Herbert Saskia-Laureen, Payerl A S, Prange M, Löb S, Büchel J, Scherer-Quenzer A, Kiesel M, Wöckel A, Faller H, Meng K
Department of Obstetrics and Gynaecology, University Medical Centre Würzburg, Josef-Schneider-Straße 8, 97080, Würzburg, Germany.
Department of Obstetrics and Gynaecology, Regiomed Kliniken, Coburg, Germany.
Arch Gynecol Obstet. 2025 Feb;311(2):467-479. doi: 10.1007/s00404-024-07805-7. Epub 2024 Nov 22.
Although therapy and psychosocial care for patients with breast cancer and gynaecological cancer has improved in the last years, there are still many issues that require further investigation. Unmet supportive care needs can lead to a lower adherence to treatment and a lower quality of life. Patients' needs seem to be highest during the time of treatment. Thus, this study investigated needs and quality of life.
In this German prospective study, we enrolled 292 patients with breast cancer and gynaecological cancer during the time of treatment. Data on needs were assessed using instruments that had proven feasible in earlier studies. Data on quality of life (QoL) were assessed using the European Organization for Research and Treatment of Cancer QoL Core Questionnaire (EORTC QLQ-C30). We investigated correlations between needs and sociodemographic data as well as quality of life.
Among all cancer entities we observed that 150 patients (51.5%) showed unmet information needs, 221 patients (75.7%) showed at least one high supportive care need, and 91 patients (31.2%) had psychological care needs. Data showed statistically significant correlations between these needs and sociodemographic data as well as quality of life. These correlations generally showed small to medium effect sizes. Older women showed less supportive care needs (r = - 0.24; p < 0.001), (r = - 0.15; p = 0.010). Furthermore, recruitment after surgery was associated with statistically significant higher information needs (r = 0.14; p = 0.015), whereas recruitment during chemotherapy was associated with statistically significant less information needs (r = - 0.15; p = 0.013). Positive correlations were shown for the level of received information and physical functioning (r = 0.12; p = 0.047), social functioning (r = 0.16; p = 0.009) and global quality of life (r = 0.19, p = 0.002) as well as satisfaction with information and physical (r = 0.16; p = 0.006), social (r = 0.24; p < 0.001), cognitive functioning (r = 0.14; p = 0.017) as well as global quality of life (r = 0.25; p < 0.001). Negative correlations were reported for information needs and emotional functioning (r = - 0.12; p = 0.035) and global quality of life (r = - 0.15; p = 0.011). Supportive care needs also correlated negatively with physical (r = - 0.23; p < 0.001), role (r = - 0.23; p < 0.001), emotional (r = - 0.35; p < 0.001), cognitive (r = - 0.24; p < 0.001), social functioning (r = - 0.30; p < 0.001), and global quality of life (r = - 0.35; p < 0.001). Also, patients with at least one high supportive care need correlated negatively with role (r = - 0.15; p = 0.014), emotional (r = - 0.23; p < 0.001), social functioning (r = - 0.30; p = 0.001), and global quality of life (r = - 0.35; p < 0.001). There was no statistical significance concerning cancer side. Thus, both groups are reported together. Furthermore, there was no statistical significance concerning disease status.
Overall, this study highlights the importance of tailored information and supportive care interventions. Addressing these needs, particularly in terms of information provision and psychosocial support, could lead to improved quality of life and better overall patient outcomes.
尽管近年来乳腺癌和妇科癌症患者的治疗及心理社会护理有所改善,但仍有许多问题需要进一步研究。未满足的支持性护理需求可能导致治疗依从性降低和生活质量下降。患者的需求似乎在治疗期间最为强烈。因此,本研究调查了需求和生活质量。
在这项德国前瞻性研究中,我们招募了292名处于治疗期的乳腺癌和妇科癌症患者。使用在早期研究中已证明可行的工具评估需求数据。使用欧洲癌症研究与治疗组织生活质量核心问卷(EORTC QLQ - C30)评估生活质量(QoL)数据。我们调查了需求与社会人口统计学数据以及生活质量之间的相关性。
在所有癌症类型中,我们观察到150名患者(51.5%)存在未满足的信息需求,221名患者(75.7%)至少有一项高度的支持性护理需求,91名患者(31.2%)有心理护理需求。数据显示这些需求与社会人口统计学数据以及生活质量之间存在统计学上的显著相关性。这些相关性总体显示出小到中等的效应量。老年女性的支持性护理需求较少(r = - 0.24;p < 0.001),(r = - 0.15;p = 0.010)。此外,术后入组与统计学上显著更高的信息需求相关(r = 0.14;p = 0.015),而化疗期间入组与统计学上显著更少的信息需求相关(r = - 0.15;p = 0.013)。所接收信息的水平与身体功能(r = 0.12;p = 0.047)、社会功能(r = 0.16;p = 0.009)和总体生活质量(r = 0.19,p = 0.002)以及对信息的满意度与身体(r = 0.16;p = 0.006)、社会(r = 0.24;p < 0.001)、认知功能(r = 0.14;p = 0.017)以及总体生活质量(r = 0.25;p < 0.001)之间呈正相关。信息需求与情绪功能(r = - 0.12;p = 0.035)和总体生活质量(r = - 0.15;p = 0.011)之间呈负相关。支持性护理需求也与身体(r = - 0.23;p < 0.001)、角色(r = - 0.23;p < 0.001)、情绪(r = - 0.35;p < 0.001)、认知(r = - 0.24;p < 0.001)、社会功能(r = - 0.30;p < 0.001)以及总体生活质量(r = - 0.35;p < 0.001)呈负相关。此外,至少有一项高度支持性护理需求的患者与角色(r = - 0.15;p = 0.014)、情绪(r = - 0.23;p < 0.001)、社会功能(r = - 0.30;p = 0.001)以及总体生活质量(r = - 0.35;p < 0.001)呈负相关。癌症类型方面无统计学意义。因此,两组一起报告。此外,疾病状态方面也无统计学意义。
总体而言,本研究强调了量身定制的信息和支持性护理干预的重要性。满足这些需求,特别是在信息提供和心理社会支持方面,可能会提高生活质量并改善患者的总体结局。