Mor V, Masterson-Allen S, Houts P, Siegel K
Center for Gerontology and Health Care Research, Brown University, Providence, Rhode Island 02912.
Cancer. 1992 Feb 1;69(3):829-38. doi: 10.1002/1097-0142(19920201)69:3<829::aid-cncr2820690335>3.0.co;2-i.
Changes in the daily living needs of 629 patients with advanced cancer were investigated (1) during and (2) 3 to 6 months after a course of outpatient chemotherapy and/or radiation treatment. The analytic sample consisted of patients completing both baseline and follow-up interviews (n = 434). At both times, the point prevalence of need and unmet need for assistance with personal care, instrumental activities, transportation, and home health tasks was calculated. In addition, the prevalence of new need and unmet need at follow-up was determined as were the rates of resolution of baseline need. The prevalence of need for assistance with personal care increased from 7% at baseline to 16% at follow-up; the dynamic of need acquisition and resolution resulted in relatively constant prevalence rates in other task areas. Acquisition of need at follow-up was associated primarily with disease and treatment-related characteristics. Approximately one third of patients reporting need for assistance during at least one interview did not have enough help. New unmet need at follow-up was associated most strongly with patients' mobility and the ability of their informal support system to provide care. The apparently rapid fluctuation in patients' experience of need and unmet need suggests the necessity for ongoing appraisal of patients' physical condition and social situation.
对629例晚期癌症患者在（1）门诊化疗和/或放射治疗期间以及（2）疗程结束后3至6个月的日常生活需求变化进行了调查。分析样本包括完成基线和随访访谈的患者（n = 434）。在两个时间点，均计算了个人护理、工具性活动、交通和家庭健康任务方面需求和未满足需求的时点患病率。此外，还确定了随访时新需求和未满足需求的患病率以及基线需求的解决率。个人护理方面的需求患病率从基线时的7%上升至随访时的16%；需求获取和解决的动态变化导致其他任务领域的患病率相对稳定。随访时需求的获取主要与疾病和治疗相关特征有关。在至少一次访谈中报告需要帮助的患者中，约三分之一没有得到足够的帮助。随访时新出现的未满足需求与患者的活动能力及其非正式支持系统提供护理的能力最为相关。患者需求和未满足需求体验的明显快速波动表明有必要持续评估患者的身体状况和社会状况。
