Gordon Louisa G, Battistutta Diana, Scuffham Paul, Tweeddale Margaret, Newman Beth
Centre for Health Research School of Public Health, Queensland University of Technology, Kelvin Grove, Brisbane, Australia.
Breast Cancer Res Treat. 2005 Oct;93(3):217-26. doi: 10.1007/s10549-005-5151-5.
As the number of women surviving breast cancer increases, with implications for the health system, research into the physical and psychosocial sequelae of the cancer and its treatment is a priority. This research estimated self-reported health-related quality of life (HRQoL) associated with two rehabilitation interventions for breast cancer survivors, compared to a non-intervention group. Women were selected if they received an early home-based physiotherapy intervention (DAART, n = 36) or a group-based exercise and psychosocial intervention (STRETCH, n = 31). Questionnaires on HRQoL, using the Functional Assessment of Cancer Therapy - Breast Cancer plus Arm Morbidity module, were administered at pre-, post-intervention, 6- and 12-months post-diagnosis. Data on a non-intervention group (n = 208) were available 6- and 12-months post-diagnosis. Comparing pre/post-intervention measures, benefits were evident for functional well-being, including reductions in arm morbidity and upper-body disability for participants completing the DAART service at one-to-two months following diagnosis. In contrast, minimal changes were observed between pre/post-intervention measures for the STRETCH group at approximately 4-months post-diagnosis. Overall, mean HRQoL scores (adjusted for age, chemotherapy, hormone therapy, high blood pressure and occupation type) improved gradually across all groups from 6- to 12-months post-diagnosis, and no prominent differences were found. However, this obscured declining HRQoL scores for 20-40% of women at 12 months post-diagnosis, despite receiving supportive care services. Greater awareness and screening for adjustment problems among breast cancer survivors is required throughout the disease trajectory. Early physiotherapy after surgery has the potential for short-term functional, physical and overall HRQoL benefits.
随着乳腺癌存活女性数量的增加，这对卫生系统产生了影响，因此对癌症及其治疗的身体和心理社会后遗症进行研究成为当务之急。本研究评估了与两种针对乳腺癌幸存者的康复干预措施相关的自我报告的健康相关生活质量（HRQoL），并与非干预组进行了比较。如果女性接受早期家庭物理治疗干预（DAART，n = 36）或基于小组的运动和心理社会干预（STRETCH，n = 31），则被纳入研究。使用癌症治疗功能评估 - 乳腺癌加手臂发病率模块的HRQoL问卷在干预前、干预后、诊断后6个月和12个月进行发放。在诊断后6个月和12个月可获得非干预组（n = 208）的数据。比较干预前后的测量结果，功能幸福感方面的益处很明显，包括对于在诊断后一到两个月完成DAART服务的参与者，手臂发病率和上身残疾程度有所降低。相比之下，在诊断后约4个月时，STRETCH组干预前后的测量结果变化极小。总体而言，所有组的平均HRQoL分数（根据年龄、化疗、激素治疗、高血压和职业类型进行调整）在诊断后6个月至12个月期间逐渐改善，未发现显著差异。然而，这掩盖了诊断后12个月时20%至40%女性的HRQoL分数下降情况，尽管她们接受了支持性护理服务。在整个疾病过程中，需要提高对乳腺癌幸存者调整问题的认识并加强筛查。术后早期物理治疗有可能带来短期功能、身体和整体HRQoL方面的益处。
