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Psychological effects of routine follow up on cancer patients after surgery
G M Kiebert1, K Welvaart, J Kievit
1Medical Decision Making Unit, Faculty of Medicine, University of Leiden, The Netherlands.
Objectives:
To assess the subjective value that patients with cancer place on regular follow up after operation; to see what effects regular follow up visits have on the patient's physical and psychological wellbeing; and to find out which variables influence patients wellbeing and attitudes to follow up.
Design:
Survey by questionnaire.
Setting:
University Hospital Leiden, the Netherlands.
Subjects:
127 Patients who had been operated on for cancer.
Interventions:
67 Patients were assessed one month before a routine follow up visit, and 60 on the day of the follow up; 46 of the second group were assessed again two weeks later.
Main Outcome Measures:
Answers to questions about physical and psychological wellbeing.
Results:
Most patients were in favour of regular follow up visits at the hospital, and thought that the advantages outweighed the disadvantages. There were more reports of psychological than physical distress one month beforehand, but these were significantly less two weeks after the appointment compared with one month before (p = 0.003) and on the day of the appointment (p < 0.001). Regular follow up visits do not temporarily increase physical or psychological distress; rather there is a temporary decrease, less fear of recurrence, and less perception of any disadvantages. Women in general, and those with breast cancer in particular and patients with a lower educational standard in particular, had significantly more psychological complaints.
Conclusions:
Regular follow up visits are in general welcomed by patients who have had operations for cancer.