Weissflog Gregor, Singer Susanne, Meyer Alexandra, Wittekind Christian, Dietrich Arne, Weimann Arved, Brähler Elmar, Ernst Jochen
Department of Mental Health, Medical Psychology and Medical Sociology, University of Leipzig, Germany.
Onkologie. 2012;35(4):162-8. doi: 10.1159/000337362. Epub 2012 Mar 15.
Since 2006, in Germany colorectal cancer patients can be treated in certified colorectal cancer centers. The aim of this explorative study was to investigate whether there are differences in the quality of life (QoL) of colorectal cancer patients who were treated in certified versus noncertified centers.
A total of 284 colorectal cancer patients participated in the study: 184 patients from certified colorectal cancer centers and 100 patients from noncertified centers. Data on QoL (using the Quality of Life Questionnaire of the European Organization for Research and Treatment of Cancer (EORTC-QLQ C30)), patient satisfaction, mental distress and sociodemographic data were assessed with a questionnaire in a written survey after the hospital stay. The moderating influence of patientrelated characteristics (e.g. age, sex, patient satisfaction, and psychological distress) and cancerrelated factors (Union internationale contre le cancer (UICC) stage) were tested.
On a descriptive level, patients from noncertified centers had a higher QoL in 5 subdimensions (higher physical and role functioning and less insomnia, appetite loss and financial difficulties). After adjustment, only 2 differences remained significant: physical functioning (p < 0.01) and role functioning (p = 0.02).
Structural improvements in the oncological care are not necessarily reflected in a better QoL of the patients treated in certified colorectal cancer centers. The findings are discussed in the context of the applied study design.
自2006年起,德国的结直肠癌患者可在经认证的结直肠癌中心接受治疗。这项探索性研究的目的是调查在经认证与未经认证的中心接受治疗的结直肠癌患者在生活质量(QoL)方面是否存在差异。
共有284名结直肠癌患者参与了该研究:184名来自经认证的结直肠癌中心,100名来自未经认证的中心。在患者出院后的书面调查中,通过问卷评估了生活质量数据(使用欧洲癌症研究与治疗组织生活质量问卷(EORTC - QLQ C30))、患者满意度、心理困扰和社会人口统计学数据。对患者相关特征(如年龄、性别、患者满意度和心理困扰)以及癌症相关因素(国际抗癌联盟(UICC)分期)的调节作用进行了测试。
在描述性层面上,来自未经认证中心的患者在5个亚维度上生活质量更高(身体和角色功能更好,失眠、食欲减退和经济困难更少)。调整后,仅2个差异仍具有显著性:身体功能(p < 0.01)和角色功能(p = 0.02)。
肿瘤护理的结构性改善不一定体现在经认证的结直肠癌中心接受治疗的患者具有更好的生活质量。在应用研究设计的背景下对这些发现进行了讨论。