Drury Amanda, Payne Sheila, Brady Anne-Marie
a School of Nursing & Midwifery, Faculty of Health Sciences, Trinity College Dublin , Dublin , Ireland.
b International Observatory on End of Life Care, Division of Health Research, Lancaster University , Lancaster , UK.
Acta Oncol. 2017 Feb;56(2):205-211. doi: 10.1080/0284186X.2016.1266084. Epub 2017 Jan 9.
The Institute of Medicine report 'From Cancer Patient to Cancer Survivor' has drawn widespread attention to the experiences of cancer survivors. Research examining the symptom experiences of survivors are proliferative within the literature but limited by samples which include multiple tumor groups and varying inclusion criteria. This cross-sectional quantitative study seeks to examine pain and quality of life (QoL) in the context of colorectal cancer (CRC) survivorship, as defined by the Institute of Medicine.
A purposive sample of CRC survivors (n = 252) attending hospitals and cancer support centers in the Republic of Ireland were recruited between September 2014 and January 2016. Self-rated health (SRH), QoL and pain were assessed in the sample using the EuroQOL questionnaire, the Functional Assessment of Therapy-Colorectal (FACT-C) questionnaire, and symptom experience items.
One hundred participants (40%) indicated they had pain on the day of the survey or in the past week. Of those with pain, many also experienced a lack of energy (95%), bowel dysfunction (74%), sleep disturbance (76%) or interference with their ability to enjoy life (75%). Pain was associated with younger age, female gender, current chemotherapy treatment, and previous radiotherapy treatment. Although participants reported positive QoL scores, statistical analysis revealed pain was linked to significantly poorer SRH and overall QoL, and poorer physical, emotional, functional, social/family and CRC-specific wellbeing, compared to those who did not indicate pain.
Pain was experienced by almost two fifths of CRC survivors up to five years after treatment and was associated with poorer SRH and QoL. In light of these findings, healthcare professionals must endeavor to manage cancer survivors' needs in a manner which is cognizant of the burden of pain and in the context of other symptoms and morbidities experienced by long-term cancer survivors.
美国医学研究所的报告《从癌症患者到癌症幸存者》引起了人们对癌症幸存者经历的广泛关注。在文献中，研究癌症幸存者症状体验的研究越来越多，但受到样本的限制，这些样本包括多个肿瘤组且纳入标准各异。这项横断面定量研究旨在按照美国医学研究所的定义，在结直肠癌（CRC）幸存者的背景下研究疼痛和生活质量（QoL）。
2014年9月至2016年1月期间，从爱尔兰共和国的医院和癌症支持中心招募了252名CRC幸存者作为有目的样本。使用欧洲生活质量调查问卷、结直肠癌治疗功能评估（FACT-C）问卷和症状体验项目对样本中的自我评定健康状况（SRH）、生活质量和疼痛进行评估。
100名参与者（40%）表示在调查当天或过去一周有疼痛。在有疼痛的参与者中，许多人还经历了精力不足（95%）、肠道功能障碍（74%）、睡眠障碍（76%）或生活乐趣受到影响（75%）。疼痛与年龄较小、女性、当前化疗治疗以及既往放疗治疗有关。尽管参与者报告的生活质量得分呈阳性，但统计分析显示，与未表示有疼痛的参与者相比，疼痛与明显较差的自我评定健康状况和总体生活质量以及较差的身体、情感、功能、社会/家庭和结直肠癌特异性健康状况有关。
近五分之二的CRC幸存者在治疗后长达五年仍经历疼痛，且疼痛与较差的自我评定健康状况和生活质量有关。鉴于这些发现，医疗保健专业人员必须努力以一种认识到疼痛负担并结合长期癌症幸存者经历的其他症状和疾病的方式来满足癌症幸存者的需求。
