社区消化道恶性肿瘤患者生活质量的影响因素及患者自我倾注对生活质量的影响研究

Study on the influencing factors of quality of life of patients with gastrointestinal cancer in community and the influence of patients′self-infusion on quality of life

目的探讨社区消化道恶性肿瘤患者生活质量的影响因素并分析患者自我倾注对生活质量的影响。方法采用便利抽样的方法,选取2021年1月至2022年1月河北省石家庄市5家社区卫生服务中心记录的,在我国肿瘤登记信息系统中诊断为食管癌、胃癌以及结直肠癌的消化道恶性肿瘤患者作为研究对象。采用问卷方式调查其生活质量及自我倾注情况,调查表包括欧洲癌症研究与治疗组织生活质量问卷(EORTC QLQ-C30)、自我倾注量表(SFAS)及自行设计的一般情况问卷调查表。结果本研究共调查社区消化道恶性肿瘤患者190例,回收有效问卷185份,有效回收率为97.4%。生活质量测定量表调查显示,社区消化道恶性肿瘤患者总健康状况得分为(50.7±18.3)分,功能领域中认知功能得分最高为(87.1±13.4)分,社会功能得分最低为(69.8±23.8)分;症状领域中疲倦得分最高为33.3(33.3,55.6)分。SFAS调查显示,社区消化道恶性肿瘤患者的自我倾注总得分为(59.2±10.2)分。Spearman相关性分析显示,社区消化道恶性肿瘤患者的自我倾注得分与总健康状况得分以及功能领域中躯体、角色、认知、情绪和社会功能5个维度得分均呈负相关,与症状领域中疲倦、恶心与呕吐得分及单一条目中食欲丧失、经济困难得分呈正相关(均P<0.05)。多元线性回归分析结果显示,婚姻状况、文化程度、主要照顾者、家庭月收入以及自我倾注均是社区消化道恶性肿瘤患者总健康状况得分的影响因素(均P<0.05)。受试者工作特征曲线显示,自我倾注得分预测患者总健康状况得分的曲线下面积为0.716(95%置信区间:0.642~0.789),敏感度为61.9%,特异度为73.6%。结论社区消化道恶性肿瘤患者的生活质量受婚姻状况、文化程度、主要照顾者等多种因素影响,其中自我倾注状况与社区消化道恶性肿瘤患者生活质量水平密切相关,对生活质量的高低有一定的预测作用。

Objective To explore the influencing factors of quality of life of patients with gastrointestinal cancer in community and analyze the influence of patients′self-infusion on quality of life.Methods From January 2021 to January 2022,convenience sampling was used to select patients with gastrointestinal malignant tumors recorded in 5 community health service centers in Shijiazhuang,Hebei Province and diagnosed with esophageal cancer,gastric cancer and colorectal cancer in the Chinese Cancer Registry Information System as the research objects.The European organization for research and treatment of cancer quality of life questionnaire(EORTC QLQ-C30),self-infusion attention scale(SFAS)and self-designed general information questionnaire were used to investigate their quality of life and self-commitment.Results A total of 190 patients with gastrointestinal cancer were investigated in this study,and 185 valid questionnaires were collected,with an effective recovery rate of 97.4%.The survey of quality of life measurement scale showed that the total health status score of patients with gastrointestinal cancer in the community was(50.7±18.3),the highest score of cognitive function was(87.1±13.4),the lowest score of social function was(69.8±23.8),and the highest score of fatigue was 33.3(33.3,55.6).The SFAS survey showed that the total score of self-infusion of patients with gastrointestinal cancer in the community was(59.2±10.2).Spearman correlation analysis showed that the score of self-infusion was negatively correlated with the total health status score and the scores of physical,role,cognitive,emotional and social function in the functional domain,and positively correlated with the scores of fatigue,nausea and vomiting in the symptom domain and the scores of appetite loss and economic difficulty in the single item(all P<0.05).The results of multiple linear regression analysis showed that marital status,education level,main caregiver,family monthly income and self-infusion were the influencing factors of the total health status of patients with digestive tract malignant tumors in the community(all P<0.05).The receiver operating characteristic curve showed that the area under the curve of self-infusion score predicting the total health status score of patients was 0.716(95%confidence interval:0.642-0.789),the sensitivity was 61.9%,and the specificity was 73.6%.Conclusions The quality of life of patients with gastrointestinal cancer in the community is affected by many factors such as marital status,education level,main caregivers and so on.The self-infusion status is closely related to the quality of life of patients with gastrointestinal cancer in the community,and has a certain predictive effect on the quality of life.