Kasai H
Department of Anesthesiology, Hokkaido University School of Medicine, Sapporo, Japan.
Hokkaido Igaku Zasshi. 1994 Mar;69(2):282-92.
A new assessment of quality of life (QOL) was made for cancer patients. The QOL assessment consists of 12 items: pain; nausea; constipation; general fatigue; sleep; eating; activity; a daily life pattern; conversation; treatment acceptability; satisfaction at the present status and family exhaustion. Ranges of scores are one (best) to five (worst). For visual expression of QOL, the author made an original method called "QOL diagram", drawn with a circle which has 12 diverging lines marked five points indicating the score for each item. QOL changes after cancer pain control with either oral or intravenous morphine were examined in 22 adult cancer patients by the QOL assessment. Laxatives and anti-nausea drugs were mostly prescribed at the same time in order to avoid side effects of morphine. QOL was evaluated and recorded by the author through an individual interview with each patient. It was observed that the psychological factors were improved along with pain relief. Although items such as general fatigue, nausea, constipation, sleep and eating did not change considerably at first, they improved well with time in the oral morphine group. On the other hand, there was no marked time-dependent change in the intravenous morphine group. Items such as activity, a daily life pattern and conversation were rather negative than positive. These items seem to be more important to improve QOL of the cancer patients, in particular, whose general status is relatively good. In conclusion, the QOL diagram helped us to follow subtle changes of status and needs of cancer patients. And it enables us to easily assess risks and benefits of the treatment plans including palliative care and home supportive programs. It is designed for both patients and medical staffs to use easily and repeatedly. However, the further evaluation and refinement will be needed to verify validity and reliability of the QOL diagram before a routine clinical application.
对癌症患者进行了一项新的生活质量（QOL）评估。生活质量评估包括12个项目：疼痛、恶心、便秘、全身疲劳、睡眠、饮食、活动、日常生活模式、交谈、治疗可接受性、对现状的满意度以及家庭疲惫感。分数范围为1分（最佳）至5分（最差）。为了直观呈现生活质量，作者设计了一种名为“生活质量图”的原创方法，该图由一个圆圈构成，圆圈上有12条发散线，每条线标有5个点，分别代表每个项目的得分。通过生活质量评估，对22名成年癌症患者口服或静脉注射吗啡控制癌痛后的生活质量变化进行了研究。为避免吗啡的副作用，大多同时开具了泻药和抗恶心药物。作者通过与每位患者单独面谈来评估和记录生活质量。结果发现，随着疼痛缓解，心理因素也得到改善。虽然全身疲劳、恶心、便秘、睡眠和饮食等项目起初变化不大，但口服吗啡组随着时间推移有明显改善。另一方面，静脉注射吗啡组没有明显的时间依赖性变化。活动、日常生活模式和交谈等项目呈现负面而非正面变化。这些项目对于改善癌症患者的生活质量似乎更为重要，尤其是对于一般状况相对较好的患者。总之，生活质量图有助于我们跟踪癌症患者状况和需求的细微变化。它使我们能够轻松评估包括姑息治疗和家庭支持项目在内的治疗方案的风险和益处。它的设计便于患者和医护人员轻松且反复使用。然而，在常规临床应用之前，还需要进一步评估和完善，以验证生活质量图的有效性和可靠性。
