PO.CL11.02 · 临床研究
探索接受姑息性化疗的晚期癌症患者生活质量的精神层面损害因素
Exploring the spiritual detriments of the quality of life among patients with advanced cancers undergoing palliative chemotherapy
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摘要 Abstract
中文摘要
背景：癌症占总死亡人数的28.7%，为首要死因，且这一趋势仍在稳步上升。在韩国，癌症生存率也持续改善，从1991年至2022年间由45.2%提高到72.9%。随着现在每10名癌症患者中有7名能存活超过五年，医疗服务提供者的关注点已从单纯提高生存率转向提升生活质量（QoL）。QoL被公认为癌症治疗和康复过程中的一项重要指标。尤其在晚期癌症患者中，在其余生中改善QoL成为一项关键的治疗目标，需要持续的评估和干预。尽管现有关于癌症人群QoL的证据不断积累，但对接受姑息性化疗的晚期癌症患者QoL的精神层面决定因素的理解仍然有限。本研究旨在探索接受姑息性化疗的晚期癌症患者QoL的精神层面损害因素。
方法：本横断面描述性研究采用便利抽样，招募2023年9月至2025年3月期间在某大学医院接受姑息性化疗的参与者。不确定感、癌症应对、精神幸福感和QoL分别使用韩文版Mishel疾病不确定感量表-成人版、癌症应对问卷、慢性病治疗功能评估-精神幸福感量表和癌症特异性生活质量量表进行测量。人口学和临床数据来自电子健康档案或人口学问卷。使用SPSS 30.0版进行多元回归分析。
结果：在共165名参与者中，88名（53.3%）为男性；平均年龄为54.86（SD=8.34）岁；62名（37.6%）被诊断为结直肠癌。平均化疗疗程数为17.16（SD=17.03）。疼痛（beta=-.221，p=.001）、不确定感（beta=-.250，p<.001）、精神幸福感（beta=.316，p<.001）和结直肠癌（beta=.250，p=.002）解释了QoL方差的37.2%（校正R²为.372）。
结论：为改善接受姑息性化疗的晚期癌症患者的QoL，维持精神幸福感至关重要。应将包括精神层面成分在内的QoL整体评估、疼痛管理、及时提供治疗信息以减少不确定感，纳入改善晚期癌症患者QoL的干预策略中。
查看英文原文 English abstract
Background: Cancers account for 28.7% of total deaths, with the leading cause of death, and this trend is steadily increasing. In South Korea, cancer survival rates have also consistently improved, from 45.2% to 72.9% between 1991 and 2022. As 7 out of 10 cancer patients now survive more than five years, the interest of healthcare providers has shifted beyond merely improving survival rates to enhancing quality of life (QoL). QoL is recognized as an essential indicator in cancer treatment and recovery processes. Especially in patients with advanced cancer, improving QoL during their remaining life span becomes a key therapeutic goal, requiring continuous assessment and interventions. Although existing cumulative evidence for QoL in the cancer population, understanding the spiritual determinants of QoL among patients with advanced cancers undergoing palliative chemotherapy is still limited. This study aimed to explore the spiritual detriments of the QoL among patients with advanced cancers undergoing palliative chemotherapy.
Methods: This cross-sectional, descriptive study utilized convenience sampling to recruit participants undergoing palliative chemotherapy at a university hospital between September 2023 and March 2025. Uncertainty, Cancer coping, Spiritual well-being, and QoL were measured by the Korean version of the Mishel Uncertainty in Illness Scale - Adult Form, the Cancer Coping Questionnaire, the Functional Assessment of Chronic Illness Therapy-Spiritual Well-being Scale, and the Cancer-Specific Quality of Life scale, respectively. Demographic and Clinical data were obtained from electronic health records or demographic questionnaires. Multiple regression analysis was performed using SPSS version 30.0.
Results: Among a total of 165 participants, 88 (53.3%) were males; the mean age was 54.86 (SD = 8.34) years; 62(37.6%) were diagnosed with colorectal cancers. The average number of chemotherapy sessions was 17.16 (SD =17.03). Pain (beta=-.221, p=.001), uncertainty (beta=-.250, p=<.001), and spiritual well-being (beta=.316, p=<.001), Colorectal cancer (beta=.250, p=.002) explained 37.2% of the variance (adjusted R² of .372) in QoL.
Conclusion: To improve the QoL of patients with advanced cancers undergoing palliative chemotherapy, maintaining spiritual well-being is crucial. Holistic assessment of QoL, including spiritual components and management of pain, providing treatment information in a timely manner to reduce uncertainty, should be included in the intervention strategy to improve QoL in patients with advanced cancers.
利益披露 Disclosure
J. Son, None..
J. Lee, None..
S. Hwang, None..
J. Kim, None.