a Department of Medical Oncology , Cancer Centre, General Hospital Groeninge , Kortrijk , Belgium.
b Department of Radiation Oncology and Experimental Cancer Research , Ghent University , Ghent , Belgium.
J Psychosoc Oncol. 2019 Jul-Aug;37(4):427-440. doi: 10.1080/07347332.2018.1504154. Epub 2019 Feb 23.
Cognitive complaints, of objective or subjective nature, may negatively impact cancer patients' quality of life (QoL). Further, the early detection of cognitive alterations may lead to an improved QoL. However, the content of such screening is yet unclear. This paper presents long-term QoL data of cancer patients treated with curative intent and its relation with objective and subjective cognitive complaints, and patient-reported outcome measures (PROMs).
QoL data, measured by the EORTC QLQ C-30, were obtained at baseline, 6 (T1), 12 (T2), and 24 months (T3) after treatment start, and compared between patients with and without objective and subjective cognitive complaints. The predictive value of PROMs was also examined.
QoL data at baseline was collected in 125 patients. Response rates at T1, T2, and T3 were 84.7%, 81.5%, and 83.1%, respectively. Eighty-nine patients returned their QoL questionnaires at all times. Baseline subjective cognitive complaints had a stronger association with worse scores on patients' overall QoL and QoL subscale scores than objective cognitive complaints. An exploratory analysis into the value of PROMs in predicting long-term QoL at T3 revealed a significant effect for the Hospital Anxiety and Depression Scale-Depression and FACIT Fatigue scale.
Self-perceived cognitive alterations are negatively associated with patients' overall QoL. As these troubles may already be present at baseline, oncology nurses should screen for the early signs of subjective cognitive complaints by use of PROMs, in order to refer the patient to proper intervention programs which may lead to an improved long-term QoL and faster reintegration into society.
认知主诉,无论其性质是客观的还是主观的,都可能对癌症患者的生活质量(QoL)产生负面影响。此外,早期发现认知改变可能会提高 QoL。然而,这种筛查的内容尚不清楚。本文介绍了接受根治性治疗的癌症患者的长期 QoL 数据及其与客观和主观认知主诉以及患者报告的结果测量(PROMs)的关系。
使用 EORTC QLQ C-30 在治疗开始时、6 个月(T1)、12 个月(T2)和 24 个月(T3)后测量 QoL 数据,并比较有和没有客观和主观认知主诉的患者之间的差异。还检查了 PROMs 的预测价值。
基线时收集了 125 名患者的 QoL 数据。T1、T2 和 T3 的应答率分别为 84.7%、81.5%和 83.1%。89 名患者在所有时间都返回了他们的 QoL 问卷。基线主观认知主诉与患者整体 QoL 和 QoL 子量表评分较差的关联强于客观认知主诉。对 PROMs 在预测 T3 时长期 QoL 的价值进行的探索性分析显示,医院焦虑和抑郁量表-抑郁和 FACIT 疲劳量表具有显著影响。
自我感知的认知改变与患者的整体 QoL 呈负相关。由于这些问题可能已经存在于基线时,肿瘤护士应使用 PROMs 筛查主观认知主诉的早期迹象,以便将患者转介给适当的干预计划,从而提高长期 QoL 并更快地重新融入社会。