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乳腺癌患者的应对策略、疼痛与生活质量

Coping Strategies, Pain, and Quality of Life in Patients with Breast Cancer.

作者信息

Ośmiałowska Edyta, Misiąg Weronika, Chabowski Mariusz, Jankowska-Polańska Beata

机构信息

Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, 51-618 Wroclaw, Poland.

Student Research Group No 180, Faculty of Medicine, Wroclaw Medical University, 50-367 Wroclaw, Poland.

出版信息

J Clin Med. 2021 Sep 28;10(19):4469. doi: 10.3390/jcm10194469.

Abstract

INTRODUCTION

Each year, around 16,500 women in Poland are diagnosed with breast cancer, the second most common cause of death in women. In Poland, nearly 70,000 women live with breast cancer diagnosed within the last 5 years. Quality of life (QoL) research is particularly important in cancer patients, as it provides knowledge on their psychological and physical health, as well as the environment in which the patients function, all of which is essential to implementing multidisciplinary care involving the best use of the appropriate methods. Carrying the burden of cancer is a major challenge for patients. The strategy that patients use to cope with breast cancer significantly affects their quality of life. The purpose of the study is to assess the impact of coping strategies on the QoL in breast cancer patients.

MATERIAL AND METHODS

The prospective study included a group of 202 women who had undergone surgical treatment for breast cancer at the Lower Silesian Cancer Center and who reported for follow-up appointments at the Oncology Clinic and the Surgical Oncology Clinic. For the study, we used the: EORTC QLQ-C30 cancer questionnaire, EORTC QLQ-BR23 module, Mental Adjustment to Cancer (Mini-MAC) scale, visual analog scale (VAS) for pain intensity, as well as the patients' medical records, hospital records, and our own survey form.

RESULTS

The mean patient age was 53 years. Most patients had been diagnosed with cancer between one and two years before. In the women studied, there was a negative association between QoL and the choice of a destructive strategy for coping with cancer, and a positive one between QoL and a constructive coping strategy. Severe pain caused by the disease and its treatment significantly decreased the patients' QoL in multiple domains.

CONCLUSIONS

Patients choosing constructive strategies obtained higher QoL scores, while greater reliance on destructive coping strategies was associated with significantly worse QoL. In all functioning domains, higher levels of pain were associated with poorer QoL and more severe symptoms associated with the disease and its treatment.

摘要

引言

在波兰,每年约有16,500名女性被诊断出患有乳腺癌,乳腺癌是女性第二大常见死因。在波兰,近70,000名女性患有在过去5年内被诊断出的乳腺癌。生活质量(QoL)研究在癌症患者中尤为重要,因为它能提供有关患者心理和身体健康以及患者所处环境的信息,所有这些对于实施涉及最佳使用适当方法的多学科护理至关重要。承受癌症负担对患者来说是一项重大挑战。患者应对乳腺癌所采用的策略会显著影响其生活质量。本研究的目的是评估应对策略对乳腺癌患者生活质量的影响。

材料与方法

这项前瞻性研究纳入了一组202名女性,她们在西里西亚癌症中心接受了乳腺癌手术治疗,并到肿瘤诊所和外科肿瘤诊所进行随访预约。在研究中,我们使用了:欧洲癌症研究与治疗组织(EORTC)的QLQ - C30癌症问卷、EORTC QLQ - BR23模块、癌症心理调适(Mini - MAC)量表、疼痛强度视觉模拟量表(VAS),以及患者的病历、医院记录和我们自己的调查问卷。

结果

患者的平均年龄为53岁。大多数患者在一到两年前被诊断出患有癌症。在所研究的女性中,生活质量与应对癌症的消极策略选择之间存在负相关,与建设性应对策略之间存在正相关。疾病及其治疗引起的剧痛在多个领域显著降低了患者的生活质量。

结论

选择建设性策略的患者获得了更高的生活质量评分,而更多地依赖消极应对策略则与明显更差的生活质量相关。在所有功能领域,更高程度的疼痛与更差的生活质量以及与疾病及其治疗相关更严重的症状相关。

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