回復期にある婦人科がん術後患者のQOLの実態と関連要因

Actual Status of and Factors Related to the Quality of Life of Patients in the Recovery Phase after Surgical Procedures for Gynecological Cancer

要旨

　目的：本研究は，回復期にある婦人科がん術後患者におけるQOLの実態と関連要因を明らかにすることを目的とした．

　方法：婦人科外来患者112名を対象に，基本属性，治療状況，QOL尺度（FACT-G），更年期症状（SMI），抑うつ（SDS），夫婦関係満足度，ソーシャルサポートで構成される調査用紙を用い聞き取り調査を行った．分析は記述統計を求め，FACT-Gについて比較および相関分析を行ったうえ，関連の認められた項目について重回帰分析を行った．

　結果：多発がんを除く110名を分析対象とした（有効回答率98.2％）．FACT-Gは平均86.4±11.6点であり，関連が認められたのは配偶者・パートナーの有無，経済状況，社会役割変化，排尿障害の有無，排便障害の有無，SMI，SDS，夫婦関係満足度，ソーシャルサポートであった．重回帰分析の結果，ソーシャルサポート（β＝−.42，p＜.001）がQOLに肯定的な影響，抑うつ（β＝−.51，p＜.001）がQOLに否定的な影響を及ぼすことが明らかになった．

　結論：回復期にある婦人科がん術後患者のQOL向上のためには，ソーシャルサポートの強化と抑うつの予防，早期発見と対処が重要な看護支援であることが示唆された．

Abstract

　Objective: To investigate the actual status of and factors related to the quality of life(QOL)of patients in the recovery phase after surgical procedures for gynecological cancer.

　Method: We conducted a survey among a group of 112 outpatients with gynecological cancer. The survey comprised questions related to postoperative complications, the satisfaction level in the patient's marital relationship, and social support received. The Functional Assessment of Cancer Therapy- General(FACT-G), the short depression inventory, and the simplified menopausal index were also a part of the survey for assessing QOL levels. Descriptive statistics were obtained from the analysis and a comparison and correlation analysis was performed for FACT-G results. Subsequently, a multiple regression analysis was performed for the items that were correlated.

　Results: Of the 112 patients, 110 responded to the survey(98.2%). The average FACT-G score was 86.4±11.6. The FACT-G score was significantly related to the relationship of the patients with their husband or partner(p＜0.05), fecal excretion disorders(p＜0.05), urination trouble(p＜0.05), economic stability(p＜0.001), and the change in social role(p＜0.05). Multiple regression analysis revealed that social support(β=0.42, p＜0.001)had a positive effect on QOL while depression(β =0.51, p＜0.001)had a negative effect on QOL.

　Conclusion: To improve QOL of patients in the recovery phase after surgical procedures for gynecological cancer, we suggest that a detailed analysis of the social support received by these patients and their depression levels is essential in addition to provision of nursing care support.