Health-related quality of life and psychological distress among cancer survivors in Southeast Asia: results from a longitudinal study in eight low- and middle-income countries.
Health-related quality of life and psychological distress among cancer survivors in Southeast Asia: results from a longitudinal study in eight low- and middle-income countries.
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DOI：
10.1186/s12916-016-0768-2
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发表时间：
2017-01-13
期刊：
影响因子：
9.3
通讯作者：
ACTION Study Group
中科院分区：
文献类型：
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作者：
ACTION Study Group
更好地了解癌症幸存者的健康相关生活质量（HRQoL）和心理困扰可以提高认识，促进癌症幸存者护理政策的制定，并促进低收入和中等收入国家（LMIC）更有针对性地使用有限的资源。因此，本文的主要目的是评估东南亚癌症幸存者的HRQoL和心理困扰的患病率，并确定这些结果的危险因素。ACTION研究是一项在东南亚8个LMIC中进行的纵向研究，在诊断后1年随访了5249名首次癌症幸存者。使用EORTC QLQ-C30和EQ-5D评估HRQoL。使用医院焦虑和抑郁量表评估心理困扰（焦虑和抑郁）。一般线性模型和多元Logistic回归被用来确定HRQoL和心理困扰的独立预测因素。诊断后一年，幸存者的平均EORTC QLQ-C30总体健康评分为66.2/100（SD 22.0），EQ-5D的平均指数评分为0.74（SD 0.23），37%的幸存者至少有轻度焦虑，46%的幸存者至少有轻度抑郁。肺癌和淋巴瘤患者的HRQoL最差，焦虑和抑郁的患病率最高，而女性乳腺癌和宫颈癌患者的HRQoL得分最高，心理困扰最少。HRQoL和心理困扰结果较差的最重要预测因素是诊断时的癌症分期。年龄、合并症、治疗和一些社会经济因素与HRQoL和心理困扰相关。东南亚中低收入国家的癌症幸存者HRQoL受损，相当大比例的人有心理困扰。诊断时癌症分期为晚期的患者和社会经济地位较差的患者最有可能出现这种不良结局。需要为癌症患者提供支持性干预措施，解决患者福祉的更广泛方面，以及解决及时治疗的财务和其他障碍的政策。本文的在线版本（doi：10.1186/s12916-016-0768-2）包含补充材料，可供授权用户使用。
A better understanding of health-related quality of life (HRQoL) and psychological distress in cancer survivors can raise awareness, promote the development of policies in cancer survivorship care, and facilitate better targeted use of limited resources in low- and middle-income countries (LMICs). The main objectives of this paper were therefore to assess HRQoL and the prevalence of psychological distress amongst cancer survivors in Southeast Asia and identify risk factors of these outcomes. The ACTION study was a longitudinal study in eight LMICs in Southeast Asia with 5249 first time cancer survivors followed up at 1 year after diagnosis. HRQoL was assessed using the EORTC QLQ-C30 and EQ-5D. Psychological distress (anxiety and depression) was assessed using the Hospital Anxiety and Depression Scale. General linear models and multiple logistic regression were used to identify independent predictors of HRQoL and psychological distress. One year after diagnosis, the mean EORTC QLQ-C30 global health score for survivors was 66.2 out of 100 (SD 22.0), the mean index score on the EQ-5D was 0.74 (SD 0.23), 37% of survivors had at least mild levels of anxiety, and 46% showed at least mild levels of depression. Poorest HRQoL and highest prevalence of anxiety and depression were seen in patients with lung cancer and lymphomas, while highest scores and least psychological distress were seen in female patients with breast and cervical cancer. The most significant predictor of poor HRQoL and psychological distress outcomes was cancer stage at diagnosis. Age, co-morbidities, treatment, and several socioeconomic factors were associated with HRQoL and psychological distress. Cancer survivors in LMICs in Southeast Asia have impaired HRQoL and substantial proportions have psychological distress. Patients with advanced cancer stages at diagnosis and those in a poor socioeconomic position were most at risk of such poor outcomes. Supportive interventions for cancer patients that address wider aspects of patient wellbeing are needed, as well as policies that address financial and other barriers to timely treatment. The online version of this article (doi:10.1186/s12916-016-0768-2) contains supplementary material, which is available to authorized users.