Lundh Marie Høyer, Lampic Claudia, Nordin Karin, Ahlgren Johan, Bergkvist Leif, Lambe Mats, Berglund Anders, Johansson Birgitta
Regional Cancer Centre, Uppsala University Hospital, Uppsala, Sweden.
Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
Psychooncology. 2013 Oct;22(10):2321-31. doi: 10.1002/pon.3285. Epub 2013 Apr 14.
To investigate whether longitudinal changes in health-related quality of life (HRQoL) among breast cancer patients vary by prediagnosis occupational status or postdiagnosis changes in working time.
We identified 1573 patients in the Breast Cancer Quality Register of Central Sweden and asked them to participate in a longitudinal questionnaire study. A total of n = 841 women completed three questionnaires within a mean time of 4, 16, and 38 months postdiagnosis. Generalized estimating equation models were used to examine changes in European Organization for Research and Treatment of Cancer Quality of Life Questionnaire and the Breast Cancer-Specific Quality of Life Questionnaire subscales stratified by prediagnosis occupational status and postdiagnosis changes in working time.
Over time, the proportion of employed women reporting good functioning increased more, and the proportion reporting a high level of symptoms decreased more compared with women on sick leave/disability pension and retirement pensioners (p < 0.001). The latter two also showed a worsening in several subscales (p < 0.05). Among employed women, more consistent improvements in role and social functioning were observed among those with an increase/no change in working time than among those who had decreased it or stopped working (p < 0.05). A decrease in the proportion reporting pain was observed among women with an increase/no change in working time compared with women with decreased working time, among whom the proportion reporting pain increased (p = 0.008).
Being employed prediagnosis and resuming work to the same extent as prior to the breast cancer diagnosis are associated with consistent improvements in HRQoL. These results highlight the importance of interventions to improve HRQoL and policies to support return to work following diagnosis.
探讨乳腺癌患者健康相关生活质量（HRQoL）的纵向变化是否因诊断前职业状况或诊断后工作时间变化而异。
我们在瑞典中部乳腺癌质量登记处识别出1573名患者，并邀请他们参与一项纵向问卷调查研究。共有n = 841名女性在诊断后平均4、16和38个月内完成了三份问卷。采用广义估计方程模型，以诊断前职业状况和诊断后工作时间变化分层，研究欧洲癌症研究与治疗组织生活质量问卷和乳腺癌特异性生活质量问卷各子量表的变化情况。
随着时间推移，与休病假/领取残疾抚恤金者和退休人员相比，报告功能良好的在职女性比例增加更多，报告症状严重程度高的比例下降更多（p < 0.001）。后两者在几个子量表上也出现了恶化（p < 0.05）。在职女性中，工作时间增加/无变化者在角色和社会功能方面的改善比工作时间减少或停止工作者更为一致（p < 0.05）。与工作时间减少的女性相比，工作时间增加/无变化的女性报告疼痛的比例下降，而工作时间减少的女性报告疼痛的比例增加（p = 0.008）。
诊断前就业且恢复到与乳腺癌诊断前相同程度的工作与HRQoL的持续改善相关。这些结果凸显了改善HRQoL干预措施以及支持诊断后重返工作岗位政策的重要性。
