Litwin M S, Fitzpatrick J M, Fossa S D, Newling D W
Departments of Urology and Health Services, University of California at Los Angeles, Los Angeles, California, USA.
Prostate. 1999 Sep 15;41(1):58-67. doi: 10.1002/(sici)1097-0045(19990915)41:1<58::aid-pros8>3.0.co;2-3.
While the traditional goal in the management of patients with prostate cancer has been to maximize survival, the recent advent of the medical outcomes movement has underscored the importance of patient-centered issues, such as health-related quality of life (HRQOL).
In this paper we present a comprehensive approach to the study of HRQOL in men with prostate cancer. We begin by defining HRQOL in general, discussing its measurement, and placing it in the context of prostate cancer. We then describe the primary goals of HRQOL research and present examples of validated instruments. We finish by proposing a quality of life research agenda for the next two decades.
Contemporary perspectives on HRQOL are based on the World Health Organization's definition of health as not merely the absence of disease, but as a state of physical, emotional, and social well-being. HRQOL measurement must adhere to the strict methodological principles of survey psychometrics and is best accomplished with any of several validated instruments. Once collected, HRQOL information is useful for prostate cancer patients facing difficult treatment decisions.
A solid foundation for HRQOL research has been built in early- and late-stage prostate cancer. It includes the development of new instruments and the establishment of descriptive data. This groundwork will allow investigators to address more complex research issues, such as interpreting interactions among HRQOL domains, presenting HRQOL data to future patients, optimally timing HRQOL data collection, uncovering innate and alterable factors that influence HRQOL, and exploring the intercultural nuances of HRQOL assessment.
虽然前列腺癌患者管理的传统目标一直是最大化生存率，但近期医学成果运动的出现凸显了以患者为中心的问题的重要性，如健康相关生活质量（HRQOL）。
在本文中，我们提出了一种研究前列腺癌男性患者HRQOL的综合方法。我们首先总体定义HRQOL，讨论其测量方法，并将其置于前列腺癌的背景中。然后我们描述HRQOL研究的主要目标，并给出经过验证的工具的示例。最后，我们提出了未来二十年的生活质量研究议程。
当代对HRQOL的观点基于世界卫生组织对健康的定义，即健康不仅仅是没有疾病，而是身体、情感和社会福祉的一种状态。HRQOL测量必须遵循调查心理测量学的严格方法原则，并且最好使用几种经过验证的工具中的任何一种来完成。一旦收集到，HRQOL信息对于面临艰难治疗决策的前列腺癌患者是有用的。
在前列腺癌的早期和晚期已经为HRQOL研究奠定了坚实的基础。这包括新工具的开发和描述性数据的建立。这项基础工作将使研究人员能够解决更复杂的研究问题，例如解释HRQOL各领域之间的相互作用、向未来患者呈现HRQOL数据、优化HRQOL数据收集的时间、发现影响HRQOL的内在和可改变因素，以及探索HRQOL评估的跨文化细微差别。
