Patients' perceptions of the side-effects of prostate cancer treatment - A qualitative interview study
Patients' perceptions of the side-effects of prostate cancer treatment - A qualitative interview study
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DOI：
10.1016/j.socscimed.2006.01.027
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发表时间：
2006-08-01
影响因子：
5.4
通讯作者：
Essink-Bot, Marie-Louise
中科院分区：
文献类型：
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作者：
Korfage, Ida Joanna;Hak, Tony;Essink-Bot, Marie-Louise
原发性前列腺癌治疗通常导致泌尿、肠道和/或性功能不佳。这些影响并非不可避免。治疗后，患者通常报告较高的健康相关生活质量（QoL）评分。疾病特异性和通用结果之间的这种差异提出了一个问题，即副作用实际上对患者有什么意义。在一项定性研究中，我们探讨了两种可能解释这种差异的机制：通用生活质量指标对这些特定症状的不敏感性和对健康变化的适应性（反应转移）。在半结构化的采访，33例前列腺癌患者在荷兰，我们收集了他们的意见，关于健康和生活质量的数据，我们观察了受访者的行为时，完成健康状况和生活质量问卷，并征求意见生活质量问卷，其项目，其内容的有效性。我们观察到，患者轻视性（dys）功能是指老年。我们发现，虽然他们可能会考虑性，泌尿和肠道功能障碍的问题，他们没有考虑这些功能障碍时，完成生活质量的措施，因为他们不认为这些功能障碍的健康方面。这一发现揭示了一个迄今为止尚未确定的原因，即健康状况的一般措施不敏感。此外，反应转变似乎存在：许多患者接受了前列腺癌治疗的不可避免的后果，他们认为这种情况危及生命。我们的结论是，通用生活质量的措施不能揭示性，泌尿和肠道功能障碍对患者的影响，因为这些功能障碍不被视为健康问题。通过介绍这些发现，我们希望引起人们对一般情况下，特别是前列腺癌患者生活质量评估复杂化的问题的注意。(c)2006爱思唯尔有限公司保留所有权利。
Primary prostate cancer treatment often results in suboptimal urinary, bowel and/or sexual function. These effects are not inevitable. After treatment patients typically report high health related quality of life (QoL) scores. This discrepancy between disease-specific and generic results raises the question which meaning side effects actually have to patients. In a qualitative study we explored two mechanisms which could possibly explain the discrepancy: insensitivity of generic QoL measures to these specific symptoms and adaptation to changed health (response shift). In semi-structured interviews with 33 prostate cancer patients in the Netherlands we collected data on their opinions regarding health and QoL, we observed how respondents behaved when completing health status and QoL questionnaires, and solicited comments on a QoL questionnaire, its items, and its content validity. We observed that patients trivialized sexual (dys) function referring to old age. We found that while they might consider sexual, urinary, and bowel dysfunctions as problems, they did not take such dysfunctions into account when completing QoL measures because they did not view these dysfunctions as aspects of health. This finding reveals a so far unidentified cause of the insensitivity of generic measures of health status.Furthermore, response shift appeared to be present: many patients accepted the side effects as inevitable consequences of having been treated for prostate cancer, a condition they perceived as life threatening. We conclude that generic QoL measures cannot reveal the impact of sexual, urinary and bowel dysfunctions on patients because such dysfunctions are not perceived as health problems. By presenting these findings we want to draw attention to issues that complicate QoL assessments in general and in prostate cancer patients in particular. (c) 2006 Elsevier Ltd. All rights reserved.