Assessment of Psychological Burden in Individuals with Hereditary Risk of Pancreatic Cancer Under Surveillance: Evaluation of Distress 3 Years After Enrollment
Notice bibliographique
Résumé
Background: Pancreatic cancer (PC) remains one of the deadliest malignancies, with long-term survival often reliant on early detection through surgery and chemotherapy. Unfortunately, the late-stage presentation of the disease contributes to its poor prognosis, leading to an increased focus on surveillance for high-risk individuals (HRIs) to facilitate earlier diagnosis. Despite the growing implementation of such programmes globally, there is a lack of longitudinal studies examining the benefits of PC surveillance, particularly regarding the well-being of participants. The study aimed to evaluate the distress experienced by HRIs 3-years after engaging in PC screening at Verona Pancreas Institute and to describe which participant characteristics contributed to the increase in stress. Methods: This is a longitudinal follow-up (FU) of a previously published cohort. HRIs with heredo-familial predisposition undergoing PC surveillance with MRCP and a clinical visit were re-evaluated from 2019 to 2023 in the same psychological assessment using Perceived Stress Scale (PSS), General Self-Efficacy Scale (GSES), Coping Orientation to Problems Experienced (COPE) and The Scale of Perceived Social Support (MSPSS) 3 years after the baseline assessment. The FU assessments were conducted by a clinical psychologist via telephone after the radiological and clinical evaluations were made. Results: Of the 54 HRIs initially evaluated, ten did not respond to phone contacts. The remaining 44 HRIs, of whom 29 (65.9%) were female, with a mean age of 56.1 years (SD = 10.2), agreed to participate in a FU psychological assessment. After 3 years, the participant exhibited an increase in stress levels (PSS—T0 mean 14.8; T1 mean 16.9), a decrease in problem-solving abilities (GSES—from 32.02 to 28.09, p < 0.01), a deterioration in adaptive capacity to the situation (COPE total score from 64.0 to 61.39, p = 0.05), and a reduction in perceived social support (MSPSS—T0: 4.59; T1: 4.27, p = 0.02). A significant decrease was also observed in the use of denial (from 2.84 to 2.32; p = 0.02). Based on the psychological characteristics of the 44 HRIs, stratified according to PSS reassessed at FU, 3 distinct clusters were identified: (a) Normal Stress (32% of the sample): HRIs with a PSS score < 14; (b) Stable Clinical Stress (46% of the sample): HRIs with PSS at FU > 14 and PSS at baseline > 14; (c) New Clinical Stress (22% of the sample): HRIs with PSS at FU > 14 and PSS at baseline < 14. After 3 years of surveillance for PC, 67% of the total study sample (Stable Clinical Stress group and New Clinical Stress group) exhibited high perceived stress. Over the course of the 3 years, 7 HRIs (15.9%) lost a family member due to PC. Conclusions: The data suggest the need to include psychological care pathways within the surveillance programmes. These insights can enhance existing literature and aid in creating comprehensive surveillance programmes for PC, addressing all care aspects, including mental health.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».