College of Nursing, Taipei Medical University, Taipei, Taiwan.
J Clin Nurs. 2012 Jan;21(1-2):70-9. doi: 10.1111/j.1365-2702.2011.03735.x. Epub 2011 Jun 27.
To examine changes in quality of life among patients with breast cancer and factors related to it, during the first three months after diagnosis.
Numerous studies have examined quality of life among cancer survivors or among patients with cancer after aggressive treatment; such research has demonstrated that quality of life in the third month after surgery can significantly predict quality of life in the long run. In contrast, changes in quality of life causes among patients during the acute treatment phase have not been well studied.
Prospective longitudinal study.
Newly diagnosed patients with breast cancer were recruited during 2008-2009. Sixty-one cases completed the four data collections on the day before operation and one, two and three months after surgery. Data were collected using the Functional Living Index-Cancer, Symptom Distress Scale, the Self-Efficacy Scale and a 0-10 Anxiety Numeric Rating Scale. Generalized Estimating Equations were applied for data analysis.
There were significant changes in quality of life over the three months following surgery, and the worst quality of life was observed in the first month after surgery. Less advanced stages of cancer, lower anxiety, less symptom distress and higher perceived self-efficacy in the preoperative interview could significantly predict which patients experienced more positive quality of life trends. Fatigue, limited shoulder function and perceived poor appearance were the most significant factors predicting changes of quality of life.
Preoperative physical and psychological factors, as well as sense of self-efficacy for managing the cancer, are important factors for predicting changes in patients' quality of life.
Healthcare providers should be alert to factors contributing to changes of quality of life among patients receiving chemotherapy. Interventions based on these results should be developed and their effectiveness tested for their impact on breast cancer patients' quality of life. Clinical interventions based on these results should be developed to improve breast cancer patients' quality of life.
在诊断后三个月内，检查乳腺癌患者的生活质量变化及其相关因素。
许多研究已经检查了癌症幸存者或接受过积极治疗的癌症患者的生活质量；这些研究表明，手术后第三个月的生活质量可以显著预测长期的生活质量。相比之下，在急性治疗阶段患者生活质量变化的原因尚未得到很好的研究。
前瞻性纵向研究。
在 2008-2009 年期间招募新诊断的乳腺癌患者。61 例患者在手术前一天和手术后一个、两个月和三个月完成了四次数据采集。使用功能生活指数-癌症、症状困扰量表、自我效能量表和 0-10 焦虑数字评分量表收集数据。采用广义估计方程进行数据分析。
手术三个月后生活质量有显著变化，手术后第一个月生活质量最差。癌症分期较低、术前焦虑较低、症状困扰较轻、自我效能感较高，这些因素可显著预测哪些患者生活质量趋势更积极。疲劳、肩部功能受限和自我感觉外观较差是预测生活质量变化的最重要因素。
术前的身体和心理因素以及管理癌症的自我效能感是预测患者生活质量变化的重要因素。
医护人员应注意导致接受化疗的患者生活质量变化的因素。应根据这些结果制定干预措施，并测试其对乳腺癌患者生活质量的影响。应根据这些结果制定临床干预措施，以提高乳腺癌患者的生活质量。
