肿瘤患者生活质量与应对策略的比较研究
Comparative Study of the Quality of Life and Coping Strategies in Oncology Patients.
作者信息
Meneguin Silmara, Alves Izadora Gama, Camargo Heloiza Thais Felipe, Pollo Camila Fernandes, Segalla Amanda Vitoria Zorzi, de Oliveira Cesar
机构信息
Department of Nursing, Botucatu Medical School, São Paulo State University, São Paulo 18618-970, Brazil.
Department of Epidemiology & Public Health, University College London, London WC1E 6BT, UK.
出版信息
Eur J Investig Health Psychol Educ. 2024 Feb 6;14(2):339-350. doi: 10.3390/ejihpe14020023.
BACKGROUND
Despite the current data on morbidity and mortality, a growing number of patients with a diagnosis of cancer survive due to an early diagnosis and advances in treatment modalities. This study aimed to compare the quality of life and coping strategies in three groups of patients with cancer and identify associated clinical and sociodemographic characteristics.
METHODS
A comparative study was conducted with outpatients at a public hospital in the state of São Paulo, Brazil. The 300 participants were assigned to three groups: patients in palliative care (Group A), patients in post-treatment follow-up with no evidence of disease (Group B), and patients undergoing treatment for cancer (Group C). Data collection involved the use of the McGill Quality of Life Questionnaire and the Ways of Coping Questionnaire. No generic quality-of-life assessment tool was utilized, as it would not be able to appropriately evaluate the impact of the disease on the specific group of patients receiving palliative care.
RESULTS
Coping strategies were underused. Participants in the palliative care group had poorer quality of life, particularly in the psychological well-being and physical symptom domains. Age, currently undergoing treatment, and level of education were significantly associated with coping scores. Age, gender, income, and the absence of pharmacological pain control were independently associated with quality-of-life scores. Moreover, a positive association was found between coping and quality of life.
CONCLUSION
Cancer patients in palliative care generally report a lower quality of life. However, male patients, those who did not rely on pharmacological pain control, and those with higher coping scores reported a better perception of their quality of life. This perception tended to decrease with age and income level. Patients currently undergoing treatment for the disease were more likely to use coping strategies. Patients with higher education and quality-of-life scores also had better coping scores. However, the use of coping strategies decreased with age.
背景
尽管目前有关于发病率和死亡率的数据，但由于早期诊断和治疗方式的进步，越来越多被诊断为癌症的患者得以存活。本研究旨在比较三组癌症患者的生活质量和应对策略，并确定相关的临床和社会人口学特征。
方法
在巴西圣保罗州的一家公立医院对门诊患者进行了一项比较研究。300名参与者被分为三组：姑息治疗患者（A组）、治疗后随访且无疾病证据的患者（B组）以及正在接受癌症治疗的患者（C组）。数据收集使用了麦吉尔生活质量问卷和应对方式问卷。未使用通用的生活质量评估工具，因为它无法适当评估疾病对接受姑息治疗的特定患者群体的影响。
结果
应对策略未得到充分利用。姑息治疗组的参与者生活质量较差，尤其是在心理健康和身体症状方面。年龄、当前正在接受治疗以及教育程度与应对得分显著相关。年龄、性别、收入以及缺乏药物疼痛控制与生活质量得分独立相关。此外，应对与生活质量之间存在正相关。
结论
姑息治疗中的癌症患者总体上报告生活质量较低。然而，男性患者、不依赖药物疼痛控制的患者以及应对得分较高的患者对其生活质量的感知较好。这种感知往往随着年龄和收入水平的降低而下降。目前正在接受疾病治疗的患者更有可能使用应对策略。教育程度较高和生活质量得分较高的患者应对得分也较好。然而，应对策略的使用随着年龄的增长而减少。
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