晚期慢性阻塞性肺疾病患者及晚期癌症患者的生存质量比较研究  

A comparative study of the quality of life of patients with advanced chronic obstructive pulmonary disease and terminal cancer

作　　者：彭美慈[1] 钟佩雯[1] 梁颖琴[1] 陈健生 刘锦城 梁万福 陈裕丽[1] 陈满辉[1] 

机构地区：[1]香港理工大学护理学院 [2]灵实医院胸肺及纾缓治疗科 [3]律敦治医院胸肺内科 [4]基督教联合医院老人内科

出　　处：《中华护理杂志》2006年第3期202-206,共5页Chinese Journal of Nursing

基　　金：中国香港特别行政区大学研资局(PolyU7257/00H)赞助

摘　　要：目的比较晚期慢性阻塞性肺疾病(COPD)患者及晚期癌症患者的生存质量(Quality of life,QOL),探讨COPD患者对临终关怀的需求。方法访问COPD患者108例及癌症患者50例。采用晚期病患者生存质量量表(Quality-of-Lif Concerns in the End-of-Life Questionnaire,QOLC-E)作评估。通过统计分析,比较两组的QOL分数。结果COPD患者的基本活动程度及操作活动程度均明显低于癌症患者(t=-6.2,-4.7,P均<0.01)。而在QOLC-E的8个分类中,COPD患者在“身体不适”、“负面情绪”及“存在困扰”得分均比癌症患者低,但是“生活价值”一类却较高,差异均有显著性(P<0.05)结论研究结果显示晚期COPD患者及晚期癌症患者有相近的生存质量关注,但关注面各有不同。一方面意味临终关怀应扩展至晚期COPD患者,另一方面也显示COPD患者的诉求与晚期癌症患者不尽相同,故在发展有关服务的同时,要考虑COPD患者的独特性。Objective Compare the quality-of-life concerns of patients with advanced chronic obstructive pulmonary disease （COPD） and terminal cancer, and explore the palliative care needs of advanced COPD patients. Methods 108 advanced COPD patients and 50 terminal cancer patients were interviewed using the Quality-ofrLife Concerns in the End-of-Life Questionnaire （QOLC-E）. QOLC-E comprises four positive and four negative subscales. The positive subscales are support, value of life, food-related concerns and healthcare concerns; the negative subscales are physical discomfort, negative emotions, a sense of alienation and existential distress. The overall QOL, eight QOLC-E subscale scores, and self-maintenance and instrumental activities of daily living （P-ADL and I-ADL） scores of the two patient groups were compared using independent t tests. Results The advanced COPD patients were more dependent in activities of daily living than the terminal cancer patients （t =-6.2,-4.7, P〈0.01）. They had a lower overall QOL evaluation than cancer patients （t=-2.1,P〈0.05）. No significant difference was found in the mean QOLC-E score between COPD and cancer patients （t=-1.6, P〉 0. 05）. The COPD patients scored lower in three out of the four negative subscales, while the cancer patients scored lower in the value of life subscale （P〈0.05）among the four positive subscales. Conclusions The results showed that both advanced COPD and terminal cancer patients bore similar quality-of-life concerns. However, the advanced COPD patients assessed their quality of life worse than that of the terminal cancer patients. The results highly suggest that palliative medicine and hospice care should be extended to patients with advanced COPD, taking into account the unique characteristics of COPD patients.

关 键 词：肿瘤 比较研究 肺疾病 慢性阻塞性 生活质量 临终医护 

分 类 号：R48[医药卫生—临床医学]