Holt Kamila A, Mogensen Ole, Jensen Pernille T, Hansen Dorte G
a Institute of Clinical Research, Research Unit of Obstetrics and Gynaecology, University of Southern Denmark and Department of Obstetrics and Gynaecology , Odense University Hospital , Odense , Denmark.
b Department of Obstetrics and Gynaecology , Odense University Hospital , Odense , Denmark.
Acta Oncol. 2015 Nov;54(10):1814-23. doi: 10.3109/0284186X.2015.1037009. Epub 2015 May 6.
Rehabilitation should be integrated in the routine cancer care of women treated for gynaecological cancers. Goal setting is expected to facilitate the process through patient involvement and motivation. Our knowledge about goal setting in cancer rehabilitation is, however, sparse.
This study aimed to: 1) analyse rehabilitation goals defined during hospital-based rehabilitation in patients with gynaecological cancer, with regard to number, category, changes over time, and differences between cancer diagnosis, and 2) analyse the association between health-related quality of life and goals defined for rehabilitation.
Consecutively, all patients treated surgically for endometrial, ovarian, and cervical cancer were invited for hospital-based rehabilitation at Odense University Hospital, Denmark, including two sessions at the hospital one and three months following surgery and two phone calls for follow-up. Questionnaires from the EORTC were used to prepare patients and facilitate individual goal setting with definitions of up to three goals. All goals were grouped into six categories.
A total of 151 (63%) patients accepted the invitation including 50 endometrial, 65 ovarian, and 36 cervical cancers patients. All patients defined goals at the first session, 76.4% defined three goals, 21.9% two, and 1.6% had one goal. Physical goals decreased over time but were the most frequent at both sessions (98% and 89%). At both sessions, the social and emotional categories were the second and third most frequent among patients with endometrial and ovarian cancer. Sexual issues were dominant among the cervical cancer patients. Regression analysis showed significant association between quality of life scores and goal setting within the social and emotional domains.
Goal setting seemed feasible in all problem areas. The EORTC questionnaires were helpful during the process although expectations of the sub-scores being predictive of which areas to address were not convincing.
康复应纳入接受妇科癌症治疗的女性的常规癌症护理中。目标设定有望通过患者参与和积极性促进这一过程。然而，我们对癌症康复中目标设定的了解却很少。
本研究旨在：1）分析妇科癌症患者在医院康复期间确定的康复目标，包括目标数量、类别、随时间的变化以及癌症诊断之间的差异；2）分析健康相关生活质量与康复目标之间的关联。
连续邀请所有接受子宫内膜癌、卵巢癌和宫颈癌手术治疗的患者到丹麦欧登塞大学医院进行医院康复，包括术后1个月和3个月在医院进行的两次康复治疗以及两次随访电话。使用欧洲癌症研究与治疗组织（EORTC）的问卷让患者做好准备，并促进个人目标设定，目标定义最多为三个。所有目标分为六类。
共有151名（63%）患者接受邀请，其中包括50名子宫内膜癌患者、65名卵巢癌患者和36名宫颈癌患者。所有患者在第一次康复治疗时都确定了目标，76.4%的患者确定了三个目标，21.9%的患者确定了两个目标，1.6%的患者确定了一个目标。身体目标随时间减少，但在两次康复治疗中都是最常见的（分别为98%和89%）。在两次康复治疗中，社会和情感类别在子宫内膜癌和卵巢癌患者中分别是第二和第三常见的。性问题在宫颈癌患者中占主导地位。回归分析显示生活质量得分与社会和情感领域内的目标设定之间存在显著关联。
在所有问题领域，目标设定似乎都是可行的。EORTC问卷在这一过程中很有帮助，尽管认为子分数可预测应解决哪些领域的期望并不令人信服。
