| Summary: | 碩士 === 高雄醫學大學 === 醫務管理暨醫療資訊學系碩士班 === 104 === Purposes:
Health-related quality of life before and after hepatocellular carcinoma (HCC) treatment is the recent clinical and academic important health issue to explore. Incidence of HCC in Asia remains high, and it is the leading cause of death in Taiwan. Thus, the study was conducted to evaluate longitudinal trends pre-operative and post-operative health-related quality of life, anxiety and depression symptoms in HCC patients receiving operation and to define the significant predictors.
Research Methods:
This was a prospective and longitudinal study collecting information with questionnaire from November 2010 through January 2015, with HCC patients underwent liver resection in two teaching hospitals in southern Taiwan. Quality of life was measured using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), Functional Assessment of Cancer Therapy-Hepatobiliary (FACT-Hep), the Short Form (36) Health Survey (SF-36), Beck Anxiety Inventory (BAI), and the Beck Depression Inventory-II (BDI-II) with follow-up at five points in time: pre-operation, three months, six months, one year and two years after surgery respectively. Statistical analysis with trends by using generalized estimating equations (GEE); define significant predictors and minimal clinically important difference in Health-related quality of life of post-operative HCC patients.
Results:
The study enrolled 409 patients underwent HCC surgery with the average age was 61.1 years of age and male gender accounted for 69.9%. There was significant improvement in emotional stability, additional matters hepatobiliary cancer, liver cancer therapy functional assessment test indicators, general cancer therapy functional assessment and liver cancer therapy score as compared as pre-operation, however, cognitive and family/society function did not have significant difference. Cognitive function, facet pain and breathing difficulties at six months after surgery compared to three months after surgery had significant differences. There was significant differences in social function, facet pain, breathing difficulties at one year after surgery compared to six months after surgery. The overall quality of life except social function had significant difference at two years after surgery compared to one year after surgery. The predictors of health-related anxiety, depression and quality of life included gender, marital status, living with family, smoking habits, drinking habits, hepatitis B, hepatitis C, tumor size, tumor stage, the risk of anesthesia ASA, hospital length of stay and re-admission within 30 days after surgery.
Conclusions and Recommendations:
Health-related quality of life, anxiety and depression at three months after HCC surgery have significant improvement and continue to improve at six months after surgery, however, no more change at one year after surgery. HCC patients had lots of physical and psychological factors that would affect their health-related quality of life. Therefore, it is very important to family, friends and medical staff to provide support before and after surgery.
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