Hinz Andreas, Wedding Ulrich, Schulte Thomas, Friedrich Michael, Mehnert-Theuerkauf Anja, Schnabel Astrid, Lordick Florian
Department of Medical Psychology and Medical Sociology, Comprehensive Cancer Center Central Germany, University Medical Center Leipzig, Leipzig, Germany.
Department of Palliative Care, Comprehensive Cancer Center Central Germany, Jena University Hospital, Jena, Germany.
Front Psychol. 2025 Jun 5;16:1439655. doi: 10.3389/fpsyg.2025.1439655. eCollection 2025.
Quality of life (QoL) has become a relevant outcome criterion in oncology in general and in palliative care in particular. The aims of this study were to compare the QoL of cancer patients receiving palliative care with groups of mixed cancer patients and with the general population, and to test whether response shift effects influence the assessment of QoL.
This study included data from several cross-sectional investigations: one sample of 152 cancer patients receiving palliative care, two samples of patients with mixed cancer diagnoses ( > 500), and two samples of the general population ( > 1,000). QoL was assessed with the EORTC QLQ-C30 and with two anchoring vignettes for identifying response shift.
QoL was highest in the general population (EORTC QLQ-C30 mean sum score = 87.4), followed by the mixed cancer patients ( = 70.9) and the palliative care group ( = 58.2). Both groups of cancer patients rated the anchoring vignette, which presented a subject with mainly physical problems, as being healthier than the general population did.
The results show in which specific dimensions advanced cancer patients report strong detriments in QoL. The different assessments of the vignettes indicate a response shift effect so that the cancer patients have changed their frames of reference for assessing QoL in such a way that they indicate less severe restrictions. This means that the reductions in QoL in cancer patients, as measured with standard questionnaires, tend to underestimate the true detriments.
生活质量（QoL）已成为肿瘤学领域尤其是姑息治疗中一项重要的结果指标。本研究旨在比较接受姑息治疗的癌症患者与混合癌症患者群体以及普通人群的生活质量，并检验反应转移效应是否会影响生活质量的评估。
本研究纳入了多项横断面调查的数据：一个样本为152名接受姑息治疗的癌症患者，两个样本为混合癌症诊断患者（>500名），以及两个普通人群样本（>1000名）。使用欧洲癌症研究与治疗组织生活质量核心问卷（EORTC QLQ-C30）和两个用于识别反应转移的锚定 vignettes 对生活质量进行评估。
普通人群的生活质量最高（EORTC QLQ-C30平均总分=87.4），其次是混合癌症患者（=70.9）和姑息治疗组（=58.2）。两组癌症患者对主要呈现身体问题的锚定 vignette 的评分均高于普通人群。
结果显示了晚期癌症患者在生活质量的哪些具体维度上报告有严重损害。对 vignettes 的不同评估表明存在反应转移效应，即癌症患者改变了他们评估生活质量的参照框架，从而表明限制程度较轻。这意味着用标准问卷测量的癌症患者生活质量的降低往往低估了实际损害。
