항암화학요법으로 인한 말초신경병증을 경험하는 대장암 환자의 삶의 질
Quality of Life in Colorectal Cancer Patients with Chemotherapy-Induced Peripheral Neuropathy
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초록
본 연구는 말초신경병증을 경험하는 대장암 환자의 삶의 질을 확인하고자 한 서술적 횡단적 조사연구이다. 연구대상은 서울 시내에 소재한 A종합병원 종양내과에서 옥살리플라틴을 투여 받았거나 받고 있는 대장암 환자 중 말초신경병증을 경험하고 있는 93명을 대상으로 EORTC QLQ C30과 CIPN20을 사용하여 삶의 질을 측정하였다. 연구결과는 다음과 같다. 첫째, 대장암 환자의 건강관련 삶의 질 중 전반적인 삶의 질은 59.41점, 기능영역은 73.29점, 증상영역은 26.72점으로 나타났다. 둘째, 말초신경병증으로 인한 삶의 질은 감각영역 32.70점, 자율신경영역 22.88점, 운동영역 16.12점으로 나타났다. 셋째, 말초신경병증으로 인한 삶의 질에서 감각영역은 나이(F=4.388, p=.006), 말초신경병증 등급(t=-6.120, p<.001), 당뇨여부(t=2.865, p=.005), 현재 항암화학요법여부(t=-3.466, p=.001), 비약물요법 여부(t=2.632, p=.010)에서 통계적으로 유의한 결과를 나타냈다. 넷째, 건강관련 삶의 질 중 전반적인 삶의 질은 말초신경병증으로 인한 삶의 질의 하부 영역인 자율신경영역(r=-.54, p<.001)과는 유의한 부적 상관관계를 나타냈다. 기능영역과 감각영역은 말초신경병증으로 삶의 질의 하부 영역 세 가지 감각영역(r=-.51, p<.001, r=.40, p<.001), 운동영역(r=-.56, p<.001, r=.50, p<.001), 자율신경영역(r=-.56, p<.001, r=.67, p<.001)에서 모두 부적, 정적 상관관계를 나타냈다. 이상의 결과로 옥살리플라틴 투여로 말초신경병증을 경험하는 대장암 환자의 건강관련 삶의 질이 말초신경병증을 경험하지 않는 환자들 보다 증상영역은 비슷하지만 전반적인 삶의 질과 기능영역의 삶의 질은 상대적으로 낮은 것을 알 수 있었다. 앞으로 항암화학요법으로 인한 말초신경병증을 경험하는 다른 암 환자와의 비교연구가 필요할 것으로 생각되고 말초신경병증 완화와 삶의 질 향상을 위한 간호중재 개발을 제언한다.
Abstract
Purpose: The purpose of this study was to identify the quality of life in colorectal cancer patients with chemotherapy-induced peripheral neuropathy. Methods: A total of 93 patients were recruited in the cross-sectional survey design. Quality of life in colorectal cancer patients were measured by European Organization for Research and Treatment of Cancer (EORTC) QLQ C30 and CIPN20. Results: In the QLQ C30, the mean score of the global health status was 59.41, the functional scale was 73.29 and symptom scale was 26.72. In CIPN20, the mean score of sensory scale was 32.70, autonomic scale was 22.88 and motor scale was 16.12. In the QLQ C30, the global health status showed significant differences according to surgery (p=.027) and the functional scale, and the symptom scale showed significant differences according to gender (p=.046, p=.020) and nonpharmacologic intervention (p=.001, p=.009). The CIPN20, the sensory scale showed significant differences according to age (p=.006), DM (p=.005), grade of CIPN (p=<.001) the status of chemotherapy (p=.001) and nonpharmacologic intervention (p=.010). Conclusion: The level of quality of life in colorectal cancer patients with peripheral neuropathy was relatively low. There is a need for developing a nursing intervention for colorectal cancer patients to improve their quality of life and to decrease chemotherapy-induced peripheral neuropathy.
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