摘要目的 了解恶性肿瘤骨转移住院患者的生活质量现状及其相关影响因素.方法 采用自行设计的问卷调查2011年3月至9月间在我院肿瘤中心确诊的恶性肿瘤骨转移的住院患者82例,调查内容包括患者一般情况、临床诊疗相关信息、癌症患者生活质量核心调查量表( QLQ-C30)、症状负荷量表中文版(MDASI-C)、医院焦虑抑郁量表(HADS).结果 82例骨转移患者完成调查,QLQ-C30量表中生活质量标准化得分(53.28±19.20)分,功能子量表中得分最低的是社会功能,平均(47.54±32.47)分；在症状子量表中得分最高的是乏力,平均(56.65±25.23)分.在MDASI-C量表中症状负荷最重的是乏力、苦恼与疼痛,分数依次为(5.28±2.56)分、(3.67±3.18)分、(3.59±3.25)分；干扰生活最重的方面是家务劳动与走路,平均得分为(6.18±3.43)分与(4.79±3.37)分.Spearman相关分析示症状负荷中疼痛、乏力、苦恼、悲伤、气短、麻木显著影响患者生活质量.24例(29.3％)诊断为焦虑,17例(20.7％)诊断为抑郁,焦虑和抑郁情绪影响总体生活质量和多维度功能.结论 疼痛、乏力等症状负荷以及负性情绪显著影响恶性肿瘤骨转移患者生活质量,干扰生活最严重的是家务劳动与走路.恶性肿瘤骨转移患者的综合治疗应重视心理康复,同时给予相应康复治疗以改善功能、减轻症状,提高生活质量.

abstractsObjective To investigate factors influencing the quality of life (QOL) of cancer patients with bone metastases. Methods Eighty-two cancer patients with hone metastasis were investigated.A questionnaire designed according to European Organization for Treatment of Cancer quality of life questionnaire ( EORTC QLQ-C30),Monroe Dunaway Anderson symptom inventory-Chinese edition (MADSI-C) and hospital anxiety and depression scale (HADS) standards was used to collect the information. Results The average total standardized QOL score of these cancer patients was 53.28±19.20.Among the function subscales,social function got the lowest average score (47.54),while among the symptom subscales fatigue got the highest average score (56.65).According to the MDASI-C,the most serious symptom burdens were fatigue,distress and pain; working and walking experienced the most interference.The symptom burdens correlated significantly with the QOL results.Twenty-four of the patients (29.3％) had been diagnosed with anxiety,and 17 (20.7％) were diagnosed with depression.Anxiety and depression continued to be significantly associated with overall QOL and its various dimensions. Conclusions The results　show that the burden of fatigue and pain,as well as of anxiety and depression are significantly associated with impaired QOL among cancer patients with bone metastasis.Work (housework) and walking were the most severely affected activities.Psychological rehabilitation should be focused on the comprehensive treatment of patients with bone　metastasis along with other appropriate rehabilitation strategies to enhance their overall functioning,relieve their　symptoms and improve their QOL.