Læknablaðið - 15.08.1996, Page 44

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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-