Pathomjaruwat Thitiporn, Matchim Yaowarat, Armer Jane M
Faculty of Nursing, Thammasat University, Pathum Thani, Thailand.
Sinclair School of Nursing, University of Missouri, Columbia, USA.
Belitung Nurs J. 2025 Aug 3;11(4):370-383. doi: 10.33546/bnj.3853. eCollection 2025.
Health-related quality of life (HRQoL) is a critical indicator in individuals with cancer. Patients diagnosed with hepatocellular carcinoma (HCC) commonly experience a decline in HRQoL due to both the progression of the disease and the adverse effects associated with treatment. Despite the high prevalence of HCC in Thailand, there is a paucity of research examining the HRQoL of Thai patients and the factors that may influence it.
This study aimed to examine HRQoL in Thai patients with HCC and evaluated the relationships between disease stage, comorbidities, albumin level, functional status (FS), self-management behaviors (SMBs), and HRQoL.
A correlational, cross-sectional study was conducted with 408 patients with HCC recruited from six hospitals in central Thailand between April and September 2024. Data collection included demographic and clinical information, along with the Functional Assessment of Cancer Therapy-Hepatobiliary (FACT-Hep) scale, Inventory of Functional Status-Cancer (IFS-CA), and the SMB scale for patients with HCC. All instruments were validated and reliable. Data were analyzed using descriptive statistics and multiple regression analysis.
Most participants were at intermediate (38.97%) or advanced (24.26%) stages of HCC. Overall HRQoL was high (mean FACT-Hep score = 147.92 ± 26.09). Disease stage, comorbidities, albumin level, FS, and SMBs were all significantly correlated with HRQoL ( = 0.771). Together, these factors explained 58.9% of the variance in HRQoL ( = 0.589, = 117.745, <0.001). Significant predictors of HRQoL included disease stage (β = -0.116), comorbidities (β = -0.080), albumin level (β = 0.278), FS (β = 0.388), and SMBs (β = 0.296). Among these, FS was the strongest predictor.
Improving self-management behaviors, functional status, and nutritional status shows promise for enhancing HRQoL in patients with HCC. These findings can guide nurses in developing interventions to support patients with HCC and improve their quality of life.
健康相关生活质量（HRQoL）是癌症患者的一项关键指标。被诊断为肝细胞癌（HCC）的患者通常会因疾病进展和治疗相关不良反应而出现HRQoL下降。尽管泰国HCC的患病率很高，但针对泰国患者的HRQoL及其可能影响因素的研究却很少。
本研究旨在调查泰国HCC患者的HRQoL，并评估疾病分期、合并症、白蛋白水平、功能状态（FS）、自我管理行为（SMBs）与HRQoL之间的关系。
2024年4月至9月，对从泰国中部六家医院招募的408例HCC患者进行了一项相关性横断面研究。数据收集包括人口统计学和临床信息，以及癌症治疗-肝胆功能评估（FACT-Hep）量表、癌症功能状态量表（IFS-CA）和HCC患者的SMB量表。所有工具均经过验证且可靠。数据采用描述性统计和多元回归分析。
大多数参与者处于HCC的中期（38.97%）或晚期（24.26%）。总体HRQoL较高（FACT-Hep平均得分=147.92±26.09）。疾病分期、合并症、白蛋白水平、FS和SMBs均与HRQoL显著相关（=0.771）。这些因素共同解释了HRQoL方差的58.9%（=0.589，=117.745，<0.001）。HRQoL的显著预测因素包括疾病分期（β=-0.116）、合并症（β=-0.080）、白蛋白水平（β=0.278）、FS（β=0.388）和SMBs（β=0.296）。其中，FS是最强的预测因素。
改善自我管理行为、功能状态和营养状况有望提高HCC患者的HRQoL。这些发现可为护士制定支持HCC患者并改善其生活质量的干预措施提供指导。
