卵巢癌患者化学治疗期间生存质量的调查与分析

目的：调查与分析卵巢恶性肿瘤患者化学治疗期间的生存质量。方法：采用卵巢癌治疗功能评价系统(Functional Assessment of Cancer Therapy-Ovary,FACT-O)，分别在第2次、第4次及第6次化疗的3个阶段对复旦大学附属妇产科医院的卵巢恶性肿瘤患者54例进行生存质量的问卷调查。结果:①第1、第2阶段总体生存质量位于中等水平的例数占77．8％和73．3％，第3阶段位于上等水平的例数占100％。②3个阶段中，生活功能维度和卵巢癌特异维度的因子分在6个维度中始终都是最低和次低。结论:在化疗过程中，在没有复发和疾病进展的前提下，卵巢恶性肿瘤患者的生存质量为中、上水平；影响生存质量最重要的两个维度是生活功能维度和卵巢癌特异性维度。提示医务人员应加强对患者心理抚慰和性别重新定位的重视，同时需努力提高帮助患者恢复生活功能的临床技能．     

卵巢癌术后病人生存质量研究现状

介绍生存质量的定义及研究卵巢癌病人生存质量的目的、意义,阐述卵巢癌病人生存质量的研究工具及不同时期卵巢癌病人的生存质量。指出我国对卵巢癌病人生存质量的研究主要集中在病人生存质量或其影响因素的研究和提高病人生存质量的干预措施两方面,对出院后相关随访研究、病人并发症发生情况及生活信心等方面研究较少,同时对术后病人生存质量的研究方法较局限且样本量有限。我国对卵巢癌病人生活质量评价工具多采用国外量表汉化版,缺乏适合我国国情的生存质量评价工具。同时,除心理干预、支持性护理、自我管理及依从性研究外,还应针对其他生存质量可控性影响因素进行多维度护理干预,以帮助卵巢癌病人提高生存质量。     

妇科恶性肿瘤患者的生存质量评价

章主要介绍了妇科肿瘤（宫颈癌、卵巢癌、子宫内腺癌和外阴癌）患的生存质量评价方法。妇科肿瘤生存质量测定量表主要包括个人特征、家庭情况、生理状况、心理状况、躯体焦虑、社会关系、满意程度及生存质量总分，量表的计算采用评分法，以低优原则评价生存质量的好与坏。如何用一综合指标来反映这些变化，是目前研究的重要课题。在评价妇科恶性肿瘤患生存质量时，采用了多维、简明、可靠、有效的量表来反映患的真实情况，以供在研究中参考应用。     

卵巢癌病人化疗期间的生存质量和社会支持

卵巢恶性肿瘤病人的生存率较低，5a生存率徘徊在25％～30％，成为威胁妇女生命的主要疾病之一。化疗是治疗卵巢恶性肿瘤的主要方法之一，但化疗往往持续时间较长，过程非常艰苦，在此期间，如何能够最大限度地提高病人的生存质量是首先需要解决的问题。本研究通过对拥有不同社会支     

世界卫生组织生存质量测定量表中文版介绍及其使用说明

本文介绍了世界卫生组织对与健康有关的生存质量的定义,世界卫生组织生存质量测定量表的发展,量表（ＷＨＯＱＯＬ－１００和ＷＨＯＰＯＬ－ＢＲＥＦ）的结构、内容和应用,并详细介绍了量表的使用方法。     

世界卫生组织生存质量测定量表中文版介绍及其使用说明

本文介绍了世界卫生组织对与健康有关的生存质量的定义,世界卫生组织生存质量测定量表的发展,量表(WHOQOL-100和WHOQOL-BREF)的结构、内容和应用,并详细介绍了量表的使用方法.     

SF-36中文版对偏头痛患者生存质量的调查

目的:探讨偏头痛患者生存质量的现状并分析其影响因素,为改善患者的生存质量提供依据.方法:采用健康状况量表SF-36中文版对122例偏头痛患者和112例健康对照进行现场问卷调查.用两样本t检验比较两组生存质量评分,以多元逐步回归分析筛选偏头痛组生存质量的影响因素.结果:偏头痛组在生理功能、生理职能、躯体疼痛、总体健康、精力、社会功能、情感职能、精神健康8个维度的评分上均显著低于对照组(P<0.01);偏头痛患者生理综合评分的影响因素有头痛频率、头痛程度、学历,心理综合评分的影响因素有头痛程度、头痛频率、病程、学历.结论:偏头痛患者生存质量偏低,通过控制其影响因素如头痛频率、程度等可能有助于改善患者的生存质量.     

妇科恶性肿瘤患者的生存质量评价

文章主要介绍了妇科肿瘤(宫颈癌、卵巢癌、子宫内膜癌和外阴癌)患者的生存质量评价方法。妇科肿瘤生存质量测定量表主要包括个人特征、家庭情况、生理状况、心理状况、躯体焦虑、社会关系、满意程度及生存质量总分,量表的计算采用评分法,以低优原则评价生存质量的好与坏。如何用一综合指标来反映这些变化,是目前研究的重要课题。在评价妇科恶性肿瘤患者生存质量时,采用了多维、简明、可靠、有效的量表来反映患者的真实情况,以供在研究中参考应用。     

卵巢癌患者可修饰性心理困扰影响因素及其与生存质量的相关性分析

目的分析卵巢癌患者可修饰性心理困扰影响因素及其与生存质量相关性。方法采用便利抽样法,选取2017年9月~2019年3月我院收治的卵巢癌患者262例,分析患者可修饰性心理困扰率、困扰程度、生存质量及心理困扰与生存质量的相关性。采用多因素Logistic回归分析可修饰性心理困扰影响因素。结果262例卵巢癌患者中,可修饰性心理困扰低状态126例(48.09%)、中等状态108例(41.22%)、高等状态28例(10.69%),生存质量良好118例(45.04%)、不佳144例(54.96%)。单因素分析结果显示,文化程度、独居、家庭月收入、肿瘤分期、社会支持度、疾病认知度、自我效能感、应对方式、生存质量比较,差异有统计学意义(P<0.05)。多因素Logistic分析结果显示,社会支持度、疾病认知度、自我效能感、应对方式、生存质量是卵巢癌患者可修饰性心理困扰处于中高状态的风险因素(P<0.05)。且可修饰性心理困扰状态与生存质量互为负相关关系(P<0.05)。结论卵巢癌患者可修饰性心理困扰影响因素多样,而弱化或消除影响因素利于减轻心理困扰,有助于改善生存质量,生存质量的改善又可缓解可修饰性心理困扰,促进良性循环形成。     

腹腔镜下卵巢癌减灭术对恶性卵巢癌患者近期疗效、生理状态及生存质量的影响

：目的：探讨在恶性卵巢癌患者治疗中腹腔镜下卵巢癌减灭术的应用对患者近期疗效、生理状态及生存质量的影响。方法：选取2018年2月~2020年2月接受治疗的80例恶性卵巢癌患者作为研究对象,根据手术方法的不同将患者分为观察组24例与对照组56例。对照组进行传统开腹手术治疗,观察组进行腹腔镜下卵巢癌减灭术治疗,对两组临床指标、生理状态、生存质量及近期疗效进行比较。结果：两组近期疗效比较无明显统计学差异（P＞0.05）;观察组手术时间、术后排气时间、肠胃功能恢复时间、住院时间与对照组相比更短（P＜0.05）,术中出血量、术后引流量与对照组相比更少（P＜0.05）;两组治疗后Karnofsky功能状态评分有所降低（P＜0.05）,生命质量评价量表评分明显提高（P＜0.05）;但两组治疗后Karnofsky功能状态、生命质量评价量表评分比较无明显统计学差异（P＞0.05）。结论：将腹腔镜下卵巢癌减灭术应用于恶性卵巢癌患者能够缩短手术时间,降低术后出血量,促进患者恢复,其近期疗效、生理状态、生存质量与传统开腹手术相当。     

EORTC QLQ-C30 and FACT-Lym for the assessment of health-related quality of life of newly diagnosed lymphoma patients undergoing chemotherapy

PurposeThe aim of this study was to assess the validity of the European Organization for Research and Treatment of Cancer Quality of Life, Core 30 (EORTC QLQ-C30) and Functional Assessment of Chronic illness Therapy-Lymphoma (FACT-Lym) instruments (Greek version) in patients with lymphoma undergoing chemotherapy, as well as the comparative evaluation of the questionnaires themselves.MethodHealth related quality of life (HRQoL) was assessed using the two previously mentioned instruments as well as the generic Short Form 36 (SF-36), which was used as a standard and its scores were compared to the corresponding norms of the Greek general population. The sample consisted of 80 newly diagnosed patients with lymphoma, who had completed their chemotherapy treatment. Reliability (Cronbach's a), central tendency and variability for the scales were assessed. Associations between the instruments' scales were examined via Spearman's correlations.ResultsCronbach's a, was >0.70 for all the scales, with exception of the emotional well being scale of FACT-Lym and two functional scales of QLQ-C30. There is a significant correlation between similar scales of the questionnaires, and particularly strong (>0.50) between global, functional and physical subscales of the FACT-Lym and QLQ-C30 instruments. Also, five scales of the SF-36, showed significantly lower mean values compared to the corresponding Greek norms.ConclusionsThe Greek versions of FACT-Lym and QLQ-C30 appear to be reliable and valid tools for assessing HRQoL in this category of patients. The two disease-specific QoL instruments complement each other and neither can be replaced by the other.     

The validity of EORTC QLQ-C30 fatigue scale in advanced cancer patients and cancer survivors

Fatigue is a major complaint among advanced cancer patients. Several instruments are available for measuring fatigue. The EORTC QLQ-C30 is one of the most frequently used health-related quality of life (HRQOL) instruments, and it includes a three-item fatigue subscale. Limited knowledge exists about the validity, performance and sensitivity of EORTC QLQ-C30 fatigue scale as compared with a fatigue-specific instrument. The aim of the present study was to validate the EORTC QLQ-C30 fatigue scale (FA) against the Fatigue Questionnaire (FQ). The FQ is frequently used and was developed to measure fatigue in both cancer and noncancer populations. The FQ measures physical (PF, seven items) and mental fatigue (MF, four items). The study population included two different cohorts: A) patients with advanced metastatic cancer included in a prospective randomized study of palliative radiotherapy (n = 238); B) patients with leukaemia and malignant lymphoma curatively treated with stem-cell transplantation and high-dose chemotherapy (n = 128). The analysis demonstrated that the FA correlated higher with the PF scale (r = 0.67-0.75) as compared with the MF scale (r = 0.49-0.61). The item scale correlations between FA items and the PF scale were consistently higher than between FA items and the MF scale. A factor analysis including all the items within the FA and the FQ identified two factors. All FA items loaded on a PF factor (0.70-0.85). A floor/ ceiling effect, indicating a high number of respondents with lowest, respectively, highest scores was observed more frequently in the FA as compared with the FQ. The PF discriminated better between diagnostic groups with different levels of fatigue than the FA did. In conclusion, the EORTC QLQ-C30 fatigue scale is measuring physical fatigue. A floor/ ceiling effect seems to appear for the EORTC QLQ-C30 fatigue scale. The validity of the EORTC QLQ-C30 fatigue scale is to be questioned for use in palliative care patients. In studies with fatigue as a defined end point, a domain-specific instrument should, therefore, be added.     

EORTC QLQ-LC43量表在中国肺癌患者中的有效性验证

目的 验证EORTC QLQ-LC43量表在中国肺癌患者中应用的有效性.方法 以2012年11月至2013年4月在天津肿瘤医院接受门诊治疗的214例肺癌患者作为调查对象,同时完成量表EORTC QLQ-LC43和SF-36的测评,并进行KPS评分,对结果采用Cronbach α系数、Pearson 相关检验及Kruskal-Wallis检验进行统计分析.结果 除认知功能（Cronbach α=0.401）外,其余各维度信度均较好（Cronbach α＞0.7）;EORTC QLQ-LC43与SF-36中相同或相似的维度具有较好的相关性,共性量表C30中与功能相关的维度除情绪功能（EF）外,各维度与KPS得分相关性均较好,而与症状相关的维度相关性则较低,在肺癌症状子量表中,呼吸困难（LC-DY）与KPS的相关性较好,其余条目均相关性一般;按照KPS评分高低将患者分为3组,组间LC43评分比较,除DY、LC-HA维度外,差异均有统计学意义.结论 EORTC QLQ-LC43量表应用于中国肺癌患者,具有良好的信度和效度.     

Fatigue in patients with cancer: results with National Cancer Institute of Canada Clinical Trials Group studies employing the EORTC QLQ-C30

 The purpose of this study was to examine the factors which affect the level of fatigue among patients participating in clinical trials in which this symptom had been assessed with the EORTC QLQ-C30. Data were assembled from 2390 patients in ten clinical trials in which the QLQ-C30 had been used to assess baseline and on-study quality of life. The relationship between the level of fatigue reported by the patients on the fatigue scale of this questionnaire and patient and disease characteristics was assessed in univariate and multivariate cross-sectional analyses. In addition, changes in fatigue scores were compared in a longitudinal analysis among patients on two arms of an anti-emetic trial whose emesis control was markedly different. Baseline fatigue levels differed substantially among patients taking part in the different trials. Factors associated with greater fatigue severity on univariate analysis included: female gender, presence of metastatic disease, and poorer performance status. In addition, on multivariate analyses the oldest patients were found to have less fatigue, as were patients with breast cancer, while patients with ovarian and lung cancer experienced greater fatigue. Patients on the arm of the anti-emetic trial in which emesis was better controlled showed significantly less increase in fatigue after receiving chemotherapy. The fatigue scale of the QLQ-C30 appears to provide a useful approach to assessing this important symptom. The relationships found between fatigue and patient and disease characteristics need further exploration as does the degree to which the QLQ-C30 fully captures this dimension of quality of life.     

Psychometric properties of the Arabic version of EORTC QLQ-C15-PAL among cancer patients in Jordan

Purpose

Health related quality of life (HRQOL) is an important outcome in cancer care and needs assessment by a valid questionnaire. HRQOL questionnaires need to be validated after translations to other languages and cultural settings. The purpose of this study is to evaluate the psychometric properties of the Arabic version of the European Organization for Research and Treatment of Cancer Quality of Life 15 items Questionnaire for Palliative Care (EORTC QLQ-C15-PAL).

Methods

This is a cross-sectional study of a convenient sample of inpatients with cancer.

Results

One hundred seventy-five patients completed the EORTC QLQ-C15-PAL questionnaire. Cronbach’s alpha coefficient met the 0.7 alpha criterion. Confirmatory factor analysis met the goodness of fit criteria; goodness-of-fit index (GFI), comparative fit index (CFI), normed fit index (NFI) and non-normed fit index (NNFI) >0.90 and root mean square error of approximation (RMSEA) <0.06. All item-scale correlation coefficients exceeded the set value of 0.40, indicating satisfactory convergent validity. In terms of discriminant validity, all items in the questionnaire showed a higher item-scale correlation than item-other scale correlation, except for items 1 and 2 (physical function scale) that showed a higher correlation with fatigue. Construct validity was tested by item inter scale correlation coefficient. All constructs had correlation coefficient <0.70. External validity was tested by comparison of scores of patients who had metastasis and who did not have metastasis. Significant differences (P value <0.05) were found in all scales except for nausea. Age groups were compared and showed significant differences for physical function, fatigue, and global score of HRQOL.

Conclusion

The Arabic version of the EORTC QLQ-C15-PAL is valid and reliable.

     

Validation and comparison of the health-related quality-of-life instruments EORTC QLQ-C30 and SF-36 in assessment of patients with chronic nonmalignant pain

The EORTC QLQ-C30 health-related quality of life (HRQoL) questionnaire was developed for use in clinical cancer trials. It has also been applied in studies of patients with chronic nonmalignant pain in spite of nondocumented validity. Validation of the EORTC QLQ-C30 in this patient population and comparison with the traditional first choice HRQoL instrument in chronic nonmalignant pain, the SF-36, are, therefore, required. Two hundred eighty-six patients admitted to the tertiary multidisciplinary pain center at St. Olavs University Hospital in Trondheim, Norway, completed both the EORTC QLQ-C30 and the SF-36 at admittance. Correlations between EORTC QLQ-C30 and SF-36 measures of the same concept were between 0.70 and 0.81 for all five domains covered by both instruments. Internal consistency was below 0.70 for the EORTC QLQ-C30 scales physical functioning (0.57), pain (0.68), role functioning (0.43), cognitive functioning (0.66), and nausea/vomiting (0.53), as well as the SF-36 scale role emotional functioning (0.66). Large floor or ceiling effects were seen for several EORTC QLQ-C30 scales. While SF-36 addresses no other symptoms than pain and fatigue, the EORTC QLQ-C30 also includes sleep, financial difficulties, nausea/vomiting, dyspnea, appetite loss, constipation, and diarrhea. Even though some EORTC QLQ-C30 scales have unsatisfactory internal consistency, EORTC QLQ-C30, similar to SF-36, has overall acceptable psychometric properties. The EORTC QLQ-C30 is a valid alternative to the SF-36 when a broader assessment of symptoms is desired.     

脑卒中患者生存质量量表效度研究

目的：检验脑卒中患者生存质量疾病专表-脑卒中影响量表（SIS）应用于中国脑卒中患者的效度。方法：遵照SIS量表的发行机构MAPI推荐的程序及借鉴中山大学公共卫生学院统计学教研室译制经验编译SIS量表中文版，并使用此中文版对初次脑卒中发病后1个月的住院患者（180例）进行测量，运用相应的统计学方法进行效度分析。结果：SIS量表中文版的8个领域与FCA量表、SF-36量表的相关部分进行Pearson相关性分析，相关系数经统计学检验P〈0．05。结构效度中各公因子所包括的条目基本与原量表相同。结论：中文版SIS量表具有良好的效度，适用于脑卒中患者生存质量的评测。