Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA.
J Geriatr Oncol. 2013 Apr;4(2):166-73. doi: 10.1016/j.jgo.2012.12.002. Epub 2013 Jan 8.
The purpose of this study was to gather preliminary data on both direct and moderating effects of health status, the social environment, and perceived personal control on the symptom distress and quality of life (QOL) for older patients with cancer during a treatment regimen of chemotherapy.
Participants were patients with cancer aged≥65years being treated with a variety of chemotherapy regimens specific to their particular diagnosis. Using a longitudinal study design, we measured patients at baseline prior to beginning chemotherapy, midpoint in the regimen, and upon discharge (approximately 2weeks after chemotherapy completion). Outcomes of interest were symptom distress and QOL. Multivariate linear regression was used to determine the association between the predictors and outcomes, controlling for demographic and clinical characteristics.
Our final sample consisted of 94 patients with cancer (35 males; 59 females; mean age 73.5years). In the health status domain, lower body strength was inversely associated with symptom distress (p=0.025) and positively associated with QOL (p=0.015). In the social environment domain, social support was inversely associated with fatigue (p=0.001) and depression (p<0.001), and positively associated with QOL (p=0.016 and p=0.029 at midpoint and endpoint, respectively). Personal control variables, mastery and self-efficacy, were significantly associated with multiple outcomes of interest.
Mastery was the best predictor of symptom distress and QOL. Self-efficacy, social support, and lower body functioning are important predictors of these outcomes among older patients with cancer undergoing chemotherapy.
本研究旨在收集有关健康状况、社会环境和感知到的个人控制对老年癌症患者在化疗治疗方案期间的症状困扰和生活质量（QOL）的直接和调节作用的初步数据。
参与者为年龄≥65 岁的癌症患者，正在接受各种特定于其特定诊断的化疗方案治疗。使用纵向研究设计，我们在开始化疗前、化疗方案中点和出院时（化疗完成后大约 2 周）测量患者。感兴趣的结果是症状困扰和 QOL。多变量线性回归用于确定预测因素与结果之间的关联，同时控制人口统计学和临床特征。
我们的最终样本包括 94 名癌症患者（35 名男性；59 名女性；平均年龄 73.5 岁）。在健康状况领域，较低的体力与症状困扰呈负相关（p=0.025），与 QOL 呈正相关（p=0.015）。在社会环境领域，社会支持与疲劳（p=0.001）和抑郁（p<0.001）呈负相关，与 QOL 呈正相关（分别在中点和终点时 p=0.016 和 p=0.029）。个人控制变量，掌握和自我效能，与多个感兴趣的结果显著相关。
掌握是症状困扰和 QOL 的最佳预测因素。自我效能、社会支持和较低的身体功能是老年癌症患者接受化疗时这些结果的重要预测因素。
