Title:The Impact of HAPPY (Humanity Assurance Protocol in Interventional
Radiotherapy) on the Psychological Well-being of Gynecological Cancer
Patients
Volume: 17
Issue: 2
Author(s): Luca Tagliaferri, Silvia Mancini, Valentina Lancellotta*, Loredana Dinapoli, Nikola Capocchiano, Patrizia Cornacchione, Sara Scalise, Rosa Autorino, Maura Campitelli, Giuseppe Ferdinando Colloca, Bruno Fionda, Angeles Rovirosa, Gabriella Macchia, Gabriella Ferrandina and Maria Antonietta Gambacorta
Affiliation:
- Dipartimento di Diagnostica per Immagini, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, UOC Radioterapia
Oncologica, Radioterapia Oncologica ed Ematologia, 00168, Rome, Italy
Keywords:
Endovaginal interventional radiotherapy, brachytherapy, distress, anxiety, discomfort, HAPPY protocol.
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.
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.
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.
