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일회용 약물주입기로 가정에서 항암치료 중인 대장암 환자의 삶의 질

Quality of Life in Colorectal Cancer Patients at Home 5-Fluorouracil Chemotherapy with Disposable Elastomeric Infusion Pumps

  • 투고 : 2022.01.31
  • 심사 : 2022.02.24
  • 발행 : 2022.04.30

초록

Purpose: The purpose of this study was to examine the psychological distress related to quality of life (QoL) of patients with colorectal cancer receiving 5-fluorouracil (5-FU) chemotherapy at home with disposable Elastomeric infusion pumps. Methods: In this study, 179 colorectal outpatients were recruited between September 2019 and January 2021. National Cancer Center Psychological Symptom Inventory scores, general self-efficacy, and the EORTC QLQ-C30 scores were measured. Data were analyzed using Independent t-test, One-way ANOVA with Bonferroni post hoc analysis, and hierarchical multiple linear regression with the SPSS/WIN 26.0 programs. Results: The overall prevalence of psychological distress was 52.0% in colorectal patients. In multiple regression, psychological distress (β=-.20, p=.005), appetite loss (β=-.20, p=.001), chemotherapy cycles (β= .19, p=.002), fatigue (β=-.16, p=.035), physical functioning (β=-.16, p=.024), and emotional functioning (β=-.15, p=.025) were significant factors of QoL, and the final model explained 45.0% of the total variance of QoL. Conclusion: Supporting patients toward decreased psychological distress and increased physical and emotional functioning, especially in the first or second cycle of chemotherapy, could be used to improve their QoL. To consider the thresholds for clinical importance, it is necessary to increase the interpretation of psychological distress in clinical practice and further research.

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참고문헌

  1. Hong S, Won YJ, Lee JJ, Jung KW, Kong HJ, Im JS, et al. Cancer statistics in Korea: Incidence, mortality, survival, and prevalence in 2018. Cancer Research and Treatment. 2021;53(2):301-315. https://doi.org/10.4143/crt.2021.291
  2. Benson AB, Venook AP, Al-Hawary MM, Arain MA, Chen YJ, Ciombor KK, et al. Colon cancer, version 2.2021, NCCN clinical practice guidelines in oncology. Journal of the National Comprehensive Cancer Network. 2021;19(3):329-359. https://doi.org/10.6004/jnccn.2021.0012
  3. Grothey A, Sobrero A, Meyerhardt JA, Yoshino T, Paul J, Taieb J, et al. Prospective pooled analysis of six phase III trials investigating duration of adjuvant (adjuv) oxaliplatin-based therapy (3 vs 6 months) for patients (pts) with stage III colon cancer (CC): Updated results of IDEA (International Duration Evaluation of Adjuvant chemotherapy). Annals of Oncology. 2017;28(Suppl 5):v613. https://doi.org/10.1093/annonc/mdx440.014
  4. Heinemann V, von Weikersthal LF, Decker T, Kiani A, Vehling-Kaiser U, Al-Batran SE, et al. FOLFIRI plus cetuximab versus FOLFIRI plus bevacizumab as first-line treatment for patients with metastatic colorectal cancer (FIRE-3): A randomised, open-label, phase 3 trial. Lancet Oncology. 2014;15(10):1065-1075. https://doi.org/10.1016/s1470-2045(14)70330-4
  5. Mak S, Hui P, Wan W, Yih C. At-home chemotherapy infusion for patients with advanced cancer in Hong Kong. Hong Kong Journal of Radiolology. 2020;23(2):122-129. https://doi.org/10.12809/hkjr2017181
  6. Evans JM, Qiu M, MacKinnon M, Green E, Peterson K, Kaizer L, et al. A multi-method review of home-based chemotherapy. European Journal of Cancer Care. 2016;25(5):883-902. https://doi.org/10.1111/ecc.12408
  7. Salman D, Biliune J, Kayyali R, Ashton J, Brown P, McCarthy T, et al. Evaluation of the performance of elastomeric pumps in practice: Are we under-delivering on chemotherapy treatments? Current Medical Research and Opinion. 2017;33(12): 2153-2159. https://doi.org/10.1080/03007995.2017.1374936
  8. Sabbagh Dit Hawasli R, Barton S, Nabhani-Gebara S. Ambulatory chemotherapy: Past, present, and future. Journal of Oncology Pharmacy Practice. 2021;27(4):962-973. https://doi.org/10.1177/1078155220985916
  9. Al-Kadhimi M, Hill ME, Fine E, Adess ME, Polish A, Wiebe LA, et al. Ambulatory 5FU infusion pumps: Patient perceptions and quality of life. Journal of Clinical Oncology. 2019; 37(4 Suppl):663. https://doi.org/10.1200/JCO.2019.37.4_suppl.663
  10. Joo EH. The comparision of the medical quality and cost between inpatient chemotherapy and ambulatory chemotherapy (portable infusion pump use): In colorectal cancer patient [master's thesis]. Seoul: Yonsei University; 2008. 65 p.
  11. Baek Y, Yi M. Factors influencing quality of life during chemotherapy for colorectal cancer patients in South Korea. Journal of Korean Academy of Nursing. 2015;45(4):604-612. https://doi.org/10.4040/jkan.2015.45.4.604
  12. Seo HJ, Ryu EJ, Ham MY. Relationships among mood status, social support, symptom experience and quality of life in colorectal cancer patients - Based on the theory of unpleasant symptoms. Asian Oncolgy Nursing. 2018;18(2):104-113. https://doi.org/10.5388/aon.2018.18.2.104
  13. Han SS, Han SS, Han JW. The influences of depression, anxiety, social support and knowledge of anticancer drugs on the chemotherapy-induced peripheral neuropathy among colorectal cancer patients receiving oxaliplatin. Journal of Korean Clinical Nursing Research. 2013;19(2):298-308. https://doi.org/10.22650/JKCNR.2013.19.2.298
  14. Jang HS, Choi EO. Factors influencing quality of sleep among patients with colorectal cancer receiving chemotherapy. Asian Oncolgy Nursing. 2016;16(2):103-111. https://doi.org/10.5388/aon.2016.16.2.103
  15. Seo JY, Yi M. Distress and quality of life in cancer patients receiving chemotherapy. Asian Oncolgy Nursing. 2015;15(1):18-27. https://doi.org/10.5388/aon.2015.15.1.18
  16. Oh PJ, Lim SY. Change of cancer symptom, depression and quality of life based on phases of chemotherapy in patients with colorectal or stomach cancer: A prospective study. Korean Journal of Adult Nursing. 2017;29(3):313-322. https://doi.org/10.7475/kjan.2017.29.3.313
  17. Zhang M, Peng L, Liu W, Wen Y, Wu X, Zheng M, et al. Physical and psychological predictors of quality of life in Chinese colorectal cancer patients during chemotherapy. Cancer Nursing. 2015;38(4):312-321. https://doi.org/10.1097/ncc.0000000000000190
  18. Jeong G, Kim K, Kwak Y. Quality of life in colorectal cancer patients according to the severity of symptom clusters classification. Asian Oncology Nursing. 2014;14(2):74-83. https://doi.org/10.5388/aon.2014.14.2.74
  19. Liang SY, Chao TC, Tseng LM, Tsay SL, Lin KC, Tung HH. Symptom-management self-efficacy mediates the effects of symptom distress on the quality of life among Taiwanese oncology outpatients with breast cancer. Cancer Nursing. 2016;39(1):67-73. https://doi.org/10.1097/ncc.0000000000000244
  20. Kim JH, Choi KS, Kim TW, Hong YS. Quality of life in colorectal cancer patients with chemotherapy-induced peripheral neuropathy. Asian Oncology Nursing. 2011;11(3):254-262. https://doi.org/10.5388/jkon.2011.11.3.254
  21. Lee SH, Lee TG, Baek MJ, Kim JJ, Park SS, Lee SJ. Quality of life changes during adjuvant chemotherapy in patients with colon cancer. Korean Journal of Clinical Oncology. 2016;12(1):60-66. https://doi.org/10.14216/kjco.16010
  22. Rolke HB, Bakke PS, Gallefoss F. Health related quality of life, mood disorders and coping abilities in an unselected sample of patients with primary lung cancer. Respiratory Medicine. 2008;102(10):1460-1467. https://doi.org/10.1016/j.rmed.2008.04.002
  23. Oh PJ, Lee EO, Tae YS, Um DC. Effects of a program to promote self-efficacy and hope on the self: Care behaviors and the quality of life in patients with leukemia. Journal of Korean Academy of Nursing. 1997;27(3):627-638. https://doi.org/10.4040/jnas.1997.27.3.627
  24. Shim EJ, Hahm BJ, Yu ES, Kim HK, Cho SJ, Chang SM, et al. Development and validation of the National Cancer Center Psychological Symptom Inventory. Psycho-Oncology. 2017;26(7):1036-1043. https://doi.org/10.1002/pon.4277
  25. Oh ST, Lee S, Lee H, Chang MH, Hong SJ, Choi WJ. Reflection of pain in cancer patients using a new screening tool for psychological distress. Korean Journal of Psychosomatic Medicine. 2017;25(1):56-62. https://doi.org/10.22722/KJPM.2017.25.1.056
  26. Yun YH, Park YS, Lee ES, Bang SM, Heo DS, Park SY, et al. Validation of the Korean version of the EORTC QLQ-C30. Quality of Life Research. 2004;13(4):863-868. https://doi.org/10.1023/b:Qure.0000021692.81214.70
  27. Giesinger JM, Loth FL, Aaronson NK, Arraras JI, Caocci G, Efficace F, et al. Thresholds for clinical importance were established to improve interpretation of the EORTC QLQ-C30 in clinical practice and research. Journal of Clinical Epidemiology. 2020;118:1-8. https://doi.org/10.1016/j.jclinepi.2019.10.003
  28. Park SH, Choi HY, Lim WJ, Moon BI, Lim WS. An anxiety, depressed mood, and insomnia in newly diagnosed women breast cancer patients and thyroid cancer patients. Korean Journal of Biological Psychiatry. 2017;24(4):204-211. https://doi.org/10.22857/kjbp.2017.24.4.005
  29. Kim GM, Kim SJ, Song SK, Kim HR, Kang BD, Noh SH, et al. Prevalence and prognostic implications of psychological distress in patients with gastric cancer. BMC Cancer. 2017;17:283. https://doi.org/10.1186/s12885-017-3260-2
  30. Kim JH. Influencing factors on depression in stomach cancer patients receiving chemotherapy. Korean Journal of Adult Nursing. 2012;24(6):588-596. https://doi.org/10.7475/kjan.2012.24.6.588