老年肿瘤患者治疗与康复需求国内多中心调查结果

发布时间：2018-06-24 08:49

本文选题：老年 + 肿瘤　；参考：《中国康复医学杂志》2017年03期

【摘要】：目的:了解老年肿瘤患者治疗常见症状与康复需求的情况,为老年肿瘤患者提供恰当的康复指导方法。方法:国内共6家三甲医院采用便利抽样的方法纳入年龄65岁及以上的经病理学诊断明确的恶性肿瘤的老年患者。通过日常生活活动能力量表(activities of daily life,ADL),查尔森并发症指数(Charlson comorbidity index,CCI),安德森(MD Anderson)症状问卷-中医版(MDASI-TCM)及康复需求调查问卷等形式调查患者的康复需求情况。结果:共收回有效问卷637份。637例老年肿瘤患者中男性340例(53.4%),女性297例(46.6%),患者中位年龄71岁(65—92岁)。ADL评分60分占95.5%。采用MDASI-TCM肿瘤常见症状问卷对常见症状进行调查,困扰患者前十位的症状为:乏力77.5%,健忘62.0%,睡眠不安60.6%,口干56.4%,苦恼51.8%,胃口差51.7%,疼痛51.7%,咳嗽50.1%,气短49.9%和怕冷49.0%。绝大多数患者(283/637,44.4%)认为对生活质量影响最大的痛苦是没有控制的症状,其次为心情不好(82/637,12.9%)。在影响生活质量的最大痛苦症状方面,乏力(149/637,23.4%),疼痛(119/637,18.7%),失眠(58/637,9.1%),纳差(56/637,8.8%)和咳嗽(50/637,7.8%)。与MDSIA-TCM症状结果基本一致。有超过一半的患者(334/637,52.4%)了解康复相关知识,且无论是否了解康复相关知识,83.7%(533/637)的患者愿意接受康复指导。康复需求具体包括:希望得到康复指导(372/637,58.4%)肿瘤知识咨询(323/637,50.7%),营养指导(293/637,46.0%)和心理辅导(137/637,21.5%)。有81.0%的患者愿意接受中医康复,并希望能够达到增加免疫(461/637,72.4%),身体调节(390/637,61.2%),减轻症状(381/637,59.8%)和改善体力(339/637,53.2%)等目的。结论:由老年肿瘤患者自诉的不适症状与MDASI-TCM症状量表所得到的症状分布情况基本一致,说明MDASITCM量表适用于老年肿瘤患者的症状评估;老年肿瘤患者的治疗目的和康复需求基本一致,减少痛苦症状应得到高度重视,老年肿瘤患者康复过程中对中医中药有极大的需求。
[Abstract]:Objective: to investigate the common symptoms and rehabilitation needs of elderly patients with tumor, and to provide appropriate rehabilitation guidance for elderly patients with tumor. Methods: convenience sampling was used in 6 hospitals in China to include elderly patients aged 65 and above with definite malignant tumor diagnosed by pathology. The rehabilitation needs of the patients were investigated by the activity of daily living (activities of daily), Charlson comorbidity index (CCI), MD Anderson symptom questionnaire (MDASI-TCM) and rehabilitation needs questionnaire (MDASI-TCM). Results: a total of 637 cases (53.4%) were male and 297 (46.6%) were female. The median age of the patients was 71 years (65-92 years) .ADL score was 95.5%. MDASI-TCM tumor symptom questionnaire was used to investigate the common symptoms. The top ten symptoms were: fatigue 77.5b, amnesia 62.0, sleep restlessness 60.6, dry mouth 56.4cm, distress 51.8, bad appetite 51.7%, pain 51.7%, cough 50.1%, shortness of breath 49.9% and cold 49.0%. The overwhelming majority of patients (283 / 637 / 44.4%) thought that the pain that had the greatest impact on the quality of life was uncontrolled symptoms, followed by bad mood (82 / 637 / 12.9%). The most painful symptoms affecting quality of life were fatigue (149 / 63723.4%), pain (119 / 637 / 18.7%), insomnia (58 / 637 / 9.1%), anorexia (56 / 637 / 8. 8%) and cough (50 / 637 / 7.8%). The results were consistent with those of MDSIA-TCM. More than half of the patients (334 / 637 / 52.4%) knew about rehabilitative knowledge, and 83.7% (533 / 637) of patients were willing to receive rehabilitation guidance. The specific needs of rehabilitation included: seeking rehabilitation guidance (372 / 637 / 58.4%), consulting on cancer knowledge (323 / 637 / 50.7%), nutrition guidance (293 / 637 / 637 / 46.0%) and psychological counseling (137 / 637 / 51.5%). 81.0% of the patients were willing to undergo TCM rehabilitation and hoped to increase immunity (461 / 637), body regulation (390 / 637 / 61.2%), relieve symptoms (381 / 637 / 59.8%) and improve physical strength (33963 / 7 / 53.2%). Conclusion: the distribution of symptoms obtained by MDASI-TCM symptom scale is basically the same as that obtained by MDASI-TCM symptom scale, which indicates that MDASITCM scale is suitable for the evaluation of symptoms in elderly patients with tumor. The purpose of treatment and rehabilitation of elderly tumor patients are basically the same, reducing pain symptoms should be attached great importance to, there is a great demand for Chinese medicine in the recovery process of elderly tumor patients.
【作者单位】：北京大学肿瘤医院暨北京市肿瘤防治研究所中西医结合暨老年肿瘤科恶性肿瘤发病机制及转化研究教育部重点实验室;中国中医科学院西苑医院肿瘤科;福建省肿瘤医院放射治疗科;安徽省肿瘤医院肿瘤内科;辽宁省肿瘤医院内科;
【基金】：北京医院管理局青苗人才计划北京市卫生局首都卫生发展科研专项课题
【分类号】：R730.5

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