Barnes D, Rivera R, Gibson S, Craig C, Cragun J, Monk B, Chase D
1Department of Gynecologic Oncology, Creighton University School of Medicine at St. Joseph's Hospital and Medical Center, Phoenix, AZ USA.
2University of Arizona Cancer Center, Tucson, AZ USA.
Gynecol Oncol Res Pract. 2018 Jul 12;5:4. doi: 10.1186/s40661-018-0062-4. eCollection 2018.
Measuring QoL is essential to the field of gynecologic oncology but there seems to be limited standardized data regarding collecting QoL assessments throughout a patient's cancer treatment especially in non-clinical trial patients. The aim of this study is to explore patient characteristics that may be associated with poor quality of life (QoL) in women with gynecologic cancers at two University of Arizona Cancer Center (UACC) sites.
A cross-sectional survey was conducted among English speaking women with gynecologic malignancies at the University of Arizona Cancer Centers in Phoenix and Tucson from April 2012 to July 2015. The survey was a paper packet of questions that was distributed to cancer patients at the time of their clinic visit. The packet contained questions on demographic information, treatment, lifestyle characteristics, pelvic pain and Health-related quality of life (HRQoL). Measures included the generic and cancer-specific scores on the Functional Assessment of Cancer Therapy-General (FACT-G) and the Female Genitourinary Pain Index (GUPI). The total scores and subdomains were compared with descriptive variables (age, body mass index (BMI), diet, exercise, disease status, treatment and support group attendance) using Cronbach alpha (α), Spearman rank correlations (ρ), and Holm's Bonferroni method.
One-hundred and forty-nine women completed the survey; 55% ( = 81) were older than 60 years, 38% ( = 45) were obese (BMI > 30), 46% ( = 66) exercised daily, and 84% ( = 111) ate one or more daily serving of fruit and vegetables. Women in remission, those who exercised daily and ate fruits/vegetables were less likely to have their symptoms impact their QoL. Younger women were more likely to report genitourinary issues ( = - 0.22) and overall problems with QoL ( = - 0.29) than older women. Among FACT-G support group responses, we found those that did not attend support groups had a significantly higher emotional wellbeing ( = 0.05).
This study identified potential areas of clinical focus, which aid in understanding our approach to caring for gynecologic cancer patients and improvement of their HRQoL. We identified that age, pelvic pain, and lifestyle characteristics have indicators to poor QoL in women with gynecologic cancers. In this population, younger women and those with pelvic pain complaints, poor diet and exercise habits should be targeted early for supportive care interventions to improve QoL throughout both treatment and survivorship.
生活质量(QoL)评估对于妇科肿瘤学领域至关重要,但在患者整个癌症治疗过程中收集QoL评估的标准化数据似乎有限,尤其是在非临床试验患者中。本研究的目的是探讨在亚利桑那大学癌症中心(UACC)的两个地点,与妇科癌症女性生活质量差可能相关的患者特征。
2012年4月至2015年7月,在菲尼克斯和图森的亚利桑那大学癌症中心,对讲英语的妇科恶性肿瘤女性进行了一项横断面调查。该调查是一组纸质问题,在患者门诊时分发给癌症患者。问卷包含有关人口统计学信息、治疗、生活方式特征、盆腔疼痛和健康相关生活质量(HRQoL)的问题。测量指标包括癌症治疗功能评估通用版(FACT-G)的通用和癌症特异性评分以及女性泌尿生殖系统疼痛指数(GUPI)。使用克朗巴哈α系数(α)、斯皮尔曼等级相关性(ρ)和霍尔姆邦费罗尼方法,将总分和子领域与描述性变量(年龄、体重指数(BMI)、饮食、运动、疾病状态、治疗和支持小组参与情况)进行比较。
149名女性完成了调查;55%(n = 81)年龄超过60岁,38%(n = 45)肥胖(BMI>30),46%(n = 66)每天锻炼,84%(n = 111)每天食用一份或多份水果和蔬菜。处于缓解期的女性、每天锻炼且食用水果/蔬菜的女性,其症状对生活质量产生影响的可能性较小。与老年女性相比,年轻女性更有可能报告泌尿生殖系统问题(r = -0.22)和总体生活质量问题(r = -0.29)。在FACT-G支持小组的反馈中,我们发现未参加支持小组的人情绪健康状况明显更高(p = 0.05)。
本研究确定了潜在的临床关注领域,有助于理解我们对妇科癌症患者的护理方法并改善其HRQoL。我们发现年龄、盆腔疼痛和生活方式特征是妇科癌症女性生活质量差的指标。在这一人群中,年轻女性以及有盆腔疼痛主诉、饮食和运动习惯不良的女性应尽早接受支持性护理干预,以在治疗和生存期间改善生活质量。