P220 DEVELOPMENT OF A NEW PSYCHOLOGICAL TOOL TO IMPROVE PATIENT ABILITIES TO DEAL WITH ESOPHAGECTOMY: PRELIMINARY RESULTS

Aim This study aims to create a tool for evaluation of patient ability to deal with postoperative course after esophagectomy for cancer. Background & Methods Esophagectomy requires patient to be active and compliant to face up to postoperative impairments. Health related quality of life (HRQoL) data in short and medium-term after surgery show that competences used by patients are not appropriate. Lack of patient abilities to manage postoperative course influences patient recovery and reduces HRQoL. Psychological analysis of patient clinical needs was conducted to identify peculiar patient competences involved after esophagectomy. Four competences (future forethought; context evaluation; consequences of own actions forethought; use of available resources), each relevant to four areas (clinical; familiar; working; daily-activities) were identified and converted in open-ended questions to assess patient level of skills: a 16 questions structured interview was composed. From April to June 2019 we performed a feasibility study on 18 consecutive patients between 3rd and 15th postoperative day. They underwent esophagectomy for esophageal or esophagogastric junction cancer in two high volume centers. Patients with metastasis, with language problems due to neurological impairment or age <18 were excluded. M.A.D.I.T.-Methodology of Computerized Textual Data Analysis (University of Padua) was used. Results Each interview was administered orally to all patients and took 15 minutes. 5 questions were asked to be repeated. No complaints or negative comments were received. Non-responding percentage was 0,4% (one question in one interview). Textual corpus was composed of 3210 words, passable of analysis. No differences between postoperative days administration were found. M.A.D.I.T. analysis showed that answers were adequate and pertinent and allowed us to stratify patients in three different levels of competences (low, median, high). No need of additional competences or areas was observed. Conclusion This new psychological tool shows content validity, adequacy and pertinence to the study aim. It is understandable, easy, quick to be answered during any postoperative day and useful to identify patients with low abilities to deal with esophagectomy. Therefore a multicentric study will be conducted to use this tool further in multiple-choice format with a larger number of patients, in order to identify which patients will benefit of psychological intervention for HRQoL improvement.