Faculty of Pharmacy, Medical University, Pleven, Bulgaria.
Department of Political and Social Sciences, University of Catania, Catania, Italy.
Cent Eur J Public Health. 2022 Sep;30(3):160-165. doi: 10.21101/cejph.a7095.
The present study investigates the determinants of oncology patients' Health-Related Quality of Life (HRQoL) in Bulgaria. Looking at some patients' characteristics, including control variables in the estimated model - demographics and the time from the disease onset, it studies the relevance of HRQoL diverse factors: some of them are related to the physical and psychological dimensions of the patients' illness experience, such as the levels of pain and anxiety/depression; some other concern more specifically the patients' therapeutic path, i.e., the feeling of participation in the therapy, their perceived uncertainty in illness (predictability and complexity), and the quality of the information received from the nurses and other medical personnel.
A questionnaire collecting information on HRQoL, uncertainty in illness and patients' experience with the hospital treatment has been administered to 306 oncology patients at four oncology centres in Bulgaria. Data has then been employed in the estimation of a Tobit model: the dependent variable selected has been the variation in the Visual Analogue Scale (VAS) score. The econometric model takes into account the characteristics of censoring in the dependent variable.
Overall, the coefficients estimated, and the regression itself showed a good level of significance. Some dimensions of EuroQol-5D (EQ-5D) questionnaire - pain and anxiety/depression - have a significant impact on HRQoL, as well as some features of uncertainty in illness, as unpredictability and complexity. As expected, the longer the time elapsed from the diagnosis, the higher the reported HRQoL; the value of the information provided to the patients by the nurses as well as physicians is also relevant.
This study presents an analysis of the impact of uncertainty in illness, feeling of participation in the therapy, and communication with the hospital personnel on oncological patients' HRQoL, which increases the scanty evidence referring to the patient-centred care in the Bulgarian hospital setting. Further deepening might concern a wider sample, including data collected at other medical centres and/or in other geographical areas in Bulgaria as well as in other European countries.
本研究旨在探讨保加利亚肿瘤患者健康相关生活质量（HRQoL）的决定因素。通过观察一些患者的特征，包括估计模型中的控制变量 - 人口统计学和疾病发病时间，研究 HRQoL 不同因素的相关性：其中一些与患者疾病体验的身体和心理维度有关，例如疼痛和焦虑/抑郁水平；另一些则更具体地关注患者的治疗路径，即对治疗的参与感、对疾病的不确定性（可预测性和复杂性）的感知，以及从护士和其他医务人员那里获得的信息质量。
在保加利亚的四个肿瘤中心，向 306 名肿瘤患者发放了一份调查问卷，收集有关 HRQoL、疾病不确定性和患者对医院治疗体验的信息。然后，使用数据估计了一个 Tobit 模型：选择的因变量是视觉模拟量表（VAS）评分的变化。计量经济学模型考虑了因变量的截断特征。
总体而言，估计的系数和回归本身都具有很好的显著性水平。EuroQol-5D（EQ-5D）问卷的一些维度 - 疼痛和焦虑/抑郁 - 对 HRQoL 有显著影响，疾病不确定性的一些特征，如不可预测性和复杂性，也有显著影响。正如预期的那样，从诊断到现在的时间越长，报告的 HRQoL 越高；护士和医生向患者提供的信息的价值也很重要。
本研究分析了疾病不确定性、治疗参与感和与医院人员沟通对肿瘤患者 HRQoL 的影响，这增加了关于保加利亚医院以患者为中心的护理的证据。进一步深入研究可能涉及更广泛的样本，包括在其他医疗中心和/或在保加利亚其他地理区域以及其他欧洲国家收集的数据。
