脑膜瘤切除术后的生活质量-印度和澳大利亚患者的跨文化比较。
Quality of life after resection of a meningioma-A cross-cultural comparison of Indian and Australian patients.
机构信息
Faculty of Medicine, Department of Surgery, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia.
Department of Neurosurgery, The Royal Melbourne Hospital, Melbourne, Australia.
出版信息
PLoS One. 2022 Sep 26;17(9):e0275184. doi: 10.1371/journal.pone.0275184. eCollection 2022.
PURPOSE
To compare health-related quality of life (HRQoL) and symptom burden following meningioma resection in patients from two samples from Australia and India. This will add to the body of data on the longer-term consequences of living with a meningioma in two socio-economically and culturally different countries.
METHODS
The European Organisation for Research and Treatment of Cancer (EORTC) Core Quality of Life Questionnaire (QLQ-C30), Brain Neoplasm Module (QLQ-BN20) and the Hospital Anxiety and Depression Scale (HADS) were administered to 159 Australian and 92 Indian meningioma patients over 24 months postoperative. A linear mixed model analysis identified differences between groups over time.
RESULTS
Australian patients reported better physical functioning in the early months after surgery (T1: mean diff: 19.8, p<0.001; T2: mean diff: 12.5, p = 0.016) whereas Indian patients reported better global HRQoL (mean: -20.3, p<0.001) and emotional functioning (mean diff:-15.6, p = 0.020) at 12-24 months. In general, Australian patients reported more sleep and fatigue symptoms while Indian patients reported more gastro-intestinal symptoms over the 2-year follow-up. Future uncertainty and symptoms common for brain tumour patients were consistently more commonly reported by patients in Australia than in India. No differences for depression and anxiety were identified.
CONCLUSION
This is the first cross cultural study to directly compare postoperative HRQoL in meningioma patients. Some differences in HRQoL domains and symptom burden may be explained by culturally intrinsic reporting of symptoms, as well as higher care support from family members in India. Although there were differences in some HRQoL domains, clinically meaningful differences between the two samples were less common than perhaps expected. This may be due to an Indian sample with high literacy and financial resources to afford surgery and follow up care.
目的
比较澳大利亚和印度两个样本的脑膜瘤切除术后患者的健康相关生活质量（HRQoL）和症状负担。这将增加关于在两个社会经济和文化背景不同的国家生活中患有脑膜瘤的长期后果的数据。
方法
对 159 名澳大利亚和 92 名印度脑膜瘤患者在术后 24 个月内进行欧洲癌症研究与治疗组织（EORTC）核心生活质量问卷（QLQ-C30）、脑肿瘤模块（QLQ-BN20）和医院焦虑抑郁量表（HADS）的测定。线性混合模型分析确定了组间随时间的差异。
结果
澳大利亚患者在手术后的早期几个月报告了更好的身体功能（T1：平均差异：19.8，p<0.001；T2：平均差异：12.5，p=0.016），而印度患者在 12-24 个月时报告了更好的总体 HRQoL（平均：-20.3，p<0.001）和情绪功能（平均差异：-15.6，p=0.020）。一般来说，澳大利亚患者报告在 2 年随访期间睡眠和疲劳症状更多，而印度患者报告胃肠道症状更多。未来的不确定性和常见的脑肿瘤患者的症状在澳大利亚患者中比在印度患者中更常见地报告。未发现抑郁和焦虑的差异。
结论
这是第一个直接比较脑膜瘤患者术后 HRQoL 的跨文化研究。在一些 HRQoL 领域和症状负担方面的差异可能可以用症状的内在文化报告以及印度家庭成员提供的更高的护理支持来解释。尽管在一些 HRQoL 领域存在差异，但两个样本之间的临床意义差异并不像预期的那么常见。这可能是由于印度样本具有较高的文化程度和经济资源，能够负担得起手术和后续护理。
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