Yu C L, Fielding R, Chan C L, Sham J S
Unit for Behavioral Sciences, Department of Community Medicine, The University of Hong Kong, Hong Kong SAR, China.
Cancer. 2001 Oct 15;92(8):2126-35. doi: 10.1002/cncr.1554.
Nasopharyngeal carcinoma (NPC) is highly prevalent in southern China. Prominent acute side effects of radiotherapy create problems in daily living and working that can generate considerable financial difficulties. A better adjustment to a diagnosis of NPC appears to be associated with an improved rate of recovery, a better quality of life (QoL), a quicker return to work, and normal functioning. Patient satisfaction with physician consultation and the way information is provided in particular may have significant bearing on QoL. The current study reports on short-term QoL after radiotherapy in NPC patients as a function of satisfaction with the information provided.
Newly referred Hong Kong Chinese NPC patients (n = 211) completed interview measures at baseline before the initiation of radiotherapy, at 4 months after baseline (immediate posttreatment consultation) (FU 1), and again at 8 months (short-term postradiation period) after baseline (FU 2). Satisfaction with the information provided was measured by five items selected from the cognitive subscale of the Medical Interview Satisfaction Scale (MISS). QoL was measured by the Chinese version of the Functional Assessment of Cancer Therapy-General Scale (FACT-G (Ch)).
After adjustment for overall patient satisfaction (the PSQ-9), optimism, worry about family, anger, eating ability, subjective health, family income, and occupation at FU 1, treatment between baseline and FU 1, and disease recurrence after baseline, the 5-item MISS at FU 1 (beta = 0.21, P < 0.01) was found to significantly predict patient QoL at FU 2. Adjustment for baseline QoL and disease stage did not appear to alter this relation (beta = 0.20, P < 0.01).
To the authors' knowledge, there is very little research concerning NPC. The results of the current study reinforced the need to improve physicians' information provision during consultations with Chinese NPC patients shortly after the end of treatment.
鼻咽癌（NPC）在中国南方高度流行。放疗明显的急性副作用给日常生活和工作带来问题，可能产生相当大的经济困难。对鼻咽癌诊断的更好适应似乎与更高的康复率、更好的生活质量（QoL）、更快重返工作岗位和正常功能有关。患者对医生咨询尤其是信息提供方式的满意度可能对生活质量有重大影响。本研究报告了鼻咽癌患者放疗后的短期生活质量与对所提供信息满意度之间的关系。
新转诊的香港华裔鼻咽癌患者（n = 211）在放疗开始前的基线期、基线期后4个月（即刻治疗后咨询）（随访1）以及基线期后8个月（放疗后短期）（随访2）完成访谈测量。对所提供信息的满意度通过从医学访谈满意度量表（MISS）认知子量表中选取的5个项目进行测量。生活质量通过癌症治疗功能评估通用量表中文版（FACT - G（Ch））进行测量。
在对随访1时的总体患者满意度（PSQ - 9）、乐观情绪、对家庭的担忧、愤怒、进食能力、主观健康状况、家庭收入和职业、基线期与随访1之间的治疗以及基线期后的疾病复发进行调整后，发现随访1时的5项MISS（β = 0.21，P < 0.01）显著预测随访2时的患者生活质量。对基线生活质量和疾病分期进行调整似乎并未改变这种关系（β = 0.20，P < 0.01）。
据作者所知，关于鼻咽癌的研究非常少。本研究结果强化了在治疗结束后不久与华裔鼻咽癌患者会诊期间改善医生信息提供的必要性。
