Predictors of health-related quality of life in neurosurgical brain tumor patients: focus on patient-centered perspective
Predictors of health-related quality of life in neurosurgical brain tumor patients: focus on patient-centered perspective
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DOI：
10.1007/s00701-013-1930-7
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发表时间：
2014-02-01
影响因子：
2.4
通讯作者：
Bunevicius, Robertas
中科院分区：
文献类型：
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作者：
Bunevicius, Adomas;Tamasauskas, Sarunas;Bunevicius, Robertas
在脑肿瘤（BT）患者中，健康相关生活质量（HRQoL）和心理特征之间的关联在很大程度上仍然未知。我们评估了BT患者的人格特征、临床因素、心理困扰症状和认知状态与HRQoL的关系。（妇女占69%;年龄55.8 ± 14.5岁）进行HRQoL评价（SF-36量表），大五人格特质（十项人格量表），心理困扰症状（医院焦虑和抑郁量表或HADS），认知功能（简易精神状态检查或MMSE）和临床特征，包括功能状态（Barthel指数或BI）。最常见的BT诊断是脑膜瘤（39%）和高级别胶质瘤（18%）。只有在单变量回归分析中与SF-36领域显著相关的因素才被纳入各自的多变量模型，并从SF-36评分总方差的6%-49%进行预测。更高的TIPI情绪稳定性评分与更高的SF-36情绪健康（beta = 0.23，p < 0.001）和一般健康（beta = 0.18，p = 0.01）评分独立相关，更高的TIPI意识评分与更高的SF-36情绪健康评分独立相关（beta = 0.13，p = 0.02）。除身体功能外，HADS焦虑和HADS抑郁评分是所有SF-36评分中最强的独立决定因素（β值范围为0.14 - 0.56; p值为0.03）。BI评分是SF-36身体功能评分的最强独立决定因素（β = 0.36，p < 0.001）。MMSE评分与除情绪健康和社会功能SF-36评分外的所有评分相关。意识和情绪稳定性应被视为BT患者HRQoL的重要人格相关决定因素。心理困扰、功能障碍和认知障碍也是HRQoL的重要预测因素。
In brain tumor (BT) patients, the association between health-related quality of life (HRQoL) and psychological characteristics remains largely unknown. We evaluated the association of personality traits, clinical factors, psychological distress symptoms, and cognitive state with HRQoL in BT patients.On admission for BT surgery, 200 patients (69 % women; age 55.8 +/- 14.5 years) were evaluated for HRQoL (SF-36 scale), Big-Five personality traits (Ten-Item Personality Inventory), psychological distress symptoms (Hospital Anxiety and Depression Scale or HADS), cognitive function (Mini-Mental State Examination or MMSE) and clinical characteristics, including functional status (Barthel index or BI). The most common BT diagnoses were meningioma (39 %) and high-grade glioma (18 %).Only factors significantly associated with SF-36 domains in univariable regression analyses were included in their respective multivariable models and predicted from 6 %-49 % of the total variance of SF-36 scores. Greater TIPI emotional stability score was independently associated with greater SF-36 emotional well-being (beta = 0.23, p < 0.001) and general health (beta = 0.18, p = 0.01) scores, and greater TIPI consciousness score, with greater SF-36 emotional well-being score (beta = 0.13, p = 0.02). HADS-anxiety and HADS-depression scores were the strongest independent determinants of all, except physical functioning, SF-36 scores (beta-values range from 0.14 to 0.56; p values a parts per thousand currency signaEuro parts per thousand 0.03). BI score was the strongest independent determinant of SF-36 physical functioning score (beta = 0.36, p < 0.001). MMSE score was associated with all but emotional well-being and social functioning SF-36 scores.Consciousness and emotional stability should be considered important personality-related determinants of HRQoL in BT patients. Psychological distress, functional disability, and cognitive impairment are also important predictors of HRQoL.