1 Department of Social Medicine, Zhejiang University School of Medicine , Hangzhou, P.R. China .
2 Department of Non-Communicable and Chronic Disease Control and Prevention, Hangzhou Center for Disease Control and Prevention , Hangzhou, P.R. China .
Thyroid. 2018 Aug;28(8):1013-1023. doi: 10.1089/thy.2017.0213. Epub 2018 Jul 2.
The purpose of this study was to evaluate health-related quality of life (HRQoL) of community thyroid cancer survivors in Hangzhou, China, and to explore the important correlates defining HRQoL.
All thyroid cancer patients who met study criteria in 183 communities were invited to participate (N = 1551). A self-administered questionnaire including collection of personal information and HRQoL instruments was completed by each participant (n = 970), with a response rate of 62.5%. HRQoL was assessed using the Short Form 36 Health Survey and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire. Data for comparison were derived from a representative Hangzhou community sample (N = 1790). After bivariate analyses, multiple linear regression analyses were conducted to investigate independent associations between socio-demographic variables, clinical characteristics, life-style behaviors, and HRQoL.
Information from 965 participants was available for analysis. A total of 92.1% were diagnosed with papillary thyroid cancer, known as the most common type of thyroid cancer. In general, thyroid cancer survivors have impaired quality of life compared to the age- and sex-matched reference population using the Short Form 36 Health Survey. Thyroid cancer survivors reported the highest level of fatigue and insomnia. Multivariable regression analyses showed that being employed, higher education, and per capita disposable income (24,000-56,000 ¥ per year), and undertaking 30 minutes of moderate physical activity at least five days a week were independent correlates of high physical component summary scores, while being overweight or obese and having a higher dose of levothyroxine intake per day had a negative influence. Being employed, higher per capita disposable income (>56,000 ¥ per year), undertaking 30 minutes of moderate physical activity at least five days a week, and eating more fruit were positively associated with mental component summary scores, while females and patients having more surgeries reported lower mental component summary scores. The global quality of life scale scores were associated with education, employment status, marital status, per capita disposable income, physical activity per week, fruit intake per day, and type of surgery.
Although patients with thyroid cancer have a very good prognosis overall, in this study, they often experienced more problems than the community reference population, independent of their age and sex. Sex, education, marital status, employment status, weight status, per capita disposable income, number of surgeries, type of surgery, physical activity per week, fruit intake, and levothyroxine intake per day are important correlates of HRQoL of thyroid cancer survivors. Awareness of these relevant factors could help healthcare professionals provide better supportive care.
本研究旨在评估中国杭州社区甲状腺癌幸存者的健康相关生活质量（HRQoL），并探讨定义 HRQoL 的重要相关因素。
在 183 个社区中，邀请所有符合研究标准的甲状腺癌患者参加（n=1551）。每位参与者（n=970）完成一份包括个人信息和 HRQoL 工具收集的自我管理问卷，应答率为 62.5%。使用简短的 36 项健康调查和欧洲癌症研究与治疗组织生活质量问卷评估 HRQoL。用于比较的数据来自具有代表性的杭州社区样本（n=1790）。在进行双变量分析后，进行多元线性回归分析，以调查社会人口统计学变量、临床特征、生活方式行为与 HRQoL 之间的独立关联。
965 名参与者的信息可用于分析。92.1%的患者被诊断为甲状腺癌，这是最常见的甲状腺癌类型。一般来说，与年龄和性别匹配的参考人群相比，甲状腺癌幸存者的生活质量较差，使用简短的 36 项健康调查。甲状腺癌幸存者报告疲劳和失眠程度最高。多变量回归分析显示，就业、较高的教育程度和人均可支配收入（24000-56000 元/年），以及每周至少进行 5 天、每次 30 分钟的适度体育活动是身体成分综合评分高的独立相关因素，而超重或肥胖以及每天摄入较高剂量的左甲状腺素则有负面影响。就业、较高的人均可支配收入（>56000 元/年）、每周至少进行 30 分钟的适度体育活动、每天多吃水果与心理成分综合评分呈正相关，而女性和手术次数较多的患者心理成分综合评分较低。总体生活质量量表评分与教育程度、就业状况、婚姻状况、人均可支配收入、每周体育活动量、每天水果摄入量和手术类型有关。
尽管甲状腺癌患者总体预后非常好，但在本研究中，他们经常经历比社区参考人群更多的问题，这与他们的年龄和性别无关。性别、教育程度、婚姻状况、就业状况、体重状况、人均可支配收入、手术次数、手术类型、每周体育活动量、水果摄入量、每天左甲状腺素摄入量是甲状腺癌幸存者 HRQoL 的重要相关因素。了解这些相关因素可以帮助医疗保健专业人员提供更好的支持性护理。
