Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Division of Oncology, Tel Aviv Sourasky Medical Center, Israel.
Division of Psychology, Tel Aviv University, Israel.
ESMO Open. 2022 Jun;7(3):100498. doi: 10.1016/j.esmoop.2022.100498. Epub 2022 May 25.
While side-effects and health-related quality of life (QoL) are routinely assessed in clinical trials, commonly used tools do not measure patients' ability to maintain normal daily activities. QoL can be severely affected directly by the disease, the treatment side-effects and by personal and societal misconceptions promoting avoidance from activities perceived as dangerous for cancer patients. We examined practices of actively treated patients with cancer.
A questionnaire was designed, assessing daily activities (11 items) and dietary limitations (7 items) distributed between October and December 2019 (before the coronavirus pandemic) among patients treated at the Oncology Division of Tel Aviv Sourasky Medical Center.
The study population comprised 208 patients who participated in the survey. The majority reported at least one social-environmental avoidance or dietary limitation (136, 65% and 120, 57.7%, respectively), including abstaining from social contact, avoiding pets, public domains, traveling and maintaining dietary constraints. Adoption of these measures was not associated with clinical, demographic factors and treatment type. The major sources guiding restrictions came from advice of non-medical personnel (55.7%), the Internet (7.2%) and personal choice by the patients themselves (24%).
Most cancer patients reported compromised daily activities, which are likely attributed to misbeliefs about disease and treatment, and have a deleterious impact on QoL, in its wider sense, namely, the ability to conduct a full and meaningful life. These findings call for the development and implementation of tools examining patients' real-life activity, beyond side-effects or health-related QoL (HRQoL). We propose this assessment as an integral part in the evaluation of new drugs and technologies and as an additional endpoint in pivotal clinical trials.
虽然在临床试验中常规评估副作用和健康相关生活质量(QoL),但常用工具并不能衡量患者维持正常日常活动的能力。QoL 可能会直接受到疾病、治疗副作用以及个人和社会对促进避免被认为对癌症患者危险的活动的误解的影响。我们研究了积极接受治疗的癌症患者的做法。
我们设计了一份问卷,评估了 2019 年 10 月至 12 月(冠状病毒大流行之前)在特拉维夫索拉斯基医学中心肿瘤科接受治疗的患者的日常活动(11 项)和饮食限制(7 项)。
研究人群包括 208 名参与调查的患者。大多数患者报告至少有一种社会环境回避或饮食限制(分别为 136 例,占 65%和 120 例,占 57.7%),包括避免社交接触、避免宠物、公共场所、旅行和保持饮食限制。采取这些措施与临床、人口统计学因素和治疗类型无关。限制的主要来源是来自非医务人员的建议(55.7%)、互联网(7.2%)和患者自己的个人选择(24%)。
大多数癌症患者报告日常活动受限,这可能归因于对疾病和治疗的误解,对更广泛意义上的 QoL 产生不利影响,即全面而有意义地生活的能力。这些发现呼吁开发和实施评估患者实际生活活动的工具,超越副作用或健康相关生活质量(HRQoL)。我们建议将这种评估作为新药和技术评估的一个组成部分,并作为关键临床试验的附加终点。