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骨髓纤维化患者的生活:使用叙事医学收集的身体、情感和经济影响——来自意大利“重返生活”项目的结果。

Life for patients with myelofibrosis: the physical, emotional and financial impact, collected using narrative medicine-Results from the Italian 'Back to Life' project.

机构信息

Seràgnoli Institute of Hematology and Medical Oncology, S. Orsola-Malpighi Hospital, Bologna, Italy.

Hematology, City of Health and Science Hospital and University, Torino, Italy.

出版信息

Qual Life Res. 2018 Jun;27(6):1545-1554. doi: 10.1007/s11136-018-1827-2. Epub 2018 Mar 8.

Abstract

PURPOSE

Myelofibrosis (MF) is a chronic myeloproliferative neoplasm characterised by an aggressive clinical course, with disabling symptoms and reduced survival. Patients experience a severely impaired quality of life and their families face the upheaval of daily routines and high disease-related financial costs. The aim of this study was to investigate the perceptions of Italian patients and their caregivers about living with MF and the burden of illness associated with MF.

METHODS

A quali-quantitative questionnaire and a prompted written narrative survey were administered to patients affected by primary or post-essential thrombocythemia/post-polycythaemia vera MF and their primary caregiver in 35 Italian haematological centres.

RESULTS

In total, 287 questionnaires were returned by patients and 98 by caregivers, with 215 and 62, respectively, including the narrative. At the time of diagnosis, the most commonly expressed emotional states of patients were fear, distress and anger, confirming the difficulty of this phase. A high level of emotional distress was also reported by caregivers. Along the pathway of care, the ability to cope with the disease differed according to the quality of care received. The mean cost to each patient attributable to MF was estimated as €12,466 per year, with an estimated average annual cost of loss of income of €7774 per patient and €4692 per caregiver.

CONCLUSIONS

Better understanding of the personal life of MF patients and their families could improve the relationships between health workers and patients, resulting in better focused healthcare pathways and more effective financial support to maintain patients in their social roles.

摘要

目的

骨髓纤维化(MF)是一种慢性骨髓增生性肿瘤,具有侵袭性临床病程,导致致残症状和降低生存率。患者经历严重的生活质量受损,其家庭面临日常生活的剧变和与疾病相关的高昂经济成本。本研究旨在调查意大利患者及其照护者对 MF 生活的看法以及与 MF 相关的疾病负担。

方法

在 35 家意大利血液学中心,对原发性或继发于原发性血小板增多症/继发于真性红细胞增多症的 MF 患者及其主要照护者进行了定性-定量问卷和提示性书面叙事调查。

结果

共收回 287 份患者问卷和 98 份照护者问卷,其中分别有 215 份和 62 份包含叙事内容。在诊断时,患者最常表达的情绪状态是恐惧、痛苦和愤怒,这证实了这一阶段的困难。照护者也报告了较高水平的情绪困扰。在护理路径中,根据所获得的护理质量,应对疾病的能力有所不同。归因于 MF 的每位患者的平均年费用估计为 12466 欧元,每位患者的平均年收入损失估计为 7774 欧元,每位照护者为 4692 欧元。

结论

更好地了解 MF 患者及其家庭的个人生活可以改善卫生工作者与患者之间的关系,从而改善更有针对性的医疗保健路径,并提供更有效的经济支持,以维持患者的社会角色。

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