Evaluating the effect of patient education led by medical physicists on anxiety and depression induced by radiotherapy

评估由医学物理学家主导的患者教育对放射治疗引起的焦虑和抑郁的影响

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Abstract

The complex technical aspects of radiotherapy can be overwhelming for patients, exacerbating treatment-related anxiety and depression while reducing their satisfaction with medical care. To address this issue, we introduced an intervention where medical physicists directly offer technical consultation to patients undergoing radiotherapy. To assess its effectiveness, we conducted a randomized controlled clinical trial to examine the impact of this intervention on anxiety, depression, treatment adherence. This randomized controlled trial included first-time radiotherapy patients, randomized to a communication group (two face-to-face consultations with a medical physicist before simulation positioning and first treatment, involving explanations of radiotherapy technology, procedures, etc.) and a clinical group (standard process without physicist interaction). Assessments (anxiety via GAD-7, depression via PHQ-9, treatment understanding, satisfaction) were done at baseline, before simulation positioning, before first treatment, and after final treatment, analyzed with a generalized mixed-effects model. Eighty first-time radiotherapy patients completed the study, with no significant baseline differences between the communication (n = 40) and clinical groups (n = 40). Generalized mixed-effects models showed significant group × time interactions for PHQ-9 (F = 3.422, P = 0.018) and GAD-7 (F = 2.87, P = 0.037). At pre-simulation and pre-first treatment, both scores were significantly lower in the communication group (all P < 0.01), with no post-treatment differences. The communication group had earlier emotional improvement. Subgroup benefits were greater in patients ≤ 59 years, breast cancer patients, and female patients. Direct communication with medical physicists reduces radiotherapy-related anxiety and depression (significantly at intermediate stages). Subgroup differences exist, with breast cancer patients and those ≤ 59 years benefiting more.

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