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肺癌住院患者生命质量调查及其影响因素
孙昊1,王伟杰1,周荃1,常艺凡1,韩佳澔2,朱志朋2,陆晓芳3,苏彤1*
0
(1. 海军军医大学(第二军医大学)心理系医学心理学教研室, 上海 200433;
2. 海军军医大学(第二军医大学)临床医学专业学员队, 上海 200433;
3. 海军军医大学(第二军医大学)长海医院检验科, 上海 200433
*通信作者)
摘要:
目的 调查肺癌住院患者的生命质量,探讨肺癌患者生命质量的影响因素。方法 选择2016年9月至2017年3月在海军军医大学(第二军医大学)长海医院呼吸内科住院的肺癌患者120例,发放调查问卷;采用EORTC QLQ-C30中文版和肺癌特异模块QLQ-LC13评估患者的生命质量,以患者的一般资料为自变量、生命质量各领域得分为因变量,进行肺癌生命质量影响因素的多重线性回归分析。结果 回收有效问卷95份,回收率79.2%。性别、年龄、职业、居住地、子女数量、吸烟、饮酒、肿瘤分期、肿瘤是否转移、是否伴随其他疾病和化学治疗次数与生命质量不同领域得分相关(P<0.05)。年龄较小(<50岁)的患者食欲缺乏(β=-8.266)、腹泻(β=-5.263)和咽下困难(β=-6.307)症状得分较高;女性的认知功能领域得分低于男性(β=-11.270),恶心呕吐(β=11.725)和食欲缺乏(β=17.090)症状领域得分高于男性;肿瘤分期晚(Ⅳ期)者腹泻症状重(β=2.070);无职业者腹泻症状重(β=7.130);化学治疗次数多(6次以上)的患者疼痛症状明显(β=5.871);伴随其他疾病的患者总健康状况(β=-17.239)较差,且周围神经病变(β=11.970)和胸痛(β=11.061)症状较重;吸烟者气促症状较明显(β=21.151),饮酒者便秘症状较明显(β=13.525);肿瘤转移者的角色功能领域得分高(β=15.039)。居住地与多个生命质量领域得分相关,上海地区患者生命质量较好。子女数量多(≥2个)的患者不易发怒,情绪更稳定(β=10.078)。结论 肺癌患者在接受治疗的过程中,其身体状况与情绪心理状况都需要得到关注,有必要根据患者的个体特点提供相应的社会支持与心理疏导,从而改善患者的生命质量和预后。
关键词:  肺肿瘤  生命质量  问卷调查  影响因素  回归分析
DOI:10.16781/j.0258-879x.2018.06.0615
投稿时间:2017-12-27修订日期:2018-02-06
基金项目:国家自然科学基金(81602734),第二军医大学青年启动基金(2012QN02),第二军医大学本科学员创新实践能力孵化基地(FH2016114).
Quality of life of inpatients with lung cancer and related influencing factors
SUN Hao1,WANG Wei-jie1,ZHOU Quan1,CHANG Yi-fan1,HAN Jia-hao2,ZHU Zhi-peng2,LU Xiao-fang3,SU Tong1*
(1. Department of Medical Psycholgy, Faculty of Psychology, Navy Medical University(Second Military Medical University), Shanghai 200433, China;
2. Student Team of Clinical Medicine, Navy Medical University(Second Military Medical University), Shanghai 200433, China;
3. Department of Laboratory Medicine, Changhai Hospital, Navy Medical University(Second Military Medical University), Shanghai 200433, China
*Corresponding author)
Abstract:
Objective To investigate the quality of life of inpatients with lung cancer and its influencing factors. Methods A total of 120 inpatients with lung cancer in Department of Respiratory Medicine of Changhai Hospital of Navy Medical University (Second Military Medical University) from Sep. 2016 to Mar. 2017 were surveyed. The Chinese version of EORTC QLQ-C30 and lung cancer specific module QLQ-LC13 were used to assess the quality of life of the inpatients. The multiple linear regression analysis was performed to analyze the factors influencing life quality, with the general data of the inpatients as independent variables and the scores of various domains of life quality as dependent variables. Results A total of 95 valid questionnaires were recovered, and the response rate was 79.2%. Gender, age, occupation, residence, number of children, smoking, drinking, tumor staging, metastasis, with or without concomitant diseases and frequency of chemotherapy were related to the scores of different domains of life quality (P<0.05). Patients with younger age (<50 years old) had higher symptom scores of anorexia (β=-8.266), diarrhea (β=-5.263), and dysphagia (β=-6.307). Female patients had a lower score of cognitive function (β=-11.270), and had higher symptom scores of nausea/vomiting (β=11.725) and anorexia (β=17.090) versus male patients. Patients with advanced tumor stage (Ⅳ) or without occupation both had higher symptom scores of diarrhea (β=2.070, 7.130). Patients with frequent chemotherapies (more than six times) had a higher symptom score of pain (β=5.871). Patients with concomitant diseases had a lower score of overall health status (β=-17.239), and had higher symptom scores of peripheral neuropathy (β=11.970) and pain in the chest (β=11.061). Smoking patients had a higher symptom score of dyspnea (β=21.151). Drinking patients had a higher symptom score of constipation (β=13.525). Patients with tumor metastasis had a higher score of role function (β=15.039). Residence was associated with several domains of life quality; inpatients in Shanghai had better life quality. Patients with large number of children (≥ 2) were more emotionally stable (β=10.078). Conclusion Patients with lung cancer should be concerned about their physical condition and psychological condition during treatment. It is necessary to provide corresponding social support and psychological counseling based on the individual characteristics in order to improve the quality of life and prognosis of lung cancer patients.
Key words:  lung neoplasms  quality of life  questionnaires  influencing factors  regression analysis