监测前列腺癌幸存者的健康相关生活质量和症状:一项随机试验

Kimberly M Davis, David Dawson, Scott Kelly, Sara Red, Sofiya Penek, John Lynch, Sean Collins, Barlow Lynch, Michael Porrazzo, Michael Bass, Kathryn L Taylor
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引用次数: 13

摘要

背景:常规症状和健康相关生活质量(HRQOL)评估可以吸引患者,给予提供者反馈,并改善医患沟通。目的:比较技术辅助症状监测系统与常规护理对早期前列腺癌(PCa)幸存者HRQOL和医患沟通的影响。方法:男性94例,平均年龄62岁,多为非洲裔美国人(AA;61.7%),治疗后10-19个月。患者随机分为症状监测加反馈组(SM + F;n = 49)或常规护理(UC;N = 45)。SM+F参与者完成了12项电话辅助监测干预。所有参与者完成了一次基线和两次随访访谈。结果:在SM+F参与者中,对监测系统的看法是积极的:97.1%的人认为它容易/非常容易使用,85%的人认为所有患者都可以从中受益。在基线时,男性报告了良好的一般和癌症特异性HRQOL和医患沟通,但较差的泌尿和性功能。虽然没有干预的总体影响,但事后探索性分析表明,在AA男性中,接受SM+F的患者在医患沟通(P < 0.05)、总体HRQOL (P < 0.05)和性功能(P < 0.05)方面相对于UC有改善。局限性:幸存者随访护理的可变性,获得符合条件的参与者的机会有限,以及使用报告的医生培训很少,可能会减少医生的投资。结论:总体而言,前列腺癌幸存者接受该监测系统。探索性分析表明,这种技术辅助监测系统可能对非洲裔美国人特别有益。进一步的研究需要更大的样本,更多的干预时间点,并增加医生培训,以加强干预的影响。
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Monitoring of health-related quality of life and symptoms in prostate cancer survivors: a randomized trial.

Background: Routine symptom and health-related quality of life (HRQOL) assessments can engage patients, give provider feedback, and improve doctor/patient communication.

Objective: We compared the impact of a technology-assisted symptom monitoring system versus usual care on HRQOL and doctor/patient communication in early-stage prostate cancer (PCa) survivors.

Methods: Men (N = 94) were on average 62-years old, mostly African American (AA; 61.7%), and 10-19 months post-treatment. They were randomized to symptom monitoring plus feedback (SM + F; n = 49) or usual care (UC; n = 45). SM+F participants completed a 12-item telephoneassisted monitoring intervention. All participants completed a baseline and 2 follow-up interviews.

Results: Among the SM+F participants, perceptions of the monitoring system were positive: 97.1% endorsed it as easy/very easy to use and 85% felt all patients could benefit from it. At baseline, men reported favorable general and cancer-specific HRQOL and doctor/patient communication, but poorer urinary and sexual function. Although there was no overall impact of the intervention, post hoc exploratory analyses indicated that among AA men, those who received SM+F improved relative to UC on doctor/patient communication (P < .05), general HRQOL (P < .06), and sexual function (P < .05).

Limitations: Variability in survivor follow-up care, limited access to eligible participants, and minimal physician training in the use of reports likely decreased physician investment.

Conclusion: Overall, PCa survivors were receptive to this monitoring system. Exploratory analyses suggest that this technology-assisted monitoring system may be of particular benefit to African American men. Additional studies with larger samples, more intervention time-points, and increased physician training are needed to strengthen the intervention's impact.

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Measuring the quality of palliative care and supportive oncology: principles and practice. Illness perceptions matter: understanding quality of life and advanced illness behaviors in female patients with late-stage cancer. Monitoring of health-related quality of life and symptoms in prostate cancer survivors: a randomized trial. Characterization of skin reactions and pain reported by patients receiving radiation therapy for cancer at different sites. Whole brain radiotherapy for poor prognosis patients with brain metastases: predictably poor results.
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