癌症相关经济毒性在社会再融合与生活质量中的中介效应研究

The mediating effect of cancer-related financial toxicity in social reintegration and quality of life

目的调查癌症患者的经济毒性、社会再融合与生活质量现状,分析癌症患者经济毒性对社会再融合和生活质量的影响,探讨癌症患者经济毒性、社会再融合与生活质量的路径关系。方法便利选取2021年11月-2022年3月在复旦大学附属肿瘤医院接受治疗且符合纳排标准的582例患者,采用一般资料调查表、中文版患者报告结局的经济毒性综合评分量表(comprehensive scores for financial toxicity based on the patient-reported outcome measures,COST-PROM)、中文版重返正常生活指数量表(reintegration to normal life index,RNLI)及癌症患者生命质量测定量表EORTC V3.0中文版(European organization for research and treatment of cancer quality of life questionnaire,EORTC QLQ-C30)调查患者经济毒性、社会再融合及生活质量现况,并进行路径分析。结果研究对象经济毒性得分为(21.60±8.58)分,社会再融合得分为(73.69±20.65)分,生活质量得分为(350.52±92.52)分;患者经济毒性与其社会再融合、生活质量都呈现正相关关系;经济毒性在社会再融合和生活质量之间起中介作用。结论社会再融合不仅直接影响生活质量,而且能通过经济毒性进一步影响生活质量,未来的癌症护理实践应努力降低癌症患者的经济毒性、提高其社会再融合的程度,从而改善癌症患者的生活质量。

Objective To investigate financial toxicity,social reintegration,and quality of life in cancer patients,and analyze the effect of financial toxicity on social reintegration and life quality of cancer patients,and to explore the pathway relationship among financial toxicity,social reintegration,and quality of life in cancer patients.Methods A total of 582 patients who were treated in the internal medicine ward of Fudan University Cancer Hospital from November 2021 to March 2022 and met the inclusion and exclusion criteria were conveniently enrolled,and the general information questionnaire,comprehensive scores for financial toxicity based on the patient-reported outcome measures(COST-PROM),Chinese version of reintegration to normal life index(RNLI),and European organization for research and treatment of cancer quality of life questionnaire EORTC V3.0 Chinese version(EORTC QLQ-C30)were used to investigate their financial toxicity,social reintegration,and quality of life,and path analysis was performed.Results The scores of financial toxicity were(21.60±8.58)points,social reintegration scores were(73.69±20.65)points,and quality of life scores were(350.52±92.52)points;There was a positive correlation between the financial toxicity of patients and their social reintegration and quality of life;Financial toxicity mediated the association between social reintegration and quality of life.Conclusion Social reintegration not only directly affects the quality of life,but also further affect the quality of life through financial toxicity,and future cancer care practices should strive to reduce the financial toxicity of cancer patients and increase the degree of social reintegration,so as to improve the quality of life of cancer patients.