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健康相关生活质量与医疗保健满意度:墨西哥多发性骨髓瘤患者与临床分期的关系

Health-Related Quality of Life and Satisfaction With Health Care: Relation to Clinical Stage in Mexican Patients With Multiple Myeloma.

作者信息

Balderas-Peña Luz-Ma-Adriana, Miranda-Ruvalcaba Claudia, Robles-Espinoza Andrea Isabel, Sat-Muñoz Daniel, Ruiz Miguel Garcés, García-Luna Eduardo, Nava-Zavala Arnulfo Hernan, Rubio-Jurado Benjamín

机构信息

1 Unidad de Investigación Biomédica 02, Unidad Médica de Alta Especialidad (UMAE), Hospital de Especialidades (HE), Centro Médico Nacional de Occidente (CMNO), Instituto Mexicano del Seguro Social (IMSS), Guadalajara, Jalisco, Mexico.

2 Departamento de Morfología, División de Disciplinas Básicas para la Salud, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico.

出版信息

Cancer Control. 2019 Jan-Dec;26(1):1073274819831281. doi: 10.1177/1073274819831281.

Abstract

Multiple myeloma (MM) is characterized by bone pain, pathologic fractures, bone destruction, and secondary hypercalcemia, all these conditions impact on health-related quality of life of patients. The objective was to evaluate the global health state and health-related quality of life in a group of patients with MM who attended a tertiary health-care center of the Instituto Mexicano del Seguro Social in Mexico, through the questionnaires designed by European Organization for Research and Treatment of Cancer (EORTC) quality of life group. Exploratory cross-sectional study in patients with MM treated in a Department of Hematology in a High-Specialty Medical Unit was conducted. Patients older than 18 years of age, men and women, were selected, and their informed written consent was obtained. We included all consecutive cases treated from January 2012 to December 2014. Questionnaires EORTC QLQ-C30, EORTC QLQ-MY20, and EORTC IN-PATSAT-32 were used. We studied 37 patients, 19 (51%) men and 18 women. The mean age was 61.9 years. Twenty-two (59.46%) patients presented with clinical stage III. The mean time for diagnosis was 33.11 months. The most used first-line treatment schedule was melphalan/prednisone/thalidomide (15; 40%). The global health median was 66.67, and symptoms showed a median score of 22.22. Treatment side effects score was 16.67; for general satisfaction, the median score was 75. In conclusion, the patients showed an advanced clinical stage and poor prognosis but had scores higher than 50 in functional scales and lower than 50 for symptom scales. The scores for symptom scales were related to age, renal failure, and disease-free survival. Identification of quality of life and satisfaction of care markers allow for early therapeutic intervention and efficiency and enable a change in quality of life and perception of care in Health Services.

摘要

多发性骨髓瘤(MM)的特征为骨痛、病理性骨折、骨质破坏和继发性高钙血症,所有这些情况都会影响患者的健康相关生活质量。目的是通过欧洲癌症研究与治疗组织(EORTC)生活质量小组设计的问卷,评估在墨西哥墨西哥社会保障局第三级医疗保健中心就诊的一组MM患者的总体健康状况和健康相关生活质量。在一家高专科医疗单位的血液科对MM患者进行了探索性横断面研究。选取年龄大于18岁的男性和女性患者,并获得其知情书面同意。我们纳入了2012年1月至2014年12月期间治疗的所有连续病例。使用了EORTC QLQ-C30、EORTC QLQ-MY20和EORTC IN-PATSAT-32问卷。我们研究了37例患者,其中19例(51%)为男性,18例为女性。平均年龄为61.9岁。22例(59.46%)患者处于临床III期。诊断的平均时间为33.11个月。最常用的一线治疗方案是美法仑/泼尼松/沙利度胺(15例;40%)。总体健康中位数为66.67,症状中位数评分为22.22。治疗副作用评分为16.67;总体满意度中位数评分为75。总之,患者临床分期较晚且预后较差,但功能量表得分高于50分,症状量表得分低于50分。症状量表得分与年龄、肾衰竭和无病生存期相关。识别生活质量和护理标志物满意度有助于早期治疗干预和提高效率,并能改善生活质量和对卫生服务护理的认知。

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