Health-Related Quality of Life Among Long-Term Rectal Cancer Survivors With an Ostomy: Manifestations by Sex
Health-Related Quality of Life Among Long-Term Rectal Cancer Survivors With an Ostomy: Manifestations by Sex
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DOI：
10.1200/jco.2008.20.9502
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发表时间：
2009-10-01
影响因子：
45.3
通讯作者：
Hornbrook, Mark C.
中科院分区：
文献类型：
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作者：
Krouse, Robert S.;Herrinton, Lisa J.;Hornbrook, Mark C.
目的肠造口可能会给长期（>= 5 年）直肠癌 (RC) 幸存者带来重大挑战。明确常见的挑战和社会人口统计学或临床差异将进一步制定量身定制的干预措施，以改善健康相关的生活质量 (HRQOL)。 患者和方法这是一项在三个 Kaiser Permanente 地区对长期 RC 幸存者进行的匹配横断面研究。邮寄的调查问卷包括修改后的希望之城生活质量造口术 (mCOH-QOL-造口术) 和医疗结果研究 36 项简短健康调查，版本 2 (SF-36v2)。接受调查的群体是永久性造口者（病例）和不需要造口者（对照组）。 RC 幸存者在性别、年龄和诊断后时间上进行了匹配。组间比较采用回归分析，并调整了年龄、合并症评分、放射治疗史、收入和工作状态。结果缓解率为 54%（909 人中有 491 人）。病例和对照具有相似的人口特征。根据 mCOH-QOL-造口术，与对照组相比，男性和女性病例的社会幸福感均显着较差，而只有女性病例的总体 HRQOL 和心理健康状况显着较差。对于年轻女性（<75 岁）来说，与老年女性相比，造口术对身体健康的影响更大。基于 SF-36v2，在八个量表中的七个以及身体和精神成分总结分数上观察到女性病例和对照之间具有统计显着性和有意义的差异。结论男性和女性报告了不同的挑战概况，表明需要有针对性或针对性别的干预措施来改善该人群的 HRQOL。这可能包括关注 75 岁以下女性造口幸存者的身体 HRQOL。
PurposeIntestinal stomas can pose significant challenges for long-term (>= 5 years) rectal cancer (RC) survivors. Specifying common challenges and sociodemographic or clinical differences will further the development of tailored interventions to improve health-related quality of life (HRQOL).Patients and MethodsThis was a matched cross-sectional study of long-term RC survivors conducted in three Kaiser Permanente regions. The mailed questionnaire included the modified City of Hope Quality of Life-Ostomy (mCOH-QOL-Ostomy) and Medical Outcomes Study 36-Item Short-Form Health Survey, version 2 (SF-36v2). Groups surveyed were permanent ostomates (cases) and those who did not require an ostomy (controls). RC survivors were matched on sex, age, and time since diagnosis. Comparisons between groups used regression analysis with adjustment for age, comorbidity score, history of radiation therapy, income, and work status.ResultsResponse rate was 54% (491 of 909). Cases and controls had similar demographic characteristics. On the basis of the mCOH-QOL-Ostomy, both male and female cases had significantly worse social well-being compared with controls, while only female cases reported significantly worse overall HRQOL and psychological well-being. For younger females (< age 75 years), ostomy had a greater impact on physical well-being compared with older females. Based on the SF-36v2, statistically significant and meaningful differences between female cases and controls were observed for seven of the eight scales and on the physical and mental component summary scores.ConclusionMen and women report a different profile of challenges, suggesting the need for targeted or sex-specific interventions to improve HRQOL in this population. This may include focus on physical HRQOL for female ostomy survivors younger than age 75.