癌症青少年和青年的赋权：与健康相关生活质量的关系。
Empowerment in adolescents and young adults with cancer: Relationship with health-related quality of life.
作者信息
Kaal Suzanne E J, Husson Olga, van Duivenboden Saskia, Jansen Rosemarie, Manten-Horst Eveliene, Servaes Petra, Prins Judith B, van den Berg Sanne W, van der Graaf Winette T A
机构信息
Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands.
Dutch AYA "Young & Cancer" Platform, AYA Platform Radboudumc, Radboud University Medical Center, Nijmegen, The Netherlands.
出版信息
Cancer. 2017 Oct 15;123(20):4039-4047. doi: 10.1002/cncr.30827. Epub 2017 Jul 11.
BACKGROUND
The difficulties adolescents and young adults (AYAs) encounter during a cancer experience may result in a reduction in or absence of empowerment. The aims of the current study were to assess levels of empowerment and associated (demographic, clinical, or psychological) factors and examine the association between empowerment and health-related quality of life (HRQOL) among AYA patients with cancer.
METHODS
Patients aged 18 to 35 years at time of cancer diagnosis and who were seen by 1 of the members of the specialized multidisciplinary AYA team of the Radboud University Medical Center were invited to complete questionnaires regarding empowerment; HRQOL; and sociodemographic, clinical, and psychological characteristics (autonomy, coping, unmet social support needs, and psychological distress).
RESULTS
A total of 83 AYA patients completed the questionnaires. The mean age of the participants at the time of diagnosis was 27.5 years. The vast majority had been treated with chemotherapy (86%), had a more advanced stage of disease, and had completed treatment at the time of participation (74%). The mean empowerment level was 154.1 (standard deviation, 17.8) with a range of 114 to 200. Multivariate analysis demonstrated that the autonomy subscales of self-awareness (β = .35), capacity for managing new situations (β = .19), and social support (β = .35) were found to be positively associated with empowerment. Coping difficulties (β = -.19) were found to be negatively associated with empowerment. Empowerment was independently associated with physical (β = .31), psychological (β = .50), social (β = .39), religious (β = .33), and total HRQOL (β = .52; all P<.01).
CONCLUSIONS
Low levels of empowerment were associated with low levels of autonomy and social support, female sex, and coping difficulties among AYA patients with cancer. Recognizing these patients as candidates for empowerment interventions ultimately could help to improve HRQOL in late adolescence and young adulthood. Cancer 2017;123:4039-47. © 2017 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
背景
青少年和青年成人（AYA）在患癌经历中遇到的困难可能导致其权能降低或缺失。本研究的目的是评估AYA癌症患者的权能水平及相关（人口统计学、临床或心理）因素，并检验权能与健康相关生活质量（HRQOL）之间的关联。
方法
邀请在癌症诊断时年龄为18至35岁且由拉德堡德大学医学中心专门的多学科AYA团队成员诊治过的患者完成关于权能、HRQOL以及社会人口统计学、临床和心理特征（自主性、应对方式、未满足的社会支持需求和心理困扰）的问卷。
结果
共有83名AYA患者完成了问卷。参与者诊断时的平均年龄为27.5岁。绝大多数患者接受过化疗（86%），疾病分期较晚，且在参与研究时已完成治疗（74%）。权能平均水平为154.1（标准差为17.8），范围为114至200。多变量分析表明，自我意识（β = 0.35）、应对新情况的能力（β = 0.19）和社会支持（β = 0.35）的自主性子量表与权能呈正相关。应对困难（β = -0.19）与权能呈负相关。权能与身体（β = 0.31）、心理（β = 0.50）、社会（β = 0.39）、宗教（β = 0.33）和总的HRQOL（β = 0.52；均P < 0.01）独立相关。
结论
AYA癌症患者权能水平低与自主性和社会支持水平低、女性性别以及应对困难有关。将这些患者视为权能干预的对象最终可能有助于改善青少年晚期和青年成人的HRQOL。《癌症》2017年；123:4039 - 47。© 2017作者。《癌症》由威利期刊公司代表美国癌症协会出版。这是一篇根据知识共享署名 - 非商业性使用许可协议发布的开放获取文章，允许在任何媒介中使用、传播和复制，前提是原始作品得到恰当引用且不用于商业目的。
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