Zhang Zhao-Li, Xu Zhen, Yang Shi-Kun, Huang Jin-Gui, Huang Feng-Mei, Shi Yu-Mei
Department of Nursing, Chongqing University Cancer Hospital, Chongqing, 400030, People's Republic of China.
Department of Medical Oncology, Chongqing University Cancer Hospital, Chongqing, 400030, People's Republic of China.
Cancer Manag Res. 2024 Aug 27;16:1077-1090. doi: 10.2147/CMAR.S470862. eCollection 2024.
The purpose of this study is to understand the level of quality of life (QOL) of lung cancer patients receiving immunotherapy and to clarify the potential mediating role of self-perceived burden (SPB) in the relationship between financial toxicity (FT) and QOL.
A convenience sample of 342 lung cancer patients receiving immunotherapy was recruited from a cancer hospital from October 2022 to April 2023 for this cross-sectional study. The participants were requested to complete the following structured questionnaires: a sociodemographic and clinical questionnaire, the Functional Assessment of Cancer Therapy-Lung (FACT-L), the Self-Perceived Burden Scale (SPBS) and the COmprehensive Score for Financial Toxicity (COST). The data were subjected to Pearson correlation analysis and bootstrapping analysis in structural equation modelling.
The total FACT-L score was 79.90±15.84 points in 322 lung cancer patients receiving immunotherapy. FT ( = 0.37, < 0.01) and SPB ( = -0.27, < 0.01) had a direct effect on QOL. In addition, SPB partly mediated the association between FT and QOL, and the standardized indirect effect was 0.19, accounting for 33.9% of the total effect.
The present study revealed that there is still much room for improvement in the QOL of lung cancer patients during immunotherapy. A greater financial burden resulted in a greater self-perceived burden and was thus associated with inferior QOL. It is imperative for oncology nurses to routinely assess QOL, FT or risk and SPB for lung cancer patients undergoing immunotherapy as well as to assist those patients in understanding the potential financial risk of each choice and help them take more active roles in their routine clinical care.
本研究旨在了解接受免疫治疗的肺癌患者的生活质量（QOL）水平，并阐明自我感知负担（SPB）在财务毒性（FT）与QOL关系中的潜在中介作用。
2022年10月至2023年4月，从一家癌症医院招募了342例接受免疫治疗的肺癌患者作为便利样本，进行这项横断面研究。要求参与者完成以下结构化问卷：社会人口统计学和临床问卷、癌症治疗功能评估-肺癌（FACT-L）、自我感知负担量表（SPBS）和财务毒性综合评分（COST）。对数据进行Pearson相关分析和结构方程模型中的Bootstrapping分析。
322例接受免疫治疗的肺癌患者的FACT-L总分为79.90±15.84分。FT（=0.37，<0.01）和SPB（=-0.27，<0.01）对QOL有直接影响。此外，SPB部分介导了FT与QOL之间的关联，标准化间接效应为0.19，占总效应的33.9%。
本研究表明，肺癌患者在免疫治疗期间的QOL仍有很大提升空间。更大的经济负担导致更大的自我感知负担，从而与较差的QOL相关。肿瘤护士必须定期评估接受免疫治疗的肺癌患者的QOL、FT或风险以及SPB，并协助这些患者了解每种选择的潜在财务风险，帮助他们在日常临床护理中发挥更积极的作用。
