Dimensions of quality of life expressed by men treated for metastatic prostate cancer
Dimensions of quality of life expressed by men treated for metastatic prostate cancer
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DOI：
10.1016/s0277-9536(97)00058-0
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发表时间：
1997-10-01
影响因子：
5.4
通讯作者：
Watkins, H
中科院分区：
文献类型：
--
作者：
Clark, JA;Wray, N;Watkins, H
寻求积极治疗转移性前列腺癌的男性面临着药物或手术去势的选择。虽然这两种替代品都有记录的副作用（例如性欲丧失，乳房增大和压痛，潮热和恶心），但其心理社会影响尚未得到充分了解。作为患者治疗决策研究的一部分，我们试图构建一个以患者为基础的测量方法，测量这些男性在治疗后所经历的显著疾病和治疗相关的生活质量。焦点小组（15名患者，两名妻子）被用来开发候选Likert量表问卷项目，代表患者认为重要的生活质量问题。这些项目与症状评估，合并症，功能状态和福祉的一般措施，在休斯敦VAMC和其他两家休斯顿医院（n = 201，响应率= 63%）治疗的患者的邮件调查相结合。心理测量分析（主成分和多特质量表）被用来确定不同的生活质量的维度;与通用措施的相关性，并在验证分析中使用症状报告。焦点小组数据的定性分析确定了三个主要领域的生活质量：自我认知，焦虑的治疗效果，并与决策和治疗过程中的关注。心理测量学分析确定了9个可靠和有效的指标前列腺癌相关的生活质量：身体形象，性问题，配偶的感情，配偶的担忧，男子气概，癌症相关的自我形象，癌症困扰，癌症接受，治疗决定的遗憾。内部一致性（α）范围为0.71至0.90。与参考量表（如MOS心理健康指数，情绪状态）和症状状态的相关性支持并行效度。前列腺癌患者认为他们的治疗的一些重要的心理社会后果。这些结果由9个量表表示，包括一个简短的（35项）疾病和治疗敏感的健康相关生活质量工具，我们将使用它来监测患者的治疗选择的结果。(C)1997 Elsevier Science Ltd.
Men who pursue active treatment for metastatic prostate cancer face a choice between medical or surgical castration. While both alternatives have documented side-effects (e.g. loss of libido, breast enlargement and tenderness, hot flashes, and nausea), their psychosocial impacts are not well understood. As part of a study of patients' treatment decision making, we have sought to construct a patient-based measure of the salient disease and treatment-related qualities of life experienced by these men subsequent to treatment. Focus groups (15 with patients, two with wives) were used to develop candidate Likert scale questionnaire items representing quality of life issues that patients said were important. These items were combined with assessments of symptoms, comorbidity, and generic measures of functional status and well-being in a mail survey of patients treated at the Houston VAMC and two other Houston hospitals (n = 201, response rate = 63%). Psychometric analyses (principal components and multitrait scaling) were used to identify distinct dimensions of life quality; correlations with generic measures, and symptom reports were used in validation analyses. Qualitative analyses of focus group data identified three major domains of life quality: self-perceptions, anxiety about the effects of treatment, and concern with the process of decision making and treatment. Psychometric analyses identified nine reliable and valid indicators of prostate cancer-related quality of life: body image, sexual problems, spouse affection, spouse worry, masculinity, cancer-related self-image, cancer distress, cancer acceptance, and regret of treatment decision. Internal consistency (alpha) ranged from 0.71 to 0.90. Correlations with reference scales (e.g. MOS Mental Health Index, Profile of Mood States) and symptom status supported concurrent validity. Prostate cancer patients perceive a number of important psychosocial consequences of their treatment. These consequences are represented by nine scales comprising a brief (35 items) disease and treatment sensitive health-related quality of life instrument, which we will use in monitoring the outcomes of patients' treatment choices. (C) 1997 Elsevier Science Ltd.