The Role of Telemedicine for Psychological Support for Oncological Patients Who Have Received Radiotherapy
2. Materials and Methods
- A descriptive collection of personality features, psychosocial elements and cognitive and emotional processing capacity regarding the event, paying attention to the patient’s history.
- An evaluation of anxiety and depression with Hospital Anxiety Depression Scale (HADS) [31,32], which is a four-point scale (from 0 to 3) consisting of 14 questions to which the patients had to respond, referring to their symptoms during the previous week. The HADS scale is divided into 2 subscales which investigate anxiety (HADS-A) and depression (HADS-D), respectively. Seven of the 14 elements of the HADS scale correspond to the HADS-A subscale and the remaining 7 to the HADS-D subscale, ranging from 0 (no discomfort) to 21 (extreme discomfort). Scores of 8 or more in both subscales indicate the presence of a disorder.
- An evaluation of distress using the Distress Thermometer (DT) . It is a single-item instrument, consisting of a visual analog scale and represented by a thermometer ranging from 0 (no discomfort) to 10 (extreme discomfort). A score of 4 or more indicates the presence of a disorder.
- An assessment of the varying coping strategies used by patients in response to stress by the Brief COPE (BC) [34,35]. It is an instrument composed of 14 scales for a total of 28 items (positive restructuring, distracting attention, expression, use of instrumental support, operational coping, denial, religion, humor, behavioral disengagement, use of emotional support, substance use, acceptance, planning, self-accusation).
- An evaluation of post-traumatic stress symptoms using the Impact of Event Scale-revised (IES-R) . The IES-R is a 22-item self-report measure (for DSM-IV) that assesses subjective distress caused by traumatic events. It is a revised version of the older version; the IES-R contains 7 additional items related to the hyperarousal symptoms of PTSD (post-traumatic stress disorder), which were not included in the original IES. Respondents are asked to identify a specific stressful life event and then indicate how much they were distressed or bothered during the previous seven days by each “difficulty” listed. Items are rated on a 5-point scale ranging from 0 (“not at all”) to 4 (“extremely”). The IES-R yields a total score (ranging from 0 to 88); significant symptoms were defined by a score of more than 33.
3.1. Overall Population Who Received Psychological Assessment during RT
Population Followed after RT: Tele-Visit Versus in-Person Evaluation
- First of all, in the TC group, a predominance of poor-prognosis diseases was present (brain tumor, metastatic tumor and head and neck tumor), with a high incidence of recurrence post-treatment and a subsequent higher anxiety score.
- In the OS group, most of the patients had breast cancer (young patients with good prognosis); the high level of anxiety (Figure 2) was also reduced during follow-up because no recurrence was reported.
- For phycologists, the evaluation of expression throughout the body is more difficult to evaluate during tele-consults; thus, the psychological strategy could be longer and less precise. The present data are in line with a recent Cochrane publication. The predominance of telephone-delivered interventions for psychological symptoms is unsurprising. Telephone counseling has been shown to be effective in reducing psychological symptoms, including depression and anxiety, in patient populations other than those affected by cancer. Further, this review has demonstrated that telephone-delivered interventions are being developed for managing a range of physical as well as psychological cancer-related symptoms .
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
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|Total Number of Patients (pts)||82|
|Group OS||30 pts (36.6%)|
|Median age (range)||51 years (35–67)|
|Type of cancer|
|Median RT session (range)||21 (5–30)|
|Median psycho-therapeutic meetings (range)||3.5 (2–5)|
|Median psycho-therapeutic meetings in FUP (range)||8 (4–28)|
|Group TC||52 pts (63.4%)|
|Median age (range)||48.5 years (18–75)|
|Type of cancer|
|Median RT session (range)||23 (10–33)|
|Median psycho-therapeutic meetings (range)||4 (2–6)|
|Median psycho-therapeutic meetings in FUP (range)||8 (4–24)|
|RT: radiotherapy; OS: on-site; TC: tele-consult|
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Caliandro, M.; Carbonara, R.; Surgo, A.; Ciliberti, M.P.; Di Guglielmo, F.C.; Bonaparte, I.; Paulicelli, E.; Gregucci, F.; Turchiano, A.; Fiorentino, A. The Role of Telemedicine for Psychological Support for Oncological Patients Who Have Received Radiotherapy. Curr. Oncol. 2023, 30, 5158-5167. https://doi.org/10.3390/curroncol30050390
Caliandro M, Carbonara R, Surgo A, Ciliberti MP, Di Guglielmo FC, Bonaparte I, Paulicelli E, Gregucci F, Turchiano A, Fiorentino A. The Role of Telemedicine for Psychological Support for Oncological Patients Who Have Received Radiotherapy. Current Oncology. 2023; 30(5):5158-5167. https://doi.org/10.3390/curroncol30050390Chicago/Turabian Style
Caliandro, Morena, Roberta Carbonara, Alessia Surgo, Maria Paola Ciliberti, Fiorella Cristina Di Guglielmo, Ilaria Bonaparte, Eleonora Paulicelli, Fabiana Gregucci, Angela Turchiano, and Alba Fiorentino. 2023. "The Role of Telemedicine for Psychological Support for Oncological Patients Who Have Received Radiotherapy" Current Oncology 30, no. 5: 5158-5167. https://doi.org/10.3390/curroncol30050390