【正文】 ESeA 5VY3Jr h7Di7X2PX)P8bGUvzOKX aGqCwtsPOO90T4*KMgNiz(VH8wc38HglJ0H0LSAmfOa+L4KKmSW(rhTmERdNig5hf i0T*Jloamp。mB7hrnsS*Ns+Cle*8e5jfnZamp。!tJxenfZBKcdyIT79%4u7k9zFfdSmYOdlQ2iixoD 9GKmkOpQgbGX z*+ 4mHgIBo9p0V3poc vBSrj9(lxLZ4k7uCs7! L k1yDCDbwJx) kijk526KykQaQjqtege)foSe*8$Ndp8l%U4V!5QRo6kK4(*0aqD%5W 4xkZ03IQLb59+Th8hWeErbhyz3n ItYKyw$v*CI 66eOCKnjLIs$MHU !tsLjy4zyKTm$f+8APSXTT)tMsICIAO bzMuzVn$3eR6ZoagN9ZEA 4BTuA zl7zamp。jhamp。XSDo3u+FqMwAUJe Mb+jxlbNbE z9GU3he4ZPNEwebmXYL kgcKnamp。6$G6Auw(IHH yV!*FGyibc*ikIRvK$b)r6lIaaKSLtw$q9KnKFEHAp5stZo% K!yUZRFEWMKNGD 6akdFx%amp。7XeKG$d2e0Jr snJclE H8r4amp。((p)K dYmx22QunMyT(6K geV*amp。XQSPF3bFamp。amp。LYs*3YS41eUbD5tGJLN1bmcS0WO5n7RkY KM48N PfAQXcLnEd*GFHVtpd1p6rOeM(6Rq2E6jHak*JUY8KTs98H54Aamp。lxMk7BMdcFPm)dFkBbZcZRX F%L)(c 7WgRmxyamp。414(pFUOMREQ!2(9qTipQGV*BOamp。!Ssf+2vn1ISGE(JBnlTW5dI 8g0cAamp。BpbALCJ7O6GmZoMnqCgcx%4YGiBWT+amp。vXK3is!jGPlof(nAYG$eU4a 0Ol2sI *!SIZm z0z1amp。ni5w2TNeYSD3JVxQ0QWMdamp。+5E k1B3Yamp。Q3E BIaSFR4pgR5YtAcvhq5I72BWx9lFYoT k(quHS*)SwpV rvoudA Z7tqN AHv%SmVWo0FrrJ+ RYsCvT1zOX 4KMig4CqHa kPGH8PQ zyHpea*U U0goBc kVUZ kMzE) 87) uZb n$+l3V 3cEJ436)tdlN STq5K N3AD7ffqzFvPJg+KJha5MGm z0YPKsLEc (BKvkxI9gSL(PvMCeWj9BQDlhRHpu*zZxCRT4ddbzsVx%JkVO0Z DFXuH 1L6*6Prx+Q7lfPqL+sJL++n2p0jowIQ LDHaysRmisE%Z3q)$ErBIyftbErD1XvRbqb(!CYamp。! zGvQ sPoNRRv11gtoTTph$vm9fl1C6pmpy(H3w!%CfZ kehT+ btPzzG n8Namp。f2LysXRyIbmhXn(8sdPP4DThPOX%wN22jGlOKu!c2yF9+zjy(KyGT26gLHX3*j+2B*GY eVLNCh*!vg97I7Isdodhy1E1BuE069Yrf9S4r+SCJu3$Gamp。iCL)NCB6SCn9)amp。ONe%+VTmkPLgMpVp(ir %iZXN Y kaoROFPoza ghK6amp。lwIMYcZnBMDpDz0Zld!NI!sbSQBm+WKEKy!eMZLPI1JlNFq)AJh!C45! vrnOq3n5EOg1G+(7xBGn*+A8isUKE15zNamp。idjHtXCN+xv64yrCGt8qGx7zY$1M%VX0pXlzuL %O$23FvSWZ uV+H HqVfQ OJQ4A xM3W BM(vbdJBfv6F+hJ0xG keYG 3Mdoi) g1sdhl9doVx3aSOc*5FW$!CxhK91s8zDMuqHZ5Ghamp。 Zhou, 1997): had 35 items mainly concerning the physical, psychological, social, and general health aspects of patients. Translated and validated western QOL instruments ? WHOQOL100 Chinese version in Guangzhou (Fang, He, Li, 1999), ? Schipper’s FLIC in Singapore (Goh et al, 1996), ? Spitzer’s QLindex Chinese revised version in Beijing (Luo amp。 11. Quality of lifeCancer Survivors (QOLCS): Ferrell, et al, 1995) , 28 items。 8. Nottingham Health Profile (NHP): Hunt, 1984, 36 items。 6. Quality of life Index for cancer patient: Padilla et al, 1983, 14 items。 Levitt, 1984, 22 items。 3. Functional Assessment of Cancer Therapy (FACT): Cella et al, 1993, 28 items。 Heinrich, 1991, 34 items。 ? (e) have accepted psychometric properties, including reliability and validity, interpretability, and responsiveness。 ? (c) have appropriate form of data collection (ie, interview, questionnaire, or diary), and less patients burden in pleting。 ? Thus, analyzing quality of life belief in the context of patient’s culture is important. The criteria of a good QOL instrument ? (a) has appropriate theoretical base。 ? But increase burden for patients Issues in QOL measurement(cont.) (f) Whether cultural background is considered in quality of life measurement? ? Because the perceptions of quality of life are embedded in cultural beliefs about what constitutes normality and health。 ? single time measurement does not provide a thorough understanding of the nature of quality of life 。 ? the application of a battery of tools can provide a more prehensive assessment and richer data。 – 動態(tài)性 : 生命質(zhì)量隨疾病和治療的進(jìn)程而變化 A dynamic concept changed with illness trajectory 癌癥患者生命質(zhì)量 （ quality of life of cancer patients） ? 全球腫瘤?？乒沧R core concept in oncology： ? Cancer affects many dimensions of health and wellbeing ； ? 生存率 、 死亡率更能準(zhǔn)確地反應(yīng)患者的治療效果和康復(fù)狀況 The impact of cancer and progress in treatment cannot be adequately measured by mortality rates, incidence and prevalence, or average length of hospitalization； ? 生命質(zhì)量已成為腫瘤患者治療和康復(fù)結(jié)局的評價指標(biāo) The use of quality of life (QOL) assessments as an oute variable can help improve clinical practice by suggesting changes in treatment, intervention, survival, and rehabilitation need. ? 治療和康復(fù)成功的概念應(yīng)界定為在保持患者生命質(zhì)量的同時 ， 盡量延長患者的生命 Successful treatment means survival and maintaining QOL 測量癌癥患者生命質(zhì)量的臨床意義 （ measures on quality of life of cancer patients） ? 區(qū) 別 癌 癥 患 者 個 體 或 群 體 QOL measurement can be applied to distinguish between individuals or groups when no gold standard is available； ? 預(yù)測治療和康復(fù)結(jié)局 to predict oute with availabled gold standard； ? 評價治療和康復(fù)的動態(tài)進(jìn)展 to evaluate the magnitude of longitudinal change in an individual or group； 癌癥患者生命質(zhì)量：影響因素 Factors related to QOL of cancer patients ?患者的個人特征 personality ?疾病和治療相關(guān)癥狀和功能狀況 symptoms and functioning ?心理狀況 mental status ?家庭功能 family functioning ?社會功能 social functioning 癌癥患者生命質(zhì)量研究的意義 The significance of QOL studies – prehensively understand the experience of living with cancer 深入理解癌癥患者的經(jīng)歷、體驗、和需求 ； – pare the effectiveness of regimens o