Riedl David, Giesinger Johannes M, Wintner Lisa M, Loth Fanny L, Rumpold Gerhard, Greil Richard, Nickels Alain, Licht Thomas, Holzner Bernhard
Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University of Innsbruck, Innsbruck, Austria.
Innsbruck Institute of Patient-Centered Outcome Research (IIPCOR), Innsbruck, Austria.
Wien Klin Wochenschr. 2017 Oct;129(19-20):692-701. doi: 10.1007/s00508-017-1266-z. Epub 2017 Sep 15.
With the growing number of cancer survivors worldwide the need for high quality cancer rehabilitation after primary treatment is steadily increasing. The aim of the present study was to investigate change of psychological distress and health-related quality of life (HRQOL) during multidisciplinary inpatient cancer rehabilitation in a large sample of cancer survivors suffering from different cancer entities.
We analyzed data from routine HRQOL and distress monitoring at a cancer inpatient rehabilitation center. Cancer survivors completed the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core-30 (EORTC QLQ-C30) and the Hospital Anxiety and Depression Scale (HADS) before and after multidisciplinary rehabilitation treatment. Changes of patients' functioning and symptoms were analyzed using repeated measures analysis of variance (ANOVA) and effect sizes (Cohens' d). Patients' pretreatment and posttreatment scores were compared to reference data from the German general population.
A total of 939 patients (mean age 58.6 years, SD 11.9 years; 59.9% women) who attended rehabilitation from January 2014 to September 2015 were included in the analysis. We found clinically meaningful improvement in almost all domains of the EORTC QLQ-C30 as well as in anxiety and depression (HADS). The largest improvements were found for the QLQ-C30 subscales emotional functioning (d = 0.78), fatigue (d = 0.65), and social functioning (d = 0.56).
We found clinically meaningful improvements of patients' HRQOL, anxiety and depression during an oncological inpatient rehabilitation treatment. Our results warrant further prospective controlled studies to evaluate the long-term effectiveness of inpatient rehabilitation.
随着全球癌症幸存者数量的不断增加，对初次治疗后高质量癌症康复的需求也在稳步上升。本研究的目的是调查患有不同癌症类型的大量癌症幸存者在多学科住院癌症康复期间心理困扰和健康相关生活质量（HRQOL）的变化。
我们分析了癌症住院康复中心常规HRQOL和困扰监测的数据。癌症幸存者在多学科康复治疗前后完成了欧洲癌症研究与治疗组织（EORTC）生活质量问卷核心30（EORTC QLQ-C30）和医院焦虑抑郁量表（HADS）。使用重复测量方差分析（ANOVA）和效应量（科恩d）分析患者功能和症状的变化。将患者治疗前和治疗后的得分与德国普通人群的参考数据进行比较。
分析纳入了2014年1月至2015年9月期间接受康复治疗的939名患者（平均年龄58.6岁，标准差11.9岁；59.9%为女性）。我们发现EORTC QLQ-C30的几乎所有领域以及焦虑和抑郁（HADS）都有临床意义上的改善。QLQ-C30子量表中情绪功能（d = 0.78）、疲劳（d = 0.65）和社会功能（d = 0.56）的改善最为显著。
我们发现在肿瘤住院康复治疗期间，患者的HRQOL、焦虑和抑郁有临床意义上的改善。我们的结果值得进一步进行前瞻性对照研究，以评估住院康复的长期效果。
