Sussex Health Outcomes Research & Education in Cancer (SHORE-C), Brighton & Sussex Medical School, University of Sussex, Falmer, East Sussex, England, UK.
School of Medicine, Keele University, University Road, Staffordshire, England, UK.
Support Care Cancer. 2023 Sep 12;31(10):570. doi: 10.1007/s00520-023-08002-z.
To describe trends and explore factors associated with quality of life (QoL) and psychological morbidity and assess breast cancer (BC) health service use over a 12-month period for patients joining the supported self-management (SSM)/patient-initiated follow-up (PIFU) pathway.
Participants completed questionnaires at baseline, 3, 6, 9 and 12 months that measured QoL (FACT-B, EQ 5D-5L), self-efficacy (GSE), psychological morbidity (GHQ-12), roles and responsibilities (PRRS) and service use (cost diary).
99/110 patients completed all timepoints; 32% (35/110) had received chemotherapy. The chemotherapy group had poorer QoL; FACT-B total score mean differences were 8.53 (95% CI: 3.42 to 13.64), 5.38 (95% CI: 0.17 to 10.58) and 8.00 (95% CI: 2.76 to 13.24) at 6, 9 and 12 months, respectively. The odds of psychological morbidity (GHQ12 >4) were 5.5-fold greater for those treated with chemotherapy. Financial and caring burdens (PRRS) were worse for this group (mean difference in change at 9 months 3.25 (95% CI: 0.42 to 6.07)). GSE and GHQ-12 scores impacted FACT-B total scores, indicating QoL decline for those with high baseline psychological morbidity. Chemotherapy patients or those with high psychological morbidity or were unable to carry out normal activities had the highest service costs. Over the 12 months, 68.2% participants phoned/emailed breast care nurses, and 53.3% visited a hospital breast clinician.
The data suggest that chemotherapy patients and/or those with heightened psychological morbidity might benefit from closer monitoring and/or supportive interventions whilst on the SSM/PIFU pathway. Reduced access due to COVID-19 could have affected service use.
描述趋势并探讨与生活质量（QoL）和心理发病率相关的因素，并评估加入支持性自我管理（SSM）/患者发起的随访（PIFU）途径的患者在 12 个月内的乳腺癌（BC）健康服务使用情况。
参与者在基线、3、6、9 和 12 个月时完成了问卷，这些问卷测量了生活质量（FACT-B、EQ 5D-5L）、自我效能（GSE）、心理发病率（GHQ-12）、角色和责任（PRRS）以及服务使用（费用日记）。
99/110 名患者完成了所有时间点的随访；32%（35/110）接受了化疗。化疗组的生活质量较差；FACT-B 总分的平均差异分别为 6、9 和 12 个月时的 8.53（95%CI：3.42 至 13.64）、5.38（95%CI：0.17 至 10.58）和 8.00（95%CI：2.76 至 13.24）。接受化疗的患者心理发病率（GHQ12>4）的可能性是未接受化疗的患者的 5.5 倍。该组的经济和照顾负担（PRRS）更重（9 个月时变化的平均差异为 3.25（95%CI：0.42 至 6.07））。GSE 和 GHQ-12 评分影响 FACT-B 总分，表明基线心理发病率高的患者生活质量下降。接受化疗的患者或心理发病率高的患者或无法进行正常活动的患者的服务费用最高。在 12 个月期间，68.2%的参与者通过电话/电子邮件联系了乳腺护理护士，53.3%的参与者访问了医院乳腺临床医生。
数据表明，化疗患者和/或心理发病率较高的患者可能受益于在 SSM/PIFU 途径上接受更密切的监测和/或支持性干预。由于 COVID-19，服务的使用可能会受到影响。
