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Suzuki K, Morishita S, Nakano J, Okayama T, Inoue J, Tanaka T, Fukushima T. Association between quality of life and mortality risk in patients with breast cancer: a systematic review and meta-analysis. Breast Cancer 2024; 31:552-561. [PMID: 38592636 DOI: 10.1007/s12282-024-01581-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 03/26/2024] [Indexed: 04/10/2024]
Abstract
BACKGROUND Patients with breast cancer present with various problems that have an adverse effect on the quality of life (QOL). However, the association between the QOL and mortality among patients with breast cancer remains controversial. Therefore, this systematic review and meta-analysis aimed to determine whether QOL impacts prognosis in patients with breast cancer. METHODS The databases of CINAHL, Scopus, and PubMed databases were searched to retrieve observational studies that assessed the QOL and mortality risk in patients with breast cancer published before December 2022. RESULTS Among the 119,061 articles retrieved, six observational studies were included in the meta-analysis. Physical QOL (hazard ratio [HR]: 1.04, 95% confidence interval [CI]: 1.01-1.07, p = 0.003), emotional QOL (HR: 1.01, 95% CI: 1.00-1.03, p = 0.05), and role QOL (HR: 1.01, 95% CI: 1.00-1.01, p = 0.007) showed significant associations with mortality risk. In contrast, global QOL, cognitive QOL, and social QOL showed no associations with mortality risk. Subgroup analysis performed according to treatment time points revealed that the post-treatment physical QOL was associated with mortality risk. CONCLUSIONS Physical QOL, emotional QOL, and role QOL are associated with mortality risk in patients with breast cancer. Furthermore, post-treatment physical QOL showed a more significant association with prolonged survival than pre-treatment physical QOL.
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Affiliation(s)
- Katsuyoshi Suzuki
- Division of Rehabilitation Medicine, Shizuoka Cancer Center, Shizuoka, Japan
| | - Shinichiro Morishita
- Department of Physical Therapy, School of Health Sciences, Fukushima Medical University, Fukushima, Japan
| | - Jiro Nakano
- Faculty of Rehabilitation, Kansai Medical University, Osaka, Japan
| | - Taro Okayama
- Division of Rehabilitation Medicine, Shizuoka Cancer Center, Shizuoka, Japan
| | - Junichiro Inoue
- Division of Rehabilitation Medicine, Kobe University Hospital International Clinical Cancer Research Center, Kobe, Japan
| | - Takashi Tanaka
- Department of Rehabilitation, Hyogo Medical University Hospital, Nishinomiya, Japan
| | - Takuya Fukushima
- Faculty of Rehabilitation, Kansai Medical University, Osaka, Japan.
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Fukushima T, Suzuki K, Tanaka T, Okayama T, Inoue J, Morishita S, Nakano J. Global quality of life and mortality risk in patients with cancer: a systematic review and meta-analysis. Qual Life Res 2024:10.1007/s11136-024-03691-3. [PMID: 38811448 DOI: 10.1007/s11136-024-03691-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2024] [Indexed: 05/31/2024]
Abstract
PURPOSE This systematic review and meta-analysis aimed to examine the impact of global quality of life (QOL) on mortality risk in patients with cancer, considering cancer type and timepoint of QOL assessment. METHODS A systematic search was conducted using Cumulated Index to Nursing and Allied Health Literature, PubMed/MEDLINE, and Scopus databases from inception to December 2022. Observational studies that assessed QOL and examined mortality risk in patients with cancer were extracted. Subgroup analyses were performed for cancer types and timepoints of QOL assessment. RESULTS Overall, global QOL was significantly associated with mortality risk (hazard ratio: 1.06, 95% confidence interval: 1.05-1.07; p < 0.00001). A subgroup analysis based on cancer type demonstrated that lung, head and neck, breast, esophagus, colon, prostate, hematologic, liver, gynecologic, stomach, brain, bladder, bone and soft tissue, and mixed type cancers were significantly associated with mortality risk; however, melanoma and pancreatic cancer were not significantly associated with mortality risk. Additionally, global QOL was associated with mortality risk at all timepoints (pretreatment, posttreatment, and palliative phase); pretreatment QOL had the largest impact, followed by posttreatment QOL. CONCLUSION These findings provide evidence that QOL is associated with mortality risk in patients with cancer at any timepoint. These results indicate the importance of evaluating the QOL and supportive interventions to improve QOL in any phase.
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Affiliation(s)
- Takuya Fukushima
- Faculty of Rehabilitation, Kansai Medical University, Osaka, Japan.
| | - Katsuyoshi Suzuki
- Division of Rehabilitation Medicine, Shizuoka Cancer Center, Shizuoka, Japan
| | - Takashi Tanaka
- Department of Rehabilitation, Hyogo Medical University Hospital, Nishinomiya, Japan
| | - Taro Okayama
- Division of Rehabilitation Medicine, Shizuoka Cancer Center, Shizuoka, Japan
| | - Junichiro Inoue
- Division of Rehabilitation Medicine, Kobe University Hospital International Clinical Cancer Research Center, Kobe, Japan
| | - Shinichiro Morishita
- Department of Physical Therapy, School of Health Science, Fukushima Medical University, Fukushima, Japan
| | - Jiro Nakano
- Faculty of Rehabilitation, Kansai Medical University, Osaka, Japan
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Im EO, Yi JS, Chee W. Immigration Transition and Symptom Distress Changes by a Technology-Based Intervention: Asian American Breast Cancer Survivors. Comput Inform Nurs 2023; 41:316-322. [PMID: 35797029 PMCID: PMC9816349 DOI: 10.1097/cin.0000000000000938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Technology-based programs using computers and mobile devices are known to be effective in providing information and support to marginalized populations including immigrants. Yet, little is still known on the factors that may influence the effectiveness of technology-based programs in improving symptom experience, including immigration transition, especially among Asian American breast cancer survivors. This study aimed to identify the characteristics related to immigration transition that significantly affected the symptom distress changes by a technology-based information and coaching/support program among Asian American breast cancer survivors. This secondary analysis was conducted with the data from 102 Asian American breast cancer survivors from a randomized clinical trial in progress. Multiple instruments were used: the questions on background characteristics and immigration transition and the Memorial Symptom Assessment Scale-Short Form. The data were analyzed using repeated-measurement analyses and decision tree analyses. The mean changes in the symptoms distress scores were as follows: -0.12 (SD, 0.47) in the Global Distress Index scores; -0.08 (SD, 0.43) in the physical symptom distress scores; and -0.15 (SD, 0.65) in the psychological symptom distress scores. The characteristics with the highest impact on the symptom distress score changes included the immigration age for Global Distress Index and physical symptom distress score and the level of acculturation for psychological symptom distress score.
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Affiliation(s)
- Eun-Ok Im
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | - Jee-Seon Yi
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
- College of Nursing · Institute of Health Sciences, Gyeongsang National University, Jinju, Republic of Korea
| | - Wonshik Chee
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
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Cancer Patients’ Age-Related Benefits from Mobile Neurofeedback-Therapy in Quality of Life and Self-efficacy: A Clinical Waitlist Control Study. Appl Psychophysiol Biofeedback 2022; 48:217-227. [DOI: 10.1007/s10484-022-09571-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2022] [Indexed: 11/19/2022]
Abstract
AbstractElectroencephalographic neurofeedback (EEG NF) can improve quality of life (QoL) and reduce distress by modifying the amplitude of selected brain frequencies. This study aims to investigate the effects of NF therapy on QoL and self-efficacy in cancer patients and to explore age-related reactions. In a waitlist control paradigm, psychometric data (EORTC QLQ-C30, General Self-Efficacy Scale) of 20 patients were collected at three different time points, each five weeks apart. An outpatient 10-session NF intervention (mobile) was conducted between the second and third measurement point. QoL and self-efficacy changed significantly over time (QoL: F(2,36) = 5.294, p < .05, η2 = .227; Self-efficacy: F(2,26) = 8.178, p < .05, η2 = .386). While QoL increased in younger patients, older patients initially showed a decrease in QoL, which then increased during intervention. Younger patients did not differ from older patients in QoL in both waitlist control (T0-T1) and intervention phase (T1–T2). QoL in older patients significantly differed between waitlist control and intervention phase (Z = − 2.023, p < .05, d = 1.085). Self-efficacy increased in both age categories. Younger and older patients did not differ in self-efficacy in waitlist control, but in intervention phase (F(1,16) = 7.014, p < .05, η2 = .319). The current findings suggest that NF therapy is a promising treatment modality for improving QoL in cancer patients. Our study reveals NF being a tool to influence self-efficacy, which should receive more appreciation in clinical care. However, the effect of NF in different age groups as well as the influence on further cancer-related symptoms should be investigated in future research.
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Fleming S, Jones T, Janda M, Vagenas D, Ward L, Reul-Hirche H, Sandler C, Obermair A, Hayes S. Physical activity trajectories following gynecological cancer: results from a prospective, longitudinal cohort study. Int J Gynecol Cancer 2020; 30:1784-1790. [PMID: 32727928 DOI: 10.1136/ijgc-2020-001543] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 06/29/2020] [Accepted: 07/01/2020] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Participating in physical activity after a diagnosis of cancer is associated with reduced morbidity and improved outcomes. However, declines in, and low levels of, physical activity are well documented in the broader cancer population, but with limited evidence following gynecological cancer. OBJECTIVE To describe physical activity levels from before and up to 2 years after gynecological cancer surgery; to explore the relationship between physical activity patterns and quality of life; and to describe characteristics associated with physical activity trajectories post-gynecological cancer. METHODS Women with gynecological cancer (n=408) participated in a prospective study that assessed physical activity and quality of life pre-surgery (baseline), at 6 weeks, and 3, 6, 9, 12, 15, 18 and 24 months post-surgery. Validated questionnaires were used to assess physical activity (Active Australia Survey) and quality of life outcomes (Functional Assessment of Cancer Therapy-General). Generalized estimating equation modeling, group-based trajectory analysis, and analysis of variance were used to identify physical activity levels over time, to categorize women into physical activity trajectory groups, and to assess the relationship between physical activity levels and quality of life, respectively. RESULTS Women had a mean±SD age of 60±11.4 years at diagnosis, with the majority diagnosed with endometrial cancer (n=235, 58%) or stage I disease (n=241, 59%). Most women (80%) started with and maintained low levels of physical activity (1-10 metabolic equivalent task hours per week), reported no physical activity throughout the follow-up period, or reduced physical activity levels over time. Only 19% of women maintained or doubled physical activity levels, so that by 24 months post-diagnosis they were engaging in sufficient levels of physical activity. Women with endometrial cancer (58% of the sample) were more likely to be overweight or obese and to report low levels of physical activity or none at all. Higher physical activity levels were associated with higher quality of life (p<0.05). CONCLUSION The low baseline and surveillance levels of physical activity show that the vast majority of gynecological cancer survivors have the ability to improve their physical activity levels. Integration of physical activity advice and support into standard care could lead to gains in quality of life during gynecological cancer survivorship.
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Affiliation(s)
- Steven Fleming
- College of Public Health, University of Kentucky, Lexington, Kentucky, USA
| | - Tamara Jones
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Monika Janda
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia.,Centre for Health Services Research, The University of Queensland Faculty of Medicine, Brisbane, Queensland, Australia
| | - Dimitrios Vagenas
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Leigh Ward
- School of Chemistry and Molecular Biosciences, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Hildegard Reul-Hirche
- Physiotherapy Department, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Carolina Sandler
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia.,School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Andreas Obermair
- Queensland Centre of Gynecological Research, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Sandra Hayes
- Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
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Stevens CJ, Hegel MT, Bakitas MA, Bruce M, Azuero A, Pisu M, Chamberlin M, Keene K, Rocque G, Ellis D, Gilbert T, Morency JL, Newman RM, Codini ME, Thorp KE, Dos Anjos SM, Cloyd DZ, Echols J, Milford AN, Ingram SA, Davis J, Lyons KD. Study protocol for a multisite randomised controlled trial of a rehabilitation intervention to reduce participation restrictions among female breast cancer survivors. BMJ Open 2020; 10:e036864. [PMID: 32060166 PMCID: PMC7044873 DOI: 10.1136/bmjopen-2020-036864] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Many breast cancer survivors report an inability to fully participate in activities of daily living after completing cancer treatment. Reduced activity participation is linked to negative consequences for individuals (eg, depression, reduced quality of life) and society (reduced workforce participation). There is currently a lack of evidence-based interventions that directly foster cancer survivors' optimal participation in life roles and activities. Pilot study data suggest rehabilitation interventions based on behavioural activation (BA) and problem-solving treatment (PST) can facilitate post-treatment role resumption among breast cancer survivors. METHODS AND ANALYSIS This protocol describes a multisite randomised controlled trial comparing a 4-month long, nine-session BA and PST-informed rehabilitation intervention (BA/PS) against a time-matched, attention control condition. The overall objective is to assess the efficacy of BA/PS for enhancing breast cancer survivors' activity participation and quality of life over time. A total of 300 breast cancer survivors reporting participation restrictions after completing curative treatment for stage 1-3 breast cancer within the past year will be recruited across two sites (Dartmouth-Hitchcock Medical Center and University of Alabama at Birmingham). Assessments are collected on enrolment (T1) and 8 (T2), 20 (T3) and 44 (T4) weeks later. ETHICS AND DISSEMINATION Study procedures are approved by the Committee for the Protection of Human Subjects at Dartmouth College, acting as the single Institutional Review Board of record for both study sites (STUDY 00031380). Results of the study will be presented at national meetings and submitted for publication in peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT03915548; Pre-results.
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Affiliation(s)
- Courtney J Stevens
- Psychiatry Research, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
- Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire, USA
| | - Mark T Hegel
- Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire, USA
| | - Marie Anne Bakitas
- School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Martha Bruce
- Psychiatry Research, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
- Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire, USA
| | - Andres Azuero
- School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Maria Pisu
- Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Mary Chamberlin
- Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire, USA
- Department of Hematology Oncology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Kimberly Keene
- Radiation Oncology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Gabrielle Rocque
- Medicine, Divisions of Hematology and Oncology, and Geriatrics, Gerontology, and Palliative Care, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Daphne Ellis
- Psychiatry Research, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Tiffany Gilbert
- Psychiatry Research, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Jamme L Morency
- Physical Medicine and Rehabilitation, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Robin M Newman
- Occupational Therapy, Boston University College of Health and Rehabilitation Sciences Sargent College, Boston, Massachusetts, USA
| | - Megan E Codini
- Physical Medicine and Rehabilitation, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Karen E Thorp
- Physical Medicine and Rehabilitation, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Sarah M Dos Anjos
- Occupational Therapy, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Danielle Z Cloyd
- School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Jennifer Echols
- School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Ashley N Milford
- School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Stacey A Ingram
- Department of Medicine, Division of Hematology and Oncology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Jasmine Davis
- Department of Medicine, Division of Hematology and Oncology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Kathleen Doyle Lyons
- Psychiatry Research, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
- Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire, USA
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Jamshidi F, Akbarfahimi N, Hosseini SA, Shayan A, Fazeli A. Determining Occupational Performance Issues in Women with
Breast Cancer Referred to Treatment Centers of Hamadan,
Iran. Asian Pac J Cancer Prev 2019; 20:1113-1118. [PMID: 31030483 PMCID: PMC6948897 DOI: 10.31557/apjcp.2019.20.4.1113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Objective: Women with breast cancer experience functional limitations at the time of diagnosis and after the initial
treatment of cancer. Such limitations interfere with participation in self-care, work affairs, and leisure activities. The
present study aimed to determine occupational performance priorities in women with breast cancer who had referred
to treatment centers in Hamadan, Iran. Methods: In this cross-sectional, descriptive-analytical study, 102 women
with breast cancer who had referred to treatment centers in Hamadan were selected through convenience sampling.
The participants’ information was gathered using their medical records and a demographic information questionnaire.
Then, they were interviewed using the Canadian Occupational Performance Measure (COPM) to determine their
occupational performance issues. The gathered data were coded and analyzed using the SPSS statistical software,
version 16. Results: The results indicated that out of the 22 defined codes for the patients’ selected activities, 45.8%,
30.8%, and 23.4% belonged to self-care, productivity, and leisure domains, respectively. Conclusion: Women with
breast cancer experience various occupational performance issues due to disease complications and received treatments.
In the present study, self-care comprised the occupational performance priority. Determining the clients’ intervention
priorities, which is among the bases of occupational therapy interventions, can help women with breast cancer reach
the desired quality of life.
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Affiliation(s)
- Farkhondeh Jamshidi
- Department of Occupational Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
| | - Nazila Akbarfahimi
- Department of Occupational Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
| | - Seyed Ali Hosseini
- Department of Occupational Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
| | - Arezoo Shayan
- Faculty of Nursing and Midwifery, Mother and Child Care Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Asal Fazeli
- Department of Clinical Psychology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Lee CK, Hudson M, Simes J, Ribi K, Bernhard J, Coates AS. When do patient reported quality of life indicators become prognostic in breast cancer? Health Qual Life Outcomes 2018; 16:13. [PMID: 29329582 PMCID: PMC5767023 DOI: 10.1186/s12955-017-0834-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 12/26/2017] [Indexed: 01/26/2023] Open
Abstract
Background Various patient reported quality-of-life indicators are independently prognostic for survival in metastatic breast cancer and other cancers. The same measures recorded at first diagnosis of early breast cancer carry no corresponding prognostic information. The present study aims to assess at what time in the disease evolution the prognostic association appears. Methods Among 8024 patients enrolled in one of seven randomized controlled trials in early-stage breast cancer 3247 had a breast cancer relapse after a median follow-up of 12.1 years. Of these 677 had completed QL indicator assessments within defined windows 1, 2 or 3 months prior to relapse. We performed Cox regression analyses using these assessments and using identical instruments after relapse. All analyses were stratified by trial and adjusted for baseline clinicopathologic factors. Results QL indicators in the months before relapse were not significantly prognostic for subsequent survival with the possibly chance exception of mood at the second month before relapse. After relapse, physical well-being was statistically significantly associated with survival (P < 0.001). This prognostic significance increased in later post-relapse assessments. Similar findings were observed using patient-reported indicators for nausea and vomiting, appetite, coping effort, and health perception. Conclusions Before cancer relapse, QL indicators were not generally prognostic for subsequent survival. After relapse, QL indicators substantially predicted OS, with a stronger association later in the course of relapsed disease. Simple patient perception of disease burden seems unlikely to explain this sudden change: rather the patient’s awareness of disease relapse must contribute.
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Affiliation(s)
- Chee Khoon Lee
- National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Locked Bag 7, Camperdown, NSW, 1450, Australia
| | - Malcolm Hudson
- National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Locked Bag 7, Camperdown, NSW, 1450, Australia
| | - John Simes
- National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Locked Bag 7, Camperdown, NSW, 1450, Australia
| | - Karin Ribi
- International Breast Cancer Study Group, Bern, Switzerland
| | - Jürg Bernhard
- International Breast Cancer Study Group, Bern, Switzerland.,International Breast Cancer Study Group and Inselspital, Bern University Hospital, Bern, Switzerland
| | - Alan S Coates
- National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Locked Bag 7, Camperdown, NSW, 1450, Australia. .,International Breast Cancer Study Group, Bern, Switzerland.
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Levine EG, Yoo G, Aviv C. Predictors of quality of life among ethnically diverse breast cancer survivors. APPLIED RESEARCH IN QUALITY OF LIFE 2017; 12:1-16. [PMID: 28392845 PMCID: PMC5381814 DOI: 10.1007/s11482-016-9447-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 01/11/2016] [Indexed: 06/07/2023]
Abstract
PURPOSE Few studies have examined predictors of quality of life (QOL) of breast cancer survivors over time. METHODS Breast cancer survivors (n=116) were asked to complete measures of QOL, mood, spirituality, and social support every 6 months from 2-4 years post treatment. RESULTS Overall QOL at 4 years was predicted by previous physical and functional well-being, the breast cancer-specific items, and vigor and current levels of social support (Adj R2=.72, F=30.53, p<.001). Physical QOL was predicted by previous levels of physical and functional well- being and current levels of functional and social/family well-being (Adj R2=.84, F=44.30, p<.001). Functional well- being was predicted by prior levels of physical, functional, and social/family well-being and current levels of physical well-being and vigor (Adj R2=.72, F=3-.53, p<.001). Emotional well-being was predicted by previous levels of emotional well-being and current physical well-being, the breast cancer-specific items, and anxiety (Adj R2=.60, F=26.30, p<.001). Social/family well-being was predicted by previous levels of social/family well-being, social support, and confusion (Adj R2=.71, F=34.18, p<<000). The breast cancer-specific items were predicted by age, previous levels of the breast cancer-specific items, confusion and current levels of emotional and functional well-being and spirituality (Adj R2=.58, F=17.57, p<.001). CONCLUSIONS Over all and specific dimensions of QOL at 4 years were predicted by different combinations of QOL, mood, and spirituality. Interventions should be tailored to which dimensions of QOL are affected and other types of QOL as well as social support, mood, and spirituality as coping mechanisms that influence the specific dimension of QOL affected.
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10
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Positive psychological functioning in breast cancer: An integrative review. Breast 2016; 27:136-68. [DOI: 10.1016/j.breast.2016.04.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Revised: 03/29/2016] [Accepted: 04/02/2016] [Indexed: 01/03/2023] Open
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Hahn EA, Segawa E, Kaiser K, Cella D, Smith BD. Health-related quality of life among women with ductal carcinomain situor early invasive breast cancer: validation of the FACT-B (version 4). ACTA ACUST UNITED AC 2016. [DOI: 10.1080/23809000.2016.1134259] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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12
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Lyons KD, Svensborn IA, Kornblith AB, Hegel MT. A Content Analysis of Functional Recovery Strategies of Breast Cancer Survivors. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2015; 35:73-80. [PMID: 26460469 DOI: 10.1177/1539449214567306] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Seventeen breast cancer survivors completed a 6-week, telephone-delivered, behavioral activation/problem-solving intervention designed to reduce participation restrictions. A content analysis of the session data was conducted to identify the goals and patterns of goal attainment and to understand what women were trying to achieve in their recovery. The 17 women set 141 goals. Sixty-six (47%) of the goals reflected a desire to add a new activity to their routine and 75 (53%) of the goals reflected a desire to perform a routine activity more efficiently. The women primarily set goals to address challenges in exercising (24%), work (13%), nutrition (12%), instrumental activities of daily living (IADLs; 10%), stress management (9%), and social activities (9%). The women set an average of 8 goals and met 71% of their goals. The intervention shows promise in helping women set and achieve a number of functional goals as part of breast cancer recovery.
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13
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14
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Breast Cancer EDGE Task Force Outcomes: Clinical Measures of Health Related Quality of Life. REHABILITATION ONCOLOGY 2015. [DOI: 10.1097/01893697-201533010-00003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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15
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Factors predicting adherence to risk management behaviors of women at increased risk for developing lymphedema. Support Care Cancer 2014; 23:61-9. [PMID: 24970542 DOI: 10.1007/s00520-014-2321-1] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Accepted: 06/11/2014] [Indexed: 12/31/2022]
Abstract
PURPOSE Lymphedema affects 20-30% of women following breast cancer treatment. However, even when women are informed, they do not necessarily adhere to recommended lymphedema self-management regimens. Utilizing the Cognitive-Social Health Information Processing framework, we assessed the cognitive and emotional factors influencing adherence to lymphedema risk management. METHODS Women with breast cancer who had undergone breast and lymph node surgery were recruited through the Fox Chase Cancer Center breast clinic. Participants (N = 103) completed measures of lymphedema-related perceived risk, beliefs and expectancies, distress, self-regulatory ability to manage distress, knowledge, and adherence to risk management behaviors. They then received the American Cancer Society publication "Lymphedema: What Every Woman with Breast Cancer Should Know." Cognitive and affective variables were reassessed at 6 and 12 months post-baseline. RESULTS Maximum likelihood multilevel model analyses indicated that overall adherence increased over time, with significant differences between baseline and 6- and 12-month assessments. Adherence to wearing gloves was significantly lower than that for all other behaviors except electric razor use. Distress significantly decreased, and knowledge significantly increased, over time. Greater knowledge, higher self-efficacy to enact behaviors, lower distress, and higher self-regulatory ability to manage distress were associated with increased adherence. CONCLUSIONS Women who understand lymphedema risk management and feel confident in managing this risk are more likely to adhere to recommended strategies. These factors should be rigorously assessed as part of routine care to ensure that women have the self-efficacy to seek treatment and the self-regulatory skills to manage distress, which may undermine attempts to seek medical assistance.
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Fiszer C, Dolbeault S, Sultan S, Brédart A. Prevalence, intensity, and predictors of the supportive care needs of women diagnosed with breast cancer: a systematic review. Psychooncology 2013; 23:361-74. [PMID: 24677334 DOI: 10.1002/pon.3432] [Citation(s) in RCA: 179] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2013] [Revised: 09/16/2013] [Accepted: 09/18/2013] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The assessment of supportive care needs is a crucial step in the development of appropriate interventions that may improve the quality of life of cancer patients. This review describes and analyzes the prevalence and predictors of the unmet supportive care needs of breast cancer (BC) patients and survivors and suggests paths for further research. METHOD Multiple databases were searched, considering only quantitative studies using validated needs assessment instruments and focusing uniquely on women diagnosed with BC. RESULTS Out of 761 hits, 23 studies answered to all eligibility criteria. Nineteen were cross-sectional, and the remaining four were longitudinal. Most included patients at different moments along the BC trajectory, from diagnosis to decades into survivorship, with the major proportion of patients under treatment. Only five concentrated on the posttreatment phase into extended survivorship. The concerns of women diagnosed with BC clustered around psychological and information needs, with the top concern being 'fear of the cancer returning'. Predictors of higher levels of needs included advanced disease stage, greater symptom burden, shorter time since diagnosis, higher levels of distress, and younger age. Prevalence differed between cultures with Asian women reporting greater information needs and lower psychological needs compared with Western women. CONCLUSIONS Revealing which needs BC patients consider most urgent and the factors related to greater needs will permit the development of improved and targeted supportive care. Future research should comprise longitudinal designs concentrating on women at specific moments along the BC trajectory for a dynamic understanding of these needs.
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Affiliation(s)
- Chavie Fiszer
- Laboratoire de Psychopathologie et Processus de Santé (LPPS EA 4057), IUPDP, Université Paris Descartes, Boulogne-Billancourt, France; Psycho-Oncology Unit/Supportive Care Department, Curie Institute, Paris, France
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McDonough MH, Sabiston CM, Wrosch C. Predicting changes in posttraumatic growth and subjective well-being among breast cancer survivors: the role of social support and stress. Psychooncology 2013; 23:114-20. [DOI: 10.1002/pon.3380] [Citation(s) in RCA: 91] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Revised: 07/12/2013] [Accepted: 07/23/2013] [Indexed: 11/12/2022]
Affiliation(s)
- Meghan H. McDonough
- Department of Health and Kinesiology; Purdue University; West Lafayette IN USA
| | - Catherine M. Sabiston
- Department of Kinesiology and Physical Education; The University of Toronto; Toronto ON Canada
| | - Carsten Wrosch
- Department of Psychology; Concordia University; Montreal QC Canada
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Exercise for health: a randomized, controlled trial evaluating the impact of a pragmatic, translational exercise intervention on the quality of life, function and treatment-related side effects following breast cancer. Breast Cancer Res Treat 2012; 137:175-86. [PMID: 23139058 DOI: 10.1007/s10549-012-2331-y] [Citation(s) in RCA: 129] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2012] [Accepted: 10/31/2012] [Indexed: 10/27/2022]
Abstract
Exercise for Health was a randomized, controlled trial designed to evaluate two modes of delivering (face-to-face [FtF] and over-the-telephone [Tel]) an 8-month translational exercise intervention, commencing 6-weeks post-breast cancer surgery (PS). Outcomes included quality of life (QoL), function (fitness and upper body) and treatment-related side effects (fatigue, lymphoedema, body mass index, menopausal symptoms, anxiety, depression and pain). Generalised estimating equation modelling determined time (baseline [5 weeks PS], mid-intervention [6 months PS], post-intervention [12 months PS]), group (FtF, Tel, Usual Care [UC]) and time-by-group effects. 194 women representative of the breast cancer population were randomised to the FtF (n = 67), Tel (n = 67) and UC (n = 60) groups. There were significant (p < 0.05) interaction effects on QoL, fitness and fatigue with differences being observed between the treatment groups and the UC group. Trends observed for the treatment groups were similar. The treatment groups reported improved QoL, fitness and fatigue over time and changes observed between baseline and post-intervention were clinically relevant. In contrast, the UC group experienced no change, or worsening QoL, fitness and fatigue, mid-intervention. Although improvements in the UC group occurred by 12-months post-surgery, the change did not meet the clinically relevant threshold. There were no differences in other treatment-related side effects between groups. This translational intervention trial, delivered either FtF or Tel, supports exercise as a form of adjuvant breast cancer therapy that can prevent declines in fitness and function during treatment and optimise recovery post-treatment.
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Eakin EG, Lawler SP, Winkler EAH, Hayes SC. A Randomized Trial of a Telephone-Delivered Exercise Intervention for Non-urban Dwelling Women Newly Diagnosed with Breast Cancer: Exercise for Health. Ann Behav Med 2011; 43:229-38. [PMID: 22109352 DOI: 10.1007/s12160-011-9324-7] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Affiliation(s)
- Elizabeth G Eakin
- School of Population Health, Cancer Prevention Research Centre, The University of Queensland, Herston, Australia.
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Hayes SC, Rye S, Battistutta D, DiSipio T, Newman B. Upper-body morbidity following breast cancer treatment is common, may persist longer-term and adversely influences quality of life. Health Qual Life Outcomes 2010; 8:92. [PMID: 20804558 PMCID: PMC2940926 DOI: 10.1186/1477-7525-8-92] [Citation(s) in RCA: 91] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2010] [Accepted: 08/31/2010] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Impairments in upper-body function (UBF) are common following breast cancer. However, the relationship between arm morbidity and quality of life (QoL) remains unclear. This investigation uses longitudinal data to describe UBF in a population-based sample of women with breast cancer and examines its relationship with QoL. METHODS Australian women (n=287) with unilateral breast cancer were assessed at three-monthly intervals, from six- to 18-months post-surgery (PS). Strength, endurance and flexibility were used to assess objective UBF, while the Disability of the Arm, Shoulder and Hand questionnaire and the Functional Assessment of Cancer Therapy-Breast questionnaire were used to assess self-reported UBF and QoL, respectively. RESULTS Although mean UBF improved over time, up to 41% of women revealed declines in UBF between six- and 18-months PS. Older age, lower socioeconomic position, treatment on the dominant side, mastectomy, more extensive lymph node removal and having lymphoedema each increased odds of declines in UBF by at least two-fold (p<0.05). Lower baseline and declines in perceived UBF between six- and 18-months PS were each associated with poorer QoL at 18-months PS (p<0.05). CONCLUSIONS Significant upper-body morbidity is experienced by many following breast cancer treatment, persisting longer term, and adversely influencing the QoL of breast cancer survivors.
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Affiliation(s)
- Sandra C Hayes
- School of Public Health, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Queensland, 4059, Australia.
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