利用电子患者报告结局平台评估社区卵巢癌幸存者的心理社会和生活质量体验。
Utilization of an Electronic Patient-Reported Outcome Platform to Evaluate the Psychosocial and Quality-of-Life Experience Among a Community Sample of Ovarian Cancer Survivors.
机构信息
Department of Medicine, Section of Hematology/Oncology, MacLean Center for Clinical Medical Ethics, Cancer Research Center, Supportive Oncology Program, The University of Chicago Medicine, Chicago, IL.
Department of Gynecology/Obstetrics, Section of Gynecologic Oncology, The University of Chicago Medicine, Chicago, IL.
出版信息
JCO Clin Cancer Inform. 2022 Aug;6:e2200035. doi: 10.1200/CCI.22.00035.
PURPOSE
Novel distress screening approaches using electronic patient-reported outcome (ePRO) measurements are critical for the provision of comprehensive quality community cancer care. Using an ePRO platform, the prevalence of psychosocial factors (distress, post-traumatic growth, resilience, and financial stress) affecting quality of life in ovarian cancer survivors (OCSs) was examined.
METHODS
A cross-sectional OCS sample from the National Ovarian Cancer Coalition-Illinois Chapter completed web-based clinical, sociodemographic, and psychosocial assessment using well-validated measures: Hospital Anxiety/Depression Scale-anxiety/depression, Post-traumatic Growth Inventory, Brief Resilience Scale, comprehensive score for financial toxicity, and Functional Assessment of Cancer Therapy-Ovarian (FACT-O/health-related quality of life [HRQOL]). Correlational analyses between variables were conducted.
RESULTS
Fifty-eight percent (174 of 300) of OCS completed virtual assessment: median age 59 (range 32-83) years, 94.2% White, 60.3% married/in domestic partnership, 59.6% stage III-IV, 48.8% employed full-time/part-time, 55.2% had college/postgraduate education, 71.9% completed primary treatment, and median disease duration 6 (range < 1-34) years. On average, OCS endorsed normal levels of anxiety (mean ± standard deviation = 6.9 ± 3.8), depression (4.1 ± 3.6), mild total distress (10.9 ± 8.9), high post-traumatic growth (72.6 ± 21.5), normal resilience (3.7 ± 0.72), good FACT-O-HRQOL (112.6 ± 22.8), and mild financial stress (26 ± 10). Poor FACT-O emotional well-being was associated with greater participant distress ( < .001). Partial correlational analyses revealed negative correlations between FACT-O-HRQOL and anxiety ( = -0.65, < .001), depression ( = -0.76, < .001), and total distress ( = -0.92, < .001). Yet, high FACT-O-HRQOL was positively correlated with post-traumatic coping ( = 0.27; = .006) and resilience ( = 0.63; < .001).
CONCLUSION
ePRO assessment is feasible for identification of unique psychosocial factors, for example, financial toxicity and resilience, affecting HRQOL for OCS. Future investigation should explore large-scale, longitudinal ePRO assessment of the OCS psychosocial experience using innovative measures and community-based advocacy populations.
目的
使用电子患者报告结果（ePRO）测量方法进行新颖的痛苦筛查对于提供全面的癌症社区护理质量至关重要。本研究通过使用 ePRO 平台，检查了影响卵巢癌幸存者（OCS）生活质量的心理社会因素（痛苦、创伤后成长、韧性和经济压力）的患病率。
方法
来自全国卵巢癌联盟-伊利诺伊分会的 OCS 横断面样本使用经过充分验证的测量方法完成了基于网络的临床、社会人口统计学和心理社会评估：医院焦虑/抑郁量表-焦虑/抑郁、创伤后成长量表、简明韧性量表、综合财务毒性评分和癌症治疗卵巢功能评估-FACT-O/健康相关生活质量（FACT-O/HRQOL）。对变量之间的相关性进行了分析。
结果
58%（174/300）的 OCS 完成了虚拟评估：中位年龄 59（范围 32-83）岁，94.2%为白人，60.3%已婚/处于婚姻关系中，60.3%为已婚/处于婚姻关系中，59.6%为 III-IV 期，48.8%全职/兼职，55.2%具有大学/研究生学历，71.9%完成了主要治疗，疾病持续时间中位数为 6（范围<1-34）年。平均而言，OCS 报告了正常水平的焦虑（均值±标准差=6.9±3.8）、抑郁（4.1±3.6）、轻度总痛苦（10.9±8.9）、高创伤后成长（72.6±21.5）、正常韧性（3.7±0.72）、良好的 FACT-O-HRQOL（112.6±22.8）和轻度财务压力（26±10）。较差的 FACT-O 情绪健康状况与更大的患者痛苦相关（<0.001）。部分相关分析显示，FACT-O-HRQOL 与焦虑（=−0.65，<0.001）、抑郁（=−0.76，<0.001）和总痛苦（=−0.92，<0.001）呈负相关。然而，高 FACT-O-HRQOL 与创伤后应对（=0.27；=0.006）和韧性（=0.63；<0.001）呈正相关。
结论
ePRO 评估对于识别影响 OCS 生活质量的独特心理社会因素（例如财务毒性和韧性）是可行的。未来的研究应该使用创新的措施和社区倡导人群，探索对 OCS 心理社会体验的大规模、纵向 ePRO 评估。
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