Quality of life of women treated with radiotherapy for breast cancer

Goals of work Radiotherapy is routinely used in the treatment of early breast cancer, particularly in women who have undergone lumpectomy. Its impact on the quality of life of patients is important and is taken into consideration when making informed choices about treatment from both a patient’s and health professional’s point of view. This study reports on the quality of life of women at baseline, the completion of radiotherapy and 7 months after the completion of radiotherapy. Materials and methods European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C-30 and BR-23 questionnaires were used to evaluate quality of life of 61 women treated with radiotherapy for breast cancer. Additionally, demographic and treatment variables were analysed in relation to quality of life outcomes to determine if there were any significant predictors of quality of life. Main results There was no difference in quality of life of women at baseline, completion and 7 months after completion of radiotherapy. Fatigue and breast symptoms increased during radiotherapy but returned to baseline levels at 7 months. Fatigue was the strongest predictor of poor quality of life in women after radiotherapy. Conclusion Women retain a high quality of life and return to baseline function by 7 months after radiotherapy. Treatment may best be targeted to alleviate fatigue and breast symptoms during radiotherapy.     

A randomised,placebo-controlled,double-blind trial of the effects of d-methylphenidate on fatigue and cognitive dysfunction in women undergoing adjuvant chemotherapy for breast cancer

BACKGROUND: Women who receive adjuvant chemotherapy for breast cancer develop fatigue, and a subset reports cognitive impairment. Methylphenidate is reported to improve fatigue and to decrease cognitive impairment in other populations. MATERIALS AND METHODS: Women were randomised early during their chemotherapy to receive d-methylphenidate (d-MPH), a form of methylphenidate, or an identical appearing placebo. All participants took placebo for one cycle to ensure compliance and then study medication until completion of chemotherapy. Subjects were assessed at baseline, end of chemotherapy and at approximately 6 months follow-up with the High Sensitivity Cognitive Screen (HSCS) and the Hopkins Verbal Learning Test-Revised (HVLT-R). They also completed the self-report Functional Assessment of Cancer Therapy-General (FACT-G) and FACT-F (F = fatigue) questionnaires, evaluating quality of life and fatigue. RESULTS: A total of 57 evaluable women were randomised: 29 to d-MPH and 28 to placebo; the study did not meet its accrual goal of 170 patients, mainly because women were reluctant to take additional medication in general and methylphenidate in particular. Groups were well matched for age (median, 50 years) and education. d-MPH and placebo were well tolerated. There were no significant differences between the randomised groups in classification of cognitive function by HSCS or in summed FACT-F fatigue scores (the primary endpoints of the study) at any of the assessments. There were also no differences in HLTV-R scores or quality of life. CONCLUSIONS: This study is underpowered, but there are no trends to suggest that d-MPH, taken concurrently with adjuvant chemotherapy, improves quality of life or fatigue.     

Values of sleep/wake, activity/rest, circadian rhythms, and fatigue prior to adjuvant breast cancer chemotherapy

Fatigue is the most prevalent and distressing symptom experienced by patients receiving adjuvant chemotherapy for early stage breast cancer. Higher fatigue levels have been related to sleep maintenance problems and low daytime activity in patients who have received chemotherapy, but knowledge describing these relationships prior to chemotherapy is sparse. The Piper Integrated Fatigue Model guided this study, which describes sleep/wake, activity/rest, circadian rhythms, and fatigue and how they interrelate in women with Stage I, II, or IIIA breast cancer during the 48 hours prior to the first adjuvant chemotherapy treatment. The present report describes these variables in 130 females, mean age=51.4 years; the majority were married and employed. Subjective sleep was measured by the Pittsburgh Sleep Quality Index and fatigue was measured by the Piper Fatigue Scale. Wrist actigraphy was used to objectively measure sleep/wake, activity/rest, and circadian rhythms. Mean Pittsburgh Sleep Quality Index score was 6.73+/-3.4, indicating poor sleep. Objective sleep/wake results were within normal limits established for healthy individuals, except for the number and length of night awakenings. Objective activity/rest results were within normal limits except for low mean daytime activity. Circadian rhythm mesor was 132.3 (24.6) and amplitude was 97.2 (22.8). Mean Piper Fatigue Scale score was 2.56+/-2, with 72% reporting mild fatigue. There were significant relationships between subjective and objective sleep, but no consistent patterns. Higher total and subscale fatigue scores were correlated with most components of poorer subjective sleep quality (r=0.25-0.42, P< or =0.005).     

The quality of life and self-efficacy of Turkish breast cancer patients undergoing chemotherapy

Self-efficacy has a positive effect on health behaviors, symptom control, compliance with cancer treatment, and quality of life. This study aims to describe the quality of life and self-efficacy of Turkish breast cancer patients undergoing chemotherapy. The sample consisted of 141 patients. Data was gathered using a Patient Information Form, the Functional Assessment of Cancer Therapy-Breast Cancer (FACT-B), a scale about Strategies Used by Patients to Promote Health and the Rotterdam Symptom Checklist. All quality of life dimensions were negatively affected at a significant level. Following commencement of chemotherapy, there was an increase in the negative effect on physical well-being, emotional well-being and additional concerns subscales and total FACT-B and their self-efficacy was negatively affected to a moderate degree. However, a significant degree of change did not occur in the self-efficacy. During treatment the physical symptoms and psychological distress increased and the activity level was negatively affected. The quality of life and self-efficacy were influenced by personal and medical characteristics, showing consistency with similar studies. Because there are negative effects of cancer and chemotherapy on patients' quality of life and self-efficacy, nurses need to focus on designing psychosocial interventions to improve their self-efficacy and quality of life.     

团体治疗对化疗期乳腺癌家庭主要照顾者生活质量及疲乏感的研究

目的探讨有效改善化疗期乳腺癌家庭主要照顾者生活质量及疲乏感的干预方式。方法选取乳腺癌家庭主要照顾者53例为研究对象,应用随机数字表法将研究对象分为观察组26例和对照组27例。对照组给予健康教育、心理支持等常规护理方法,观察组在常规护理基础上给予多学科联合的团体治疗课程。应用领悟社会支持量表、疲乏量表、希望指数量表、一般自我效能量表和癌症照顾者生活质量量表,分别于干预前一日和干预后3个月、6个月测量各项评价指标的结果。结果重复测量方差分析显示,两组生活质量总分的组间效应、时间效应及交互效应差异均有统计学意义(P0.05),其中心理健康和精神健康维度的时间效应及交互效应差异均有统计学意义(P0.05);社会适应维度的交互效应差异有统计学意义(P0.05),两组疲乏总分的时间效应及交互效应差异均有统计学意义(P0.05);两组自我效能的组间效应、时间效应及交互效应差异均有统计学意义(P0.05)。结论团体课程可以有效改善化疗期乳腺癌家庭主要照顾者生活质量,缓解疲乏程度,改善身心健康状况,适合应用于临床实践。     

环境因素对乳腺癌化疗患者生命质量的影响

目的 了解乳腺癌化疗患者生命质量现状,探索影响其生命质量的环境因素.方法 选取术后化疗的原发性乳腺癌患者201例,应用人口统计学和临床特征调查表、世界卫生组织残疾评定量表第二版及环境因素调查表进行测量,并对测量结果进行分析.结果 乳腺癌患者生命质量各个方面均有不同程度困难,统计分析表明,“朋友的物质或情感支持以及相互联系”、“社会保障的服务、体制和政策”以及“社会准则、实践和观念”是影响乳腺癌患者生命质量的环境因素.结论 在加强患者术后功能康复的同时,护理工作者应倡导对乳腺癌人群提供良好的社会保障服务,提高大众对乳腺癌疾病的科学认知,拓展患者社会支持来源,提高患者的社会支持水平.     

乳腺癌患者术后自我效能与生存质量的相关性研究

目的 了解乳腺癌行改良根治手术后接受化疗患者自我效能与生存质量的关系,为临床治疗、健康教育和临床护理提供相应的依据.方法 采用问卷调查法对115例接受乳腺癌行改良根治手术后接受化疗患者进行自我效能与生存质量的调查,并分析二者的关系.结果 接受乳腺癌行改良根治手术后接受化疗患者生存质量总分为(105.62±6.68)分,患者的自我效能显著低于常模;本组患者的自我效能与生存质量存在显著相关性.结论 医护人员应重视和加强对乳腺癌术后患者的管理.建议护理专家对乳腺癌行改良根治手术后接受化疗患者给予有效的护理干预,以改善并提高患者的自我效能和生存质量.     

延续性社会支持对乳腺癌术后化疗期患者生存质量的影响

目的 探讨乳腺癌患者术后化疗期延续性社会支持系统与生存质量之间的关系,为化疗期护理提供理论依据。 方法 将80例乳腺癌根治术后化疗患者随机分为对照组与观察组,每组40例。对照组进行常规护理,观察组在对照组基础上实施延续性社会支持干预。应用焦虑自评量表(self-rating anxiety scale, SAS)、抑郁自评量表(self-rating depression scale, SDS)和生存功能质量评价量表对2组进行调查研究。 结果 化疗期结束后,观察组SAS和SDS评分明显低于对照组;观察组在躯体功能、情绪功能、认知功能、社会功能4个方面的生存功能质量评分明显高于对照组,2组在角色功能评分上比较,差异无统计学意义。 结论 认知感支持是延续性社会支持的重要措施,延续性社会支持系统的建立和完善,可提高乳腺癌术后化疗期患者的生存质量。     

Impacts of self-care education on adverse events and mental health related quality of life in breast cancer patients under chemotherapy

ObjectiveAs a consequence of its high incidence, breast cancer has become a severe health risk in women. Chemotherapy is one of the main treatments for breast cancer, but causes a decline in life quality of patients. Self-care is a non-medical intervention and has been reported to improve the life quality of colorectal cancer patients. We aim to explore whether self-care is also effective in breast cancer.Materials and methods85 breast cancer patients under chemotherapy participated in this research, among whom 44 patients received the self-care education. The physical and mental conditions of patients before and after chemotherapy were evaluated by Anxiety Inventory, Rotterdam Symptom checklists and QLQ-C30.ResultsThe result showed that the occurrence rates of symptoms were significantly reduced after self-care measures. Anxiety Inventory and Rotterdam Symptom checklists indicated that self-care measures could improve both the physical and mental conditions of patients. The Global Quality of Life (QoL) from QLQ-C30 questionnaire further confirmed the effectiveness of self-care measures in breast cancer patients.ConclusionsBased on the results, self-care measures are effective in improving the physical and mental conditions of breast cancer patients under chemotherapy. Self-care measures play an important role in improving patients’ life quality.     

乳腺癌患者的生活质量及其影响因素

目的探讨乳腺癌患者的生活质量(QOL)及其影响因素,提高乳腺癌患者生活质量。方法采用中国癌症患者生活质量问卷调查表,对2004年1月~2004年4月中国医学科学院肿瘤医院收治的131例女性乳腺癌患者进行调查。结果乳腺癌患者生活质量良好,独居患者QOL得分明显低于与家人同住者(P<0.05),而在心理活动方面更为明显(P<0.01)。年龄<45岁患者QOL得分中,心理活动方面低于老年患者(P<0.05);经济状况较差患者QOL得分中,心理活动方面低于经济状况良好患者(P<0.05)。结论本组乳腺癌患者的生活质量尚可,居住情况、经济状况及年龄因素与生活质量密切相关,对乳腺癌患者加强心理护理,可改善患者的生活质量。     

认知疗法对农村乳腺癌化疗期患者生命质量的影响

目的 探讨认知疗法对提高农村乳腺癌化疗期患者生命质量的效果,为制定相应的干预措施提供依据.方法 选择2006年5月至2008年5月病理诊断为乳腺癌,并行改良根治术后,开始接受化疗治疗的农村乳腺癌患者120例为研究对象.采用随机分组方法分为干预组及对照组各60例.干预组在常规护理的同时给予6个月的认知干预治疗,对照组接受乳腺癌化疗治疗的常规护理.分别在住院及复查期间的第5天及第1,3,6个月对2组进行健康相关生命质量的评价,观察并比较2组的治疗效果.结果 干预后第5天及第1,3,6个月,干预组与对照组健康相关生命质量总分比较差异显著,认知干预治疗后,干预组健康相关生命质量总分的下降趋势明显快于对照组,提示干预组相关生命质量优于对照组. 结论认知干预疗法是提高农村乳腺癌化疗期患者生命质量的有效方法.     

认知疗法对农村乳腺癌化疗期患者生命质量的影响

目的 探讨认知疗法对提高农村乳腺癌化疗期患者生命质量的效果,为制定相应的干预措施提供依据.方法 选择2006年5月至2008年5月病理诊断为乳腺癌,并行改良根治术后,开始接受化疗治疗的农村乳腺癌患者120例为研究对象.采用随机分组方法分为干预组及对照组各60例.干预组在常规护理的同时给予6个月的认知干预治疗,对照组接受乳腺癌化疗治疗的常规护理.分别在住院及复查期间的第5天及第1,3,6个月对2组进行健康相关生命质量的评价,观察并比较2组的治疗效果.结果 干预后第5天及第1,3,6个月,干预组与对照组健康相关生命质量总分比较差异显著,认知干预治疗后,干预组健康相关生命质量总分的下降趋势明显快于对照组,提示干预组相关生命质量优于对照组. 结论认知干预疗法是提高农村乳腺癌化疗期患者生命质量的有效方法.     

乳腺癌患者生活质量及其影响因素的调查

素与生活质量密切相关,对乳腺癌患者加强心理护理,可改善患者的生活质量.     

乳腺癌患者自我管理行为与癌性疲乏及生存质量的相关研究

目的探讨乳腺癌患者自我管理行为、癌性疲乏、生存质量三者之间的关系。方法采用乳腺癌生存质量量表(FACT-B)、癌性疲乏量表(CFS)、慢性病自我管理行为量表(CDSMS)对2015年10月-2016年6月在两所三级甲等医院接受治疗的415例乳腺癌患者进行横断面调查。结果患者生存质量总分为(73.92±8.15)分,癌性疲乏得分(36.76±9.53)分,慢性病自我管理行为总分为(37.84±9.10)分;自我管理行为与生存质量呈正相关(r=0.761,P0.01),癌性疲乏与生存质量呈负相关(r=-0.424,P0.01);结构方程模型分析表明,自我管理行为、癌性疲乏对乳腺癌患者的生存质量有直接的预测作用(P0.01),自我管理行为对癌性疲乏也有直接负向预测作用(P0.01),并通过癌性疲乏的中介作用对生存质量起间接效应。结论乳腺癌患者的自我管理行为能力较低,疲乏症状明显,在临床护理工作中,医务人员应加强患者自我管理教育,减轻疲乏症状的程度,积极引导病人改善其情绪状态,提高生存质量。     

人文关怀对乳腺癌术后化疗患者不良反应及生存质量的影响

目的：探讨人文关怀对乳腺癌术后化疗患者不良反应及生存质量的影响。方法选取2010年1月-2012年12月收治的乳腺癌术后化疗患者96例,按照随机数字表法随机分为对照组和观察组各48例,对照组给予常规护理,观察组在对照组基础上给予健康教育和心理护理等细致人文关怀的护理干预,分析两种护理方法对患者术后化疗不良反应及生存质量的影响。结果观察组患者术后化疗引起的不良反应总评分为（29．98±13．12）分,对照组为（41．53±14．37）分,两组比较差异有统计学意义（t＝4．32,P ＜0．01）。观察组患者生活质量总评分为（64．81±15．36）分,对照组为（48．91±15．07）分,两组比较差异有统计学意义（t＝5．35,P＜0．01）。结论健康教育和心理护理等细致人文关怀能够有效提高乳腺癌术后化疗患者的生存质量,减少术后化疗引起的不良反应。     

不同中心静脉通路对乳腺癌化疗患者生活质量影响的对比研究

目的比较经外周静脉置入中心静脉导管(PICC)、经颈内静脉植入输液港(胸壁港)及经上臂静脉植入输液港(上臂港)对乳腺癌化疗患者生活质量的影响。方法采用方便抽样法选取2018年11月至2019年6月在北京市2所三级甲等综合医院乳腺科的342例乳腺癌化疗患者作为研究对象,使用一般资料调查表及健康相关生活质量量表进行调查,比较置入不同中心静脉通路的患者生活质量的差异。结果更多自费(10.2%)或新农合(16.2%)患者选择PICC作为化疗通路,且PICC患者带管时间[66(44,113)d]较胸壁港[130(68.5,325.5)d]和上臂港[184(65,323)d]更短(P<0.001)。更多靶向治疗患者选择上臂港(49.5%)或胸壁港(48.4%)作为治疗通路(P=0.002)。PICC患者的生理机能[75(65,80)分]、生理职能[0(0,0)分]、社会功能[44.4(33.3,66.7)分]、情感职能[0(0,66.7)分]以及生理健康[216(192,241)分]、心理健康[211.7(190.4,256.9)分]得分较胸壁港[分别为85(75,90)分、25(0,100)分、77.8(55.6,100)分、100(0,100)分、256(191,314)分、306.9(211.9,359.8)分]和上臂港[分别为80(75,90)分、50(0,100)分、88.9(55.6,100)分、100(0,100)分、277(199,356)分、319.8(235.8,360.9)分]更差(P均<0.05),PICC患者一般健康状况得分[57(50,72)分]低于上臂港[72(50,85)分,P<0.05]。结论使用PICC化疗的患者生活质量低于使用输液港化疗的患者,而不同部位置入输液港的患者生活质量差异不大。输液港是乳腺癌化疗患者的优选通路。     

社会支持与乳腺癌患者生活质量的相关性研究

目的 研究乳腺癌患者社会支持及生活质量状况并分析两者之间的关系.方法 对73例乳腺癌患者采用社会支持评定量表和生活质量评定量表QLQ-C30进行社会支持和生活质量问卷调查.结果 乳腺癌患者生活质量较差,获得的社会支持较高;社会支持与乳腺癌患者的生活质量呈正相关(r=0.274,P＜0.05).结论 社会支持与乳腺癌患者生活质量密切相关,护理人员应充分重视和利用社会支持,以提高乳腺癌患者的生活质量.     

年轻乳腺癌患者生存质量与社会支持的相关性研究

目的探讨年轻乳腺癌患者生存质量与社会支持的相关性。方法对100例年轻乳腺癌患者在术后3个月随访时，采用生存质量评定量表和社会支持评定量表进行调查，分析其相关性。结果年轻乳腺癌患者的生存质量较差，但能获得较高的社会支持。相关性分析显示，年轻乳腺癌患者生存质量与社会支持呈正相关。结论年轻乳腺癌患者的生存质量与社会支持密切相关，护士应重视并有效利用患者的社会支持，提高患者的生存质量。