Scale (HADS), EORTC QLQ-H&N35 and Impact of Event Scale (IES) at 2-3 different points in tome while waiting for treatment. Results: 63 patients and 44 partners participated. Median overall waiting time between completion of the first questionnaire and start of treatment was 31 days, during which no significant changes in psychological distress were observed. Women reported significantly more anxiety than men at baseline. Partners indicated higher levels of distress and adjustment difficulties at all moments in time. Moderate to strong correlations were found between patient- and partner-reported distress levels. Significant changes in 4 of the symptoms of HRQoL were observed: Pain, problems with speech and social eating and weight gain. There was no significant change in overall QoL. Conclusion: In general, no change in distress was experienced whilst waiting for treatment. Patients at risk of increased distress were women, patients with children under the age of 18, patients lacking social support and patients in the low-medium socio-economic status quartile. Screening for pre-treatment distress using the HADS was advised as early psychological support may help reduce post-treatment distress.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Faculty supervisor : and Nijholt, Dr. Ingrid bureau of medical student residencies |
| Supervisor name: | Harten, Michel van researcher head and neck oncology and sur and Brekel, Prof. Dr. M.W.M. van den head and neck surgeon |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:46 |
| Last Modified: | 25 Jun 2020 10:46 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/738 |
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