癌症患者生存质量研究进展

随着癌症患者生存时间和生存人数的增加,生存者本人和家属更加重视生存质量.本文总结分析近年来国内外癌症患者生存质量的研究状况,以期在癌症治疗过程中,不仅关注躯体功能和疾病本身以及由治疗带来的症状和体征,同时注重心理和社会职能.     

癌症患者生存质量研究进展

随着癌症患者生存时间和生存人数的增加,生存者本人和家属更加重视生存质量。本文总结分析近年来国内外癌症患者生存质量的研究状况,以期在癌症治疗过程中,不仅关注躯体功能和疾病本身以及由治疗带来的症状和体征,同时注重心理和社会职能。     

Quality of Life in the Decayed Historic Areas of Isfahan (DHI) Using the World Health Organization Quality of Life Instrument (WHOQOL-BREF)

The aim of this paper is to measure the quality of life (QOL) in the decayed historic areas of Isfahan (DHI). The WHOQOL-BREF instrument was used in order to find the strengths and weaknesses of these areas with regard to the domains and determine the most effective domains and indicators that would show the best ways to improve QOL in DHI. We used the multi-stage sampling technique for sampling. In the first stage the Neyman??s allocation method was used to determine sample sizes which were then distributed among the districts using the systematic sampling method (in the second stage). Household interviews were conducted to gather the needed data. Subsequently the Cronbach alpha test and second-order confirmatory factor model were used to determine the internal consistency and fitness of the WHOQOL-BREF model in DHI. The WHOQOL-BREF model provided an adequate fit to the data. Also, according to our model, the psychological domain has the highest association with QOL (0.93). This indicates that the psychological domain should have priority in improvement plans. The results show that the most significant problems are related to the physical (12.13) and psychological (12.58) domains and the highest scores among the WHOQL-BREF domains relate to the social relationships (13.24) and environment (12.61) domains. Thus, in spite of the fact that DHI have environmental difficulties from the objective point of view, they do, nevertheless, have a high score from a subjective point of view among WHOQL-BREF domains. Therefore the necessity of improvement in the DHI should be considered not only in relation to the environmental domain but also the physical, psychological and social domains.     

癌症病人的生活质量及心理干预研究

本研究在前期研究的基础上进一步探讨癌症病人的生活质量状况和心理干预的效果。运用病例对照实验设计 ,选用生活质量问卷 (QLQ C3 0 )作为主要测查工具 ,采用两因素混合实验方差分析统计方法 ,对 1 2 0名住院化疗病人进行了比较分析。结果显示 :躯体功能 (PF)、角色功能 (RF)、情绪功能(EF)、认知功能 (CF)和整体生活质量 (QL)得分在治疗前后和实验与对照组之间的交互作用均显著和非常显著 ;症状量表和单项症状中交互作用显著和非常显著的有 :疲乏 (FA)、呼吸困难 (DY)、失眠 (SL)、食欲丧失 (AP)。因此 ,化疗对病人的生活质量有明显的影响 ,经心理干预后癌症病人的各种功能状况和症状得到不同程度的改善。     

EORTC QLQ—C30及其在胸部肿瘤患者生命质量研究中的应用

生命质量研究是近年来肿瘤研究的热点之一,其主要作用评价治疗效果,选择治疗方案;应用于抗肿瘤新药筛选;用于预测患者预后和远期生存状态。EORTC QLQ-C30及其子量表在世界范围内被应用于胸部肿瘤治疗和研究当中并取得了较好效果,为评价食管癌和肺癌的各种治疗方法提供了一个较好的参考标准,同时对提高食管癌和肺癌的治疗水平和改善病人生命质量起到了一定的推动作用。     

Development and Psychometric Evaluation of an Item Bank for Computerized Adaptive Testing of the EORTC Insomnia Dimension in Cancer Patients (EORTC CAT-SL)

To further advance assessment of patient-reported outcomes, the European Organisation of Research and Treatment of Cancer (EORTC) Quality of Life Group has developed computerized adaptive test (CAT) versions of all EORTC Quality of Life Core Questionnaire (QLQ-C30) scales/items. The aim of this study was to develop and evaluate an item bank for CAT measurement of insomnia (CAT-SL). In line with the EORTC guidelines, the developmental process comprised four phases: (I) defining the concept insomnia and literature search, (II) selection and formulation of new items, (III) pre-testing and (IV) field-testing, including psychometric analyses of the final item bank. In phase I, the literature search identified 155 items that were compatible with our conceptualisation of insomnia, including both quantity and quality of sleep. In phase II, following a multistep-approach, this number was reduced to 15 candidate items. Pre-testing of these items in cancer patients (phase III) resulted in an item list of 14 items, which were field-tested among 1094 patients in phase IV. Psychometric evaluations showed that eight items could be retained in a unidimensional model. The final item bank yielded greater measurement precision than the original QLQ-C30 insomnia item. It was estimated that administering two or more items from the insomnia item bank with CAT results in a saving in sample size between approximately 15–25%. The 8-item EORTC CAT-SL item bank facilitates precise and efficient measurement of insomnia as part of the EORTC CAT system of health-related quality life assessment in both clinical research and practice.

     

EORTC QLQ-C30及其在胸部肿瘤患者生命质量研究中的应用

生命质量研究是近年来肿瘤研究的热点之一,其主要作用:评价治疗效果,选择治疗方案;应用于抗肿瘤新药筛选;用于预测患者预后和远期生存状态.EORTC QLQ-C30及其子量表在世界范围内被应用于胸部肿瘤治疗和研究当中并取得了较好效果,为评价食管癌和肺癌的各种治疗方法提供了一个较好的参考标准,同时对提高食管癌和肺癌的治疗水平和改善病人生命质量起到了一定的推动作用.     

A New Questionnaire (QRFPC25) Regarding the Religiosity and Spirituality in People with Life-Threatening Disease: Reliability and Validity in a Population of Cancer Patients Undergoing Radiotherapy

The development of a questionnaire (QRFPC25) assessing the religiosity of cancer patients. The method used for the questionnaire comprises seven multi-item and three single-item scales formed from a 25-question module. The questionnaire was completed on-site and a week after antineoplastic therapy. The final sample included 156 patients. The main topics of the QRFPC25 are the following: worship, relationship with the divine, spiritual discussion, hope, participation in holly communion, faith, life after death, love, bioethics and global quality of life (QoL). The average time of both times taken to complete the questionnaire was approximately 10 min. All multi-item scales met the minimal standards of reliability (Cronbach’s alpha coefficient ≥.70) before or after treatment. Test–retest reliability in terms of the intraclass correlation coefficient was also satisfactory (p < 0.01). Validity was assured by inter-item correlations and correlations with the European Organisation for Research and Treatment of Cancer’s Core Quality of Life Questionnaire (QLQ-C30, version 3.0), along with factor analysis which showed eight factors incorporated in the model. The QRFPC25 is a reliable and valid gauge for the assessment of religiosity in cancer patients undergoing radiotherapy.     

住院放化疗肺癌患者生活质量影响因素分析

生活质量研究是近年来肿瘤治疗研究的热点之一。应用生存质量核心问卷（QLQ—C30）及卡氏功能量表,于治疗前、中、后进行问卷式调查,探讨60例经病理证实接受放、化疗的肺癌患者生活质量的影响因素,预测患者预后和远期生存状态,为住院放化疗肺癌的治疗方法提供一个较好的参考标准,对放化疗肺癌的治疗水平和改善生活质量起到了一定的推动作用。     

Fatigue and Quality of Life Following Radiotherapy for Breast Cancer: A Comparative Study

Clinical reports suggest that fatigue is a common and disruptive long-term side effect of radiotherapy; however, there has been little systematic attention given to this phenomenon. The primary aim of this study was to assess fatigue its impact on quality of life in women who had completed radiotherapy for breast cancer. A key feature of this study was the inclusion of a comparison group of women of similar age with no history of cancer. The results indicated that the fatigue experienced by women after radiotherapy for breast cancer was not significantly different in intensity, duration, or disruptiveness from fatigue experienced by healthy women. In addition, radiotherapy recipients reported a quality of life similar to that of the healthy women. For both groups of women greater fatigue was related to a poorer quality of life. These findings suggest that following radiotherapy for breast cancer, women can expect to experience fatigue which is not worse than what they might normally experience. This information may be a useful part of psychoeducational interventions designed for women scheduled to begin radiotherapy for breast cancer.     

Quality of Life,Personality and Use of Pain Medication in Patients with Chronic Back Pain

The aim of the study was to assess whether the functional disability and the quality of life in patients with chronic back pain was associated with some personality traits and whether the use of pain medication in patients with chronic back pain can be predisposed with some personality traits. The study sample comprised 262 older patients with chronic back pain of non-inflammatory origin. The level of disability related to chronic back pain was assessed by Roland-Morris Questionnaire, health-related quality of life was assessed by Short Form 36 and personality traits by Eysenck Personality Questionnaire. Among analyzed personality traits (psychoticism, extraversion, neuroticism, lie tendencies), only neuroticism significantly predicted self-reported disability caused by back pain. Patients on pain medication had significantly worse quality of life and disability caused by back pain, but they did not differ significantly in personality traits compared to patients without pain medication. There were no differences in disability due to back pain and in level of neuroticism between patients who had jobs with higher or lower physical demand. People with higher scores on neuroticism inclined more to report a lower functional disability and the quality of life caused by chronic back pain. Patients on pain medication reported more inferior physical than psychological concept of quality of life. Use of pain medication was not associated with personality traits assessed by Eysenck Personality Questionnaire. In our elderly patients with chronic back pain, lower quality of life was associated with elevated neuroticism score and more frequent use of pain medication.     

Quality of Life and Depression in the General Korean Population: Normative Data and Associations of the 12-Item Short Form Health Survey (SF-12) and the McGill Quality of Life Questionnaire (MQOL) with Depression (Patient Health Questionnaire-9) and Socioeconomic Status

Applied Research in Quality of Life - This study aimed to present normative data of Quality of life (QoL) and to evaluate the relationship between sociodemographic factors, multidimensional QoL and...     

老年膀胱癌患者术后生活质量及其影响因素的研究

调查老年膀胱癌患者术后生活质量现状及其影响因素,为护理干预和健康管理提供依据。选择我院2013年6月至2014年1月收治的老年膀胱癌患者142例作为研究对象,于患者术后3个月采用膀胱癌特异性量表（FACT-BL）,社会支持评定量表（SSRS）进行数据收集。结果老年膀胱癌患者术后FACT-BL平均得分为（94．33＆#177;8．31）分,SSRS平均得分为（33．70＆#177;4．42）分,不同手术方式躯体状况（PWB）,社会/家庭状况（FWB）,FACT-BL 得分差异具有统计学意义（P＜0．05）,老年膀胱癌患者术后生活质量与社会支持呈正相关关系（P＜0．05）。手术方式与老年膀胱癌患者术后生活质量密切相关,应结合患者的具体情况选择合适的手术方式,实时观察患者的社会支持水平。     

晚期癌症患者生存质量评估体系建立及放弃治疗与安乐死的合法化

癌症的病因涉及一系列不同的基因和引起突变的各种遗传和环境因素.其发病的内在因素是细胞内的病毒感染或由于原癌基因突变产生的活跃癌基因.环境致癌论已普遍被人关注.癌症村是环境因素所致的一种群体疾病现象.晚期癌症患者的生存质量令人堪忧.切合晚期癌症患者生命意义治疗的研究越来越显示出其价值.医生有权对癌症晚期患者进行生存质量评估后做出放弃治疗的医嘱.建立一套完善的生存质量评估体系是临床决策放弃治疗和合法化安乐死的前提.正确而适当的临床放弃治疗和合法化安乐死是人性化选择的需要.     

Quality of Life and Optimism in Patients with Morphea

Despite extensive knowledge about quality of life of people suffering from dermatological diseases, data on patients with morphea are scarce. The aim of our study was to compare the quality of life of healthy controls and morphea patients, as well as to determine the correlation of this variable with the level of dispositional optimism. The study included 47 patients with morphea and 47 healthy controls, matched for gender and age. Cantril’s Ladder and Life Orientation Test-Revised were used to assess the levels of life satisfaction and dispositional optimism, respectively. LoSSI was used for the objective assessment. The anticipated level of life quality and the level of dispositional optimism were statistically significantly lower in morphea patients (p?=?0.032 and p?=?0.014, respectively) when compared to controls. There were no differences in the assessment of current (p?=?0.168) and past (p?=?0.318) levels of life quality. Also, we proved that type of morphea did not differentiate the current (p?=?0.175), past (p?=?0.620) and future (p?=?0.356) assessment of the quality of life. In the group of morphea patients there was a statistically significant correlation between the level of dispositional optimism and current (p?=?0.002, r?=?0.43), as well as anticipated (p?r?=?0.57) levels of life quality. Current level of life quality of healthy controls and morphea patients is comparable, whereas the latter anticipate their future life situation to be significantly worse than the former. Higher level of life satisfaction correlates with higher level of optimism.     

Health-Related Quality of Life in Iranian Breast Cancer Survivors: A Qualitative Study

Women play the most important role in Iranian families. Therefore, it is necessary to pay attention to efforts to maintain and promote their health. The diagnosis and treatment of breast cancer have significant physical and psycho-social impacts on patients, families and friends. This qualitative study was designed to analyze the role of several social and cultural factors and their relationship to health-related quality of life among Iranian breast cancer survivors. In-depth semi-structured and unstructured face-to-face interviews were conducted with 39 breast cancer survivors. The results of the present study revealed that most prevalent physical problems that were reported by Iranian breast cancer survivors were fatigue, pain and lymphedema related to the adverse effects of mastectomy. We found that most participants have a strong sense of spirituality and used this as a source of psychological support to help them accept their disease. Spirituality has been found to be a strong source of psychological support among Iranian breast cancer survivors. Religious faith has provided this community the strength and motivation to seek medical treatment and to be patient and relax. These findings can help researchers to provide a framework for the development of appropriate and effective culturally sensitive health interventions.     

Health-related Quality of Life,Fatigue, and Posttraumatic Growth of Cancer Patients Undergoing Radiation Therapy: A Longitudinal Study

The purpose of this study was to determine health-related quality of life (HRQoL), fatigue, and posttraumatic growth (PTG) among patients with breast or prostate cancer during and following radiation therapy (RT). A total of 91 patients completed measures at three time points as follows: one or two weeks before the start of RT, in the fifth/sixth week of treatment, and four to six weeks post-treatment. Consistent with the previous literature, the results of this study revealed that RT was associated with declines in global HRQoL, Physical Well-being, Social/Family Well-being, and Functional Well-being, as well as an increase in fatigue. By four to six weeks post-treatment, these factors improved significantly and returned to baseline levels with the exception of Social/Family Well-being. The PTG total score and almost all of its subscale scores did not change significantly during the period of the study. However, the subscale of Spiritual Change for PTG significantly increased during the RT, and sustained this improvement at four to six weeks post-treatment. A significant negative correlation was found between Physical Well-being and PTG total score, whereas a significant positive correlation was revealed between Social/Family Well-being and PTG total score. The results from this analysis suggest that a significant decrease in HRQoL is evident in the fifth/sixth week of RT treatment. However, recovery of HRQoL occurs as quickly as a few weeks after the end of treatment. Moreover, patients with high ratings of Social/Family Well-being experience more positive psychological changes (PTG) resulting from the cancer experience.     

A Pilot Study Addressing the Impact of Religious Practice on Quality of Life of Breast Cancer Patients During Chemotherapy

The aim of this preliminary study was to investigate whether religious practice can modify quality of life (QoL) in BC patients during chemotherapy. QoL and religion practice questionnaire (RPQ) scores were evaluated in a sample of BC patients in different moments. Before chemotherapy initiation, women with lower physical and social functional scores displayed higher RPQ scores. On the other hand, low RPQ patients worsened some QoL scores over time. Body image acceptance was positively correlated with religious practice and specifically praying activity. This preliminary study suggests the importance of religion in coping with cancer chemotherapy.     

不同程度尿蛋白患者血清甲状腺激素水平变化及其临床意义

探讨不同程度蛋白尿患者血清甲状腺激素水平的变化及其临床意义。66例不同程度蛋白尿患者,肾病综合征组28例,非肾病综合征组38例,健康对照组60例。发现蛋白尿水平与甲状腺激素水平尤其是FT3水平关系密切。在肾病综合征患者,主要表现为FT3显著降低,提示肾病综合征是正常甲状腺病态综合征的一种。     

湖北省农村集中供养五保老人生活质量研究

为了解湖北省农村福利院集中供养五保老人生活质量及其相关影响因素,利用中文SF-36量表对900例湖北省农村60岁及以上的集中供养五保老人、分散中供养五保老人和普通老年人选行调查。经多因素分析结果显示,五保老人的生活质量不仅要注意疾病、体力劳动、担心的问题等方面,更要注重不同供养环境对其产生的影响。