Perioperative comprehensive supportive care interventions for chinese patients with esophageal carcinoma: a prospective study.
OBJECTIVE
To assess the effects of perioperative comprehensive supportive care interventions on outcome of Chinese esophageal cancer patients in a prospective study.


METHODS
60 patients with primary esophageal carcinoma were randomized into an intervention group (IG, n=31) and a control group (CG, n=29). The Chinese version of symptom checklist-90 (SCL-90) was adopted to assess their psychological status. The interventions, including health education, psychological support, stress management, coping strategies and behavior training, were carried out in 3 phases (preoperative, postoperative I and postoperative II), and psychological effects were thereafter evaluated accordingly before surgery, and 1 week, 4 weeks and 24 weeks post-surgery. Medical costs were estimated at discharge. Survival of patients was estimated each year post-surgery. General health status and satisfaction-with-hospital were surveyed by a follow-up questionnaire 4 years post-surgery.


RESULTS
All the subjects demonstrated higher scores in the preoperative phase than the normal range of Chinese population concerning 7 psychological domains including somatization, obsessive-compulsive, depression, anxiety, hostility, phobic anxiety and paranoid ideation. Although no significant difference was observed between the two groups at admission, the scores of IG, which tended to decrease at a faster rate, were generally lower than those of CG at weeks 1, 4 and 24 post-surgery. The length of hospital stay and medical costs of IG were significantly less than those of CG and satisfaction-with-hospital was better. However, there was no significant difference in 4-year survival or health status between two groups.


CONCLUSIONS
Appropriate perioperative comprehensive supportive care interventions help to improve the psychological state of Chinese patients with esophageal carcinoma, to reduce health care costs and to promote satisfaction of patients and their families with hospital.
Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China E-mail : zhaoqy@sysucc.org.cn.
Xiao-Dan
XD
Zhang
Qing-Yu
QY
Zhao
Yi
Y
Fang
Guan-Xuan
GX
Chen
Hui-Fang
HF
Zhang
Wen-Xiao
WX
Zhang
Xiao-Ping
XP
Yang
D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000517:prevention & control* / Q000523:psychology; D016022:Case-Control Studies; D002681:China; D003376:Counseling; D003863:Depression / Q000517:prevention & control* / Q000523:psychology; D004938:Esophageal Neoplasms / Q000523:psychology* / Q000534:rehabilitation / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010166:Palliative Care; D019990:Perioperative Care; D011379:Prognosis; D011446:Prospective Studies; D013315:Stress, Psychological / Q000517:prevention & control*; D011795:Surveys and Questionnaires; D055815:Young Adult