德国癌症患者创伤后成长与生活质量的相关性及启示

doi:103.3761/j.issn.0254-1769.2025.07.015

摘要/Abstract

摘要：

目的分析癌症患者的创伤后成长与健康相关的生活质量间的关系，并探究其随时间的发展趋势及变化原因，为提升癌症患者的生活质量提供参考。方法采用整群抽样法，选取2008年—2011年和2018年—2019年在德国6所癌症注册中心登记的癌症长期患者为调查对象，应用一般资料调查表、德文版创伤后成长量表、欧洲癌症研究与治疗组织生活质量核心调查问卷进行基线和随访调查。对收集的资料采用线性混合回归模型进行纵向关系分析。结果最终2 704例癌症患者完成了基线和随访调查，有效样本为2 686例。创伤后成长高分组在总体健康状况/生活质量得分高于低分组得分，差异有统计学意义（P<0.05）；但在随访时，两组得分比较，差异无统计学意义（P>0.05）。创伤后成长各组与时间的交互作用在总体健康状况、失眠方面比较，差异均有统计学意义（P<0.05）。创伤后成长与经济困难得分存在稳定的正向关系（P<0.001）。结论癌症患者的创伤后成长和健康相关的生活质量存在正相关，但随时间发展关系逐渐减弱，而自觉健康相关的经济负担是持续的压力源。

关键词: 创伤后成长, 癌症患者, 生活质量, 前瞻性队列研究, 多中心研究, 护理

Abstract:

Objective To analyze the relationship between post-traumatic growth（PTG） and health-related quality of life（HRQOL） among long-term cancer survivors （time since diagnosis≥5 years） and to explore the trends and reasons for changes over time. Methods A total sampling method was used to conduct baseline and follow-up surveys on long-term cancer survivors from 6 cancer registries in Germany during 2008—2011 and 2018—2019. General information questionnaires，Post-Traumatic Growth Inventory，and European Organization for Research and Treatment of Cancer-Quality of Life Questionnaire were applied. The collected data were analyzed using a linear mixed-effects regression model for longitudinal relationships. Results A total of 2704 long-term cancer survivors completed the baseline and follow-up surveys and the effective sample size is 2 686. The high PTG group had a significantly higher overall health status/QOL score than the low PTG group，with a statistically significant difference（P<0.05）. However，the difference in scores between the 2 groups at follow-up was not statistically significant（P>0.05）. The interaction between PTG groups and time was statistically significant for overall health status and insomnia（all P<0.05）. There was a stable positive relationship between PTG and economic difficulty scores with a statistically significant difference（P<0.001）. Conclusion There is a positive correlation between PTG and HRQOL among long-term cancer survivors that weakens over time，and the perceived economic burden related to health is a continuous source of stress.

Key words: Post-Traumatic Growth, Cancer Survivors, Quality of Life, Prospective Cohort Study, Multi Center Research, Nursing Care

刘谆谆, 杨柯翼, Melissa S.Y. Thong, 陆云南, 张兰风, 冒小平. 德国癌症患者创伤后成长与生活质量的相关性及启示[J]. 中华护理杂志, 2025, 60(7): 864-870.

LIU Zhunzhun, YANG Keyi, THONG S.Y. Melissa, LU Yunnan, ZHANG Lanfeng, MAO Xiaoping. The implication and association between post-traumatic growth and health-related quality of life in German cancer survivors[J]. Chinese Journal of Nursing, 2025, 60(7): 864-870.

图/表 3

表1 癌症患者的一般资料和疾病相关特征及组间比较[例，百分比（%）]

Table 1 General information and disease characteristics of the participants [cases，percentage（%）]

表2 创伤后成长高分组和低分组癌症患者基线和随访时生活质量得分比较（分，$\bar{x}±s$）

Table 2 HRQOL score of 2 groups of participants at baseline and follow-up（score，$\bar{x}±s$）

表3 癌症患者生活质量得分的线性混合模型结果

Table 3 Linear mixed models of quality of life results for cancer patients

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