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单家医疗机构原发性脑肿瘤人群的社会心理困扰和健康相关生活质量的横断面分析。

A cross sectional analysis from a single institution's experience of psychosocial distress and health-related quality of life in the primary brain tumor population.

机构信息

Duke University Health System, The Preston Robert Tisch Brain Tumor Center at Duke, Room 047 Baker House, Trent Drive, DUMC Box 3624, Durham, NC, 27710, USA.

Department of Neurology, Duke University Medical Center, Durham, NC, 27710, USA.

出版信息

J Neurooncol. 2017 Sep;134(2):363-369. doi: 10.1007/s11060-017-2535-4. Epub 2017 Jul 1.

Abstract

Primary brain tumor patients experience high levels of distress. The purpose of this cross-sectional, retrospective study is to evaluate the level and different sources of psychosocial distress and how these pertain to health-related quality of life (HRQoL). The Primary and Recurrent Glioma registry at Duke's The Preston Robert Tisch Brain Tumor Center was queried retrospectively for demographic and clinical information on patients seen between December 2013 and February 2014. Data also included the National Comprehensive Cancer Network's Distress Thermometer (NCCN-DT), Functional Assessment of Cancer Therapy-Brain Cancer (FACT-Br), and Functional Assessment of Chronic Illness Therapy- Fatigue (FACIT-F). 829 subjects completed questionnaires. 54% were male; 96% completed the NCCN-DT; 33.3% had a DT score ≥4 (moderate/severe distress). Women reported DT ≥ 4 more often than men (38.6 vs 29.0%; p = 0.005). Patients within 1 year of diagnosis reported DT ≥ 4 more often than those 1+ years after diagnosis (38.8 vs 30.9%; p = 0.034). 73.0% reported physical problems; the most frequent being fatigue (43.2%) and memory/concentration (40.9%). 42.0% complained of emotional problems with worry (29.4%) and nervousness (22.4%) being the most common. Patients who reported at least one practical, family, emotional or physical problem had significantly lower HRQoL scores (p < 0.001). Primary brain tumor patients experience memory dysfunction, fatigue, nervousness, worry, and financial concerns, which have a negative effect on the patient's HRQoL. By identifying and addressing these stressors, it may be possible to improve patient HRQoL.

摘要

原发性脑肿瘤患者经历着较高水平的痛苦。本横断面回顾性研究的目的是评估心理社会痛苦的水平和不同来源,以及这些与健康相关的生活质量(HRQoL)的关系。杜克大学普雷斯顿·罗伯特·提施脑肿瘤中心的原发性和复发性神经胶质瘤登记处回顾性地查询了 2013 年 12 月至 2014 年 2 月间就诊的患者的人口统计学和临床信息。数据还包括国家综合癌症网络的痛苦温度计(NCCN-DT)、癌症治疗脑癌功能评估(FACT-Br)和慢性疾病治疗疲劳功能评估(FACIT-F)。829 名受试者完成了问卷。54%为男性;96%完成了 NCCN-DT;33.3%的人 DT 评分≥4(中度/重度痛苦)。女性报告 DT≥4 的比例高于男性(38.6%比 29.0%;p=0.005)。诊断后 1 年内的患者报告 DT≥4 的比例高于诊断后 1 年以上的患者(38.8%比 30.9%;p=0.034)。73.0%的患者报告存在身体问题;最常见的是疲劳(43.2%)和记忆力/注意力(40.9%)。42.0%的患者抱怨存在情绪问题,其中担忧(29.4%)和紧张不安(22.4%)最为常见。报告至少存在一个实际问题、家庭问题、情绪问题或身体问题的患者,其 HRQoL 评分显著降低(p<0.001)。原发性脑肿瘤患者经历着记忆力障碍、疲劳、紧张不安、担忧和经济问题,这些问题对患者的 HRQoL 产生负面影响。通过识别和解决这些压力源,可能提高患者的 HRQoL。

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