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Grant SJ, Yanguela J, Odebunmi O, Grimshaw AA, Giri S, Wheeler SB. Systematic Review of Interventions Addressing Racial and Ethnic Disparities in Cancer Care and Health Outcomes. J Clin Oncol 2024; 42:1563-1574. [PMID: 38382005 PMCID: PMC11095878 DOI: 10.1200/jco.23.01290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 10/19/2023] [Accepted: 11/16/2023] [Indexed: 02/23/2024] Open
Abstract
PURPOSE Cancer health disparities result from complex interactions among socioeconomic, behavioral, and biological factors, disproportionately affecting marginalized racial and ethnic groups. The objective of this review is to synthesize existing evidence on interventions addressing racial or ethnic disparities in cancer-related health care access and clinical outcomes. METHODS A comprehensive search of Cochrane Library, Google Scholar, Ovid MEDLINE, Ovid Embase, PubMed, Scopus, and Web of Science Core Collection was conducted from database inception to February 23, 2023. Controlled vocabulary and keywords helped to identify studies on cancer-related disparities and interventions in adults age 18 years or older. Two reviewers followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis reporting guidelines. Study quality was assessed using the Joanna Briggs Institute Critical Appraisal Tool. RESULTS Of 7,526 screened studies, 34 met the inclusion criteria involving 24,134 participants. Most studies focused on breast cancer (n = 17) and Hispanic/Latino populations (n = 10) and enrolled participants primarily from community-based sites (n = 19). Twenty-one studies examined patient-centered outcomes, such as health-related quality of life and psychological well-being, while 15 studies assessed process-of-care outcomes, such as timeliness of care. Most studies followed a community-based participatory research framework. Five patient-centered outcome studies reported a positive intervention effect, often combining cancer education with psychological well-being interventions. Among the 15 process-of-care outcome studies, nine reported positive effects, with the majority (n = 8) being navigation-based interventions. CONCLUSION This systematic review emphasizes the vital role of community partnerships in addressing racial and ethnic disparities in oncology care and highlights the need for standardized approaches in intervention research because of the heterogeneity of studied interventions. Furthermore, the prevailing emphasis on breast cancer and Hispanic populations indicates the need for future investigations into other priority demographic groups.
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Affiliation(s)
- Shakira J. Grant
- Division of Hematology, Department of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Juan Yanguela
- Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC
- Department of Health Policy and Management, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Olufeyisayo Odebunmi
- Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC
- Department of Health Policy and Management, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Alyssa A. Grimshaw
- Harvey Cushing/John Hay Whitney Medical Library, Yale University, New Haven, CT
| | - Smith Giri
- Institute for Cancer Outcomes & Survivorship, University of Alabama at Birmingham, Birmingham, AL
| | - Stephanie B. Wheeler
- Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC
- Department of Health Policy and Management, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC
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Agyemang-Duah W, Abdullah A, Rosenberg MW. Caregiver burden and health-related quality of life: A study of informal caregivers of older adults in Ghana. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2024; 43:31. [PMID: 38383532 PMCID: PMC10882722 DOI: 10.1186/s41043-024-00509-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 01/22/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND Similar to many developing countries, caregiver burden remains high in Ghana which may affect informal caregivers of older adults' health-related quality of life (HRQoL). However, no study has examined the association between caregiver burden and HRQoL among informal caregivers of older adults in Ghana to date. Understanding this association may well help to inform health and social policy measures to improve HRQoL among informal caregivers of older adults in Ghana. Situated within a conceptual model of HRQoL, the purpose of this study was to examine the relationship between caregiver burden and HRQoL among informal caregivers of older adults in Ghana. METHODS We obtained cross-sectional data from informal caregiving, health, and healthcare (N = 1853) survey conducted between July and September 2022 among caregivers (≥ 18 years) of older adults (≥ 50 years) in the Ashanti Region of Ghana. The World Health Organization Impact of Caregiving Scale was used to measure caregiver burden. An 8-item short form Health Survey scale developed by the RAND Corporation and the Medical Outcomes Study was used to measure HRQoL. Generalized Linear Models were employed to estimate the association between caregiver burden and HRQoL. Beta values and standard errors were reported with a significance level of 0.05 or less. RESULTS The mean age of the informal caregivers was 39.15 years and that of the care recipients was 75.08 years. In our final model, the results showed that caregiver burden was negatively associated with HRQoL (β = - .286, SE = .0123, p value = 0.001). In line with the conceptual model of HRQoL, we also found that socio-economic, cultural, demographic and healthcare factors were significantly associated with HRQoL. For instance, participants with no formal education (β = -1.204, SE= .4085, p value = 0.01), those with primary level of education (β = -2.390, SE= .5099, p value = 0.001) or junior high school education (β = -1.113, SE= .3903, p value= 0.01) had a significantly decreased HRQoL compared to those with tertiary level of education. Participants who were between the ages of 18-24 (β = 2.960, SE= .6306, p value=0.001), 25-34 (β = 1.728, SE= .5794, p value = 0.01) or 35-44 (β = 1.604, SE= .5764, p value= 0.01) years significantly had increased HRQoL compared to those who were 65 years or above. Also, participants who did not utilize healthcare services in the past year before the survey significantly had increased HRQoL compared to those who utilized healthcare services five or more times in the past year (β = 4.786, SE=. 4610, p value= 0.001). CONCLUSION Consistent with our hypothesis, this study reported a significant negative association between caregiver burden and HRQoL. Our findings partially support the conceptual model of HRQoL used in this study. We recommend that health and social policy measures to improve HRQoL among informal caregivers of older adults should consider caregiver burden as well as other significant socio-economic, cultural, demographic, and healthcare factors.
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Affiliation(s)
- Williams Agyemang-Duah
- Department of Geography and Planning, Queen's University, Kingston, ON, K7L 3N6, Canada.
| | - Alhassan Abdullah
- College of Education, Psychology and Social Work, Flinders University, Adelaide, SA, Australia
| | - Mark W Rosenberg
- Department of Geography and Planning, Queen's University, Kingston, ON, K7L 3N6, Canada
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Zhang Y, Chai C, Xiong J, Zhang L, Zheng J, Ning Z, Wang Y. The impact of anxiety, depression, and social support on the relationship between HIV-related stigma and mental health-related quality of life among Chinese patients: a cross-sectional, moderate-mediation study. BMC Psychiatry 2023; 23:818. [PMID: 37940853 PMCID: PMC10634100 DOI: 10.1186/s12888-023-05103-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 08/10/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND/OBJECTIVE People living with HIV (PLWH) are prone to mental health problems and evidence indicates that HIV-related stigma can negatively impact mental health-related quality of life. This study explored potential mechanisms between HIV-related stigma and mental health-related quality of life, specifically whether anxiety or depression mediates, and whether social support moderates, the relationship. METHOD A total of 1197 Chinese PLWH participated in the study. The Berger HIV Stigma Scale, the Hospital Anxiety and Depression Scale (HADS), the 12-item Brief Health Survey (SF-12), and the Multidimensional Scale of Perceived Social Support (MSPSS) were employed. RESULTS HIV-related stigma was negatively associated with mental health-related quality of life. Anxiety and depression partially mediated the relationship between HIV-related stigma and mental health-related quality of life; social support played a moderating role. CONCLUSIONS The mental health-related quality of life in PLWH was shown to be indirectly affected by HIV-related stigma through anxiety and depression in China. The negative impact of HIV-related stigma decreased with increased social support.
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Affiliation(s)
- Yushu Zhang
- School of Public Health, Fudan University, Shanghai, China
- NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Chengliang Chai
- Department of AIDS/STDs Control and Prevention, Zhejiang Provincial Center for Diseases Control and Prevention, Zhejiang Province, Hangzhou, China
| | - Jianjing Xiong
- Jing'an District Center for Disease Prevention and Control, Shanghai, China
| | - Lin Zhang
- Center for Disease Control and Prevention, 10, East Section of Taihao Road, Henan Province, Zhoukou, 466000, China
| | - Jinlei Zheng
- Zhejiang Provincial Center for Disease Control and Prevention, Zhejiang Province, Hangzhou, China
| | - Zhen Ning
- Division of Tuberculosis and AIDS Control and Prevent Shanghai Municipal Center for Disease Control and Prevention 1380, Zhongshan Xi Road, Shanghai, 200336, China.
| | - Ying Wang
- NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China.
- Department of Social Medicine, School of Public Health, Fudan University, Shanghai, 200032, China.
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Black LL, Peugh JL, Pai ALH. Health Competence Beliefs and Health-Related Quality of Life Among Adolescent and Young Adult Survivors of Childhood Cancer and Healthy Peers. J Adolesc Young Adult Oncol 2023; 12:653-661. [PMID: 36862533 DOI: 10.1089/jayao.2022.0162] [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: 03/03/2023] Open
Abstract
Purpose: Adolescent and young adult (AYA) survivors of childhood cancer are at risk for late-effects that can impact how one perceives their health and well-being. Understanding beliefs about health competence and well-being among survivors can help identify support needs and increase adherence to long-term follow-up guidelines. This study examined differences in health competence beliefs and health-related quality of life (HRQOL) between AYA survivors of childhood cancer and matched healthy peers. In addition, the relationship between health competence beliefs and HRQOL, as well as the moderating effect of cancer survivorship, was investigated. Methods: Survivors (n = 49) and healthy peers (n = 54) completed measures about health competence beliefs (i.e., Health Perception, Cognitive Competence, Autonomy, and School/Work Functioning) and HRQOL. Multiple group analysis was used to investigate differences in health competence beliefs and HRQOL between survivors and peers. Multivariate multiple regression analyses were used to investigate the relationships between health competence beliefs and HRQOL. Finally, a history of cancer was examined as a possible moderator using additional multivariate multiple regression analyses. Results: Survivors reported significantly lower Health Perception, Cognitive Competence, Autonomy, and School/Work Functioning scores compared to healthy peers. Among both groups, Health Perception and Cognitive Competence scores were associated with multiple domains of HRQOL. These relationships were not moderated by having a history of cancer. Conclusions: Perceptions about one's health and cognitive abilities may impact HRQOL among AYA survivors of childhood cancer and health peers. Identifying those at risk for poor well-being may help to guide interventions aimed at increasing adherence to medical recommendations.
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Affiliation(s)
- Lora L Black
- Department of Psychiatry & Behavioral Sciences, University of Kansas Medical Center, Kansas City, Kansas, USA
- Department of Anesthesiology, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - James L Peugh
- Department of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Pediatrics, University of Cincinnati Medical School, Cincinnati, Ohio, USA
| | - Ahna L H Pai
- Department of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Pediatrics, University of Cincinnati Medical School, Cincinnati, Ohio, USA
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Rodríguez-Guidonet I, Andrade-Pino P, Monfort-Vinuesa C, Rincon E. Avatar-Based Strategies for Breast Cancer Patients: A Systematic Review. Cancers (Basel) 2023; 15:4031. [PMID: 37627059 PMCID: PMC10452070 DOI: 10.3390/cancers15164031] [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: 06/27/2023] [Revised: 07/22/2023] [Accepted: 07/31/2023] [Indexed: 08/27/2023] Open
Abstract
There is a lack of studies to determine if avatar-based protocols could be considered an efficient and accurate strategy to improve psychological well-being in oncology patients, even though it represents a growing field of research. To the best of our knowledge, this is the first systematic review addressing the effectiveness of avatar-based treatments to enhance quality of life (QoL) and psychological well-being in breast cancer patients. The purpose of this study was to review the scientific literature of those studies involving avatar-based technology and breast cancer patients in order to answer the following questions. (1) Are avatar-based strategies useful to im-prove QoL and psychological well-being (anxiety and depression symptoms) in breast cancer patients? (2) Which is the best way to develop avatar-based protocols for breast cancer patients? We conducted a systematic review of the peer-reviewed literature from EBSCO, Ovid, PubMed, Scopus, and Web of Science (WOS), following the PRISMA statements and using "avatar + breast cancer" or "avatar + cancer" as keywords. Studies which were published in either English or Spanish and which addressed QoL and psychological well-being in breast cancer patients were reviewed. The results will contribute to developing innovative avatar-based strategies focused on breast cancer patients.
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Affiliation(s)
| | - Paula Andrade-Pino
- Psycho-Technology Lab, Universidad San Pablo-CEU, CEU Universities, 28005 Madrid, Spain
| | - Carlos Monfort-Vinuesa
- Psycho-Technology Lab, Universidad San Pablo-CEU, CEU Universities, 28005 Madrid, Spain
- Departamento de Psicología y Pedagogía, Facultad de Medicina, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, 28005 Madrid, Spain
- Departamento de Medicina Interna, HM Hospital, Universidad San Pablo-CEU, CEU Universities, 28005 Madrid, Spain
| | - Esther Rincon
- Psycho-Technology Lab, Universidad San Pablo-CEU, CEU Universities, 28005 Madrid, Spain
- Departamento de Psicología y Pedagogía, Facultad de Medicina, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, 28005 Madrid, Spain
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Zhong H, Wei F, Song Y, Chen H, Ni Z. Health-related quality of life and associated factors among people living with HIV/AIDS in Sichuan, China: A cross-sectional study. Front Public Health 2023; 11:1133657. [PMID: 36992898 PMCID: PMC10040810 DOI: 10.3389/fpubh.2023.1133657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 02/20/2023] [Indexed: 03/14/2023] Open
Abstract
PurposeThis study aimed to explore health-related quality of life (HRQoL) and its associated factors among people living with HIV/AIDS (PLWH) in Sichuan, China.MethodsA total of 401 PLWH were recruited from the city of Panzhihua between August 2018 and January 2019. Demographic characteristics and disease-related data were collected by self-administered questionnaires and medical system records. Health-related quality of life (HRQoL) was measured by the medical outcome study HIV health survey (MOS-HIV), which measured ten subdimensions and two summarized dimensions, the physical health summary score (PHS) and the mental health summary score (MHS). Logistic regression models were used to explore the variables independently associated with quality of life.ResultsThe PHS and MHS measured by MOS-HIV were 53.66 ± 6.80 and 51.31 ± 7.66, respectively. Younger age, higher educational level, no methadone use, higher CD4 lymphocyte counts, less symptom counts and heathy BMI significantly were associated with higher HRQOL in the univariate χ2-test analysis. Education level was found to have a significant influence on patients' quality of life, both in physical health (P = 0.022) and mental health (P = 0.002) dimensions. Younger age (P = 0.032), higher CD4 lymphocyte counts (P = 0.007), less symptom counts (P < 0.001) and health BMI level (P < 0.001) were positively related to the PHS of quality of life in the multivariable logistic regression model.ConclusionThe HRQoL of PLWH in Sinchuan Province was relatively low. Age, educational level, methadone use, CD4 lymphocyte counts, symptom counts and BMI were positively related to quality of life. This study indicates that health caregivers should pay more attention to comorbidity issues and mental health in PLWH, especially for those with lower education levels, unhealthy body mass index, more symptomatic presentation and older age.
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Affiliation(s)
- Hua Zhong
- West China School of Nursing, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Fuling Wei
- West China School of Nursing, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yuqing Song
- West China School of Nursing, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Hong Chen
- West China School of Nursing, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- *Correspondence: Hong Chen
| | - Zhao Ni
- Center for Interdisciplinary Research on AIDS (CIRA), Yale University, New Haven, CT, United States
- School of Nursing, Yale University, New Haven, CT, United States
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Henning O, Alfstad KÅ, Johannessen Landmark C, Helmstaedter C, Lossius MI, Holth Skogan A. Use of screening tools to assess comorbidities and adverse events in patients with epilepsy. A European Reference Network for Rare and Complex Epilepsies (EpiCARE) survey. Seizure 2022; 101:237-243. [PMID: 36115293 DOI: 10.1016/j.seizure.2022.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 09/08/2022] [Indexed: 11/18/2022] Open
Abstract
PURPOSE As comorbidities can affect treatment decisions, quality of life, and prognosis in epilepsy, it is important that they are detected and addressed as soon as possible. Screening tools can help by rapidly assessing various additional challenges in epilepsy. METHODS To map the use and perceived benefit of different screening instruments for quality of life, psychiatric comorbidity, and cognition, along with side effects from anti-seizure medication in Europe, we sent an online questionnaire to dedicated epilepsy centres departments within the European Reference Network for Rare and Complex Epilepsies (EpiCARE). RESULTS Among the 40 hospitals in the EpiCARE network, we received responses from 25 (63%), with 28 individual respondents. Most respondents reported using screening for quality of life (86%) and psychiatric comorbidity (82%), but relatively few (14%) screen for sexual problems. Many (47) different tools were used for evaluation of cognitive dysfunction, but just a few (5) different tools were used to screen for adverse events. The optimization of individual patient care was one main reason given for using screening tools (58%-100% - depending on purpose of tool), another was research (50% - 88% - depending on purpose of tool). A major benefit of using screening tools perceived by the respondents is the detection of "hidden" comorbidity (67% - 90% - depending on purpose of tool). CONCLUSION In the absence of a broad consensus regarding use of screening tools, practices vary considerably among epilepsy centres. Greater emphasis should be directed towards harmonizing use of screening tools. Future research should address how screening results influence treatment choices, and how these might affect clinical care.
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Affiliation(s)
- Oliver Henning
- The National Centre for Epilepsy, Division of Clinical Neuroscience, Oslo University Hospital, P.O. Box 4950, Norway.
| | - Kristin Å Alfstad
- The National Centre for Epilepsy, Division of Clinical Neuroscience, Oslo University Hospital, P.O. Box 4950, Norway
| | - Cecilie Johannessen Landmark
- The National Centre for Epilepsy, Division of Clinical Neuroscience, Oslo University Hospital, P.O. Box 4950, Norway; Section for Clinical Pharmacology, Department of Pharmacology, Oslo University Hospital, Norway; Department of Pharmacy, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | | | - Morten I Lossius
- The National Centre for Epilepsy, Division of Clinical Neuroscience, Oslo University Hospital, P.O. Box 4950, Norway; Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Annette Holth Skogan
- The National Centre for Epilepsy, Division of Clinical Neuroscience, Oslo University Hospital, P.O. Box 4950, Norway
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Mei YX, Zhang ZX, Wu H, Hou J, Liu XT, Sang SX, Mao ZX, Zhang WH, Yang DB, Wang CJ. Health-Related Quality of Life and Its Related Factors in Survivors of Stroke in Rural China: A Large-Scale Cross-Sectional Study. Front Public Health 2022; 10:810185. [PMID: 35450122 PMCID: PMC9016152 DOI: 10.3389/fpubh.2022.810185] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 02/18/2022] [Indexed: 12/12/2022] Open
Abstract
Background Stroke is a major health threat and the leading cause of mortality and disability in China. The aims of this study were to identify the possible influencing factors of health-related quality of life (HRQoL) and its domain-specific contents in stroke patients in rural areas in China. Methods A total of 1,709 stroke patients aged 36–79 years from the baseline data of Henan Rural Cohort study (n = 39,259) were included in the cross-sectional study. The Chinese version of the European Quality of Life Five Dimension (including mobility, self-care, usual activities, pain/discomfort, and anxiety/depression) Five Level Scale (EQ-5D-5L) and visual analog scale (VAS) were used to evaluate HRQoL in stroke patients. Tobit regression models, generalized linear models and binary logistic regression models were constructed to determine potential influencing factors of the EQ-5D utility index, as well as influencing factors of each domain and VAS score. Results The mean utility index and VAS scores of stroke patients were 0.885 (SD, 0.204), and 68.39 (SD, 17.31), respectively. Pain/discomfort (PD, 35.2%) and mobility (MO, 30.4%) were the most frequently reported issues. Regression models revealed that illiterate; a low monthly income; low physical activity intensity; and diabetes, anxiety, depression, or poor sleep quality were significantly associated with lower utility index and VAS scores among stroke patients. In addition, patients with stroke who were older, female, drinking, smoking, and consuming a high-fat diet, had a higher BMI, and lived with a stroke for a longer time, were also significantly associated with different dimensions of the EQ-5D. Conclusion Patients with stroke in rural areas in China had a low HRQoL. Factors associated with the EQ-5D utility index as well as each domain and VAS score, need to be considered by health providers in rural areas. Patients with stroke in rural areas need to be included in national basic public medical services and managed systematically by medical institutions.
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Affiliation(s)
- Yong-Xia Mei
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China.,Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China.,The People's Hospital of Hebi, Hebi, China
| | - Zhen-Xiang Zhang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
| | - Hui Wu
- School of Public Health, Xinxiang Medical University, Xinxiang, China.,School of Public Health, Tianjin Medical University, Tianjin, China.,Henan Province General Medical Educations and Research Center, Xinxiang, China
| | - Jian Hou
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Xiao-Tian Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Sheng-Xiang Sang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Zhen-Xing Mao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Wei-Hong Zhang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
| | | | - Chong-Jian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
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Torres Blasco N, Costas Muñiz R, Zamore C, Porter L, Claros M, Bernal G, Shen MJ, Breitbart W, Castro EM. Cultural adaptation of meaning-centered psychotherapy for latino families: a protocol. BMJ Open 2022; 12:e045487. [PMID: 35379609 PMCID: PMC8981324 DOI: 10.1136/bmjopen-2020-045487] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Literature suggests couple-based interventions that target quality of life and communication can lead to positive outcomes for patients with cancer and their partners. Nevertheless, to date, an intervention to address the needs of Latino families coping with advanced cancer has not been developed. Meta-analytic evidence suggests that culturally adapted evidenced-based intervention targeting a specific cultural group is four times more effective. Our goal is to culturally adapt a novel psychosocial intervention protocol entitled 'Caregivers-Patients Support to Latinx coping advanced-cancer' (CASA). We hypothesised that combine two evidence-based interventions and adapting them, we will sustain a sense of meaning and improving communication as patients approach the end of life among the patient-caregiver dyad. METHODS AND ANALYSIS To culturally adapt CASA, we will follow an innovative hybrid research framework that combines elements of an efficacy model and best practices from the ecological validity model, adaptation process model and intervention mapping. As a first step, we adapt a novel psychosocial intervention protocol entitled protocol entitled 'Caregivers-Patients Support to Latinx coping advanced-cancer' (CASA). The initial CASA protocol integrates two empirically based interventions, meaning-centred psychotherapy and couple communication skills training. This is an exploratory and prepilot study, and it is not necessary for a size calculation. However, based on recommendations for exploratory studies of this nature, a priori size of 114 is selected. We will receive CASA protocol feedback (phase 1b: refine) by conducting 114 questionnaires and 15 semistructured interviews with patients with advanced cancer and their caregivers. The primary outcomes of this study will be identifying the foundational information needed to further the develop the CASA (phase IIa: proof-of-concept and phase IIb: pilot study). ETHICS AND DISSEMINATION The Institutional Review Board of Ponce Research Institute approved the study protocol #1907017527A002. Results will be disseminated through peer-reviewed publications.
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Affiliation(s)
| | - Rosario Costas Muñiz
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Carolina Zamore
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Laura Porter
- Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina, USA
| | - Maria Claros
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Guillermo Bernal
- Professor of Psychology (Retired), Universidad de Puerto Rico, San Juan, Puerto Rico
| | | | - William Breitbart
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - E M Castro
- SBBS, Ponce Health Sciences University, Ponce, Puerto Rico
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Health-related quality of life in cancer immunotherapy: a systematic perspective, using causal loop diagrams. Qual Life Res 2022; 31:2357-2366. [PMID: 35298735 PMCID: PMC8929267 DOI: 10.1007/s11136-022-03110-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2022] [Indexed: 11/26/2022]
Abstract
Purpose System science offers a unique set of tools, including causal loop diagrams (CLDs), for stakeholders to better grasp the complexity of factors surrounding quality of life. Because the health-related quality of life (HRQoL) of cancer immunotherapy patients exists within an intricate system affected by and affecting many factors across multiple dimensions, the development of a systems-level model can provide a powerful framework to aid the understanding of this complexity. We developed a CLD for HRQoL of cancer immunotherapy patients. Methods We first applied a literature-based approach to construct a CLD for patients following immunotherapy. We then iteratively reviewed and enhanced the CLD through interviews with subject matter experts. Results Based on the reviewed literature and subject matter expert input, we produced a CLD representing the system surrounding cancer immunotherapy patients’ HRQoL. Several feedback loops are identified that span clinical experiences, oncology teams’ perceptions about immunotherapy, social support structures, and further research and development in cancer immunotherapy, in addition to other components. The CLD enables visualization of thought experiments regarding how a change anywhere in the system can ultimately worsen or improve patients’ HRQoL. Conclusion The CLD illustrates the valuable contribution of a systems perspective to quality-of-life research. This systems-based qualitative representation gives insight on strategies to inhibit harmful effects, enhance beneficial effects, and inherent tradeoffs within the system. The CLD identifies gaps in the literature and offers a communication tool for diverse stakeholders. Our research method provides an example for studying the complexities of quality of life in other health domains. Supplementary Information The online version contains supplementary material available at 10.1007/s11136-022-03110-5.
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Nolan TS, Ivankova N, Carson TL, Spaulding AM, Dunovan S, Davies S, Enah C, Meneses K. Life after breast cancer: 'Being' a young African American survivor. ETHNICITY & HEALTH 2022; 27:247-274. [PMID: 31642349 DOI: 10.1080/13557858.2019.1682524] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 09/23/2019] [Indexed: 06/10/2023]
Abstract
Objective: In the United States, 26,534 young women (≤45 years) were diagnosed with breast cancer in 2017. Young African American (AA) women have higher incidence and mortality rates than Whites and Hispanics. Yet, few published studies describe survivorship (life after breast cancer diagnosis) experiences among this group. Here, we explore the lived experience of young AA breast cancer survivorship (via quality of life [QOL]).Design: This phenomenological study was framed by the QOL Applied to Breast Cancer model. Fifteen young AA survivors from the Southern U. S. participated in two semi-structured interviews. Methods of transcendental phenomenology were used for data collection and analysis.Results: Five themes emerged from participants' (mean age = 35 years; survivorship = 4 years) descriptions of survivorship experience: (1) actively managing spiritual self, (2) actively managing physical self, (3) actively managing psychological self, (4) actively managing social self, and (5) seeking survivorship knowledge. Participants perceived survivorship as a labile 'new normal' and 'ongoing struggle,' in which spirituality and survivorship knowledge were key to restructuring their lives.Conclusions: Survivorship among young AA survivors was more fluid and complex than the QOL model explained. Findings describe young AA breast cancer survivorship and indicate areas of potential strengths and distress. Healthcare providers and ancillary staff must exercise cultural competence to assess and anticipate young AA survivors' needs and concerns. Implementing targeted survivorship interventions, accounting for cultural contexts (e.g. high spirituality) and need for age-specific survivorship information, may improve QOL among young AA survivors.
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Affiliation(s)
- Timiya S Nolan
- College of Nursing, The Ohio State University, Columbus, OH, USA
| | - Nataliya Ivankova
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Tiffany L Carson
- Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Shanon Dunovan
- College of Nursing, University of Nebraska Medical Center, Omaha, NE, USA
| | - Susan Davies
- School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Comfort Enah
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Karen Meneses
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
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12
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Janic A, Vincent A, Stinson J, Dimaras H. Values of Retinoblastoma Survivors and Parents Regarding Treatment Outcomes: A Qualitative Study. JCO Oncol Pract 2022; 18:e1000-e1015. [PMID: 34985991 DOI: 10.1200/op.21.00474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Retinoblastoma is an aggressive pediatric eye cancer. Patient-reported outcome measures reveal important insights into how patients perceive their own health. Currently, there is no widely used or validated measure for assessment of retinoblastoma outcomes. The purpose of this research was to uncover which treatment outcomes that retinoblastoma survivors and their parents value, to inform the development of a future measure. METHODS This qualitative, cross-sectional study included retinoblastoma survivors age 6 years and older and parents of retinoblastoma survivors. Participants who did not demonstrate fluency in English were excluded. Study participants participated in semistructured interviews or focus groups, either in person at The Hospital for Sick Children, Toronto, Canada, or through secure videoconference, between March 3, 2019, and January 25, 2020. Iterative rounds of opening coding, codebook development, and coresearcher analysis were used to identify key emergent themes and subthemes. RESULTS Seventeen adults participated in six focus groups. Nine pediatric survivors participated in individual interviews. Four common themes emerged from all participant groups: (1) definition of treatment success, (2) enucleation-acceptance and challenges, (3) treatment outcomes to measure, and (4) need for outcome reporting. An additional, unique theme was identified in all pediatric discussions: worries and coping mechanisms. Treatment outcomes deemed valuable were related to the following domains: psychosocial outcomes, daily functioning, functional vision, retinoblastoma education, cosmetic outcomes, and secondary eye conditions. CONCLUSION This study represents the first stage in the development of a retinoblastoma-specific patient-reported outcome measure. The findings reveal insight into what outcomes are valued by survivors after treatment and offer promise to improve outcomes assessment for retinoblastoma.
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Affiliation(s)
- Ana Janic
- Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, Canada.,Department of Ophthalmology & Vision Sciences, The Hospital for Sick Children, Toronto, Canada.,Department of Ophthalmology & Vision Sciences, University of Toronto, Toronto, Canada.,Child Health Evaluative Sciences Program, SickKids Research Institute, Toronto, Canada
| | - Ajoy Vincent
- Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, Canada.,Department of Ophthalmology & Vision Sciences, The Hospital for Sick Children, Toronto, Canada.,Department of Ophthalmology & Vision Sciences, University of Toronto, Toronto, Canada.,Genetics and Genome Biology, SickKids Research Institute, Toronto, Canada
| | - Jennifer Stinson
- Child Health Evaluative Sciences Program, SickKids Research Institute, Toronto, Canada.,Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, Toronto, Canada.,Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
| | - Helen Dimaras
- Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, Canada.,Department of Ophthalmology & Vision Sciences, The Hospital for Sick Children, Toronto, Canada.,Department of Ophthalmology & Vision Sciences, University of Toronto, Toronto, Canada.,Child Health Evaluative Sciences Program, SickKids Research Institute, Toronto, Canada.,The Centre for Global Child Health, SickKids Research Institute, Toronto, Canada.,Division of Clinical Public Health, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
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13
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Hurtado-de-Mendoza A, Gonzales F, Song M, Holmes EJ, Graves KD, Retnam R, Gómez-Trillos S, Lopez K, Edmonds MC, Sheppard VB. Association between aspects of social support and health-related quality of life domains among African American and White breast cancer survivors. J Cancer Surviv 2021; 16:1379-1389. [PMID: 34655040 PMCID: PMC10166003 DOI: 10.1007/s11764-021-01119-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 10/01/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE Social support is associated with breast cancer survivors' health-related quality of life (HRQoL). More nuanced information is needed regarding aspects of social support associated with different HRQoL domains among diverse populations. We assessed the association between emotional/informational and tangible support and five HRQoL domains and evaluated race as an effect modifier. METHODS African American and White women (n = 545) diagnosed with hormone-receptor-positive breast cancer completed a survey that assessed sociodemographic, clinical, and psychosocial factors. We assessed bivariate relationships between emotional/informational and tangible support along with overall HRQoL and each HRQoL domain.We tested interactions between race and emotional/informational and tangible social support using linear regression. RESULTS The sample included African American (29%) and White (71%) breast cancer survivors. Emotional/informational social support had a statistically significant positive association with emotional well-being (β = .08, p = 0.005), social well-being (β = 0.36, p < 0.001), functional well-being (β = .22, p < .001), breast cancer concerns (β = .16, p = 0.002), and overall HRQoL (β = .83, p < .001). Similarly, tangible social support had a statistically significant positive association with emotional well-being (β = .14, p = 0.004), social well-being (β = .51, p < .001), functional well-being (β = .39, p < .001), and overall HRQoL (β = 1.27, p < .001). The interactions between race and social support were not statistically significant (p > 0.05). CONCLUSIONS Results underscore the importance of the different social support types among breast cancer survivors, regardless of survivors' race. IMPLICATIONS FOR CANCER SURVIVORS Population-based interventions can be standardized and disseminated to provide guidance on how to increase emotional/information and tangible support for all breast cancer survivors by caregivers, health providers, and communities.
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Affiliation(s)
- Alejandra Hurtado-de-Mendoza
- Department of Oncology, Georgetown University Medical Center, Washington, DC, USA. .,Fisher Center for Hereditary Cancer and Clinical Cancer Genomics, Georgetown Lombardi Comprehensive Cancer Center, Washington, DC, USA.
| | - Felisa Gonzales
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA.,The Colorado Trust, Denver, CO, USA
| | - Minna Song
- Department of Oncology, Georgetown University Medical Center, Washington, DC, USA
| | - Esther J Holmes
- Department of Health Behavior and Policy, VCU School of Medicine, Richmond, VA, USA
| | - Kristi D Graves
- Department of Oncology, Georgetown University Medical Center, Washington, DC, USA.,Fisher Center for Hereditary Cancer and Clinical Cancer Genomics, Georgetown Lombardi Comprehensive Cancer Center, Washington, DC, USA
| | - Reuben Retnam
- Department of Health Behavior and Policy, VCU School of Medicine, Richmond, VA, USA
| | - Sara Gómez-Trillos
- Department of Oncology, Georgetown University Medical Center, Washington, DC, USA.,Fisher Center for Hereditary Cancer and Clinical Cancer Genomics, Georgetown Lombardi Comprehensive Cancer Center, Washington, DC, USA
| | - Katherine Lopez
- Department of Oncology, Georgetown University Medical Center, Washington, DC, USA
| | - Megan C Edmonds
- Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Vanessa B Sheppard
- Department of Health Behavior and Policy, VCU School of Medicine, Richmond, VA, USA.,Office of Health Equity and Disparities Research, VCU Massey Cancer Center, Richmond, VA, USA
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14
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Aronson KI, Suzuki A. Health Related Quality of Life in Interstitial Lung Disease: Can We Use the Same Concepts Around the World? Front Med (Lausanne) 2021; 8:745908. [PMID: 34692737 PMCID: PMC8526733 DOI: 10.3389/fmed.2021.745908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 08/31/2021] [Indexed: 01/17/2023] Open
Abstract
Health-Related Quality of Life (HRQOL) is increasingly viewed as an important patient-centered outcome by leading health organizations, clinicians, and patients alike. This is especially true in the interstitial lung disease community where patients often struggle with progressive and debilitating disease with few therapeutic options. In order to test the effectiveness of new pharmacologic therapies and non-pharmacologic interventions globally in ILD, this will require expansion of clinical research studies to a multinational level and HRQOL will be an important endpoint to many. In order to successfully expand trials across multiple nations and compare the results of studies between different communities we must recognize that there are differences in the concepts of HRQOL across the world and have strategies to address these differences. In this review, we will describe the different global influences on HRQOL both generally and in the context of ILD, discuss the processes of linguistic translation and cross-cultural adaptation of HRQOL Patient Reported Outcome Measures (PROMs), and highlight the gaps and opportunities for improving HRQOL measurement in ILD across the world.
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Affiliation(s)
- Kerri I. Aronson
- Division of Pulmonary and Critical Care Medicine, Weill Cornell Medicine, New York, NY, United States
| | - Atsushi Suzuki
- Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
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15
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Lu Q, Warmoth K, Chen L, Wu CS, Chu Q, Li Y, Gallagher MW, Stanton AL, Kagawa Singer M, Young L, Loh A. A Culturally Sensitive Social Support Intervention for Chinese American Breast Cancer Survivors (Joy Luck Academy): Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2021; 10:e30950. [PMID: 34550088 PMCID: PMC8495571 DOI: 10.2196/30950] [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: 06/03/2021] [Accepted: 07/06/2021] [Indexed: 11/24/2022] Open
Abstract
Background Breast cancer is the most prevalent type of cancer among Asian American women. Chinese American immigrant breast cancer survivors face unique challenges because of cultural and socioecological factors. They report emotional distress and the need for social, emotional, and spiritual support. However, culturally and linguistically appropriate information for managing survivorship health care is often unavailable. Objective To improve the health outcomes for this underserved and understudied population, we developed, designed, and launched a randomized controlled trial to test the health benefits of a culturally sensitive social support intervention (Joy Luck Academy). In this paper, we describe the research protocol. Methods This randomized controlled trial will enroll Chinese-speaking, stage 0 to 3 breast cancer survivors who have completed treatment within the previous 36 months using a community-based participatory research approach. We will randomly assign 168 participants to the intervention or control group. The intervention arm will attend 7 weekly 3.5-hour peer mentor and educational sessions. The control group will receive the educational information. We will assess health outcomes at baseline, immediately after the Joy Luck Academy, and at 1- and 4-month follow-ups. The primary outcome is quality of life, as measured by the Functional Assessment of Cancer Therapy scale. Secondary outcomes include depressive symptoms, positive affect, fatigue, and perceived stress. We will also explore how the intervention influences cortisol levels. To identify how and to whom the program is effective, we will measure social and personal resources and theorized mechanisms and perform qualitative interviews with a subsample of participants to enhance the interpretation of quantitative data. Results Recruitment began in February 2015, and data collection was completed in February 2019. We expect to complete data management by August 2021 and publish results in 2022. Conclusions If the Joy Luck Academy is demonstrated to be effective, it may be easily disseminated as an intervention for other groups of Asian American immigrant breast cancer survivors. Furthermore, similar programs could be integrated into other diverse communities. Trial Registration ClinicalTrials.gov NCT02946697; http://clinicaltrials.gov/ct2/show/NCT02946697. International Registered Report Identifier (IRRID) DERR1-10.2196/30950
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Affiliation(s)
- Qian Lu
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.,Department of Psychology, University of Houston, Houston, TX, United States
| | - Krystal Warmoth
- Department of Psychology, University of Houston, Houston, TX, United States
| | - Lingjun Chen
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Christine S Wu
- Department of Psychology, University of Houston, Houston, TX, United States
| | - Qiao Chu
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Yisheng Li
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | | | - Annette L Stanton
- Department of Psychology, University of California Los Angeles, Los Angeles, CA, United States.,Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, United States
| | - Marjorie Kagawa Singer
- Department of Community Health Sciences, University of California Los Angeles, Los Angeles, CA, United States
| | - Lucy Young
- Herald Cancer Association, San Gabriel, CA, United States
| | - Alice Loh
- Herald Cancer Association, San Gabriel, CA, United States
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16
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Drury A, Payne S, Brady AM. Prevalence vs impact: a mixed methods study of survivorship issues in colorectal cancer. Qual Life Res 2021; 31:1117-1134. [PMID: 34417713 PMCID: PMC8960628 DOI: 10.1007/s11136-021-02975-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/13/2021] [Indexed: 12/03/2022]
Abstract
Purpose This study aims to explore the prevalence of CRC survivorship issues and their impact on survivors’ quality of life (QoL). Methods This study utilised a mixed methods sequential explanatory design. Adult CRC survivors between 6- and 60-months post-diagnosis (n = 304) were purposively recruited from three hospitals and twenty-one cancer support centres in Ireland. QoL was evaluated using the EuroQol and FACT-C questionnaires and results compared to population norms. 22 survey participants took part in semi-structured interviews exploring the impact of survivorship issues on their daily lives. Results While CRC survivors reported QoL outcomes comparable to or better than normative populations, 54% were dissatisfied with their QoL. The most common survivorship issues reported included negative body image (74%), fatigue (68%), sexual dysfunction (66%) and sleep disturbance (59%). Thematic analysis of the qualitative data illustrated survivors’ attempts to live with the impact of cancer and its treatment (loss, fear, impact) and striving to contextualise, reframe and understand the consequences of cancer and its treatment (control, vigilance, benefit). Within these themes, the cross-domain impact of less prevalent symptoms including bowel dysfunction (28–57%) and peripheral neuropathy (47%) were widely discussed. Conclusions Although cancer survivors report positive QoL outcomes, many experience distressing physical, psychological and social effects. The findings suggest less common and difficult to manage symptoms are the greatest source of distress and unmet need. Support and information must be tailored to address survivors’ individual needs and preferences for support, informed by holistic person-centred assessment. Supplementary Information The online version contains supplementary material available at 10.1007/s11136-021-02975-2.
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Affiliation(s)
- Amanda Drury
- School of Nursing, Midwifery and Health Systems, University College Dublin, Belfield, Dublin 4, Ireland.
| | - Sheila Payne
- Division of Health Research, International Observatory on End of Life Care, Lancaster University, Lancaster, LA1 4AT, UK
| | - Anne-Marie Brady
- School of Nursing & Midwifery, Faculty of Health Sciences, Trinity College Dublin, 24 D'Olier Street, Dublin 2, D02 T283, Ireland
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17
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Ashing KT, Yeung S, Lai L, Young L, Wong AG. A preliminary prospective study of health-related quality of life among Chinese-American breast cancer survivors. Support Care Cancer 2021; 29:6021-6030. [PMID: 33783625 DOI: 10.1007/s00520-021-06181-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 03/24/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE This study examined the predictors of health-related quality of life (HRQOL) and changes in HRQOL over a 1-year period among Chinese-American breast cancer survivors (BCS). METHODS A two-wave longitudinal research design included participants from hospital-based cancer registries and community organizations in Los Angeles. Participants completed mailed questionnaires at baseline and 12-month follow-up. HRQOL was measured using the Functional Assessment of Cancer Therapy-General (FACT-G v.4). Change in HRQOL was assessed using a 7-point meaningful change score. RESULTS Participants were 73 Chinese-American BCS, a majority of whom were middle-aged (M = 54.6, SD = 9.2), lower income (63% < 45K), and diagnosed with stage I-II (83%) breast cancer. Regression analyses showed that multilevel contextual factors including general health perception, quality of care, life stress, and improvement in general health perception significantly predicted HRQOL at baseline and follow-up. The final model explained 72% of the variance of HRQOL. The examination of meaningful change indicated that improvement was reported by 32% (n = 22) and deterioration by 25% (n = 17); the majority indicated minimal change (43%, n = 30). Improvement was associated with increases in family communication, social support, and general health perception, while deterioration was associated with declines in social support, family communication, and general health perception. CONCLUSION Findings indicate that among Chinese-American BCS, HRQOL is influenced by socioecological factors such as family communication and life stress. Results suggest that cancer survivorship outcomes research may benefit from theoretical foundations that examine the broader contextual dimensions that seem to impact and predict HRQOL. Implications for research are discussed.
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Affiliation(s)
- Kimlin Tam Ashing
- Department of Population Sciences, City of Hope Comprehensive Cancer Center, Beckman Research Institute, 1500 E Duarte Road, Duarte, CA, 91010-3000, USA.
| | - Sophia Yeung
- Lung Cancer Screening and Prevention Program, City of Hope National Medical Center, Duarte, CA, USA
| | - Lily Lai
- Lung Cancer Screening and Prevention Program, City of Hope National Medical Center, Duarte, CA, USA
| | - Lucy Young
- Herald Cancer Association, Chinese Christian Herald Crusades, San Gabriel, CA, USA
| | - Alison G Wong
- Fuller Theological Seminary, School of Psychology & Marriage and Family Therapy, Pasadena, CA, USA
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18
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Flores NJ, Mathew MJ, Fortson LS, Abernethy AD, Ashing KT. The Influence of Culture, Social, and Religious Support on Well-Being in Breast Cancer Survivorship. Cureus 2021; 13:e14158. [PMID: 33936871 PMCID: PMC8078221 DOI: 10.7759/cureus.14158] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objective Latina and African American breast cancer survivors (BCS) are affected by health disparities that have negatively impacted their health outcomes and quality of life more than other BCS. Examining the relationships among social support, culture, and well-being in underserved groups may help clarify critical factors that influence health disparities in cancer survivors. Methodology Ethnic salience (impact of ethnicity on identity), religious support, social support, and well-being were examined in African American and Latina breast cancer survivors using archival data. Participants included 320 breast cancer survivors (28% African American and 72% Latina) ranging from 26-89 years old and one to five years post breast cancer diagnosis. Results Ethnic salience was positively associated with well-being (p < .001). African American breast cancer survivors endorsed greater well-being, social support, religious support, and ethnic salience than Latinas (ps < .05). Religious support was associated with well-being even after controlling for the effects of general social support [ΔR2 = .02, p = .005; F(5, 298) = 23.67]. Conclusion Ethnic salience and religious support are important factors in understanding health disparities and should inform survivorship care plans for underserved populations.
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Affiliation(s)
- Nathaniel J Flores
- School of Psychology & Marriage and Family Therapy, Fuller Theological Seminary, Pasadena, USA
| | - Mary J Mathew
- School of Psychology & Marriage and Family Therapy, Fuller Theological Seminary, Pasadena, USA
| | - Leah S Fortson
- Department of Clinical Psychology, Azusa Pacific University, Azusa, USA
| | - Alexis D Abernethy
- School of Psychology & Marriage and Family Therapy, Fuller Theological Seminary, Pasadena, USA
| | - Kimlin T Ashing
- Department of Population Sciences, City of Hope, Duarte, USA
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19
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de Vere Hunt I, Kilgour JM, Danby R, Peniket A, Matin RN. "Is this the GVHD?" A qualitative exploration of quality of life issues in individuals with graft-versus-host disease following allogeneic stem cell transplant and their experiences of a specialist multidisciplinary bone marrow transplant service. Health Qual Life Outcomes 2021; 19:11. [PMID: 33413414 PMCID: PMC7791741 DOI: 10.1186/s12955-020-01651-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Accepted: 12/14/2020] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Graft-versus-host disease (GVHD) is a significant cause of morbidity and mortality following allogeneic stem cell transplantation. These patients face unique challenges due to the complexity of GVHD which can affect multiple organ systems, and the toxicity of treatments. Despite the known impact on quality of life (QOL), qualitative data within the bone marrow transplantation (BMT) literature is rare, and there has been no qualitative work exploring patient experience of specialist healthcare provision for GVHD in the United Kingdom. METHODS We conducted a primary explorative qualitative study of the experience of QOL issues and multidisciplinary care in patients with chronic GVHD following allogeneic stem cell transplantation. Eight patients were identified using convenience sampling from specialist BMT outpatient clinics. Following consent, patients were interviewed individually via telephone. Transcripts of interviews were analyzed using an inductive thematic approach. RESULTS Mean participant age was 61-years-old (range 45-68), with a mean time post-transplant of 3 years at time of interview (range 3 months-15 years). Five key QOL themes were identified: (1) 'Restricted as to what I can do'; (2) Troubling symptoms-'you can sort of get GVHD anywhere'; (3) Confusion/uncertainty over GVHD symptoms-'Is this the GVHD?'; (4) Unpredictable course and uncertainty about the future; and (5) Adapting to the sick role. In addition, four themes related to experience of service provision were identified: (1) personal care and close relationship with BMT nurses; (2) efficiency versus long waits-'On the case straight away'; (3) information provision-'went into it with a bit of a rosy view'; and (4) the role of support groups. CONCLUSIONS These qualitative data reflect the heterogeneity of experiences of the GVHD patient population, reflecting the need for a flexible and nuanced approach to patient care with emphasis on comprehensive information provision. We have identified the key role that BMT specialist nurses within the multidisciplinary team play in supporting patients. We advocate future research should focus on ways to meet the complex needs of this patient group and ensure that the personal care and close relationships are not lost in service redesigns embracing remote consultations.
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Affiliation(s)
- Isabella de Vere Hunt
- Department of Dermatology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - James M Kilgour
- Department of Dermatology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
- Department of Dermatology, Stanford University, Discovery Hall - D143, 455 Broadway, Redwood City, CA, 94063, USA.
| | - Robert Danby
- Department of Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Andy Peniket
- Department of Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Rubeta N Matin
- Department of Dermatology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
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20
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Hastert TA, McDougall JA, Strayhorn SM, Nair M, Beebe-Dimmer JL, Schwartz AG. Social needs and health-related quality of life among African American cancer survivors: Results from the Detroit Research on Cancer Survivors study. Cancer 2020; 127:467-475. [PMID: 33225460 DOI: 10.1002/cncr.33286] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 09/28/2020] [Accepted: 09/30/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND Social needs may affect cancer survivors' health-related quality of life (HRQOL) above and beyond sociodemographic and cancer-related factors. The purpose of this study was to estimate associations between social needs and HRQOL. METHODS Results included data from 1754 participants in the Detroit Research on Cancer Survivors cohort, a population-based study of African American survivors of breast, colorectal, lung, and prostate cancer. Social needs included items related to food insecurity, utility shutoffs, housing instability, not getting health care because of cost or a lack of transportation, and perceptions of neighborhood safety. HRQOL was measured with the validated Functional Assessment of Cancer Therapy-General (FACT-G). Linear regression models controlled for demographic, socioeconomic, and cancer-related factors. RESULTS More than one-third of the survivors (36.3%) reported social needs including 17.1% of survivors reported 2 or more. The prevalence of social needs ranged from 14.8% for food insecurity to 8.9% for utility shutoffs. FACT-G score differences associated with social needs were -12.2 (95% confidence interval [CI] to -15.2 to -9.3) for not getting care because of a lack of transportation, -11.3 (95% CI, -14.2 to -8.4) for housing instability, -10.1 (95% CI, -12.7 to -7.4) for food insecurity, -9.8 (95% CI, -12.7 to -6.9) for feeling unsafe in the neighborhood, -8.6 (95% CI, -11.7 to -5.4) for utility shutoffs, and -6.7 (95% CI, -9.2 to -4.1) for not getting care because of cost. CONCLUSIONS Social needs were common in this cohort of African American cancer survivors and were associated with clinically significant differences in HRQOL. Clinical oncology care and survivorship care planning may present opportunities to screen for and address social needs to mitigate their impact on survivors' HRQOL.
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Affiliation(s)
- Theresa A Hastert
- Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan.,Population Studies and Disparities Research Program, Karmanos Cancer Institute, Detroit, Michigan
| | - Jean A McDougall
- Department of Internal Medicine, University of New Mexico, Albuquerque, New Mexico
| | - Shaila M Strayhorn
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois
| | - Mrudula Nair
- Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan.,Population Studies and Disparities Research Program, Karmanos Cancer Institute, Detroit, Michigan
| | - Jennifer L Beebe-Dimmer
- Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan.,Population Studies and Disparities Research Program, Karmanos Cancer Institute, Detroit, Michigan
| | - Ann G Schwartz
- Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan.,Population Studies and Disparities Research Program, Karmanos Cancer Institute, Detroit, Michigan
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21
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Almatkyzy G, Mojica CM, Stroup AM, Llanos AAM, O'Malley D, Xu B, Tsui J. Predictors of health-related quality of life among Hispanic and non-Hispanic White breast cancer survivors in New Jersey. J Psychosoc Oncol 2020; 39:595-612. [PMID: 33198603 DOI: 10.1080/07347332.2020.1844844] [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] [Indexed: 10/23/2022]
Abstract
PURPOSE To examine predictors of health-related quality of life (HRQoL) in Hispanic and non-Hispanic White (NHW) breast cancer (BC) survivors. DESIGN Cross-sectional study using survey data. PARTICIPANTS Women diagnosed with BC at ages 21-79 years, between 2012-2014, recruited from the New Jersey State Cancer Registry. METHODS HRQoL was assessed using the Functional Assessment Cancer Therapy (FACT-G) instrument. Descriptive statistics compared Hispanics and NHWs, and multivariate regression analyses identified predictors of HRQoL. RESULTS HRQoL was significantly higher scores among NHW (85.7 ± 18.5) than Hispanics (79.4 ± 20.1) (p < 0.05). In multivariate analyses, comorbidities (β: -13.3, 95%CI: -20.6, -5.92), late-stage diagnosis (β: -5.67, 95%CI: -10.7, -0.62), lower income (β: -13.9, 95%CI: -19.8, -7.97) and younger age at diagnosis were associated with lower HRQoL. CONCLUSION Socio-demographic and clinic characteristics were significant predictors of HRQoL among diverse BC survivors. IMPLICATIONS FOR PSYCHOSOCIAL ONCOLOGY Supportive psychosocial care interventions tailored to the needs of young, low-income BC survivors with comorbidities are needed.
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Affiliation(s)
- Gulaiim Almatkyzy
- School of Social and Behavioral Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon, USA
| | - Cynthia M Mojica
- School of Social and Behavioral Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon, USA
| | - Antoinette M Stroup
- Division of Cancer Epidemiology, Rutgers School of Public Health, Cancer Prevention and Cancer Control, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| | - Adana A M Llanos
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, New Jersey, USA
| | - Denalee O'Malley
- Department of Family Medicine and Community Health, Rutgers State University of New Jersey, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
| | - Baichen Xu
- Division of Population Science, Rutgers Cancer Institute of New, New Brunswick, New Jersey, USA
| | - Jennifer Tsui
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
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Liu Z, Doege D, Thong MSY, Arndt V. The relationship between posttraumatic growth and health-related quality of life in adult cancer survivors: A systematic review. J Affect Disord 2020; 276:159-168. [PMID: 32697695 DOI: 10.1016/j.jad.2020.07.044] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 06/04/2020] [Accepted: 07/05/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Studies have reported mixed findings on the relationship between posttraumatic growth (PTG) and health-related quality of life (HRQOL) in cancer survivors. This review aims to give an overview of these studies and to identify potential study- and sample-level factors that could contribute to the heterogeneity of those findings on the relationship between PTG and HRQOL in cancer survivors. METHODS Multiple electronic databases were systematically searched using the concepts 'posttraumatic growth', 'cancer', and 'health-related quality of life'. Eligible studies (published until 2018) were reviewed, quality-assessed, and effect sizes were extracted and synthesized. RESULTS Of the 37 included articles, 22 received a rating of 'weak', 11 'moderate' and 4 'strong' in study quality assessment. The overall sample comprised 7954 individuals, mean age of 55.30 years, >50% females, predominantly breast cancer, and survivors mainly within 5 years post-diagnosis. The synthesized results revealed a positive association between PTG and HRQOL (Fisher's z= 0.16) on a total scale, with significant high heterogeneity (I2=75%). Variations in HRQOL measurement and methodological inconsistency contributed to study-level differences of effect sizes. Sample-level characteristics such as geographic region, smaller sample sizes (n < 100) and so on contributed to heterogeneity. LIMITATIONS Studies assessing the relationship between PTG and HRQOL were heterogeneous, of weak study quality generally, and results were difficult to combine. CONCLUSIONS Most studies found a positive relationship between the factors suggesting that PTG may play a role for successful coping following cancer. However, studies of higher quality and longitudinal design are needed.
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Affiliation(s)
- Zhunzhun Liu
- Unit of Cancer Survivorship, Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), P.O. Box 101949, 69009 Heidelberg, Germany; Medical Faculty of Heidelberg, University of Heidelberg, Heidelberg, Germany
| | - Daniela Doege
- Unit of Cancer Survivorship, Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), P.O. Box 101949, 69009 Heidelberg, Germany
| | - Melissa S Y Thong
- Unit of Cancer Survivorship, Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), P.O. Box 101949, 69009 Heidelberg, Germany
| | - Volker Arndt
- Unit of Cancer Survivorship, Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), P.O. Box 101949, 69009 Heidelberg, Germany.
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Janic A, Bowden S, Levy S, Stinson J, Dimaras H. Patient-reported outcome measures for retinoblastoma: a scoping review. J Patient Rep Outcomes 2020; 4:66. [PMID: 32770435 PMCID: PMC7415058 DOI: 10.1186/s41687-020-00232-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 08/03/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Retinoblastoma is a childhood retinal cancer with lifelong consequences such as vision loss and increased risk of second cancer. Patient-reported outcome measures (PROMs) are instruments that measure outcomes related to health directly reported by patients. The purpose of this study was to determine the scope, characteristics and quality of PROMs used in retinoblastoma and related fields of pediatric ophthalmology and pediatric oncology. METHODS Databases MEDLINE and Embase were searched for studies in the English language that reported on PROMs used in retinoblastoma, pediatric oncology, or pediatric ophthalmology; grey literature and studies reporting on developmental PROM phases were excluded. PROMs were grouped by the construct measured and domains assessed, and classified as condition-specific or generic. A subsequent search was then conducted in MEDLINE and Embase for studies assessing measurement properties of the identified PROMs. PROMs with associated studies were assessed for their methodologic quality using the COnsensus-based standard for the Selection of health Measurement INstruments (COSMIN) strategy. RESULTS Among 110 eligible studies uncovered by the database searches, 143 PROMs were identified: one retinoblastoma-specific, 56 ophthalmology- and 86 oncology-related. The most common construct measured was 'health-related quality of life' and the most common domain assessed was emotional well-being. Of the 143 PROMs, 100 had associated validation studies; the one retinoblastoma-specific PROM was not validated. Quality assessment revealed 34/100 PROMs received a score of sufficient quality in both subcategories of 'overall content validity'; 3/100 received a score of sufficient quality in both subcategories of 'internal structure'; 0/100 received a score of sufficient quality in all three subcategories of 'remaining measurement properties'. The Patient-Reported Outcome Measure Information System (PROMIS) Pediatric Profile-25 was the highest-scoring PROM identified, meeting COSMIN standards for 2/3 measurement property categories (and 5/7 subcategories). Eleven additional PROMs were identified which had sufficient scores in 1/3 measurement property categories (and 5/7 subcategories). CONCLUSION The study identified several PROMs from the pediatric ophthalmology and pediatric oncology literature that could be relevant to the retinoblastoma population, but many have limits to their validation. Future development of a retinoblastoma-specific PROM, performed in partnership with retinoblastoma patients to support optimal content validity, could first focus on the selection and definition of the optimal construct to measure, followed potentially by adaptation and further validation of the relevant PROMs with strong methodologic quality identified in this study.
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Affiliation(s)
- Ana Janic
- Faculty of Medicine, University of Toronto, 1 King's College Circle, Toronto, M5S 1A8, Canada
- Department of Ophthalmology & Vision Sciences, The Hospital for Sick Children, 555 University Ave, Toronto, M5G 2R3, Canada
- Child Health Evaluative Sciences Program, SickKids Research Institute, 686 Bay Street, Toronto, M5G 0A4, Canada
- Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, 555 University Ave, Toronto, M5G 2R3, Canada
| | - Sylvie Bowden
- Faculty of Medicine, University of Toronto, 1 King's College Circle, Toronto, M5S 1A8, Canada
- Department of Ophthalmology & Vision Sciences, The Hospital for Sick Children, 555 University Ave, Toronto, M5G 2R3, Canada
| | - Sarah Levy
- Department of Ophthalmology & Vision Sciences, The Hospital for Sick Children, 555 University Ave, Toronto, M5G 2R3, Canada
- Child Health Evaluative Sciences Program, SickKids Research Institute, 686 Bay Street, Toronto, M5G 0A4, Canada
| | - Jennifer Stinson
- Child Health Evaluative Sciences Program, SickKids Research Institute, 686 Bay Street, Toronto, M5G 0A4, Canada
- Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, 555 University Ave, Toronto, M5G 2R3, Canada
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Toronto, M5T 1P8, Canada
| | - Helen Dimaras
- Faculty of Medicine, University of Toronto, 1 King's College Circle, Toronto, M5S 1A8, Canada.
- Department of Ophthalmology & Vision Sciences, The Hospital for Sick Children, 555 University Ave, Toronto, M5G 2R3, Canada.
- Child Health Evaluative Sciences Program, SickKids Research Institute, 686 Bay Street, Toronto, M5G 0A4, Canada.
- The Centre for Global Child Health, SickKids Research Institute, 686 Bay Street, Toronto, M5G 0A4, Canada.
- Division of Clinical Public Health, University of Toronto, 150 College Street, Toronto, M5T 3M7, Canada.
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Exploring health-related quality of life and frailty in older adults based on the Korean Frailty and Aging Cohort Study. Qual Life Res 2020; 29:2911-2919. [PMID: 32607792 DOI: 10.1007/s11136-020-02568-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE The study aimed to analyze the association between frailty and health-related quality of life (HRQOL) based on the Korean Frailty and Aging Cohort Study. METHODS In this cross-sectional study, 2905 adults aged 70 to 84 years were enrolled. Frailty was determined according to the Fried frailty index. HRQOL was measured using the 5-level EuroQol questionnaire (EQ-5D-5L) and the 12-item Short-Form Health Survey version 2 (SF-12). Hierarchical linear regressions were conducted to examine the relationship between frailty and HRQOL and a logistic regression analysis was performed to estimate odds ratios of frailty status in the scores of the lowest quartiles in each scale. RESULTS Of the total respondents, 7.8% were frail, 47.0% were pre-frail, and 45.2% were robust. Frail respondents had significantly lower HRQOL scores than robust respondents, especially for EQ-5D-5L utility weights (0.74 vs 0.93). Frailty was strongly associated with decreased HRQOL in both physical and mental component summary of SF-12 (p < 0.001). Both pre-frail and frail states were related to greater odds of scoring in the bottom 25% of HRQOL scales compared to the non-frail state (p < 0.0001). CONCLUSION Frailty was associated with declined HRQOL in Korean older adults. This result recommends raising awareness about identifying and preventing frailty for better quality of life in the Korean elderly population.
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Drury A, Payne S, Brady AM. Colorectal cancer survivors' quality of life: a qualitative study of unmet need. BMJ Support Palliat Care 2020:bmjspcare-2020-002190. [PMID: 32601151 DOI: 10.1136/bmjspcare-2020-002190] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 05/10/2020] [Accepted: 06/02/2020] [Indexed: 11/04/2022]
Abstract
OBJECTIVE Cancer survivors' perceptions of healthcare have been identified as a predictor of quality of life (QoL) outcomes. This study aims to explore colorectal cancer (CRC) survivors' perceptions of how cancer-related healthcare affects their QoL. METHODS Semistructured interviews were conducted with 22 CRC survivors receiving follow-up care between 1 and 5 years post diagnosis. Interviews were recorded, transcribed and analysed thematically. RESULTS Five themes described the impact of healthcare experiences on CRC survivors' QoL. While cancer survivors spoke positively of their relationships with healthcare professionals, many experienced a range of unmet information and supportive care needs. Participants described a range of positive and negative experiences, as power dynamics and navigation of healthcare systems had implications for their QoL. Where negative healthcare events aligned, survivors' autonomy, dignity and confidence were undermined, and survivorship issues could be inadequately addressed. To address persistent unmet needs, survivors developed a safety net(work) of supports to bridge the gap of unmet needs in healthcare with varying outcomes. CONCLUSIONS Cancer survivors' experience of follow-up and healthcare can positively or negatively affect their QoL. Preparation for cancer survivorship must be incorporated into the acute phase of diagnosis and treatment and interlinked with clear pathways of survivorship care and accessible supportive care, which support survivors to be equal partners in their healthcare. Understanding cancer survivors' knowledge, expertise and mastery of their condition is essential to ensure delivery of person-centred supportive care that adequately addresses the survivor's unmet needs.
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Affiliation(s)
- Amanda Drury
- School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, D04 V1W8, Ireland
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Dublin 2, Ireland
| | - Sheila Payne
- School of Health and Medicine, University of Lancaster, Lancaster, Lancashire, UK
| | - Anne-Marie Brady
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Dublin 2, Ireland
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Lee KT, George M, Lowry S, Ashing KT. A Review and Considerations on Palliative Care Improvements for African Americans With Cancer. Am J Hosp Palliat Care 2020; 38:671-677. [PMID: 32489113 DOI: 10.1177/1049909120930205] [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] [Indexed: 11/17/2022] Open
Abstract
Hospice and Palliative care benefits are infrequently realized by African American patients with cancer. With the increasing recognition of the critical role of early utilization of palliative services for optimal and quality patient care, it is important to acknowledge disparities and barriers to access that minority patients may face. The purpose of this paper is to discuss the status of palliative care delivery for African American patients within the structure and framework of the clinical practice guideline domains established by the National Consensus Project for Palliative Care. This perspectives paper describes the different aspects of palliative care and the interplay with African American culture. Here, we also attempt to identify the multilevel barriers (health care system and provider level) to palliative care among African Americans as a required step toward decreasing the disparities in access, coverage, utilization, and benefit of palliative care. Furthermore, this paper may serve as an educational guide for health care workers who care for African American patients with cancer.
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Affiliation(s)
- Kimberley T Lee
- Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, USA
| | - Marshalee George
- Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, USA
| | - Sarah Lowry
- Department of Hematology/Medical Oncology, 89020School of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Kimlin T Ashing
- Division of Health Equities, 20220City of Hope Medical Center, Duarte, CA, USA
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28
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Lee I, Park C. The mediating effect of social support on uncertainty in illness and quality of life of female cancer survivors: a cross-sectional study. Health Qual Life Outcomes 2020; 18:143. [PMID: 32429954 PMCID: PMC7236321 DOI: 10.1186/s12955-020-01392-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Accepted: 05/05/2020] [Indexed: 11/25/2022] Open
Affiliation(s)
- Insook Lee
- Department of Nursing, Changwon National University, C.P.O. Box 51140, Changwon, Republic of South Korea
| | - Changseung Park
- Division of Nursing, Cheju Halla University, Jeju, Republic of South Korea
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Wippold GM, Nmezi N, Williams JL, Butler J, Hodge TM. An Exploratory Study to Understand Factors Associated with Health-related Quality of Life Among Uninsured/Underinsured Patients as Identified by Clinic Providers and Staff. J Prim Care Community Health 2020; 11:2150132720949412. [PMID: 32783582 PMCID: PMC7425270 DOI: 10.1177/2150132720949412] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 07/22/2020] [Accepted: 07/22/2020] [Indexed: 12/25/2022] Open
Abstract
Since the release of Healthy People 2020, there has been extensive research understanding factors associated with health-related quality of life (HRQoL) among specific populations. Despite this growing body of research, little has been conducted to understand the factors associated with HRQoL among uninsured/underinsured Americans. The purposes of the present study were to assess clinic staff to determine: (1) whether there is a need to examine HRQoL among uninsured/underinsured individuals, (2) whether there is a need for tailored HRQoL-promoting interventions among uninsured/underinsured individuals, and (3) the factors associated with HRQoL among uninsured/underinsured individuals. A survey was sent to an association of 41 clinics that provides free medical services to uninsured/underinsured individuals. The majority of participants indicated that uninsured/underinsured individuals experience unique factors associated with HRQoL and that there was a need to implement tailored HRQoL-improving interventions among uninsured/underinsured individuals. The results also present the personal/contextual factors associated with HRQoL of uninsured/underinsured individuals.
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Affiliation(s)
| | | | - Jaime L. Williams
- Jackson Health System, University of Miami Miller School of Medicine, Miami, FL, USA
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Nolan TS, Browning K, Vo JB, Meadows RJ, Paxton RJ. CE: Assessing and Managing Spiritual Distress in Cancer Survivorship. Am J Nurs 2020; 120:40-47. [PMID: 31880708 PMCID: PMC10680153 DOI: 10.1097/01.naj.0000652032.51780.56] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
More than 67% of people diagnosed with cancer in the United States are alive five years after receiving the diagnosis; but even if they are cancer free, the effects of the disease and its treatment will remain with them for the rest of their lives. Distress, which can be of a psychological, social, physical, or spiritual nature, is common among cancer survivors. Spiritual distress is a broad concept that is not necessarily associated with any specific religious beliefs, practices, or affiliations. Both religious and nonreligious people may have a strong sense of spirituality and may experience spiritual distress at various points throughout cancer survivorship. But clinicians often neglect to explore the spiritual components of distress, and despite the well-established association between spiritual well-being and quality of life, few of the instruments designed to assess the care needs of cancer survivors address spiritual needs. Through a composite clinical case, this article illustrates how nurses can incorporate into practice evidence-based recommendations for assessing and managing spiritual distress in cancer survivors.
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Affiliation(s)
- Timiya S Nolan
- Timiya S. Nolan is an assistant professor in the College of Nursing at Ohio State University (OSU), Columbus, and a nurse scientist at the OSU Wexner Medical Center. Kristine Browning is an associate professor of clinical nursing and assistant dean for graduate clinical programs in the OSU College of Nursing and an NP at the OSU Wexner Medical Center-James Cancer Hospital. At the time this article was written, Jacqueline B. Vo was a PhD candidate at the University of Alabama, Birmingham (UAB); she is now a graduate of that program. Rachel J. Meadows is a predoctoral fellow in the OSU College of Public Health. Raheem J. Paxton is an associate professor in the UAB College of Community Health Sciences. This article grew out of the lead author's doctoral dissertation, the writing of which was funded by the American Cancer Society and the Susan G. Komen Graduate Traineeship in Disparities Research. Contact author: Timiya S. Nolan, . The authors and planners have disclosed no potential conflicts of interest, financial or otherwise. A podcast with the authors is available at www.ajnonline.com
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Drury A, Payne S, Brady AM. Identifying associations between quality of life outcomes and healthcare-related variables among colorectal cancer survivors: A cross-sectional survey study. Int J Nurs Stud 2020; 101:103434. [DOI: 10.1016/j.ijnurstu.2019.103434] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Revised: 09/10/2019] [Accepted: 09/13/2019] [Indexed: 01/28/2023]
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Yanez B, Baik SH, Oswald LB, Buitrago D, Buscemi J, Iacobelli F, Perez-Tamayo A, Fajardo P, Serrano G, Guitelman J, Penedo FJ. An Electronic Health Intervention for Latina Women Undergoing Breast Cancer Treatment (My Guide for Breast Cancer Treatment): Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2019; 8:e14339. [PMID: 31833834 PMCID: PMC6935046 DOI: 10.2196/14339] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 08/09/2019] [Accepted: 08/13/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Among Latinas and Hispanics (henceforth referred to as Latinas), breast cancer is the most commonly diagnosed cancer and the leading cause of cancer-related deaths. However, few interventions have been developed to meet the needs of Latina women undergoing active treatment for breast cancer. OBJECTIVE This paper aims to describe the procedures and methods of My Guide for Breast Cancer Treatment and the plans for conducting a multisite randomized controlled trial to investigate the feasibility and preliminary efficacy of this smartphone-based app for Latina women in active treatment for breast cancer. METHODS Study participants will be randomized to the My Guide for Breast Cancer Treatment intervention or the enhanced usual care control condition for 12 weeks. Participants will have access to innovative features such as gamification via virtual awards to reinforce usage and an adaptive section that presents targeted material based on their self-reported concerns and needs. Using a stepped-care approach, intervention participants will also receive telecoaching to enhance their adherence to the app. Study outcomes and intervention targets will be measured at study enrollment (before randomization), 6 and 12 weeks after initial app use. General and disease-specific health-related quality of life (HRQoL) and symptom burden are the study's primary outcomes, whereas anxiety, depression, fear of cancer recurrence, physical activity, and dietary intake are secondary outcomes. RESULTS Recruitment began in August 2019 and is expected to be completed by August 2020. We expect to submit study results for publication by fall 2020. CONCLUSIONS My Guide for Breast Cancer Treatment has the potential to improve HRQoL and reduce symptom burden, and increase access to supportive care resources among Latina breast cancer patients. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/14339.
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Affiliation(s)
- Betina Yanez
- Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Sharon H Baik
- Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Laura B Oswald
- Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Diana Buitrago
- Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | | | | | | | - Precilla Fajardo
- Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Gabriela Serrano
- Northwestern University Feinberg School of Medicine, Chicago, IL, United States
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Junger KW, Modi AC, Guilfoyle SM, Smith G, Wagner J, Mucci GA, Huszti H, Mara CA. Establishing clinical cutoffs for the PedsQL™ Epilepsy Module. Epilepsy Behav 2019; 99:106463. [PMID: 31476729 DOI: 10.1016/j.yebeh.2019.106463] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 07/28/2019] [Accepted: 07/28/2019] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The purpose of the present study was to establish clinical cutoffs for the PedsQL Epilepsy Module scales by dichotomizing scores into normative or impaired. We predicted that these cutoffs would be useful in identifying children at greater risk for impairments in health-related quality of life (HRQOL) including those who exhibit effects of ongoing seizures, antiepileptic drugs (AEDs), and polytherapy. METHODS Two hundred and thirty-seven youth (2-18 years old) and their caregivers were recruited from five tertiary care hospitals across the United States. Caregivers and youth (5 years and older) completed the parent- or self-report versions of the PedsQL Epilepsy Module. Caregivers also completed measures of behavior and mood, AED side effects, and executive functioning in children. Clinical cutoffs were calculated in two ways: anchor-based (receiver operating characteristic (ROC) curve) and distribution-based (0.5 standard deviation (SD)). Medical characteristics were abstracted from the medical chart. t-Tests and chi-square tests were used to determine whether children's HRQOL classified as normative or impaired in epilepsy quality of life differed on seizure freedom, AED side effects, and polytherapy. RESULTS The final clinical cutoffs were as follows for each PedsQL Epilepsy Module subscale (caregiver and child): Impact (Parent = 60.7; Child = 64.39), Cognitive (Parent = 38.11; Child = 50.97), Executive Functioning (Parent = 46.65; Child = 57.15), Sleep (Parent = 42.07; Child = 43.90), and Mood/Behavior (Parent = 54.14; Child = 53.30). Youth with more severe AED side effects, ongoing seizures, and/or on polytherapy were more likely to have impaired quality of life across domains. CONCLUSION Clinical cutoffs extend this instrument's utility in surveilling common psychosocial comorbidities, tracking changes in functioning over time, and informing clinical decision-making in youth with epilepsy including recommendations for additional assessment and intervention by a range of health providers serving youth with epilepsy (YWE).
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Affiliation(s)
- Katherine W Junger
- Cincinnati Children's Hospital Medical Center, University of Cincinnati-College of Medicine, United States of America.
| | - Avani C Modi
- Cincinnati Children's Hospital Medical Center, University of Cincinnati-College of Medicine, United States of America
| | - Shanna M Guilfoyle
- Cincinnati Children's Hospital Medical Center, University of Cincinnati-College of Medicine, United States of America
| | - Gigi Smith
- Medical University of South Carolina, United States of America
| | - Janelle Wagner
- Medical University of South Carolina, United States of America
| | - Grace A Mucci
- Children's Hospital of Orange County, United States of America
| | - Heather Huszti
- Children's Hospital of Orange County, United States of America
| | - Constance A Mara
- Cincinnati Children's Hospital Medical Center, University of Cincinnati-College of Medicine, United States of America
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Buscemi J, Buitrago D, Iacobelli F, Penedo F, Maciel C, Guitleman J, Balakrishnan A, Corden M, Adler RF, Bouchard LC, Perez-Tamayo A, Yanez BR. Feasibility of a Smartphone-based pilot intervention for Hispanic breast cancer survivors: a brief report. Transl Behav Med 2019; 9:638-645. [PMID: 29986120 PMCID: PMC7184867 DOI: 10.1093/tbm/iby058] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 02/28/2018] [Accepted: 05/22/2018] [Indexed: 11/13/2022] Open
Abstract
Hispanic breast cancer survivors (BCS) are at high risk for experiencing poor health-related quality of life (HRQoL) after completion of active breast cancer treatment. Therefore, there is a need to develop culturally tailored interventions for Hispanic BCS. To date, there have been limited interventions that have demonstrated that increasing cancer-related knowledge, self-efficacy in communication, and self-management skills can improve HRQoL among Hispanic BCS. These interventions have been delivered in person or by phone, which may be burdensome for Hispanic BCS. To facilitate intervention delivery, we developed My Guide, a Smartphone application aimed at improving HRQoL among Hispanic BCS. The purpose of the current study is to describe the feasibility results of a 4-week pilot trial testing My Guide among Hispanic BCS. Twenty-five women enrolled in the study (75% recruitment rate) and 22 women were retained (91.6% retention rate). Mean time spent using My Guide across the 4 weeks was 9.25 hr, and mean score on the satisfaction survey was 65.91 (range 42-70), in which higher scores reflect greater satisfaction. Participants' scores on the Breast Cancer Knowledge Questionnaire significantly improved from study baseline (M = 9.50, SD = 2.92) to the postintervention assessment (M = 11.14, SD = 2.66), d = 0.59. Participants' HRQoL scores improved over the course of 4 weeks, but these improvements were not statistically significant. Overall, My Guide was feasible and acceptable. Future studies will assess the preliminary efficacy of My Guide in improving HRQoL in a larger, randomized trial of Hispanic BCS.
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Affiliation(s)
- Joanna Buscemi
- Department of Psychology, DePaul University, Chicago, IL, USA
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
| | - Diana Buitrago
- Department of Medical Social Sciences, Northwestern University, Evanston, IL, USA
| | - Francisco Iacobelli
- Department of Computer Science, Northeastern Illinois University, DeKalb, IL, USA
| | - Frank Penedo
- Department of Medical Social Sciences, Northwestern University, Evanston, IL, USA
| | - Crystal Maciel
- Department of Medical Social Sciences, Northwestern University, Evanston, IL, USA
| | | | - Aparna Balakrishnan
- Department of Medical Social Sciences, Northwestern University, Evanston, IL, USA
| | - Marya Corden
- Department of Preventive Medicine Northwestern University, Evanston, IL, USA
| | - Rachel F Adler
- Department of Computer Science, Northeastern Illinois University, DeKalb, IL, USA
| | - Laura C Bouchard
- Department of Medical Social Sciences, Northwestern University, Evanston, IL, USA
| | | | - Betina R Yanez
- Department of Medical Social Sciences, Northwestern University, Evanston, IL, USA
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Ashing KT, Soto-Perez-de-Celis E. Disparities within a disparity: Global health and health equity in geriatric oncology. J Geriatr Oncol 2019; 11:200-202. [PMID: 31235437 DOI: 10.1016/j.jgo.2019.06.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Accepted: 06/15/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Kimlin Tam Ashing
- Center of Community Alliance for Research & Education, Division of Health Equities City of Hope Medical Center, Duarte, CA, USA
| | - Enrique Soto-Perez-de-Celis
- Department of Geriatrics, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico.
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Ashing KT, George M. Exploring the efficacy of a paraprofessional delivered telephonic psychoeducational intervention on emotional well-being in African American breast cancer survivors. Support Care Cancer 2019; 28:1163-1171. [DOI: 10.1007/s00520-019-04899-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 05/29/2019] [Indexed: 12/20/2022]
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Oswald LB, Guitelman J, Buitrago D, Buscemi J, Iacobelli F, Perez-Tamayo A, Penedo F, Yanez B. Community Perspectives: Developing and Implementing a Smartphone Intervention for Latina Breast Cancer Survivors in Chicago. Prog Community Health Partnersh 2019; 13:131-136. [PMID: 31378743 PMCID: PMC6894161 DOI: 10.1353/cpr.2019.0046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Compared with non-Latina White breast cancer survivors (BCS), Latina BCS have poorer health-related quality of life and greater psychosocial needs. However, Latinas are less engaged in clinical research owing to barriers including less access to health-related information, less awareness of clinical trials, and practical barriers (e.g., competing time demands). Latina BCS are in need of educational and health-related resources that are culturally informed, scalable, and accessible. In 2015, the Chicago Cancer Health Equity Collaborative (ChicagoCHEC), a National Cancer Institute research collaborative, and ALAS-WINGS, a community organization providing educational and supportive resources to Latina BCS, partnered to develop My Guide. My Guide is a smartphone application-based intervention for Latina BCS designed to improve health-related quality of life (HRQOL). This article summarizes the experiences of ChicagoCHEC and ALAS-WINGS throughout the community-engaged research (CEnR) partnership. Using existing relationships in community and academic settings via CEnR provides an ideal starting point for tailoring resources to Latina BCS and engaging Latina BCS in health-related research.
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Huang Y, Luo D, Chen X, Zhang D, Wang M, Qiu Y, Liu Y, Peng B, Niu L, Xiao S. Changes and determinants of health-related quality of life among people newly diagnosed with HIV in China: a 1-year follow-up study. Qual Life Res 2019; 28:35-46. [PMID: 30206817 PMCID: PMC6339666 DOI: 10.1007/s11136-018-1998-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2018] [Indexed: 01/05/2023]
Abstract
PURPOSE This study aimed to investigate changes in health-related quality of life (HRQoL) among people newly diagnosed with HIV and to identify factors associated with HRQoL. METHODS Newly diagnosed HIV-positive individuals were consecutively recruited and assessed at baseline and 1-year follow-up after diagnosis. HRQoL was measured through the physical health summary score (PHS) and mental health summary score (MHS) derived from the Medical Outcomes Study HIV Health Survey. Socio-demographic, clinical, and psychological information was also collected at both times. Generalized estimating equations were applied to explore factors associated with HRQoL in 1 year. RESULTS A total of 410 participants were included. After 1 year, significant increases were observed for both the mean PHS score (53.5-55.0; p = 0.009) and the mean MHS score (44.2-49.0; p < 0.001). Older age (p = 0.024), rural household registration (p = 0.031), HIV-related symptoms (p < 0.001), and depression (p = 0.014) were negatively associated with PHS. Additionally, the negative association between stress and PHS increased over time (β = - 0.07 for the baseline; β = - 0.18 for the 12-month follow-up; p < 0.001). HIV-related symptoms, depression, lower social support, and higher levels of stress (all p < 0.001) were negatively associated with MHS. Additionally, the negative relationship between stress and MHS was stronger among participants who were asymptomatic (p = 0.015). CONCLUSION A relatively lower HRQoL among HIV-infected people shortly after HIV diagnosis and an increase in HRQoL among people 1 year after HIV diagnosis were observed. Additional attention should be paid to individuals of older age, from rural areas, with HIV-related symptoms, with depression, with high levels of stress, and with a lack of social support.
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Affiliation(s)
- Yunxiang Huang
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, People's Republic of China
| | - Dan Luo
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, People's Republic of China.
| | - Xi Chen
- Hunan Provincial Center for Disease Prevention and Control, Changsha, Hunan, People's Republic of China
| | - Dexing Zhang
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong, People's Republic of China
| | - Min Wang
- HIV/AIDS Research Institute, The First Hospital of Changsha, Changsha, Hunan, People's Republic of China
| | - Yangyang Qiu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, People's Republic of China
| | - Ying Liu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, People's Republic of China
| | - Bihua Peng
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, People's Republic of China
| | - Lu Niu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, People's Republic of China
| | - Shuiyuan Xiao
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, People's Republic of China
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Nolan TS, Ivankova N, Carson TL, Spaulding A, Davies S, Enah C, Meneses K. Perceptions of a Breast Cancer Survivorship Intervention: Pearls of Wisdom from Young African American Women. J Adolesc Young Adult Oncol 2018; 8:165-171. [PMID: 30407099 DOI: 10.1089/jayao.2018.0055] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE African American (AA) women ages 20-44 develop breast cancer at higher rates compared with Caucasian women. These young survivors (<45 years) also have disparate quality of life (QOL). Little is known about survivorship information needs of young AA survivors. The purpose of this study was to explore young AA survivors' perceptions of an existing QOL intervention for breast cancer survivors, identifying information needs to address using a targeted intervention. METHODS Two semistructured interviews were conducted with each of 15 young AA survivors who had completed breast cancer treatment. This article focuses on the second interview in which young AA survivors reviewed intervention materials and described their perceptions of the intervention. Content analysis was used to identify themes, which were validated by participants. RESULTS Participants (n: 15; mean age at study entry: 35 years) reported that the existing evidence-based intervention discussed relevant but general survivorship information. They suggested adapting the information for young AA survivors: addition of content geared toward finances, how to better communicate to manage dating and relationships, how to engage in healthful activities, and how to find local resources for any stage of survivorship. Furthermore, they suggested multiple modes of information delivery and inclusion of diverse imagery. CONCLUSION Engaging young AA survivors yielded pearls of wisdom, highlighting the general nature of an existing intervention and suggesting adaptations to meet young AA survivors' information needs. Applying such pearls can be a powerful method to target survivorship interventions for this disparate group of cancer survivors.
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Affiliation(s)
- Timiya S Nolan
- 1 College of Nursing, The Ohio State University , Columbus, Ohio
| | - Nataliya Ivankova
- 2 School of Nursing, University of Alabama at Birmingham , Birmingham, Alabama
| | - Tiffany L Carson
- 3 School of Medicine, and University of Alabama at Birmingham , Birmingham, Alabama
| | - Amelia Spaulding
- 1 College of Nursing, The Ohio State University , Columbus, Ohio
| | - Susan Davies
- 4 School of Public Health, University of Alabama at Birmingham , Birmingham, Alabama
| | - Comfort Enah
- 2 School of Nursing, University of Alabama at Birmingham , Birmingham, Alabama
| | - Karen Meneses
- 2 School of Nursing, University of Alabama at Birmingham , Birmingham, Alabama
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Ongete G, Duffy FJR. The impact of occupational splash, sharps and needlestick injuries (SSNIs) on the quality of life of healthcare workers in a Kenyan university hospital. Work 2018; 59:103-119. [PMID: 29439382 DOI: 10.3233/wor-172664] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Infection as a consequence of splash sharps and needlestick injuries (SSNIs) is a hazard faced by healthcare workers. Little is known about the impact this has on quality of life particularly in countries where the risk of infection is high. OBJECTIVE This study aims to describe the impact SSNIs have on the quality of life of healthcare workers in Kenya, where blood borne illness prevalence is high. METHODS A hospital-wide survey of a facility in Nairobi was conducted. Data was collected online from at risk healthcare workers using Burckhardt and Anderson's Quality of Life Scale (QOLS) and a 10-item symptoms questionnaire. RESULTS Of the 416 participants, 192 (46.2%) had experienced SSNIs. Their mean QOLS scores were considerably lower than that predicted for a healthy population. The relationship between symptoms and QOLS scores showed a strong positive correlation (Pearson's r = 0.753). Tests of association between QOLS scores and SSNI type, anti-retroviral (ARV) drug use, educational level and staff cadre revealed significant association (p < 0.05). However, on key demographic variables, the association was non-dependent, indicating that the impact was felt similarly by many staff. CONCLUSIONS SSNIs clearly impact on healthcare workers quality of life. Hospital management should ensure measures are taken to reduce SSNIs and provide appropriate personal protection equipment. For staff experiencing an SSNI, psychological wellbeing should be assessed and appropriate expert help provided.
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Social inequalities in quality of life in a cohort of women diagnosed with breast cancer in Barcelona (DAMA Cohort). Cancer Epidemiol 2018; 54:38-47. [DOI: 10.1016/j.canep.2018.03.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 02/21/2018] [Accepted: 03/14/2018] [Indexed: 01/01/2023]
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Yanez BR, Buitrago D, Buscemi J, Iacobelli F, Adler RF, Corden ME, Perez-Tamayo A, Guitelman J, Penedo FJ. Study design and protocol for My Guide: An e-health intervention to improve patient-centered outcomes among Hispanic breast cancer survivors. Contemp Clin Trials 2018; 65:61-68. [PMID: 29198729 PMCID: PMC6040887 DOI: 10.1016/j.cct.2017.11.018] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Revised: 11/28/2017] [Accepted: 11/29/2017] [Indexed: 10/18/2022]
Abstract
Breast cancer is the most commonly diagnosed non-skin cancer in women and the leading cause of death among Hispanic women living in the United States. Relative to non-Hispanic white women, Hispanic women report poorer health related quality of life (HRQoL) after treatment. Although eHealth interventions delivered via Smartphones are a viable approach to addressing supportive care accessibility issues while also integrating multidisciplinary approaches for improving HRQoL, few eHealth interventions have been developed that specifically target Hispanic breast cancer survivors (BCS). This manuscript describes the methodology of a multi-site, randomized controlled behavioral trial investigating the feasibility and preliminary efficacy of a Smartphone application aimed at improving HRQoL and cancer-specific distress among Hispanic BCS. Participants will be randomized to receive the intervention application, My Guide (psychoeducation & self-management program), or the health education control condition application, My Health (health education), for six weeks. All participants will also receive weekly telecoaching to enhance adherence to both control and intervention conditions. We will measure the study's primary outcomes, general and disease-specific HRQoL and cancer-specific distress, at three time points: prior to, immediately after the intervention, and eight weeks after initial application use. My Guide may have the potential to improve HRQoL, and to address issues of limited access to supportive care among Hispanic women recovering from breast cancer treatment.
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Affiliation(s)
- Betina R Yanez
- Northwestern University, Department of Medical Social Sciences, 633 N St. Clair St. 19th Floor, Chicago, IL 60611, United States.
| | - Diana Buitrago
- Northwestern University, Department of Medical Social Sciences, 633 N St. Clair St. 19th Floor, Chicago, IL 60611, United States
| | - Joanna Buscemi
- DePaul University, Department of Psychology, 2219 N Kenmore Ave., Chicago, IL 60614, United States; University of Illinois at Chicago, Institute for Health Research and Policy, 1747 W Roosevelt Rd., Chicago, IL 60608, United States
| | - Francisco Iacobelli
- Northeastern Illinois University, Department of Computer Science, 5500 N St. Louis Ave., Chicago, IL 60625, United States
| | - Rachel F Adler
- Northeastern Illinois University, Department of Computer Science, 5500 N St. Louis Ave., Chicago, IL 60625, United States
| | - Marya E Corden
- Northwestern University, Department of Medical Social Sciences, 633 N St. Clair St. 19th Floor, Chicago, IL 60611, United States
| | - Alejandra Perez-Tamayo
- University of Illinois at Chicago, Department of Surgery, 1801 W Taylor St., Chicago, IL 60608, United States
| | - Judy Guitelman
- ALAS-WINGS, The Latina Association for Breast Cancer, 3023 N Clark St. Suite 613, Chicago, IL 60657, United States
| | - Frank J Penedo
- Northwestern University, Department of Medical Social Sciences, 633 N St. Clair St. 19th Floor, Chicago, IL 60611, United States
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Michaelis R, Tang V, Wagner JL, Modi AC, LaFrance WC, Goldstein LH, Lundgren T, Reuber M. Cochrane systematic review and meta-analysis of the impact of psychological treatments for people with epilepsy on health-related quality of life. Epilepsia 2018; 59:315-332. [DOI: 10.1111/epi.13989] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2017] [Indexed: 12/16/2022]
Affiliation(s)
- Rosa Michaelis
- Department of Neurology; Herdecke Community Hospital; University of Witten/Herdecke; Herdecke Germany
- Department of Psychiatry; St. Marien-Hospital Hamm; Hamm Germany
| | - Venus Tang
- Department of Clinical Psychology; Prince of Wales Hospital; Hong Kong
- Division of Neurosurgery; Department of Surgery; Faculty of Medicine; Chinese University of Hong Kong; Hong Kong
| | - Janelle L. Wagner
- College of Nursing and Department of Pediatrics; Medical University of South Carolina; Charleston SC USA
| | - Avani C. Modi
- Division of Behavioral Medicine and Clinical Psychology; Cincinnati Children's Hospital Medical Center; Cincinnati OH USA
| | - W. Curt LaFrance
- Departments of Psychiatry and Neurology; Rhode Island Hospital; Brown University; Providence RI USA
| | - Laura H. Goldstein
- Department of Psychology; Institute of Psychiatry, Psychology, and Neuroscience; King's College London; London UK
| | - Tobias Lundgren
- Department of Clinical Neuroscience; Center for Psychiatry Research; Karolinska Institute; Stockholm Sweden
| | - Markus Reuber
- Academic Neurology Unit; Royal Hallamshire Hospital; University of Sheffield; Sheffield UK
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Kim SH, Seong DH, Yoon SM, Choi YD, Choi E, Song H. Predictors of health-related quality of life in Korean prostate cancer patients receiving androgen deprivation therapy. Eur J Oncol Nurs 2017; 30:84-90. [DOI: 10.1016/j.ejon.2017.08.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 08/23/2017] [Accepted: 08/26/2017] [Indexed: 01/19/2023]
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Drury A, Payne S, Brady AM. Cancer survivorship: Advancing the concept in the context of colorectal cancer. Eur J Oncol Nurs 2017; 29:135-147. [PMID: 28720260 DOI: 10.1016/j.ejon.2017.06.006] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 06/10/2017] [Accepted: 06/21/2017] [Indexed: 12/31/2022]
Abstract
PURPOSE Previous conceptualizations of cancer survivorship have focused on heterogeneous cancer survivors, with little consideration of the validity of conclusions for homogeneous tumour groups. This paper aims to examine the concept of cancer survivorship in the context of colorectal cancer (CRC). METHOD Rodgers' (1989) Evolutionary Method of Concept Analysis guided this study. A systematic search of PUBMED, CINAHL, PsycINFO and The Cochrane Library was conducted in November 2016 to identify studies of CRC survivorship. The Braun and Clarke (2006) framework guided the analysis and interpretation of data extracted from eighty-five publications. RESULTS Similar to general populations of cancer survivors, CRC survivors experience survivorship as an individual, life-changing process, punctuated by uncertainty and a duality of positive and negative outcomes affecting quality of life. However, CRC survivors experience specific concerns arising from the management of their disease. The concept of cancer survivorship has evolved over the past decade as the importance of navigating the healthcare system and its resources, and the constellation of met and unmet needs of cancer survivors are realised. CONCLUSIONS The results highlight core similarities between survivorship in the context of CRC and other tumour groups, but underlines issues specific to CRC survivorship. Communication and support are key issues in survivorship care which may detrimentally affect CRC survivors' well-being if they are inadequately addressed. Healthcare professionals (HCP's) therefore have a duty to ensure cancer survivors' health, information and supportive care needs are met in the aftermath of treatment.
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Affiliation(s)
- Amanda Drury
- School of Nursing & Midwifery, Faculty of Health Sciences, Trinity College Dublin, Dublin 2, Ireland.
| | - Sheila Payne
- International Observatory on End of Life Care, Division of Health Research, Lancaster University, Lancaster, UK
| | - Anne-Marie Brady
- School of Nursing & Midwifery, Faculty of Health Sciences, Trinity College Dublin, Dublin 2, Ireland; Centre for Practice and Healthcare Innovation, School of Nursing & Midwifery, Faculty of Health Sciences, Trinity College Dublin, Dublin 2, Ireland
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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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Vadaparampil ST, Christie J, Donovan KA, Kim J, Augusto B, Kasting ML, Holt CL, Ashing K, Halbert CH, Pal T. Health-related quality of life in Black breast cancer survivors with and without triple-negative breast cancer (TNBC). Breast Cancer Res Treat 2017; 163:331-342. [PMID: 28258353 PMCID: PMC5568024 DOI: 10.1007/s10549-017-4173-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 02/21/2017] [Indexed: 01/09/2023]
Abstract
PURPOSE Black women are more likely to develop early-onset (≤50 years) breast cancer (BC) and have the lowest five-year, cause-specific survival rate of any United States (U.S.) racial or ethnic group. These disparities can be attributed partially to the higher rate of triple-negative BC (TNBC) in Blacks. Yet, little is known about health-related quality of life (HRQOL) among Black women with TNBC. METHODS Black women with invasive BC ≤ 50 years were recruited via the Florida Cancer Data System as part of a population-based case-only study of etiology and outcomes of early-onset invasive BC. Of 460 consented participants, a subset of 355 self-reported sociodemographic, clinical, and psychosocial variables. Descriptive analyses included participants with known TNBC (n = 85) or non-TNBC (n = 245) disease. Univariable and multivariable analyses were conducted to examine differences in factors associated with HRQOL. RESULTS In unadjusted analyses, TNBC participants had significantly lower FACT-B total scores (90.1 ± 27.9) compared to non-TNBC (98.5 ± 27.6) participants (p < 0.05). For the TNBC group, multivariable analyses indicated five individual-level, and three systemic-level factors explain 80% of the response variation in HRQOL. For the non-TNBC group, seven individual-level factors and three systemic-level factors account for 76% of the variation in HRQOL scores. CONCLUSIONS Compared to Black women with non-TNBC, TNBC women have worse HRQOL. There are key individual and systemic-level factors that are unique to both groups. Findings can inform future HRQOL interventions to support young Black BC survivors.
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Affiliation(s)
- Susan T Vadaparampil
- Moffitt Cancer Center, 12902 Magnolia Drive, MRC-CANCONT, Tampa, FL, 33612, USA.
| | - Juliette Christie
- University of Maryland, 4200 Valley Drive, Room 1242W, College Park, MD, 20742, USA
| | - Kristine A Donovan
- Moffitt Cancer Center, 12902 Magnolia Drive, MRC-CANCONT, Tampa, FL, 33612, USA
| | - Jongphil Kim
- Moffitt Cancer Center, 12902 Magnolia Drive, MRC-CANCONT, Tampa, FL, 33612, USA
| | - Bianca Augusto
- Moffitt Cancer Center, 12902 Magnolia Drive, MRC-CANCONT, Tampa, FL, 33612, USA
| | - Monica L Kasting
- Moffitt Cancer Center, 12902 Magnolia Drive, MRC-CANCONT, Tampa, FL, 33612, USA
| | - Cheryl L Holt
- University of Maryland, 4200 Valley Drive, Room 1242W, College Park, MD, 20742, USA
| | - Kimlin Ashing
- City of Hope, 1500 East Duarte Road, Duarte, CA, 91010, USA
| | | | - Tuya Pal
- Moffitt Cancer Center, 12902 Magnolia Drive, MRC-CANCONT, Tampa, FL, 33612, USA
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Sosnowski R, Kulpa M, Ziętalewicz U, Wolski JK, Nowakowski R, Bakuła R, Demkow T. Basic issues concerning health-related quality of life. Cent European J Urol 2017; 70:206-211. [PMID: 28721291 PMCID: PMC5510334 DOI: 10.5173/ceju.2017.923] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2016] [Revised: 11/09/2016] [Accepted: 04/12/2017] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Chronic diseases such as cancer have a strong influence on both physical health and quality of life, which together comprise the concept of health-related quality of life (HRQoL) - in other words, the complete state of physical, social, and psychological functioning. Herein, we review the literature on the theory of HRQoL in relation to oncological diseases. MATERIAL AND METHODS A literature search of English-language publications that included an analysis of the conceptual models of HRQoL was performed using PubMed. The data were screened and synthesized by all authors and relevant papers were selected. RESULTS We outline the theoretical models most often used to conceptualize HRQoL, including the Centre for Health Promotion model from the University of Toronto, the conceptual model of Wilson and Cleary and the contextual model of Ashing-Giwa formulated specifically for cancer patients. CONCLUSIONS Understanding the theoretical basis of HRQoL is indispensable for valid research in this area.
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Affiliation(s)
- Roman Sosnowski
- Urooncology Department, Maria Sklodowska Curie Memorial Cancer Hospital, Warsaw, Poland
| | - Marta Kulpa
- Department of Medical Psychology, Medical University of Warsaw, Warsaw, Poland
| | - Urszula Ziętalewicz
- Department of Health Psychology and Rehabilitation, Faculty of Psychology, University of Warsaw, Warsaw, Poland
| | - Jan Karol Wolski
- Urooncology Department, Maria Sklodowska Curie Memorial Cancer Hospital, Warsaw, Poland
| | - Robert Nowakowski
- Urooncology Department, Maria Sklodowska Curie Memorial Cancer Hospital, Warsaw, Poland
| | - Robert Bakuła
- Urooncology Department, Maria Sklodowska Curie Memorial Cancer Hospital, Warsaw, Poland
| | - Tomasz Demkow
- Urooncology Department, Maria Sklodowska Curie Memorial Cancer Hospital, Warsaw, Poland
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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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Zhang T, Shi W, Huang Z, Gao D, Guo Z, Liu J, Chongsuvivatwong V. Influence of culture, residential segregation and socioeconomic development on rural elderly health-related quality of life in Guangxi, China. Health Qual Life Outcomes 2016; 14:98. [PMID: 27356505 PMCID: PMC4928288 DOI: 10.1186/s12955-016-0499-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Accepted: 06/17/2016] [Indexed: 11/24/2022] Open
Abstract
Background This study aimed to assess ethnic differences in health-related quality of life (HRQoL) among the rural elderly, and to examine the influence of ethnic culture, residential segregation and socioeconomic development on HRQoL. Methods A total of 6,511 rural elderly aged 60 years and older from 5,541 households in 116 villages across eight ethnic groups in Guangxi Zhuang Autonomous region were selected and assessed for HRQoL. The EQ-5D index values were calculated based on the Chinese Time Trade-Off values set. The EQ-5D descriptive system scores, visual analogue scale scores, and index values were described by ethnic group. The EQ-5D index was modeled against ethnic culture, residential segregation and socioeconomic development using villages as random effects. Results The median (IQR) of HRQoL among all the ethnic groups was 0.88 (0.80, 0.96). Pain/discomfort was the most prevalent problem, followed by anxiety/depression. After controlling for sociodemographic characteristics, a significant difference in HRQoL among ethnic groups persisted, but this was not true for residential segregation. Conclusion Social welfare and health policies designed to improve the health of the rural elderly should focus more on older, female, less-educated, Yao minority individuals as well as lower-income households.
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Affiliation(s)
- Tai Zhang
- Epidemiology & Biostatistics Unit, Faculty of Public Health, Dali University, Dali, 671000, People's Republic of China
| | - Wuxiang Shi
- Health Management Unit, Faculty of Humanities and Management, Guilin Medical University, Guilin, 541004, People's Republic of China
| | - Zhaoquan Huang
- Health Management Unit, Faculty of Humanities and Management, Guilin Medical University, Guilin, 541004, People's Republic of China.
| | - Dong Gao
- Health Management Unit, Faculty of Humanities and Management, Guilin Medical University, Guilin, 541004, People's Republic of China
| | - Zhenyou Guo
- Health Management Unit, Faculty of Humanities and Management, Guilin Medical University, Guilin, 541004, People's Republic of China
| | - Jianying Liu
- Health Management Unit, Faculty of Humanities and Management, Guilin Medical University, Guilin, 541004, People's Republic of China
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