A five-year prospective study of quality of life after colorectal cancer
A five-year prospective study of quality of life after colorectal cancer
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DOI：
10.1007/s11136-011-0067-5
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发表时间：
2012-11-01
影响因子：
3.5
通讯作者：
Baade, Peter
中科院分区：
文献类型：
--
作者：
Chambers, Suzanne K.;Meng, Xingqiong;Baade, Peter
目的 结直肠癌术后的长期（>= 5 年）生活质量尚未得到很好的描述。本研究评估了结直肠癌幸存者 5 年以上的生活质量 (QOL) 和心理困扰，以描述随时间的变化和长期结果的前因。方法对 763 名结直肠癌患者进行了一项基于人群的前瞻性调查，评估了诊断后 5 个月的社会人口统计学变量、健康行为、乐观情绪、威胁评估和感知社会支持，作为 5 年 QOL 和心理困扰的预测因素 诊断后。结果 QOL 随着时间的推移而改善（每项测量 P < 0.01）；然而，心理困扰的测量值保持稳定（每项测量 P < 0.07）。生活质量较差和/或心理困扰较大的风险因素包括：疾病晚期、永久性造口、直肠癌、疲劳、吸烟、单身、社会支持度低、乐观度低以及对癌症威胁的评估更为消极。作为女性、养宠物、拥有私人健康保险、接受手术和辅助治疗具有保护作用。 结论 与反应转移理论一致，结直肠癌术后生活质量的影响因素是多因素的，包括易感的社会人口、医学和心理变量。针对社会支持和威胁评估的心理社会干预可能对该患者群体有效。对于来自社会环境较差、有多种适应能力较差的风险因素的人，可能需要额外的支持。卫生系统的影响需要进一步调查。
Purpose Long-term (>= 5 years) quality of life after colorectal cancer is not well described. The present study assessed quality of life (QOL) and psychological distress in colorectal cancer survivors more than 5 years to describe changes over time and antecedents of long-term outcomes.Method A prospective survey of a population-based sample of 763 colorectal cancer patients assessed socio-demographic variables, health behaviors, optimism, threat appraisal, and perceived social support at 5 months post-diagnosis as predictors of QOL and psychological distress 5 years post-diagnosis.Results QOL improved over time (P < 0.01 for each measure); however, measures of psychological distress remained stable (P < 0.07 for each measure). Risk factors for poorer QOL and/or greater psychological distress included: later stage disease, having a permanent stoma, rectal cancer, fatigue, smoking, being single, low social support, low optimism, and a more negative cancer threat appraisal. Being women, having a pet, having a private health insurance, and receiving both surgery and adjuvant treatment were protective.Conclusion Consistent with response shift theory, the antecedents of QOL after colorectal cancer are multifactorial and include predisposing socio-demographic, medical, and psychological variables. Psychosocial interventions that target both social support and threat appraisal may be effective for this patient group. Additional stepped-up support may be needed for people from a poorer social environment who have multiple risk factors for poorer adjustment. Health system effects require further investigation.