| Malignant tumor (MT) is a hard-to-cure disease which is a severe threat to human health, and has brought great pain to patients and their families. Caring about the quality of life (QOL) of tumor patients has turned out to be a major part of community health service (CHS). It is important to launch education on tumor prevention to patients’ family members as they are a part of high risk population. It will be meaningful to know MT patients’ QOL as well as their family members’ knowledge, attitude and practice (KAP) on tumor prevention so that we can launch the comprehensive community MT prevention and can provide both sustainable development mode and strategy.ObjectivesTo have an explore on comprehensive community prevention measure through evaluating tumor patients’ living status and QOL as well as their family members’ KAP on tumor prevention by having a knowledge of the status of MT patients’ management in different communities in Changning District.MethodsA cross-sectional study was carried out in all the 290 patients diagnosed in tertiary hospitals from Jan 1st 2008 to Dec 31st 2009 who lived in Tianshan Community and Hongqiao Community, Changning District. Household visit and health status questionnaire (SF-36; Chinese Version) are applied in the research. A grown-up family member (mostly spouses, some parents children and siblings) was randomly chosen to have< Survey on tumor related knowledge, attitude and practice>. The incidence and survival data were provided by the Cancer Registry system of Changning CDC.Results1. MT patients’ overall QOL is lowThe original score of QOL in all dimensions was lower than the domestic and international regular model, higher than senior (>=60 years old) MT patients’ and patients’ with only liver cancer. And their total score in Physical component scales (PCS) and mental component scales (MCS) is lower than 52. It preliminarily indicated that TM patients’ QOL score was lower than both domestic and international regular model and higher than senior MT patients’and simple liver cancer victims’. Female patient’s QOL is higher. Despite the fact that their average score in physiological function dimension was lower than males, the rest of their QOL dimension score are all higher than male’s. Among them, there exist statistically significant differences in general health status, mental health and MCS. The QOL was decreased with the increase of age. Each age group showed statistically significant difference (P<0.05) in general health status, emotional function, social function, physiological function, somatic pain and physical health. Younger patients’ QOL is better than elder patients’. With the development of disease, the QOL declined. The average score in stageⅠwas 96.8; the average score in stageⅡwas 99.6; in stageⅢit was 91.4 and it was 93.0 in stageⅣ. The highest score was 99.6 for stageⅡpatients. The lowest one was 91.4 for stageⅢpatients. Both stageⅠand stageⅡpatients were at the early stage of cancer, their acceptability to cancer was better than those in advanced stages. And their damages in both physical and physiological function were gentler while stageⅣpatients suffered in losses of general health status, physiological function as well as social function. Viewed from the overall trend, patients’ QOL declined with the development of disease.2. Comprehensive management is effective in improving patients’QOLResults of QoL assessed by SF-36 showed that there were no statistically significant differences stratified by age, severity of cancer and type of cancer of patients. In general, the score of patients in Tianshan Community, where comprehensive management mode was applied is higher than those in Hongqiao Community, where traditional management mode was used in every dimensions. The physiological functions of Tianshan:72.4, Hongqiao:62.1; General health status: Tianshan:57.3, Hongqiao:48.3; Emotional function:Tianshan 74.0,Hongqiao:71.4; Energy:Tianshan 66.6,Hongqiao:61.1; Mental health:Tianshan 74.3,Hongqiao: 67.8; Social function:Tianshan 96.1,Hongqiao:88.0; Physiological function: Tianshan 74.0,Hongqiao:67.7; Somatic pain:Tianshan 81.0,Hongqiao:71.4; PCS: Tianshan 46.6,Hongqiao:43.0; MCS:Tianshan 52.4,Hongqiao:50.1. It showed statistically significant difference (P<0.05) in almost every dimension except in emotional function. MT patients’QOL in Tianshan Community was better than those in Hongqiao Community. Comprehensive management mode was helpful in improving patients’QOL.3. Knowledge, attitude and practice in tumor prevention of the family member of patients were limitedThe general awareness rate of tumor related knowledge was 90.0%. The awareness rate of such concepts as "early detection, early diagnosis and early treatment", "Smoking is a reason for lung cancer" ranked high. It reached 97.4% and 95.5%. However, those in such ideas as "Hepatitis B vaccine can prevent liver cancer" and "Passive smoking is the cause of lung cancer" ranked low. It was 73.1% and 84.7%.The accurate rate in attitudes on tumor prevention was 85.0%. "Tumor should be treated right after detection" ranked first at 95.9% while the lowest was only 57.1% in "I’m will to pay for the hepatitis B vaccine".The average forming rate of tumor related behavior was 79.5%. "Frequently eat vegetable "and "Frequently eat fruit" ranked first two. They were 91.8% and 91.0%. Followed by avoid drinking and smoking. They were 87.3% and 81.0%; Stay no nervous ranked last. It was 55.6%.78.4% of the people gain tumor related knowledge from TV programs. Fetching knowledge from newspapers and magazines, relatives, colleagues and friends, health related books accounted for 62.3%,58.65% and 51.9%. Only 32.1% of the information is from doctors. They get even less from the Internet.4. Gender, occupation and education level were associated with patients’family member’s KAP in tumor prevention.After the stratification analysis in every dimension of KAP, the result showed:In awareness of knowledge:Retired people performed better than in-service people (retired 10.22, on-the-job personnel 9.96 points). In behavior:women performed better than men (6.65 female,6.12 male); college graduates or above gained a higher score (6.68) than primary school graduates (6.64). Junior school and high school graduates ranked low (6.24). After the Spearman rank correlation analysis, the score of the knowledge and attitudes are closely related, but it showed no difference in behavior.ConclusionThe general QOL of patients from Changningi community management was low for the present. And it was influenced by gender, age and stages of the disease. Community based comprehensive intervention management could help to improve patients’ QOL from a certain extent. At the same time, there still exist all kinds of lacks and difference in MT patients’ family members’ KAP on tumor prevention. And interviewees in different gender, occupation and education level showed difference in knowledge, attitude and practice. Knowledge was related with attitude but showed no relationship with practice. |
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