晚期恶性肿瘤患者发生抑郁的相关因素研究

目的 调查晚期恶性肿瘤患者的抑郁情况并分析相关影响因素。方法 分别采用Beck抑郁问卷（BDI）、应对方式问卷、生活质量问卷对晚期恶性肿瘤住院患者进行调查,分析BDI评分与应对方式、生活质量各因子间的相关性。结果 （1） 213例被调查患者中,95.3％存在明显抑郁症状,BDI评分为（26.29±10.03）分。（2） BDI评分与应对方式中解决问题因子（r=-0.378, P=0.000）、求助因子（r=-0.259, P=0.000）均呈负相关,与自责因子呈正相关（r=0.374, P=0.000）。（3） BDI评分与生活质量问卷中的躯体功能、角色功能、情绪功能、认知功能、社会功能及恶心呕吐、疼痛、食欲减退等症状呈正相关,而与总健康因子呈负相关（r=-0.296,P=0.000）。结论 晚期恶性肿瘤患者存在普遍的抑郁状态,且与应对方式和生活质量某些因子间存在相关性,因此有针对性地给予心理干预,帮助患者采用积极的应对方式,有利于减轻患者的抑郁,改善生活质量。     

恶性骨肿瘤患者的心理健康与应对方式的相关性及其对临床效果的影响

目的：了解骨肿瘤患者的心理健康状态及其与患者使用的应对方式的相关性,并探讨其对临床效果的影响。方法采用方便抽样的方法选取恶性骨肿瘤的患者102例,对所有患者的心理状况、应对方式进行问卷调查,并于治疗间歇期进行跟踪随访,调查其生存状态,采用独立样本t检验进行组间差异比较,组间的相关性采用Pearson相关分析。结果 SCL-90总分及各项因子在骨科恶性肿瘤患者得分显著高于常模组,差异具有统计学意义（ P＜0．05）。面对应对与SCL-90评分的相关性分析中,除躯体化、敌对、恐怖外,总分及其他各因子均与面对应对方式呈负相关（ P＜0．05）;回避应对方式与除躯体化、强迫、抑郁外的总分及其他各项因子均呈一定的负相关（P＜0．05）;屈服应对方式与除偏执、精神病性外的其他各因素均呈一定的正相关（ P＜0．05）。评分PIHS＜45分的患者的SCL-90总分及大部分因子（除了躯体化因子）明显低于PIHS＞45分的患者（P＜0．05）。与PIHS＞45分的患者相比,PIHS＜45分的患者面对、回避应对得分明显更高,屈服应对评分明显更低（ P＜0．05）。结论骨科恶性肿瘤患者的心理健康水平明显低于正常人,且与采用消极应对存在明显的相关性。负面情绪及消极应对共同作用,导致患者出现严重的心理障碍,进而导致患者的病情发展和影响治疗效果,不利于病情恢复。     

恶性肿瘤住院患者营养状况与生活质量分析

目的:分析恶性肿瘤住院患者营养状况、生活质量现状及其相关性。方法:选取2018年2月至2018年11月我院入院的1 057例恶性肿瘤患者,采用NRS2002实施营养风险筛查、PG-SGA评估其营养状况、EORTC QLQ-C30调查其生活质量,在患者出院后收集住院期间营养支持情况。结果:1 057例患者中,34.3%存在营养风险,51.8%存在营养不良;营养良好组的白蛋白、血红蛋白、红细胞计数、体重、体质量指数、三头肌皮褶厚度、握力均高于营养不良组（P＜0.05）。营养良好组在总体健康状况及5个功能领域的分数高于营养不良组（P＜0.05）;在9个症状领域的得分低于营养不良组（P＜0.05）;营养状况与总体健康状况及5个功能领域呈负相关（P＜0.05）,与9个症状领域呈正相关（P＜0.05）。肿瘤患者营养支持率低,仅17.69%的患者得到营养支持。结论:恶性肿瘤住院患者营养状况普遍较差,营养不良影响患者生活质量。     

围术期心理干预对行TURP治疗的老年晚期前列腺癌患者心理状态、术后恢复的影响

目的:探讨心理干预对行经尿道前列腺电切术（transurethral resection of prostate,TURP）治疗的老年晚期前列腺癌患者抑郁焦虑状态、术后恢复的影响。方法:选取2015年2月至2017年5月驻马店市第一人民医院收治的行TURP治疗的124例老年晚期前列腺癌患者为研究对象。按照入院时间将患者分为干预组与对照组,对照组60例患者采用常规护理。干预组64例患者在常规护理基础上进行围术期心理干预,并在出院前做出院指导并鼓励患者做出院后咨询,比较两种干预模式的差异。结果:在入院后24 h,两组患者的SAS评分、SDS评分无明显差异（P＞0.05）。在术前12 h、出院前24 h两个时间点,对照组的SAS评分、SDS评分均显著高于干预组（P＜0.05）。在入院后24 h,大部分患者均出现了轻中度的焦虑和抑郁,两组患者存在心理障碍的人数构成比无明显差异（P＞0.05）。术前12 h,两组患者处于焦虑、抑郁状态的人数显著增多,对照组中重度焦虑抑郁的患者比例显著高于干预组（P＜0.05）。出院前24 h,两组患者心理障碍均得到明显缓解,但对照组的中重度焦虑、抑郁的患者比例仍然高于干预组（P＜0.05）。两组患者的手术时间、膀胱冲洗时间、术后并发症类型无明显差异（P＞0.05）。但干预组患者的术后尿管留置时间、住院时间明显较短,并发症发生率更低,满意度评分明显较高（P＜0.05）。随着康复时间的延长,两组患者的康复知识得分、生活质量的疾病纬度得分明显升高（P＜0.05）,但对照组生活质量的其他指标均无明显改善（P＞0.05）,而干预组的IPSS评分、生活质量总分、生理纬度得分、社会纬度得分、心理纬度得分、生活满意度均显著改善。这表明,干预组患者的生活质量改善显著好于对照组。结论:围术期心理干预可有效改善TURP患者围术期心理状态,降低并发症发生率,促进术后康复,值得临床推广。     

伴有抑郁障碍的晚期癌症住院患者的症状频率及强度调查

目的 探讨伴有抑郁障碍的晚期癌症患者的症状频率及强度,并分析抑郁与症状的关系。方法采用埃德蒙顿症状评估量表（ESAS）与抑郁自评量表（SDS）对196例晚期癌症住院患者进行调查。使用卡方检验及秩和检验比较伴有抑郁与无抑郁患者的症状发生频率及症状强度;抑郁与症状间的相关性分析用Spearman相关分析。结果 196例晚期癌症患者中76例（38.8％）伴有抑郁障碍（SDS评分≥53）。与无抑郁患者比较,伴有抑郁障碍的晚期癌症患者发生频率显著增加的症状依次为：自我感觉差（98.7％ vs.86.7％,P=0.029）、食欲下降（97.3％ vs.74.2％,P=0.002）、疼痛（94.7％ vs.63.3％,P＜0.001）、焦虑（84.2％ vs.49.2％,P＜0.001）、气短（84.2％ vs.71.7％,P=0.021）、瞌睡（73.7％ vs. 55.8％;P=0.006）及恶心（61.8％ vs.38.3％,P＜0.001）;而在症状强度（ESAS评分≥1）上则依次为自我感觉差、乏力、食欲下降、焦虑以及气短（P＜0.05）。Spearman相关分析显示,SDS与ESAS各症状间呈正相关,其中SDS与抑郁、乏力及焦虑呈高度正相关（相关系数r分别为0.57、0.52及0.51,P均＜0.001）。结论 伴有抑郁障碍的晚期癌症住院患者普遍存在严重的症状负荷。对症状频率和强度的认识有助于发现抑郁障碍并采取干预措施,从而进一步提高患者的生活质量。     

心理干预在缓解晚期消化道癌痛中的应用

 目的　探讨心理干预治疗在缓解伴有抑郁状态的晚期消化道癌症患者疼痛及提高其生活质量中的应用。方法　将疼痛数字分级法（NRS）评分≥4分,汉密顿抑郁量表（HAMD）评分≥18分的40例晚期消化道癌疼痛患者随机分为治疗组（A组）和对照组（B组）各20例,两组均应用芬太尼透皮贴剂止痛及帕罗西汀抗抑郁,治疗组在此基础上辅以心理干预治疗。6周后对各项指标进行评定。结果　治疗组患者的NRS、HAMD评分均明显低于对照组,差异有统计学意义（P＜0.05,P＜0.01）,且生活质量各项评分也明显好于对照组（P＜0.05）。结论　心理干预治疗是伴有抑郁状态的晚期消化道癌疼痛患者摆脱疼痛痛苦、提高生活质量的一种重要治疗方法。。     

中青年乳腺癌患者配偶心理弹性水平与焦虑抑郁状态及应对方式的相关性分析

目的调查中青年乳腺癌患者配偶心理弹性水平与焦虑抑郁状态的相关性,并分析不同心理弹性水平与应对方式的相关性。方法选取2016年10月至2018年2月,南京医科大学附属南京市妇幼保健院收治的93例中青年乳腺癌女性患者（25～45岁）的配偶作为研究对象,采用自编调查表、心理弹性量表（CD RISC）、医院焦虑抑郁量表（HADS）、简易应对方式量表（SCSQ）开展问卷调查。 结果患者配偶总心理弹性得分（5774±1544）,其中坚韧维度得分（3018±786）、自强维度得分（1834±550）、乐观维度得分（922±249）。心理弹性高分组的焦虑、抑郁比例均低于心理弹性低分组（4800％比7200％,P＜005）、（3200％比6800％,P＜005）。在应对方式计分上,心理弹性高分组较心理弹性低分组的积极应对计分更高［（186±025）比（107±022）,P＜001］,消极应对计分更低［（116±035）比（202±023）,P＜001］。心理弹性得分总分及各维度得分均与积极应对呈正相关（r=0785,0800,0747,0691）,与消极应对呈负相关（r=-0667,-0696,-0622,-0566）,P＜001。结论中青年乳腺癌患者配偶的心理弹性水平整体偏低,心理弹性低分者较高分者有更明显的焦虑抑郁状态。心理弹性高分者能更积极地应对不良生活事件;而心理弹性低分者更倾向于消极对待。应关心患者配偶心理状态,减轻其焦虑、抑郁等负性情绪,鼓励其采取积极应对方式,协助提高乳腺癌患者生活质量。     

终末期肾病合并恶性肿瘤血透患者心理健康、生存质量与应对方式现状及其相关性分析

目的：分析终末期肾病（end stage renal disease， ERSD）合并恶性肿瘤行维持性透析（maintenance hemodialysis， MHD）患者的心理健康、生存质量和应对方式的现况，探讨三者之间的关系。方法：本研究为横断面调查，选取2018 年 1 月至 2022 年 6 月在我院肾病中心行 MHD 的 ERSD 合并恶性肿瘤患者 155 例作为研究对象，采用症状自评量表（Symptom Check List-90， SCL-90）、世界卫生组织生存质量测定量表（World Health Organization Quality of Life with 31 Question， WHOQOL-31）和医学应对问卷（Medical Coping Modes Questionnaire， MCMQ）分别对研究对象的心理健康、应对方式和生存质量进行评价。结果：患者 SCL-90 总分为（181.92±46.18）分，平均分≥ 2.0 分的阳性维度依次为：躯体化症状、焦虑、抑郁、恐怖和人际关系敏感。患者在总体生存质量及健康状况条目得分以及生理领域、心理领域、社会关系领域的维度得分均低于正常人常模（P < 0.05）；而在环境领域和精神支柱与个人信仰的维度得分则高于常人常模组（P < 0.05）。患者应对方式选择中，因子平均得分从高到低依次是：面对因子、回避因子、屈服因子。患者的总体生存质量和健康状况、心理领域与 SCL-90 量表总分、屈服因子呈负相关关系，与面对因子呈正相关关系；生理领域与 SCL-90 量表总分呈负相关关系，与面对因子呈正相关关系。结论：ERSD 合并恶性肿瘤行 MHD患者存在一定的心理健康问题，生存质量较低，但多数患者仍然采取积极的方式面对疾病。     

心理干预对恶性肿瘤患者及其配偶生活质量影响的研究

目的：建立心理干预模式，研究其对恶性肿瘤患者及其配偶生活质量的临床效果。方法：收集大港医院住院恶性肿瘤患者及配偶共120对，随机分为干预组（64对）和对照组（56对）；入院1周内两组患者均填写症状自评量表（SCL-90）及简明健康状况调查表（SF-36），以评测患者及配偶心理健康水平和生活质量水平；对照组给予常规护理，干预组在常规护理的基础上给予心理干预，6周后，对患者及配偶心理健康水平及生活质量进行重新评价，确定干预对患者及配偶的影响作用。结果：1）SCL-90量表测量结果提示，患者组在总分、阳性项目数、躯体化、强迫、人际关系、抑郁、焦虑及恐惧方面因子分高于常模；配偶在总分、阳性项目数、人际关系、抑郁及焦虑方面因子分高于常模；患者在躯体化、强迫、恐惧因子分上高于配偶；配偶在焦虑、抑郁因子分上高于患者。2）与常模相比较，患者生活质量各维度得分均显著下降，配偶在活力、社会功能、情绪角色和精神健康维度得分下降。3）影响患者生活质量的因素包括患者的肿瘤分期、患者的抑郁、配偶的焦虑和抑郁、患者的SCL-90总分及家庭月收入。4）6周后，干预组患者及配偶心理健康水平及生活质量优于对照组。结论：恶性肿瘤患者和配偶均存在不同程度和不同维度的心理健康水平及生活质量水平的下降；患者及配偶的心理水平失衡是导致患者生活质量下降的重要因素；心理干预有利于改善恶性肿瘤患者及配偶的心理健康水平，并有利于提高其生活质量；恶性肿瘤的临床护理工作应重视患者及配偶的生活质量，把生活质量作为一个重要的医疗评价指标。     

直肠癌放疗患者的生活质量与情绪障碍的相关研究

目的探讨直肠癌放疗患者的生活质量与情绪障碍的相关关系。方法利用病例对照、单因素统计分析及相关性分析方法,采用SAS、SDS、TCSQ以及SF-36量表对67例直肠癌放疗患者进行评定。结果局部晚期或术后复发患者较术后常规放疗患者表现出更高水平的焦虑和抑郁（P〈0.05）,表现出更多的消极应对方式（P〈0.05）,相应生活质量评估中情感角色、生命活力、心理健康及社会功能水平明显偏低（P〈0.05）。SDS、SAS水平与生活质量具有明显相关性（P〈0.05）。结论局部晚期或术后复发患者具有更高的情绪障碍发生率,表现出较高水平的抑郁和焦虑,生活质量受到较大的影响,应该对存在有情绪障碍的癌症患者进行心理干预或药物治疗。     

Impact of Caregiver’s Psychological Aspects towards Quality of Life of Children with Acute Lymphoblastic Leukemia (ALL)

Background: Families who have children with Acute Lymphoblastic Leukemia (ALL) are at high risk of experiencing stress. Stress on the family can cause the formation of negative communication in children so that families tend to spend more time in dealing with negative emotions through negative actions. This study aimed to analyze the correlation between stress, anxiety, and depression in caregiver with pediatric ALL outcome. Methods: A cross sectional study was conducted on children with ALL and their caregivers at the Pediatric Ward, Dr. Soetomo Hospital, Surabaya. Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI) questionnaire were used to measure anxiety and depression in caregivers. Previous stressful experiences in children and caregivers were assessed by The Perceived Stress Scale (PSS), Children quality of life was assessed by pediatric quality of life inventory (PedsQL™) questionnaire. Pearson and Spearman correlation strength test was performed for the statistical analysis. Results: There is no significant correlation between stress level of caregivers with the quality of life of children with ALL (P > 0.05). There is negative correlation between the level of anxiety and depression in caregivers with the quality of life of children (P < 0.05). There is negative correlation between children stress level with the quality of life of children (P < 0.05). Conclusion: The psychological condition of the caregiver affects the quality of life of children. The higher the level of anxiety and depression in caregivers, the lower the quality of life of children.     

Quality of life,anxiety and depression in Turkish breast cancer patients and in their husbands

The aim of the present study is to investigate anxiety and depression levels and quality of life of Turkish breast cancer patients and their husbands with Beck depression, STAI scoring system, and EORTC-QLQ-C30 quality of life scale. Fifty-five patients with breast cancer undergoing chemotherapy who applied to Dokuz Eylul University Faculty of Medicine, Department of Oncology, and their husbands were included in this study. The series of forms including the questions regarding the demographic characteristics of the patient, Beck Depression Inventory (BDI), the State-Trait Anxiety Inventory (STAI), and EORTC-QLQ-C30 (version 3) were completed during face-to-face interviews by trained interviewers for determination of the psychological status and quality of life of the patients. The mean Beck depression scores of patients and their husbands were 13 ± 9.3 (range 2–46) and 7.9 ± 5.7 (range 0–27) (P = 0.001). The mean STAI scores of patients and their husbands were 44.9 ± 8.7 (range 20–58) and 41.7 ± 8.0 (range 26–59) (P = 0.09).Twenty-nine percent of the patients and 5.4% of the husbands (Beck Depression scores ≥17 points) were determined as depressive. It was determined that the EORTC-QLQ C30 physical and social function scales of the patients were significantly lower than their husbands. The difference of global quality of life scores and other function scales (role, cognitive, emotional function scales) between patients and their husbands were not significant. It was found that depression of breast cancer patients were significantly higher than their husbands. But there was no significant difference between the EORTC-QLQ C30 global quality of life scores and STAI scores of the breast cancer patients and their husbands.     

癌痛对抑郁及免疫功能的影响

目的:分析癌痛与抑郁和免疫功能之间的相关性。方法:收集我科室从2013年1月至2016年12月收治的73例晚期肿瘤患者,37例癌痛组,36例无癌痛组,进行数字疼痛强度量表(NRS)、抑郁自评量表(SDS)、生活质量、免疫功能等的调查分析比较。结果:癌痛与无癌痛的两组患者抑郁的发生比较有统计学意义(P＜0.05),癌痛程度与抑郁程度有相关性(P＜0.05);癌痛与无癌痛的两组患者生活质量的比较差异有统计学意义(P＜0.05)。癌痛与无癌痛的两组患者CD3+、CD4+、CD8+比较差异无明显统计学意义(P＞0．05)。结论:抑郁的发生与癌痛相关,抑郁程度和癌痛程度也有极大关联。癌痛可明显影响患者生活质量,但对免疫功能影响不明显。     

Preparatory grief, psychological distress and hopelessness in advanced cancer patients

A study was undertaken to evaluate the preparatory grief process in advanced cancer patients and its relationship with hopelessness, depression and anxiety. In total, 94 advanced cancer patients treated in a Pain Relief and Palliative Care Unit completed the Preparatory Grief in Advanced Cancer Patients (PGAC) Scale, the Greek Hospital Anxiety and Depression (G-HAD) scales, and a measure of hopelessness the Beck Hopelessness Scale. The strongest correlation was found between grief and hopelessness ( r  = 0.63, P  < 0.0005) and PGAC-1 'self-consciousness' ( r  = 0.54, P  < 0.0005). Similarly, strong associations revealed between PGAC total with anxiety (HAD-D) and depression (HAD-D) ( P  < 0.0005). Significant associations were depicted between hopelessness, depression and anxiety with PGAC-total as well as with its components. Statistically significant associations were also obtained between grief, metastases ( P  = 0.073) and education ( P  = 0.043). In the multiple regression analysis (enter method), anxiety ( P  < 0.0005) was the strongest predictor of preparatory grief followed by hopelessness ( P  = 0.002), presence of metastases ( P  = 0.004) and depression ( P  = 0.033). Depression, hopelessness, anxiety and terminally ill patients' metastases contribute to the prediction of preparatory grief in this population.     

Evaluation of sexuality,health-related quality-of-life and depression in advanced cancer patients: A prospective study in a Phase I clinical trial unit of predominantly targeted anticancer drugs

BackgroundThe advent of molecular targeted agents (MTA) has opened a new era of therapy in oncology. However, some of the toxicities and side-effects of these new drugs are not explored as is the case with the potential impact of MTA on sexuality. This study aimed to prospectively evaluate health-related quality of life (HRQoL), depression and sexual function in advanced cancer patients treated in a Phase I drug unit evaluating MTA.Patents and methodsIn total, 63 of 74 eligible patients agreed to participate in the study. Four validated self-questionnaires were used: the Medical Outcomes Study Short-Form General Health Survey (SF12), the short form Beck Depression Inventory (BDI), the International Index of Erectile Function (IIEF) and the Female Sexual Function Index (FSFI). Forty-seven patients (75%) responded at baseline and 31 (65%) at 1-month.ResultsThis is the first evaluation of HRQoL, depression and sexual function in a Phase I drug unit. At baseline, patients had a good mental and physical function despite their disease progression. The response rate was 75% for sexual questionnaires. For 57% of females and 68% of males, quality of sexual life was a subject of interest. After 1-month of treatment, sexual dysfunction included lack of lubrication and comfort in females and erectile dysfunction in males with a statistical association of anti-angiogenic inhibitors in males (p = 0.04).ConclusionsPatients on MTA in Phase I clinical trials had a preserved mental and physical activity whereas their sexual activity declined in both sexes. The impact of MTA on HRQoL and especially sexual function should be routinely assessed in further studies to better understand their potential impact in advanced cancer patients.     

中晚期非小细胞肺癌患者的心理特征及临床意义

目的探讨中晚期非小细胞肺癌患者的心理特征及临床意义。方法选取110例新确诊的中晚期非小细胞肺癌患者,分别采用Connor-Davidson心理韧性量表(CD-RISC)、Zung抑郁自评量表、一般自我效能感量表(GSES)、社会支持评定量表(SSRS)、医学应对问卷(MCMQ)和世界卫生组织生存质量(WHOQOL-100)测定量表对患者的心理弹性、抑郁程度、自我效能水平、社会支持、应对方式和生活质量进行评分,分析患者心理弹性评分与各量表评分的相关性。结果新确诊中晚期非小细胞肺癌患者的心理弹性总分为(58.5±12.6)分,抑郁评分为(59.2±8.7)分,自我效能水平评分为(31.5±7.7)分,社会支持评分为(36.9±7.5)分,生活质量评分为(59.7±13.2)分。应对方式评分中,面对应对、回避应对及屈服应对评分分别为(18.7±5.5)、(15.2±3.9)和(9.4±3.5)分。新确诊中晚期非小细胞肺癌患者的心理弹性评分与自我效能水平、社会支持、面对应对及生活质量评分均呈正相关(P﹤0.01),与屈服应对、抑郁评分均呈负相关(P﹤0.01)。结论新确诊中晚期非小细胞肺癌患者的心理弹性评分较低,且与自我效能、社会支持、面对应对和生活质量评分均呈正相关,与屈服应对、抑郁评分均呈负相关。     

Requestioning depression in patients with cancer: contribution of somatic and affective symptoms to Beck's Depression Inventory.

BACKGROUND: Depressive symptoms are a major complaint reported by cancer patients. Somatic and affective symptoms can contribute to depression. PATIENTS AND METHODS: We investigated the prevalence of somatic and affective depressive symptoms with the Beck Depression Inventory (BDI) in 213 hospitalized cancer patients prior to the start of chemotherapy. RESULTS: Seventeen of 213 patients (8%) were screened positive for major depression; 40 (19%) had mild to moderate depressive symptoms. The corresponding figures for somatic and affective symptoms were 33.3% and 2.8% in the patients with major depression and 23.0% and 8.0% in those with mild to moderate depressive symptoms. Female patients, patients with solid tumour and those with functional limitations had significantly higher mean scores. All differences were related to higher scores in somatic and not in affective items. CONCLUSIONS: Most alterations in the BDI in cancer patients are related to somatic and not to affective symptoms and may be attributed not to depression but to severity of the underlying disease.     

Association between changes in quality of life scores and survival in non-small cell lung cancer patients

In patients with advanced cancer, quality of life is as meaningful to patients as the actual length of life. We investigated whether changes in quality of life could predict survival in non-small cell lung cancer. Quality of life was evaluated using EORTC QLQ-C30 (European Organisation for the Research and Treatment of Cancer Quality of Life Questionnaire). Cox regression evaluated the prognostic significance of baseline, 3-month and changes in quality of life scores after adjusting for age, gender, treatment history and stage. Two hundred and seventeen patients were men and 213 women. One hundred and fifty-nine patients had stage III while 271 had stage IV disease. Baseline quality of life scales predictive of survival upon multivariate analysis were physical (hazard ratio, 0.90; 95% confidence interval, 0.81-0.98; P= 0.02) and global (hazard ratio, 0.92; 95% confidence interval, 0.87-0.96; P < 0.001). On multivariate analysis, no change variables were significantly predictive of survival. However, in stage IV patients, change in physical function over a period of 3 months showed marginal significance such that every 10-point increase in physical function change score was associated with an 8% decreased risk of death. These findings should be used in clinical practice to systematically address quality of life-related problems of lung cancer patients throughout their treatment course.     

头颈部肿瘤患者生活质量及相关因素分析

目的探讨头颈部肿瘤患者的生活质量及相关影响因素。方法选取108例头颈部肿瘤患者作为研究对象,采用自行拟定头颈部肿瘤患者一般情况问卷调查表、欧洲癌症研究和治疗协作组生活质量核心问卷（EORTC QLQ-C30）、核心量表的头颈部肿瘤特异性问卷（QLQ-H＆N35）,社会支持评定量表、焦虑自评量表（SAS）及Beck抑郁问卷等对患者进行问卷调查。结果 EORTC QLQ-C30调查结果显示,患者躯体功能、角色功能、情感功能、认知功能、社会功能、症状评分均低于健康人（P〈0.05）,生活质量总评分为（68.78±12.45）分,头颈部肿瘤患者生活质量评分明显低于健康人（t=26.06,P〈0.05）。QLQ-H＆N35调查结果显示,患者社会进食困难及社会接触困难两种症状最为明显。对头颈部肿瘤患者生活质量相关因素分析结果显示,临床分期、疾病不良反应、焦虑及抑郁情况为影响生活质量的危险因素（P〈0.05）,而社会支持为保护性因素（P〈0.05）。结论头颈部肿瘤患者生活质量明显下降,主要不良影响因素为肿瘤分期、疾病不良反应、患者焦虑及抑郁情况,有利的影响因素为社会支持。     

The Effect of Exercise on Life Quality and Depression Levels of Breast Cancer Patients

Introduction: The aim of this study is to determine the effects of aerobic and stretching exercises on quality of life and depression levels of breast cancer patients. Methods: A total of 48 women (mean age 45.0±2.2 years) who were previously diagnosed with breast cancer and completed their treatment with no metastasis, were included in the study. Of these, 24 women who received the exercise program were assigned as the study group, while the remaining 24 women who did not receive the exercise program were assigned as the control group. The study group received a 12-week aerobic exercise program at the fitness club and home-based resistance exercise program designed by a sport scientist at the doctoral level. The control group was encouraged to maintain their normal level of physical activity and exercise habits throughout the study. The WHOQOL-BREF, EORTC-QLQ-C30 quality of life assessments and Beck depression inventory (BDI) were used to evaluate quality of life and the severity of depression before and after 12-week exercise programs. Results: EORTC QLQ-C30 scoring showed that in the study group aerobic exercise positively impacted quality of life on the functional scales (physical p=0.001, role p=0.039, emotional p=0.031, social functioning p=0.010) and symptoms (fatigue p=0.001, pain p=0.001, sleep disturbance p=0.038 and financial impact p=0.015). WHOQOL-BREF assessment areas, (general p=0.001, physical p=0.02, mental p=0.001 and social health p=0.017) relationships also improved as a result of exercise. BDI showed that severity of depression in the study group decreased significantly (p=0.001). Conclusion: This study showed that aerobic and resistance exercises improved quality of life and decreased depression levels of women who previously received breast cancer treatments.