Trajectory of the Quality of Life in Colorectal Cancer Patients: A Follow-up Study

• Main Authors: Hsiu-Chi Hung, 洪秀吉
• Other Authors: Shiow-Luan Tsay
• Format: Others
• Language: zh-TW
• Published: 2013
• Online Access: http://ndltd.ncl.edu.tw/handle/96289274273013315751

博士 === 國立臺北護理健康大學 === 護理研究所 === 101 === This study employed prospective and repeat measurement design to explore the recovery trajectory and its predictors of the first-diagnosed colorectal cancer patients on symptom distress, fatigue, depression and quality of life before and 6 months after the surgery. The patients for this study were collected in a hospital in Central Taiwan. A total of 134 patients diagnosed with colorectal cancer and undergone surgery were interviewed with structural questionnaires and studied. These data were collected at four time points from the patients , pre-operation, one month, three months and six months after surgery. Study tools included patients’ demographic , characteristics of the disease, the memorial symptom assessment scale（MSAS）, Visual analog scale (VAS), Karnofsky Performance Scale (KPS), Brief Fatigue Inventory (BFI). Hospital Anxiety and Depression Scale (HADS) and the Chinese-version functional assessment of cancer therapy-colon (FACT-C). Data were analyzed using SPSS 17.0 and SAS9.2 software with descriptive statistic methods including frequency, percentage, mean, standard deviation and inferential methods like independent t-test, paired t-test analysis, ANOVA, generalized estimating equations analysis (GEE) and Latent Class Growth Analysis (LCGA). All scores of the study instruments for the colorectal cancer patients were compared before and six months after surgery. The results showed that the score of GDI increased from 0.55 to 0.62, PHYS increased from 0.43 to 0.56 and PSYCO increased from 0.66 to 0.72. Fatigue-wise, the score of fatigue severity increased from 2.54 to 4.04 and fatigue interference increased from 1.56 to 2.4 six month after surgery. Depression-wise, the score decreased from 6.8 to 5.6 . In the aspect of quality of life, score of FACTC decreased from 89.1 to 84.8 ; PWB decreased from 21.6 to 20.5, SWB increased from 18.1 to 18.4 , EWB decreased from 15.9 to 15.7 , FWB decreased from 16.9 to 13.1 and CRC decreased from 17.9 to 17.0 six month after surgery. Significant differences were observed from the variables specifically, symptom distress, fatigue, depression, overall quality of life and FWB and the remaining variables showed no significant differences. Based on LCGA to explore the recovery trajectory of the patients after the surgical treatment, the results showed three trajectories for each GDI, PHYS and PSYCHO, the influence factors were pain for GDI, KPS and perceived disease severity for PHYS, and treatment methods, pain and KPS for PSYCHO respectively. ; three trajectories for fatigue severity and their influence factors were pain, KPS, perceived disease severity and GDI; four trajectories for fatigue interference and their influence factors were pain, Hb, perceived disease severity and GDI; four sets for trajectories for depression level with their influence factors being pain, KPS, GDI, fatigue severity and fatigue interference; four trajectories for FACTC and their influence factors were GDI, PHYS, fatigue severity, fatigue interference and depression; three trajectories for PWB and their influence factors were KPS, perceived disease severity, GDI, fatigue severity, fatigue inference and depression; four trajectories of EWB and their interference factors were Hb, pain, GDI, fatigue severity and fatigue interference; for trajectories for EWB and their factors were perceived disease severity, pain, GDI, fatigue severity, fatigue interference and depression and finally, four trajectories for CCS and their influence factors were Hb, KPS, pain, perceived disease severity , GDI, fatigue severity, fatigue interference and depression. The results of this study are to provide the medical personnel taking care of the colorectal cancer patients with the related knowledge, including the changes and recovery conditions of the post-surgery patients on factors like symptom distress, fatigue severity, fatigue interference, depression and quality of life, to serve as the reference for different stages of care taking and nursing intervention.