Institute for Medical Epidemiology, Biometrics and Informatics (IMEBI), Interdisciplinary Center for Health Sciences, Medical School of the Martin-Luther University Halle-Wittenberg, Magdeburger Strasse 8, 06097, Halle (Saale), Germany.
Department of Epidemiology, Faculty of Public Health, Universitas Indonesia, Depok, Indonesia.
Qual Life Res. 2021 Feb;30(2):315-343. doi: 10.1007/s11136-020-02633-z. Epub 2020 Sep 18.
This systematic review aims to summarize factors that influence the quality of life (QOL) of advanced cancer patients in palliative care (PC) in developing countries. Understanding this context in developing countries milieu is necessary; however, this outcome is rarely reported.
Following the PRISMA guidelines, the electronic databases MEDLINE, Embase, CINAHL, and Web of Science were systematically searched using the search terms: QOL, cancer, PC, and names of all developing countries. Studies with less than ten subjects, qualitative or pilot studies, reviews, conference abstracts, and that reported validation of QOL questionnaires were excluded.
Fifty-five studies from 15 developing countries in the African (n = 5), Latin America and the Caribbean (n = 10), and Asian (n = 40) region were included in the narrative synthesis. 65.4% were cross-sectional, 27.3% were cohort studies, 7.3% were RCTs or quasi-experimental studies. Around 30 QOL factors were studied with 20 different types of QOL instruments. Advanced cancer patients who were older, married/ever married, participated in additional care within PC, used complementary and alternative medicine (CAM), and practiced spirituality/religiosity showed higher QOL score. Low educational level and high depression were associated with a lower QOL.
Various factors affect QOL among cancer patients in PC. Patients valued the use of CAMs; however, the quality and safety aspects should be properly addressed. Important factors that influenced the QOL score were social and spiritual support. While there is a general need to develop PC strategies further, recognizing patients' needs should be prioritized in national cancer programs.
本系统评价旨在总结影响发展中国家姑息治疗（PC）晚期癌症患者生活质量（QOL）的因素。了解发展中国家环境中的这一情况是必要的；然而，这一结果很少有报道。
根据 PRISMA 指南，使用 QOL、癌症、PC 和所有发展中国家的名称等检索词，系统地检索了 MEDLINE、Embase、CINAHL 和 Web of Science 电子数据库。排除了研究对象少于 10 人的研究、定性或试点研究、综述、会议摘要以及报告 QOL 问卷验证的研究。
从非洲（n=5）、拉丁美洲和加勒比（n=10）以及亚洲（n=40）15 个发展中国家的 55 项研究中纳入了叙述性综合分析。65.4%为横断面研究，27.3%为队列研究，7.3%为 RCT 或准实验研究。研究了大约 30 个 QOL 因素，使用了 20 种不同类型的 QOL 工具。年龄较大、已婚/曾已婚、在 PC 中接受额外护理、使用补充和替代医学（CAM）以及实践灵性/宗教信仰的晚期癌症患者的 QOL 评分较高。教育程度低和抑郁程度高与较低的 QOL 相关。
姑息治疗中癌症患者的 QOL 受到多种因素的影响。患者重视 CAM 的使用，但应适当解决质量和安全方面的问题。影响 QOL 评分的重要因素是社会和精神支持。虽然普遍需要进一步制定 PC 策略，但在国家癌症计划中应优先考虑患者的需求。
