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恶性中枢神经系统与非中枢神经系统肿瘤患者的主要照顾者的健康相关生活质量:一项对比研究。

Health-related quality of life of significant others of patients with malignant CNS versus non-CNS tumors: a comparative study.

机构信息

Department of Medical Psychology, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, The Netherlands,

出版信息

J Neurooncol. 2013 Oct;115(1):87-94. doi: 10.1007/s11060-013-1198-z. Epub 2013 Jul 4.

Abstract

It is often assumed that brain tumor patients' significant others (SOs: partners, other family members or close friends) may face greater stress than those of patients with malignancies not involving the central nervous system (CNS), due to progressive changes in neurological and cognitive functioning. We compared health-related quality of life (HRQOL) of SOs of patients with high-grade glioma (HGG) and low-grade glioma (LGG) with that of SOs of patients with non-CNS tumors with similar prognosis and at a similar phase in the disease trajectory (i.e. non-small cell lung cancer (NSCLC) and low-grade hematological malignancies (NHL/CLL), respectively). HRQOL of SOs and patients was assessed using the Short Form-36 (SF-36) Health Survey. Patients' neurological functioning was indexed and they underwent comprehensive neurocognitive testing. SOs of 213 LGG patients, 99 NHL/CLL patients, 55 HGG patients and 29 NSCLC patients participated. The SOs of LGG and NHL/CLL patients reported similar levels of HRQOL. SOs of HGG patients reported significantly lower mental health scores (MCS; p = 0.041) and social functioning (p = 0.028) than those of NSCLC patients. Mental health scores (MCS) of HGG and NSCLC patients were associated significantly with the mental health of their SOs (p = 0.013 and p < 0.001, respectively). Surprisingly, HGG patients' cognitive and neurological functioning were not predictive of SOs' mental health at the multivariate level. SOs of patients with highly malignant CNS tumors in the acute phase are at increased risk of compromised HRQOL compared to those of patients with systemic tumors without CNS involvement and a comparable life expectancy.

摘要

人们通常认为,与非中枢神经系统(CNS)恶性肿瘤患者相比,脑肿瘤患者的重要他人(SO:伴侣、其他家庭成员或亲密朋友)可能面临更大的压力,因为中枢神经系统的神经和认知功能会逐渐发生变化。我们比较了高级别胶质瘤(HGG)和低级别胶质瘤(LGG)患者 SO 的健康相关生活质量(HRQOL)与具有相似预后和疾病轨迹相似阶段(即非小细胞肺癌(NSCLC)和低级别血液恶性肿瘤(NHL/CLL)的非 CNS 肿瘤患者 SO 的 HRQOL。使用简明健康调查 36 项量表(SF-36)评估 SO 和患者的 HRQOL。患者的神经功能被索引,他们接受了全面的神经认知测试。213 名 LGG 患者、99 名 NHL/CLL 患者、55 名 HGG 患者和 29 名 NSCLC 患者的 SO 参与了研究。LGG 和 NHL/CLL 患者的 SO 报告了相似水平的 HRQOL。HGG 患者的心理健康评分(MCS;p=0.041)和社会功能(p=0.028)明显低于 NSCLC 患者。HGG 和 NSCLC 患者的心理健康评分(MCS)与他们 SO 的心理健康状况显著相关(p=0.013 和 p<0.001)。令人惊讶的是,在多变量水平上,HGG 患者的认知和神经功能并不能预测 SO 的心理健康状况。在急性阶段,患有高度恶性 CNS 肿瘤的患者的 SO 的 HRQOL 面临受损的风险增加,与患有非 CNS 受累的全身性肿瘤且预期寿命相当的患者相比。

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