Quality of life in cancer patients--an hypothesis

Quality of life is a difficult concept to define and to measure. An hypothesis is proposed which suggests that the quality of life measures the difference, or the gap, at a particular period of time between the hopes and expectations of the individual and that individual's present experiences. Quality of life can only be described by the individual, and must take into account many aspects of life. The approach is goal-orientated, and one of task analysis. The hypothesis is developed in a diagramatic way, and several methods of testing the hypothesis suggested.     

老年肿瘤患者的生活质量评价

当今临床医学的特点之一是更加重视患的生活质量，即不但要求把病治好，而且要提高生活质量。老年肿瘤患由于自身条件的特殊性，往往很难选择合适的治疗方案，然而若不给予积极处理，这些患可能危险性更大。因此，应有合适的评价方法以便更好地评价老年肿瘤患治疗方案的利弊。生活质量(quality of life，QOL)是一套评价健康水平的指标体系，测定躯体功能、心理功能、     

年轻宫颈癌患者的生命质量

生命质量是一个包括生物医学和社会心理内容的综合概念 ,能够更全面地反映人体健康状况。本文介绍了年轻宫颈癌的临床特点 ,从身体状况、心理状况、社会的支持与影响以及经济状况四个方面讨论了其生命质量的下降情况及其主要原因 ,并提出了如何改善年轻宫颈癌患者生命质量的对策     

腹腔镜手术后直肠癌患者生活质量评价

目的:评价腹腔镜手术后直肠癌患者生活质量。方法:本研究是前瞻性非随机观察研究。2004年9月至2005年12月间共51位直肠癌患者加入研究并接受了手术治疗,其中腹腔镜手术组23人,开腹手术组28人。以EORTC QLQ-C30和QLQ-CR38量表测定患者术前、出院时和术后3个月时的生活质量。结果:术前腹腔镜组患者角色功能(Role functioning)低于开腹组患者,但是腹腔镜组患者较少有经济困难,差异有统计学意义(P<0.05),但是没有临床意义。两组患者其余各领域评分均无差异(P>0.05)。两组患者术后各领域评分相当(P>0.05)。腹腔镜手术组患者只是在出院时的疼痛轻于开腹手术组患者,差异有统计学意义(U=218.5,P=0.042),但是没有临床意义。结论:与开腹手术比较,直肠癌腹腔镜手术只在术后短期内显示了有限的优势。腹腔镜手术对直肠癌患者生活质量影响的评价有待于进一步研究。     

胃癌根治术后患者生活质量评价

目的评价胃癌根治术后患者远期生活质量。方法选择2009年1月至2010年1月河南大学淮河医院收治的行胃癌根治术患者53例作为研究对象。采用生命质量指标(QL-Index)量表对患者术后1、3、6、12和24个月生活质量进行评分,并记录各时间点患者并发症发生情况。结果 42例患者获得完整随访资料,胃癌根治术后患者总体生活质量随时间的延长逐渐提高,其中活动、日常生活、健康及精神评分随时间延长明显增加(P<0.05);而支持评分随时间推移明显下降(P<0.05)。术后各时间点患者食欲下降、腹胀、反流及倾倒综合征等并发症发生率比较差异无统计学意义(P>0.05)。结论胃癌根治术患者术后生活质量随时间增加逐步提高。     

宫颈浸润癌患者术后生存质量调查分析

目的探讨影响宫颈浸润癌术后患者生存质量的因素。方法对2002年9月至2009年9月深圳市人民医院87例经手术治疗的宫颈浸润癌患者进行生存质量调查,生存质量量表应用欧洲癌症研究和治疗机构的生存质量量表C30（EORTC QLQ—C30）,结果应用t检验、方差分析及逐步回归分析。结果影响宫颈浸润癌术后患者生存质量的因素包括：性生活情况、医疗费用来源、家庭经济、临床分期、病理类型（P〈0．05）。结论重视宫颈癌的早诊早治,减轻医疗负担,加强医院健康教育工作,指导患者术后及早开始性生活有助于提高患者生存质量。     

结肠癌患者术后生活质量的评价

目的应用SF-36量表中文版评价结肠癌患者术后的生活质量及其影响因素。方法选取经手术治疗的结肠癌患者116例及100例正常对照应用SF-36量表中文版调查问卷,分析两组间综合评分及量表各维度得分的关系,及其影响因素。结果结肠癌患者术后生活质量综合评分与对照组差异无显著性（P〉0．05）,但生理机能和生理职能维度得分较对照组低（P〈0．05）。综合评分影响因素为并存疾病数且呈负相关。各维度影响因素：躯体疼痛维度为并存疾病数、年龄和职业,一般健康状况维度为并存疾病数和体重指数,精力维度为职业,社会功能维度为并存疾病数,生理机能维度为并存疾病数。结论应用SF-36量表中文版评价安徽省结肠癌患者术后的生活质量综合评分较高,提示生活质量较好,但受并存疾病数影响较大。     

评估肺癌患者生活质量的方法学

最近10年来,对肺癌病人心理和社会需求的认识和关注不断增加。健康的丧失和/或治疗的影响可能造成躯体性或功能性损害、社会家庭关系破裂和心理上的应激,所有这些都影响病人的生活质量(quality     

Quality of life varies with pain during treatment in adolescents with cancer

Pain is one of the most feared problems for adolescents with cancer. Pain produces stress with negative physiological and psychological effects. Therefore, effective pain management during cancer treatment may influence the outcome. This study investigates variations in pain and quality of life during treatment in adolescents with cancer, and whether there is a co-variation between the two. In a prospective longitudinal questionnaire investigation, quality of life in eight adolescents with cancer was assessed with the psychological general well-being index (PGWB) and compared with the patients' experiences of pain according to repeated structured interviews. Pain troubled the adolescents most in the beginning and in the end of the treatment period, but troubled them less in-between. During treatment, quality of life was low in the beginning, higher in the middle and lower in the end. Pain co-varied inversely with quality of life and the adolescents thus seemed to have higher quality of life when pain-relieved. This finding emphasizes the importance of pain management in children and adolescents with cancer.     

Quality of life among patients with hematological cancer in a Malaysian hospital

The aim of this study was to determine the prevalence of symptoms and problems in hospitalized hematological cancer patients. A cross-sectional design was carried out with 105 respondents in Ampang hospital in Kuala Lumpur. The European Organization for Research and Treatment of Cancer Quality Of Life questionnaire (EORTC QLQ-C30) was used. Patients with a minimum response of "a little" were defined as having a symptom/problem while patients with a response of "quite a bit" were classified as having a "severe symptom/problem". The four most prevalent symptoms/problems identified were fatigue, financial difficulties, reduced role function and reduced social function. Multiple myeloma patients (MM) were identified as having the most symptoms/problems.     

Measuring health-related quality of life in clinical trials that evaluate the role of chemotherapy in cancer treatment

Quality of life is a subjective multidimentional concept that can be assessed by means of validated questionnaires completed by patients. The psychological effects of a diagnosis of cancer and the physical effects of the disease and its treating have a major impact on a patient's health-related quality of life. Much cancer treatment, especially chemotherapy for metastatic disease, is given for palliation. Palliation implies improvement in either the duration or quality of life remaining. However, treatment patients with common metastatic tumours to prolong life is generally unsuccessful, so improving quality of life is a more realistic goal. Most trials involve evaluating shrinkage of a tumour (i.e., tumour response), which does not imply a benefit to the patient. Few trials have assessed quality of life directly, although several validated instruments, described here, are available to quantify quality of life in cancer patients. These instruments represent a wide scope, from evaluating general health to assessing the quality of life of patients with specific types and stages of cancer. They respond to changes in clinical state and are strongly predictive of survival. Measures of quality of life should be incorporated in all clinical trials where treatment is palliative, and a simple, relevant measure of quality of life should be used as a (or the) primary outcome measure. Other measures of quality of life are important to ensure that gains in one area do not occur at the expense of others. A few large trials incorporating these principles have shown that chemotherapy can provide palliation for patients with advanced cancer.     

晚期肺癌患者生存质量及影响因素初探

目的:对晚期肺癌患者生存质量及相关因素进行评估,探讨与之相关的影响因素.方法:采用EORTCQLQ-C30、SDS量表,调查215例晚期肺癌患者.对患者的一般特征及病期特征进行统计描述;所有数据采用均数和标准差进行统计描述;晚期肺癌患者QLQ-C30各维度与参考值比较;组间生存质量各个维度、总得分及抑郁评分比较,统计学方法采用t检验、方差分析、秩和检验;采用简单线性相关分析指标间的关联性.结果:215例晚期肺癌患者的生存质量指标均低于参考值.年轻、收入较高及教育程度较高的男性患者的生存质量较好,高龄、收入较低及教育程度较低的女性患者的生存质量相对较差;Ⅳ期肺癌患者生存质量远不如ⅢB期的患者;经济困难在无业或自由职业患者中表现尤为突出;以上组间低收入人群及Ⅳ期肺癌患者抑郁情绪较明显.结论:该研究结果对制定医保政策的政府部门提供理论依据,提示医护人员更应关注晚期肺癌患者中特殊群体的生存质量.     

Measuring disease-specific quality of life in clinical trials.

While measurement of quality of life is a vital part of assessing the effect of treatment in many clinical trials, a measure that is responsive to clinically important change is often unavailable. Investigators are therefore faced with the challenge of constructing an index for a specific condition or even for a single trial. There are several stages in the development and testing of a quality-of-life measure: selecting an initial item pool, choosing the "best" items from that pool, deciding on questionnaire format, pretesting the instrument, and demonstrating the responsiveness and validity of the instrument. At each stage the investigator must choose between a rigorous, time-consuming approach to questionnaire construction that will establish the clinical relevance, responsiveness and validity of the instrument and a more efficient, less costly strategy that leaves reproducibility, responsiveness and validity untested. This article describes these options and outlines a pragmatic approach that yields consistently satisfactory disease-specific measures of quality of life.     

肺癌住院患者生命质量调查及其影响因素

目的 调查肺癌住院患者的生命质量,探讨肺癌患者生命质量的影响因素。方法 选择2016年9月至2017年3月在海军军医大学（第二军医大学）长海医院呼吸内科住院的肺癌患者120例,发放调查问卷;采用EORTC QLQ-C30中文版和肺癌特异模块QLQ-LC13评估患者的生命质量,以患者的一般资料为自变量、生命质量各领域得分为因变量,进行肺癌生命质量影响因素的多重线性回归分析。结果 回收有效问卷95份,回收率79.2%。性别、年龄、职业、居住地、子女数量、吸烟、饮酒、肿瘤分期、肿瘤是否转移、是否伴随其他疾病和化学治疗次数与生命质量不同领域得分相关（P<0.05）。年龄较小（<50岁）的患者食欲缺乏（β=－8.266）、腹泻（β=－5.263）和咽下困难（β=－6.307）症状得分较高;女性的认知功能领域得分低于男性（β=－11.270）,恶心呕吐（β=11.725）和食欲缺乏（β=17.090）症状领域得分高于男性;肿瘤分期晚（Ⅳ期）者腹泻症状重（β=2.070）;无职业者腹泻症状重（β=7.130）;化学治疗次数多（6次以上）的患者疼痛症状明显（β=5.871）;伴随其他疾病的患者总健康状况（β=－17.239）较差,且周围神经病变（β=11.970）和胸痛（β=11.061）症状较重;吸烟者气促症状较明显（β=21.151）,饮酒者便秘症状较明显（β=13.525）;肿瘤转移者的角色功能领域得分高（β=15.039）。居住地与多个生命质量领域得分相关,上海地区患者生命质量较好。子女数量多（≥2个）的患者不易发怒,情绪更稳定（β=10.078）。结论 肺癌患者在接受治疗的过程中,其身体状况与情绪心理状况都需要得到关注,有必要根据患者的个体特点提供相应的社会支持与心理疏导,从而改善患者的生命质量和预后。