局部前列腺癌的种族差异:黑人和白人退伍军人的偏好、乐观和生活质量的初步研究

Sara K. Knight , Amy K. Siston , Joan S. Chmiel , Nicholas Slimack , Arthur S. Elstein , Gretchen B. Chapman , Robert B. Nadler , Charles L. Bennett
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引用次数: 23

摘要

种族差异可能影响与前列腺癌治疗相关的偏好和结果,但尚未得到很好的描述。我们的目的是评估新诊断为局限性前列腺癌的黑人和白人退伍军人的前瞻性偏好,乐观,参与护理和生活质量(QOL)。共有95名自称为黑人/非裔美国人或白人的新诊断的局限性前列腺癌患者完成了一项“时间权衡”任务,以评估当前健康状况和轻度、中度和重度功能损害的效用;前列腺癌相关属性(如泌尿功能)的重要性排序;基线和随访的乐观度、参与护理和生活质量的测量。在治疗前、治疗后3个月和12个月安排面谈。在基线上,黑人和白人都将疼痛、肠道和膀胱功能列为他们最关心的问题。乐观、参与护理和生活质量相似。黑人对轻度损害的效用低于白人,但对中度和严重问题的效用相似。与基线相比,两组在3个月和12个月时的生活质量均有所下降。然而,即使对婚姻状况、教育水平和治疗进行调整,与白人相比,黑人恶心和呕吐的增加较少,性兴趣和体重增加的困难更多。黑人和白人退伍军人以相似的优先顺序、乐观态度和参与护理进入局部前列腺癌治疗。在诊断后的第一年,两组患者的生活质量下降都很普遍,但在恶心、呕吐、性兴趣和体重增加方面存在种族差异。
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Ethnic Variation in Localized Prostate Cancer: A Pilot Study of Preferences, Optimism, and Quality of Life Among Black and White Veterans

Ethnic variations that may influence the preferences and outcomes associated with prostate cancer treatment are not well delineated. Our objective was to evaluate prospectively preferences, optimism, involvement in care, and quality of life (QOL) in black and white veterans newly diagnosed with localized prostate cancer. A total of 95 men who identified themselves as black/African-American or white who had newly diagnosed, localized prostate cancer completed a "time trade-off" task to assess utilities for current health and mild, moderate, and severe functional impairment; importance rankings for attributes associated with prostate cancer (eg, urinary function); and baseline and follow-up measures of optimism, involvement in care, and QOL. Interviews were scheduled before treatment, and at 3 and 12 months after treatment. At baseline, both blacks and whites ranked pain, bowel, and bladder function as their most important concerns. Optimism, involvement in care, and QOL were similar. Utilities for mild impairment were lower for blacks than whites, but were similar for moderate and severe problems. Decline in QOL at 3 and 12 months compared to baseline occurred for both groups. However, even with adjustment for marital status, education level, and treatment, blacks had less increase in nausea and vomiting and more increase in difficulty with sexual interest and weight gain compared with whites. Black and white veterans entered localized prostate cancer treatment with similar priorities, optimism, and involvement in care. Quality-of-life declines were common to both groups during the first year after diagnosis, but ethnic variation occurred with respect to nausea and vomiting, sexual interest, and weight gain.

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