Cheng K K F, Wong W H, Koh C
Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Level 2, Clinical Research Centre, MD11, 10 Medical Drive, Singapore, 117597, Singapore.
National University Hospital, National University Health System, Singapore, 119074, Singapore.
Support Care Cancer. 2016 May;24(5):2025-2033. doi: 10.1007/s00520-015-2994-0. Epub 2015 Nov 4.
This study aimed to compare the symptoms, unmet needs, and QoL reported by women at 6 months to <2 years and 2 to 5 years following surgery and adjuvant treatment for breast cancer. It also evaluated the relationships among symptoms, unmet needs, and QoL using structural equation modeling.
In this study, 113 and 137 survivors following breast cancer treatment 6 months to <2 years and 2 to 5 years, respectively, completed the Memorial Symptom Assessment Scale, the Supportive Care Needs Survey-34, and the Medical Outcomes Study 12-item Short Form Health Survey version 2.0 during their medical follow-up.
The mean numbers of symptoms and unmet needs were 5.43 and 3.0, respectively, for survivors at <2 years, and 5.24 and 2.42, respectively, for survivors at 2 to 5 years following treatment. The most common reported symptoms were related primarily to physical domains. No significant differences were found between the two survivor groups on the MSAS scores. Survivors at <2 years reported significantly higher scores in Psychological and Health Care System/Information needs (p < 0.01), and lower composite scores in physical and mental QoL (p < 0.05) than those at 2 to 5 years post-treatment. Significant direct and indirect effects were found of symptom burden through unmet needs on survivors' physical and mental QoL after adjustment for survival time, and the models showed a good fit.
Results suggest that breast cancer survivors continue to endure many symptoms independent of the survivorship period. The unmet needs mediate the relationship between symptom burden and survivors' QoL.
本研究旨在比较乳腺癌手术及辅助治疗后6个月至不到2年以及2至5年的女性所报告的症状、未满足的需求和生活质量。本研究还使用结构方程模型评估了症状、未满足的需求和生活质量之间的关系。
在本研究中，分别有113名和137名乳腺癌治疗后6个月至不到2年以及2至5年的幸存者，在其医学随访期间完成了纪念症状评估量表、支持性护理需求调查-34以及医学结局研究12项简短健康调查2.0版。
治疗后不到2年的幸存者，其症状和未满足需求的平均数量分别为5.43和3.0，治疗后2至5年的幸存者，其症状和未满足需求的平均数量分别为5.24和2.42。报告的最常见症状主要与身体领域有关。两组幸存者在纪念症状评估量表得分上未发现显著差异。治疗后不到2年的幸存者在心理和医疗保健系统/信息需求方面的得分显著更高（p<0.01），而在身体和心理健康生活质量方面的综合得分低于治疗后2至5年的幸存者（p<0.05）。在调整生存时间后，发现症状负担通过未满足的需求对幸存者的身体和心理健康生活质量有显著的直接和间接影响，且模型显示拟合良好。
结果表明，乳腺癌幸存者无论处于生存期的哪个阶段，都继续忍受着许多症状。未满足的需求介导了症状负担与幸存者生活质量之间的关系。
