Psychological effects of the intensified follow-up of the CEAwatch trial after treatment for colorectal cancer

Background
The aim of the study was to evaluate psychological effects of the state-of-art intensified follow-up protocol for colorectal cancer patients in the CEAwatch trial.
Method
At two time points during the CEAwatch trial questionnaires regarding patients’ attitude towards follow-up, patients’ psychological functioning and patients’ experiences and expectations were sent to participants by post. Linear mixed models were fitted to assess the influences and secular trends of the intensified follow-up on patients’ attitude towards follow-up and psychological functioning. As secondary outcome, odds ratios were calculated using ordinal logistic mixed model to compare patients’ experiences to their expectations, as well as their experiences at two different time points.
Results
No statistical significant effects of the intensified follow-up were found on patients’ attitude towards the follow-up and psychological functioning variables. Patients had high expectations of the intensified follow-up and their experiences at the second time point were more positive compared to the scores at the first time point.
Conclusion
The intensified follow-up protocol posed no adverse effects on patients’ attitude towards follow-up and psychological functioning. In general, patients were more nervous and anxious at the start of the new follow-up protocol, had high expectations of the new follow-up protocol and were troubled by the nuisances of the blood sample testing. As they spent more time in the follow-up and became more adapted to it, the nervousness and anxiety decreased and the preference for the frequent blood test became high in replacement of conversations with the doctors.

研究背景
本研究旨在评估CEAwatch试验中针对结直肠癌患者的前沿强化随访方案所产生的心理学影响。
研究方法
在CEAwatch试验期间，共设置两个时间节点，通过邮寄方式向受试者发放涵盖患者随访态度、心理功能以及诊疗体验与预期的问卷。本研究采用线性混合模型，以评估强化随访方案对患者随访态度及心理功能的影响与长期变化趋势。作为次要结局指标，本研究采用有序logistic混合模型计算比值比，以对比患者的诊疗体验与预期，以及不同时间节点下的诊疗体验差异。
研究结果
未发现强化随访方案对患者随访态度及心理功能相关变量存在统计学显著影响。患者对强化随访方案抱有较高预期，且第二时间节点的诊疗体验评分较第一时间节点更为积极。
研究结论
强化随访方案未对患者的随访态度及心理功能产生不良影响。总体而言，患者在新随访方案启动初期更为紧张焦虑，对新方案抱有较高预期，且因血液样本检测的繁琐流程而困扰。随着随访时长增加、患者逐渐适应随访流程后，其紧张与焦虑情绪有所缓解，且更倾向于接受高频血液检测以替代与医生的面诊沟通。