近期化疗对晚期肿瘤患者心理痛苦和生活质量的影响

Effects of recent chemotherapy on psychological distress and quality of life in advanced cancer patients

目的调查晚期肿瘤患者化疗前后心理痛苦和生活质量状况,分析两者相关性,探讨近期化疗对心理痛苦和生活质量的影响。方法应用心理痛苦温度计(DT)、癌症患者生活质量表(FACT-G)、一般情况调查表,对拟接受化疗的晚期患者分别在初诊时和化疗后3个月进行调查。结果共142例晚期患者纳入纵向研究,化疗前显著心理痛苦检出率(DT≥4分)高于化疗后(43.0%vs 34.5%,P<0.01),性别、受教育年数、ECOG评分、化疗疗效影响DT得分。化疗前生活质量总分低于化疗后(P<0.01),化疗前后显著心理痛苦检出组生活质量总分均低于未检出组(P<0.05),化疗前后DT值变化与QOL总分差值呈负相关(r=-0.340,P<0.01)。结论晚期肿瘤患者显著心理痛苦检出率较高,心理痛苦水平与生活质量高低关系密切,近期化疗可以减轻晚期患者心理痛苦和改善生活质量。

Objective To investigate psychological distress and quality of life and to analyze the correlation between them before and af- ter chemotherapy in advanced cancer patients, and to explore the effects of recent chemotherapy on the distress and QOL. Methods Newly diagnosed advanced cancer patients were investigated at the initial and 3 months after chemotherapy by using distress thermometer （DT）, FACT-G and general conditions questionnaire. Results A total of 142 advanced patients were brought into this longitudinal study. The prevalence of significant distress in all patients was higher prior to chemotherapy than after chemotherapy （43.0% vs 34.5%, P 〈0.01 ） ,and influencing factors of distress were gender, educational level, ECOG score and chemotherapy efficacy. The total score of QOL in all patients was lower prior to chemotherapy than after chemotherapy （P 〈 0.01 ）, and the total score of QOL in patients whose significant distress was detected was lower than those undetected （ P 〈 0.05 ）. The difference value of DT and the total score of QOL was negatively related before and after chemotherapy （ r = - 0. 340,P 〈 0.01 ）. Conclusion The prevalence of sigriificant distress is relatively high in advanced cancer patients. The level of psychological distress and quality of life is closely related. Recent chemotherapy can decrease the level of distress and improve quality of life in advanced patients.