Institute of Medical Sociology, Medical Faculty, Martin Luther University Halle-Wittenberg, Magdeburger Straße 8, 06112, Halle (Saale), Germany.
Devision of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Philipp-Rosenthal-Straße 55, 04103, Leipzig, Germany.
Support Care Cancer. 2019 Sep;27(9):3347-3355. doi: 10.1007/s00520-018-4634-y. Epub 2019 Jan 9.
PURPOSE: Studies examining longitudinal associations between socioeconomic factors and quality of life (QoL) in cancer patients are rare. This study investigates changes in QoL over a 6-month period. METHODS: Four hundred forty-two cancer patients (mean age 64, SD = 11, 70% male) completed standardized questionnaires at the beginning (t1) and end (t2) of their hospital stay and 3 (t3) and 6 months (t4) thereafter. QoL was assessed with the EORTC QLQ-C30 core questionnaire. Mixed effect models were employed to analyze individual changes in QoL in relation to socioeconomic status (education, income, job status) over the four timepoints. Age, sex, cohabitation, disease and treatment factors, and comorbidity were included as covariates in the models. RESULTS: Income was a predictive factor for QoL. Patients with a low income had 8.8 percentage points (PP) lower physical, 4.9 PP lower emotional, and 11.4 PP lower role functioning. They also had 6.6 PP lower global QoL. Lower social functioning (6.2 PP) was found in patients with higher education or university degrees compared with those who were less educated or had not undergone an apprenticeship. Income also influenced trajectories of role functioning. There was no evidence that primary or secondary education and job type were related to QoL. CONCLUSIONS: The fact that income is negatively associated with many aspects of quality of life should be considered during and after treatment with a focus on patients with special needs.
目的:研究癌症患者社会经济因素与生活质量(QoL)之间纵向关联的研究很少。本研究调查了 6 个月期间 QoL 的变化。
方法:442 名癌症患者(平均年龄 64 岁,标准差=11,70%为男性)在住院期间的开始(t1)和结束(t2)以及 3 个月(t3)和 6 个月(t4)后完成了标准化问卷。使用 EORTC QLQ-C30 核心问卷评估 QoL。采用混合效应模型分析了在四个时间点上,社会经济地位(教育、收入、工作状况)与 QoL 个体变化之间的关系。年龄、性别、同居、疾病和治疗因素以及合并症被纳入模型作为协变量。
结果:收入是 QoL 的预测因素。收入较低的患者身体功能降低 8.8 个百分点(PP),情绪功能降低 4.9 PP,角色功能降低 11.4 PP,总体 QoL 降低 6.6 PP。社会功能也降低了 6.2 个百分点(PP),在接受过高等教育或大学学位的患者中,与接受过较少教育或未接受过学徒培训的患者相比。收入也影响角色功能的轨迹。没有证据表明初级或中等教育和工作类型与 QoL 相关。
结论:收入与生活质量的许多方面呈负相关,这一事实应该在治疗期间和治疗后得到重视,特别要关注有特殊需求的患者。
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