豫北农村社区食管癌贲门癌患者的生存质量及影响因素

Quality of Life of Patients with Esophageal and Cardiac Cancer in Northern Rural Community of Henan Province and Its Influencing Factors

目的探讨豫北农村社区食管癌贲门癌患者的生存质量及其影响因素。方法应用一般情况问卷、癌症患者生存质量量表(EORTCQLQ-C30)和食管癌专用量表(OES-18)随访304例食管癌贲门癌患者。选取性别、年龄、治疗方式等11个变量,采用t检验、单因素方差分析和多元逐步回归分析这些变量对生存质量的影响。结果本组患者总体生存质量为(52.52±21.94)分,与常模比较,该组患者的总体生存质量、各功能领域评分几乎都低于常模,而症状领域及各单项项目评分除经济困难[(44.74±24.24)分]外平均水平接近常模。躯体功能得分最高为(80.77±21.92)分,社会功能得分最低为(72.37±23.58)分。影响着本组食管癌贲门癌患者生存质量的因素主要为人口社会学特征因素,包括性别、年龄、文化程度、家庭月收入、性格、医疗负担形式和疾病特征因素中的治疗后生存时间。治疗后生存时间越长,患者的总体生存质量越好。男性患者躯体功能优于女性;随着年龄的增长,患者的躯体功能越来越差。年龄越大患者的角色功能越差,但存活越久患者角色适应越好。参加新农合医保的患者和外向型性格的患者情绪功能较好。随着年龄的增长,患者的认知功能越来越差,但文化程度越高,患者的认知功能越好。家庭收入越高,患者受到经济困难的困扰越小,患者的社会功能越好。结论豫北农村社区食管癌贲门癌患者的整体生存质量较差,主要受到经济困难方面的困扰。影响其生存质量的因素主要为人口社会学特征因素和治疗后生存时间,且因素之间交互作用。

Objective To investigate the quality of life （QOL） and its influencing factors in the patients with esophageal and cardiac cancer in northern rural community of Henan province. Methods The questionnaires of the general information investigation, EORTC QLQ- C30 （3.0）, and OES- 18 were administered to 304 patients with esophageal and cardiac cancer. The influence of such 11 variables as gender, age and treatment style on the QOL was analyzed by using t test, univariate and multivariate Logistic regression analysis. Results The average score of the global QOL was （52. 52 ± 21.94）, which was significandy lower than the Norwegian normative value in the total and almost every dimension. While in symptom dimension and each single item the scores were near to the norm, except for financial difficulty score of （44.74 ± 24. 24 ）. The physical function rated the highest score of （80.77 ±21.92） among the functional scale, and the social function rated the lowest score of （72. 37 ± 23.58 ）. The main influencing factors on the QOL were in population sociology including gender, age, education, family monthly income, temperament and medical burden, as well as survival time after treatment of disease. The longer the time after treatment was, the better the general QOL was. Male patients felt better than females in physical function, and the physical function became worse with age. The older the age was the worse role function was, however the longer the survival was the better the role adaptability of the patient was. Patients who had the new rural cooperative medical insurance and an extravert character were better in emotional functioning. Cognitive function became worse with increase of age, however the higher the educated level was the better the cognitive function. And the higher family monthly income was, the smaller the disturbance of the patient in financial difficulty was, and better the patient＇s social function. Conclusion The global QOL of patients with esophageal and cardiac cancer in northern rural community of Henan province is poor. The patients are subjected most to economic difficulty. The main influencing factors on the QOL are in population sociology and the survival time after treatment, and they are interactive.