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Læknablaðið - 15.08.1996, Side 44

Læknablaðið - 15.08.1996, Side 44
590 LÆKN ABLAÐIÐ 1996; 82 Nýr doktor í læknisfræði Þann 9. febrúar 1996 varði Valgerður Sig- urðardóttir læknir doktorsritgerð sína við Há- skólann í Stokkhólmi. Ritgerðin nefnist Qual- ity ofLife ofPatients with Generalised Malignant Melanoma on Chemotherapy. Fer ágrip úr rit- gerðinni á ensku hér á eftir. Background: A quality-of-life study (QoL) was conducted in parallel to a clinical trial to examine the impact of chemotherapy on the physical, psychological, social and overall functioning and well-being of the patients with advanced malignant melanoma on chemother- apy. A tumour-specific questionnaire tech- nique (EORTC QLQ) to evaluate patients’ QoL, was studied and extensively validated. Moreover, information was gathered from care providers regarding opinions on ethical and psychological aspects of this particular treatment situation. Material: Between October 1987 and Janu- ary 1991, 95 patients with generalised melan- oma were examined. Attending nurses and rel- atives were included in the assessments. Fur- thermore, 93 individuals with hereditary risk and 123 patients with stage I melanoma were compared with the first 57 patients with ad- vanced disease regarding emotional distress. At the official closure of the study, 45 profes- sionals working at the Melanoma Unit partici- pated in the staff-questionnaire study. Methods: QoL was assessed by a set of self- administered questionnaires, the EORTC QLQ-C36, a study-specific melanoma module and the Hospital Anxiety and Depression (HAD) scale. The nurses and relatives filled in Key words: advanced malignant melanoma, care provid- ers, chemotherapy, ethics, EORTC QLQ-C36, HAD scale, melanoma module, prognostic, proxy rater, psychometric analyses, quality of life. appropriate versions. Clinical variables were obtained, either from the multicentre clinical trial or from patient files. A staff study-specific questionnaire was developed. Results: Pretreatment results disclosed a relatively low symptom burden, good func- tioning and a high overall QL. Nine weeks later there had been a significant deterioration in performance status and one-third of the pa- tients had succumbed to rapidly progressing disease. Patients still on treatment reported a significant worsening on all QoL aspects, ex- cept pain and emotional function. Low corre- lations were found between physician-rated clinical outcome and patient reports, except for neurotoxicity, confirming that the physi-

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