乳腺癌患者生存质量的影响因素分析

A study on factors related to quality oflife of patients with breast cancer

目的了解乳腺癌患者的生存质量情况及其影响因素。方法参考欧洲研究和治疗协会所拟的生存质量核心问卷(EORTC-QLQ-C30)编制乳腺癌患者生存质量评价量表。采用面访问卷的方法调查133例乳腺癌患者的生存质量及其影响因素。采用多元线性模型分析患者生存质量的影响因素。结果133例乳腺癌患者生存质量总分为(53.02±8.05)分。手术效果与患者的生存质量总分、一般躯体健康、心理健康以及自我生存质量评价呈正相关(P<0.05);“改良根治术”与患者的生存质量总分呈正相关(P<0.05);疾病分期与自我生存质量评价呈负相关(P<0.01),“因病借钱”与生存质量总分及各维度评分呈负相关(P<0.05)。结论手术效果是影响乳腺癌患者生存质量的重要因素,因此提高手术效果和开展术后康复指导是提高患者生存质量的重要方面。此外,加强医疗保障制度有利于解除患者的经济负担,提高患者的生存质量。

Objective To describe the quality of lite ot breast cancer patients and explore the risk factors for their quality of life. Methods One hundred and thirty-three cancer patients were investigated using a ＂ questionnaire for evaluation of quality of life （ for breast cancer patient） ＂. Thirty-nine items of the questionnaire were designed according to EORTC-QLQ-30. Highly-related factors of quality of life were analysed by linear regression （ stepwise method）. Results The quality of life score are 53.02 ± 8.05. ＂ Effect after surgery＂ is the positive factors affecting the score of ＂ global quality of life＂ , ＂general physical health＂ , ＂ mental health＂ and ＂ self-evaluation＂ （ β 〉 0, P 〈0.05）. ＂ Reformative radical surgery＂ is positive related with the global score of QOL （β = 0. 182, P 〈 0.01 ）. The stages of TMN is negative related with ＂ self-evaluation＂ （ β = - 0. 197, P 〈 0.01 ） ; ＂ Getting in debt because of disease＂ is the major negative factor to scores of ＂ quality of life＂ （QOL） and other sub-aspects of QOL （ β 〈 0, P 〈 0.05）. Conclusion The surgical method and effect are important factors affecting the quality of life, thus improving the surgical effect and carrying out healing instruction after surgery are the important aspects for improving patients＇ quality of life. Additionally, strengthening medical insurance, which benefit for releasing the patients＇ financial burden, is also an effective method for improving QOL of breast cancer patients.