胃癌患者生活质量的轨迹及影响因素分析

An analysis of the trajectory of quality of life in patients with stomach cancer and its influence factors

目的:探讨胃癌患者从诊断期到过渡期生活质量的轨迹变化,并分析不同生活质量轨迹的影响因素。方法:本研究采用前瞻性纵向研究设计,于2018年8月-2020年8月对江苏省某三级医院就诊的胃癌患者进行追踪调查,收集符合纳排标准患者的一般资料和症状,分别在手术前、化疗前、首次化疗后、化疗中期、化疗结束以及化疗结束后2个月共6个时间点调查患者的生活质量水平。使用增长混合模型的方法识别潜在的轨迹类型,使用单因素分析的方法分析潜在轨迹类别的影响因素。结果:共222例患者完成随访,通过构建增长混合模型识别出3条不同特点的生活质量轨迹类型,命名为组1生活质量持续下降组(37.5%);组2生活质量波动组(57.2%);组3生活质量未下降组(25.3%)。婚姻状态、肿瘤分期对生活质量的轨迹的影响有统计学意义。结论:胃癌患者从诊断期到过渡期生活质量呈现不同的变化轨迹,大部分患者能够达到良好的适应状态,婚姻状态、肿瘤分期是生活质量轨迹的影响因素。

Objective:To explore the trajectory changes of the quality of life of patients with stomach cancer from the diagnosis period to the transition period,and to analyze the factors affecting the trajectory of different quality of life.Methods:This study used forward-looking longitudinal research design,gastric cancer patients from August 2018 to August 2020 in a third-level hospital in Jiangsu Province were given followed-up investigation by collecting the general data and symptoms of patients who meet the standards before surgery,before chemotherapy,after the first chemotherapy,chemotherapy in the middle,chemotherapy ended and 2 months after the end of chemotherapy to evaluate the quality of life of patients.The growth hybrid model method was used to identify potential track types and a single-factor analysis method was used to analyze the influence factors of potential track categories.Results:A total of 222 patients completed follow-up,3 types of quality of life trajectory with different characteristics were identified by constructing a growth hybrid model,named group 1,quality of life continued to decline group(37.5%)group 2,namely the qualily of life fluctuating group(57.2%);group 3,the quality of life not decreasing group(25.3%).The effect of marital status and tumor stage on the trajectory of quality of life is of statistical significance.Conclusion:Gastric cancer patients show different changes in quality of life from diagnosis period to transition period.Most patients can achieve a good state of adaptation.Marriage status,tumor stage are the influence factors of quality of life trajectory.