Ethnic variation in return to baseline values of patient-reported outcomes in older prostate cancer patients
Ethnic variation in return to baseline values of patient-reported outcomes in older prostate cancer patients
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DOI：
10.1002/cncr.22675
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发表时间：
2007-06-01
期刊：
影响因子：
6.2
通讯作者：
Malkowicz, S. Bruce
中科院分区：
文献类型：
--
作者：
Jayadevappa, Ravishankar;Johnson, Jerry C.;Malkowicz, S. Bruce
背景。患者报告的结果的种族差异，例如健康相关的生活质量 (HRQoL) 和护理满意度，是老年前列腺癌 (PCa) 患者管理中尚未研究的领域。方法。在这项 2002 年至 2004 年间的前瞻性队列研究中，作者从城市学术医院和退伍军人管理局医院招募了 214 名新诊断为前列腺癌的老年（≥ 65 岁）男性。参与者在基线以及 3、6 和 12 个月的随访时完成了一般 (SF-36)、前列腺特异性 (UCLA-PCI) HRQoL 和护理满意度 (CSQ-8) 调查。使用临床显着差异来计算基线恢复。作者使用方差分析和对数线性模型控制混杂变量后，比较了返回基线 HRQoL 的时间。生存曲线用于比较不同种族恢复到基线的时间。 结果。回归分析显示，年龄和婚姻状况有关，而不是种族。是根治性前列腺切除术的独立预测因子。而不是放射治疗。非裔美国人在诊断时报告 HRQoL 评分较低，并且需要更长的时间才能恢复到基线。对数线性分析表明，非裔美国人种族与身体角色（比值比 [OR]，0.46；标准误 [SE]，0.40）、情感角色（OR，0.37；SE，0.43）、身体疼痛（OR，0.74；SE，0.10）、泌尿功能（OR，0.90；SE，0.11）和泌尿问题的 12 个月得分较低相关。 （OR，0.72；SE，0.17）。两组对护理的满意度均较高。结论。非裔美国老年人的预后较差，需要更长的时间才能恢复到基线 HRQoL。这些差异凸显了在治疗前与患者和家属讨论期望以及治疗后支持服务的需要的必要性。
BACKGROUND. Ethnic variation in patient-reported outcomes such as health-related quality of life (HRQoL) and satisfaction with care are understudied areas in the management of elderly prostate cancer (PCa) patients.METHODS. In this prospective cohort study, between the years 2002 and 2004, the authors recruited 214 older (>= 65 years) men with newly diagnosed PCa from an urban academic hospital and a Veterans Administration hospital. Participants completed generic (SF-36), prostate-specific (UCLA-PCI) HRQoL, and satisfaction with care (CSQ-8) surveys at baseline and at 3, 6, and 12-months follow-up. Clinically significant difference was used to compute return to baseline. The authors compared time to return to baseline HRQoL after controlling for confounding variables by using ANOVA and log-linear models. Survival curves were used to compare time to return to baseline across ethnicity.RESULTS. Regression analysis revealed that age and marital status, not ethnicity. were independent predictors of radical prostatectomy. rather than radiation treatment. African Americans reported lower HRQoL scores at diagnosis and required a longer time to return to baseline. Log-linear analysis indicated that African-American ethnicity was associated with lower 12-month scores for role physical (odds ratio [OR], 0.46; standard error [SE], 0.40), role emotional (OR, 0.37; SE, 0.43), bodily pain (OR, 0.74; SE, 0.10), urinary function (OR, 0.90; SE, 0.11), and urinary bother (OR, 0.72; SE, 0.17). Both groups reported comparably high levels of satisfaction with care.CONCLUSIONS. African-American elderly exhibited poorer outcomes and required a longer time to return to baseline HRQoL. These differences highlight the need for discussion with patients and families prior to treatment about expectations and the need for support services post-treatment.