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肺癌女性的生活质量与疾病意义

Quality of life and meaning of illness of women with lung cancer.

作者信息

Sarna Linda, Brown Jean K, Cooley Mary E, Williams Roma D, Chernecky Cynthia, Padilla Geraldine, Danao Leda Layo

机构信息

School of Nursing, University of California, Los Angeles, CA, USA.

出版信息

Oncol Nurs Forum. 2005 Jan 19;32(1):E9-19. doi: 10.1188/05.ONF.E9-E19.

Abstract

PURPOSE/OBJECTIVES: To describe the quality of life (QOL) of women with non-small cell lung cancer (NSCLC) and examine relationships of demographic, clinical, health status, and meaning of illness (MOI) characteristics to QOL.

DESIGN

Descriptive, cross-sectional survey.

SETTING

In-person interviews in homes or research offices.

SAMPLE

217 women with NSCLC (greater than 6 months and less than 5 years since diagnosis, mean = 2 years); 19% of the women had advanced disease. The mean age was 65 years.

METHODS

Assessments of QOL with cancer-specific (QOL Scale-Patient Version) and generic (Short Form-36) self-reports, health status (i.e., number and type of comorbid conditions, presence of depressed mood using the Center for Epidemiologic Studies Depression Scale, smoking status), and MOI (positive and negative perceptions).

MAIN RESEARCH VARIABLES

QOL, health status, MOI, and demographic and clinical characteristics.

FINDINGS

Serious disruptions in psychological and social aspects of QOL were common. Depressed mood, negative conceptualizations of MOI, and younger age explained 37% of the variance of global QOL and were correlated with poorer physical, psychological, and social dimensions of QOL. Thirty-six percent reported negative ascriptions of MOI; 35% experienced depressed mood; more than 75% reported distress with their diagnosis, family distress, and impact of sexual function as lowering their QOL; and 67% reported comorbid conditions, the most common being chronic obstructive pulmonary disease (31%).

CONCLUSIONS

Women with lung cancer experience a range of disruptions in QOL, and more than a third associate lung cancer with negative meaning. Younger age, depressed mood, and number of comorbid diseases are risk factors for negative QOL.

IMPLICATIONS FOR NURSING

These findings support the importance of assessing the QOL, MOI, and health status of women with lung cancer even after treatment is completed. Younger women may be at higher risk for disruptions.

摘要

目的/目标:描述非小细胞肺癌(NSCLC)女性患者的生活质量(QOL),并研究人口统计学、临床、健康状况以及疾病意义(MOI)特征与生活质量之间的关系。

设计

描述性横断面调查。

地点

在患者家中或研究办公室进行面对面访谈。

样本

217例非小细胞肺癌女性患者(诊断后6个月以上、5年以下,平均2年);19%的女性患有晚期疾病。平均年龄为65岁。

方法

采用癌症特异性(生活质量量表-患者版)和通用(简短健康调查问卷-36)自我报告评估生活质量,评估健康状况(即合并症的数量和类型、使用流行病学研究中心抑郁量表评估抑郁情绪的存在情况、吸烟状况)以及疾病意义(积极和消极认知)。

主要研究变量

生活质量、健康状况、疾病意义以及人口统计学和临床特征。

研究结果

生活质量在心理和社会方面的严重干扰很常见。抑郁情绪、对疾病意义的消极认知以及较年轻的年龄解释了总体生活质量差异的37%,并与生活质量较差的身体、心理和社会维度相关。36%的患者报告对疾病意义有消极归因;35%的患者有抑郁情绪;超过75%的患者报告诊断带来的痛苦、家庭困扰以及性功能影响降低了他们的生活质量;67%的患者报告有合并症,最常见的是慢性阻塞性肺疾病(31%)。

结论

肺癌女性患者在生活质量方面经历了一系列干扰,超过三分之一的患者将肺癌与消极意义联系起来。较年轻的年龄、抑郁情绪和合并症数量是生活质量较差的危险因素。

对护理的启示

这些发现支持了即使在治疗完成后仍需评估肺癌女性患者生活质量、疾病意义和健康状况的重要性。年轻女性可能面临更高的干扰风险。

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