Zhang Meifen, Peng Lifen, Liu Weiyan, Wen Yongshan, Wu Xiaodan, Zheng Meichun, Zhu Yaping, Liu Qianwen, Chan Sally
Author Affiliations: School of Nursing (Dr Zhang); Department of Nursing, the First Affiliated Hospital (Ms Peng); Department of Nursing, Sun Yat-sen Memorial Hospital (Ms Liu); Department of Nursing, Cancer Center (Ms Wen, Wu, Zheng, Zhu, and Liu), Sun Yat-sen University, Guangzhou, China; School of Nursing and Midwifery, The University of Newcastle, Australia (Dr Chan).
Cancer Nurs. 2015 Jul-Aug;38(4):312-21. doi: 10.1097/NCC.0000000000000190.
Maintaining quality of life (QOL) during chemotherapy is a critical aspect of cancer treatment. Instruments have been developed to assess symptom distress, self-efficacy, anxiety, depression, and other factors impacting QOL during cancer treatment, but Chinese versions have become available only recently.
The aim of this study was to identify factors predictive of QOL during chemotherapy in Chinese colorectal cancer (CRC) patients.
Patients completed Chinese versions of the Hospital Anxiety and Depression Scale, MD Anderson Symptom Inventory (a measure of symptom distress), Stanford Inventory of Cancer Patient Adjustment (a measure of self-efficacy), and Functional Assessment of Cancer Treatment-General (a measure of QOL) before and after 3 and 6 months of chemotherapy.
Of 152 consecutive CRC patients (men/women, 98/54; mean age, 53.3 ± 11.3 years, 25-75 years; stage II/III, 59/93), 121 completed all questionnaires (79.6%). Self-efficacy dimensions "communication," "activity management," "personal management," and "affective management" improved progressively over 6 months (all P < .05). Fatigue, nausea, lack of appetite, disturbed sleep, and vomiting peaked at 3 months and declined thereafter (P < .05). Patients who are younger than 60 years, are male, and with stage II CRC exhibited higher 3- and 6-month QOL scores (all P < .05). Multiple regression identified self-efficacy, anxiety, and symptom distress as independent predictors of QOL at 6 months.
Enhanced self-efficacy, reduced symptom distress, and lower general anxiety would improve QOL during chemotherapy for CRC patients.These instruments can help identify CRC patients at risk of low QOL for additional psychotherapy or specific treatment modifications.
在化疗期间维持生活质量（QOL）是癌症治疗的一个关键方面。已经开发出了一些工具来评估症状困扰、自我效能感、焦虑、抑郁以及其他在癌症治疗期间影响生活质量的因素，但中文版的工具直到最近才出现。
本研究的目的是确定中国结直肠癌（CRC）患者化疗期间生活质量的预测因素。
患者在化疗3个月和6个月前后完成中文版的医院焦虑抑郁量表、MD安德森症状量表（一种症状困扰测量工具）、斯坦福癌症患者适应量表（一种自我效能感测量工具）以及癌症治疗功能评估通用量表（一种生活质量测量工具）。
在152例连续的CRC患者中（男性/女性，98/54；平均年龄，53.3±11.3岁，25 - 75岁；II/III期，59/93），121例完成了所有问卷（79.6%）。自我效能感维度“沟通”“活动管理”“个人管理”和“情感管理”在6个月内逐渐改善（均P < 0.05）。疲劳、恶心、食欲不振、睡眠障碍和呕吐在3个月时达到峰值，此后下降（P < 0.05）。年龄小于60岁、男性以及患有II期CRC的患者在3个月和6个月时的生活质量得分更高（均P < 0.05）。多元回归分析确定自我效能感、焦虑和症状困扰是6个月时生活质量的独立预测因素。
增强自我效能感、减轻症状困扰以及降低总体焦虑水平可改善CRC患者化疗期间的生活质量。这些工具有助于识别生活质量低风险的CRC患者，以便进行额外的心理治疗或特定的治疗调整。
