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大型综合医院中接受治疗的中国肺癌住院患者的健康相关生活质量:一项横断面研究。

Health-related quality of life in Chinese inpatients with lung cancer treatedin large general hospitals: across-sectional study.

作者信息

Gu Wen, Xu Yan-Min, Zhong Bao-Liang

机构信息

Department of Psychiatry, Shenzhen Key Laboratory for Psychological Healthcare, Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, China.

Department of Psychiatry, Affiliated Wuhan Mental Health Center (The Ninth Clinical School), Tongji Medical College of Huazhong University of Science & Technology, Wuhan, China.

出版信息

BMJ Open. 2018 Apr 24;8(4):e019873. doi: 10.1136/bmjopen-2017-019873.

Abstract

OBJECTIVE

In China, psychosocial problems of patients with cancer are under-recognised and undertreated in medical oncology practice. This study examined the health-related quality of life (QOL) in inpatients with lung cancer treated in large general hospitals and explored the demographic, clinical and psychosocial factors associated with QOL.

DESIGN

Cross-sectional study.

PARTICIPANTS AND SETTING

Altogether, 148 inpatients with lung cancer were consecutively recruited from two large general hospitals in Tianjin, China.

MAIN OUTCOME MEASURED

QOL, pain intensity, depressive and anxiety symptoms, and social support were assessed with WHO QOL Scale Brief Version, four-point Verbal Rating Scale, Hospital Anxiety and Depression Scale and Social Support Rating Scale, respectively.

RESULTS

Compared with the normative data for the Chinese general population, patients had significantly lower scores in physical (t=-25.860, p<0.001) and psychological (t=-18.225, p<0.001) QOL. Being unmarried (β=-2.471, 95% CI -4.908 to -0.034), poor economic status (β=-1.764, 95% CI -2.964 to -0.564), cancer metastasis (β=-1.328, 95% CI -2.632 to -0.024), poor performance status (β=-0.959, 95% CI -1.542 to -0.376), depression (β=-0.465, 95% CI -0.631 to -0.299), anxiety (β=-0.208, 95% CI -0.354 to -0.062) and low utilisation of social support (β=-0.344, 95% CI -0.577 to -0.111) were independently associated with poor physical QOL, while female gender (β=-1.494, 95% CI -0.649 to -2.339), less education years (β=-0.209, 95% CI -0.294 to -0.123), currently receiving chemotherapy (β=-1.536, 95% CI -3.051 to -0.021), small-cell cancer (β=-1.157, 95% CI -2.223 to -0.091), more intense pain (β=-0.535, 95% CI -0.919 to -0.151), poor performance status (β=-0.930, 95% CI -1.383 to -0.477), anxiety (β=-0.178, 95% CI -0.248 to -0.108) and inadequate subjective social support (β=-0.137, 95% CI -0.153 to -0.121) were independently associated with poor psychological QOL.

CONCLUSIONS

Inpatients with lung cancer treated in Chinese large general hospitals have poorer QOL than the general population. Effective prevention and management of psychosocial problems are potentially effective to improve their QOL.

摘要

目的

在中国,癌症患者的心理社会问题在肿瘤医学实践中未得到充分认识和治疗。本研究调查了大型综合医院肺癌住院患者的健康相关生活质量(QOL),并探讨了与生活质量相关的人口统计学、临床和心理社会因素。

设计

横断面研究。

参与者与研究地点

共从中国天津的两家大型综合医院连续招募了148例肺癌住院患者。

主要测量指标

分别采用世界卫生组织生活质量量表简版、四点口述分级量表、医院焦虑抑郁量表和社会支持评定量表评估生活质量、疼痛强度、抑郁和焦虑症状以及社会支持。

结果

与中国普通人群的标准数据相比,患者在生理(t=-25.860,p<0.001)和心理(t=-18.225,p<0.001)生活质量方面得分显著较低。未婚(β=-2.471,95%CI -4.908至-0.034)、经济状况差(β=-1.764,95%CI -2.964至-0.564)、癌症转移(β=-1.328,95%CI -2.632至-0.024)、体能状态差(β=-0.959,95%CI -1.542至-0.376)、抑郁(β=-0.465,95%CI -0.631至-0.299)、焦虑(β=-0.208,95%CI -0.354至-0.062)和社会支持利用率低(β=-0.344,95%CI -0.577至-0.111)与生理生活质量差独立相关,而女性(β=-1.494,95%CI -0.649至-2.339)、受教育年限少(β=-0.209,95%CI -0.294至-0.123)、目前正在接受化疗(β=-1.536,95%CI -3.051至-0.021)、小细胞癌(β=-1.157,95%CI -2.223至-0.091)、疼痛更剧烈(β=-0.535,95%CI -0.919至-0.151)、体能状态差(β=-0.930,95%CI -1.383至-0.477)、焦虑(β=-0.178,95%CI -0.248至-0.108)和主观社会支持不足(β=-0.137,95%CI -0.153至-0.121)与心理生活质量差独立相关。

结论

在中国大型综合医院接受治疗的肺癌住院患者的生活质量低于普通人群。有效预防和管理心理社会问题可能有效改善他们的生活质量。

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