HAPPY protocol impact on psychological well-being in patients with gynecological cancer
Valentina Lancellotta,
Italy
PO-1434
Abstract
HAPPY protocol impact on psychological well-being in patients with gynecological cancer
Authors: Valentina Lancellotta1, Loredana Dinapoli2, Silvia Mancini3, Alessandra Salvati3, Patrizia Cornacchione2, Giuseppe Ferdinando Colloca2, Martina De Angeli4, Bruno Fionda2, Gabriella Macchia5, Sara Scalise2, Maria Antonietta Gambacorta2, Luca Tagliaferri2
1Fondazione Policlinico Gemelli IRCCS, Radiation Oncology, Rome, Italy; 2Fondazione Policlinico Universitario A. Gemelli IRCCS, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Rome, Italy; 3Università Cattolica del Sacro Cuore, Radiation Oncology, Rome, Italy; 4Università di Roma Tor Vergata, Radiation Oncology, Rome, Italy; 5Gemelli Molise Hospital – Università Cattolica del Sacro Cuore, Radiation Oncology Unit, Campobassso, Italy
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Purpose or Objective
Providing information in line with patients’ needs is an important determinant for patient satisfaction and might also affect, distress, anxiety and depression levels of cancer survivors. HAPPY protocol (Humanity Assurance Protocol in interventional radiotheraPY) defined the needs of patients undergoing interventional radiotherapy (IRT, also called brachytherapy) for gynecological cancer. This study assessed the effectiveness of 8 suggestions/interventions for enhancing the patient's psychological wellbeing throughout IRT.
Material and Methods
Patients with gynecological cancer (endometrial and cervical cancer) undergoing IRT-HDR were included into the study. Three questionnaries were completed by patients both before and after IRT (T0 and T1): the Distress Thermometer (DT, a self-reported international standardized tool using a 0-to-10 rating scale); the Numerical Rating Scale (NRS), which allows patients to rate their discomfort throughout an IRT procedure by assigning a value between 0 and 10; the Hospital Anxiety and Depression Scale (HADS, a well validated and reliable self-reported measure designed to identify the presence and severity of anxiety and depression in cancer patients). During the IRT-HDR procedure was applied the HAPPY protocol.
Results
Fifty-five patients affected by gynecological cancer (42 endometrial, 13 cervical cancer) and treated with high-dose-rate (HDR)-IRT were selected from January to May 2022. The median age was 64 (range, 35-84) years. According to the International Federation of Gynecology and Obstetrics 2018, the majority of patients have Stage I endometrial cancer (29/42) and all patients with cervical cancer have a locally advanced stage (IB3-IVA).Most of patients have high education (51 patients, 92.7%) and are married or living with partner (38 patients, 69%). Only 14 patients (25.45%) are currently working. The HADS, DT and NRS average before IRT were 13.14, 4.58 and 5, respectively. The HADS, DT and NRS average after IRT and HAPPY protocol delivery were 12.31, 3.87 and 3.25, respectively. A Wilcoxon signed rank test analysis comparing T0 vs T1 scores showed a significant improvement in DT (p=0.0251), NRS (p< 0.00001) and HADS (p=0.034) (Table1).
Conclusion
Interventional radiotherapy can be perceived as a stressful experience causing anxiety and distress for most women. The emotional state of patients undergoing IRT can be improved by adhering to clear interventions/recommendations provided before IRT, which are effective and affordable adjuncts, with the cooperation of an integrated, interdisciplinary team, and can be a positive predictor for psychological outcome.