老年肿瘤患者临终生活质量多因素研究

Multifactorial Study of Life-quality of Elderly Patients in Extremis with Tumor

目的:了解住院老年肿瘤临终患者的生活质量及其影响因素。方法:采用中国肿瘤临床康复与健康癌症患者生活质量量表(QOL),社会支持评定量表,生活满意度指数A(LSIA),医院焦虑抑郁量表(HAD),主诉疼痛分级(VRS),日常生活活动量表(ADL),对150例临终患者进行测评。结果:(1)各量表总分分别为:QOL36.9±7.4,ADL56.27±34.5,社会支持40.0±6.3,HAD(A)8.9±4.1,HAD(D)11.2±4.9,LSIA11.6±3.9。(2)相关分析显示QOL总分与疼痛(r=-0.54,P<0.01)及焦虑(r=-0.65,P<0.01)、抑郁(r=-0.73,P<0.01)负相关,与ADL(r=0.74,P<0.01)、社会支持总分(r=0.30,P<0.01)、主观支持(r=0.23,P<0.05)、对支持总分(r=0.30,P<0.01)、主观支持(r=0.23,P<0.05)、对支持的利用度(r=0.32,P<0.01)、LSIA(r=0.52,P<0.01)正相关。(3)多元逐步回归分析显示ADL、VRS、社会支持总分及HAD(A)是QOL总分的独立预测变量(t分别为6.91,-4.66,3.28,-4.72,P<0.01)。结论:老年临终住院患者QOL受日常生活活动、疼痛程度、社会支持、焦虑等多种因素的影响,应针对性地给予临终关怀措施,提高生活质量。

Objective： To research the life-quality of aged patients in extremis with tumor and its influencing factors. Methods： 150 patients in extremis with tumor were evaluated using cancer patients＇ Quality of Life Scale （QOL）, s,,ocial support rate scale （SSRS）, life satisfaction index A, hospital anxiety depression scale, verbal pain rating scale （VRL）, activities of daily living scale （ADL）. Results： （ 1 ） The total score of each scaleis： QOL： 36.9±7.4, ADL： 56.27±34,5, SSRS： 40.0±6.3, HAD （A）： 8.9±4.1, HAD （D）： 11.2 ± 4.9, LSIA11.6 ± 3.9. （2） correlation analysis display QOL total score negativey correlate with pain （ r = - 0.54, P 〈 0.01 ）, anxiety （ r = - 0.65, P 〈 0.01 ）, depression （ r = - 0.73, P 〈 0.01 ） and positively correlate with ADL （ r = 0.74, P 〈 0.01 ）, SSRS （r=0.30, P〈0.01）, subjective support （r=0.23, P〈0.05）, availability of support （r=0.30, P〈0.01）, LSIA （r=0.52, P 〈0.01） ,multi-element step Regression analysis display ADL, VRS, social support total score and HAD is the independent anticipation variable of QOL total score （t = 6.91, - 4.66, 3.28, - 4.72, P 〈 0.01） .Conclusion： The QOL of aged patients in extremis is affected by activities of daily living, the degree of pain, social support, anxiety etc., so concern in extremis should be given respectively in order to increase quality of llfe.