Fröjd Camilla, Larsson Gunnel, Lampic Claudia, von Essen Louise
Department of Public Health and Caring Sciences, Psychosocial oncology, Uppsala University, Uppsala, Sweden.
Health Qual Life Outcomes. 2007 Apr 11;5:18. doi: 10.1186/1477-7525-5-18.
The aim was to investigate HRQoL and psychosocial function among patients with carcinoid tumours, longitudinally and prospectively, and to compare HRQoL among patients with carcinoid tumours to that of the Swedish general population. The aim was also to investigate the prevalence of distress during the first year after diagnosis.
At four assessments during the first year after diagnosis, HRQoL was measured by the EORTC QLQ-C30 3.0, anxiety and depression by the HADS, and prevalence, and worst aspects of distress by an interview guide. ANOVA was performed in order to study changes over time with regard to HRQoL, anxiety and depression. Comparisons regarding HRQoL between patients and the Swedish population were made by the use of one-sample t-tests and changes over time regarding the prevalence of distress was investigated by means of Cochran's Q.
High levels of physical-, emotional-, cognitive-, and social function and somewhat lower levels of role function and global quality of life were reported at all assessments. Role- and emotional function increased over time. Patients reported lower role function and global quality of life and more problems with fatigue and diarrhoea than the Swedish general population, at all assessments. Fatigue, limitations to work and pursue daily activities, and worry that the illness will get worse were among the most prevalent aspects at all assessments. At all assessments the majority reported worrying about the family's situation, the ability to care for the family, and worrying before the check-up.
It is concluded that HRQoL and psychosocial function among patients with carcinoid tumours remains stable during the first year, that the patients report a lower HRQoL than the Swedish general population, and that a majority of the patients report a number of aspects of emotional distress. In the clinical care, it should be considered that the majority of patients report not only fatigue and diarrhoea but also worries about their prognosis, their families, tests, and examinations. Efforts to reduce these worries should be made.
目的是纵向和前瞻性地调查类癌肿瘤患者的健康相关生活质量(HRQoL)和心理社会功能,并将类癌肿瘤患者的HRQoL与瑞典普通人群进行比较。目的还包括调查诊断后第一年中痛苦情绪的患病率。
在诊断后的第一年进行四次评估,通过欧洲癌症研究与治疗组织核心问卷(EORTC QLQ-C30 3.0)测量HRQoL,通过医院焦虑抑郁量表(HADS)测量焦虑和抑郁,并通过访谈指南调查痛苦情绪的患病率及其最严重的方面。进行方差分析以研究HRQoL、焦虑和抑郁随时间的变化。通过单样本t检验对患者与瑞典人群的HRQoL进行比较,并通过 Cochr an's Q检验调查痛苦情绪患病率随时间的变化。
在所有评估中,患者报告的身体、情感、认知和社会功能水平较高,而角色功能和总体生活质量水平略低。角色和情感功能随时间增加。在所有评估中,患者报告的角色功能和总体生活质量低于瑞典普通人群,并且在疲劳和腹泻方面存在更多问题。在所有评估中,疲劳、工作和日常活动受限以及担心病情恶化是最普遍的方面。在所有评估中,大多数患者报告担心家庭状况、照顾家人的能力以及检查前的担忧。
得出的结论是,类癌肿瘤患者的HRQoL和心理社会功能在第一年保持稳定,患者报告的HRQoL低于瑞典普通人群,并且大多数患者报告了一些情绪痛苦的方面。在临床护理中,应考虑到大多数患者不仅报告疲劳和腹泻,还担心他们的预后、家人、检查和检验。应努力减少这些担忧。