Beisland Elisabeth, Beisland Christian, Hjelle Karin M, Bakke August, Aarstad Anne K H, Aarstad Hans J
Department of Clinical Medicine, University of Bergen , Bergen.
Scand J Urol. 2015;49(4):282-9. doi: 10.3109/21681805.2014.990051. Epub 2014 Dec 17.
To investigate whether health-related quality of life (HRQoL) depends on psychosocial factors, rather than on factors related to the cancer treatment, this study explored the associations between HRQoL, personality, choice of coping and clinical parameters in surgically treated renal cell carcinoma (RCC) patients.
After exclusions (e.g. death, dementia), 260 patients were found to be eligible and invited to participate. The response rate was 71%. HRQoL was determined by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), personality by the Eysenck Personality Inventory and coping by the COPE Questionnaire. Given tumour treatment, TNM stage and patient-reported comorbidity were also determined. The HRQoL indices were also summarized in general quality of life/health, functional sum and symptom sum scores.
EORTC C30 sum scores were negatively associated with the personality trait of neuroticism [common variance (CV) 19-36%]. Avoidant choice of coping inversely accounted for 9-18% of the total HRQoL variance, while reported coping by humour was to some extent negatively associated with HRQoL score (CVmax 4%). Indeed, all of the quality of life indices except for one were significantly negatively correlated with neuroticism and avoidance coping. Patients with low HRQoL due to treatment, secondary to flank or open surgery, reported a closer association between problem-focused choice of coping and HRQoL than the other patients. Moreover, present comorbidities were uniquely associated with a lowered HRQoL.
HRQoL is related to treatment-related factors in RCC patients, but shown here to be more strongly associated with psychological factors and present comorbidity. These findings suggest that attention should be paid to supportive treatment of RCC patients.
为了研究健康相关生活质量(HRQoL)是否取决于社会心理因素,而非癌症治疗相关因素,本研究探讨了接受手术治疗的肾细胞癌(RCC)患者的HRQoL、人格、应对方式选择与临床参数之间的关联。
排除(如死亡、痴呆等)后,发现260例患者符合条件并受邀参与。应答率为71%。HRQoL由欧洲癌症研究与治疗组织生活质量问卷(EORTC QLQ-C30)测定,人格由艾森克人格问卷测定,应对方式由应对问卷测定。同时确定肿瘤治疗情况、TNM分期及患者报告的合并症。HRQoL指标还汇总为总体生活质量/健康、功能总分和症状总分。
EORTC C30总分与神经质人格特质呈负相关[共同方差(CV)为19 - 36%]。回避型应对方式选择反向解释了HRQoL总方差的9 - 18%,而报告的幽默应对方式在一定程度上与HRQoL评分呈负相关(最大CV为4%)。事实上,除一项外,所有生活质量指标均与神经质和回避型应对显著负相关。因治疗导致HRQoL较低、继发于侧腹或开放手术的患者报告,与其他患者相比,问题聚焦型应对方式选择与HRQoL之间的关联更为密切。此外,当前合并症与较低的HRQoL存在独特关联。
RCC患者的HRQoL与治疗相关因素有关,但在此显示与心理因素和当前合并症的关联更强。这些发现表明应关注RCC患者的支持性治疗。