Anderson Christopher B, Rapkin Bruce, Reaves Brieyona C, Sun Arony J, Morganstern Bradley, Dalbagni Guido, Donat Machele, Herr Harry W, Laudone Vincent P, Bochner Bernard H
Urology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA.
Psychooncology. 2017 Feb;26(2):206-213. doi: 10.1002/pon.4025. Epub 2015 Nov 30.
We sought to determine if idiographic, or self-defined, measures added to our understanding of patients with bladder cancer's quality of life (QOL) prior to radical cystectomy (RC). We tested whether idiographic measures increased prediction of global QOL beyond standard (nomothetic) measures of QOL components.
We administered the European Organization for Research and Treatment of Cancer Quality of Life Questionnaires (QLQ)-C30 and QLQ-BLM30, and our own idiographic Quality of Life Appraisal Profile prior to RC. Idiographic measures included number of goal statements, distance from goal attainment, and ability to complete goal attainment activities. Multivariate linear regression was used to predict measures of global QOL and related constructs of life satisfaction and mental health.
Two hundred fiftheen patients reported a median of 8 (interquartile range [IQR] 6, 11) goals and half had an average goal attainment rating above 6.9 out of 10 (IQR 5.5, 8.2). On multivariable analysis, QLQ-C30 role functioning and QLQ-BLM30 future perspective explained 15.7% of the variability in preoperative global QOL. Including goal attainment and activity difficulty explained an additional 12% of global QOL variance. Smaller gains were seen on measures of global health, life satisfaction, mental health, and activity, suggesting that idiographic measures capture aspects of QOL distinct from health and functional status defined by nomothetic scales.
Idiographic assessment of QOL added to prediction of global QOL above and beyond health-related components measured using nomothetic instruments. This self-defined information may be valuable in communicating with cancer patients about their QOL. Copyright © 2015 John Wiley & Sons, Ltd.
我们试图确定，在根治性膀胱切除术（RC）之前，个性化（即自我定义）的测量方法是否能增进我们对膀胱癌患者生活质量（QOL）的理解。我们测试了个性化测量方法是否能在QOL组成部分的标准（共性）测量方法之外，提高对总体QOL的预测能力。
在RC之前，我们对患者进行了欧洲癌症研究与治疗组织生活质量问卷（QLQ）-C30和QLQ-BLM30，以及我们自己的个性化生活质量评估概况调查。个性化测量方法包括目标陈述的数量、与目标达成的距离，以及完成目标达成活动的能力。多元线性回归用于预测总体QOL的测量值以及生活满意度和心理健康等相关结构。
215名患者报告的目标中位数为8个（四分位间距[IQR]为6，11），半数患者的平均目标达成评分高于6.9（满分10分，IQR为5.5，8.2）。在多变量分析中，QLQ-C30角色功能和QLQ-BLM30未来展望解释了术前总体QOL变异性的15.7%。纳入目标达成情况和活动难度又解释了总体QOL方差的12%。在总体健康、生活满意度、心理健康和活动的测量方面，增益较小，这表明个性化测量方法捕捉到了QOL中与共性量表所定义的健康和功能状态不同的方面。
QOL的个性化评估在使用共性工具测量的与健康相关的组成部分之外，增加了对总体QOL的预测。这种自我定义的信息在与癌症患者沟通其QOL方面可能很有价值。版权所有© 2015约翰·威利父子有限公司。
