行姑息治疗的肺癌患者生活质量及其影响因素的调查研究
|
摘要
背景肺癌是我国发病率和病死率最高的恶性肿瘤,而大多数患者确诊时已处于中晚期。近年来随着生物-心理-社会医学模式的转变,肺癌患者生活质量受到临床关注。目的调查分析行姑息治疗的肺癌患者生活质量及其影响因素。方法 2018年4—8月,采用便利抽样方法选取山东大学附属千佛山医院、山东省肿瘤医院、山东省中医院3家三级甲等医院中行姑息治疗的肺癌患者150例。自制一般情况调查表,采用现场调查方法收集患者一般情况(包括性别、年龄、婚姻状况、居住地、文化程度、吸烟史、家庭月收入及肿瘤病理类型、肿瘤分型、肿瘤病理分期、肿瘤分化程度),采用ECOG评分标准评估患者整体健康水平,采用肺癌患者生存质量测定量表FACT-L中文版(V4.0)评估患者生活质量。行姑息治疗的肺癌患者生活质量评分相关因素分析采用多元逐步线性回归分析。结果(1)本研究共发放150份问卷,有效问卷回收率为96%(144/150)。本组患者生活质量总评分(74.47±15.46)分。(2)不同性别、婚姻状况、居住地、文化程度、家庭月收入、肿瘤病理类型、肿瘤分型、肿瘤病理分期、肿瘤分化程度及有无吸烟史患者生活质量评分比较,差异无统计学意义(P>0.05);不同年龄、ECOG分级患者生活质量评分比较,差异有统计学意义(P<0.05)。(3)多元逐步线性回归分析结果显示,ECOG评分与行姑息治疗的肺癌患者生活质量评分呈负相关(β=-4.550,P<0.05)。结论行姑息治疗的肺癌患者生活质量较低,而ECOG评分是患者生活质量的独立影响因素。
Background Lung cancer is one of malignant tumors with the highest morbidity and mortality in China,while most patients are often diagnosed with mid or late stage of lung cancer. In recent years,with the change of bio-psycho-social medical model,quality of life in patients with lung cancer had attracted clinical attention. Objective To investigate the quality of life and its influencing factors in lung cancer patients treated with palliative therapy. Methods From April to August 2018,a total of 150 patients with lung cancer who received palliative therapy were selected from Qianfoshan Hospital Affiliated to Shandong University,Shandong Provincial Cancer Hospital and Shandong Provincial Traditional Chinese Medicine Hospital. Self-made General Information Questionnaire was used to collect general information(including gender,ages,marital status,habitual residence,educational levels,history of smoking,family monthly income,tumor pathological types,tumor types,pathological stages or degrees of cancer) by field investigation,Eastern Cooperative Oncology Group(ECOG)score was used to assess the overall health status,and Chinese Version Functional Assessment of Cancer Therapy-Lung(FACT-L)(V4.0)was used to assess the quality of life. Multivariate stepwise linear regression analysis was used to analyze the influencing factors of quality of life score in patients with lung cancer treated with palliative treatment. Results(1)A total of 150 questionnaires were sent out in this study,and the effective response rate was 96%(144/150). Total score of quality of life of the 144 patients was(74.47±15.46).(2)There was no statistically significant difference in quality of life score in patients with different gender,marital status,habitual residence,educational levels,family monthly income,pathological types,tumor types,pathological stages or degrees of cancer differentiation,with history of smoking or not(P>0.05);there was statistically significant difference in quality of life score in patients with different ages and ECOG grades,respectively(P<0.05).(3)Multivariate stepwise linear regression analysis showed that,ECOG score was negatively correlated with quality of life score in lung cancer patients treated with palliative therapy(β=-4.550,P<0.05). Conclusion Quality of life is at a low level in lung cancer patients treated with palliative therapy,and ECOG score is an independent influencing factor of the quality of life.
Background Lung cancer is one of malignant tumors with the highest morbidity and mortality in China,while most patients are often diagnosed with mid or late stage of lung cancer. In recent years,with the change of bio-psycho-social medical model,quality of life in patients with lung cancer had attracted clinical attention. Objective To investigate the quality of life and its influencing factors in lung cancer patients treated with palliative therapy. Methods From April to August 2018,a total of 150 patients with lung cancer who received palliative therapy were selected from Qianfoshan Hospital Affiliated to Shandong University,Shandong Provincial Cancer Hospital and Shandong Provincial Traditional Chinese Medicine Hospital. Self-made General Information Questionnaire was used to collect general information(including gender,ages,marital status,habitual residence,educational levels,history of smoking,family monthly income,tumor pathological types,tumor types,pathological stages or degrees of cancer) by field investigation,Eastern Cooperative Oncology Group(ECOG)score was used to assess the overall health status,and Chinese Version Functional Assessment of Cancer Therapy-Lung(FACT-L)(V4.0)was used to assess the quality of life. Multivariate stepwise linear regression analysis was used to analyze the influencing factors of quality of life score in patients with lung cancer treated with palliative treatment. Results(1)A total of 150 questionnaires were sent out in this study,and the effective response rate was 96%(144/150). Total score of quality of life of the 144 patients was(74.47±15.46).(2)There was no statistically significant difference in quality of life score in patients with different gender,marital status,habitual residence,educational levels,family monthly income,pathological types,tumor types,pathological stages or degrees of cancer differentiation,with history of smoking or not(P>0.05);there was statistically significant difference in quality of life score in patients with different ages and ECOG grades,respectively(P<0.05).(3)Multivariate stepwise linear regression analysis showed that,ECOG score was negatively correlated with quality of life score in lung cancer patients treated with palliative therapy(β=-4.550,P<0.05). Conclusion Quality of life is at a low level in lung cancer patients treated with palliative therapy,and ECOG score is an independent influencing factor of the quality of life.
引文
[1]陈万青,孙可欣,郑荣寿,等.2014年中国分地区恶性肿瘤发病和死亡分析[J].中国肿瘤,2018,27(1):1-14.DOI:10.11735/j.issn.1004-0242.2018.01.A001.
[2]TEMEL J S,GREER J A,MUZIKANSKY A,et al.Early palliative care for patients with metastatic non-small-cell lung cancer[J].NEnglJMed,2010,363(9):733-742.DOI:10.1056/NEJMoa1000678.
[3]全科医生小词典——姑息治疗[J].中国全科医学,2018,21(2):248.
[4]BRAUN D P,GUPTA D,STAREN E D.Quality of life assessment as a predictor of survival in non-small cell lung cancer[J].BMC Cancer,2011,11(1):353.DOI:10.1186/1471-2407-11-353.
[5]GUPTA D,BRAUN D P,STAREN E D.Association between changes in quality of life scores and survival in non-small cell lung cancer patients[J].Eur J Cancer Care(Engl),2012,21(5):614-622.DOI:10.1111/j.1365-2354.2012.01332.x.
[6]LI T C,LI C I,CHUN-HUA T,et al.Quality of life predicts survival in patients with non-small cell lung cancer[J].BMC Public Health,2012,12(1):790.DOI:10.1186/1471-2458-12-790.
[7]孟娜,钟媛,刘珊珊,等.晚期肺癌患者症状群及生活质量的调查及相关性分析[J].临床肺科杂志,2018,23(3):433-437.DOI:10.3969/j.issn.1009-6663.2018.03.013.
[8]李琳.肺癌患者治疗期间症状群变化及影响因素研究[D].广州:南方医科大学,2016.
[9]CELLA D F,TULSKY D S,GRAY G,et al.The Functional Assessment of Cancer Therapy scale:development and validation of the general measure[J].J Clin Oncol,1993,11(3):570-579.
[10]FORD D W,KOCH K A,RAY D E,et al.Palliative and endof-life care in lung cancer:Diagnosis and management of lung cancer,3rd ed:American College of Chest Physicians evidencebased clinical practice guidelines[J].Chest,2013,143(5):e498S-512S.DOI:10.1378/chest.12-2367.
[11]POLANSKI J,JANKOWSKA-POLANSKA B,ROSINCZUK J,et al.Quality of life of patients with lung cancer[J].Onco Targets Ther,2016,9:1023-1028.DOI:10.2147/OTT.S100685.
[12]胡莉亚,陈元.肺癌患者生活质量的评价[J].癌症进展,2014,12(4):306-311.DOI:10.11877/j.issn.1672-1535.2014.12.04.01
[13]何亚平,楼玮群,陈杰灵,等.病程12个月及以上非小细胞肺癌患者生活质量评估及影响因素研究[J].上海交通大学学报(医学版),2018,38(7):775-780.DOI:10.3969/j.issn.1674-8115.2018.07.010.
[14]万莉,谢莉玲,王富兰,等.卵巢癌患者症状群与生活质量的动态研究[J].护理学杂志,2015,30(10):16-20.DOI:10.3870/hlxzz.2015.10.016.
[15]ROILAND R A,HEIDRICH S M.Symptom Clusters and Quality of Life in Older Breast Cancer Survivors[J].Oncol Nurs Forum,2011,38(6):672-680.DOI:10.1188/11.onf.672-680.
[16]闫巍,王杰萍,张洪波,等.连续性健康管理对提高老年共病患者生活质量的重要性分析[J].中国全科医学,2018,21(27):3302-3306.DOI:10.12114/j.issn.1007-9572.2018.00.113.
[17]KIM H J,BARSEVICK A M,TULMAN L.Predictors of the intensity of symptoms in a cluster in patients with breast cancer[J].J Nurs Scholarsh,2009,41(2):158-165.DOI:10.1111/j.1547-5069.2009.01267.x.
[2]TEMEL J S,GREER J A,MUZIKANSKY A,et al.Early palliative care for patients with metastatic non-small-cell lung cancer[J].NEnglJMed,2010,363(9):733-742.DOI:10.1056/NEJMoa1000678.
[3]全科医生小词典——姑息治疗[J].中国全科医学,2018,21(2):248.
[4]BRAUN D P,GUPTA D,STAREN E D.Quality of life assessment as a predictor of survival in non-small cell lung cancer[J].BMC Cancer,2011,11(1):353.DOI:10.1186/1471-2407-11-353.
[5]GUPTA D,BRAUN D P,STAREN E D.Association between changes in quality of life scores and survival in non-small cell lung cancer patients[J].Eur J Cancer Care(Engl),2012,21(5):614-622.DOI:10.1111/j.1365-2354.2012.01332.x.
[6]LI T C,LI C I,CHUN-HUA T,et al.Quality of life predicts survival in patients with non-small cell lung cancer[J].BMC Public Health,2012,12(1):790.DOI:10.1186/1471-2458-12-790.
[7]孟娜,钟媛,刘珊珊,等.晚期肺癌患者症状群及生活质量的调查及相关性分析[J].临床肺科杂志,2018,23(3):433-437.DOI:10.3969/j.issn.1009-6663.2018.03.013.
[8]李琳.肺癌患者治疗期间症状群变化及影响因素研究[D].广州:南方医科大学,2016.
[9]CELLA D F,TULSKY D S,GRAY G,et al.The Functional Assessment of Cancer Therapy scale:development and validation of the general measure[J].J Clin Oncol,1993,11(3):570-579.
[10]FORD D W,KOCH K A,RAY D E,et al.Palliative and endof-life care in lung cancer:Diagnosis and management of lung cancer,3rd ed:American College of Chest Physicians evidencebased clinical practice guidelines[J].Chest,2013,143(5):e498S-512S.DOI:10.1378/chest.12-2367.
[11]POLANSKI J,JANKOWSKA-POLANSKA B,ROSINCZUK J,et al.Quality of life of patients with lung cancer[J].Onco Targets Ther,2016,9:1023-1028.DOI:10.2147/OTT.S100685.
[12]胡莉亚,陈元.肺癌患者生活质量的评价[J].癌症进展,2014,12(4):306-311.DOI:10.11877/j.issn.1672-1535.2014.12.04.01
[13]何亚平,楼玮群,陈杰灵,等.病程12个月及以上非小细胞肺癌患者生活质量评估及影响因素研究[J].上海交通大学学报(医学版),2018,38(7):775-780.DOI:10.3969/j.issn.1674-8115.2018.07.010.
[14]万莉,谢莉玲,王富兰,等.卵巢癌患者症状群与生活质量的动态研究[J].护理学杂志,2015,30(10):16-20.DOI:10.3870/hlxzz.2015.10.016.
[15]ROILAND R A,HEIDRICH S M.Symptom Clusters and Quality of Life in Older Breast Cancer Survivors[J].Oncol Nurs Forum,2011,38(6):672-680.DOI:10.1188/11.onf.672-680.
[16]闫巍,王杰萍,张洪波,等.连续性健康管理对提高老年共病患者生活质量的重要性分析[J].中国全科医学,2018,21(27):3302-3306.DOI:10.12114/j.issn.1007-9572.2018.00.113.
[17]KIM H J,BARSEVICK A M,TULMAN L.Predictors of the intensity of symptoms in a cluster in patients with breast cancer[J].J Nurs Scholarsh,2009,41(2):158-165.DOI:10.1111/j.1547-5069.2009.01267.x.