Islam Md Serajul
Department of Haematology, Guy's & St. Thomas Hospital, London.
Department of Haematology, Broomfield Hospital, Chelmsford, UK.
Oncol Rev. 2018 Jul 4;12(2):374. doi: 10.4081/oncol.2018.374.
Haematological malignancies can have devastating effects on the patients' physical, emotional, psycho-sexual, educational and economic health. With the improvement of therapies patients with these malignancies are living longer, however significant proportion these patient show poor quality of life (QoL) due to various physical and psychological consequences of the disease and the treatments. Health-related QoL (HRQoL) is multi-dimensional and temporal, relating to a state of functional, physical, psychological and social/family well-being. Compared with the general population, HRQoL of these patients is worse in most dimensions. However without routine holistic need assessment (HNA), clinicians are unlikely to identify patients with clinically significant distress. Surviving cancer is a chronic life-altering condition with several factors negatively affecting their QoL, such as psychological problems, including depression and excessive fear of recurrence, as well as social aspects, such as unemployment and social isolation. These need to be adequately understood and addressed in the healthcare of long-term survivors of haematological cancer. Applying a holistic approach to patient care has many benefits and yet, only around 25% of cancer survivors in the UK receive a holistic needs assessment. The efforts of the last decade have established the importance of ensuring access to psychosocial services for haematological cancer survivors. We need to determine the most effective practices and how best to deliver them across diverse settings. Distress, like haematological cancer, is not a single entity, and one treatment does not fit all. Psychosocialoncology needs to increase its research in comparative effectiveness.
血液系统恶性肿瘤会对患者的身体、情感、心理性、教育和经济健康产生毁灭性影响。随着治疗方法的改进,这些恶性肿瘤患者的生存期延长了,然而,由于疾病和治疗带来的各种身体和心理后果,这些患者中有很大一部分生活质量较差。与健康相关的生活质量(HRQoL)是多维度和随时间变化的,与功能、身体、心理以及社会/家庭幸福感的状态相关。与普通人群相比,这些患者的HRQoL在大多数维度上都更差。然而,如果没有进行常规的整体需求评估(HNA),临床医生不太可能识别出有临床显著痛苦的患者。癌症幸存者面临着一种改变生活的慢性状况,有几个因素会对他们的生活质量产生负面影响,比如心理问题,包括抑郁和对复发的过度恐惧,以及社会方面的问题,如失业和社会孤立。在血液系统癌症长期幸存者的医疗保健中,需要充分理解并解决这些问题。对患者护理采用整体方法有很多益处,然而,在英国只有约25%的癌症幸存者接受了整体需求评估。过去十年的努力已经确立了确保血液系统癌症幸存者能够获得心理社会服务的重要性。我们需要确定最有效的做法以及如何在不同环境中最好地提供这些服务。痛苦,就像血液系统癌症一样,不是单一的实体,一种治疗方法并不适用于所有人。心理肿瘤学需要增加其在比较疗效方面的研究。