Kenne Sarenmalm Elisabeth, Ohlén Joakim, Jonsson Tommy, Gaston-Johansson Fannie
Research and Development Centre, Skaraborg Hospital, Kärnsjukhuset, Skövde, Sweden.
J Pain Symptom Manage. 2007 Jul;34(1):24-39. doi: 10.1016/j.jpainsymman.2006.10.017. Epub 2007 Jun 4.
Little is known about how postmenopausal women with recurrent breast cancer cope with distressing symptoms and which factors predict health-related quality of life (HRQOL). In the present study, 56 consecutively enrolled patients completed questionnaires measuring symptom occurrence, coping capacity, coping efforts, and HRQOL at the time of recurrence. Results from this study illustrate that women with recurrent breast cancer suffer from multiple, concurrent, and interrelated symptoms of illness, anxiety, depression, and fatigue. Highly prevalent symptoms are lack of energy, difficulty sleeping, pain, worrying, problems with sexual interest, feeling sad, and dry mouth. The most frequently occurring symptom is problem with sexual interest, and the most severe symptom is worrying. The most distressing symptom experienced is pain. The majority of the women report 10-23 symptoms. Women who experience multiple symptoms also report higher levels of symptom distress. The experience of distressing symptoms is predicted by coping capacity, and the coping efforts experienced predict HRQOL. Patients with lower coping capacity report higher prevalence of symptoms, experience higher levels of distress, and experience worse perceived health, which in turn may decrease their HRQOL. To help women manage recurrent breast cancer, it is important to use multidimensional measurement to identify, evaluate, and treat distressing symptoms, and not assess single symptoms only. Care must be based upon the awareness of critical factors that exacerbate vulnerability to distress, as well as the ability to adapt to a recurrent breast cancer disease.
对于绝经后复发性乳腺癌女性如何应对令人痛苦的症状以及哪些因素可预测健康相关生活质量（HRQOL），我们知之甚少。在本研究中，56名连续入组的患者在复发时完成了测量症状发生情况、应对能力、应对努力程度和HRQOL的问卷调查。该研究结果表明，复发性乳腺癌女性患有多种、同时出现且相互关联的疾病、焦虑、抑郁和疲劳症状。高度普遍的症状包括精力不足、睡眠困难、疼痛、担忧、性兴趣问题、悲伤情绪和口干。最常出现的症状是性兴趣问题，最严重的症状是担忧。经历的最令人痛苦的症状是疼痛。大多数女性报告有10 - 23种症状。经历多种症状的女性也报告有更高程度的症状困扰。令人痛苦的症状体验可由应对能力预测，而经历的应对努力程度可预测HRQOL。应对能力较低的患者报告的症状患病率更高，经历的困扰程度更高，且自我感觉健康状况更差，这反过来可能会降低她们的HRQOL。为帮助女性应对复发性乳腺癌，重要的是使用多维测量方法来识别、评估和治疗令人痛苦的症状，而不仅仅是评估单一症状。护理必须基于对加剧痛苦易感性的关键因素的认识，以及适应复发性乳腺癌疾病的能力。
