乳腺癌化疗患者癌性疲乏、应对方式与生活质量的相关性

目的:探讨乳腺癌化疗患者癌性疲乏、应对方式与生活质量之间的相关性.方法:本研究是横断面研究,采用方便抽样法选择乳腺癌改良根治术后行药物化疗的女性患者120例,用癌性疲乏自评量表 (the Revised Piper Fatigue Scale,PFS)、Jalowiec的应对量表 (Jalowiec Coping Scale,JCS)和欧洲癌症研究与治疗组织开发的癌症患者生命质量测定系列量表的核心问卷[Quality of Life Questionnaire-Core 30,QLQ-C30(V3.0)]和针对乳腺癌人群的特异性问卷 (Quality of Life Questionnaire-Breast 23,QLQ-BR23),分别测评患者的癌性疲乏水平、应对方式和生活质量状况.采用Spearman相关分析患者癌性疲乏状况、应对方式以及生活质量三者之间的相关性.结果:乳腺癌化疗患者的癌性疲乏总分与QLQ-C30的功能和总体健康状况呈负相关(r＝-0.24,-0.39;均P<0.01);积极的应对方式如勇敢面对、乐观与PFS的感知维度呈负相关(r＝-0.25,-0.18;均P<0.05),与QLQ-BR23的功能维度呈正相关(r＝0.35,0.21;均P<0.05);消极应对方式如情感、听天由命与PFS的认知维度呈正相关(r＝0.33,0.18;均P<0.05),与QLQ-BR23的功能维度呈负相关(r＝-0.40,-0.32;均P<0.05),与QLQ-BR23症状维度呈正相关(r＝0.40,0.28;均P<0.05).结论:乳腺癌化疗患者所经历的癌性疲乏状况、采取的应对方式及其生活质量三者间存在一定程度的关联,此发现对临床护理有指导意义.

Relationship among Cancer-Related Fatigue,Coping Style and Quality of Life in Patients of Breast Cancer with Chemotherapy

Objective:To explore the relationship among the cancer-related fatigue,coping styles and quality of life in breast cancer patients with chemotherapy.Methods:A total 120 female breast cancer patients were selected as the subjects.The instrument used for data collection was a questionnaire that was composed of four parts:the demographic data form,the Revised Piper Fatigue Scale (PFS),Jalowiec Coping Scale (JCS),Quality of Life Questionnaire-Core 30 (QLQ-C30),and Quality of Life Questionnaire-Breast 23 (QLQ-BR23).The statistical software SPSS was used for data analysis.Cancer-related fatigue,coping styles,quality of life and their related factors were determined by nonparametric tests.Spearman correlation coefficient was used to investigate the relationship among cancer-related fatigue,coping styles and quality of life in breast cancer patients with chemotherapy.Results:There was a significant negative moderate correlation between cancer-related fatigue and the quality of life (r＝-0.24,P<0.01),and negative correlation between cancer-related fatigue and the total health status (r＝-0.39,P<0.01).The positive coping styles including optimistic and confronting were negatively correlated with cancer-related fatigue (r＝-0.25,-0.18，Ps<0.05),and were positively related to the functional domain of quality of life(r＝0.35，0.21， Ps<0.05).The positive coping styles including emotive,fatalistic,and palliative were positively correlated with cancer-related fatigue (r＝0.25,0.18,and 0.28， Ps<0.05),and were negatively correlated with the functional domain of quality of life (r＝-0.40,-0.32，Ps<0.05),and emotive and fatalistic were positively related to the symptomatic domain of quality of life(r＝0.40,0.28,Ps<0.05).Conclusion:There exists a certain degree of correlation among cancer-related fatigue,coping styles and quality of life in breast cancer patients with chemotherapy,which may guide the clinical care.