接受姑息治疗的肺癌患者的情绪低落和生活质量自我评估

A. Nowicki, Paulina Farbicka, M. Krajnik
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引用次数: 5

摘要

目的:评价肺癌患者从姑息治疗开始至死亡期间的抑郁程度和生活质量自我评价。材料与方法本研究纳入了2012-2013年比得哥什市姑息医学中心的63例肺癌患者,从治疗开始直到死亡。使用ESAS量表中的视觉模拟量表评估排便,使用EORTC QLQ-C30问题30对生活质量进行自我评估。结果19例(30%)和24例(38%)患者最初出现“中度”和“非常”强烈的排便,在第二次评估中分别出现23例(36%)和30例(48%)患者。在两步量表中,平均生活质量在这方面下降了0.09 (p = 0.005)。在第一次和第三次评估之间,“中度”抑郁的强度增加。最初发生在2例(9%)患者中,在第三次评估时发生在14例(66%)患者中。相比之下,“非常”严重的抑郁水平在第一次和第三次评估之间没有显着变化。平均生活质量下降0.23分(p = 0.004)。只有镇痛治疗与生活质量之间存在显著关系(p < 0.0005)。其他因素如年龄、从诊断到开始治疗的时间、居住地、性别或经济状况不影响生活质量。结论患者生活质量自我评价随时间延长而恶化。在生命的最后3周内,排便的强度没有变化。在多变量分析中,在年龄、性别、居住地、从诊断到开始姑息治疗的时间、经济状况和使用止痛药类型等选定的变量中,只有后者对自我评估的生活质量有影响。
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Dejection and self-assessment of quality of life in patients with lung cancer subjected to palliative care
Aim of the study To evaluate the intensity of dejection and self-assessment of quality of life in patients with lung cancer from the start of palliative care until death. Material and methods The study included 63 patients with lung cancer from the start of care until death in palliative medicine centers in Bydgoszcz in 2012–2013. The visual-analogue scale constituting part of the ESAS scale was used to assess dejection, while question number 30 of the EORTC QLQ-C30 was used for self-assessment of quality of life. Results “Moderate” and “very” intense dejection initially occurred in 19 (30%) and 24 (38%), and in the 2nd assessment in as many as 23 (36%) and 30 (48%) patients. Average quality of life deteriorated in this respect by 0.09 in the two-step scale (p = 0.005). Increase in the intensity of “moderate” dejection occurred between the 1st and 3rd assessment. Initially it occurred in 2 (9%) patients and in 14 (66%) during the 3rd assessment. In contrast, the levels of “very” severe dejection did not change significantly between the 1st and the 3rd assessment. The average quality of life deteriorated by 0.23 points (p = 0.004). A significant relationship was found only between analgesic treatment and quality of life (p < 0.0005). Other factors such as age, time from diagnosis to start of treatment, place of residence, sex, or financial condition did not affect the quality of life. Conclusions Self-assessment of the quality of life worsens with time. The intensity of dejection does not change in the last 3 weeks of life. In multivariate analysis, among the selected variables such as age, sex, place of residence, time from diagnosis to start of palliative care, financial condition, and type of painkillers used, only the latter has an impact on self-assessed quality of life.
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