Duan H, Gamper E, Becherer A, Hoffmann M
Medical University of Vienna, Dept. of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Vienna, Austria.
Innsbruck Medical University, Univ.-Clinic for Nuclear Medicine, Univ.-Clinic for Psychiatry and Psychotherapy, Innsbruck, Austria.
Oral Oncol. 2015 Jun;51(6):S1-5. doi: 10.1016/j.oraloncology.2015.03.008. Epub 2015 Apr 25.
While there is agreement that quality of life (QoL) is a central aim of medical treatment, the methods of its evaluation as well as its role in the patient's overall treatment experience are under continuous scrutiny. Different perspectives on patients' QoL have emerged; from the treating physician, from the psychologist, and naturally from the patient him/herself. This article provides insights into each of these views within the context of thyroid cancer where, as a consequence of increasing incidence and decreasing mortality rates, QoL aspects deserve close attention. Physicians often find themselves in situations where they perform a balancing act between what they know is best from a somatic point of view and learning about what is best for the individual patient. For psychologists in the field of oncology, a main area of interest is the incorporation of the patient's perspective into research by using patient-reported outcomes (PROs) which include QoL assessment. PROs can also be used in clinical practice as a way to start a conversation about symptoms and QoL aspects that perhaps patients might not volunteer, and this allows physicians to address QoL issues more directly. Patients usually appreciate being asked about all aspects of QoL, and need sound information about how their QoL might be affected by the disease and its treatment. By examining and understanding the different perspectives on QoL, and how QoL differs in patients with thyroid cancer compared with other cancers, it is hoped that the QoL can be enhanced in this particular patient group.
虽然人们一致认为生活质量(QoL)是医学治疗的核心目标,但其评估方法以及在患者整体治疗体验中的作用仍在不断受到审视。对于患者生活质量出现了不同的观点;来自主治医生、心理学家,当然还有患者自身。本文在甲状腺癌的背景下深入探讨了这些观点中的每一个,由于发病率上升和死亡率下降,生活质量方面值得密切关注。医生常常发现自己处于一种平衡状态,即在从躯体角度知道什么是最佳方案与了解什么对个体患者最有利之间进行权衡。对于肿瘤学领域的心理学家来说,一个主要的兴趣领域是通过使用包括生活质量评估在内的患者报告结局(PROs)将患者的观点纳入研究。PROs也可用于临床实践,作为开启关于症状和生活质量方面话题的一种方式,这些方面患者可能不会主动提及,这使医生能够更直接地解决生活质量问题。患者通常很感激被问及生活质量的各个方面,并且需要关于其生活质量可能如何受到疾病及其治疗影响的可靠信息。通过审视和理解关于生活质量的不同观点,以及与其他癌症相比甲状腺癌患者的生活质量有何不同,希望能提高这个特定患者群体的生活质量。