转移性脊柱疾病患者问题清单项目与临床显著困扰之间的关系

IF 2.6 2区 医学 Q2 CLINICAL NEUROLOGY
Spine Pub Date : 2025-03-25 DOI:10.1097/BRS.0000000000005343
Dana G Rowe, Joshua Woo, Seeley Yoo, Jacqueline M Emerson, Ellen O'Callaghan, Michael Goodin, Kerri-Anne Crowell, Victoria Bradley, Jeremy Reynolds, Margaret O Johnson, Melissa M Erickson, C Rory Goodwin
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引用次数: 0

摘要

研究设计:回顾性队列研究。目的:本研究旨在确定转移性脊柱疾病患者痛苦的来源,并阐明与临床显著痛苦相关的因素。背景资料总结:癌症患者的苦恼与较差的预后和较低的生活质量有关。患有转移性脊柱疾病的患者特别容易受到临床显著程度的困扰。然而,导致这些患者痛苦的具体因素在很大程度上尚未被探索。方法:我们回顾性分析2015年至2023年接受手术的转移性脊柱疾病(MSD)患者的医疗记录。我们分析了手术前30天内国家综合癌症网络(NCCN)窘迫温度计(DT)评分和问题清单项目,这被定义为“基线”窘迫。我们计算了每个问题的出现频率和有临床显著困扰的患者比例(DT评分≥4)。我们使用卡方检验来分析问题列表项目与显著困扰之间的关联,结果的显著性阈值为:在160名MSD患者中,48.1%的患者报告有临床显著困扰。患者最常报告的是身体问题(93.8%),其次是情绪问题(55.6%)和实际问题(31.9%)。最常见的个人问题是疼痛(72.5%),其次是疲劳(48.1%)和担忧(41.2%)。情感(P=0.001)、实践(P=0.04)和社会关注(P=0.039)与临床显著的痛苦显著相关,但身体关注无显著相关性(P=0.05)。结论:尽管身体上的担忧在MSD患者中最常见,但在转移性脊柱疾病患者中,情绪和实际的担忧与显著的痛苦更密切相关。这些发现强调了多学科护理的必要性,重点关注情感和实际问题,以提高患者的生活质量。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Associations Between Problem List Items and Clinically Significant Distress in Patients with Metastatic Spine Disease.

Study design: Retrospective cohort study.

Objective: This study aimed to identify sources of distress in patients with metastatic spine disease and elucidate factors associated with clinically significant distress.

Summary of background data: Distress is associated with poorer outcomes and lower quality of life in cancer patients. Patients with metastatic spine disease are particularly vulnerable to clinically significant levels of distress. However, specific factors contributing to distress in these patients have been largely unexplored.

Methods: We retrospectively reviewed medical records of patients with metastatic spine disease (MSD) who underwent surgery from 2015 to 2023. We analyzed National Comprehensive Cancer Network (NCCN) Distress Thermometer (DT) scores and Problem List items within 30 days prior to surgery, which was defined as "baseline" distress. We calculated the frequency of each problem and the proportion of patients with clinically significant distress (DT score ≥4). We used chi-square tests to analyze associations between Problem List items and significant distress, with a significance threshold of P<0.05.

Results: Among 160 patients with MSD, 48.1% reported clinically significant distress. Patients most frequently reported Physical concerns (93.8%), followed by Emotional (55.6%) and Practical concerns (31.9%). The most common individual Problem List item was pain (72.5%), followed by fatigue (48.1%) and worry (41.2%). Emotional (P=0.001), Practical (P=0.04), and Social concerns (P=0.039) were significantly associated with clinically significant distress, but Physical concerns were not (P=0.05).

Conclusion: Though physical concerns were most common for patients with MSD, emotional and practical concerns were more strongly associated with significant distress among patients with metastatic spine disease. These findings highlight the need for multidisciplinary care focused on emotional and practical issues to enhance patients' quality of life.

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来源期刊
Spine
Spine 医学-临床神经学
CiteScore
5.90
自引率
6.70%
发文量
361
审稿时长
6.0 months
期刊介绍: Lippincott Williams & Wilkins is a leading international publisher of professional health information for physicians, nurses, specialized clinicians and students. For a complete listing of titles currently published by Lippincott Williams & Wilkins and detailed information about print, online, and other offerings, please visit the LWW Online Store. Recognized internationally as the leading journal in its field, Spine is an international, peer-reviewed, bi-weekly periodical that considers for publication original articles in the field of Spine. It is the leading subspecialty journal for the treatment of spinal disorders. Only original papers are considered for publication with the understanding that they are contributed solely to Spine. The Journal does not publish articles reporting material that has been reported at length elsewhere.
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