肺癌患者首次化疗前后生存质量评价研究

目的：评估肺癌化疗患者首次化疗前后的生存质量并探究与之相关的影响因素,帮助临床护理人员制定有效、有针对性的护理计划。方法：接受首次化疗的晚期非小细胞肺癌患者,经病理确诊,排除伴有严重的并发症,有系统严重疾病需要专科治疗者。结果：共调查118例首次接受化疗的晚期非小细胞肺癌患者,生存质量总分、躯体功能、心理功能、社会功能和特异模块等方面,化疗后明显高于化疗前。结论：对比肺癌患者化疗前后生存质量评价的结果,我们可以看出化疗后肺癌患者的生存质量总分高于化疗前。因此,护理肺癌化疗病人的过程中,建议将生存质量作为护理评估的一个综合性指标。     

食管癌术后患者社会支持与生存质量的相关性研究

目的:通过调查食管癌术后患者社会支持情况,分析其社会支持与生存质量的关系,为提高术后患者生存质量提供有效的依据.方法:采用社会支持评定量表及QLQ-C30问卷对66例食管癌术后患者进行问卷调查,了解患者术后社会支持情况,分析社会支持与生存质量的关系.结果:食管癌患者术后的社会支持总分(40.55±5.88)、客观支持(10.05±1.91)、主观支持(22.73±4.08)及支持利用度(7.77±1.31)得分与对照组相比较,其中社会支持总分、主观支持得分明显高于对照组,而客观支持及支持利用度得分则明显低于对照组,差异有统计学意义(P＜0.01).患者术后的客观支持与角色功能(r=0.627,P＜ 0.01)、社会功能(r=0.369,P＜ 0.01)呈正相关;主观支持与角色功能(r=0.418,P＜ 0.01)呈正相关;支持利用度与社会功能(r=0.388,P＜ 0.01)呈正相关,与认知功能(r=-0.351,P＜0.01)呈负相关.结论:食管癌术后患者整体的社会支持状况良好,而客观支持及对社会支持利用度的情况则不够理想,其社会支持情况与生存质量密切相关.     

护理干预对妇科肿瘤术后化疗患者生存质量的影响

目的 探讨护理干预对妇科肿瘤术后化疗患者生存质量的影响.方法 选择2008年6月至2009年12月我院收治的妇科肿瘤术后化疗患者74例,随机将患者分为干预组和对照组各37例.2组患者在化疗的同时均给予常规治疗及护理,而干预组则在此基础上给予系统性护理干预措施,并对2组患者的焦虑、抑郁及生存质量评分情况等指标进行对比分析.结果 与对照组相比,护理干预后干预组在躯体功能、角色功能、认知功能、情绪功能、社会功能和整体功能等方面的评分均明显提高.与此同时,干预组焦虑和抑郁的评分均明显降低.结论 采用系统性的护理十预措施对妇科肿瘤术后化疗患者生存质量的提高具有十分重要的临床价值,值得进一步的推广和应用.     

食管癌贲门癌术后患者生活质量评价

目的 研究食管癌贲门癌术后患者生活质量的评价及影响因素. 方法 对行食管癌贲门癌手术,术后生存 5年以上患者进行生活质量问卷随访调查. 结果 第 1年生活质量满意度为 42.7% ,第 5年生活质量满意度 79.9% .比较差异有显著性意义( u=2.11,P< 0.05).无远期消化道症状患者的生活满意度为 88%,有远期消化道症状患者的生活满意度为 6.3%,比较差异有显著性意义(χ 2=6.98,P< 0.01).自我精神状态良好的患者生活质量满意度为 91%.自我精神状态较差的患者生活质量满意度为 14%.比较差异有显著性意义(χ 2=7.31,P< 0.01). 结论 患者术后的精神状态、远期消化道并发症是影响术后生活质量的主要因素.     

医护一体化护理对食管癌患者术后应激反应与近期生存质量的影响

目的：探讨医护一体化护理干预对食管癌患者术后应激反应和近期生存质量的影响。方法将62例食管癌患者采用随机数字表法随机分为干预组32例和对照组30例,两组患者均于手术当日晨（术前）、术后第5天（术后）采集静脉血分别测定应激反应指标含量,包括空腹血糖（ FBG）、C-反应蛋白（CRP）、白细胞介素-6（IL-6）、血浆皮质醇（Cor）。对照组采用常规护理模式,干预组采用医护一体化护理模式。采用生存质量问卷调查表评价两组患者术前和术后2周的生存质量,并进行比较。结果术前干预组与对照组患者FBG、CRP、IL-6和Cor的水平差异均无统计学意义（P＞0．05）。术后第5天,对照组患者的FBG、CRP和Cor水平高于干预组,差异有统计学意义（ t值分别为3．724,7．203,4.137;P＜0．05）,IL-6水平差异无统计学意义（t＝0．452,P＞0．05）。两组患者术后第5天FBG、CRP、IL-6和Cor的水平均高于术前水平,差异有统计学意义（ t值分别为3．031,5．361,2．864,3．534和6．990,10.755,2．415,8．166;P＜0．05）。生存质量评价中,两组患者术前各功能项目和症状项目得分差异无统计学意义（P＞0．05）;手术后2周干预组的全部功能项目得分高于对照组,差异有统计学意义（P＜0.05）;干预组症状项目得分均低于对照组,其中7项得分差异有统计学意义（P＜0．05）,2项差异无统计学意义（ P＞0．05）。结论医护一体化护理干预能减轻食管癌患者术后的应激反应,提高患者的近期生存质量。     

消化道肿瘤化疗患者生存质量现状及影响因素分析

目的描述消化道肿瘤患者化疗不同阶段生存质量水平变化并探讨其影响因素。方法采用便利抽样的方法,选择符合入选标准的84例患者,应用一般资料问卷和欧洲癌症研究与治疗组织的生存质量核心问卷量表(第3版,中文版)来收集资料;采用方差分析,比较患者化疗不同阶段生存质量的差异,使用多元逐步回归确定影响生存质量的主要因素。结果患者躯体功能、社会功能、情绪功能、总体状况、疲乏、食欲下降、便秘、经济困难等分值在化疗前后比较,差异有统计学意义(P0.01)。影响患者生存质量的因素有临床分期、文化程度、化疗同时放疗、卡氏体能评分、主要陪护人员是否直系亲属和性别(P0.01)。结论消化道肿瘤患者在化疗期间生存质量整体水平较低,针对影响患者生存质量的主要因素,临床护理人员应予以足够重视,并采取积极的应对措施,以改善患者化疗期间的生存质量。     

内镜下金属支架置入术对中晚期食管癌和食管气管瘘患者生存质量的影响

目的探讨在中晚期食管癌和食管气管瘘患者中采用内镜下金属支架置入术治疗对其生存质量的影响。方法采用癌症患者生活质量核心量表(EORTCQLQ-C30)中文版和食管癌专用量表(QLQ-OES18),对34例中晚期食管癌及食管气管瘘患者进行内镜下金属支架置入术治疗前1d、治疗后4周的生存质量进行问卷调查。结果治疗后4周,患者总体生活质量和躯体、角色、情绪、社会功能评分较术前显著升高(P<0.05),但认知功能无明显变化(P>0.05);吞咽困难、疲乏、进食、梗阻、咳嗽显著改善,反流加重;恶心呕吐、疼痛、咽口水、食欲减退、口干、言语有所改善,但差异无统计学意义(P>0.05)。结论内镜下金属支架置入术能改善中晚期食管癌和食管气管瘘患者生存质量。     

三维适形放疗同步化疗对食管癌患者生存质量的影响观察

目的:探讨三维适形放疗同步化疗对食管癌患者生存质量的影响。方法:选取我院2015年1月~2016年10月收治的96例中晚期食管癌患者为研究对象,随机分为A组和B组,各48例。A组给予单纯三维适形放疗,B组在A组基础上联合化疗。比较两组临床疗效、不良反应发生率及生存质量评分。结果:B组治疗总有效率明显高于A组(P0.05);两组放射性食管炎、放射性肺损伤发生率比较无显著性差异(P0.05),但B组白细胞降低、血小板减少、肝功能异常、心脏毒性发生率明显高于A组(P0.05);治疗前,两组生存质量评分比较无显著性差异(P0.05);治疗后,A组功能性维度评分高于B组,症状维度评分低于B组(P0.05);治疗3个月后,B组功能性维度评分高于A组,症状维度评分低于A组(P0.05)。结论 :三维适形放疗同步化疗方案治疗食管癌效果显著,但治疗期间容易引发不良反应,影响患者生存质量评分,但治疗后短期内生存质量即可逐渐恢复,相对于单纯放疗的患者获益更多,临床应给予足够重视。     

综合护理干预提高妇科肿瘤术后化疗患者生存质量的效果观察

目的 探讨综合护理干预对妇科肿瘤术后化疗患者生存质量的影响.方法 选择80例妇科肿瘤术后化疗患者,按随机数字表法随机分为干预组和对照组各40例,对照组给予常规护理,干预组实施综合护理干预.采用世界卫生组织生存质量量表简表中文版(WHOQOL-BREF)比较两组患者生存质量.结果 干预前两组患者WHOQOL-BREF得分比较,差异无统计学意义(P＞0.05);干预后干预组WHOQOL-BREF生理领域、心理领域、社会关系领域、环境领域得分分别为(50.79±3.17),(49.40±5.33),(51.30±1.77),(53.21±4.10)分,均高于对照组的(46.21±4.51),(43.23±4.66),(45.00±2.91),(49.99±3.12)分,差异均有统计学意义(t分别为4.79,6.81,10.22,4.61;P ＜0.05).结论 采用系统性的护理干预措施对妇科肿瘤术后化疗患者生存质量的提高具有十分重要的临床价值,值得进一步的推广和应用.     

自我管理教育对胶质瘤术后化疗患者生存质量的研究

目的 探讨自我管理教育对脑胶质瘤术后化疗患者生存质量的影响。方法 胶质瘤术后化疗患者80例前瞻性随机平行对照研究,对照组和观察组各40例。对照组行常规护理,观察组在对照组常规护理的基础上增加自我管理教育。结果 自我管理教育后观察组的自我效能评分和生存质量水平都明显高于对照组评分,差异具有显著意义(P＜0.01)。同时,观察组在接受自我管理教育前后的生存质量水平也有明显改善,差异具有显著意义(P＜0.01)。结论 自我管理教育可以有效提高胶质瘤术后化疗患患者的自我效能和自我管理水平,提高患者依从性,进而提高生存质量。     

What symptom and functional dimensions can be predictors for global ratings of overall quality of life in lung cancer patients?

Purpose This study explores what dimensions of a health-related quality of life (HRQOL) questionnaire predict global ratings of overall quality of life (QOL) in lung cancer patients in assessments by patients and significant others, respectively. Material and methods The analyses were based on dyadic assessments from lung cancer patients and their significant others. A subset of scales and items from the Swedish version of the European Organization for Research and Treatment of Cancer (EORTC) QLQ C30 and the lung-cancer-specific module, LC-13, was selected. Using multiple regression procedures, the relative importance of different symptoms and of functional impairments in predicting overall QOL was examined. Results The multiple regressions revealed that emotional functioning and fatigue were the only significant predictors of overall QOL for both the patients and the significant others’ assessments. In addition, physical functioning was found to be another predictor in the significant others’ assessments. Conclusion The results emphasize that it is essential to consider both emotional functioning and fatigue as important areas for overall QOL in lung cancer patients.     

恶性淋巴瘤患者生活质量量表评价

目的将 EORTC QLQ-C30翻译成相应的中文版量表,通过测量恶性淋巴瘤患者的生活质量对该量表进行心理测量学考评,为恶性淋巴瘤患者生活质量评价提供依据. 方法 EORTC QLQ-C30中文版量表包括 5个功能领域方面(躯体、角色、认知、情绪、社会)、 3个症状领域方面(疲劳、恶心呕吐、疼痛),整体健康状况、其他症状领域以及疾病和治疗对家庭经济的影响.测量 80对恶性淋巴瘤患者及非肿瘤患者对照生活质量. 结果 EORTC QLQ-C30中文版量表的重测信度≥ 0.7,在躯体、情绪功能、恶心呕吐、疼痛等方面内部一致性信度克郎巴赫系数α≥ 0.7,方差分析显示恶性淋巴瘤患者在角色、社会功能、整体功能领域、经济影响、总量表得分方面的生活质量低于对照. 结论 EORTC QLQ-C30中文版量表具有良好的信度和效度,可作为国内恶性淋巴瘤患者生活质量的测评工具.     

喉切除术后患者的生存质量量表

目的:研制并测试喉切除术后患者生存质量量表。方法:依据1993年WHO制定的生存质量一般准则,通过指标的收集和筛选,制定喉切除术后患者生存质量量表。选择1996-06/2002-06在中山大学附属第一医院因喉癌行喉切除术后满6个月的患者81例,对36例喉部分切除和45例喉全切除的患者进行上述量表问卷调查,考核该量表的可行性、信度和效度。结果:①量表指标筛选结果:经过对收集的81个指标的多次筛选,最终得到生存质量量表的22个评价指标。②量表结构:由22个评价指标及1个有关患者对自己总体健康状况和生存质量评价的问题(满分100分)组成。覆盖了身体机能、喉功能、心理状态、独立生活能力、社会关系与环境以及气管造口等6个方面。采用等级描述评分法,每个问题有5个选项,由差到好依次分值为1～5分。③量表的接受率和完成率分别为73%和93%,完成时间为10min以内;分半信度、克朗巴赫系数和方差比分别为0.842,0.889和0.155,表明量表有较好的信度。通过测试准则关联效度及内容效度,表明量表是有效的。结论:设计的喉切除术后患者生存质量量表有喉切除术的专业特性,具有较好的可行性、信度及效度。     

The assessment of health-related quality of life and related factors in Chinese elderly patients undergoing chemotherapy for advanced cancer: A cross-sectional study

Purpose of the research(i) To assess the health-related quality of life (HRQOL) and analyse the potential contributing factors of HRQOL in elderly cancer patients in China; and (ii) to evaluate the possible correlation between the Medical Outcomes 36-Item Short Form Health Survey (SF-36) and the European Organization for Research and Treatment of Cancer, quality of life questionnaire (EORTC QLQ-C30).Methods and sampleA total of 109 elderly patients undergoing chemotherapy with advanced cancer completed a survey assessing HRQOL, anxiety and depression. HRQOL was measured by SF-36 and EORTC QLQ-C30. Anxiety and depression, was measured by the Hospital Anxiety and Depression Scale (HADS).Key resultsScales pertaining to role functioning, including SF-36 role physical (25.92 ± 37.10) and role emotional (36.12 ± 43.50), EORTC QLQ-C30 role functioning (46.94 ± 36.86), were the worst domains of SF-36 and EORTC QLQ-C30 respectively. Financial impact (55.77 ± 36.55) and fatigue (46.18 ± 26.48) were the top two highest scores among all nine symptom-related scales of EORTC QLQ C-30. The correlation matrix of SF-36 versus EORTC QLQ-C30 showed that, in general, there was good correlation between scales pertaining to the same health domain, and low correlation was observed between scales pertaining to different domains.ConclusionsThe findings of this study highlight role functioning, financial impact, fatigue, anxiety, and depression as areas where elderly cancer patients could most benefit from intervention. These findings also call attention to HRQOL and its related factors in elderly cancer patients. Interventions to be developed for improving HRQOL in cancer patients are highly recommended.     

Quality of life and symptom control in hospice patients with cancer receiving chemotherapy

The value of palliative chemotherapy for hospice patients is difficult to quantify and little is known about outcomes from these treatments. This study examined quality of life and symptom control in hospice patients with cancer receiving chemotherapy and in a control group of hospice patients with cancer who had not received chemotherapy for at least 3 months. Using a case-control study design matching patients by age, gender, race, and cancer diagnosis, patients receiving chemotherapy reported a similar number of symptoms as patients off chemotherapy. Global symptom distress was comparable in both groups as was quality of life. Patients in both groups were similar at the symptom-specific level, however, patients on chemotherapy had better symptom outcomes for urination problems (p=0.03), numbness/tingling (p=0.03), muscle weakness (p=0.07), and pain (p=0.09). Patients on chemotherapy had poorer symptom control involving change in taste (p=0.01) and cough (p=0.01). Patients on chemotherapy were more likely than those off chemotherapy to report that chemotherapy "made them feel better" (p=0.01) and "allowed better symptom control" (p=0.01), indicating that patients taking chemotherapy had more subjective benefit from chemotherapy when compared to those off chemotherapy. The two groups showed no difference in the rate of survival.     

Health-related quality of life during the last three months of life in patients with advanced cancer

Goals of work  The aim of the study was to explore the development of functioning impairments and symptom occurrence during the last months of life of advanced cancer patients. Materials and methods  Self-reported data from 116 patients who all completed the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire—Core 30 (EORTC QLQ-C30) at 3, 2 and 1 month before death were analysed. Main results  All functioning aspects deteriorated. For physical, cognitive and social function, the most marked changes occurred between 2 and 1 month before death. The proportion reporting serious difficulties with self-care activities increased from 14% to 43%. The most seriously affected activity could not be distinguished from the EORTC QLQ-C30 scores. Levels of fatigue, dyspnoea and appetite loss increased significantly. More than 50% of the patients had severe pain at all assessments, and only a minor number (8%) reported any improvement. Conclusions  The findings have implications for the planning of care and indicate that further research is required to improve assessment, treatment and follow-up procedures. Adequate pain treatment seems still to be a challenge. Anorexia, fatigue as well as dyspnoea are all symptoms that need further focus.     

食管癌病人放化疗后焦虑状况的调查分析

[目的]了解食管癌病人放化疗后焦虑状况及相关影响因素。[方法]应用焦虑自评量表（SAS）对100例食管癌病人进行问卷调查,辅以自行设计的调查表进行原因调查。[结果]100例调查对象中有焦虑反应36例（36%）,放化疗后焦虑症状评分明显高于国内常模（t=19.94,P〈0.01）;影响食管癌病人焦虑的相关因素为恐惧疾病、治疗副反应、家庭支持、治疗效果、死亡威胁、照护问题、治疗费用方面、疼痛（P〉0.05）。[结论]食管癌病人放化疗后焦虑的发生率较高,应针对影响食管癌病人焦虑的相关因素采取相应的护理干预措施,以减轻病人的焦虑程度。