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Vrancken Peeters NJMC, van Til JA, Huberts AS, Siesling S, Husson O, Koppert LB. Internal Responsiveness of EQ-5D-5L and EORTC QLQ-C30 in Dutch Breast Cancer Patients during the First Year Post-Surgery: A Longitudinal Cohort Study. Cancers (Basel) 2024; 16:1952. [PMID: 38893073 PMCID: PMC11170999 DOI: 10.3390/cancers16111952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Revised: 05/17/2024] [Accepted: 05/18/2024] [Indexed: 06/21/2024] Open
Abstract
The EuroQoL 5-Dimension 5-Level questionnaire (EQ-5D-5L) and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 (EORTC QLQ-C30) are commonly used Patient-Reported Outcome Measures (PROMs) for breast cancer. This study assesses and compares the internal responsiveness of the EQ-5D-5L and EORTC QLQ-C30 in Dutch breast cancer patients during the first year post-surgery. Women diagnosed with breast cancer who completed the EQ-5D-5L and EORTC QLQ-C30 pre-operatively (T0), 6 months (T6), and 12 months post-surgery (T12) were included. Mean differences of the EQ-5D-5L and EORTC QLQ-C30 between baseline and 6 months (delta 1) and between baseline and 12 months post-surgery (delta 2) were calculated and compared against the respective minimal clinically important differences (MCIDs) of 0.08 and 5. Internal responsiveness was assessed using effect sizes (ES) and standardized response means (SRM) for both deltas. In total, 333 breast cancer patients were included. Delta 1 and delta 2 for the EQ-5D-5L index and most scales of the EORTC QLQ-C30 were below the MCID. The internal responsiveness for both PROMs was small (ES and SRM < 0.5), with greater internal responsiveness for delta 1 compared to delta 2. The EQ-5D-5L index showed greater internal responsiveness than the EORTC QLQ-C30 Global Quality of Life scale and summary score. These findings are valuable for the interpretation of both PROMs in Dutch breast cancer research and clinical care.
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Affiliation(s)
- Noëlle J. M. C. Vrancken Peeters
- Department of Surgical Oncology, Erasmus MC, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, 1066 CX Amsterdam, The Netherlands
| | - Janine A. van Til
- Department of Health Technology and Services Research, Technical Medical Centre, University of Twente, 7522 NB Enschede, The Netherlands
| | - Anouk S. Huberts
- Department of Quality and Patient Care, Erasmus MC, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands
| | - Sabine Siesling
- Department of Health Technology and Services Research, Technical Medical Centre, University of Twente, 7522 NB Enschede, The Netherlands
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), 3511 DT Utrecht, The Netherlands
| | - Olga Husson
- Department of Surgical Oncology, Erasmus MC, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, 1066 CX Amsterdam, The Netherlands
| | - Linetta B. Koppert
- Department of Surgical Oncology, Erasmus MC, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands
- Department of Quality and Patient Care, Erasmus MC, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands
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Javan Biparva A, Raoofi S, Rafiei S, Pashazadeh Kan F, Kazerooni M, Bagheribayati F, Masoumi M, Doustmehraban M, Sanaei M, Zarabi F, Raoofi N, Beiramy Chomalu Z, Ahmadi B, Seyghalani Talab F, Sadat Hoseini B, Asadollahi E, Mir M, Deylami S, Zareei M, Sanaei H, Dousti Nia Kakavand F, Koohestani H, Nasiri M, Vali N, Ghashghaee A. Global quality of life in breast cancer: systematic review and meta-analysis. BMJ Support Palliat Care 2024; 13:e528-e536. [PMID: 35710706 PMCID: PMC10850719 DOI: 10.1136/bmjspcare-2022-003642] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 05/30/2022] [Indexed: 11/12/2022]
Abstract
BACKGROUND Breast cancer (BC) is the most common cancer among women worldwide. We conducted a systematic review and meta-analysis to cover the existing research gap and contribute to existing knowledge to provide both researchers and clinicians with a better profile on the topic and consequently help improve the quality of life (QoL) of patients with BC. METHODS A comprehensive review of original articles published in English from January 2000 to October 2021 from databases including Embase, Scopus, PubMed and Web of Science was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. RESULTS Based on the meta-regression which examined a total of 9012 patients with BC, the QoL score calculated by EORTC QLQ-C30 was 64.72 (95% CI 59.24 to 70.20), while the score obtained from FACT-B was 84.39 (95% CI 64.24 to 104.54) and the scores from QLQ-BR23 and SF-36 were 66.33 (95% CI 62.76 to 69.90) and 57.23 (95% CI 47.65 to 66.82), respectively. A meta-analysis affirmed a significant direct relationship between the QoL score of patients with BC and their age (p=0.03). The results also revealed that the QoL scores of patients who had completed treatment were higher than those who were currently under treatment. CONCLUSION The present systematic review identified several factors that affect the QoL of women with BC worldwide and provided several implications for developing policy interventions to effectively improve the QoL of women with BC. In this way, clinicians can sufficiently give advice to their patients with the purpose of improving their QoL. PROSPERO registration number CRD42022309791.
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Affiliation(s)
- Akbar Javan Biparva
- Student Research Committee, School of Health Management and Medical Informatics, Iranian Center of Excellence in Health Management, Tabriz University of Medical Sciences, Tabriz, Iran (the Islamic Republic of)
| | - Samira Raoofi
- Student Research Committee, School of Health Management and Information Sciences Branch, Iran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
- Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Sima Rafiei
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Fatemeh Pashazadeh Kan
- Student Research Committee, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Mitra Kazerooni
- Department of Obstetrics and Gynecology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Farzaneh Bagheribayati
- Cellular and Molecular Biology, University of Zanjan, Zanjan, Iran (the Islamic Republic of)
| | - Maryam Masoumi
- Clinical Research and Development Center, Qom University of Medical Sciences, Qom, Iran (the Islamic Republic of)
| | - Maryam Doustmehraban
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Mohaddeseh Sanaei
- Student Research Committee, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Farnaz Zarabi
- Department of Anesthesia, Faculty of Allied Medicine, Iran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Neda Raoofi
- Clinical Research Development Center, Imam Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran (the Islamic Republic of)
| | - Zahra Beiramy Chomalu
- Student Research Committee, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Behrooz Ahmadi
- Clinical Research Development Center, Imam Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran (the Islamic Republic of)
| | | | - Batool Sadat Hoseini
- Department of Anesthesia, Faculty of Allied Medicine, Iran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Elnaz Asadollahi
- Student Research Committee, School of Health Management and Information Sciences Branch, Iran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Maryam Mir
- Student Research Committee, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Sama Deylami
- Student Research Committee, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Mahsa Zareei
- Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Hadis Sanaei
- School of health Managment and information sciences, University of Social welfare and Rehabilitation sciences, Tehran, Iran
| | - Fateme Dousti Nia Kakavand
- Student Research Committee, School of Health Management and Information Sciences Branch, Iran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Hooman Koohestani
- Department of Neurosurgery, 7Tir Hospital, Iran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | | | - Negin Vali
- Shahid AkbarAbadi Clinical Research Development unit (SHACRDU), Iran University of Medical Sciences, Tehran, Iran
| | - Ahmad Ghashghaee
- Student Research Committee, Qazvin University of Medical Sciences, Qazvin, Iran
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Ayub F, Khan TM, Baig MR, Amin MU, Tahir H. Quality of life and wellbeing among breast cancer patients in Lahore, Pakistan. Front Oncol 2023; 13:1105411. [PMID: 37456255 PMCID: PMC10341154 DOI: 10.3389/fonc.2023.1105411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 06/08/2023] [Indexed: 07/18/2023] Open
Abstract
Background Breast cancer has a high incidence rate, emphasizing the necessity of enhanced information on health-related quality of life (HrQOL) in this population of patients. The aim of this study was to identify the factors influencing the QOL experienced by patients in Pakistan. Methods A cross-sectional study was conducted on women with breast cancer, and four instruments were used on a random sample of 130 Pakistani women: FACIT-B Version 4 questionnaire,WHO causality assessment scale, Naranjo's algorithm, and a demographic/clinical characteristics section. Data analysis included descriptive analysis, independent sample t-test, and analysis of variance (ANOVA) test. Results The patients' mean age was 49.10 (standard deviation (SD) 10.89); 98.5% were married. The mean score was 18.34 for physical wellbeing (SD 5.92; interquartile range (IQR) 11), 16.33 for social/family wellbeing (SD 6.3; IQR 11.25), 13.6 for emotional wellbeing (SD 3.55; IQR 6), 17.13 for functional wellbeing (SD 3.73; IQR 6), and 24.86 for breast cancer subscale (SD 3.64; IQR 4). The study found that the age, entitlement, recurrence, marital status, salary, number of doses, duration of cancer treatment, and chemotherapy sessions were significantly related to QOL terms in the assessment of the FACIT-B scale. The WHO causality evaluation scale determined that 78.1% of the responses were "probable" and 20.1% were "possible". According to Naranjo's algorithm assessment scale, 80% of adverse drug reactions (ADRs) were "probable", whereas 18.4% were declared "possible". Chemotherapy-induced anemia was the most often reported ADR in 64.6% of patients, followed by chemotherapy-induced nausea and vomiting (61.5%). Conclusion Healthcare practitioners must acknowledge and take into account the significance of QOL in addition to therapy for breast cancer patients in order to enhance their health. The findings of this study will aid in filling gaps in current unknown knowledge and identifying sites where patients require additional assistance. Because cancer and chemotherapy clearly have a negative impact on individuals' QOL, oncologists must concentrate on strategies that help cancer patients during their sickness and treatment while also enhancing self-care and QOL. Those with cancer will benefit from emotional wellbeing and adaptation to their disease.
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Affiliation(s)
- Fiza Ayub
- Institute of Pharmaceutical Science, University of Veterinary and Animal Science UVAS, Lahore, Pakistan
| | - Tahir Mehmood Khan
- Institute of Pharmaceutical Science, University of Veterinary and Animal Science UVAS, Lahore, Pakistan
| | - Mirza Rafi Baig
- Department of Clinical Pharmacy and Pharmacotherapeutics, Dubai Pharmacy College for Girls, Dubai, United Arab Emirates
| | | | - Humera Tahir
- Ruth Pfau College of Nutrition Sciences, Lahore Medical and Dental College, Lahore, Pakistan
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Shariff-Marco S, Sangaramoorthy M, Ellis L, Thomsen C, Roh JM, Kroenke C, Valice E, Kwan ML, Ambrosone C, Kushi L, Gomez SL. Impact of Racial/Ethnic Discrimination on Quality of Life Among Breast Cancer Survivors. Am J Epidemiol 2023; 192:367-376. [PMID: 36458447 PMCID: PMC10372860 DOI: 10.1093/aje/kwac208] [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] [Received: 04/19/2022] [Revised: 11/15/2022] [Accepted: 11/30/2022] [Indexed: 12/04/2022] Open
Abstract
Although racial/ethnic disparities in health-care access, treatment, and cancer outcomes are well documented, the impact of racial/ethnic discrimination on cancer survivorship is unclear. We examined associations between quality of life (QoL) and self-reported discrimination among 3,991 women with breast cancer recruited during 2006-2013 from the Pathways Study in the Kaiser Permanente Northern California integrated health-care system, using linear regression models. Overall, 31% of women reported experiencing racial/ethnic discrimination, with differences by race/ethnicity (82% among non-Hispanic Black women vs. 19% among non-Hispanic White women) and nativity (40% among foreign-born Hispanic women vs. 76% among US-born Asian-American women). Experiencing racial/ethnic discrimination was associated with lower QoL in fully adjusted models. The mean QoL score was 119.6 (95% confidence interval (CI): 102.0, 137.1) for women who did not report discrimination, 115.5 (95% CI: 98.0, 133.0) for those who reported some discrimination/less than the median level, and 110.2 (95% CI: 92.7, 127.7) for those who reported more discrimination/greater than or equal to the median level. Discrimination was associated with lower QoL among women who used passive coping strategies or lived in neighborhoods with high neighborhood socioeconomic status, neighborhoods with high levels of segregation, or non-ethnic enclaves. Among breast cancer survivors, clinically meaningful differences in QoL scores were associated with racial/ethnic discrimination. Additional studies are needed to understand potential pathways through which these social factors affect survivorship outcomes.
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Affiliation(s)
- Salma Shariff-Marco
- Correspondence to Dr. Salma Shariff-Marco, Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, 550 16th Street, MH-2633, San Francisco, CA 94158 (e-mail: )
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Wang Y, Gavan SP, Steinke D, Cheung KL, Chen LC. The impact of age on health utility values for older women with early-stage breast cancer: a systematic review and meta-regression. Health Qual Life Outcomes 2022; 20:169. [PMID: 36564800 PMCID: PMC9789668 DOI: 10.1186/s12955-022-02067-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 11/07/2022] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION An increasing number of postmenopausal women are diagnosed with breast cancer at an older age (≥ 70 years). There is a lack of synthesised health utility data to support decision-making for managing breast cancer in this older population. This study aimed to identify the availability of, and the subsequent impact of age on, health state utility values (HSUVs) measured by the EQ-5D for older women with early-stage breast cancer. METHOD This systematic review identified EQ-5D (3L or 5L version) HSUVs for postmenopausal women with early-stage breast cancer. Studies were identified from a previous systematic review (inception to 2009) and an electronic database search (Medline and Embase; 2009 to September 2021). Mean HSUVs were summarised by health state. Quality appraisal was performed on studies reporting HSUVs for older ages (≥ 70 years). Multivariable meta-regression assessed the association between HSUVs and age, health state, treatments received, and time of measuring the utility values (greater or less than one year post-treatment). RESULTS Fifty EQ-5D HSUVs were identified from 13 studies. Mean HSUVs decreased as health state worsened: from the stable (mean=0.83) to progression (mean=0.79) and advanced (mean=0.68) states. Two studies reported six HSUVs estimated from the sample of women with a mean age ≥ 70. Meta-regression model fit improved by including age as an independent variable and attenuated the estimated utility decrements associated with worse health states. Utility decrements for the progression and advanced states were -0.052 (95%CI: -0.097, -0.007) and -0.143 (95%CI: -0.264, -0.022) respectively. The breast cancer-specific utility decrement associated with a one-year increase in age was -0.001 (95%CI: -0.004, 0.002). CONCLUSION Relevant and accurate HSUVs are essential to help support decision-making about the most effective and cost-effective ways to manage early-stage breast cancer in older women. Age has a vital role in determining health utility values in this population. This study provides analysts and decision-makers with HSUVs and utility decrements that reflect the disease process in this older population.
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Affiliation(s)
- Yubo Wang
- grid.5379.80000000121662407Centre for Pharmacoepidemiology and Drug Safety, Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Stopford Building, Oxford Road, 1stFloor Stopford Building, Manchester, M13 9PT UK
| | - Sean P. Gavan
- grid.5379.80000000121662407Manchester Centre for Health Economics, Faculty of Biology, Medicine and Health, The University of Manchester, Oxford Road, Manchester, M13 9PL UK
| | - Douglas Steinke
- grid.5379.80000000121662407Centre for Pharmacoepidemiology and Drug Safety, Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Stopford Building, Oxford Road, 1stFloor Stopford Building, Manchester, M13 9PT UK
| | - Kwok-Leung Cheung
- grid.4563.40000 0004 1936 8868School of Medicine, University of Nottingham, Royal Derby Hospital Centre, Uttoxeter Road, Derby, DE22 3DT UK
| | - Li-Chia Chen
- grid.5379.80000000121662407Centre for Pharmacoepidemiology and Drug Safety, Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Stopford Building, Oxford Road, 1stFloor Stopford Building, Manchester, M13 9PT UK
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Wang J, Yi Y, Wan X, Zeng X, Peng Y, Tan C. Cost-Effectiveness Analysis of Trastuzumab Deruxtecan versus Trastuzumab Emtansine in Human Epidermal Growth Factor Receptor 2-Positive Metastatic Breast Cancer in the USA. Adv Ther 2022; 39:4583-4593. [PMID: 35943715 DOI: 10.1007/s12325-022-02273-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 07/13/2022] [Indexed: 01/30/2023]
Abstract
INTRODUCTION Based on data from the DESTINY-Breast03 trial, we performed a cost-effectiveness analysis of trastuzumab deruxtecan (T-DXd) in patients with human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer who had been previously treated with trastuzumab and a taxane from the US payer perspective. METHODS We conducted a Markov model to assess the cost-effectiveness of T-DXd versus trastuzumab emtansine (T-DM1). The simulation time horizon for this model was the lifetime of patients. Transition probabilities were based on data from the DESTINY-Breast03 trial. Health utility data were derived from published studies. Outcome measures were costs (in 2022 US$), quality-adjusted life-years (QALYs), and the incremental cost-effectiveness ratio (ICER). One-way and probabilistic sensitivity analyses assessed the uncertainty of key model parameters and their joint impact on the base-case results. RESULTS The base-case results found that T-DXd provided an improvement of 3.90 QALYs compared with T-DM1, and the ICER was $220,533 per QALY. The one-way sensitivity analysis demonstrated that the utility value of progression-free survival, hazard ratios of T-Dxd versus T-DM1, and cost of T-Dxd contributed substantial uncertainty to the model. Probabilistic sensitivity analysis predicted T-DXd being cost-effective compared to T-DM1 was 0, 1, 16, and 46% at willingness-to-pay of $50,000, $100,000, $150,000, and 200,000 per QALY, respectively. CONCLUSION T-DXd was unlikely to offer a reasonable value for the money spent compared to T-DM1 in a US payer setting.
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Affiliation(s)
- Jingyan Wang
- Department of Pediatric Orthopedics, The Hunan Children's Hospital, Changsha, 410011, Hunan, China
| | - Yinzhi Yi
- Department of Pediatric Orthopedics, The Hunan Children's Hospital, Changsha, 410011, Hunan, China
| | - Xiaomin Wan
- Department of Pharmacy, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Xiaohui Zeng
- PET-CT Center, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Ye Peng
- Department of Pharmacy, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Chongqing Tan
- Department of Pharmacy, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China.
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Al-Shalabi R, Abu-Huwaij R, Hamed R, Abbas MM. The antimicrobial and the antiproliferative effect of human triple negative breast cancer cells using the greenly synthesized iron oxide nanoparticles. J Drug Deliv Sci Technol 2022. [DOI: 10.1016/j.jddst.2022.103642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Zheng C, Yu LX, Jia HY, Cui SD, Tian FG, Fan ZM, Geng CZ, Cao XC, Yang ZL, Wang X, Liang H, Wang S, Jiang HC, Duan XN, Wang HB, Li GL, Wang QT, Zhang JG, Jin F, Tang JH, Li L, Zhu SG, Zuo WS, Wang F, Zhou F, Xiang YJ, Guo MM, Wang YJ, Huang SY, Liu LY, Yu ZG. Relationship Between Lifestyle Habits and Health-Related Quality of Life of Recently Diagnosed Breast Cancer Patients: A Comparison Between Younger and Older Women in China. Front Public Health 2021; 9:767151. [PMID: 34976926 PMCID: PMC8714764 DOI: 10.3389/fpubh.2021.767151] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 11/10/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: The aim of this study was to evaluate the relationship between lifestyle habits and health-related quality of life (HRQoL) among different ages who were initially diagnosed with breast cancer (within the first 2 weeks) and to determine the contribution of lifestyle habits factors on HRQoL. Methods: Patients with breast cancer were recruited from 22 hospitals in 11 provinces or municipalities in northern and eastern China. The Functional Assessment of Cancer Therapy-Breast Cancer (FACT-B) was used to measure HRQoL. Chi-square test, ANOVA, and multivariable generalized linear models were conducted to identify the differences in HRQoL between two age groups (age <50 years and ≥50 years) and to evaluate the contribution of lifestyle habits factors on HRQoL of patients with breast cancer. Results: About 1,199 eligible patients with breast cancer were used for analysis. Younger women (aged <50 years) appeared to show lower scores than older women (aged ≥50 years) in HRQoL subscales, including emotional well-being (p = 0.003), functional well-being (p = 0.006), breast cancer subscale (p = 0.038), and FACT-B Total scores (p = 0.028). Tea and alcohol consumption and being very satisfied with sleep and current life were the strongest predictors of higher HRQoL in younger group. Meanwhile, no coffee consumption, frequent participation in physical activities, high sleep satisfaction, and current life satisfaction were the key predictors of higher HRQoL in older women with breast cancer. Conclusion: The relationship of the nine lifestyle habit items with HRQoL differed among younger and older women. The associated variable of low HRQoL can help clinicians take intervention early in order to improve the prognosis of patients with breast cancer.
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Affiliation(s)
- Chao Zheng
- Department of Breast Surgery, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Institute of Translational Medicine of Breast Disease Prevention and Treatment, Shandong University, Jinan, China
| | - Li-Xiang Yu
- Department of Breast Surgery, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Institute of Translational Medicine of Breast Disease Prevention and Treatment, Shandong University, Jinan, China
| | - Hong-Ying Jia
- Center of Evidence-Based Medicine, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Shu-De Cui
- Department of Breast Surgery, Affiliated Tumor Hospital of Zhengzhou University, Zhengzhou, China
| | - Fu-Guo Tian
- Department of Breast Surgery, Shanxi Cancer Hospital, Taiyuan, China
| | - Zhi-Min Fan
- Department of Breast Surgery, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Cui-Zhi Geng
- Breast Center, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Xu-Chen Cao
- Department of Breast Surgery, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Zhen-Lin Yang
- Department of Thyroid and Breast Surgery, The First Affiliated Hospital of Binzhou Medical University, Binzhou, China
| | - Xiang Wang
- Department of Breast Surgery, Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Hong Liang
- Department of General Surgery, Linyi People's Hospital, Linyi, China
| | - Shu Wang
- Breast Disease Center, Peking University People's Hospital, Beijing, China
| | - Hong-Chuan Jiang
- Department of General Surgery, Beijing Chaoyang Hospital, Beijing, China
| | - Xue-Ning Duan
- Breast Disease Center, Peking University First Hospital, Beijing, China
| | - Hai-Bo Wang
- Breast Center, Qingdao University Affiliated Hospital, Qingdao, China
| | - Guo-Lou Li
- Department of Breast and Thyroid Surgery, Weifang Traditional Chinese Hospital, Weifang, China
| | - Qi-Tang Wang
- Department of Breast Surgery, The Second Affiliated Hospital of Qingdao Medical College, Qingdao Central Hospital, Qingdao, China
| | - Jian-Guo Zhang
- Department of General Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Feng Jin
- Department of Breast Surgery, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Jin-Hai Tang
- Department of General Surgery, Nanjing Medical University Affiliated Cancer Hospital, Cancer Institute of Jiangsu Province, Nanjing, China
| | - Liang Li
- Department of Breast and Thyroid Surgery, Zibo Central Hospital, Zibo, China
| | - Shi-Guang Zhu
- Department of Breast Surgery, Yantai Yuhuangding Hospital, Yantai, China
| | - Wen-Shu Zuo
- Breast Cancer Center, Shandong Cancer Hospital, Jinan, China
| | - Fei Wang
- Department of Breast Surgery, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Institute of Translational Medicine of Breast Disease Prevention and Treatment, Shandong University, Jinan, China
| | - Fei Zhou
- Department of Breast Surgery, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Institute of Translational Medicine of Breast Disease Prevention and Treatment, Shandong University, Jinan, China
| | - Yu-Juan Xiang
- Department of Breast Surgery, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Institute of Translational Medicine of Breast Disease Prevention and Treatment, Shandong University, Jinan, China
| | - Ming-Ming Guo
- Department of Breast Surgery, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Institute of Translational Medicine of Breast Disease Prevention and Treatment, Shandong University, Jinan, China
| | - Yong-Jiu Wang
- Department of Breast Surgery, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Institute of Translational Medicine of Breast Disease Prevention and Treatment, Shandong University, Jinan, China
| | - Shu-Ya Huang
- Department of Breast Surgery, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Institute of Translational Medicine of Breast Disease Prevention and Treatment, Shandong University, Jinan, China
| | - Li-Yuan Liu
- Department of Breast Surgery, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Institute of Translational Medicine of Breast Disease Prevention and Treatment, Shandong University, Jinan, China
- *Correspondence: Li-Yuan Liu ; orcid.org/0000-0002-9862-7471
| | - Zhi-Gang Yu
- Department of Breast Surgery, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Institute of Translational Medicine of Breast Disease Prevention and Treatment, Shandong University, Jinan, China
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9
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Niveau N, New B, Beaudoin M. How Should Self-Esteem Be Considered in Cancer Patients? Front Psychol 2021; 12:763900. [PMID: 34777169 PMCID: PMC8581674 DOI: 10.3389/fpsyg.2021.763900] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 10/05/2021] [Indexed: 12/24/2022] Open
Abstract
Numerous studies showed that cancer significantly increases the risk of developing depressive and anxious symptoms. It has been shown that self-esteem is an important psychological resource and is associated with many health behaviors. Furthermore, the vulnerability model of low self-esteem, which has received strong empirical support, highlights that low self-esteem is a real risk factor in the development of depressive disorders. This article aims at providing an overview of the involvement of self-esteem in the psychological adjustment to cancer. After briefly reviewing the literature, we suggest that its implication in the development of depressive disorders and its association with coping strategies and social support in cancer patients justify the consideration of self-esteem in oncology psychological care, especially in young adult patients and those with significant physical impairment following treatment.
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Affiliation(s)
- Noémie Niveau
- LPNC, CNRS, Univ. Savoie Mont-Blanc, Chambéry, France.,LIP/PC2S, Univ. Savoie Mont-Blanc, Chambéry, France
| | - Boris New
- LPNC, CNRS, Univ. Savoie Mont-Blanc, Chambéry, France
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10
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Malak MZ, Tawalbeh LI, Al-Amer RM. Depressive Symptoms among Older Jordanian Patients with Cancer Undergoing Treatment. Clin Gerontol 2021; 44:133-142. [PMID: 32924883 DOI: 10.1080/07317115.2020.1818660] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVES To date, predictive and risk factors for depression among older patients with cancer have not been adequately studied in the Middle Eastern countries including Jordan. Therefore, this study aimed to assess the levels of depressive symptoms, anxiety, and hope among older Jordanian patients with cancer aged 60 years and over who are currently undergoing treatment, and to identify the relationship between selected factors (socio-demographic, treatment, and psychological) and depressive symptoms. METHODS A cross-sectional design was conducted on a convenience sample consisting of 150 patients with cancer from one of the biggest governmental hospitals in Jordan. RESULTS The findings revealed that almost 34% and 27% of the patients experienced anxiety and depression and had a moderate level of hope. Correlating factors with depression were age, duration of treatment, hope, anxiety, educational level, and health insurance. However, low duration of treatment, high anxiety, and low hope were the significant predictors of high depression. CONCLUSION Understanding the risk factors correlated with depression could help develop early interventions to enhance the psychological consequences for patients with cancer at risk for depression. CLINICAL IMPLICATIONS Health-care providers need to develop psychological care for older patients with cancer and interventions directed at minimizing depression. Also, nurses should focus on providing holistic care including physical, social, psychological, and spiritual dimensions. Depression care should be an important part of the comprehensive treatment care plan for older patients undergoing cancer treatment.
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Affiliation(s)
- Malakeh Z Malak
- Community Health Nursing, Faculty of Nursing, Al-Zaytoonah University of Jordan , Amman, Jordan
| | - Loai I Tawalbeh
- Adult Health Nursing, Faculty of Nursing, Al-AlBayt University , Al-Mafraq, Jordan
| | - Rasmieh M Al-Amer
- Psychiatric Health Nursing, Faculty of Nursing, Isra' University , Amman, Jordan.,School of Nursing and Midwifery, Western Sydney University , Sydney, Australia
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11
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Diaby V, Almutairi RD, Babcock A, Moussa RK, Ali A. Cost-effectiveness of treatments for HER2-positive metastatic breast cancer and associated metastases: an overview of systematic reviews. Expert Rev Pharmacoecon Outcomes Res 2020; 21:353-364. [PMID: 33213205 DOI: 10.1080/14737167.2021.1848553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Introduction: Treatment of human epithelial growth factor receptor 2 (HER2)-positive breast cancer has rapidly evolved over the past decades with the addition of trastuzumab, lapatinib, pertuzumab, and trastuzumab emtansine (T-DM1). These treatments have dramatically impacted the survival of HER2-positive metastatic breast cancer (mBC) patients. Nonetheless, these agents are associated with high price tags, begging the question, 'Are treatments for HER2-positive metastatic breast cancer and associated metastases cost-effective'?Areas covered: We examine evidence on the cost-effectiveness of treatments for HER2-positive metastatic breast cancer and associated metastases through a review of systematic reviews on the topic. Additionally, we discuss the implications of our findings and provide recommendations for future directions in the assessment of the cost-effectiveness of targeted directed agents for HER2-positive mBC.Expert opinion: Heterogeneous evidence from cost-effectiveness studies on the use of targeted directed agents for HER2-positive mBC across the world caution against cross-country comparisons of the value of such treatments. It also militates in favor of the production and use of cost-effectiveness analyses for local rather than global decision-making, thus ensuring that economic evaluations reflect the needs of local decision-makers and populations for which they are devised.
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Affiliation(s)
- Vakaramoko Diaby
- Department of Pharmaceutical Outcomes and Policy (POP), College of Pharmacy, HPNP 3317, University of Florida, Gainesville, FL, USA
| | - Reem D Almutairi
- Department of Pharmaceutical Business and Administration Sciences, MCPHS University, Boston, MA, USA
| | - Aram Babcock
- Department of Pharmaceutical Outcomes and Policy (POP), College of Pharmacy, HPNP 3317, University of Florida, Gainesville, FL, USA
| | - Richard K Moussa
- Université De Cergy-Pontoise, France and Ecole Nationale Supérieure De Statistiques Et d'Economie Appliquée (ENSEA), Côte d'Ivoire
| | - Askal Ali
- College of Pharmacy and Pharmaceutical Sciences, Florida A&M University, Tallahassee, FL, USA
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12
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Pereira M, Moreira CS, Nogueira-Silva C, Izdebski P, Pereira MG. Breast cancer post-surgical impact on women´s quality of life during chemotherapy treatment: A structural equation modelling approach. Eur J Cancer Care (Engl) 2020; 30:e13349. [PMID: 33159394 DOI: 10.1111/ecc.13349] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 07/02/2020] [Accepted: 08/07/2020] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Breast cancer is an important public health problem that is increasing in incidence, being a stressor with a negative impact on women's quality of life. This study is focused on the evaluation of temporal precursors (one month before) of women's quality of life undergoing chemotherapy, considering post-surgical personal, clinical, cognitive and neuropsychophysiological factors, according to the Transactional Stress and Coping Model. METHODS This longitudinal study included 112 patients with breast cancer. Data were collected in two different moments: before and during the adjuvant chemotherapy. Structural equation modelling was used to support a theoretically based model in which some antecedent factors impact patients' long-term quality of life through a set of mediators. RESULTS The associations of breast symptoms, body image and sexual functioning with psychological distress and quality of life were totally mediated by illness perceptions, while the associations of working memory with psychological distress and quality of life were totally mediated by self-efficacy for coping. Patients with greater psychological distress showed higher levels of nadir cortisol. CONCLUSIONS Results showed the importance of assessing patients' perceptions of their illness, prior to chemotherapy, as well as promoting more self-efficacy for coping, in order to improve women's emotional state and quality of life.
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Affiliation(s)
- Marta Pereira
- School of Psychology, University of Minho, Psychology Research Center (CIPsi), Braga, Portugal
| | - Célia Sofia Moreira
- Faculty of Sciences and Center of Mathematics (FCUP & CMUP), University of Porto, Porto, Portugal
| | - Cristina Nogueira-Silva
- Life and Health Sciences Research Institute, School of Medicine, University of Minho, Braga, Portugal.,Life and Health Sciences Research Institute /3B's-PT Government Associate Laboratory, Braga, Portugal.,Department of Obstetrics and Gynaecology, Hospital de Braga, Braga, Portugal
| | - Pawel Izdebski
- Institute of Psychology of the Kazimierz Wielki, University in Bydgoszcz, Bydgoszcz, Poland
| | - M Graça Pereira
- School of Psychology, University of Minho, Psychology Research Center (CIPsi), Braga, Portugal
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13
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Chow WL, Tan SM, Aung KCY, Chua SYN, Sim HC. Factors influencing quality of life of Asian breast cancer patients and their caregivers at diagnosis: perceived medical and psychosocial needs. Singapore Med J 2020; 61:532-539. [PMID: 31423539 PMCID: PMC7930309 DOI: 10.11622/smedj.2019099] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
INTRODUCTION We aimed to examine the relative importance of medical and psychosocial needs of Asian breast cancer patients and their caregivers, and to identify the determinants of quality of life (QoL) at the time of diagnosis. METHODS This is a prospective observational study of the perceived needs and QoL of 99 dyads of breast cancer patients and their caregivers at diagnosis. A self-administered questionnaire was used to measure the perceived importance of medical and psychosocial support needs. Short Form-36 health survey (SF-36) version 2 was used to measure QoL. We also collected patient and caregiver demographic profiles and disease-specific information. Descriptive analysis of perceived needs was performed. SF-36 scores for eight domains and composite scores were calculated. Bivariate analysis and linear regression were performed to identify significant independent predictors of QoL of patients and caregivers. RESULTS The mean ages of the patients and caregivers were 56.5 years and 51.7 years, respectively. To have family around (73%), prompt information about treatment and treatment options, including side effects (71%), and prompt treatment for side effects (71%) were the top three needs among patients and their caregivers. Supportive nurses and prompt treatment for side effects positively improved patients' social functioning and bodily pain scores. Stage of disease, age, education and ethnicity also influenced QoL. Only the presence of chronic disease influenced caregivers' physical functioning and role-physical scores. CONCLUSION Patients and caregivers have similar perceptions of needs at diagnosis. A supportive healthcare team can positively influence patients' QoL, highlighting the importance of tailoring support according to needs.
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Affiliation(s)
- Wai Leng Chow
- Health Services Research, Changi General Hospital, Singapore
| | - Su-Ming Tan
- General Surgery, Changi General Hospital, Singapore
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14
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El Haidari R, Abbas LA, Nerich V, Anota A. Factors Associated with Health-Related Quality of Life in Women with Breast Cancer in the Middle East: A Systematic Review. Cancers (Basel) 2020; 12:cancers12030696. [PMID: 32187972 PMCID: PMC7140018 DOI: 10.3390/cancers12030696] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 03/09/2020] [Accepted: 03/09/2020] [Indexed: 02/06/2023] Open
Abstract
Objectives: The aim of the present systematic review was to identify the factors that potentially influence health-related quality of life (HRQoL) in women with breast cancer (BC) in the Middle East. Methods: A systematic search of the PubMed, Ovid Medline, Cochrane, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, and Ebscohost databases was conducted to identify all relevant articles published in peer-reviewed journals up to April 2018. The keywords were “Health related quality of life”, “Breast Cancer”, and “Middle East countries”. The Newcastle–Ottawa (NOS) scale was used to evaluate the methodological quality of the included studies. Due to the methodological heterogeneity of the identified studies, no statistical pooling of the individual effect estimates was carried out; instead, the results were summarized descriptively. Results: A total of 5668 articles were screened and 33 studies were retained. The vast majority of these studies were cross-sectional and only two were longitudinal prospective studies. Concerning the methodological quality, only 39% were of high quality. Our comprehensive literature review identified several modifiable and non-modifiable risk factors associated with HRQoL, including sociodemographic, clinical, and treatment-related factors as well as behavioral and psychosocial factors. Conclusion: This study has many implications for clinical practice and may provide a framework for establishing policy interventions to improve HRQoL among women with BC. Healthcare systems in the Middle East are encouraged to develop interventional programs targeting modifiable factors, particularly socio-demographic, behavioral, and psychosocial factors.
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Affiliation(s)
- Rana El Haidari
- Environments and Health doctoral school, University of Bourgogne Franche-Comté, 25000 Besançon, France
- INSERM (French Institut of Health and Medical Research), EFS BFC (Etablissement français du sang Bourgogne franhce-comté), UMR1098 (Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique), University of Bourgogne Franche-Comté, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, F-25000 Besançon, France; (V.N.); (A.A.)
- Correspondence: or ; Tel.: +96-1-7166-2058
| | - Linda Abou Abbas
- Neuroscience research center, Faculty of medical sciences, Lebanese university, 1001 Beirut, Lebanon;
| | - Virginie Nerich
- INSERM (French Institut of Health and Medical Research), EFS BFC (Etablissement français du sang Bourgogne franhce-comté), UMR1098 (Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique), University of Bourgogne Franche-Comté, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, F-25000 Besançon, France; (V.N.); (A.A.)
- Department of Pharmacy, University Hospital of Besançon, 25030 Besançon, France
| | - Amélie Anota
- INSERM (French Institut of Health and Medical Research), EFS BFC (Etablissement français du sang Bourgogne franhce-comté), UMR1098 (Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique), University of Bourgogne Franche-Comté, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, F-25000 Besançon, France; (V.N.); (A.A.)
- Methodology and Quality of Life in Oncology Unit, University Hospital of Besançon, 25000 Besançon, France
- French National Platform Quality of Life and Cancer, 250000 Besançon, France
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15
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Golembiewski E, Allen KS, Blackmon AM, Hinrichs RJ, Vest JR. Combining Nonclinical Determinants of Health and Clinical Data for Research and Evaluation: Rapid Review. JMIR Public Health Surveill 2019; 5:e12846. [PMID: 31593550 PMCID: PMC6803891 DOI: 10.2196/12846] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 05/23/2019] [Accepted: 07/19/2019] [Indexed: 02/06/2023] Open
Abstract
Background Nonclinical determinants of health are of increasing importance to health care delivery and health policy. Concurrent with growing interest in better addressing patients’ nonmedical issues is the exponential growth in availability of data sources that provide insight into these nonclinical determinants of health. Objective This review aimed to characterize the state of the existing literature on the use of nonclinical health indicators in conjunction with clinical data sources. Methods We conducted a rapid review of articles and relevant agency publications published in English. Eligible studies described the effect of, the methods for, or the need for combining nonclinical data with clinical data and were published in the United States between January 2010 and April 2018. Additional reports were obtained by manual searching. Records were screened for inclusion in 2 rounds by 4 trained reviewers with interrater reliability checks. From each article, we abstracted the measures, data sources, and level of measurement (individual or aggregate) for each nonclinical determinant of health reported. Results A total of 178 articles were included in the review. The articles collectively reported on 744 different nonclinical determinants of health measures. Measures related to socioeconomic status and material conditions were most prevalent (included in 90% of articles), followed by the closely related domain of social circumstances (included in 25% of articles), reflecting the widespread availability and use of standard demographic measures such as household income, marital status, education, race, and ethnicity in public health surveillance. Measures related to health-related behaviors (eg, smoking, diet, tobacco, and substance abuse), the built environment (eg, transportation, sidewalks, and buildings), natural environment (eg, air quality and pollution), and health services and conditions (eg, provider of care supply, utilization, and disease prevalence) were less common, whereas measures related to public policies were rare. When combining nonclinical and clinical data, a majority of studies associated aggregate, area-level nonclinical measures with individual-level clinical data by matching geographical location. Conclusions A variety of nonclinical determinants of health measures have been widely but unevenly used in conjunction with clinical data to support population health research.
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Affiliation(s)
| | - Katie S Allen
- IUPUI Richard M Fairbanks School of Public Health, Indianapolis, IN, United States.,Regenstrief Institute, Inc, Indianapolis, IN, United States
| | - Amber M Blackmon
- IUPUI Richard M Fairbanks School of Public Health, Indianapolis, IN, United States
| | | | - Joshua R Vest
- IUPUI Richard M Fairbanks School of Public Health, Indianapolis, IN, United States.,Regenstrief Institute, Inc, Indianapolis, IN, United States
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16
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Nageeti TH, Elzahrany HR, Gabra AO, Obaid AA, Jastania RA. Quality of life assessment of breast cancer patients in Saudi Arabia. J Family Community Med 2019; 26:98-102. [PMID: 31143080 PMCID: PMC6515765 DOI: 10.4103/jfcm.jfcm_4_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND To assess the quality of life (QOL) of females with breast cancer in Saudi Arabia and its association with patients' demographic, social, and clinical data. MATERIALS AND METHODS This analytical cross-sectional study was conducted among breast cancer patients attending King Abdullah Medical City, Makkah. Participants were asked to complete a self-administered structured questionnaire. We utilized the validated Arabic version of the European Organization for Research and Treatment of Cancer QOL-C30 (EORTC-QOL-C30) and breast cancer module QLQ-BR23 (EORTC-QOL-BR-23). Data were analysed using SPSS; mean and standard deviation computed for continuous variables, and percentages for categorical variables. Student's t-test performed to compare mean scores for various groups. RESULTS Eighty-eight women participated in the study. The participants had a mean global health score of 64.0, standard deviation (SD) = 27.7. Of the functional scales, role functioning scored the highest (mean 71.2, SD = 31), while social and emotional functioning scored the lowest, (mean 57 SD = 35.8) and (mean 59.5 SD = 32), respectively. On the symptom scales, the most troubling symptoms were fatigue and insomnia, (mean 48.86 SD = 29.4) and (mean = 48, SD = 35), respectively. On the disease-specific tool (QLQ-BR23), body image and future perspective scored the lowest with a mean of 60.2 SD = 35 and 42.0 SD = 39.6, respectively. The most distressing symptom was hair loss (mean 61.56 SD = 41). CONCLUSIONS Our population showed an acceptable overall global health score. However, they scored low on the important functional and symptoms domains. This study implies that patient age, social, and physical factors were possible determinants of global health and QOL scores. The healthcare system of Saudi Arabia should, therefore, address all these different aspects of QOL of breast cancer survivors.
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Affiliation(s)
- Tahani H Nageeti
- Department of Radiation Oncology, King Abdullah Medical City - Holy, Capital, Makkah, Saudi Arabia
| | - Huda R Elzahrany
- Department of Pathology, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Aisha O Gabra
- Department of Surgery, Maternity and Children Hospital, Makkah, Saudi Arabia
| | - Arwa A Obaid
- Department of Surgery, Albaha University, Al Bahah, Saudi Arabia
| | - Raid A Jastania
- Department of Pathology, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
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17
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Ritzwoller DP, Hassett MJ, Uno H, Cronin AM, Carroll NM, Hornbrook MC, Kushi LC. Development, Validation, and Dissemination of a Breast Cancer Recurrence Detection and Timing Informatics Algorithm. J Natl Cancer Inst 2019; 110:273-281. [PMID: 29873757 DOI: 10.1093/jnci/djx200] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 08/24/2017] [Indexed: 12/13/2022] Open
Abstract
Background This study developed, validated, and disseminated a generalizable informatics algorithm for detecting breast cancer recurrence and timing using a gold standard measure of recurrence coupled with data derived from a readily available common data model that pools health insurance claims and electronic health records data. Methods The algorithm has two parts: to detect the presence of recurrence and to estimate the timing of recurrence. The primary data source was the Cancer Research Network Virtual Data Warehouse (VDW). Sixteen potential indicators of recurrence were considered for model development. The final recurrence detection and timing models were determined, respectively, by maximizing the area under the ROC curve (AUROC) and minimizing average absolute error. Detection and timing algorithms were validated using VDW data in comparison with a gold standard recurrence capture from a third site in which recurrences were validated through chart review. Performance of this algorithm, stratified by stage at diagnosis, was compared with other published algorithms. All statistical tests were two-sided. Results Detection model AUROCs were 0.939 (95% confidence interval [CI] = 0.917 to 0.955) in the training data set (n = 3370) and 0.956 (95% CI = 0.944 to 0.971) and 0.900 (95% CI = 0.872 to 0.928), respectively, in the two validation data sets (n = 3370 and 3961, respectively). Timing models yielded average absolute prediction errors of 12.6% (95% CI = 10.5% to 14.5%) in the training data and 11.7% (95% CI = 9.9% to 13.5%) and 10.8% (95% CI = 9.6% to 12.2%) in the validation data sets, respectively, and were statistically significantly lower by 12.6% (95% CI = 8.8% to 16.5%, P < .001) than those estimated using previously reported timing algorithms. Similar covariates were included in both detection and timing algorithms but differed substantially from previous studies. Conclusions Valid and reliable detection of recurrence using data derived from electronic medical records and insurance claims is feasible. These tools will enable extensive, novel research on quality, effectiveness, and outcomes for breast cancer patients and those who develop recurrence.
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Affiliation(s)
| | - Michael J Hassett
- Dana-Farber Cancer Institute, Boston, MA, Harvard Medical School, Boston, MA
| | - Hajime Uno
- Dana-Farber Cancer Institute, Boston, MA, Harvard Medical School, Boston, MA
| | - Angel M Cronin
- Dana-Farber Cancer Institute, Boston, MA, Harvard Medical School, Boston, MA
| | - Nikki M Carroll
- Institute for Health Research, Kaiser Permanente Colorado, Denver, CO
| | | | - Lawrence C Kushi
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
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18
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Malak MZ, Tawalbeh LI, Abu Sharour LM. Predictors of quality of life among older patients with cancer during treatment. J Res Nurs 2018; 23:598-611. [PMID: 34394479 DOI: 10.1177/1744987118785939] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Background Improving quality of life in older patients with cancer has become an important goal of healthcare providers. Aims The purpose of this study was to identify the predictors of quality of life among older patients with cancer, aged 60 years and over during the treatment period. Methods A descriptive correlational study was conducted among 150 patients. The Functional Assessment of Cancer Therapy Scale, Herth Hope Index and Hospital Anxiety and Depression Scale were used. Results The results showed that the total quality-of-life mean score was 58.50 (SD = 7.44), indicating low overall quality of life. The social-family well-being subscale had the highest mean (20.50, SD = 3.79) among all subscales of quality of life, while the emotional well-being subscale had the lowest mean (8.06, SD = 4.23). Hope and educational level had statistically significant positive relationships with all subscales of quality of life. However, anxiety was associated negatively with physical, social-family and functional well-being subscales, but positively with the emotional well-being subscale. Anxiety, income, marital status, health insurance, duration of treatment, educational level, gender and hope were identified as predictors of quality-of-life subscales. Conclusions The results could help to develop specific programmes that may improve quality of life among older patients with cancer during treatment.
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Affiliation(s)
- Malakeh Z Malak
- Assistant Professor, Faculty of Nursing, Al-Zaytoonah University of Jordan, Jordan
| | - Loai I Tawalbeh
- Associate Professor, Faculty of Nursing, Al-AlBayt University, Jordan
| | - Loai M Abu Sharour
- Associate Professor, Faculty of Nursing, Al-Zaytoonah University of Jordan, Jordan
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Oh YK, Hwang SY. [Impact of Uncertainty on the Quality of Life of Young Breast Cancer Patients: Focusing on Mediating Effect of Marital Intimacy]. J Korean Acad Nurs 2018. [PMID: 29535284 DOI: 10.4040/jkan.2018.48.1.50] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
PURPOSE The purpose of this study was to examine the mediating effect of marital intimacy on the impact of uncertainty on the quality of life (QoL) of young breast cancer patients. METHODS This study used a pathway analysis with 154 young breast cancer cases in their early diagnosis stage at a medical center in Korea. Data were collected from November 2016 to February 2017 and analyzed using correlation analysis and pathway analysis. RESULTS Uncertainty, marital intimacy, and 4 sub-scales of QoL showed a significant correlation. Marital intimacy was directly affected by uncertainty (β=-.39, p=.013) and 4 sub-scales of QoL were also affected by uncertainty. Among the 4 sub-scales of QoL, physical well-being (PWB) (β=.17, p=.026), social well-being (SWB) (β=.49, p=.010), and functional well-being (FWB) (β=.38, p=.009) were affected by marital intimacy but emotional well-being (EWB) was not affected by it. The mediating effect of marital intimacy on the impact of uncertainty on QoL was confirmed. Marital intimacy showed a significant indirect effect on PWB (β=-.07, p=.024), SWB (β=-.19, p=.008), and FWB (β=-.15, p=.005), and it means that marital intimacy has a partial mediating effect on the impact of uncertainty on PWB, SWB, and FWB. CONCLUSION Effects of uncertainty on QoL was mediated by marital intimacy of young breast cancer patients in their early diagnosis stage. It suggests that marital intimacy needs to be considered in providing nursing intervention for young breast cancer patients.
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Affiliation(s)
| | - Seon Young Hwang
- School of Nursing · The Research Institute of Nursing Science, Hanyang University, Seoul, Korea.
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20
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Bhandari S, Sriyuktasuth A, Pongthavornkamol K. Treatment-Related Quality of Life in Nepalese Women with Breast Cancer. Asian Pac J Cancer Prev 2017; 18:3365-3371. [PMID: 29286605 PMCID: PMC5980896 DOI: 10.22034/apjcp.2017.18.12.3365] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Objective: To identify the level of quality of life and its predictors in Nepalese women with breast cancer while receiving chemotherapy. Methods: This cross-sectional study with a predictive design was conducted for a conveniently selected sample of 85 Nepalese women with primary breast cancer receiving chemotherapy at outpatient clinics of three cancer hospitals of Kathmandu, Nepal. Data were collected during December 2016 and February 2017 using demographic sheets, the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire and the modified Medical Outcomes Study Social Support Survey. Descriptive and inferential statistics were employed for data analysis. Results: The mean age of the sample was 50.2 years (SD = 11.50). Study participants reported moderate to poor quality of life (M = 33.5, SD = 23.5). Multiple regression analysis showed that age, years of education, stage, past breast surgery, overall symptom severity, and social support significantly explained 56.8% of the variance in quality of life (R2 = .568, F (8,76) = 12.469, p = .000). However, overall symptom severity (β = -.477, p= .000) and social support (β = .183, p = .050) were the most important predictors. Conclusions: As Nepalese women reported decreased quality of life, nurses should provide preventive and supportive services to improve the quality of life of their patients during chemotherapy.
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Zhang H, Zhao Q, Cao P, Ren G. Resilience and Quality of Life: Exploring the Mediator Role of Social Support in Patients with Breast Cancer. Med Sci Monit 2017; 23:5969-5979. [PMID: 29248937 PMCID: PMC5744469 DOI: 10.12659/msm.907730] [Citation(s) in RCA: 131] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The diagnosis and treatment of breast cancer can provoke a series of negative emotional changes in patients, further affecting their quality of life. It has been shown that patients with higher resilience have better quality of life. Social support systems are important protective factors that are necessary for the process of resilience to occur. Hence, this study aimed to investigate the role of social support in the relationship between resilience and quality of life among Chinese patients with breast cancer. MATERIAL AND METHODS A demographic-disease survey, the Chinese version of the Connor-Davidson Resilience Scale 25, Medical Outcomes Study Social Support Survey, and Functional Assessment of Cancer Therapy Breast Cancer Version 3 were used to interview 98 patients with breast cancer from a teaching hospital in Chongqing, China. Data analysis was performed by descriptive statistics, independent-sample t test, one-way ANOVA, and regression analyses. RESULTS The mean scores of resilience, social support, and quality of life were 54.68, 61.73, and 80.74 respectively, which were in the moderate range. Participants with stronger social support had higher resilience and better quality of life. Social support played a partial mediator role in the relationship between resilience and quality of life. The mediation effect ratio was 28.0%. CONCLUSIONS Social support is essential for the development of resilience and the improvement of quality of life in Chinese patients with breast cancer. Health professionals should provide appropriate guidelines to help patients seek effective support and enhance their resilience to improve their quality of life after breast cancer.
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Affiliation(s)
- Hailing Zhang
- Department of Nursing, First Affiliated Hospital of Chongqing Medical University, Chongqing, China (mainland)
| | - Qinghua Zhao
- Department of Nursing, First Affiliated Hospital of Chongqing Medical University, Chongqing, China (mainland)
| | - Peiye Cao
- Department of Nursing, First Affiliated Hospital of Chongqing Medical University, Chongqing, China (mainland)
| | - Guosheng Ren
- Department of the Breast Surgery, First Affiliated Hospital of Chongqing Medical University, Chongqing, China (mainland)
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22
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Amatya B, Khan F, Galea MP. Optimizing post-acute care in breast cancer survivors: a rehabilitation perspective. J Multidiscip Healthc 2017; 10:347-357. [PMID: 28919774 PMCID: PMC5587162 DOI: 10.2147/jmdh.s117362] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Breast cancer (BC) is the most common malignancy and a leading cause of morbidity and mortality in women worldwide. Therapeutic advances and improved survival rates of women with BC have implications for long-term impact on disability, psychological function and quality of life (QoL), which may be amenable to rehabilitation. The focus of rehabilitation is on managing disability, reducing sequelae and symptoms, and enhancing participation and societal reintegration, to achieve the highest possible independence and the best QoL. Rehabilitation interventions should be considered early for maintaining functional capacity and reducing the risk of losing important abilities or independence and should be individualized depending on disease phase, functional deficits, personal requirements and specific goals. A number of interventions have been trialled to support rehabilitation input for women with BC, which include physical therapy, psychological interventions (psychotherapy, cognitive behavioral training) and others. Multidisciplinary rehabilitation and uni-disciplinary interventions such as physical therapy have been shown to be beneficial in reducing disability, and improving participation and QoL. There is a need for comprehensive assessment of health domains in BC patients using a standardized framework and a common language for describing the impact of disease at different levels, using the International Classification of Functioning, Disability and Health core sets. This will provide more detailed information on the needs of these patients, so more efficient and targeted rehabilitation interventions can be provided.
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Affiliation(s)
- Bhasker Amatya
- Department of Rehabilitation Medicine, Royal Melbourne Hospital
- Australian Rehabilitation Research Centre, Royal Melbourne Hospital
- Department of Medicine, The University of Melbourne, Parkville, VIC, Australia
| | - Fary Khan
- Department of Rehabilitation Medicine, Royal Melbourne Hospital
- Australian Rehabilitation Research Centre, Royal Melbourne Hospital
- Department of Medicine, The University of Melbourne, Parkville, VIC, Australia
| | - Mary P Galea
- Department of Rehabilitation Medicine, Royal Melbourne Hospital
- Australian Rehabilitation Research Centre, Royal Melbourne Hospital
- Department of Medicine, The University of Melbourne, Parkville, VIC, Australia
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23
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Merrill RM, Johnson E. Benefits of marriage on relative and conditional relative cancer survival differ between males and females in the USA. J Cancer Surviv 2017; 11:578-589. [PMID: 28770444 DOI: 10.1007/s11764-017-0627-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 06/23/2017] [Indexed: 12/25/2022]
Abstract
PURPOSE The purpose of the paper is to assess the influence of marital status on conditional relative survival of cancer according to sex. METHODS Analyses involved 779,978 males and 1,032,868 females diagnosed with 1 of 13 cancer types between 2000 and 2008, and followed through 2013. Data are from the Surveillance, Epidemiology, and End Results (SEER) Program. Regression models were adjusted for age, sex, race, and tumor stage. RESULTS Five-year relative survival conditional on years already survived is higher among married patients with less lethal cancers (oral cavity and pharynx, colon and rectum, breast, urinary bladder, kidney and renal pelvis, melanoma of the skin, thyroid, lymphoma). For more lethal cancers, married patients have similar (liver, lung and bronchus, pancreas, leukemia) or poorer (brain and other nervous system) cancer survival. Separated/divorced or widowed patients have the lowest conditional relative survival rates. For most cancers, 5-year cancer relative survival rates conditional on time already survived through 5 years approach 70 to 90% of that for the general population. The beneficial effect of marriage on survival decreases with years already survived. Superior conditional relative survival rates in females decrease with time already survived and are less pronounced in married patients. CONCLUSION Five-year relative survival rates improve with time already survived. The benefits of marriage on conditional relative survival are greater for less lethal cancers. Greater 5-year conditional relative survival rates in females narrow with time already survived and are less pronounced in married patients. IMPLICATIONS FOR CANCER SURVIVORS Conditional relative survival rates of cancer can lead to more informed decisions and understanding regarding treatment and prognosis.
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Affiliation(s)
- Ray M Merrill
- Department of Health Science, College of Life Sciences, Brigham Young University, 2063 Life Sciences Building, Provo, UT, 84604, USA.
| | - Erin Johnson
- Department of Health Science, College of Life Sciences, Brigham Young University, 2063 Life Sciences Building, Provo, UT, 84604, USA
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24
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Salakari M, Pylkkänen L, Sillanmäki L, Nurminen R, Rautava P, Koskenvuo M, Suominen S. Social support and breast cancer: A comparatory study of breast cancer survivors, women with mental depression, women with hypertension and healthy female controls. Breast 2017; 35:85-90. [PMID: 28667868 DOI: 10.1016/j.breast.2017.06.017] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2017] [Accepted: 06/20/2017] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES Among breast cancer (BC) survivors, inadequate social support (SS) is associated with a significant increase in cancer-related mortality and reduction in quality of life (QoL). The aim of the study was to explore perceived SS during BC trajectory by comparing BC survivors, women with depression, women with arterial hypertension, and healthy female controls to each other, and to compare perceived balance of receiving and providing SS. MATERIAL AND METHODS The data of ongoing prospective postal survey was linked with national health registries. Respondents with BC (n = 64), depression (n = 471), arterial hypertension (n = 841) and healthy controls (n = 6274) formed the study population. SS was measured by a Sarason's 6-item shortened version of the Social Support Questionnaire (SSQ). The modified Antonucci's (1986) social support convoy model of the network of individuals was used to measure the dominating direction of SS. RESULTS The main provider of SS for all participants combined was the spouse or partner (94.3%), close relative (12.0%) and friends (5.4%). In all groups, particularly in the BC and arterial hypertension group, spouse or partner was seen as the most important supporter. The group suffering from depression reported significantly less SS in each domain of appraisal (p < 0.001). In total, 24.6% of all respondents reported receipt dominance of SS. CONCLUSION SS is a well-known determinant of wellbeing. Our study lends support to the spouse's or the partner's central role during the recovery phase of BC. Identification of factors improving the overall QoL of BC survivors is an important public health challenge.
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Affiliation(s)
- Minna Salakari
- University of Turku, Department of Public Health, Joukahaisenkatu 3-5, 20520, Turku, Finland.
| | - Liisa Pylkkänen
- Cancer Society of Finland, Unioninkatu 22, 00130, Helsinki, Finland.
| | - Lauri Sillanmäki
- University of Helsinki, Department of Occupational Health, Mannerheimintie 172, 00300, Helsinki, Finland.
| | - Raija Nurminen
- University of Applied Science Turku, Ruiskatu 8, 20740, Turku, Finland.
| | - Päivi Rautava
- Turku University Hospital, Kiinanmyllynkatu 4-8, 20520, Turku, Finland.
| | - Markku Koskenvuo
- University of Helsinki, Department of Occupational Health, Mannerheimintie 172, 00300, Helsinki, Finland.
| | - Sakari Suominen
- University of Turku, Department of Public Health, Joukahaisenkatu 3-5, 20520, Turku, Finland.
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25
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Tejeda S, Stolley MR, Vijayasiri G, Campbell RT, Estwing Ferrans C, Warnecke RB, Rauscher GH. Negative psychological consequences of breast cancer among recently diagnosed ethnically diverse women. Psychooncology 2017; 26:2245-2252. [PMID: 28499328 DOI: 10.1002/pon.4456] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Revised: 03/23/2017] [Accepted: 05/08/2017] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Breast cancer has psychological consequences that impact quality of life. We examined factors associated with negative psychological consequences of a breast cancer diagnosis, in a diverse sample of 910 recently diagnosed patients (378 African American, 372 white, and 160 Latina). METHODS Patients completed an in-person interview as part of the Breast Cancer Care in Chicago study within an average of 4 months from diagnosis. The Cockburn negative psychological consequences of breast cancer screening scale was revised to focus on a breast cancer diagnosis. Path analysis assessed predictors of psychological consequences and potential mediators between race/ethnicity and psychological consequences. RESULTS Compared to white counterparts, bivariate analysis showed African American (β = 1.4, P < .05) and Latina (β = 3.6, P < .001) women reported greater psychological consequences. Strongest predictors (P < .05 for all) included unmet social support (β = .38), and provider trust (β = .12), followed by stage at diagnosis (β = .10) and perceived neighborhood social disorder (β = .09).The strongest mediator between race/ethnicity and psychological consequences was unmet social support. CONCLUSIONS African American and Latina women reported greater psychological consequences related to their breast cancer diagnosis; this disparity was mediated by differences in unmet social support. Social support represents a promising point of intervention.
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Affiliation(s)
- Silvia Tejeda
- Institute for Health Research and Policy, University of Illinois at Chicago (UIC), Chicago, IL, USA
| | - Melinda R Stolley
- Institute for Health Research and Policy, University of Illinois at Chicago (UIC), Chicago, IL, USA.,Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Ganga Vijayasiri
- Institute for Health Research and Policy, University of Illinois at Chicago (UIC), Chicago, IL, USA
| | - Richard T Campbell
- Institute for Health Research and Policy, University of Illinois at Chicago (UIC), Chicago, IL, USA.,Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago (UIC), Chicago, IL, USA
| | - Carol Estwing Ferrans
- Institute for Health Research and Policy, University of Illinois at Chicago (UIC), Chicago, IL, USA.,Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago (UIC), Chicago, IL, USA
| | - Richard B Warnecke
- Institute for Health Research and Policy, University of Illinois at Chicago (UIC), Chicago, IL, USA
| | - Garth H Rauscher
- Institute for Health Research and Policy, University of Illinois at Chicago (UIC), Chicago, IL, USA.,Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago (UIC), Chicago, IL, USA
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26
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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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27
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Lu Q, You J, Kavanagh A, Warmoth K, Meng Z, Chen Z, Chandwani KD, Perkins GH, McQuade JL, Raghuram NV, Nagarathna R, Liao Z, Nagendra HR, Chen J, Guo X, Liu L, Arun B, Cohen L. Differences in quality of life between American and Chinese breast cancer survivors. Support Care Cancer 2016; 24:3775-82. [PMID: 27048455 PMCID: PMC5421630 DOI: 10.1007/s00520-016-3195-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 03/28/2016] [Indexed: 11/26/2022]
Abstract
OBJECTIVE It has been speculated that cancer survivors in Asia may have lower quality of life (QOL) compared with their Western counterparts. However, no studies have made international comparisons in QOL using a comprehensive measure. This study aimed to compare Chinese breast cancer survivors' QOL with US counterparts and examine if demographic and medical factors were associated with QOL across groups. METHOD The sample consisted of 159 breast cancer patients (97 Chinese and 62 American) who completed the Functional Assessment for Cancer Therapy Breast Cancer (FACT-B) scale before the start of radiotherapy in Shanghai, China and Houston, USA. RESULTS Higher income was associated with higher QOL total scores in both Chinese and American cancer patients, but QOL was not significantly associated with other factors including age, education, disease stage, mastectomy, and chemotherapy. Consistent with hypotheses, compared to their US counterparts, Chinese breast cancer survivors reported lower QOL and all four subdimensions including functional well-being (FWB), physical well-being (PWB), emotional well-being (EWB), and social well-being (SWB); they also reported more breast cancer-specific concerns (BCS). Differences were also clinically significant for Functional Assessment for Cancer Therapy General (FACT-G) scale total scores and the FWB subscale. After controlling for demographic and medical covariates, these differences remained except for the SWB and BCS. Furthermore, Chinese breast cancer survivors receiving chemotherapy reported significantly lower FACT-G scores than those who did not, but this difference did not emerge among US breast cancer survivors. DISCUSSION Chinese breast cancer survivors reported poorer QOL on multiple domains compared to US women. Findings indicate that better strategies are needed to help improve the QOL of Chinese breast cancer survivors, especially those who underwent chemotherapy.
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Affiliation(s)
- Qian Lu
- Department of Psychology, University of Houston, 126 Heyne Building, Houston, 77204, TX, USA.
| | - Jin You
- WuHan University, Wuhan, China
| | - April Kavanagh
- The University of Texas School of Public Health, Houston, USA
| | - Krystal Warmoth
- Department of Psychology, University of Houston, 126 Heyne Building, Houston, 77204, TX, USA
| | - Zhiqiang Meng
- Fudan University Shanghai Cancer Center, Shanghai, China
| | - Zhen Chen
- Fudan University Shanghai Cancer Center, Shanghai, China
| | | | | | | | | | | | - Zhongxing Liao
- The University of Texas MD Anderson Cancer Center, Houston, USA
| | | | - Jiayi Chen
- Fudan University Shanghai Cancer Center, Shanghai, China
| | - Xiaoma Guo
- Fudan University Shanghai Cancer Center, Shanghai, China
| | - Luming Liu
- Fudan University Shanghai Cancer Center, Shanghai, China
| | - Banu Arun
- The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Lorenzo Cohen
- The University of Texas MD Anderson Cancer Center, Houston, USA.
- Department of Palliative, Rehabilitation, and Integrative Medicine, Section of Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA.
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28
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Hershman DL, Kushi LH, Hillyer GC, Coromilas E, Buono D, Lamerato L, Bovbjerg DH, Mandelblatt JS, Tsai WY, Zhong X, Jacobson JS, Wright JD, Neugut AI. Psychosocial factors related to non-persistence with adjuvant endocrine therapy among women with breast cancer: the Breast Cancer Quality of Care Study (BQUAL). Breast Cancer Res Treat 2016; 157:133-43. [PMID: 27086286 DOI: 10.1007/s10549-016-3788-x] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 04/05/2016] [Indexed: 11/25/2022]
Abstract
Non-adherence to adjuvant endocrine therapy (ET) for breast cancer (BC) is common. Our goal was to determine the associations between psychosocial factors and ET non-persistence. We recruited women with BC receiving care in an integrated healthcare system between 2006 and 2010. Using a subset of patients treated with ET, we investigated factors related to ET non-persistence (discontinuation) based on pharmacy records (≥90 days gap). Serial interviews were conducted at baseline and every 6 months. The Functional Assessment of Cancer Therapy (FACT), Medical Outcomes Survey, Treatment Satisfaction Questionnaire (TSQM), Impact of Events Scale (IES), Interpersonal Processes of Care measure, and Decision-making beliefs and concerns were measured. Multivariate models assessed factors associated with non-persistence. Of the 523 women in our final cohort who initiated ET and had a subsequent evaluation, 94 (18 %) were non-persistent over a 2-year follow-up. The cohort was primarily white (74.4 %), stage 1 (60.6 %), and on an aromatase inhibitor (68.1 %). Women in the highest income category had a lower odds of being non-persistent (OR 0.43, 95 % CI 0.23-0.81). Quality of life and attitudes toward ET at baseline were associated with non-persistence. At follow-up, the FACT, TSQM, and IES were associated with non-persistence (p < 0.001). Most women continued ET. Women who reported a better attitude toward ET, better quality of life, and more treatment satisfaction, were less likely to be non-persistent and those who reported intrusive/avoidant thoughts were more likely to be non-persistent. Interventions to enhance the psychosocial well-being of patients should be evaluated to increase adherence.
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Affiliation(s)
- Dawn L Hershman
- Department of Medicine, Columbia University, 161 Ft Washington, Room 1068, New York, NY, 10032, USA.
- Herbert Irving Comprehensive Cancer Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
- Department of Epidemiology, Columbia University, New York, NY, USA.
| | - Lawrence H Kushi
- Division of Research, Kaiser-Permanente of Northern California, Oakland, CA, USA
| | - Grace Clarke Hillyer
- Herbert Irving Comprehensive Cancer Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Department of Epidemiology, Columbia University, New York, NY, USA
| | - Ellie Coromilas
- Department of Medicine, Columbia University, 161 Ft Washington, Room 1068, New York, NY, 10032, USA
| | - Donna Buono
- Department of Epidemiology, Columbia University, New York, NY, USA
| | - Lois Lamerato
- Department of Public Health Sciences, Henry Ford Health System, Detroit, MI, USA
| | - Dana H Bovbjerg
- Departments of Psychiatry, Psychology and Behavioral and Community Health Sciences, University of Pittsburgh, Pittsburgh, PA, USA
- University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA
| | - Jeanne S Mandelblatt
- Department of Oncology and Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC, USA
| | - Wei-Yann Tsai
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Xiaobo Zhong
- Department of Epidemiology, Columbia University, New York, NY, USA
| | - Judith S Jacobson
- Herbert Irving Comprehensive Cancer Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Department of Epidemiology, Columbia University, New York, NY, USA
| | - Jason D Wright
- Herbert Irving Comprehensive Cancer Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Department of Obstetrics and Gynecology, Columbia University, 161 Ft Washington, Room 1068, New York, NY, 10032, USA
| | - Alfred I Neugut
- Department of Medicine, Columbia University, 161 Ft Washington, Room 1068, New York, NY, 10032, USA
- Herbert Irving Comprehensive Cancer Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Department of Epidemiology, Columbia University, New York, NY, USA
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29
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Yan B, Yang LM, Hao LP, Yang C, Quan L, Wang LH, Wu Z, Li XP, Gao YT, Sun Q, Yuan JM. Determinants of Quality of Life for Breast Cancer Patients in Shanghai, China. PLoS One 2016; 11:e0153714. [PMID: 27082440 PMCID: PMC4833339 DOI: 10.1371/journal.pone.0153714] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 04/01/2016] [Indexed: 12/22/2022] Open
Abstract
Purpose To evaluate the association of social support status, health insurance and clinical factors with the quality of life of Chinese women with breast cancer. Methods Information on demographics, clinical characteristics, and social support status was collected from 1,160 women with newly diagnosed breast cancer in Shanghai, China. The Perceived Social Support Scale was used to assess different sources of social support for breast cancer patients. The quality of life was evaluated using the Functional Assessment of Cancer Therapy-Breast Cancer that consisted of five domains: breast cancer-specific, emotional, functional, physical, and social & family well-being. Multivariate linear regression models were used to evaluate the associations of demographic variables, clinical characteristics, and social support status with the quality of life measures. Results Adequate social support from family members, friends and neighbors, and higher scores of Perceived Social Support Scale were associated with significantly improved quality of life of breast cancer patients. Higher household income, medical insurance plans with low copayment, and treatment with traditional Chinese medicine for breast cancer all were associated with higher (better) scores of quality of life measures whereas patients receiving chemotherapy had significantly lower scores of quality of life. Conclusion Social support and financial aids may significantly improve the quality of life of breast cancer survivors.
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Affiliation(s)
- Bei Yan
- Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
- Division of Cancer Control and Population Sciences, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania, United States of America
| | - Li-Ming Yang
- Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Li-Peng Hao
- Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Chen Yang
- Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Lei Quan
- Division of Cancer Control and Population Sciences, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania, United States of America
- School of Bioscience and Bioengineering, South China University of Technology, Guangzhou, China
| | - Li-Hong Wang
- Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Zheng Wu
- Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Xiao-Pan Li
- Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Yu-Tang Gao
- Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Qiao Sun
- Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
- * E-mail: (J-MY); (QS)
| | - Jian-Min Yuan
- Division of Cancer Control and Population Sciences, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania, United States of America
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- * E-mail: (J-MY); (QS)
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30
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Cao A, Zhang J, Liu X, Wu W, Liu Y, Fan Z, Zhang A, Zhou T, Fu P, Wang S, Ouyang Q, Tang J, Jiang H, Zhang X, Pang D, He J, Shi L, Wang X, Sheng Y, Mao D, Shao Z. Health-related quality of life of postmenopausal Chinese women with hormone receptor-positive early breast cancer during treatment with adjuvant aromatase inhibitors: a prospective, multicenter, non-interventional study. Health Qual Life Outcomes 2016; 14:51. [PMID: 27009092 PMCID: PMC4806477 DOI: 10.1186/s12955-016-0446-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Accepted: 03/09/2016] [Indexed: 11/26/2022] Open
Abstract
Background Estimating quality of life (QoL) in patients with breast cancer is of importance in assessing treatment outcomes. Adjuvant endocrine therapy is widely used for hormone receptor-positive (HR+) early-stage breast cancer (EBC), and evidence suggests that aromatase inhibitors (AIs) may improve QoL for these patients. This study evaluated QoL in postmenopausal Chinese patients with HR+ EBC taking AIs. Methods This was a prospective, multicenter, and observational study that had no intent to intervene in the current treatment of recruited patients. Eligible patients were recruited within 7 days of beginning adjuvant treatment with AIs. The Functional Assessment of Cancer Therapy-Breast (FACT-B) scale was used to evaluate the patients’ QoL. Data were collected at baseline and at 6, 12, 18, and 24 months. Results From June 2010 to October 2013, a total of 494 patients with HR+ EBC were recruited from 21 centers. There was a 7.51-point increase in the patients’ mean FACT-B trial outcome index (TOI), from 90.69 at baseline to 98.72 at 24 months (P < .0001). The mean TOI scores at baseline, 6, 12, and 18 months were 90.69, 94.36, 97.71, and 96.75, respectively (P < .0001, for all). The mean (FACT-B) emotional well-being subscale scores at baseline, 6, 12, 18, and 24 months were 16.32, 16.55, 17.34 (P < .0001), 17.47 (P < .0001), and 17.85 (P < .0001), respectively, and social well-being scores were 18.61, 19.14 (P < .04), 19.35 (P < .008), 18.32, and 18.40, respectively. In the mixed model, baseline TOI, clinical visits, prior chemotherapies, age group, and axillary lymph-node dissection presented statistically significant effects on the change of FACT-B TOI and FACT-B SWB, whereas only baseline TOI, clinical visits, and prior chemotherapies presented statistically significant effects on the change of FACT-B EWB. FACT-B TOI, being the most pertinent and precise indicator of patient-reported QoL, demonstrated significant changes reflecting clinical benefit of adjuvant AIs endocrine therapy in the QoL of HR + EBC patients. Conclusions The study demonstrated significant improvements in the long-term QoL of postmenopausal Chinese patients with HR+ EBC at 6, 12, 18, and 24 months after starting treatment with AIs. The current study indicates improved long-term QoL with AI adjuvant treatment, which will aid clinicians in optimizing treatment to yield effective healthcare outcomes. Trial registration Clinicaltrials.gov NCT01144572
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Affiliation(s)
- Ayong Cao
- Department of Breast Surgery, Fudan University Shanghai Cancer Center, No. 270 Dongan Road, Xuhui District, Shanghai, 200032, China
| | - Jin Zhang
- Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, 300060, China
| | - Xiaoan Liu
- Department of Breast Surgery, Jiangsu Province Hospital, Nanjing, China
| | - Weizhu Wu
- Department of Oncology Surgery, Ningbo Medical Treatment Center Lihuili Hospital, Ningbo, 315000, China
| | - Yinhua Liu
- Breast Disease Center, Peking University First Hospital, Beijing, 100034, China
| | - Zhimin Fan
- Department of Breast Surgery, First Hospital of Jilin University, Changchun, 130021, China
| | - Anqin Zhang
- Breast Disease Center, Guangdong Women and Children's Hospital and Health Institute, Guangzhou, 510010, China
| | - Tianning Zhou
- Department of Breast Disease, Yunnan Tumor Hospital, Kunming, 650118, China
| | - Peifen Fu
- Breast Disease Center, First Affiliated Hospital of Medicine College of Zhejiang University, Hangzhou, 310006, China
| | - Shu Wang
- Breast Disease Center, Peking University People's Hospital, Beijing, 100044, China
| | - Quchang Ouyang
- Medical Oncology Center, Hunan Tumor Hospital, Changsha, 410000, China
| | - Jinhai Tang
- Department of General Surgery, Jiangsu Cancer Hospital, Nanjing, 210009, China
| | - Hongchuan Jiang
- Department of General Surgery, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, China
| | - Xiaohua Zhang
- Department of Oncology Surgery, The First Affiliated Hospital of Wenzhou Medical College, Wenzhou, 325000, China
| | - Da Pang
- Department of Breast Surgery, The Tumor Hospital of Harbin Medical University, Harbin, 150040, China
| | - Jianjun He
- Department of Surgical Oncology, The First Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, 710000, China
| | - Linxiang Shi
- Department of Breast and Thyroid Surgery, Shanghai Tenth People's Hospital, Shanghai, 200072, China
| | - Xianming Wang
- Department of Breast and Thyroid Surgery, Shenzhen Second Hospital, Shenzhen, 518000, China
| | - Yuan Sheng
- Department of Breast Surgery, Shanghai Changhai Hospital, Shanghai, 200433, China
| | - Dahua Mao
- Department of Breast Surgery, The Affiliated Hospital of Guiyang Medical College, Guiyang, Guizhou, 550004, China
| | - Zhimin Shao
- Department of Breast Surgery, Fudan University Shanghai Cancer Center, No. 270 Dongan Road, Xuhui District, Shanghai, 200032, China.
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Trogdon JG, Ekwueme DU, Chamiec-Case L, Guy GP. Breast Cancer in Young Women: Health State Utility Impacts by Race/Ethnicity. Am J Prev Med 2016; 50:262-9. [PMID: 26775905 PMCID: PMC5841540 DOI: 10.1016/j.amepre.2015.09.026] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Revised: 09/14/2015] [Accepted: 09/24/2015] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Little is known about the effect of breast cancers on health-related quality of life among women diagnosed between age 18 and 44 years. The goal of this study is to estimate the effect of breast cancer on health state utility by age at diagnosis (18-44 years versus ≥45 years) and by race/ethnicity. METHODS The analytic sample, drawn from the 2009 and 2010 Behavioral Risk Factor Surveillance System and analyzed in 2013, included women diagnosed with breast cancer between age 18 and 44 years (n=1,389) and age ≥45 years (n=6,037). Health state utility values were estimated using Healthy Days variables and a published algorithm. Regression analysis was conducted separately by age at diagnosis and race/ethnicity. RESULTS The breast cancer health state utility decrement within 1 year from date of diagnosis was larger for women diagnosed at age 18-44 years than for women diagnosed at age ≥45 years (-0.116 vs -0.070, p<0.05). Within the younger age-at-diagnosis group, Hispanic women 2-4 years after diagnosis had the largest health state utility decrement (-0.221, p<0.01), followed by non-Hispanic white women within 1 year of diagnosis (-0.126, p<0.01). CONCLUSIONS This study is the first to report estimates of health state utility values for breast cancer by age at diagnosis and race/ethnicity from a nationwide sample. The results highlight the need for separate quality of life adjustments for women by age at diagnosis and race/ethnicity when conducting cost-effectiveness analysis of breast cancer prevention, detection, and treatment.
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Affiliation(s)
- Justin G Trogdon
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
| | | | - Linda Chamiec-Case
- Public Health Economics Program, RTI International, Research Triangle Park, North Carolina
| | - Gery P Guy
- Division of Cancer Prevention and Control, CDC, Atlanta, Georgia
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Bustillo NE, McGinty HL, Dahn JR, Yanez B, Antoni MH, Kava BR, Penedo FJ. Fatalism, medical mistrust, and pretreatment health-related quality of life in ethnically diverse prostate cancer patients. Psychooncology 2015; 26:323-329. [PMID: 26553139 DOI: 10.1002/pon.4030] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 09/23/2015] [Accepted: 10/16/2015] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Few studies have examined the impact of cultural processes prevalent in minority ethnic groups such as cancer fatalism and medical mistrust on health-related quality of life (HRQoL) following a cancer diagnosis. The present study examined relationships among ethnicity, HRQoL, and two possible cultural vulnerability factors-fatalistic attitudes and medical mistrust-among an ethnically diverse sample of men with prostate cancer (PC) prior to undergoing active treatment. METHODS A total of 268 men with localized PC (30% African American, 29% Hispanic, and 41% non-Hispanic White) were assessed cross-sectionally prior to active treatment. Path analyses examined relationships among ethnicity, vulnerability factors, and HRQoL. RESULTS Ethnicity was not related to HRQoL after controlling for relevant covariates. Hispanic men reported greater cancer fatalism compared with non-Hispanic White men (β = 0.15, p = 0.03), and both Hispanics (β = 0.19, p < 0.01) and African Americans (β = 0.20, p < 0.01) reported greater medical mistrust than non-Hispanic Whites. Fatalism demonstrated a trend toward negatively impacting physical well-being (β = -0.12, p = 0.06), but was not significantly related to emotional well-being (β = -0.10, p = 0.11). Greater medical mistrust was associated with poorer physical (β = -0.14, p = 0.03) and emotional well-being (β = -0.13, p = 0.04). CONCLUSIONS Results indicate that fatalistic attitudes and medical system mistrust were more prevalent among minority men. Less trust in the medical system was associated with poorer physical and emotional well-being. Attention to perceptions of the healthcare system and its relation to HRQoL may have implications for targeting culturally driven attitudes that may compromise adjustment to a PC diagnosis.Copyright © 2015 John Wiley & Sons, Ltd.
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Affiliation(s)
| | - Heather L McGinty
- Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
| | | | - Betina Yanez
- Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
| | - Michael H Antoni
- Department of Psychology, University of Miami and Sylvester Cancer Center, Miami, FL, USA
| | - Bruce R Kava
- Miami VA Healthcare System, Miami, FL, USA.,Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Frank J Penedo
- Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
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Gonzales FA, Hurtado-de-Mendoza A, Santoyo-Olsson J, Nápoles AM. Do coping strategies mediate the effects of emotional support on emotional well-being among Spanish-speaking Latina breast cancer survivors? Psychooncology 2015; 25:1286-1292. [PMID: 26352186 DOI: 10.1002/pon.3953] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Revised: 06/12/2015] [Accepted: 08/05/2015] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This study aimed to assess the relationship between emotional social support and emotional well-being among Latina immigrants with breast cancer and test whether two culturally relevant coping strategies, fatalism and acceptance, mediate this relationship. METHODS One hundred fifty Spanish-speaking Latinas within 1 year of breast cancer diagnosis participating in a randomized trial of a stress management intervention were assessed in person at baseline and via telephone 6 months later. Survey measures included baseline emotional support, fatalism, and acceptance and emotional well-being 6 months later. Generalized linear models estimated direct effects of emotional support on emotional well-being and indirect effects through fatalism and acceptance. RESULTS Mean age was 50.1 (SD = 10.9) years; most women had low education and acculturation levels. Emotional support was negatively associated with fatalism (r = -0.24, p < 0.01) and positively associated with acceptance (r = 0.30, p < 0.001). Emotional support (r = 0.23, p = 0.005) and acceptance (r = 0.28, p = 0.001) were positively associated with emotional well-being, whereas fatalism (r = -0.36, p < 0.0001) was negatively associated with emotional well-being. In multivariable models, emotional support was associated with emotional well-being (b = 0.88, 95% CI: 0.24, 1.52). This direct effect remained significant when additionally controlling for fatalism (b = 0.66, 95% CI: 0.03, 1.30) and acceptance (b = 0.73, 95% CI: 0.09, 1.37) in separate models. There was a significant indirect effect of emotional support on emotional well-being through fatalism (b = 0.21, 95% CI: 0.04, 0.51) as well as a marginally significant effect through acceptance (b = 0.15, 95% CI: 0.001, 0.43). CONCLUSIONS Emotional support may increase well-being among Spanish-speaking Latina cancer survivors by reducing cancer fatalism.Copyright © 2015 John Wiley & Sons, Ltd.
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Affiliation(s)
- Felisa A Gonzales
- Cancer Prevention Fellowship Program, Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA.
| | - Alejandra Hurtado-de-Mendoza
- Department of Oncology, Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC, USA
| | - Jasmine Santoyo-Olsson
- Division of General Internal Medicine and the Center for Aging in Diverse Communities, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Anna María Nápoles
- Division of General Internal Medicine and the Center for Aging in Diverse Communities, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
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Alexander K, Cooper B, Paul SM, West C, Yates P, Kober KM, Aouizerat BE, Miaskowski C. Evidence of associations between cytokine gene polymorphisms and quality of life in patients with cancer and their family caregivers. Oncol Nurs Forum 2015; 41:E267-81. [PMID: 25158664 DOI: 10.1188/14.onf.e267-e281] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To identify latent classes of individuals with distinct quality-of-life (QOL) trajectories, to evaluate for differences in demographic characteristics between the latent classes, and to evaluate for variations in pro- and anti-inflammatory cytokine genes between the latent classes. DESIGN Descriptive, longitudinal study. SETTING Two radiation therapy departments located in a comprehensive cancer center and a community-based oncology program in northern California. SAMPLE 168 outpatients with prostate, breast, brain, or lung cancer and 85 of their family caregivers (FCs). METHODS Growth mixture modeling (GMM) was employed to identify latent classes of individuals based on QOL scores measured prior to, during, and for four months following completion of radiation therapy. Single nucleotide polymorphisms (SNPs) and haplotypes in 16 candidate cytokine genes were tested between the latent classes. Logistic regression was used to evaluate the relationships among genotypic and phenotypic characteristics and QOL GMM group membership. MAIN RESEARCH VARIABLES QOL latent class membership and variations in cytokine genes. FINDINGS Two latent QOL classes were found: higher and lower. Patients and FCs who were younger, identified with an ethnic minority group, had poorer functional status, or had children living at home were more likely to belong to the lower QOL class. After controlling for significant covariates, between-group differences were found in SNPs in interleukin 1 receptor 2 (IL1R2) and nuclear factor kappa beta 2 (NFKB2). For IL1R2, carrying one or two doses of the rare C allele was associated with decreased odds of belonging to the lower QOL class. For NFKB2, carriers with two doses of the rare G allele were more likely to belong to the lower QOL class. CONCLUSIONS Unique genetic markers in cytokine genes may partially explain interindividual variability in QOL. IMPLICATIONS FOR NURSING Determination of high-risk characteristics and unique genetic markers would allow for earlier identification of patients with cancer and FCs at higher risk for poorer QOL. Knowledge of these risk factors could assist in the development of more targeted clinical or supportive care interventions for those identified.
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Affiliation(s)
| | - Bruce Cooper
- School of Nursing, University of California, San Francisco (UCSF)
| | - Steven M Paul
- School of Nursing, University of California, San Francisco (UCSF)
| | - Claudia West
- School of Nursing, University of California, San Francisco (UCSF)
| | - Patsy Yates
- School of Nursing, Queensland University of Technology
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Impact of age-related socio-economic and clinical determinants of quality of life among long-term breast cancer survivors. Maturitas 2015; 81:362-70. [PMID: 25911244 DOI: 10.1016/j.maturitas.2015.03.025] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Revised: 03/29/2015] [Accepted: 03/30/2015] [Indexed: 12/24/2022]
Abstract
OBJECTIVES The main purpose of this study was to identify age-related socioeconomic and clinical determinants of quality of life among breast cancer survivors five years after the diagnosis. The secondary objective was to describe quality of life in the studied population according to age. STUDY DESIGN A cross-sectional survey in five-year breast cancer survivors was conducted in women diagnosed with breast cancer in 2007 and 2008 in Côte d'Or. MAIN OUTCOME MEASURES Quality of life was assessed with the SF-12, the EORTC-QLQ-C30 and the EORTC-QLQ-BR23 questionnaires. Socio-economic deprivation was assessed by the EPICES questionnaire. Social support was assessed by the Sarason questionnaire and clinical features were collected through the Côte d'Or breast cancer registry. Age-related determinants of quality of life were identified using multivariate mixed model analysis for each SF-12 dimension. RESULTS Overall 396 women completed the questionnaires. Women aged <65 years had a better quality of life and a greater availability of social support than did women aged ≥65 years. Body mass index, relapse and EPICES were found to be determinants of quality of life in younger women (p<0.006). For older women, comorbidities and EPICES deprivation scores were predictors of low quality of life scores (p<0.006). CONCLUSIONS Five years after breast cancer diagnosis, disease severity did not affect quality of life. The major determinants of quality of life in younger women were disease relapse and EPICES deprivation scores while those in older women were comorbidities and EPICES deprivation scores.
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Ramadas A, Qureshi AM, Dominic NA, Botross NP, Riad A, Arasoo VJT, Elangovan S. Socio-Demography and Medical History as Predictors of Health-Related Quality of Life of Breast Cancer Survivors. Asian Pac J Cancer Prev 2015; 16:1479-85. [DOI: 10.7314/apjcp.2015.16.4.1479] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Contextual factors influencing health-related quality of life in African American and Latina breast cancer survivors. J Cancer Surviv 2015; 9:441-9. [PMID: 25576214 DOI: 10.1007/s11764-014-0420-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Accepted: 12/06/2014] [Indexed: 12/19/2022]
Abstract
PURPOSE This study explored the relationships between systemic- and individual-level contextual factors and health-related quality of life (HRQOL) in a cohort of African American and Latina breast cancer survivors (BCS). METHODS Baseline questionnaire data of 320 BCS who participated in a HRQOL psycho-educational intervention were abstracted from the parent study. Hierarchical regression analysis tested the independent effects of contextual factors on HRQOL. RESULTS HRQOL was higher in BCS who: were diagnosed at < stage 2 (b = -1.38, p < 0.05), expressed satisfaction with their health care (b = 0.20, p < 0.001), had fewer comorbidities (b = - 0.60, p < 0.001) and depressive symptoms (b = -0.30, p < 0.001), and practiced healthy diet and exercise habits (b = 0.02, p < 0.05). Demographic and cancer-related factors accounted for 14 % of the variance in HRQOL (F[6, 274] = 7.25, p < 0.001). The socio-cultural context (i.e., ethnicity, life stress, perceived social support) explained 20 % of the variance in HRQOL (FΔ[3, 271] = 27.32, p < 0.001). The health care system context contributed an additional 8 % to explaining HRQOL (FΔ[1, 270] = 34.88, p < 0.001). Health status and behavioral factors accounted for 18 % of the variance (FΔ[4, 266] = 29.55, p < 0.001). The full model explained 59 % of the variance in HRQOL (F[14, 266] = 27.76, p < 0.001). CONCLUSIONS HRQOL in ethnic minority BCS is multifaceted and is significantly influenced by cancer-related, socio-cultural, health care system, health status, and behavioral contextual factors. Therefore, survivorship research and practice must address broad multi-level domains to achieve equitable and optimal breast cancer outcomes. IMPLICATIONS FOR CANCER SURVIVORS To enhance HRQOL, survivors must be provided the know-how and support to maintain healthy lifestyle and self-management practices. Advocates must engage the care team to consider systemic factors, including life stress and community resources, to be more patient-centered.
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Shuleta-Qehaja S, Sterjev Z, Shuturkova L. Evaluation of reliability and validity of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30, Albanian version) among breast cancer patients from Kosovo. Patient Prefer Adherence 2015; 9:459-65. [PMID: 25834410 PMCID: PMC4372011 DOI: 10.2147/ppa.s78334] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PATIENTS AND METHODS A sample of breast cancer patients (n=62 women) were interviewed for the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) in Albanian. Reliability of the questionnaire was considered acceptable if Cronbach's alpha was ≥0.70. Item convergent-discriminant validity was tested through multitrait scaling analysis. Construct validity was tested under the hypotheses that QLQ-C30 interscale correlations would have an acceptable value of ≥0.40 and as well as by known group comparisons assessing differences of patient subgroups with reference to disease stage and education level. RESULTS The mean age of the patients was 50 years (standard deviation: 10.9 years). Cronbach's alpha ranged from 0.54 for the cognitive functioning scale to 0.96 for the global health quality of life (GH/QoL) scale. In multitrait scaling analysis, the strength of Spearman's correlations between an item and its own subscale was ≥0.40, with the exception of item 5 (ρ=0.22); results for item discriminant validity were satisfactory, with the exception of item 5, which showed higher correlation with other subscales than with its own physical functioning. The Spearman's interscale coefficients generally were correlated with each other. Results of known group comparisons did not show significant differences in terms of disease stage. Regarding education level, patients with high school/university education had better functional scales scores only in certain subscales compared to other subgroups; furthermore, patients with secondary school education had better GH/QoL compared to other subgroups of patients. CONCLUSION The EORTC QLQ-C30 (v3.0) in Albanian was found to be valid and reliable for women with breast cancer and could be considered as a starting point for further evaluation study.
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Affiliation(s)
- Selvete Shuleta-Qehaja
- Kosovo Medicines Agency, Rrethi i spitalit (QKUK), Pristina, Kosovo, Macedonia
- Correspondence: Selvete Shuleta-Qehaja, Kosovo Medicines Agency, Rrethi i spitalit (QKUK), Pristina, Kosovo, Tel +377 44 120 902, Fax +381 38 512 243, Email
| | - Zoran Sterjev
- University ‘Ss Cyril and Methodius’, Faculty of Pharmacy, Skopje, Macedonia
| | - Ljubica Shuturkova
- University ‘Ss Cyril and Methodius’, Faculty of Pharmacy, Skopje, Macedonia
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Sohl SJ, Levine B, Avis NE. Evaluation of the Quality of Life in Adult Cancer Survivors (QLACS) scale for early post-treatment breast cancer survivors. Qual Life Res 2015; 24:205-12. [PMID: 24996392 PMCID: PMC4282954 DOI: 10.1007/s11136-014-0749-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE The end of primary treatment for cancer patients is increasingly recognized as an important time of adjustment that may impact quality of life (QoL). A psychometrically sound QoL instrument that assesses the mix of acute and longer-term concerns present during this unique time has not yet been identified. This article evaluates the Quality of Life in Adult Cancer Survivors (QLACS) scale, originally developed for long-term (>5 years) cancer survivors, as an appropriate QoL measure for this transition period. METHODS Psychometric properties of the QLACS were evaluated in a sample of post-treatment breast cancer survivors 18-24 months post-diagnosis. This observational study consisted of women (n = 552) aged 25 years and older (mean = 55.4 years) who were diagnosed with stage I, II, or III breast cancer. The 47 items of the QLACS comprise 12 domains: seven domains are generic, and five are cancer specific. RESULTS The QLACS demonstrated adequate internal consistency (Cronbach's alpha for the 12 domains ranged from 0.79 to 0.91) and good convergent and divergent validity (assessed by comparison with the Functional Assessment of Cancer Therapy and other measures). CONCLUSIONS The QLACS appears to be consistent with other widely accepted measures in capturing QoL, while also allowing for more inclusive measurement of specific issues relevant to post-treatment cancer survivors. These data, in addition to previous data supporting use of the QLACS across different cancer sites, suggest that the QLACS is a promising comprehensive QoL measure appropriate for breast cancer survivors transitioning off active treatment.
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Affiliation(s)
- Stephanie J. Sohl
- Department of Medicine, Vanderbilt University School of Medicine, Sixth Floor, Suite 600, 2525 West End Avenue, Nashville, TN 37203-1738, USA
| | - Beverly Levine
- Division of Public Health Sciences, Department of Social Sciences and Health Policy, Medical Center Boulevard, Wake Forest School of Medicine, Winston-Salem, NC 27157-1063, USA
| | - Nancy E. Avis
- Division of Public Health Sciences, Department of Social Sciences and Health Policy, Medical Center Boulevard, Wake Forest School of Medicine, Winston-Salem, NC 27157-1063, USA
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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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Schiavon CC, Vieira FGK, Ceccatto V, de Liz S, Cardoso AL, Sabel C, Gonzalez-Chica DA, da Silva EL, Galvan D, Crippa CG, Di Pietro PF. Nutrition education intervention for women with breast cancer: effect on nutritional factors and oxidative stress. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2015; 47:2-9. [PMID: 25528078 DOI: 10.1016/j.jneb.2014.09.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Revised: 09/04/2014] [Accepted: 09/19/2014] [Indexed: 06/04/2023]
Abstract
OBJECTIVES To assess the effect of a nutrition education intervention on nutritional factors and oxidative stress during treatment of breast cancer. DESIGN Nonrandomized clinical trial conducted in 2010-2011, including an evaluation at baseline and after 12 months. PARTICIPANTS Women from Brazil who had breast cancer, divided into an intervention group (IG) (n = 18) and comparison group (n = 75). INTERVENTION To increase intake of fruits and vegetables and reduce red and processed meats, via telephone and printed materials. MAIN OUTCOME MEASURES Food intake, anthropometry, and levels of lipid hydroperoxide, carbonyl proteins, reduced glutathione, and ferric reducing antioxidant power. ANALYSES Chi-square, Mann-Whitney or t tests for baseline data; Wilcoxon or paired t tests for intra-group outcomes, linear regression models, and Bonferroni multiplicity adjustment. RESULTS The researchers observed an increase in fruit and vegetable intake, reduction in red and processed meat intake, no change in body weight, and an increase in glutathione in the IG over the comparison group. However, after Bonferroni adjustment, only the consumption of fruits and vegetables and fruit was significantly higher in IG. CONCLUSIONS AND IMPLICATIONS This study presents improved dietary changes after a theory-driven nutrition education intervention. Although the sample size is small, it has proven to be clinically relevant.
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Affiliation(s)
- Cecilia C Schiavon
- Department of Nutrition, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Francilene G K Vieira
- Department of Nutrition, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Vanessa Ceccatto
- Department of Nutrition, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Sheyla de Liz
- Department of Nutrition, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Alyne L Cardoso
- Department of Nutrition, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Cristiane Sabel
- Department of Clinical Analyses, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - David A Gonzalez-Chica
- Department of Nutrition, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Edson L da Silva
- Department of Clinical Analyses, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Daisy Galvan
- Department of Nutrition, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Carlos G Crippa
- Department of Tocoginecology, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Patricia F Di Pietro
- Department of Nutrition, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil.
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Maly RC, Liu Y, Liang LJ, Ganz PA. Quality of life over 5 years after a breast cancer diagnosis among low-income women: effects of race/ethnicity and patient-physician communication. Cancer 2014; 121:916-26. [PMID: 25411008 DOI: 10.1002/cncr.29150] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 09/29/2014] [Accepted: 10/10/2014] [Indexed: 01/09/2023]
Abstract
BACKGROUND The current study was performed to identify risk factors for a lower quality of life (QOL) among low-income women with breast cancer (BC), with an emphasis on the impact of patient-physician communication. In addition, ethnic/racial group differences in QOL changes over time were examined. METHODS A longitudinal study was conducted among 921 low-income women with BC. Patients were interviewed at 6 months, 18 months, 36 months, and 60 months after their diagnosis of BC. Mixed-effect regression models were performed to investigate predictors for and time effects on QOL. The main outcomes included the Medical Outcomes Study Health Survey Short Form-36 Mental Component Summary scale (SF-36 MCS), Medical Outcomes Study Health Survey Short Form-36 Physical Component Summary scale (SF-36 PCS), and the Ladder of Life scale. Chief independent variables included physician information-giving and patient self-efficacy in interacting with physicians. RESULTS There were no significant changes noted over time in QOL except with regard to physical functioning, with survivors reporting a significant decrease over time (P<.0001). Mean SF-36 MCS and SF-36 PCS scores were lower than national general population norms at all time points. Both patient self-efficacy in interacting with physicians and physician information-giving were found to be positively associated with the SF-36 MCS (P = .03 and P = .02, respectively) and Ladder of Life (P = .01 and P = .03, respectively) scales. Latinas who were less acculturated reported higher SF-36 MCS and SF-36 PCS scores (P<.0001 and P = .01, respectively) and better global QOL (P<.0001) than white women. CONCLUSIONS Low-income women with BC experienced poor physical and mental health. The results of the current study suggest that QOL among low-income women with BC would be enhanced by interventions aimed at empowering patients in communicating with physicians and increasing the amount of information provided by physicians.
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Affiliation(s)
- Rose C Maly
- Department of Family Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California
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Rahman MM, Ahsan MA, Monalisa NN, Rahman K. Influence of socioeconomic status and BMI on the quality of life after mastectomy in Bangladeshi breast cancer patients in a public hospital. Jpn J Clin Oncol 2014; 44:1150-7. [PMID: 25425727 DOI: 10.1093/jjco/hyu144] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Quality of life after diagnosis and during treatment phases of breast cancer varies across individual to individual, country to country and from ethnicity to ethnicity. So factors affecting it are of growing research interest. The aim of the study was to investigate the influence of socioeconomic status and body mass index on the quality of life of breast cancer patients during the phases of treatment-before and after mastectomy. METHODS Two hundred and fifty-one women with breast cancer undergoing surgery were interviewed prior to and after mastectomy in National Institute of Cancer Research and Hospital, Dhaka from January 2012 to March 2013 using European Organization for Research and Treatment of Cancer Core Questionnaire (and QLQ-Br23). Socioeconomic factors like educational status, family income, occupation and body mass index were taken as investigating factors against global health status and breast cancer-related factors. RESULTS Significant reduction of the scores found that means deterioration of function in the following domains of the quality of life were found such as physical well-being (P = 0.019), emotional well-being (P = 0.035), cognitive status (P = 0.05) and the breast-specific subscales like BRBI (body image), BRBS (breast symptoms), BRAS (arm symptoms); (P = 0.013, 0.103, 0.015) was observed after surgery in lower income group. Worker group expressed also similar effect on the global health status/quality-of-life scales (P = 0.05, 0.043, 0.021) and breast subscales (P = 0.002, 0.027, 0.05), patients with lower body mass index also have a lower score also. Educational status does not affect the two groups. Younger age group patients expressed much distress. CONCLUSIONS Improvement of family income, nutritional status and improvement of working environment might have an impact on the improvement of the quality of life of breast cancer patients during the phases of treatment.
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Affiliation(s)
- Md Mizanur Rahman
- Department of Surgical Oncology, National Institute of Cancer Research and Hospital, Dhaka
| | - Md Abul Ahsan
- Department of Medical Oncology, Shaheed Shurwardy Medical College, Dhaka
| | | | - Khadiza Rahman
- Department of Surgical Oncology, National Institute of Cancer Research and Hospital, Dhaka, Bangladesh
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Fard JH, Janbabaei G. Quality of Life and its Related Factors Among Iranian Patients with Metastatic Gastrointestinal Tract Cancer: A Cross-sectional Study. Indian J Palliat Care 2014; 20:215-9. [PMID: 25191010 PMCID: PMC4154170 DOI: 10.4103/0973-1075.138398] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Context: Quality of life (QoL) is an important issue in all cancer patients; especially in patients with metastatic cancer. But there is very little information available about QoL in patients with metastatic gastrointestinal cancer. Aims: The aim of this study was to evaluate the quality of life and its associated factors among Iranian patients with metastatic gastrointestinal tract cancer. Materials and Methods: In this cross-sectional study, a total of 250 patients with metastatic gastrointestinal tract cancer were recruited from the one oncology center related to the Mazandaran University of Medical Sciences, Sari, between March 2012 and August 2013. Their QoL was evaluated using the EORTC QLQ-C30 questionnaire (Persian version). Results: In this study, the overall QoL score of patients with gastrointestinal tract cancer was 57.63, which was relatively optimal. There was a statistically significant relationship between symptoms scale and general health status domains of quality of life with age (P < 0.05). Also, there was a significant association between patients’ gender and their social functioning (P = 0.017) and also their emotional functioning (P = 0.015). Conclusions: The findings suggest that in patients with metastatic gastrointestinal cancers, the most affected functions in their QoL were social and emotional functioning which get worse with age. Thus, providing psychological counseling and psychotherapy services to deliver culturally appropriate mental health care and social support for these patients and their families’ which can lead to the improvement of QoL in these patients is strongly recommended.
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Affiliation(s)
- Jabbar Heydari Fard
- Department of Psychiatric Nursing, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ghasem Janbabaei
- Department of Internal Medicine, Mazandaran University of Medical Sciences, Sari, Iran
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Law KS, Azman N, Omar EA, Musa MY, Yusoff NM, Sulaiman SA, Hussain NHN. The effects of virgin coconut oil (VCO) as supplementation on quality of life (QOL) among breast cancer patients. Lipids Health Dis 2014; 13:139. [PMID: 25163649 PMCID: PMC4176590 DOI: 10.1186/1476-511x-13-139] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Accepted: 08/23/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Breast cancer is the most common cancer amongst Malaysian women. Both the disease and its treatment can disrupt the lives of the woman and adversely affect all aspects of life and thus can alter a woman's quality of life. The aim of this study was to examine the effect of virgin coconut oil (VCO) on the quality of life (QOL) of patients diagnosed with breast cancer. METHODS This was a prospective study of breast cancer patients admitted into the Oncology Unit of Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia. The sample consisted of 60 patients with stage III and IV breast cancer allocated to either an intervention group (n = 30) or a control group (n = 30) using a simple random table. QOL was evaluated from the first cycle of chemotherapy to the sixth cycle, and data were collected using a validated Bahasa Malaysia version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Breast Cancer Module (EORTC QLQ-C30) and its breast-specific module (QLQ-BR 23). RESULTS The mean age of breast cancer patients was 50.2 (SD = 13.5) years. There were significant mean score differences for functioning and global QOL between groups (α < 0.01). The intervention group also had better scores for symptoms including fatigue, dyspnea, sleep difficulties, and loss of appetite compared to the control group. Although there are deteriorations for sexual enjoyment, the intervention group exhibited improvement in breast functioning and symptom scores for body image, sexual function, future perspective, breast symptoms, and systemic therapy side effects. CONCLUSION VCO consumption during chemotherapy helped improve the functional status and global QOL of breast cancer patients. In addition, it reduced the symptoms related to side effects of chemotherapy.
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Affiliation(s)
- Kim Sooi Law
- Institut Perubatan dan Pergigian Termaju, Universiti Sains Malaysia, Bertam, 13200 Kepala Batas, Pulau Pinang, Malaysia.
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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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Waters EA, Liu Y, Schootman M, Jeffe DB. Worry about cancer progression and low perceived social support: implications for quality of life among early-stage breast cancer patients. Ann Behav Med 2014; 45:57-68. [PMID: 22983622 DOI: 10.1007/s12160-012-9406-1] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Worry about cancer progression and perceived social support can affect cancer survivors' quality of life (QOL). METHODS In 480 early-stage breast cancer survivors, we examined how worry about cancer progression and perceived social support 6 months after definitive surgery were associated with QOL (RAND 36-item Health Survey) at 6-, 12-, and 24-month follow-up. RESULTS At 6 months post-surgery, higher worry was associated with worse QOL for five of eight subscales. Lower social support was associated with worse QOL for four subscales. The negative effects of worry and limited social support dissipated for four subscales (worry) and two subscales (social support) by 12-month follow-up and for all subscales by 24-month follow-up. Social support at 6 months moderated the relationship between T2 worry and T4 emotional well-being; post hoc tests did not clarify the nature of the interaction. CONCLUSION Early-stage breast cancer survivors who worry about cancer progression and/or have low social support may experience lower levels of QOL that can take several months to resolve.
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Affiliation(s)
- Erika A Waters
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA.
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Hong-Li C, Xiao-Chun W, Jiang-Bin W, Jing-Bo Z, Yao W. Quality of life in patients with breast cancer and their rehabilitation needs. Pak J Med Sci 2014; 30:126-30. [PMID: 24639845 PMCID: PMC3955556 DOI: 10.12669/pjms.301.3952] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Revised: 10/24/2013] [Accepted: 10/26/2013] [Indexed: 11/30/2022] Open
Abstract
Objective: We conducted a cross sectional study to investigate the quality of life (QOL) in breast cancer patients after treatment for one year and identify factors which may facilitate improvements in health care for breast cancer. Methods: A total of 154 patients of breast cancer were collected from The First Affiliated Hospital of Harerbin Medical University during May 2008 and May 2010, and they were divided into three groups. The quality of life was assessed by Functional assessment of cancer therapy- breast (FACT-B) version 4, and a semi-structured interview was used to investigate the information and rehabilitation needs of the breast cancer patients. Results: Group II had the best social well-being, functional well-being and Total FACT-G among the three groups. Group III had the best physical well-being, emotional well-being, breast specific subscales, total FACT-B and TOI among the three groups. Higher PWB scores were significantly correlation with lower tumor stage; increased SWB scores were significantly correlated with education and occupation, and lower EWB scores were correlated with younger aged women and higher tumor stage (< 40 years). The semi-structured investigation showed all of them want to receive tumor markers detection and PET scan to prevent recurrence. 56% of these patients were worried about symptoms. 42% of the patients reported they had restriction in sexual relationship, and 57% wanted to improve their body image and reconstruction surgery. Conclusions: Breast cancer patients should be followed up for their quality of life and provided effective therapy for their physical and psychological problems.
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Affiliation(s)
- Chen Hong-Li
- Chen Hong-li, Nursing Department, The First Affiliated Hospital of Harerbin Medical University, Harerbin, China
| | - Wang Xiao-Chun
- Wang Xiao-chun, Nursing Department, The First Affiliated Hospital of Harerbin Medical University, Harerbin, China
| | - Wang Jiang-Bin
- Wang Jiang-bin, Nursing Department, The First Affiliated Hospital of Harerbin Medical University, Harerbin, China
| | - Zhang Jing-Bo
- Zhang Jing-bo, The Stomach and Spleen Portal Hypertension Surgery, The First Affiliated Hospital of Harerbin Medical University, Harerbin, China
| | - Wang Yao
- Wang Yao, Nurse Practitioner, Experimental Surgery, The First Affiliated Hospital of Harerbin Medical University, Harerbin, China
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Huang CY, Hsu MC. Social support as a moderator between depressive symptoms and quality of life outcomes of breast cancer survivors. Eur J Oncol Nurs 2013; 17:767-74. [DOI: 10.1016/j.ejon.2013.03.011] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2012] [Revised: 03/10/2013] [Accepted: 03/20/2013] [Indexed: 12/24/2022]
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Bezerra KB, Silva DSMD, Chein MBDC, Ferreira PR, Maranhão JKP, Ribeiro NL, Mochel EG. Qualidade de vida de mulheres tratadas de câncer de mama em uma cidade do nordeste do Brasil. CIENCIA & SAUDE COLETIVA 2013; 18:1933-41. [DOI: 10.1590/s1413-81232013000700008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2012] [Accepted: 11/30/2012] [Indexed: 11/22/2022] Open
Abstract
O objetivo deste estudo foi avaliar a qualidade de vida de mulheres tratadas cirurgicamente de câncer de mama no Hospital de Referência Estadual em Oncologia de São Luís (MA). A qualidade de vida foi avaliada pelo Functional Assessment of Cancer Therapy-Breast (FACT-B). As variáveis foram expressas em média e desvio padrão; e a análise estatística constou da Anova ou Kruskal Wallis e Teste t de Student ou Mann-Whitney. O nível de significância foi α < 5%. Na estatística foram usados o Stata 9.0 e o BioEstat 5.0. Participaram 197 mulheres com idade média de 53,0 ± 11,7 anos. Os valores médios do FACT-B demonstraram tendência para boa qualidade de vida, sendo o domínio Emocional o mais comprometido e a Subescala Câncer a mais favorável. O tipo de cirurgia influenciou os domínios Social, Emocional e Subescala câncer do questionário. A cirurgia não conservadora apresentou piores níveis de qualidade de vida. Viu-se relação estatística significante entre o tempo de cirurgia e os domínios Físico, Emocional e Funcional, bem como entre tempo de cirurgia e os escores do FACT-B. O tratamento adjuvante influenciou todos os domínios do FACT-B. A qualidade de vida encontrada foi relativamente boa, mas influenciada negativamente pela cirurgia não conservadora, pelo menor tempo desde a cirurgia e pelas terapias adjuvantes.
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