乳腺癌术后义乳佩戴与指导门诊的建立与管理

目的 探索乳腺癌术后义乳佩戴与指导门诊的构建与运行效果,提高乳腺癌术后患者的生活质量。方法 设立门诊对患者进行义乳佩戴与指导,为患者提供义乳款式及规格选择、义乳试戴、义乳佩戴指导等服务。结果 2021年3月至2022年8月,义乳佩戴与指导门诊服务患者414例次,患者门诊满意度为99.59%。结论 乳腺癌术后义乳佩戴与指导门诊可促进乳房全切术后患者形体管理,为患者提供安全、方便、规范、有效的义乳选择及佩戴环境,改善患者生活质量。     

前列腺癌患者的生活质量与自我形象研究

目的 了解前列腺癌患者的生活质量、接受雄激素去除治疗与否生活质量的差异性及自我形象与生活质量的相关性,为提高患者生活质量干预提供依据.方法 对155例前列腺癌患者采用自我形象量表、生活质量量表及前列腺癌特异性补充量表测量其生活质量和自我形象的认知,分析两者的相关性.结果 患者自我形象得分6.32±4.82,生活质量总分...     

痤疮患者身体意象与生活质量现状及相关研究

目的探讨痤疮患者身体意象与生活质量现状及其相关关系,为痤疮患者的心理护理提供依据。方法采用方便抽样法选取北京市某三级甲等医院皮肤科门诊就诊的痤疮患者392例,采用皮肤病生活质量指数、身体意象量表进行问卷调查。结果痤疮患者身体意象评分为8.31±6.09,生活质量评分为8.57±5.98;不同痤疮等级患者身体意象及生活质量评分比较,差异无统计学意义(均P0.05);痤疮患者身体意象与生活质量呈显著正相关(P0.01)。结论痤疮患者易形成消极身体意象,其生活质量水平较差,两者关系密切。临床护理工作中需采取措施引导患者悦纳自我和改变不良认知来提高患者身体意象水平,以提高其生活质量。     

中文版气管切开术后患者生活质量量表的言效度检验

目的 引进气管切开术后长期置管患者生活质量量表(TQOL),并检验信效度.方法 按照Brislin跨文化翻译原则对TQOL进行汉化及文化调适,使用中文版TQOL量袁调查153例气管切开术后患者的生活质量,分析其信效和效度.结果 中文版TQOL保留22个条目,因子分析共提取生理状况、躯体功能状况、社会/家庭状况、满意程度4个公因子,累计贡献率达68.45％.量表内容效度指数为0.920,Cronbach's α系数为0.907,各因子Cronbach' s α系数为0.824～0.912,Guttmann折半系数为0.925(均P＜0.01).结论 中文版TQOL具有良好的信效度,适合中国文化背景下气管切开术后长期置管患者生活质量的测量.     

The impact of mastectomy, breast-conserving treatment and immediate breast reconstruction on the quality of life of Chinese women

Background : The psychosocial impact of breast surgery has been extensively studied in the Western population. There is a relative paucity of comparable data in Oriental women who are increasingly affected by cancer of the breast. The present study investigates the effects that different types of breast surgery have on the quality of life of Chinese women. Methods : Forty‐nine Chinese women with early breast cancer were interviewed at 6 months–2 years following their primary surgery (breast‐conserving treatment (BCT; 17 patients), mastectomy (15 patients) and mastectomy with immediate breast reconstruction (17 patients)). Aspects of quality of life measured included general psychological well‐being, body image, sexual functioning and social functioning. Results : Patients who received BCT had significantly better body image scores compared to mastectomy patients. They were less worried about their appearance, had more freedom in the choice of clothing, felt less upset by the change in their body and felt more accepted by their partners. The three groups did not differ significantly in the other aspects of quality of life measured. Conclusions : Compared to mastectomy or mastectomy and immediate breast reconstruction, the most significant benefit of BCT is the preservation of a better body image.     

体重与早期乳腺癌的关系

目的 探讨体重与早期乳腺癌患者之间的关系。方法 对732例患者的临床资料进行回顾分析总结，并用卡方计算。结果 患早期乳腺癌体重重、ER受体阴性的妇女，其死亡风险2倍高于体重轻、ER受体阻性的妇女。结论 对早期乳腺癌患者诊断时体重及ER受体情况，是预测生存率的重要因素。     

Test-retest reliability,validity, and sensitivity to change of the urogenital distress inventory and the incontinence impact questionnaire

AIMS: To evaluate two quality of life measures for urinary incontinence (UI) in Scottish females. METHODS: Three groups with UI from two regions in Scotland were studied. Two groups were receiving treatment for incontinence; the third was not. Women completed the UDI and IIQ twice to allow assessment of test-retest reliability and validity. Treatment groups completed the questionnaires again, postintervention, to assess ability of the measures to detect change. Other measures used to assess validity were the SF-36, HADS, weight of urine leaked, and number of incontinence episodes. By design, the three subject groups differed significantly in their characteristics, ensuring a diverse sample of women. RESULTS: Analysis of reliability showed a clinically trivial but statistically significant decrease in total UDI (mean, -6.1; 95% CI, -11.0 to -1.5) and IIQ (mean, -9.7; 95% CI, -15.5 to -3.9) scores between test and retest assessments, possibly due to a research effect. Most items of the UDI (18 of 19) and IIQ (28 of 30) performed very well on test-retest. The UDI and IIQ were valid in that higher scores (indicating more bothersomeness of symptoms/impact on daily living) were associated with greater severity of UI. Additionally the IIQ showed the expected associations with measures of anxiety and health status. CONCLUSIONS: Both the UDI and IIQ detected changes in women's conditions due to intervention. The measures had good psychometric properties, including test-retest reliability, across subject groups.     

乳腺癌患者是否选择术后重建的相关因素调查

目的：探讨乳腺癌患者是否选择术后重建的相关影响因素。方法：随机抽取133位苏州大学附属第一医院普外科的乳腺肿瘤术后患者,以问卷调查的方式,获取其对乳房重建认可程度的信息,并进一步探讨影响术后重建的相关因素。结果：参与调查的133位患者中,有78位只选择切除手术,同55位手术切除后有意愿行BR（乳房重建）的患者相比,她们对体像的在意程度（[ORa]：18.938,P=0.005）和其丈夫决定施行手术的方式（[ORa]=17.640,P=0.030）很大程度上促使她们不选择再造手术。结论：苏州地区女性对于乳腺癌术后重建有一定的认识,部分患者有意愿行再造术,这需要加强对乳腺重建的知识的普及,加强普外科医生与整形外科医生的合作,进行乳房重建手术的进一步扩大开展。     

Psychological impact and cosmetic outcome of surgical breast cancer strategies

BACKGROUND: Current surgical treatment modalities for breast cancer include breast conserving surgery, mastectomy alone and mastectomy with breast reconstruction. There are recognized benefits of breast conservation and breast reconstruction over mastectomy but there are few studies assessing this area in Australia. The aim of the present study was to compare the various surgical strategies for breast cancer treatment in terms of quality of life, cosmesis and patient satisfaction. METHODS: A chart analysis was conducted of all patients who underwent Breast Cancer Reconstruction at the Royal Adelaide Hospital Breast Unit between 1990 and 2002. Patients were then traced and asked to take part in an interview. Mastectomy and breast conservation patients who attended outpatient clinic for follow up were also approached. All three groups were interviewed and self-assessment quality of life questionnaires (Functional Assessment of Cancer Therapy-Breast, body image) were administered. The breast conservation and reconstruction groups also underwent assessment of satisfaction and cosmesis. RESULTS: A total of 78 mastectomy, 109 breast conservation and 123 breast reconstruction patients were interviewed. Quality of life assessment was similar between the three groups but the breast conservation and reconstruction patients' body image scores were superior to the mastectomy group. Patient satisfaction was higher in the reconstruction group than the breast conservation group of patients, while cosmesis was similar. CONCLUSION: While little difference was seen on quality of life assessment, body image is improved with the use of breast conservation and reconstruction. The high satisfaction and cosmesis scores in the breast reconstruction group are an indication of the superior results that can be achieved with breast reconstruction.     

简体中文版King健康问卷在膀胱过度活动症患者中应用的信度和效度分析

目的 评价简体中文版King健康问卷(KHQ)在膀胱过度活动症(OAB)患者中应用的信度和效度.方法 采用"WHO-QOL跨文化生活质量研究问卷翻译法"将英文版KHQ翻译成简体中文,随机抽取就诊于泌尿外科门诊的OAB患者,在第0周和第2周对其进行2次简体中文版KHQ问卷调查.通过Cronbach's α系数评价问卷的内部一致性;用组内相关系数(ICC)评价重测信度;计算各问题得分与所属领域得分的Spearman等级相关系数(rs)评价内容效度;用因子分析评价结构效度.结果 48例符合纳入标准的OAB患者参与本研究,40例完成2次调查,男7例,女33例,年龄(49.6±14.3)岁.KHQ各亚量表和各领域均具有较好的内部一致性(Cronbach's α:0.7l8～0.924)、中到高的重测信度(ICC:0.567～0.995,P<0.01)以及中到高的内容效度(r:0.462～0.964,P<0.01).因子分析法显示简体中文版KHQ具有可接受的结构效度.结论简体中文版KHQ具有较好的信度和效度,可作为评估OAB患者生活质量的专用量表.     

The prognostic role of quality of life assessment in breast cancer

While the use of quality of life (QoL) assessments has been increasing in oncology, few studies have examined the prognostic significance of QoL in breast cancer. We investigated the association between QoL at presentation and survival in breast cancer. We examined 1,511 breast cancer patients treated at two single-system cancer centers between January 2001 and December 2008. QoL was evaluated using the validated survey instrument EORTC-QLQ-C30. Patient survival was defined as the time interval between the date of first patient visit and the date of death from any cause/date of last contact. Univariate and multivariate Cox regression analyses were performed to evaluate the prognostic significance of QoL after controlling for the effects of age, tumor stage, and prior treatment history. Mean age at presentation was 52.5 years. There were 590 analytic and 921 non-analytic patients. Patient stage of disease at diagnosis was I, 335; II, 591; III, 290; IV, 159; and 136 indeterminate. Median overall survival was 32.8 months (95% CI: 27.6-38.0). On univariate analysis, QoL function and symptom scales that were predictive of survival were physical (p < 0.001), role (p < 0.001), cognitive (p = 0.003), social (p < 0.001), fatigue (p < 0.001), nausea/vomiting (p < 0.001), pain (p < 0.001), dyspnea (p < 0.001), loss of appetite (p < 0.001), and constipation (p < 0.001). On multivariate analyses, only role function (degree of impairment of work and/or leisure/hobby related activities) was significantly associated with survival. This study suggests that baseline QoL (in particular, the role function) provides useful prognostic information in breast cancer.     

Neuropathic pain after breast cancer treatment and its impact on sleep quality one year after cancer diagnosis

ObjectivesData regarding the impact of breast cancer treatment-related neuropathic pain (NP) on sleep quality are scarce. Therefore, we aimed to assess the impact of breast cancer treatment-related NP on patients' sleep quality, during the first year after cancer diagnosis.Materials and methodsA total of 501 breast cancer patients were followed prospectively. Incident NP was identified through systematic evaluations after treatments and one year after enrolment. NP severity was quantified using the Brief Pain Inventory severity subscale and sleep quality was evaluated through the Pittsburgh Sleep Quality Index (PSQI), at baseline and after one year. Adjusted regression coefficients (β) and 95% confidence intervals (95%CI) were used to quantify the relation between NP and the variation in the PSQI z-scores.ResultsThe occurrence of NP was associated with a deterioration in sleep quality during the first year of follow-up, more pronounced among those with good sleep quality (PSQI≤5) than those with poor sleep quality at baseline (PSQI>5) (β = 0.44, 95%CI: 0.11 to 0.77 versus β = 0.33, 95%CI: 0.08 to 0.59). These differences were accentuated when only the cases of NP with greater severity were considered (β = 0.86, 95%CI: 0.37 to 1.35 versus β = 0.31, 95%CI: −0.08 to 0.64). Within the PSQI components, daytime dysfunction and sleep duration were the most impaired by NP.ConclusionOur findings highlight the importance of the promotion of sleep hygiene among breast cancer patients diagnosed with NP, especially among those with good sleep quality before treatments.     

Reliability and validity of the adapted Dutch version of the revised Scoliosis Research Society 22-item questionnaire

Background contextAs in other fields of medicine, there is an increasing interest among orthopedic surgeons to measure health-related quality of life in adolescent idiopathic scoliosis patients and to evaluate the burden of disease and the effectiveness of different treatment strategies. The development of the revised Scoliosis Research Society 22-item patient questionnaire (SRS-22r) enabled a comprehensive evaluation of health-related quality of life of these patients. Over the years, the SRS-22r gained wide acceptance and has been used in several different countries, languages, and cultures. The SRS-22r has not been translated into Dutch to date.PurposeTo translate the SRS-22r into Dutch and adapt it cross-culturally as outlined by international guidelines and to test its psychometric properties to measure health-related quality of life of adolescent idiopathic scoliosis patients in the Netherlands.Study design/settingA cross-sectional, multicenter validation study.Patient sampleA total of 135 adolescent idiopathic scoliosis patients (mean age 15.1 years old) of three major scoliosis centers in the Netherlands were enrolled in this study. Ninety-two (68%) subjects completed the Dutch SRS-22r, Child Health Questionnaire (CHQ)-CF87 (golden standard for adolescents), and Short Form (SF)-36 (golden standard for adults). Two weeks later, 73 (79%) of 92 respondents returned a second SRS-22r. Demographics, curve type, Risser stage, and treatment status were documented.Outcome measuresFloor and ceiling effects, internal consistency, reproducibility, concurrent validity, and discriminative ability of the Dutch version of the SRS-22r questionnaire.MethodsFor content analysis, SRS-22r domain scores (function, pain, self-image, mental health, and satisfaction with management) were explored and floor and ceiling effects were determined. Cronbach's α was calculated for internal consistency of each domain of the questionnaires and reproducibility was assessed by test-retest reliability analysis. Using Pearson's correlation coefficient, comparison of the domains of the Dutch SRS-22r with the domains of the SF-36 and Child Health Questionnaire-CF87 assessed the concurrent validity. Differences in SRS-22r domain scores between untreated patients with different curve severity determined the discriminative ability of the questionnaire.ResultsThe SRS-22r domains as well as the SF-36 and CHQ-CF87 domains demonstrated no floor effects, but the function, pain, and satisfaction with management domains had ceiling effects, indicating the proportion of subjects with the maximum score between 19.6% and 33.0%. Internal consistency was very satisfactory for all SRS-22r domains: Cronbach's α was between 0.718 and 0.852. By omitting question 15, the internal consistency of the function domain increased from 0.746 to 0.827. Test-retest reliability was ≥0.799 for all SRS-22r domains. The function, pain, mental health, and self-image domains correlated under the 0.001 significance level with the corresponding CHQ-CF87 and SF-36 domains. The satisfaction with management domain did not correlate with the other questionnaires. The SRS-22r had the ability to detect differences between groups with different curve severity; patients with a severe scoliotic curvature had significantly lower pain and self-image domain scores than patients with relatively mild scoliosis.ConclusionsThe Dutch SRS-22r had the properties needed for the measurement of patient perceived health-related quality of life of adolescent idiopathic scoliosis patients in the Netherlands. The Dutch SRS-22r could be used for the longitudinal follow-up of adolescent idiopathic scoliosis patients from adolescence to adulthood and for establishing the effects of conservative or invasive surgical treatment.     

The role of health-related quality of life in early discontinuation of chemotherapy for breast cancer

To examine the role of health-related quality of life (HRQOL) in early treatment discontinuation among women enrolled in a breast cancer clinical trial. A total of 464 women were enrolled in the Eastern Cooperative Oncology Group randomized controlled trial of adjuvant regimens comparing six cycles of cytoxan, adriamycin and 5-flurouricil (5-FU) with a 16-week regimen (weekly therapy with cytoxan, adriamycin, vincristine, methotrexate, and 5-FU) among women with lymph node positive breast cancer. One hundred sixty-four women participated in the HrQL substudy using the Breast Chemotherapy Questionnaire, which was designed to measure HRQOL in women receiving chemotherapy. Changes in global HRQOL score were examined over time as a predictor of early treatment discontinuation using generalized estimation equations (GEE) modeling and Cox proportional hazards regression. We considered early treatment discontinuation as a longitudinal binary variable determined at each time point HRQOL was measured. The results of multivariate GEE model fitting indicated that declines in HRQOL (p=0.04), older age (p=0.02), higher degree of nausea (p=0.02), higher degree of neurosensory toxicity (0.03) and lower degrees of hair loss (p=0.004) were correlated with early treatment discontinuation. We then fitted a proportional hazard regression model for time to early discontinuation with HRQOL score as a time-dependent covariate. The results were identical. Declines in HRQOL during therapy predicted early treatment discontinuation even after accounting for age and chemotherapy-related side effects. In the age of ever more aggressive treatments for breast cancer, women's perception of the impact of these treatments on their lives will become more important.     

配偶照护负担与乳腺癌患者生活质量相关性研究

目的了解配偶照护负担与乳腺癌患者生活质量的相关性,为构建优质社会支持系统提供依据。方法采用癌症患者生活质量核心问卷(QLQ-C30)和Zarit负担量表对330例乳腺癌患者及其配偶进行调查。结果患者生活质量评分(32.45±4.09)～(69.77±10.86)分;配偶照护负担(37.08±6.95)分。配偶照护个人负担、责任负担、总体负担与患者的情感功能、整体健康呈负相关(均P0.01)。结论乳腺癌患者生活质量较差,配偶照护负担较重,二者存在负相关关系,护理人员应关注患者配偶的照护负担,给予必要的社会支持,以提高患者的生活质量。     

体质指数与乳腺癌淋巴结转移关系的研究

目的 研究体质指数（BMI）与我国女性乳腺癌淋巴结转移的关系,为乳腺癌患者评估预后、实施有效治疗提供适当参考资料.方法 明确乳腺癌患者为首次患病,用BMI确定入选研究对象的肥胖程度,分析424例乳腺癌患者BMI与淋巴结转移的关系.结果 乳腺癌患者平均 BMI为（25.81±3.57） kg/m^2,处于肥胖状态,BMI与乳腺癌腋窝淋巴结转移有关（P＜0.05）.结论 通过BMI测定有助于评估乳腺癌患者预后,为她们治疗方案的制定提供参考依据.肥胖患者预后可能更差,患病后减轻体重应该对预后有益.