癌症患者生命质量测定量表体系之大肠癌量表QLICP-GR的研制

背景与目的:癌症患者生命质量测定量表体系(quality of life instruments for cancer patients,QLICP)共性模块的研制已有报道,本研究在此基础上将研制大肠癌患者生命质量测定量表(QLICP-colorectal cancer,QLICP-CR).方法:采用量表开发的程序化决策方式研制适合中国文化背景下使用的QLICP-CR,并通过110例大肠癌患者的生存质量测定对量表进行评价.采用统计描述、相关分析、配对t检验和聚类分析等进行统计学处理.结果:总量表及各个领域的重测相关系数均在0.78以上;各领域内部一致性信度的α值除社会功能及共性症状和副作用领域分别为0.66、0.63外,其余均在0.85以上;各条目与其领域的相关均大于与其它领域的相关,相关系数r值大多都在0.6以上;总量表、共性模块、特异模块、心理功能及共性症状和副作用领域得分均显示治疗前后差异有统计学意义.结论:QLICP-CR具有较好的信度、效度及反应度,可作为我国大肠癌患者生命质量的测评工具.     

癌症患者生命质量测定量表体系之乳腺癌量表QLICP-BR的研制

背景与目的:我们已经研制了癌症患者生命质量测定量表体系的共性模块(quality of life instruments for cancer patients-general module,QLICP-GM).本研究在此基础上再研制乳腺癌患者生命质量测定量表(QLICP-BR),并对其进行评价.方法:采用量表开发的程序化决策方式研制适合中国文化的QLICP-BR,并通过对186例乳腺癌患者进行的生存质量测定对量表进行评价.结果:总量表及各个领域的重测相关系数均在0.75以上;各领域内部一致性信度的α值除社会功能领域为0.58外,其余均在0.65以上;各条目与其领域的相关性均大于与其它领域的相关性,相关系数r值大多都在0.6以上;总量表、共性模块、躯体功能、心理功能及社会功能领域得分均显示治疗前后差异有统计学意义.结论:QLICP-BR具有较好的信度、效度和一定的反应度,可作为我国乳腺癌患者生命质量的测评工具.     

癌症患者生命质量测定量表体系之大肠癌量表QLICP-CR的研制

背景与目的:癌症患者生命质量测定量表体系(quality of life instrumentsfor cancer patients,QLICP)共性模块的研制已有报道,本研究在此基础上将研制大肠癌患者生命质量测定量表(QLICP-colorectal cancer,QLICP-CR)。方法:采用量表开发的程序化决策方式研制适合中国文化背景下使用的QLICP-CR,并通过110例大肠癌患者的生存质量测定对量表进行评价。采用统计描述、相关分析、配对t检验和聚类分析等进行统计学处理。结果:总量表及各个领域的重测相关系数均在0.78以上;各领域内部一致性信度的α值除社会功能及共性症状和副作用领域分别为0.66、0.63外,其余均在0.85以上;各条目与其领域的相关均大于与其它领域的相关,相关系数r值大多都在0.6以上;总量表、共性模块、特异模块、心理功能及共性症状和副作用领域得分均显示治疗前后差异有统计学意义。结论:QLICP-CR具有较好的信度、效度及反应度,可作为我国大肠癌患者生命质量的测评工具。     

癌症患者生命质量测定量表体系共性模块的研制(二):信度与效度分析

背景与目的:我们已经开发了癌症患者生命质量测定量表体系共性模块(quality of life instruments for cancer patients-general module,QLICP-GM),但其心理测量学特性有待考评.本研究拟考评QLICP-GM的信度与效度.方法:用QLICP-GM对600例肺癌、乳腺癌、大肠癌、胃癌和头颈癌患者的生命质量进行测定和评价,用相关分析、配对t检验、等效检验、结构方程模型等统计学方法分析QLICP-GM的信度和效度;同时与FACT-G量表测定和评价结果比较,分析QLICP-GM的效标效度.结果:QLICP-GM各领域及总量表的重测信度均在0.85以上,除社会功能外各领域内部一致性信度α值均在0.70以上,总量表的α值和分半信度分别为0.88和0.93;相关分析与结构方程模型分析显示量表有较好的结构效度:与FACT-G的相关分析显示有较好的效标关联效度.结论:QLICPGM具有较好的信度和效度,可用于癌症患者生命质量测定.     

癌症患者生命质量测定量表体系中各量表的测量学特性分析

目的:分析癌症患者生命质量测定量表体系(Quality of Life Instruments for Cancer Patients, QLICP)中,已研制的用于测定肺癌、乳腺癌、头颈癌、胃癌、结直肠癌和宫颈癌等6种癌症患者的量表构成及信度、效度和反应度。方法:采用量表开发的程序化方法研制各量表,然后对692例恶性肿瘤(包括85例肺癌、186例乳腺癌、133例头颈癌、86例胃癌、110例结直肠癌和92例宫颈癌)患者进行生命质量测定,通过计算总量表及各领域的克朗巴赫系数α和重测相关系数,应用探索性因子以及采用配对t检验等分析方法,考评研制量表的信度和效度。结果:6种癌症患者的生命质量测定量表均有较好的结构和符合要求的测量学特性,即有较好的信度、效度和一定的反应度。结论:肺癌、乳腺癌、头颈癌、胃癌、结直肠癌和宫颈癌等6种癌症的特异模块与QLICP体系中的共性模块结合后,可用于临床上相应癌症患者生命质量的测定。     

癌症患者生命质量测定量表体系共性模块的研制(三):反应度分析

背景与目的:我们已经开发了癌症患者生命质量测定量表体系共性模块(quality of life instruments for cancer patients-general module,QLICP-GM),并对其信度、效度进行了评价.本文拟对其反应度进行分析.方法:用QLICP-GM量表测定5种癌症600例患者治疗前后的生命质量,采用传统假设检验并结合效应大小、标准化反应均数等指标以及等效检验方法进行分析.结果:躯体功能、心理功能、共性症状及副作用3个领域和总量表均发现统计学意义的变化,其标准化反应均数在0.16～0.67之间;等效检验也发现这些领域和总量表治疗前后不具等效性.结论:QLICP-GM具有一定的反应度,可用于临床生命质量测评.     

癌症患者生命质量测定量表体系之肺癌量表QLICP-LU的研制与测量学特性评价

[目的]研制肺癌患者生命质量测定量表QLICP-LU并对其测量学特性进行评价。[方法]采用程序化决策方式(议题小组和核心小组)和量表开发理论分别研制共性模块与特异模块,二者结合形成量表,并通过85例肺癌患者进行的生命质量测定对量表的测量学特性(信度、效度、反应度)进行评价。所用到的统计学方法有相关分析、因子分析及配对t检验等。[结果]该量表的重测信度为0.78,各领域内部一致性α值及重测信度值大多在0.7以上;相关分析与因子分析显示较好的结构效度;与FACT-L为效标的效标关联效度为0.82;治疗后各领域及总量表得分均有统计学意义,且标准化反应均数SRM除社会功能外均大于0.8。[结论]QLICP-LU具有较好的信度、效度及反应度,可用于中国肺癌患者的生命质量测定。     

癌症患者生命质量测定量表FACT-G中文版评介

目的介绍美国转归研究与教育中心的癌症治疗功能评价系统中的共性模块FACT-G中文版，重点是其计分方法和应用效果评价。方法通过552例恶性肿瘤患者进行的生存质量测定对量表进行评价。采用的统计学方法有相关分析、因子分析和配对t检验。结果4个领域的重测信度均在0．85以上；各领域内部一致性信度的α值均在0．8以上；各条目与其领域的相关系数r值均在0．5以上；27个条目中提取了4个因子，累计方差贡献率为65．8％；该量表在入院治疗4周后基本上能够反映出生命质量的变化。结论FACT-G中文版具有较好的信度、效度及反应度，可用于中国癌症患者的生命质量测定。     

宫颈癌患者生命质量评价量表的编制及测评

目的:编制一套适合测评中国宫颈癌患者的生命质量评价量表(quality of life scale for cervical cancer patients,QLS-CCP),并评价其信度和效度.方法:通过文献查阅法、访谈法和专家咨询等方法确定条目池,形成初始量表.采用变异度法、t检验法、相关系数法和逐步回归法对初始量表进行条目筛选,形成最终的测试量表;采用新编制的Q LS-CCP对136例子宫颈癌患者进行调查,并对其信度和效度进行评价.结果:最终QLS-CCP包含躯体功能、心理、社会及与疾病症状4个维度,共32个条目.量表的重测相关系数、Cronbach'α系数和分半信度系数分别为0.96、0.93和0.85.效标效度较好(rs=0.591,P=0.000).因子分析找到4个公因子,可以解释总变异的57.22％,显示量表的结构效度良好,量表结构与理论构想相符,具有较好的区分效度.结论:新编制的QLS-CCP具有良好的信度和效度,可用于中国宫颈癌患者生存质量的测评.     

癌症患者生命质量测定量表体系之宫颈癌量表QLICP-CE的研制及考评

[目的]研制癌症患者生命质量测定量表体系之宫颈癌量表QLICP-CE,并对其进行考评.[方法]通过程序化决策方式并多轮的访谈和预调查等研制量表QLICP-CE.并通过对92例宫颈癌患者的测定进行评价.统计学方法包括相关分析、因子分析和配对t检验等.[结果]该量表的重测信度y为0.95,克朗巴赫系数为0.68;相关分析与因子分析显示较好的结构效度;治疗后除社会功能领域外各领域及总量表得分均有统计学意义.治疗前后基本上能够反映出生命质量的变化.[结论]QLICP-CE具有较好的信度、效度及反应度,可以用于中国宫颈癌患者的生命质量测定.     

Second Primary Cancer after Diagnosis of Stomach Cancer in Osaka, Japan

The risk of developing a second primary cancer following stomach cancer was estimated from data accumulated in the Osaka Cancer Registry. Of the 38,777 male patients and 22,391 female patients newly diagnosed in the period 1966–1986 who were followed up until the end of 1986, 778 and 267 developed a second cancer other than stomach cancer, respectively, whereas the expected numbers had been 928.8 (RR=0.84, 95%CI=0.78-0.90) and 297.7 (RR = 0.90, 95%CI = 0.79-1.01). The risks were higher among younger patients (aged 30–54 at the diagnosis of stomach cancer) than among older patients (aged 55–69 at the diagnosis of stomach cancer). Significantly elevated risks were observed for cancers of the oral cavity & pharynx (RR=l.56), colon (RH = 1.61) and rectum (RR = 1.56) for males, and oral cavity & pharynx (RR = 2.59) for females as second cancers. Results were substantially similar among the localized stomach cancer patients. Among younger male patients with gastrectomy, the risk of developing pancreatic cancer was elevated 10 or more years after stomach cancer diagnosis. The present study suggests the necessity of following up stomach cancer patients in order to enable the early diagnosis of digestive tract cancer.     

Effect of Home Care Service on the Quality of Life in Patients with Gynecological Cancer

The purpose of the research was to determine the effect of home care service on the quality of life in patientswith gynecological cancer. This randomized case control study was carried out in a womans hospital betweenSeptember 2011 and February 2012. Women undergoing gynecological cancer treatment were separated intointervention and control groups, of 35 patients each. The intervention group was provided with nursing careservice through hospital and home visits (1st, 12th weeks) within the framework of a specifically developed nursingcare plan. The control group was monitored without any intervention through the hospital routine protocols(1st, 12th weeks). Data were collected using An Interview Form, Home Visit Monitoring Form and Quality of LifeScale/Cancer Survivors. Effects of home care service on the quality of life in gynecological cancer patients wereinvestigated using chi-square tests, McNemar’s test, independent t-test and ANOVA. This study found that theintervention group receiving home care service had a moderately high quality of life (average mean: 6.01±0.64),while the control group had comparatively lower quality (average mean: 4.35±0.79) within the 12 week postdischargeperiod (p<0.05). This study found home care services to be efficient in improving the quality of life inpatients with gynecological cancer.     

Psychosocial Stressors,Social Support and Socio-demographic Variables as Determinants of Quality of Life of Turkish Breast Cancer Patients

Purpose: The aim of the present study was to investigate the effects of psychosocial stressors, social supportand socio-demographic variables on quality of life of breast cancer patients. Tools and methods: The study wasconducted between December 2004 and May 2005 and included 101 patients, treated in the Oncology Departmentsof Ege and Pamukkale University Hospitals and Denizli State Hospital. Patients’ demographic data were collectedby questionnaire. The methods used in the interviews were the Rotterdam Symptom Checklist (RSCL), and theMultidimensional Scale of Perceived Social Support (MSPSS), the Karnofsky Performance Status (KPS).Psychosocial stressors were classified according to life events using the DSM-IV multi-axial diagnostic system.Results: It was found that increase of cancer stage triggers a decrease in psychological quality of life (p<0,05);overall global life quality (p<0,001), perceived social support and performance status (p<0,05), all of these beingnegatively affected by family stressors. The patients with increased social support, better psychological andoverall quality of life (p<0,01) and younger age had more physical wellness besides overall quality of life (p<0,05);lower incomes negatively affected overall global life quality (p<0,01) and working at a job decreased thepsychological stressors (p<0,05). Conclusion: From these results, it can be postulated that psychosocial stressors,social support and some socio-demographic variables mostly affected quality of life of the breast cancer patients.     

Survival of Stomach Cancer Cases in Khon Kaen,Thailand 2000-2012

Background: Stomach cancer is an aggressive malignancy that is difficult to detect at an early stage and therefore is characterized by poor survival rates. Over the last two decades, there has been no report of gastric cancer survival in Khon Kaen province, Thailand. The aim of this retrospective cohort study was to provide up-to-date information about the survival of gastric cancer patients in this province. Materials and Methods: Data from Khon Kaen population-based cancer registry, Faculty of Medicine, Khon Kaen University were newly obtained on 650 patients who were diagnosed with stomach cancer during the period 1 January, 2000 to 31 December, 2012. These were then followed up until death or the end of the study (31 December 2014). We calculated the observed survival with the actuarial life table method, and relative survival, defined as the ratio of observed survival in the group of the stomach cancer patients to the expected survival in the entire Thai population from the estimated generation life tables for Thailand of five-year birth cohorts from 1900 - 2000. Results: The 5 year observed and 5 year relative survival rates were 17.2 % (95% CI: 13.54-21.14) and 18.2 % (95% CI: 14.3-22.4), respectively. The highest 5 year relative survival rates were demonstrated among patients aged 45-65, with stage I or II lesions, with adenocarcinomas, with a body of stomach location, well differentiated and receiving surgery and/or chemotherapy. Conclusions: The observed and relative survival rates were close to each other. Our findings provide basic information beneficial to development of an effective treatment system and appropriately improved population-based cancer registration.     

Dosimetric Comparison of Three Different Radiotherapy Techniques in Antrum-Located Stomach Cancer

Background: The current optimal radiotherapy (RT) planning technique for stomach cancer is controversial. The design of RT for stomach cancer is difficult and differs according to tumor localization. Dosimetric and clinical studies have been performed in patients with different tumor localizations. This may be the main source of inconsistencies in study results. For this reason, we attempted to find the optimal RT technique for patients with stomach cancer in similar locations. Methods: This study was based on the computed tomography datasets of 20 patients with antrum-located stomach cancer. For each patient, treatments were designed using physical wedge-based conformal RT (WB-CRT), field-in-field intensity-modulated RT (FIF-IMRT), and dynamic intensity-modulated RT (IMRT). The techniques were compared in terms of expected target volume coverage and the dose to organs at risk (OAR) using a dose-volume histogram analysis. Results: FIF-IMRT was the most homogenous technique, with a better homogeneity index than WBCRT (p<0.001) or IMRT (p<0.001). However, IMRT had a better conformity index than WBCRT (p<0.001) or FIF-IMRT (p<0.001). Additionally, all OAR, including the kidneys, liver, and spinal cord, were better protected with IMRT than with WBCRT (p=0.023 to <0.001) or FIF-IMRT (p=0.028 to <0.001). Conclusions: In comparison to FIF-IMRT and WBCRT, IMRT appears to be the most appropriate technique for antrum-located stomach cancer. To establish whether IMRT is superior overall will require clinical studies, taking into account differences in both tumor localization (cardia, body, and antrum) and organ movement in patients with stomach cancer.     

Comparison of the JCAHO Scoring System and the ESAS Scoring System in Determining the Palliative Care Needs of Gynecological Cancer Patients Treated at Hasan Sadikin Hospital

Objective: The purpose of this study was to analyze the relationship between quality of life with the JCAHO and the ESAS scoring system, and to compare the JCAHO and the ESAS scoring system in determining the palliative care needs of gynecological cancer patients treated at RSHS. Method: The subjects of this study were all gynecological cancer patients who were treated at RSHS in May-August 2020. This study was an analytic study with a cross sectional design. The data of this study were obtained from interviews, questionnaires and patient medical records, the study was analyzed bivariate using chi square with α = 0.05. Results: The results showed that the quality of life of patients with gynecological cancer was associated with the JCAHO palliative score (p <0.05), the better the patient’s quality of life, the better the JCAHO palliative score. The quality of life of gynecological cancer patients was related to ESAS (p <0.05), the better the patient’s quality of life, the better the ESAS. There was difference between the JCAHO palliative score and the ESAS in determining the palliative care needs of gynecological cancer patients (p< 0.05). Conclusion: Quality of life has correlation with palliative scores, the lower the palliative score, the better the quality of life. This study showed significant difference between the JCAHO palliative score and the ESAS in determining the palliative care needs of gynecological cancer patients. The JCAHO palliative score measures objectively how the patient is on admission for treatment, this score not only measures the intensity of symptoms but measures the underlying disease, comorbid disease, functional status of the patient and other criteria for the patient.  ESAS assesses the intensity of symptoms, the assessment of palliative care needed can change rapidly if the intensity of symptoms in patients changes.     

Quality of Life among Breast Cancer Patients Undergoing Treatment in National Cancer Centers in Nepal

Purpose: To study the quality of life and to identify associated factors among breast cancer patients undergoingtreatment in national cancer centers in Nepal. Materials and Methods: One hundred breast cancer patients wereselected and interviewed using a structured questionnaire. European Organization of Research and Treatmentof Cancer EORTC-QLQ-C30 and EORTC-QLQ-BR23 were used to assess quality of life and modified MedicalOutcome Study -Social Support survey(mMOS-SS) was used to assess social support. Only multi-item scales ofEORTC C30 and BR23 were analyzed for relationships. Independent sample T-tests and ANOVA were appliedto analyze differences in mean scores. Results: The score of global health status/quality of life (GHS/GQoL) wasmarginally above average (mean=52.8). The worst performed scales in C-30 were emotional and social functionwhile best performed scales were physical and role function. In BR-23, most of the patients fell into the problematicgroup regarding sexual function and enjoyment. Almost 90% had financial difficulties. Symptom scales did notdemonstrate many problems. Older individuals, patients with stage I breast cancer and thosewith good socialsupport were found to have good GHS/GQoL. Of all the influencing factors, social support was established tohave strong statistical associations with most of the functional scales: GHS/GQoL (0.003), emotional function(<0.001), cognitive function (0.020), social function (<0.001) and body image function (0.011). Body image wassignificantly associated with most of the influencing factors: monthly family income (0.003), type of treatment(<0.001), type of surgery (<0.001), stage of cancer (0.017) and social support (0.011). Conclusions: Strategies toimprove social support of the patients undergoing treatment should be given priority and financial difficultiesfaced by breast cancer patients should be well addressed from a policy making level by initiating health financingsystem.     

Survival of Patients with Stomach Cancer and its Determinants in Kurdistan

Background: Stomach cancer is the fourth most common cancer and the second leading cause of death from cancer in the world. In Iran, this type of cancer has high rates of incidence and mortality. This study aimed to assess the survival rate of patients with stomach cancer and its determinants in Kurdistan, a province with one of the highest incidence rates of stomach cancer in the country. Materials and Methods: We studied a total of 202 patients with stomach cancer who were admitted to Tohid Hospital in Sanandaj from 2009 to 2013. Using KaplanMeier nonparametric methods the survival rate of patients was calculated in terms of different levels of age at diagnosis, gender, education, residential area, occupation, underweight, and clinical variables including tumor histology, site of tumor, disease stage, and type of treatment. In addition, we compared the survival rates using the logrank test. Finally, Cox proportional hazards regression was applied using Stata 12 and R 3.1.0 software. The significance level was set at 0.05. Results: The mean age at diagnosis was 64.7 12.0 years. The survival rate of patients with stomach cancer was 43.9% and 7% at the first and the fifth year after diagnosis, respectively. The results of logrank test showed significant relationships between survival and age at diagnosis, education, disease stage, type of treatment, and degree of being underweight (P<0.05). Moreover, according to the results of Cox proportional hazards regression model, the variables of education, disease stage, and type of treatment were associated with patient survival (P<0.05). Conclusions: The survival rate of patients with stomach cancer is low and the prognosis is very poor. Given the poor prognosis of the patients, it is critical to find ways for early diagnosis and facilitating timely access to effective treatment methods.     

The Efficacy of Psychoeducational Support Group for Saudi Breast Cancer Survivors

Background: The adverse effects of psychological distress and quality of life are common outcomes in breast cancer survivors. Psychoeducational interventions have been widely used to reduce these adverse outcomes among those patients. This study aims to assess the impact of the Blossom support group on psychological distress and quality of life in breast cancer patients in Saudi Arabia. Methods: This study is a retrospective cohort study for the Blossom program, which was held yearly for eight weeks from 2014 until 2018. Data was collected from the survivors’ records at the Zahra Breast Cancer Association in Riyadh, Saudi Arabia. Outcome measurements: include the quality of life scale (SF-36) and Hospital Anxiety Depression Scale (HADS) with both were available in the Arabic translated version. Both tools were used as the screening measurement for the assessment of the quality of life, depression, and anxiety before and after the program. The data were analyzed using the Statistical Analytical Software (SAS), version 9.4. Statistical differences in median scores of SF-36 and HADS before and after the program was tested using Wilcoxon signed-rank test. Result: A total of 54 breast cancer survivors were enrolled in the Blossom support program over the period 2014 to 2018. Of these participants, only 25 participants completed the full eight weeks program.  There were statistically significant differences in the overall quality of life (SF-36) before and after the 8 weeks from baseline of the experiment (W = 60, P-value =0.0125). Moreover, the overall anxiety and depression scores were tested separately and the results reveal statistically significant differences in both dimensions before and after the program (Anxiety: W=132, P-value = 0.0059; depression: W=157, P-value = 0.0002). Conclusion: The Blossom support program showed a positive impact on the quality of life and the psychological well-being of breast cancer survivors. It is recommended to utilize this support program across a wide range of health organizations with breast cancer survivors as a baseline of psychological care to improve the quality of life.