The impact of prostate cancer diagnosis and treatment decision-making on health-related quality of life before treatment onset
The impact of prostate cancer diagnosis and treatment decision-making on health-related quality of life before treatment onset
复制标题
DOI：
10.1007/s00520-017-3953-8
复制
发表时间：
2018-04-01
影响因子：
3.1
通讯作者：
Kil, Paul J. M.
中科院分区：
文献类型：
--
作者：
Cuypers, Maarten;Lamers, Romy E. D.;Kil, Paul J. M.
本研究的目的是测试患者的健康相关生活质量（HRQoL）是否在前列腺活检检测Pca后下降，以及在确认Pca后的后续治疗决策后下降，并测试人格状态和特质是否与HRQoL的这些潜在变化相关。计划进行前列腺活检以检测Pca的患者（N = 377）填写关于HRQoL（EORTC QLQ-C30和PR 25）、“大五”人格特质（BFI-10）、乐观（LOT-r）和自我效能（决策自我效能量表）的基线问卷（t0）。确诊Pca的患者（N = 126）在选择治疗后2周内填写了HRQoL随访问卷，但尚未开始治疗（t1）。HRQoL在t0和t1之间下降，反映在角色和认知功能受损，疲劳、便秘和前列腺特异性症状增加。性活动和功能改善。基线HRQoL评分与特定治疗的选择无关，但对于选择治愈性治疗的患者，与选择主动监测的患者相比，决定后HRQoL下降幅度更大。乐观与基线时的HRQoL相关;决策自我效能与随访时的HRQoL呈正相关。HRQoL和“大五”人格特征之间没有相关性。接受前列腺活检和决定治疗Pca的患者HRQoL下降。选择以治愈为目的的治疗与HRQoL的更大下降相关。针对乐观和决策自我效能的干预可能有助于减少前列腺活检和治疗决策时的HRQoL损害。
The objective of this study is to test if patients' health-related quality of life (HRQoL) declines after prostate biopsy to detect Pca, and after subsequent treatment decision-making in case Pca is confirmed, and to test whether personality state and traits are associated with these potential changes in HRQoL.Patients who were scheduled for prostate biopsy to detect Pca (N = 377) filled out a baseline questionnaire about HRQoL (EORTC QLQ-C30 and PR25), "big five" personality traits (BFI-10), optimism (LOT-r), and self-efficacy (Decision Self-efficacy Scale) (t0). Patients with confirmed Pca (N = 126) filled out a follow-up questionnaire on HRQoL within 2 weeks after treatment was chosen but had not yet started (t1).HRQoL declined between t0 and t1, reflected in impaired role and cognitive functioning, and elevated fatigue, constipation, and prostate-specific symptoms. Sexual activity and functioning improved. Baseline HRQoL scores were unrelated to the selection of a particular treatment, but for patients who chose a curative treatment, post-decision HRQoL showed a greater decline compared to patients who chose active surveillance. Optimism was associated with HRQoL at baseline; decisional self-efficacy was positively associated with HRQoL at follow-up. No associations between HRQoL and the "big five" personality traits were found.Patients who have undergone prostate biopsy and treatment decision-making for Pca experience a decline in HRQoL. Choosing treatment with a curative intent was associated with greater decline in HRQoL. Interventions aimed at optimism and decision self-efficacy could be helpful to reduce HRQoL impairment around the time of prostate biopsy and treatment decision-making.