Impairments, disabilities and health related quality of life after treatment for breast cancer: a follow-up study 2.7 years after surgery
Impairments, disabilities and health related quality of life after treatment for breast cancer: a follow-up study 2.7 years after surgery
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DOI：
10.1080/09638280310001629642
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发表时间：
2004-01-21
影响因子：
2.2
通讯作者：
de Vries, J
中科院分区：
文献类型：
--
作者：
Rietman, J;Dijkstra, P;de Vries, J
目的：本研究的目的是评估乳腺癌治疗后的损伤、残疾和健康相关生活质量（QOL），并分析治疗方式、损伤、残疾和健康相关生活质量之间的关系。方法：对55例行改良根治性乳房切除术或节段性乳房切除术合并腋窝淋巴结清扫术的患者进行回顾性分析，平均随访2.7年。通过测量肩部活动范围、握力、手臂体积和疼痛来评估损伤。通过肩部残疾问卷（SDQ）评估残疾，通过RAND 36项健康调查（RAND-36）评估健康相关生活质量。地点：格罗宁根大学医院（荷兰）。结果：疼痛（60%）和握力降低（40%）是最常见的损伤。活动范围受损和水肿的发生率分别为9% - 16%和15%。SDQ组平均得分为33.7 (sd: 32.1)， RAND-36组生理功能、活力和健康感知的平均得分与女性常模组有显著差异。放疗和化疗是预测活动范围受损的重要因素。疼痛和活动范围受限分别解释了61%的残疾差异（SDQ）。在健康相关生活质量的预测中，疼痛、握力和手臂体积分别在6个、3个和2个域中为显著因素。结论：疼痛是乳腺癌治疗后最常见的评估损害，与感知残疾和健康相关生活质量密切相关。残疾是轻微的，与健康相关的生活质量（RAND-36）在9个领域中的3个领域与女性标准组不同。
Purpose : The aim of this study was to assess impairments, disabilities and health related Quality of Life (QOL) after treatment of breast cancer and to analyse the relationship between treatment modalities, impairments, disabilities and health related QOL.Method : Fifty-five patients who underwent a modified radical mastectomy or a segmental mastectomy with axillary lymph node dissection were retrospectively assessed with a mean follow up of 2.7 years after treatment. Impairments were assessed by means of measuring active shoulder range of motion, grip strength, arm volume and pain. Disabilities were assessed by means of the Shoulder Disability Questionnaire (SDQ) and health related QOL was assessed by means of the RAND 36-item Health Survey (RAND-36).Setting : University Hospital Groningen (The Netherlands).Results : Pain (60%) and reduction of grip-strength (40%) were the most frequent impairments found. The prevalence of impaired range of motion and oedema was 9 - 16% respectively 15%. Mean group score of the SDQ was 33.7 (sd: 32.1) and mean scores of the RAND-36 differed significantly for physical functioning, vitality and health perception to that of a female norm group. Radiotherapy and chemotherapy were significant factors in the prediction of impaired range of motion. Pain and restricted range of motion explained 61% respectively 12% of the variance in disability (SDQ). In the prediction of health related QOL, pain, grip strength and arm volume were significant factors respectively in six, three and two domains.Conclusions : Pain is the most frequent assessed impairment after breast cancer treatment with strong relationship to perceived disability and health related QOL. Disability is mild and health related QOL (RAND-36) differed in three of the nine domains with a female norm group.