Effect of individualized psychological intervention on negative emotion and sleep quality of patients after bladder cancer surgery: a randomized controlled trial

Zhang, Peng; Han, Xiao; Zhang, Xin; Zhu, Xuhui; Li, Tao

doi:10.21037/tau-21-534

Cited by 7 publications

(4 citation statements)

References 15 publications

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“…Since bladder cancer is significantly less common than breast or prostate cancer, no study is available so far that investigated pre-treatment sleep disturbances in patients irradiated for bladder cancer (1). Only one randomized study was found that analyzed the effect of individualized psychological intervention on post- operative sleep quality in patients undergoing surgery for bladder cancer (18). However, the prevalence of sleep problems was not stated.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Sleep Disturbances in Patients With Bladder Cancer Scheduled for Local or Loco-regional Radiochemotherapy

et al. 2022

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Background/Aim: Organ-sparing treatment is increasingly used for bladder cancer, particularly for patients with significant comorbidities or advanced age. The upcoming treatment can cause distress and sleep disturbances. This study investigated pre-radiotherapy sleep disturbances in these patients. Patients and Methods: Twenty-two patients with bladder cancer scheduled for local or loco-regional radiotherapy were retrospectively evaluated. Sixteen characteristics were analyzed for sleep disturbances including age, sex, performance score, comorbidities, previous malignancy, distress score, emotional problems, physical problems, treatment situation, treatment intent, current primary tumor and nodal stage, distant metastasis, treatment volume, concurrent chemotherapy, and Coronavirus Disease 2019 pandemic. Results: Eleven patients (50.0%) reported sleep disturbances that were significantly associated with distress scores ≥5 (p=0.035). Trends were found for age ≤75 years (p=0.183), ≥2 emotional problems (p=0.183), ≥5 physical problems (p=0.064), and distant metastasis (p=0.090). Conclusion: Half of the patients reported pre-radiotherapy sleep disturbances. Risk factors facilitate identification of patients requiring psychological support.When compared to other solid malignancies, cancers of the urinary bladder are comparably rare (1). Radical cystectomy is considered the standard approach in many institutions but can be associated with major complications including perioperative death (2-4). Therefore, bladder-sparing treatment approaches including radio-chemotherapy or radiotherapy and transurethral resection have become more popular, particularly for patients with significant comorbidities, worse performance status or advanced age (5-8). However, also multimodal bladder-sparing treatment can be quite burdensome for the patients, which may cause significant emotional distress associated with sleep disturbances. Moreover, to be scheduled for radiation therapy may aggravate the distress due to the fear of radiation exposure and high-tech machines. This idea is supported by a study performed in patients with breast or prostate cancer treated with local or loco-regional radiotherapy (9). In that study, the more pronounce sleep disturbances were reported by the patients before or during the initial phase of their course of radiotherapy. However, to our knowledge, no data have been reported so far regarding pre-treatment sleep disturbances in patients with bladder cancer assigned to a multimodal bladdersparing treatment approach. The present study aimed to provide data for this group of patients by evaluating the prevalence of sleep disturbances prior to a radio-chemotherapy course and potential risk factors for such sleep disturbances. These data will likely contribute to the identification of patients who need psycho-oncological support before the start of their radiochemotherapy treatment. Patients and MethodsTwenty-two patients with bladder cancer scheduled for local or loco-regional radiochemotherapy were retrospecti...

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Section: Discussionmentioning

confidence: 99%

Evaluation of Sleep Disturbances in Patients With Bladder Cancer Scheduled for Local or Loco-regional Radiochemotherapy

et al. 2022

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“…Patients undergoing transurethral procedures are especially at a higher risk of developing CRBD and LUTS, which is widely acknowledged in the literature. [ 8 ] CRBD and postoperative LUTS have been shown to have a negative impact on the patients’ postoperative recovery.…”

Section: Discussionmentioning

confidence: 99%

Intravesical bupivacaine in reducing catheter-related bladder discomfort and lower urinary tract symptoms after transurethral surgery: A randomized controlled trial

Purushothaman,

Kalra,

Dorairajan

et al. 2024

Indian Journal of Urology

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Introduction: The objectives of this study were to investigate the efficacy and safety of intravesical bupivacaine instillation in reducing catheter-related bladder discomfort (CRBD) and lower urinary tract symptoms (LUTS) after transurethral surgery. Methods: The study enrolled 100 American Society of Anesthesiologists (ASA) grade I–III patients aged ≥18 years undergoing transurethral resection of the prostate or transurethral resection of the bladder tumor, randomly assigned to Group B (intravesical bupivacaine) or Group S (saline). Double blinding was employed. Independent variables included demographics, surgery type, ASA grade, and intervention details. Dependent variables comprised CRBD severity, Patient Perception of Bladder Condition (PPBC), Pelvic Pain Urgency Frequency (PUF), Visual Analog Scale (VAS) for pain, need for additional analgesics, and International Prostate Symptom Score (IPSS). SPSS version 19 was used for analysis with a significance level of P < 0.05. Side effects such as hematuria were also recorded. Results: Group B reported significantly lower “moderate” CRBD immediately (2% vs. 40%, P < 0.001) and at 12 h (0% vs. 18%, P = 0.003) post-instillation compared to Group S and also required fewer additional analgesics (4% vs. 46%). The PPBC at catheter removal also favored Group B (P = 0.003) and day 1 (P < 0.001). The PUF scores were also significantly lower in Group B at catheter removal (P = 0.001) and at day 1 (P = 0.028). The IPSS was also significantly lower in the Group B on day 1 (P = 0.003) and 7 (P = 0.001). The VAS scores also favored the Group B consistently and although the side effects were higher in Group B but this was not statistically significant. Conclusion: Intravesical bupivacaine administration has the potential to alleviate CRBD and postoperative LUTS following lower urinary tract transurethral electrosurgery. The study’s findings underscore the importance of personalized pain management strategies in optimizing the patient comfort during the postoperative recovery.

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“…Negative psychological states, and their indirect influences on patient behavior (e.g., obesity, smoking, alcohol intake), may affect surgical recovery [17,19]. In particular, patients' psychological features may directly interact with the neuroendocrine and inflammatory pathways underlying the surgical stress response [17], with major repercussions on immunological perioperative state and surgical outcomes [20].…”

Section: Psychological Features and Perioperative Metabolic Adaptationmentioning

confidence: 99%

The influence of psychological interventions on surgical outcomes: a systematic review

Lanini

Amass

Calabrisotto

et al. 2022

J Anesth Analg Crit Care

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Background An amplified and/or prolonged surgical stress response might overcome the organs’ functional reserve, thus leading to postoperative complications. The aim of this systematic literature review is to underline how specific psychological interventions may contribute to improve surgical outcomes through the positive modulation of the surgical stress response in surgical patients. Methods We conducted a comprehensive literature search in the Cochrane Register of Controlled Trials, PubMed, EMBASE, Scopus, PsycINFO, and CINAHL databases. Only studies published in English from Jan 2000 to Apr 2022 and reporting pain and/or anxiety among outcome measures were included in the review. The following psychological interventions were considered: (1) relaxation techniques, (2) cognitive-behavioral therapies, (3) mindfulness, (4) narrative medicine, (5) hypnosis, and (6) coping strategies. Results Among 3167 records identified in the literature, 5 papers were considered eligible for inclusion in this review because reporting the effects that psychological features have on neurochemical signaling during perioperative metabolic adaptation and those metabolic and clinical effects that the psychological interventions had on the observed population. Conclusion Our findings confirm that psychological interventions may contribute to improve surgical outcomes via the positive influence on patients’ metabolic surgical stress response. A multidisciplinary approach integrating physical and non-physical therapies can be considered a good strategy to successfully improve surgical outcomes in the perioperative period.

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Effect of individualized psychological intervention on negative emotion and sleep quality of patients after bladder cancer surgery: a randomized controlled trial

Cited by 7 publications

References 15 publications

Evaluation of Sleep Disturbances in Patients With Bladder Cancer Scheduled for Local or Loco-regional Radiochemotherapy

Evaluation of Sleep Disturbances in Patients With Bladder Cancer Scheduled for Local or Loco-regional Radiochemotherapy

Intravesical bupivacaine in reducing catheter-related bladder discomfort and lower urinary tract symptoms after transurethral surgery: A randomized controlled trial

The influence of psychological interventions on surgical outcomes: a systematic review

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