患者对常用的头颈部癌症特异性生活质量问卷在随访中的偏好（Determin）：一项多中心随机对照试验和混合方法研究。

Patient preference for commonly-used, head and neck cancer-specific quality of life questionnaires in the follow-up setting (Determin): A multi-centre randomised controlled trial and mixed methods study.

机构信息

Institute of Head and Neck Studies and Education, School of Cancer Sciences, University of Birmingham, Edgbaston, Birmingham, UK.

King's Clinical Trials Unit (KCTU), Institute of Psychology, Psychiatry and Neuroscience, King's College London, De Crespigny Park, London, UK.

出版信息

Clin Otolaryngol. 2023 Jul;48(4):613-622. doi: 10.1111/coa.14054. Epub 2023 Apr 4.

DOI:10.1111/coa.14054

PMID:37014180

Abstract

BACKGROUND

Quality of life (QoL) assessment forms an integral part of modern cancer care and research. The aim of this study is to determine patients' preferences and willingness to complete commonly used head-and-neck cancer (HNC) QoL questionnaires (QLQs) in routine follow-up clinics.

METHODS

This is a randomised control trial of 583 subjects from 17 centres during follow-up after treatment for oral, oropharyngeal or laryngeal cancer. Subjects completed three structured validated questionnaires: EORTC QLQ-HN35; FACT-HN and UW-QOL, and an unstructured patient-generated list. The order of questionnaire presentation was randomised, and subjects were stratified by disease site and stage. Patients self-rated the questionnaires they found most helpful to communicate their health concerns to their clinicians.

RESULTS

Of the 558 respondents, 82% (457) found QLQs useful to communicate their health concerns to their clinician (OR = 15.76; 95% CI 10.83-22.94). Patients preferred the structured disease-specific instruments (OR 8.79; 95% CI 5.99-12.91), while the open list was the most disliked (OR = 4.25; 95% CI 3.04-5.94). There was no difference in preference by treatment modality. More women preferred the FACT-HN (OR = 3.01, 95% CI 1.05-8.62), and patients under 70 preferred EORTC QLQ-HN35 (OR = 3.14, 95% CI 1.3-7.59). However, only 55% of patients expressed preference to complete questionnaires routinely at the clinic.

CONCLUSIONS

Most patients found QLQs helpful during their follow-up and 55% supported routine questionnaires in follow-up clinics. Males and people over 70 years old were the least willing to complete the routine questionnaires and preferred shorter questionnaires (e.g., UW-QOL). Women preferred FACT-HN, and younger patients preferred EORTC QLQ-HN35. Reasons for the reluctance to complete questionnaires require elucidation.

摘要

背景

生活质量（QoL）评估是现代癌症护理和研究的重要组成部分。本研究旨在确定患者在常规随访诊所中完成常用头颈部癌症（HNC）QoL 问卷（QLQs）的偏好和意愿。

方法

这是一项在治疗口腔、口咽或喉癌后随访的 17 个中心的 583 名受试者的随机对照试验。受试者完成了三个结构化的经过验证的问卷：EORTC QLQ-HN35；FACT-HN 和 UW-QOL，以及一个非结构化的患者生成列表。问卷呈现的顺序是随机的，并且根据疾病部位和阶段对受试者进行分层。患者自评他们认为最有助于向医生传达健康问题的问卷。

结果

在 558 名应答者中，82%（457 名）认为 QLQs有助于向医生传达他们的健康问题（OR=15.76；95%CI 10.83-22.94）。患者更喜欢结构化的疾病特异性工具（OR 8.79；95%CI 5.99-12.91），而开放列表最不受欢迎（OR=4.25；95%CI 3.04-5.94）。治疗方式对偏好没有影响。更多的女性更喜欢 FACT-HN（OR=3.01，95%CI 1.05-8.62），而 70 岁以下的患者更喜欢 EORTC QLQ-HN35（OR=3.14，95%CI 1.3-7.59）。然而，只有 55%的患者表示愿意在诊所常规完成问卷。