Psychosocial Department, Academic Medical Centre/Emma Children's Hospital, Amsterdam, The Netherlands.
Pediatr Blood Cancer. 2012 May;58(5):766-74. doi: 10.1002/pbc.23158. Epub 2011 May 16.
The aim of the current study is to investigate the effectiveness of an intervention that provides health-related quality of life (HRQOL) scores of the patient (the QLIC-ON PROfile) to the pediatric oncologist.
Children with cancer participated in a sequential cohort intervention study: intervention N = 94, control N = 99. Primary outcomes of effectiveness were communication about HRQOL domains (t-test, Mann-Whitney U-test) and identification of HRQOL problems (chi-squared test). Secondary outcomes were satisfaction (multilevel analysis), referrals (chi-squared test), and HRQOL (multilevel analysis).
The QLIC-ON PROfile increased discussion of emotional functioning (control M = 32.9 vs. intervention M = 47.4, P < 0.05) and psychosocial functioning (M = 56.9 vs. M = 63.8, P < 0.05). Additionally more emotional problems remained unidentified in the control compared to the intervention group, for example, anger (control 26% vs. intervention 3%, P < 0.01), fear (14% vs. 0%, P < 0.01), and sadness (26% vs. 0%, P < 0.001). The intervention had no effect on satisfaction and referrals, but did improve HRQOL of patients 5-7 years of age with respect to self-esteem (P < 0.05), family activities (P < 0.05), and psychosocial functioning (P < 0.01).
We conclude that a PRO is a helpful tool for systematic monitoring HRQOL of children with cancer, without lengthening the duration of the consultation. It is recommended to be implemented in clinical practice.
本研究旨在探讨一种为儿科肿瘤医生提供患者健康相关生活质量(HRQOL)评分(QLIC-ON PROfile)的干预措施的有效性。
患有癌症的儿童参与了一项序贯队列干预研究:干预组 N = 94,对照组 N = 99。有效性的主要结局是沟通 HRQOL 领域(t 检验,Mann-Whitney U 检验)和识别 HRQOL 问题(卡方检验)。次要结局是满意度(多层次分析)、转介(卡方检验)和 HRQOL(多层次分析)。
QLIC-ON PROfile 增加了对情绪功能(对照组 M = 32.9 与干预组 M = 47.4,P < 0.05)和心理社会功能(M = 56.9 与 M = 63.8,P < 0.05)的讨论。此外,与干预组相比,对照组中更多的情绪问题仍未被识别,例如愤怒(对照组 26%,干预组 3%,P < 0.01)、恐惧(14%,0%,P < 0.01)和悲伤(26%,0%,P < 0.001)。该干预措施对满意度和转介没有影响,但确实改善了 5-7 岁患者的 HRQOL,表现在自尊(P < 0.05)、家庭活动(P < 0.05)和心理社会功能(P < 0.01)方面。
我们得出结论,PRO 是系统监测儿童癌症患者 HRQOL 的有用工具,不会延长咨询时间。建议将其纳入临床实践。