鼻咽癌患者生存质量的多因素分析

A Multi-factor Analysis of the Quality of Life for Patients with Nasopharyngeal Carcinoma

目的:探讨鼻咽癌患者的生命质量情况及其影响因素。方法:参考EORTCQLQ-C30量表,编制鼻咽癌患者“生命质量评价量表(43项)”,采用面访问卷调查方法调查了90例鼻咽癌患者的生命质量及影响因素情况。用多元Logistic回归模型分析影响患者生命质量的因素。结果:鼻咽癌患者生命质量评分为63.88±12.63。“特殊症状及副反应”及格率最低(48.9%)。听力损害、经济困难对生命质量影响比较突出,评分分别是4.67±1.67、3.17±2.95。影响生命质量的因素中,确诊距调查的时间与患者的一般躯体健康呈正相关(OR=8.12,P<0.05)。此外,“受教育程度”(OR=6.62,P<0.05)和“因病借钱”(OR=0.09,P<0.05)是影响患者总生命质量及各亚类生命质量的重要因素。年龄与特殊副反应呈负相关(OR=0.89P<0.05),受教育程度与特殊副反应呈正相关(OR=6.44P<0.05)。结论:低收入及有严重特殊副反应的患者是生命质量相关健康干预的重点人群。应针对患者开展疾病、心理及社会医学多学科的干预和健康教育。

Objective： To study the quality of life of the patients with nasopharyngeal carcinoma （NPC） and to explore the related risk-factors. Methods： A total of 90 patients were investigated by a ＂ questionnaire for evaluation of the quality of life （for nasopharyngeal carcinoma patients） ＂. Forty-three items were designed in the questionnaire according to EORTC QLQ-30. The factors of quality of life were analysed with logistic regression. Results： The means and SD of ＂quality of life score＂ was 63.88± 12.63. The passing rate （48.9%） of ＂special symptom and side effect＂ was the lowest among the scores of quality of life. The influence of ＂auditory harm＂ and ＂poor economic situation ＂on the quality of life were relatively predominant. The means and SD of these scores were 4.67±1.67 and 3.17±2.95. The time between the final diagnosis of cancer and the investigation＂ was positively correlated with the score of ＂general health status for quality of life of the patients＂ （OR=8.12, P〈0.05 ）. The positive factors affecting the score of quality of life include ＂education level＂ （OR=6.62, P〈0.05） and ＂being in debt due to disease＂ （OR=0.09, P〈0.05）. The factor of ＂Age＂ was negatively correlated with score of ＂special symptom and side effect＂ （OR=0.89 P〈0.05）. ＂Education level＂ positively correlated with score of ＂special symptom and side effect＂ （OR=6.44 P〈0.05）. Conclusion： Patients with low incomes, special symptoms and severe side effects are the major population in correlative health intervention and health instruction for improving quality of life. The muhidisciplinary measures, such as integrated intervention and health education, should be carried out to improve patients＂ quality of life.