Резюме
Гудзь А.С. Оцінка якості життя хворих із злоякісними новоутвореннями органа зору з використанням опитувальника «SF-36».
Дослідженням встановлено, що у офтальмоонкологічних хворих спостерігається зниження якості життя за рахунок фізичного і психологічного компонентів. Особливо вираженим це зниження спостерігається серед хворих пенсійного віку і при локалізації злоякісних новоутворень в оці. Визначена необхідність проведення подальших досліджень щодо встановлення причин зниження якості життя та розробки заходів медико-соціальної реабілітації хворих.
Ключові слова: злоякісні новоутворення, орган зору та його придатки, якість життя.
Резюме
Гудзь А.С. Оценка качества жизни больных со злокачественными новообразованиями органа зрения с использованием вопросника «SF-36».
Исследованием установлено, что среди офтальмоонкологических больных наблюдается снижение качества жизни за счет физического и психологического компонентов. В особенности выражено снижение качества жизни среди больных пенсионного возраста и при локализации злокачественных новообразований в глазу. Определена необходимость проведения дальнейших исследований для установления причин снижения качества жизни и разработки мероприятий медико-социальной реабилитации больных.
Ключевые слова: злокачественные новообразования, орган зрения и его придатки, качество жизни.
Summary
Hudz A.S. Estimation of quality the life of patients with the malignant new formations of the visual organ with the use of a questionnaire “SF-36”.
A study established that reduction in the quality of life due to the physical and psychological components is observed among the ophthalmo-oncologic patients. Is in particular expressed reduction in the quality of life among the patients of pension age and with the localization of malignant new formations in the eye. The need for conducting further studies for the establishment of the reasons of reduction in the quality of life and development of the measures of the medico- social rehabilitation of patients is determined.  
Key words: malignant new formations, the visual organ and its appendages, the quality of life.
Рецензент: д.мед.н., проф. А.М. Петруня

УДК 616.7-006:01.5

Львівський національний медичний університет ім. Данила Галицького

Львовский национальный медицинский университет имени Данила Галицкого

79010 г. Львов, ул. Пекарская, 69

Danylo Halytsky Lviv National Medical University

69 Pekarska str., Lviv, 79010, Ukraine

anhudz@gmail.com

The term "quality of life" steadfast in medical terminology and is increasingly being used in both research and clinical practice [3, 7]. This term includes components such as indicators of physical health, social and mental state of the patient, etc. According to the WHO recommendations, quality of life is defined as the value of the individual person's position in society (taking into account the culture and values of this society) with the goals of this person, her plans, possibilities and a mess. This quality of life is a subjective measure of satisfaction of personal needs in life, reflecting the degree of human comfort within themselves and within their society [9].

Application of quality assessment of life today covers a wide range of problems and includes: a general assessment of not only the specific healthy or sick person, but also specific population; establishing the influence of various industrial, social and other factors, prevention and rehabilitation programs; assessment of the effectiveness of treatment; the development of individualized therapy program; a comprehensive examination of efficiency; clinical trials of new drug and non-drug therapeutic approaches, etc. [2, 7, 9].

Study of quality of life in Oncology, Cancer Institute of the United States held (NCÌ) from 1985 show multi-directional violation occur with cancer patients in the process of developing a malignant tumor and the subsequent therapy and observation. In connection with this, more than half of all the foreign studies of quality of life are associated with treatment of cancer patients. In 1990, at a joint Conference of the United States National Cancer Institute (NCÌ) and the American Society of Clinical Oncology (ASCO), it was determined that the quality of life importance is the second (after survival indicators) criterion for the evaluation of the results of the special treatment of malignancies [4].

Despite the initiated investigation of quality of life in oncology, research questions regarding this indicator among ophthalmooncology patients after  special treatment are not fully investigated in the world [3, 5, 6, 8] and it is not studied in the CIS countries and in Ukraine, which does not allow to evaluate the correctness of the choice of rehabilitation programs, and to develop new programs, psychocorrection and social rehabilitation assistance to the sick patients.

The foregoing allows to consider the quality of life of ophthalmooncology patients study important research direction and defines the purpose of this study.

Research objective: to evaluate the quality of life of patients with malignant malformations of the organ and its appendages.

Materials and methods. The main tool for the evaluation of quality of life is questionarrie. Today, a lot of questionarries and forms, including a general, are designed for the assessment of the quality of life in both healthy individuals and patients with various diseases, regardless of pathology. General questionarries are comparing the quality of life in different groups of healthy individuals and patients groups, as well as between them. One of the most common is the common short form questionarrie Medìcal Outcomes Study Short Form (SF-36), developed together with the J.E.Ware. in 1988 in US [1, 10], and was adapted to the Ukrainian population and used in the study.

Custom research survey was conducted by mailing to ophthalmooncology patients. Sampling was conducted with the general population of patients who developed malignant tumors (MT) of the eye and its appendages during 2003-2007 yy (N = 5899 individuals). The General Group of patients was formed from the national cancer registry database-(National Cancer Institute of Ukraine), there were formed out four groups of research: IA – patients with eyelid skin malignant neoplasms (ICD-10 is С 26.8 and 27.4), who got sick in working age (n = 1311); IB – patients with similar localization, but who are sick in pension age (n = 3658); IIA – patients with malignant neoplasms of eye (ICD-10 code –-S69), who got sick in working age (n = 281); IIB – sick with similar localization, but who are sick in pension age (n = 280). Of the total number of members of the research group selected by 50 persons, using a random number generator in sick patient groups.

The control groups were selected from healthy persons (who had no oftal′moonkologìčnu pathology – 100 persons, 50 persons working and retirement age). These studies were examined by parametric analysis. The accuracy of the data, and the differences between the research groups were studied with the use of the Student coefficient.

Research results and their discussion. Analysis of the quality of life of ophthalmooncology patients who survived 5 years after diagnosis of malignant neoplasms of the eye and its appendages determined that in accordance with the scale of the physical and psychological components, these patients had significantly lower scores than the control group (healthy people).

We found that the biggest differences between sick and healthy group of ophthalmooncology individuals were observed on the scales: comparison of general health feeling of last year (CH =-59.5%), physical activity (PF =-53.6), mental health component (MH =-12.2%), the value of physical problems in limiting the life of (RP =-49,8%). That means, the disease affects both physical and mental health component (table 1, fig. 1).

Stratification of patients who were treated about malignant eyelid skin neoplasms (ICD-10 is С 26.8 and 27.4) (and investigated) by age group determined that the lower performance scales were all among those who got sick in pension age (IB group), compared with those who got sick in working age (Group IA). However, the most pronounced are the differences from the scales: general health (GH =-36.6%), the value of emotional problems in limiting the life of (RE =-31.2%), comparing the general health feeling to last year (CH =-30.8%) that illustrates the dominance of emotional and psychological component in the perception of health deterioration, the absence of clinical signs or reccurent progression of the cancer process (fig. 2).

Among patients who underwent malignant neoplasms of eye (ICD-10 code-S69.-) (the SECOND Group investigated), it was also found that the lower the scales were all ways of life among people who got sick in pension age (Group ÌÌB), compared to those who got sick in working age (Group ÌÌA). The most pronounced are the differences from the scales: overall health (GH = 58.4%), social activity (SF =-54.5%), physical activity (PF =-29.3%), life activity (VT =-49.6%), comparing the general health feeling to last year (CH =-47.1%), the value of physical problems in limiting the life of (RP =-37.2%). That means, among the people of retirement age who underwent malignant neoplasms of the eye and its appendages, a larger contribution to the reduction in quality of life is due to both physical and psychological components that generally affect the social activity of patients (fig. 3).     

Comparative analysis of quality of life among patients who got sick in working age, showed that quality of life is lower among patients with malignant neoplasms of eye (IIA group), compared with patients with tumors of the eyelid skin (Group IA).  Marked decline in the quality of life for all scales, but especially pronounced is reduced from scales: physical pain (BP = 49,4%), mental health component (MH =-40%), life activity (VT =-38.5%), social activity (SF =-37.9%) (fig. 4).

Our analysis found that the greater the differences in quality of life between people who are sick in retirement. Thus in patients with malignant tumors of the eye (group IIB), compared with patients with eyelid skin tumors (group IB), there are significant differences in quality of life scales of social activity (SF = -63,0%), vitality (VT = -60.9%), the value of physical problems in disability (RP = -51,4%) (Fig. 5).

Conclusions.

1. Study found that ophthalmooncology patients have reduced quality of life, due to both physical and psychological components. Especially pronounced is the decrease in quality of life observed among patients in retirement age, and when the localization of malignant tumors is in the eye.

2. These data suggest the need for further research to establish the causes reduced quality of life among ophthalmooncology patients.

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