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血液恶性肿瘤患者的生活质量及影响健康状态效用值的因素。

Quality of life of patients with hematological malignancies and factors affecting health state utility values.

机构信息

Department of Rehabilitation, Panasonic Health Insurance Organization, Matsushita Memorial Hospital, Moriguchi, Osaka, Japan.

Department of Physical Therapy, School of Health Sciences, Fukushima Medical University, 10-6 Sakaemachi, Fukushima, Fukushima, 960-8516, Japan.

出版信息

Support Care Cancer. 2022 Jun;30(6):5319-5327. doi: 10.1007/s00520-022-06958-y. Epub 2022 Mar 12.

Abstract

PURPOSE

It is well studied that physical function and social background affect the quality of life (QoL) of cancer patients. However, differences in QoL by age and factors affecting health state utility values (HSUV) of patients with hematological malignancies have not yet been sufficiently investigated. Our aim is to investigate the factors that affect QoL and HSUV in such patients.

METHODS

A total of 32 patients with hematological malignancies on outpatient chemotherapy were included. QoL and HSUV were evaluated using the EuroQol-5 Dimension 5-level (EQ-5D-5L). Physical function was assessed using grip strength, knee extension strength, 6-min walking distance, and Short Physical Performance Battery (SPPB). Fatigue was assessed using Brief Fatigue Inventory (BFI), and nutritional status was assessed using Mini Nutritional Assessment-Short Form (MNA-SF).

RESULTS

In the EQ-5D-5L, a high percentage of the patients were aware of mobility problems and pain/discomfort, and mobility problems were more common in the older-aged group (≥ 65 years old, n = 16) than in the middle-aged group (< 65 years old, n = 16). In addition, the older-aged group showed lower HSUV and physical function. SPPB (β = 0.38, p < 0.01), BFI (β =  - 0.58, p < 0.01), and MNA-SF (β = 0.29, p = 0.02) were independent factors affecting HSUV (adjusted R = 0.65, p < 0.01). BFI was correlated with HSUV in both older and middle-aged groups.

CONCLUSION

Comprehensive supports, to improve lower extremity function, fatigue, and nutritional status, are required to augment QoL and HSUV in patients with hematological malignancies.

摘要

目的

已有大量研究表明,生理机能和社会背景会影响癌症患者的生活质量(QoL)。然而,血液系统恶性肿瘤患者的 QoL 还受年龄影响,且其健康状态效用值(HSUV)的影响因素尚未得到充分研究。本研究旨在探讨这些患者的 QoL 和 HSUV 的影响因素。

方法

共纳入 32 例血液系统恶性肿瘤门诊化疗患者。采用欧洲五维健康量表 5 维度 5 级量表(EQ-5D-5L)评估 QoL,采用握力、膝关节伸展力量、6 分钟步行距离和简易体能状况量表(SPPB)评估生理机能。采用简要疲劳量表(BFI)评估疲劳,采用微型营养评估-短表单(MNA-SF)评估营养状况。

结果

在 EQ-5D-5L 中,大多数患者自觉存在移动问题和疼痛/不适,且移动问题在年龄较大组(≥65 岁,n=16)中比年龄较小组(<65 岁,n=16)更常见。此外,年龄较大组的 HSUV 和生理机能较低。SPPB(β=0.38,p<0.01)、BFI(β=-0.58,p<0.01)和 MNA-SF(β=0.29,p=0.02)是影响 HSUV 的独立因素(调整 R2=0.65,p<0.01)。BFI 与年龄较大和年龄较小组的 HSUV 均相关。

结论

需要对血液系统恶性肿瘤患者进行全面支持,以改善下肢功能、疲劳和营养状况,从而提高其 QoL 和 HSUV。

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