Kerr Jacqueline, Engel Jutta, Schlesinger-Raab Anne, Sauer Hansjörg, Hölzel Dieter
Feldstudie, Munich Cancer Registry, Ludwig-Maximilians University, Munich, Germany.
Dis Colon Rectum. 2003 Aug;46(8):1038-46. doi: 10.1097/01.DCR.0000074690.73575.99.
The purpose of the study was to examine the effect of communication on rectal cancer patients' quality of life over four years. Previous studies have either used short follow-up periods or examined only certain aspects of quality of life, such as anxiety and depression.
In a prospective, observational study, rectal cancer patients, recruited by clinicians over a two-year period, were sent questionnaires over four years. The clinical details of these patients were recorded by the Munich Cancer Registry. The psychological scores from the European Organization for Research and Treatment of Cancer QLQ-C30 and CR38 were the main outcome variables.
Thirty-nine percent of the sample reported that some aspect of the communication they received was unclear (incomprehensible or too little). More than 60 percent wished to speak more with their physician. Younger patients and those in larger hospitals were more likely to report unclear communication (P < 0.05). Analyses of covariance, controlled for age, gender, adjuvant therapy, stoma, education, clinic, and comorbidity, demonstrated that role, emotional, and social functioning scores were consistently lower in patients reporting unclear communication. Additionally, these patients experienced more problems sleeping, poorer body image, more financial worries, and a worse future perspective. Repeated measures analyses indicated that sleeping problems and emotional and social functioning difficulties persisted for at least three years.
Reports of unclear communication were associated with poorer quality of life in rectal cancer patients without disease progression.
本研究旨在探讨四年间沟通对直肠癌患者生活质量的影响。既往研究要么随访期较短，要么仅考察生活质量的某些方面，如焦虑和抑郁。
在一项前瞻性观察性研究中，临床医生在两年内招募的直肠癌患者在四年间收到调查问卷。这些患者的临床细节由慕尼黑癌症登记处记录。欧洲癌症研究与治疗组织QLQ-C30和CR38的心理评分是主要结局变量。
39%的样本报告称他们所接受沟通的某些方面不清楚（难以理解或信息过少）。超过60%的患者希望与医生进行更多交流。年轻患者和在大型医院就诊的患者更有可能报告沟通不清楚（P<0.05）。在对年龄、性别、辅助治疗、造口、教育程度、诊所和合并症进行控制的协方差分析中，报告沟通不清楚的患者在角色、情感和社会功能评分方面始终较低。此外，这些患者睡眠问题更多、身体形象较差、经济担忧更多且对未来的展望更糟。重复测量分析表明，睡眠问题以及情感和社会功能困难至少持续了三年。
在无疾病进展的直肠癌患者中，沟通不清楚的报告与较差的生活质量相关。
