Whitton A C, Rhydderch H, Furlong W, Feeny D, Barr R D
Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.
Cancer. 1997 Jul 15;80(2):258-65.
The comprehensive health status of adult survivors of brain tumors is largely unexplored.
Using a multiattribute approach embodied in a 15-item self-assessment questionnaire, the overall burden of morbidity was measured in 50 brain tumor patients who were attending a neurooncology outpatient clinic. The comprehensive health status was accorded utility scores, and comparisons were made with health status measurements of the general population.
The questionnaire was completed with ease by 90% of the respondents. Among the respondents, only 10% of the patients did not report some form of morbidity, and 80% reported multiple impairments. The most prevalent impairments occurred in the attributes of sensation, emotion, and cognition (in this predominantly ambulant group); each of these elements was limited in the majority of patients. A surprising finding was the self-report of pain by nearly 50% of the respondents.
In this group of patients, the burden of morbidity and its complexity greatly exceeded that reported for the general population and were inadequately revealed by Karnofsky performance scores. The use of multiattribute health status measurement tools offers numerous advantages and should be employed in the routine clinical management of cancer patients.
脑肿瘤成年幸存者的综合健康状况在很大程度上尚未得到研究。
采用一份包含15个项目的自我评估问卷所体现的多属性方法,对50名前往神经肿瘤门诊就诊的脑肿瘤患者的总体发病负担进行了测量。综合健康状况被赋予效用分数,并与普通人群的健康状况测量结果进行了比较。
90%的受访者轻松完成了问卷。在受访者中,只有10%的患者未报告某种形式的发病情况,80%的患者报告有多种功能障碍。最常见的功能障碍出现在感觉、情绪和认知方面(在这个以能行走为主的群体中);这些方面在大多数患者中都受到了限制。一个令人惊讶的发现是,近50%的受访者自述有疼痛。
在这组患者中,发病负担及其复杂性大大超过了普通人群报告的情况,且卡诺夫斯基表现评分未能充分体现这些情况。使用多属性健康状况测量工具具有诸多优势,应在癌症患者的常规临床管理中加以应用。