Min Xiao, Xi Chen, Lei Ji, Xiaoyan Qian, Meng Xiu, Zhuoran Li, Heng Cao, Shanshan Chen, Qing Li, Qiao Li, Xiang Wang, Jiani Wang, Yiqun Li, Xiaojuan Zheng, Pin Zhang
{"title":"老年乳腺癌患者的衰弱患病率及其对生活质量的影响：一项前瞻性横断面研究。","authors":"Min Xiao, Xi Chen, Lei Ji, Xiaoyan Qian, Meng Xiu, Zhuoran Li, Heng Cao, Shanshan Chen, Qing Li, Qiao Li, Xiang Wang, Jiani Wang, Yiqun Li, Xiaojuan Zheng, Pin Zhang","doi":"10.1111/jocn.17599","DOIUrl":null,"url":null,"abstract":"<p><strong>Aims: </strong>To evaluate the prevalence of frailty and its impact on quality of life (QoL) in older Chinese breast cancer (BC) patients, which have not been thoroughly reported in this population.</p><p><strong>Design: </strong>A prospective multi-centre cross-sectional registry study.</p><p><strong>Data sources: </strong>Data were collected from Cancer Hospital of the Chinese Academy of Medical Sciences, Peking University Third Hospital and Beijing Chaoyang District San Huan Cancer Hospital between October 2021 and July 2023.</p><p><strong>Methods: </strong>BC patients aged over 65 years were enrolled in this study. They completed three assessment scales including the FRAIL scale, Hospital Anxiety and Depression Scale (HADS) and European Organization for Research and Treatment of Cancer Quality of Life questionnaire Core 30 (EORTC QLQ-C30), to screen for frailty, related factors and QoL. Clinical and pathological data were also collected. Analysis of frailty and prefrailty risk factors was performed via logistic regression. A multivariable linear regression model was used to evaluate the mean differences in scores for each QoL domain between patients with different frailty statuses.</p><p><strong>Results: </strong>A total of 946 patients were enrolled from three hospitals in Beijing between October 2021 and July 2023. Their median age was 69 years and 73.6% of them had early-stage breast cancer. Further, 37.2% of these patients had ≥ 1 comorbidity. The prevalence of frailty was 8.8% and frailty was more common in those with aged ≥ 75 years (22.3%), those with advanced tumours (15.6%), those with anxiety (31.3%) and those with depression (29.3%). More than half (57.2%) of the patients were prefrail. Regression analysis revealed that older age (odds ratio [OR] 1.12 [95% CI 1.07-1.17], p < 0.001), an advanced tumour (OR 2.27 [1.33-3.89], p = 0.003), anxiety (OR 2.74 [1.37-5.48], p = 0.004) and depression (OR 3.84 [1.97-7.49], p < 0.001) were significantly associated with frailty. After adjusting for other factors, different frailty states were shown to be independent influencing factors for QoL in both the functional and the symptom domains (all p < 0.05).</p><p><strong>Conclusions: </strong>Our study provides data on the prevalence of frailty and prefrailty in older Chinese patients with BC. Both conditions are closely related to poor QoL. It is helpful for oncologist and clinical care to making intervention and better treatment decisions.</p><p><strong>Reporting method: </strong>The study adhered to the STROBE checklist.</p><p><strong>Implications for the profession and patient care: </strong>This study provides detailed data on the prevalence of frailty in older Chinese patients with BC and correlative factors. It suggests that clinical care should fully assess patients' frailty before making treatment decisions and provide early intervention for related factors.</p><p><strong>Patient or public contribution: </strong>Patients participated in the implementation of the project (including the informed consent and questionnaire process). No other public contribution to this research.</p><p><strong>Relevance to clinical practice: </strong>This study provides data on the prevalence of frailty in Chinese older BC patients and correlative factors. It indicates that clinicians should fully assess patients' frailty before making treatment decisions and provide early intervention for related factors.</p><p><strong>Trial registration: </strong>ChiCTR2200056070.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.2000,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Prevalence of Frailty and Its Impact on Quality of Life in Older Patients With Breast Cancer: A Prospective Cross-Sectional Study.\",\"authors\":\"Min Xiao, Xi Chen, Lei Ji, Xiaoyan Qian, Meng Xiu, Zhuoran Li, Heng Cao, Shanshan Chen, Qing Li, Qiao Li, Xiang Wang, Jiani Wang, Yiqun Li, Xiaojuan Zheng, Pin Zhang\",\"doi\":\"10.1111/jocn.17599\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aims: </strong>To evaluate the prevalence of frailty and its impact on quality of life (QoL) in older Chinese breast cancer (BC) patients, which have not been thoroughly reported in this population.</p><p><strong>Design: </strong>A prospective multi-centre cross-sectional registry study.</p><p><strong>Data sources: </strong>Data were collected from Cancer Hospital of the Chinese Academy of Medical Sciences, Peking University Third Hospital and Beijing Chaoyang District San Huan Cancer Hospital between October 2021 and July 2023.</p><p><strong>Methods: </strong>BC patients aged over 65 years were enrolled in this study. They completed three assessment scales including the FRAIL scale, Hospital Anxiety and Depression Scale (HADS) and European Organization for Research and Treatment of Cancer Quality of Life questionnaire Core 30 (EORTC QLQ-C30), to screen for frailty, related factors and QoL. Clinical and pathological data were also collected. Analysis of frailty and prefrailty risk factors was performed via logistic regression. A multivariable linear regression model was used to evaluate the mean differences in scores for each QoL domain between patients with different frailty statuses.</p><p><strong>Results: </strong>A total of 946 patients were enrolled from three hospitals in Beijing between October 2021 and July 2023. Their median age was 69 years and 73.6% of them had early-stage breast cancer. Further, 37.2% of these patients had ≥ 1 comorbidity. The prevalence of frailty was 8.8% and frailty was more common in those with aged ≥ 75 years (22.3%), those with advanced tumours (15.6%), those with anxiety (31.3%) and those with depression (29.3%). More than half (57.2%) of the patients were prefrail. Regression analysis revealed that older age (odds ratio [OR] 1.12 [95% CI 1.07-1.17], p < 0.001), an advanced tumour (OR 2.27 [1.33-3.89], p = 0.003), anxiety (OR 2.74 [1.37-5.48], p = 0.004) and depression (OR 3.84 [1.97-7.49], p < 0.001) were significantly associated with frailty. After adjusting for other factors, different frailty states were shown to be independent influencing factors for QoL in both the functional and the symptom domains (all p < 0.05).</p><p><strong>Conclusions: </strong>Our study provides data on the prevalence of frailty and prefrailty in older Chinese patients with BC. Both conditions are closely related to poor QoL. 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引用次数: 0
摘要
目的：评估中国老年乳腺癌（BC）患者的虚弱患病率及其对生活质量（QoL）的影响，这在该人群中尚未得到全面报道。设计：前瞻性多中心横断面登记研究。数据来源：数据来自中国医学科学院肿瘤医院、北京大学第三医院和北京市朝阳区三环肿瘤医院，时间为2021年10月- 2023年7月。方法：65岁以上的BC患者入组。他们完成了虚弱量表、医院焦虑抑郁量表（HADS）和欧洲癌症研究与治疗组织生活质量问卷核心30 （EORTC QLQ-C30）三个评估量表，以筛选虚弱、相关因素和生活质量。同时收集临床及病理资料。通过逻辑回归分析脆弱和脆弱的危险因素。采用多变量线性回归模型评价不同虚弱状态患者各生活质量域评分的平均差异。结果：2021年10月至2023年7月，北京三家医院共纳入946例患者。她们的中位年龄为69岁，73.6%的人患有早期乳腺癌。此外，37.2%的患者有≥1个合并症。虚弱的患病率为8.8%，在年龄≥75岁（22.3%）、晚期肿瘤（15.6%）、焦虑（31.3%）和抑郁（29.3%）患者中更为常见。超过一半（57.2%）的患者是虚弱的。回归分析显示年龄较大（优势比[OR] 1.12 [95% CI 1.07-1.17], p）。结论：我们的研究提供了中国老年BC患者虚弱和易患性患病率的数据。这两种情况都与不良的生活质量密切相关。有助于肿瘤学家和临床护理人员做出干预和更好的治疗决策。报告方法：本研究遵循STROBE检查表。对专业和患者护理的启示：本研究提供了中国老年BC患者虚弱患病率及相关因素的详细数据。提示临床护理在做出治疗决策前应充分评估患者的虚弱程度，并对相关因素进行早期干预。患者或公众贡献：患者参与项目实施（包括知情同意和问卷调查过程）。没有其他公众对这项研究的贡献。与临床实践的相关性：本研究提供了中国老年BC患者虚弱患病率及相关因素的数据。提示临床医生在做出治疗决策前应充分评估患者的虚弱程度，并对相关因素进行早期干预。试验注册：ChiCTR2200056070。
Prevalence of Frailty and Its Impact on Quality of Life in Older Patients With Breast Cancer: A Prospective Cross-Sectional Study.
Aims: To evaluate the prevalence of frailty and its impact on quality of life (QoL) in older Chinese breast cancer (BC) patients, which have not been thoroughly reported in this population.
Design: A prospective multi-centre cross-sectional registry study.
Data sources: Data were collected from Cancer Hospital of the Chinese Academy of Medical Sciences, Peking University Third Hospital and Beijing Chaoyang District San Huan Cancer Hospital between October 2021 and July 2023.
Methods: BC patients aged over 65 years were enrolled in this study. They completed three assessment scales including the FRAIL scale, Hospital Anxiety and Depression Scale (HADS) and European Organization for Research and Treatment of Cancer Quality of Life questionnaire Core 30 (EORTC QLQ-C30), to screen for frailty, related factors and QoL. Clinical and pathological data were also collected. Analysis of frailty and prefrailty risk factors was performed via logistic regression. A multivariable linear regression model was used to evaluate the mean differences in scores for each QoL domain between patients with different frailty statuses.
Results: A total of 946 patients were enrolled from three hospitals in Beijing between October 2021 and July 2023. Their median age was 69 years and 73.6% of them had early-stage breast cancer. Further, 37.2% of these patients had ≥ 1 comorbidity. The prevalence of frailty was 8.8% and frailty was more common in those with aged ≥ 75 years (22.3%), those with advanced tumours (15.6%), those with anxiety (31.3%) and those with depression (29.3%). More than half (57.2%) of the patients were prefrail. Regression analysis revealed that older age (odds ratio [OR] 1.12 [95% CI 1.07-1.17], p < 0.001), an advanced tumour (OR 2.27 [1.33-3.89], p = 0.003), anxiety (OR 2.74 [1.37-5.48], p = 0.004) and depression (OR 3.84 [1.97-7.49], p < 0.001) were significantly associated with frailty. After adjusting for other factors, different frailty states were shown to be independent influencing factors for QoL in both the functional and the symptom domains (all p < 0.05).
Conclusions: Our study provides data on the prevalence of frailty and prefrailty in older Chinese patients with BC. Both conditions are closely related to poor QoL. It is helpful for oncologist and clinical care to making intervention and better treatment decisions.
Reporting method: The study adhered to the STROBE checklist.
Implications for the profession and patient care: This study provides detailed data on the prevalence of frailty in older Chinese patients with BC and correlative factors. It suggests that clinical care should fully assess patients' frailty before making treatment decisions and provide early intervention for related factors.
Patient or public contribution: Patients participated in the implementation of the project (including the informed consent and questionnaire process). No other public contribution to this research.
Relevance to clinical practice: This study provides data on the prevalence of frailty in Chinese older BC patients and correlative factors. It indicates that clinicians should fully assess patients' frailty before making treatment decisions and provide early intervention for related factors.
期刊介绍：
The Journal of Clinical Nursing (JCN) is an international, peer reviewed, scientific journal that seeks to promote the development and exchange of knowledge that is directly relevant to all spheres of nursing practice. The primary aim is to promote a high standard of clinically related scholarship which advances and supports the practice and discipline of nursing. The Journal also aims to promote the international exchange of ideas and experience that draws from the different cultures in which practice takes place. Further, JCN seeks to enrich insight into clinical need and the implications for nursing intervention and models of service delivery. Emphasis is placed on promoting critical debate on the art and science of nursing practice.
JCN is essential reading for anyone involved in nursing practice, whether clinicians, researchers, educators, managers, policy makers, or students. The development of clinical practice and the changing patterns of inter-professional working are also central to JCN''s scope of interest. Contributions are welcomed from other health professionals on issues that have a direct impact on nursing practice.
We publish high quality papers from across the methodological spectrum that make an important and novel contribution to the field of clinical nursing (regardless of where care is provided), and which demonstrate clinical application and international relevance.
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