The Impact of HAPPY (Humanity Assurance Protocol in Interventional Radiotherapy) on the Psychological Well-being of Gynecological Cancer Patients

Abstract

Background:: HAPPY (Humanity Assurance Protocol in interventional radiotherapy) reports the necessity for gynecological cancer patients to undergo interventional radiotherapy (IRT, also called brachytherapy). The present paper has evaluated how some precautions may improve the psychological well-being of the patients during IRT. background: HAPPY (Humanity Assurance Protocol in interventional radiotherapy) defined the needs of patients undergoing interventional radiotherapy (IRT, also called brachytherapy) for gynecological cancer. This work evaluated how some recommendations/interventions may improve the psychological well-being of the patient during IRT. Methods:: Patients with gynecological cancer undergoing IRT-HDR were analyzed. Patients answered three questionnaires before the IRT procedure (T0) and at the end of IRT (T1): Distress Thermometer (DT), Numerical Rating Scale for IRT procedure distress (NRS), and Hospital Anxiety and Depression Scale (HADS). Correlations have been calculated pairwise through pandas. corrwith with a Pearson algorithm, and the p-values have been calculated through scipy.stats.pearsonr. Plots have been generated through seaborn and matplotlib. A Wilcoxon test was used. objective: To define a protocol Results:: 55 patients were selected for this study. The median age of the patients was 64 (range, 39-84) years. 52 patients were with stage I endometrial cancer, whereas 3/3 patients with cervical cancer had locally advanced stages (IIB-IVA). 26 patients had a high education level (47.3%), and 38 were married or with a partner (69.1%). Only 14/55 (25.45%) patients were working. The HADS, DT, and NRS averages before the IRT procedure (T0) were 10.2, 3.8, and 4.3, respectively. After applying the HAPPY protocol, the HADS, DT, and NRS averages after IRT (T1) were 9.4, 3.4, and 2.6, respectively. The Wilcoxon signed rank test analysis showed a significant improvement in NRS (p < 0.00001) and HADS (p = 0.034). Living with a partner, parents or relatives was the only parameter statistically significantly associated with better DT pre-IRT (p = 0.04), HADS pre-IRT (p = 0.01), DT post-IRT (p = 0.01), and HADS post-IRT (p = 0.04). Conclusion:: In our study, the HAPPY protocol was associated with a significant reduction in patients’ distress, anxiety, and discomfort result: Fifty-five patients were selected. The median age was 64 (range, 39-84) years. Most of patients with endometrial cancer were in Stage I, whereas 3/3 patients with cervical cancer had locally advanced stages (IIB-IVA). Most of patients have high education level (47.3%), married or with partner (69.1%). Only 14/55 (25.45%) patients are currently working. The HADS, DT and NRS average before IRT (T0) were 10.2, 3.8 and 4.3, respectively. After applying the HAPPY protocol, the HADS, DT and NRS average after IRT (T1) were 9.4, 3.4 and 2.6, respectively. A Wilcoxon signed rank test analysis comparing T0 vs T1 scores showed a significant improvement in NRS (p&amp;amp;lt; 0.00001) and HADS (p=0.034). conclusion: In our series, the HAPPY protocol was associated with a significant reduction of patient’s distress, anxiety and discomfort.