Chui Ping Lei, Abdullah Khatijah Lim, Wong Li Ping, Taib Nur Aishah
Department of Nursing Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
PLoS One. 2015 Oct 9;10(10):e0139952. doi: 10.1371/journal.pone.0139952. eCollection 2015.
Complementary and alternative medicine (CAM) use has become increasingly popular among patients with cancer. The purposes of this study were to compare the QOL in CAM users and non-CAM users and to determine whether CAM use influences QOL among breast cancer patients during chemotherapy.
A cross-sectional survey was conducted at two outpatient chemotherapy centers. A total of 546 patients completed the questionnaires on CAM use. QOL was evaluated based on the European Organization for Research and Treatment of Cancer (EORTC) core quality of life (QLQ-C30) and breast cancer-specific quality of life (QLQ-BR23) questionnaires.
A total of 70.7% of patients were identified as CAM users. There was no significant difference in global health status scores and in all five subscales of the QLQ C30 functional scales between CAM users and non-CAM users. On the QLQ-C30 symptom scales, CAM users (44.96±3.89) had significantly (p = 0.01) higher mean scores for financial difficulties than non-CAM users (36.29±4.81). On the QLQ-BR23 functional scales, CAM users reported significantly higher mean scores for sexual enjoyment (6.01±12.84 vs. 4.64±12.76, p = 0.04) than non-CAM users. On the QLQ-BR23 symptom scales, CAM users reported higher systemic therapy side effects (41.34±2.01 vs. 37.22±2.48, p = 0.04) and breast symptoms (15.76±2.13 vs. 11.08±2.62, p = 0.02) than non-CAM users. Multivariate logistic regression analysis indicated that the use of CAM modality was not significantly associated with higher global health status scores (p = 0.71).
While the findings indicated that there was no significant difference between users and non-users of CAM in terms of QOL, CAM may be used by health professionals as a surrogate to monitor patients with higher systemic therapy side effects and breast symptoms. Furthermore, given that CAM users reported higher financial burdens (which may have contributed to increased distress), patients should be encouraged to discuss the potential benefits and/or disadvantages of using CAM with their healthcare providers.
补充和替代医学(CAM)在癌症患者中越来越受欢迎。本研究的目的是比较使用CAM和不使用CAM的患者的生活质量(QOL),并确定在化疗期间使用CAM是否会影响乳腺癌患者的QOL。
在两个门诊化疗中心进行了一项横断面调查。共有546名患者完成了关于使用CAM的问卷调查。基于欧洲癌症研究与治疗组织(EORTC)核心生活质量(QLQ-C30)问卷和乳腺癌特异性生活质量(QLQ-BR23)问卷对QOL进行评估。
共有70.7%的患者被确定为CAM使用者。CAM使用者和非CAM使用者在总体健康状况评分以及QLQ-C30功能量表的所有五个子量表方面没有显著差异。在QLQ-C30症状量表上,CAM使用者(44.96±3.89)在经济困难方面的平均得分显著高于非CAM使用者(36.29±4.81)(p = 0.01)。在QLQ-BR23功能量表上,CAM使用者报告的性享受平均得分显著高于非CAM使用者(6.01±12.84对4.64±12.76,p = 0.04)。在QLQ-BR23症状量表上,CAM使用者报告的全身治疗副作用(41.34±2.01对37.22±2.48,p = 0.04)和乳腺症状(15.76±2.13对11.08±2.62,p = 0.02)高于非CAM使用者。多因素逻辑回归分析表明,使用CAM模式与更高的总体健康状况评分没有显著相关性(p = 0.71)。
虽然研究结果表明,在QOL方面,CAM使用者和非使用者之间没有显著差异,但医疗专业人员可以将CAM作为监测全身治疗副作用和乳腺症状较高患者的替代指标。此外,鉴于CAM使用者报告了更高的经济负担(这可能导致了更多的困扰),应鼓励患者与医疗服务提供者讨论使用CAM的潜在益处和/或弊端。