Maynooth University, Maynooth, Ireland.
National College of Ireland, Dublin, Ireland.
Psychooncology. 2018 Apr;27(4):1237-1243. doi: 10.1002/pon.4660. Epub 2018 Mar 1.
Despite a generally good prognosis, many prostate cancer survivors have poor quality of life (QOL). A greater understanding of how psychological appraisals influence QOL is merited given their potentially modifiable nature. In this study, we considered how elements of survivors' retrospective and prospective appraisals relate to QOL.
A total of 1229 prostate cancer survivors between 2 and 5 years post-diagnosis, identified from a population-based National Cancer Registry, were asked questions on their socio-demographics, health, treatment received, and adverse-effects using a cross-sectional design. QOL was assessed using the EORTC QLQ-C30. Retrospective appraisals were assessed by asking survivors to reflect on their experience of treatment-related adverse-effects compared with their prior expectations. A fear of recurrence scale assessed prospective appraisals of future disease course. A multiple regression model explored the impact of psychological appraisals on QOL, after controlling for socio-demographic, treatment, and health-related factors.
The model was significant explaining 37% of variance in QOL. The strongest associate with QOL was fear of recurrence (β = -.29; P < .001). Survivors who experienced side effects that were worse than expected had significantly lower QOL (β = -.10; P = .002). Other significant correlates of lower QOL were presence of comorbidities, having undergone a less invasive treatment, and having more advanced disease. Working at diagnosis and having a higher level of education were significantly associated with higher QOL.
Results suggest both retrospective and prospective appraisals are independently related to QOL in prostate cancer. Providing survivors with more information about possible adverse effects of treatment, as well as providing appropriate information regarding future disease progression, may improve QOL.
尽管前列腺癌患者的总体预后良好，但许多患者的生活质量较差。鉴于心理评估具有潜在的可改变性，更深入地了解其如何影响生活质量是有必要的。在这项研究中，我们考虑了幸存者回顾性和前瞻性评估的要素与生活质量的关系。
采用横断面设计，从基于人群的国家癌症登记处中确定了 1229 名诊断后 2-5 年的前列腺癌幸存者，询问他们的社会人口统计学、健康、治疗和不良反应等问题。使用 EORTC QLQ-C30 评估生活质量。通过让幸存者回顾他们的治疗相关不良反应的经历与他们之前的预期相比，评估回顾性评估。使用恐惧复发量表评估对未来疾病进程的前瞻性评估。在控制社会人口统计学、治疗和健康相关因素后，使用多元回归模型探讨心理评估对生活质量的影响。
该模型对生活质量的解释能力为 37%，具有统计学意义。与生活质量最密切相关的是对复发的恐惧（β=-.29；P<0.001）。经历的副作用比预期更严重的幸存者生活质量显著降低（β=-.10；P=0.002）。生活质量较低的其他显著相关因素包括合并症、接受的治疗侵袭性较小、疾病更晚期。诊断时工作和更高的教育水平与更高的生活质量显著相关。
结果表明，回顾性和前瞻性评估均与前列腺癌患者的生活质量独立相关。为幸存者提供更多关于治疗可能产生的不良反应的信息，并提供有关未来疾病进展的适当信息，可能会提高生活质量。
