| Summary: | 碩士 === 高雄醫學大學 === 醫務管理學研究所 === 96 === Purpose
The purpose of this research is to discuss the health-related quality of life (HRQOL) of hepatocellular carcinoma (HCC) patients with hepatectomy and also to detect the most important factors which affect the HRQOL. Last but not least, this study will also discuss the correlation between EORTC QLQ-C30 and EORTC QLQ-HCC18.
Method
This research uses both methods of retrospective cross-sectional and of prospective longitudinal study design. Questionnaire examine period is from July of 2007 to 30th of April, 2008. The major samples of studying are from Hepato-biliary-pancreatic Surgery outpatient in Kaohsiung’s medical center and ward to underwent hepatectomy of HCC patients. Regarding retrospective study, by using structural questionnaire, we could examine the HRQOL of HCC patients who underwent hepatectomy either in the 12 months after operation (n=35) or in the 24 months after operation (n=43). For the prospective study, we focused on preoperation, 6 weeks after operation and 12 weeks after operation(n=33). In this research, all data are presented in percentages or the mean ± SD value. In the statistical analysis point of view, we are using Student t-test、X2 and Fisher’s exact tests、Repeated Measure one-way ANOVA、Multiple linear regression analysis、GEE model analysis and Pearson’s correlation for this research.
Result
In this study, all HCC patients who underwent hepatectomy have average of HRQOL. In the result of retrospective study, it has only significant difference in body image within 12 months after operation and 24 months after operation, but not in other domains. In the result of prospective study, there are significant difference in the role functional, emotional functional, fatigue and pain of QLQ-C30 in prospective study. Additionally, QLQ-HCC18 of fatigue, nutrition, and pain are also showing major dissimilarity. HCC patients have bad emotional functional at preoperation; but, this situation could be improved in 6 weeks after operation. However, they show the symptoms of fatigue and pain seriously in 6 weeks after operation. This negative behavior could improve in 12 weeks after operation. In retrospective study, how many length of stay totally in the hospital, whether having an occupation and whether having complications are all factors which would affect QLQ-C30 and QLQ-HCC18. Patients will have better HRQOL, if HCC patient have shorter staying in the hospital, having an occupation and non-complications. In prospective research, time factor is the one which affects both factors of QLQ-C30 and QLQ-HCC18 at the same time. Compared with postoperations, the HRQOL of HCC patients has major difference in preoperation. In correlation analysis, it is positive correlation in the Global health status /QOL of QLQ-C30, the fatigue of QLQ-HCC18, and all domains. On one hand, QLQ-C30 is sanded for the highest negative correlation in Global health status /QOL and fatigue. On the other hand, QLQ-HCC18 is represented the highest positive correlation in body image and nutrition. In the questionnaires between QLQ-C30 and QLQ-HCC18, the study presents the positive correlation, especially in the both fatigue domains.
Conclusion and suggestion
In this research, we discover that the HRQOL of HCC patients is worse in postoperation than preoperation, especially significantly in fatigue and pain that lower the HRQOL. Hence, we will suggest that medical care workers are better to take care of patients more in the measure of pain and fatigue and the related health teaches in order to alleviate patients’ body pain, improve patients’ fatigue degree and reduce the impact of the HRQOL.
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