Knight S J, Chmiel J S, Kuzel T, Sharp L, Albers M, Fine R, Moran E M, Nadler R B, Sharifi R, Bennett C L
Department of Psychiatry, Northwestern University Medical School, Robert H. Lurie Cancer Center and Veterans Affairs Chicago Health Care Systems-Lakeside Division, Illinois, USA.
J Urol. 1998 Nov;160(5):1765-9.
Identification of metastatic disease progression is often difficult but important. Previous studies of quality of life in metastatic disease have been limited by the small number of respondents who were not white or of lower socioeconomic status. Quality of life assessment is generally done using self-administration techniques but this method is of limited usefulness for patients of low socioeconomic status, many of whom have limited reading abilities. We evaluated the feasibility and validity of interviewer administration of 3 quality of life instruments for patients of low socioeconomic status with metastatic prostate cancer.
We used instruments previously validated with self-administration methodology, including the European Organization for Research and Treatment of Cancer-Quality of Life Questionnaire-30, Functional Assessment of Cancer Therapy-General Scale and Quality of Life Index. Subjects were men with metastatic prostate cancer with stable (78) or progressive (32) disease at 4 Veterans Affairs medical centers and 1 other site. Of the patients 94% were Veterans Affairs patients and more than 60% were black.
Each quality of life instrument required less than 10 minutes of interviewer administration and was able to discriminate between patients with stable versus progressive disease on several health status domains.
These data support the feasibility and validity of quality of life measurement in patients of low socioeconomic status with metastatic prostate cancer. Consideration should be given to adding quality of life instruments to patient encounter even among low socioeconomic status, low literacy populations.
识别转移性疾病的进展往往困难但却很重要。先前关于转移性疾病患者生活质量的研究受到样本限制，样本中少数族裔或社会经济地位较低的受访者数量较少。生活质量评估通常采用自我管理技术，但这种方法对社会经济地位较低的患者用处有限，他们中的许多人阅读能力有限。我们评估了由访谈者管理三种生活质量评估工具，用于评估社会经济地位较低的转移性前列腺癌患者的可行性和有效性。
我们使用了先前经自我管理方法验证的工具，包括欧洲癌症研究与治疗组织生活质量问卷-30、癌症治疗功能评估通用量表和生活质量指数。研究对象为在4个退伍军人事务医疗中心和1个其他地点患有转移性前列腺癌且病情稳定（78例）或进展（32例）的男性患者。其中94%的患者为退伍军人事务患者，超过60%为黑人。
每种生活质量评估工具的访谈者管理时间均少于10分钟，并且能够在几个健康状况领域区分病情稳定和进展的患者。
这些数据支持了对社会经济地位较低的转移性前列腺癌患者进行生活质量测量的可行性和有效性。即使在社会经济地位较低、识字率低的人群中，也应考虑在患者诊疗过程中增加生活质量评估工具。
