Outcomes Research Branch, Applied Research Program, Division of Cancer Control and Population Science, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD, 20850, USA,
Support Care Cancer. 2014 Jan;22(1):163-72. doi: 10.1007/s00520-013-1961-x. Epub 2013 Sep 10.
We examined cancer survivors' experience of bothersome symptoms, association of symptom bother with health-related quality of life (HRQOL), survivors' perception of symptom care, and their symptom-related information needs.
Using self-report survey measures, survivors of leukemia, bladder, or colorectal cancer who were 2-5 years post-diagnosis and received follow-up care in the past year (N = 623) provided information about the presence of bothersome symptoms, symptom-related information needs, adequacy of symptom-related care, and their physical and mental HRQOL. Multivariable statistical analyses were conducted to identify correlates of symptom bother, inadequate care, and symptom information needs and to examine the association between symptom bother and HRQOL.
Twenty-eight percent of the 606 respondents experienced symptom bother in the past year (46 % of leukemia, 24 % of bladder, and 26 % of colorectal cancer survivors). Younger survivors, those of Hispanic ethnicity, with low income, those with recurrent cancer, and chemotherapy recipients were more likely to report symptom bother (all p < 0.05). Symptom bother was associated with lower physical and mental HRQOL (p < 0.001). While 92 % of survivors with symptoms discussed them with their follow-up care physician, 52 % of these reported receiving inadequate symptom care. Survivors reporting inadequate symptom care were 2.5 times as likely to identify symptom information needs compared to those who received adequate care (p < 0.05).
One in four cancer survivors report symptoms 2-5 years post-diagnosis, and only half of these survivors receive adequate care to address those symptoms. Research that refines and tests symptom care interventions for this population is warranted.
本研究旨在探讨癌症幸存者的困扰症状体验、症状困扰与健康相关生活质量（HRQOL）的相关性、幸存者对症状护理的认知以及其与症状相关的信息需求。
本研究采用自我报告问卷调查的方式，纳入了 623 名在过去一年中接受过随访护理且诊断后 2-5 年的白血病、膀胱癌或结直肠癌幸存者，以评估他们的困扰症状、与症状相关的信息需求、症状护理的充分性，以及身体和心理健康相关的 HRQOL。采用多变量统计分析方法来识别症状困扰、护理不足和症状信息需求的相关因素，并探讨症状困扰与 HRQOL 之间的关系。
在 606 名有回复的受访者中，有 28%的人在过去一年中经历了症状困扰（白血病患者中为 46%，膀胱癌患者中为 24%，结直肠癌患者中为 26%）。较年轻的幸存者、西班牙裔、收入较低、癌症复发和接受化疗的幸存者更有可能报告症状困扰（均 p<0.05）。症状困扰与较低的身体和心理健康 HRQOL 相关（p<0.001）。尽管 92%有症状的幸存者与随访护理医生讨论过这些症状，但有 52%的患者报告称他们的症状护理不足。与接受充分护理的患者相比，报告症状护理不足的患者有 2.5 倍的可能性会识别出症状相关的信息需求（p<0.05）。
四分之一的癌症幸存者在诊断后 2-5 年内会出现症状，但只有一半的患者会得到充分的护理来解决这些症状。有必要针对这一人群开展研究，以完善和检验症状护理干预措施。
