Support Care Cancer. 2013 Sep;21(9):2453-60. doi: 10.1007/s00520-013-1794-7. Epub 2013 Apr 19.
Aim of the present observational study is to focus on health-related quality of life (HRQL), mood and everyday life of breast cancer affected women disease-free 6 months after mastectomy, paying particular attention to the International Classification of Functioning, Disability and Health (ICF) framework contribution.
Sixty-five breast cancer-affected women disease-free 6 months after mastectomy hospitalized for reconstructive surgery (mean age 46.3 ± 7.3) were enrolled. Their depressive symptoms (Beck Depression Inventory-BDI-II), HRQL, and every day life functioning/barriers and facilitators (ICF) were assessed.
At the BDI-II, 6 patients (9.2 %) reported mild depression and 6 (9.2 %) severe depression; when the subscales were considered, 7 (10.8%) resulted depressed at the somatic-affective factor and 16 (24.6 %) at the cognitive factor. Compared to normative data no differences emerged at the HRQL Physical Component Summary (46.4 ± 9.3 vs 49.1 ± 10.1), whereas patients reported lower scores at the Mental HRQL Component Summary (45.9 ± 10.1 vs 51.5 ± 9.1; p = 0.00001 t = -4.3). As for the activity and participation domain, 11 of the 42 categories investigated were compromised in at least 20% of the sample: lifting and carrying objects (d430), acquisition of goods and services (d620), doing housework (d640), remunerative employment (d850), and many categories relating to interpersonal relationships; moreover the caregiver seems to be perceived as an important and positive modulator of disability.
The addition of the ICF evaluation to the usual psychological assessment gives a more complete picture, enabling a broader perspective of the psychological-clinical implications. Mainly, the women that we have evaluated continue to function in their everyday lives, thanks in part to their ability to accept help from their own families. However, they inevitably carry signs of their disease which some translating into problems with interpersonal relationships, depressive thoughts and negative ideation. Only the synergistic use of all these assessment instruments can one truly perceive all the nuances relating to the social and psychological conditions of the assessed patients' life, overcoming a binomial vision of well-being and ill-being.
本观察性研究旨在关注乳腺癌患者乳房切除术后 6 个月无病期的健康相关生活质量（HRQL）、情绪和日常生活，特别关注国际功能、残疾和健康分类（ICF）框架的贡献。
纳入 65 名乳腺癌无病期 6 个月后因重建手术住院的女性患者（平均年龄 46.3±7.3 岁）。评估她们的抑郁症状（贝克抑郁量表 - BDI-II）、HRQL 以及日常生活功能/障碍和促进因素（ICF）。
BDI-II 中，6 名患者（9.2%）报告轻度抑郁，6 名患者（9.2%）报告重度抑郁；当考虑亚量表时，7 名患者（10.8%）躯体情感因子抑郁，16 名患者（24.6%）认知因子抑郁。与常模数据相比，HRQL 身体成分综合得分无差异（46.4±9.3 vs 49.1±10.1），但患者的心理健康成分综合得分较低（45.9±10.1 vs 51.5±9.1；p=0.00001 t=-4.3）。在活动和参与领域，42 个调查类别中有 11 个在至少 20%的样本中受到影响：举起重物（d430）、获取商品和服务（d620）、做家务（d640）、有酬就业（d850），以及许多与人际关系相关的类别；此外，照顾者似乎被视为残疾的重要积极调节因素。
将 ICF 评估添加到常规心理评估中，可以提供更全面的情况，从而更广泛地了解心理临床影响。主要是，我们评估的女性继续在日常生活中发挥作用，部分原因是她们能够接受自己家庭的帮助。然而，她们不可避免地带有疾病的迹象，这导致了一些人际关系问题、抑郁思维和消极观念。只有协同使用所有这些评估工具，才能真正感知评估患者生活的社会和心理状况的所有细微差别，克服对幸福和疾病的二元化看法。
