a Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, and Comprehensive Cancer Center Mainfranken , University of Würzburg , Würzburg , Germany.
b Paracelsus Clinic Scheidegg , Scheidegg , Germany.
Acta Oncol. 2019 Apr;58(4):417-424. doi: 10.1080/0284186X.2018.1543947. Epub 2019 Jan 11.
Among patients with breast or gynecological cancer, supportive care needs are both highly prevalent and enduring. However, little is known about whether meeting patients' needs is accompanied by increased quality of life (QoL). We aimed to explore patients' supportive care needs reported at the beginning of inpatient rehabilitation and examined whether meeting these needs resulted in improved QoL.
In a multicenter, prospective cohort study with 2 measurement occasions (beginning and end of inpatient rehabilitation), 292 patients with breast and gynecological cancer (mean age 55 years; 71% breast cancer) were enrolled. In 73%, time since diagnosis was longer than 6 months. We obtained self-reports of supportive care needs in 12 domains and measured QoL using the EORTC QLQ-C30 functioning subscales.
At the beginning of inpatient rehabilitation, top-ranking severe supportive care needs concerned coordination of care (48%), medical information (45%), alleviation of physical symptoms (42%) and support with improving health behaviors (36%). At the end of inpatient rehabilitation, all needs assessed declined significantly, although many patients still expressed strong needs in some domains. However, meeting patients' needs was accompanied by improvements in all functioning subscales.
This is the first study to show that meeting breast and gynecological cancer patients' supportive care needs during inpatient rehabilitation resulted in improved QoL. Given the considerable proportions of patients still reporting unmet needs at the end of their stay, stronger and continuing efforts seem warranted to meet these needs and thus further increase QoL.
在患有乳腺癌或妇科癌症的患者中,支持性护理需求既普遍又持久。然而,对于满足患者的需求是否会提高生活质量(QoL)知之甚少。我们旨在探讨患者在住院康复开始时报告的支持性护理需求,并研究是否满足这些需求会改善 QoL。
在一项多中心、前瞻性队列研究中,我们进行了 2 次测量(住院康复开始和结束时),共纳入 292 名患有乳腺癌和妇科癌症的患者(平均年龄 55 岁;71%为乳腺癌)。在 73%的患者中,诊断时间超过 6 个月。我们在 12 个领域中获得了支持性护理需求的自我报告,并使用 EORTC QLQ-C30 功能量表测量了 QoL。
在住院康复开始时,排名最高的严重支持性护理需求涉及护理协调(48%)、医疗信息(45%)、减轻身体症状(42%)和支持改善健康行为(36%)。在住院康复结束时,所有评估的需求都显著下降,尽管许多患者在某些领域仍表达了强烈的需求。然而,满足患者的需求伴随着所有功能子量表的改善。
这是第一项表明满足住院康复期间乳腺癌和妇科癌症患者支持性护理需求会提高生活质量的研究。鉴于在住院结束时仍有相当比例的患者报告未满足的需求,似乎需要更加强有力和持续的努力来满足这些需求,从而进一步提高 QoL。