EFFECT OF RADICAL PROSTATECTOMY FOR PROSTATE-CANCER ON PATIENT QUALITY-OF-LIFE - RESULTS FROM A MEDICARE SURVEY
EFFECT OF RADICAL PROSTATECTOMY FOR PROSTATE-CANCER ON PATIENT QUALITY-OF-LIFE - RESULTS FROM A MEDICARE SURVEY
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DOI：
10.1016/s0090-4295(99)80122-8
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发表时间：
1995-06-01
期刊：
影响因子：
2.1
通讯作者：
WENNBERG, J
中科院分区：
文献类型：
--
作者：
FOWLER, FJ;BARRY, MJ;WENNBERG, J
目标。目的：评价根治性前列腺切除术的疗效。通过邮件、电话和个人访谈，对全国1072名因前列腺癌接受根治性前列腺切除术的医疗保险患者（1988 - 1990）进行了抽样调查。通过以下方式研究手术及其并发症对患者生活的影响：(1)患者对性功能障碍和泌尿功能障碍在其生活中的“问题”程度的评分；(2)生活质量的两项一般指标，即心理健康指数和一般健康指数；(3)患者报告他们对治疗结果的感觉以及他们是否会再次选择手术。平均而言，尿滴对患者的影响比性功能丧失更大，尤其是在受试者戴上尿垫的情况下；尿失禁对生活质量的测量和自我报告的手术结果有显著的不良影响。总体而言，术后患者在生活质量指标上得分相对较高（类似于经尿道前列腺切除术的良性前列腺增生患者队列），报告对结果感到积极（81%），并会再次选择手术治疗（89%）。然而，患者对手术效果的反应存在差异。结果表明，许多医疗保险患者有能力适应不良后果，如性功能丧失和尿失禁。他们还提供了个体患者对手术结果反应的可变性的证据，并加强了个性化决策对面临根治性前列腺癌患者决策的重要性。
Objectives. To assess patient responses to radical prostatectomy and its effects.Methods. A national sample was taken of 1072 Medicare patients who underwent radical prostatectomy for prostate cancer (1988 through 1990) by mail, telephone, and personal interviews. The effects of the surgery and its complications On these patients' lives were studied through: (1) patient ratings of the extent to which sexual and urinary dysfunctions were ''problems'' in their lives; (2) two general measures of quality of life, the Mental Health Index and the General Health Index; (3) patient reports of how they felt about the results of treatment and whether they would choose surgery again.Results. On average, dripping urine, particularly to the point where subjects were wearing pads, had a more significant effect on patients than loss of sexual function; incontinence had significant adverse effects on the measures of quality of life and self-reported results of surgery. Overall, postsurgical patients scored comparatively high on the quality of life measures (similar to a cohort of patients with benigh prostatic hyperplasia who had undergone transurethral resection of the prostate), reported feeling positive about the results (81%), and would choose surgical treatment again (89%). Nonetheless, there was variability in patient response to the effects of surgery.Conclusions. The results demonstrate the ability of many Medicare patients to adapt to adverse outcomes, such as loss of sexual function and incontinence. They also provide evidence of the variability of individual patients' responses to surgical results and reinforce the importance of individualized decision making for patients facing a decision about radical prostatectomy for prostate cancer.