Heim M E, Kunert S, Ozkan I
Sonnenberg-Klinik, Hardtstrasse 13, D-37242 Bad Sooden-Allendorf, Germany.
Onkologie. 2001 Jun;24(3):268-72. doi: 10.1159/000055090.
Major endpoint for the assessment of a complex inpatient rehabilitation program is the health-related quality of life. In a prospective longitudinal study we evaluated the subjective well-being of breast cancer patients by different methods.
183 breast cancer patients were asked to complete six different questionnaires at three different time points: t1: start of treatment, t2: end of treatment, t3: 3 months after t2.
In the Hospital Anxiety and Depression Scale (HADS-D) we observed high mean scores for anxiety (8.73) and depression (5.55), as compared to a healthy control population (5.8 and 3.34, respectively). There was a significant improvement for both scores at t2 (6.84 and 4.77, respectively) and for anxiety at t3 (7.68). This was confirmed by the FBK questionnaire showing a significant decrease of the psychological distress in the t1/t2 and t1/t3 time periods as well. The global health score of the QLQ-C30 instrument increased significantly at the end of the rehabilitation and was maintained at the 3-month follow-up. This was true for most of the functional subscales as well. Older widowed women with 3-4 accompanying diseases had the most profit from the program. Using the Perceived Adjustment to Chronic Illness Scale (PACIS), we observed significantly less effort of coping with the illness at t2 and t3.
At the end of a complex rehabilitation program for breast cancer patients, the health-related quality of life improved in several domains. While after a 3-month follow-up the scores were still better than before the treatment, anxiety and depression increased again. Therefore, the good results of the rehabilitation program should be maintained by continuous ambulatory treatment.
评估复杂住院康复项目的主要终点是与健康相关的生活质量。在一项前瞻性纵向研究中，我们采用不同方法评估了乳腺癌患者的主观幸福感。
183例乳腺癌患者被要求在三个不同时间点完成六种不同问卷：t1：治疗开始时，t2：治疗结束时，t3：t2后3个月。
在医院焦虑抑郁量表（HADS-D）中，我们观察到焦虑（8.73）和抑郁（5.55）的平均得分较高，而健康对照人群的得分分别为5.8和3.34。在t2时，这两项得分均有显著改善（分别为6.84和4.77），t3时焦虑得分也有改善（7.68）。FBK问卷也证实了这一点，该问卷显示在t1/t2和t1/t3时间段心理困扰也显著降低。QLQ-C30工具的总体健康得分在康复结束时显著提高，并在3个月随访时保持。大多数功能子量表也是如此。患有3 - 4种伴随疾病的老年寡妇从该项目中获益最多。使用慢性病感知调整量表（PACIS），我们观察到在t2和t3时应对疾病的努力显著减少。
在乳腺癌患者的复杂康复项目结束时，与健康相关的生活质量在多个领域得到改善。虽然经过3个月随访，得分仍优于治疗前，但焦虑和抑郁再次增加。因此，应通过持续的门诊治疗维持康复项目的良好效果。
