Erfassung von Lebensqualität bei kolorektalem Karzinom anhand des EORTC QLQ-CR29 - Eine Studie zur Anwendbarkeit des EORTC QLQ-CR29 an betroffenen Patienten

Health-related quality of life has an increasing relevance in the surveillance of patients and is often an important endpoint of clinical studies. Thus valid, exact and understandable instruments have to be created to monitor and assess quality of life in patients during a disease and its therapy. Our objective was to optimize the clinical use of the EORTC QLQ-CR29 in patients with colorectal cancer. The questionnaire was handed to 61 patients with histological-proofed colorectal cancer. The patients answered the questionnaires and additionally tested every single item regarding to understandability, comprehensibility, acceptance, alternative questions and possible missing subjects. In this study we can show that female patients identify more often problematic questions as male patients and are able to create more often alternative questions. Also patients with stomata find more deficient questions and give more alternative questions than patients without a stoma. We also can show that with increasing age patients have more difficulties in answering the questionnaire. According to the patients level of education we found only a marginal difference. Married patients and patients, who are living in households with other adults, identify less problematic questions and less often name alternatives than singles. Patients, who know about their disease longer than 1 week but less 1 month, find the highest number of difficult questions. In contrast patients, who know about their disease longer than 1 month can create the most alternative questions and give a lot of ideas of missing topics in the questionnaire. Questions regarding sexuality and sexual issues are sensed as unpleasant and unnecessary especially by female patients. In addition the patients named topics, which were not represented in the questionnaire. These were questions according to living with a stoma and its maintenance, questions regarding the patient´s future and questions according to the patient´s emotional and psychological status. Finally we asked physicians and nurses for their opinion on the questionnaire. Here we found no significant differences in their answers and the affected patient´s answers. There could be done some improvements to optimize the questionnaires understandability and acceptability like refining the answering options, using more common terms in the item´s text, a better embedding of questions regarding sexuality in the questionnaire´s context and creating more questions regarding the missing topics. In summary the EORTC QLQ-CR29 is a helpful instrument to assess health-related quality of life in patients with colorectal cancer at different times during therapy, after surgery and in long-term surveillance.