Ferrell B R, Grant M, Funk B, Garcia N, Otis-Green S, Schaffner M L
City of Hope National Medical Center, Duarte CA 91010, USA.
Cancer Pract. 1996 Nov-Dec;4(6):331-40.
Currently, 1,721,700 women are living with breast cancer in the United States. As the number of survivors of breast cancer continues to rise, so must our knowledge about unique quality-of-life concerns. This article reports the results of a study on quality of life in women with breast cancer and validates the model of quality of life in this population.
To explore these concerns and to validate a breast cancer quality-of-life model, 21 survivors of breast cancer, across three age strata (younger than 40 years, 40 to 60 years, and older than 60 years), were interviewed and asked to complete quantitative surveys on pain and quality of life.
Across all age groups, unique issues of survivorship include those related to physical, psychological, social, and spiritual well-being. In the domain of physical well-being, the areas of worst outcome were in menstrual changes and fertility, fatigue, and pain. In the domain of psychological well-being, predominant needs were in the areas of fear of the spread of cancer, distress from surgery, recurrence, fear of second cancer, impact on self-concept, and fear of future tests. The social well-being subscale identified the greatest disruption in the area of family distress. The spiritual well-being subscale showed greatest disruption in the area of uncertainty, although other aspects of this domain were usually rated in a positive direction (e.g., importance of religious activities).
The data demonstrated the need for further research, assessment, and intervention across each of the quality-of-life domains. There is a significant need to address physical problems; however, the psychological domain demonstrated the greatest area of distress. The multidimensional needs of breast cancer survivors emphasize the need for multidisciplinary collaboration.
目前,美国有172.17万名女性患有乳腺癌。随着乳腺癌幸存者数量持续增加,我们对其独特的生活质量问题的了解也必须相应增加。本文报告了一项关于乳腺癌女性生活质量的研究结果,并验证了该人群的生活质量模型。
为了探究这些问题并验证乳腺癌生活质量模型,我们采访了21名乳腺癌幸存者,她们分属三个年龄层(40岁以下、40至60岁、60岁以上),并要求她们完成关于疼痛和生活质量的定量调查。
在所有年龄组中,幸存者面临的独特问题包括与身体、心理、社会和精神健康相关的问题。在身体健康领域,最差的结果出现在月经变化与生育、疲劳和疼痛方面。在心理健康领域,主要需求集中在对癌症扩散的恐惧、手术带来的痛苦、复发、对二次患癌的恐惧、对自我概念的影响以及对未来检查的恐惧。社会健康子量表显示,家庭困扰领域受到的干扰最大。精神健康子量表显示,不确定性领域受到的干扰最大,不过该领域的其他方面通常评分呈积极方向(例如宗教活动的重要性)。
数据表明需要在生活质量的各个领域进行进一步研究、评估和干预。解决身体问题的需求非常迫切;然而,心理领域显示出痛苦程度最高。乳腺癌幸存者的多维度需求强调了多学科协作的必要性。