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 outcomeof Chinese esophageal cancer patients in a prospective study.
Methods: 60 patients with primary esophagealcarcinoma were randomized into an intervention group (IG, n=31) and a control group (CG, n=29). The Chineseversion 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 werethereafter evaluated accordingly before surgery, and 1 week, 4 weeks and 24 weeks post-surgery. Medical costswere estimated at discharge. Survival of patients was estimated each year post-surgery. General health statusand satisfaction-with-hospital were surveyed by a follow-up questionnaire 4 years post-surgery.
Results: All thesubjects demonstrated higher scores in the preoperative phase than the normal range of Chinese populationconcerning 7 psychological domains including somatization, obsessive-compulsive, depression, anxiety, hostility,phobic anxiety and paranoid ideation. Although no significant difference was observed between the two groupsat admission, the scores of IG, which tended to decrease at a faster rate, were generally lower than those of CGat weeks 1, 4 and 24 post-surgery. The length of hospital stay and medical costs of IG were significantly less thanthose of CG and satisfaction-with-hospital was better. However, there was no significant difference in 4-yearsurvival or health status between two groups.
Conclusions: Appropriate perioperative comprehensive supportivecare interventions help to improve the psychological state of Chinese patients with esophageal carcinoma, toreduce health care costs and to promote satisfaction of patients and their families with hospital.