上海市社区癌症患者生活质量及其影响因素

背景与目的:目前癌症患者生活质量的评价已经成为肿瘤临床研究的终点指标之一,其综合反映了癌症患者的生存、预后和生活状况.本研究试图通过了解上海市社区癌症患者生活质量及其影响因素,探索有针对性的干预措施,评价医疗卫生服务效果.方法:采用整群抽样的方法从上海肿瘤病例数据库中选取社区中7 967例癌症患者进行问卷调查并填写FACT-G自评量表,共回收合格调查表6 694份.统计描述其生活质量的流行病学分布,使用多元线性逐步回归分析数据,确定影响患者生活质量的主要因素.结果:社区癌症患者中,平均生活质量评分为107.62±18.77(95%CI:107.17～108.07).患者生存期、诊断时期别、肿瘤有无转移、治疗状况、体能评分KPS和疼痛VAS评分是生活质量的主要影响因素.结论:早期诊断癌症、提高临床治疗效果、提供社区康复指导与止痛服务对于提高社区癌症患者的生活质量会有帮助.

Quality of life and its influential factors of cancer patients in Shanghai

BACKGROUND & OBJECTIVE: Now the quality of life of cancer patients has become one of the end-points in cancer researches. It reflects the survival status and prognosis of cancer patients. This study was to determine the quality of life and its influential factors of cancer patients who live in communities in Shanghai, and to design suitable intervention and evaluate the effectiveness of community-based health care service. METHODS: A total of 7,967 cancer patients who lived in communities in Shanghai were selected through searching Shanghai Cancer Patient Database by cluster sampling. Questionnaire with FACT-G Self-rating Scale was applied; 6,694 valid questionnaires were obtained. The scores of quality of life were calculated and analyzed with multiple linear regression model to determine the influential factors. RESULTS: The average score of quality of life of the 6 694 cancer patients was 107.62+/-18.77 (95% CI=107.17-108.07). Duration since diagnosis, stage at diagnosis, metastasis status, treatment effect, KPS score, and pain VAS score were main influential factors of quality of life of the cancer patients. CONCLUSION: Early diagnosis of cancer, improvement of the treatment effect, and providing community health care and analgesic services might improve the quality of life of cancer patients who live in communities.