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Kumar R, Pasricha R, Gupta MK, Ravi B. Psychosocial well-being and quality of life in women with breast cancer in foothills of North India. J Cancer Res Ther 2023; 19:1176-1185. [PMID: 37787281 DOI: 10.4103/jcrt.jcrt_672_21] [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] [Indexed: 11/04/2022]
Abstract
Introduction Breast cancer remains a leading cause of unintended death among Indian women. Cancer treatment-induced pain, fatigue, nausea/vomiting, body image, and sexual problems could affect the patient psychosocial well-being and quality of life (QOL). The study aims to determine the QOL and psychosocial well-being among women with breast cancer. Materials and Methods A cross-sectional survey completed by 244 women with breast cancer at a tertiary level teaching hospital. The European Organisation for Research and Treatment of Cancer QOL Questionnaire C30, the Breast Module (QLQ-BR23), and the Hospital Anxiety and Depression Scale (HADS) is used to measure the QOL, and psychological well-being, respectively. Appropriate descriptive and inferential statistics are applied to compute the results. Results The total number of women with breast cancer interviewed was 244, with a mean age of 45.06 (standard deviation ± 11.17) years. The mean global health score was 70.97 ± 15.63. As per the QLQ-C30 scale, "physical functioning" scored the highest (70.54 ± 22.00), and "role functioning" reported the lowest (49.45 ± 36.15) mean score. Further, on the QLQ-C30 symptoms scale, "appetite loss" (45.09 ± 35.09) was the worst reported symptom, followed by "nausea and vomiting" (34.97 ± 38.39). On the BR-23 scale, body image said (68.42 ± 22.28) higher score than other domains and experience of arm-related problems (43.80 ± 26.06) were more frequently reported symptom in women. As per the HADS scale, 24.6% and 36.1% of women were in moderate anxiety and depression, respectively. The mean HADS score was 14.39 ± 5.82. Findings on predictors for the individual patient remained the same as that earlier published literature. Conclusions and Recommendations Women with breast cancer have an overall good QOL and poor psychosocial well-being. However, using a holistic approach, including identifying psychological problems and their time management, signifies the need for the studied population.
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Affiliation(s)
- Rajesh Kumar
- Department of Nursing, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Rajesh Pasricha
- Department of Radiation Oncology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Manoj Kumar Gupta
- Department of Radiation Oncology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Bina Ravi
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
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Sabet P, Karimi S, Dehghan A, Bijani M. Effect of Spirituality-Based Palliative Care on Pain, Nausea, Vomiting, and the Quality of Life in Women with Colon Cancer: A Clinical Trial in Southern Iran. JOURNAL OF RELIGION AND HEALTH 2023; 62:1985-1997. [PMID: 36809520 DOI: 10.1007/s10943-023-01742-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/11/2023] [Indexed: 06/18/2023]
Abstract
This randomized controlled clinical trial aimed to examine the effect of spirituality-based palliative care on pain, nausea, vomiting, and the quality of life in 80 Iranian colon cancer inpatients from January to June 2020 in southern Iran. Patients were randomly assigned to an intervention group and a control group. The intervention group took part in four 120-min sessions while the control group received standard care. Pain, nausea, vomiting, and quality of life were assessed before the intervention and one month after the intervention. Data were analyzed using paired t-test and independent t-test. Between-groups differences analysis showed a significant difference in the quality of life scores, pain score, as well as nausea and vomiting scores following the one-month intervention. In conclusion, this group spirituality-based palliative care intervention might be beneficial in improving quality of life and reducing symptoms.
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Affiliation(s)
- Parisa Sabet
- Department of Medical Surgical Nursing, School of Nursing, Fasa University of Medical Sciences, Fasa, Iran
| | - Shahnaz Karimi
- Department of Medical Education, Medical Education Research Center, Fasa University of Medical Sciences, Fasa, Iran.
| | - Azizallah Dehghan
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | - Mostafa Bijani
- Department of Medical Surgical Nursing, School of Nursing, Fasa University of Medical Sciences, Fasa, Iran
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3
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Jäkel K, Richter D, Leuteritz K, Sender A, Hinz A. Sexuality, fertility, family planning, family life, and partnership in young breast cancer patients: a longitudinal study. Front Psychol 2023; 14:1127359. [PMID: 37251020 PMCID: PMC10213958 DOI: 10.3389/fpsyg.2023.1127359] [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: 12/19/2022] [Accepted: 04/21/2023] [Indexed: 05/31/2023] Open
Abstract
Objectives Adolescent and young adult (AYA) breast cancer patients are often faced with sexuality-related problems. Since healthcare providers are often unfamiliar with problems specific to AYA cancer this topic is too little integrated into routine oncological care. The objective of this study was to analyze sexuality, fertility, family planning, family life, and partnership regarding satisfaction and supportive care needs in AYA breast cancer patients. Methods A total of 139 AYA breast cancer patients were examined twice, 1 year apart. The patients were asked to complete several questionnaires and to answer multiple questions about satisfaction with sexuality, fertility, family planning, family life, and corresponding supportive care needs in these domains. Results While the patients were largely satisfied with their family life and partnerships, they were less satisfied with their sexuality and family planning. Only small mean score changes were observed in these variables over the course of a year. Being a parent already and having the possibility of further completing family planning were strongly associated with higher satisfaction and lower supportive care needs in these domains. Satisfaction was generally negatively associated with supportive care needs. Older age was predictive of lower satisfaction with sexuality at follow-up. Conclusion AYA cancer patients deserve special consultations concerning the impact of cancer and treatment on their sexuality and fertility, and it is especially important that women who have yet to complete their family planning be actively offered information and support concerning sexuality and fertility protection before beginning treatment.
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Hammersen F, Fischer D, Pursche T, Strobel AM, Katalinic A, Labohm L, Waldmann A. Young Adult German Breast Cancer Patients Participating in a Three-Week Inpatient Mother–Child Rehab Program Have High Needs for Supportive Care. Cancers (Basel) 2023; 15:cancers15061770. [PMID: 36980656 PMCID: PMC10046589 DOI: 10.3390/cancers15061770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 03/10/2023] [Accepted: 03/13/2023] [Indexed: 03/17/2023] Open
Abstract
A known cut-off problem hampers the interpretation of quality of life (QOL) scores. The purpose of this study was to apply a novel approach for the EORTC QLQ-C30 instrument to identify the proportion of breast cancer (BC) patients in need of supportive care. Changes in QOL during the COVID-19 pandemic were evaluated, as well as changes over time (after treatment termination and up to 4 years later). Data were obtained from a cohort study on young adult BC patients with minor children participating in a mother–child rehab program. Cross-sectional QOL data were collected from 2015 to 2021 (baseline). Follow-up data were available for up to 4 years after diagnosis for a subgroup. The baseline cohort included 853 women (mean age 35 years). More than 50% had a need for supportive care. In the subgroup with follow-up, this proportion remained at a high level up to several years after diagnosis. During the COVID-19 pandemic, changes regarding the proportion with this need were not as high as expected—with the exception of changes on the QLQ-C30 scale ‘role functioning’ (+15%). Even several years after diagnosis, every second BC patient with minor children had a need for supportive care, which is much higher than previously found. Healthcare staff should be aware of this potential need and should address this issue.
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Affiliation(s)
- Friederike Hammersen
- Institute for Social Medicine and Epidemiology, University of Luebeck, Ratzeburger Allee 160, 23562 Luebeck, Germany; (A.K.); (L.L.)
- Correspondence: (F.H.); (A.W.)
| | - Dorothea Fischer
- Department of Obstetrics and Gynecology, Ernst von Bergmann Clinic, Charlottenstraße 72, 14467 Potsdam, Germany;
| | - Telja Pursche
- Department of Gynecology and Obstetrics, Hospital Dueren gem. GmbH, Roonstraße 30, 52351 Dueren, Germany;
| | - Angelika M. Strobel
- Department of Obstetrics and Gynecology, University Hospital of Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23562 Luebeck, Germany
| | - Alexander Katalinic
- Institute for Social Medicine and Epidemiology, University of Luebeck, Ratzeburger Allee 160, 23562 Luebeck, Germany; (A.K.); (L.L.)
- Institute for Cancer Epidemiology e.V., University of Luebeck, Ratzeburger Allee 160, 23562 Luebeck, Germany
| | - Louisa Labohm
- Institute for Social Medicine and Epidemiology, University of Luebeck, Ratzeburger Allee 160, 23562 Luebeck, Germany; (A.K.); (L.L.)
| | - Annika Waldmann
- Institute for Social Medicine and Epidemiology, University of Luebeck, Ratzeburger Allee 160, 23562 Luebeck, Germany; (A.K.); (L.L.)
- Correspondence: (F.H.); (A.W.)
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5
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Zhou K, Bellanger M, Le Lann S, Robert M, Frenel JS, Campone M. The predictive value of patient-reported outcomes on the impact of breast cancer treatment-related quality of life. Front Oncol 2022; 12:925534. [PMID: 36313651 PMCID: PMC9613969 DOI: 10.3389/fonc.2022.925534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 09/21/2022] [Indexed: 11/16/2022] Open
Abstract
Purpose Patient-reported outcomes (PROs) have been widely used to measure breast cancer (BC) treatment outcomes. However, evidence is still limited on using routinely PROs to personalize treatment decision-making, including or not chemotherapy, targeted therapy, and radiotherapy. Using patient baseline PRO scores, we aimed to use PROs before treatment initiation to predict improvement or decline in health-related quality of life (HRQoL) due to treatment that they receive. Methods In two French cancer sites, women with non-metastatic BC completed the EORTC QLQ-C30 and QLQ-BR23 and BREAST-Q questionnaires to assess their PROs at baseline and again at 6 months. The outcome measured was post-operative change in PROs with minimal important difference for QLQ-C30 domains. We performed multivariate ordinal logistic regression to estimate the incremental probability of post-operative PRO improvements and deteriorations depending upon treatment options and baseline HRQoL. Results One hundred twenty-seven women completed questionnaires. Chemotherapy had significant negative impacts on Global health status (GHS) and on physical and social functioning. Chemotherapy and radiotherapy increased patient fatigue scores after adjusting for clinical factors (p< 0.01 and p< 0.05, respectively). The incremental probability of GHS deteriorations for chemotherapy was +0.3, +0.5, and +0.34 for patients with baseline GHS scores of 40, 70, and 100, respectively. This showed that different pre-treatment PROs might predict differential effects of chemotherapy on women change in HRQoL. Conclusion Patients with different baseline PRO scores may experience dissimilar impacts from BC treatments on post-operative PROs in terms of improvements and deteriorations. Oncologists might decide to adapt the treatment option based on a given level of the negative impact. Future studies should concentrate on incorporating this information into routine clinical decision-making strategies to optimize the treatment benefit for patients.
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Affiliation(s)
- Ke Zhou
- Department of Human and Social Sciences, Institut de Cancérologie de l’Ouest René Gauducheau, Saint-Herblain, France
- *Correspondence: Ke Zhou,
| | - Martine Bellanger
- Department of Human and Social Sciences, Institut de Cancérologie de l’Ouest René Gauducheau, Saint-Herblain, France
- UMR CNRS6051 Rennes1 – EHESP School of Public Health, Rennes, France
| | - Sophie Le Lann
- Department of Quality, Risk Management and Organization, Institut de Cancérologie de l’Ouest René Gauducheau, Saint-Herblain, France
| | - Marie Robert
- Department of Medical Oncology, Institut de Cancérologie de l’Ouest, René Gauducheau, Saint-Herblain, France
| | - Jean-Sebastien Frenel
- Department of Medical Oncology, Institut de Cancérologie de l’Ouest, René Gauducheau, Saint-Herblain, France
- CRCINA Team 8, UMR 1232 INSERM, Université de Nantes, Université d’Angers, Institut de Recherche en Santé-Université de Nantes, Nantes, France
- SIRIC ILIAD, Institut de Recherche en Santé-Université de Nantes, Nantes, France
| | - Mario Campone
- Department of Medical Oncology, Institut de Cancérologie de l’Ouest, René Gauducheau, Saint-Herblain, France
- CRCINA Team 8, UMR 1232 INSERM, Université de Nantes, Université d’Angers, Institut de Recherche en Santé-Université de Nantes, Nantes, France
- SIRIC ILIAD, Institut de Recherche en Santé-Université de Nantes, Nantes, France
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Boeer B, Seller A, Schoenfisch B, Krainick-Strobel U, Dietrich A, Brucker SY, Wallwiener D, Niess A, Hahn M. The impact of rehabilitation sport on breast cancer-related lymphoedema and quality of life. Arch Gynecol Obstet 2022; 307:1529-1537. [PMID: 35879447 PMCID: PMC10110661 DOI: 10.1007/s00404-022-06609-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 05/01/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE Surgery and radiotherapy as part of breast cancer treatment can lead to lymphoedema of the upper extremities (breast cancer-related lymphoedema = BCRL) and reduce the quality of life (health-related quality of life = HRQoL). The aim of the present study was to investigate the influence of paddling in a dragon boat (PP) on HRQoL and BCRL in breast cancer survivors (BCS). METHODS Between April and October 2017, a prospective case-control study evaluated the effects of PP compared to a control group. In the paddle group (n = 28), weekly arm circumference measurements were taken at four defined anatomic areas of the arm before and after training; in the control group (n = 70), the measurements were taken once a month. At the beginning and end of the study, questionnaires from both groups (SF 36, EORTC QLQ C30) were evaluated to understand the differences in HRQoL. RESULTS The paddle group started with a higher HRQoL compared to the control group. Most interesting, whether the affected or unaffected arm, whether before or after training-the arm circumference decreased over time in the paddling group. A pre-existing lymphoedema was not negatively influenced by paddling. In the paddle group, the physical health was constant over the season, while the physical health of the control group decreased significantly over time. CONCLUSION PP in a dragon boat does not lead to the development or worsening of pre-existing lymphoedema due to breast cancer therapy, and seems to have a positive effect on the quality of life.
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Affiliation(s)
- Bettina Boeer
- Department of Women's Health, University Hospital of Tuebingen, Calwerstrasse 7, 72076, Tuebingen, Germany.
| | - Anna Seller
- Department of Women's Health, University Hospital of Tuebingen, Calwerstrasse 7, 72076, Tuebingen, Germany
| | - Birgitt Schoenfisch
- Research Institute for Women's Health, University of Tuebingen, Tuebingen, Germany
| | | | - Andreas Dietrich
- Faculty of Economics and Social Sciences, Institute for Sports Science, University of Tuebingen, Tuebingen, Germany
| | - Sara Y Brucker
- Department of Women's Health, University Hospital of Tuebingen, Calwerstrasse 7, 72076, Tuebingen, Germany
| | - Diethelm Wallwiener
- Department of Women's Health, University Hospital of Tuebingen, Calwerstrasse 7, 72076, Tuebingen, Germany
| | - Andreas Niess
- Department of Sports Medicine, University Hospital of Tuebingen, Tuebingen, Germany
| | - Markus Hahn
- Department of Women's Health, University Hospital of Tuebingen, Calwerstrasse 7, 72076, Tuebingen, Germany
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Hajj A, Chamoun R, Salameh P, Khoury R, Hachem R, Sacre H, Chahine G, Kattan J, Rabbaa Khabbaz L. Fatigue in breast cancer patients on chemotherapy: a cross-sectional study exploring clinical, biological, and genetic factors. BMC Cancer 2022; 22:16. [PMID: 34979978 PMCID: PMC8722263 DOI: 10.1186/s12885-021-09072-0] [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: 06/09/2021] [Accepted: 11/25/2021] [Indexed: 11/10/2022] Open
Abstract
Background Cancer-related fatigue (CRF) is one of the most common and distressing complaints reported by cancer patients during chemotherapy considerably impacting all aspects of a patient’s life (physical, psychosocial, professional, and socioeconomic). The aim of this study was to assess the severity of cancer-related fatigue in a group of breast cancer patients undergoing chemotherapy and explore the association between fatigue scores and sociodemographic, clinical, biological, psychiatric, and genetic factors. Methods A cross-sectional pilot study carried out at the oncology outpatient unit of Hôtel-Dieu de France University Hospital recruited 67 breast cancer patients undergoing chemotherapy between November 2017 and June 2019 to evaluate fatigue using the EORTC QLQ-C30 scale (European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire). Genotyping for seven gene polymorphisms (COMT, DRD2, OPRM1, CLOCK, PER2, CRY2, ABCB1) was performed using the Lightcycler® (Roche). Results The prevalence of fatigue was 46.3%. Multivariable analysis taking the fatigue score as the dependent variable showed that a higher number of cycles and a lower hemoglobin level were significantly associated with higher odds of exhibiting fatigue. Moreover, having at least one C allele for DRD2 SNP (vs. TT) was significantly associated with a 4.09 higher odds of expressing fatigue compared to TT patients. Finally, patients with at least one C allele for CLOCK SNP tended to display higher fatigue levels than TT patients. Conclusions Our study showed that anemic breast cancer patients with a high number of chemotherapy cycles and those carrying at least one C allele for DRD2 and CLOCK SNPs are at greater risk of exhibiting fatigue. Since no previous research has reported such genetic results, future studies are necessary to confirm our findings.
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Affiliation(s)
- Aline Hajj
- Faculty of Pharmacy, Saint-Joseph University of Beirut, Beirut, Lebanon. .,Laboratoire de Pharmacologie, Pharmacie Clinique et Contrôle de Qualité des Médicaments, Faculty of Pharmacy, Saint-Joseph University of Beirut, Beirut, Lebanon.
| | - Rami Chamoun
- Faculty of Pharmacy, Saint-Joseph University of Beirut, Beirut, Lebanon.,Laboratoire de Pharmacologie, Pharmacie Clinique et Contrôle de Qualité des Médicaments, Faculty of Pharmacy, Saint-Joseph University of Beirut, Beirut, Lebanon
| | - Pascale Salameh
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon.,Faculty of Pharmacy, Lebanese University, Beirut, Lebanon.,University of Nicosia Medical School, Nicosia, Cyprus
| | - Rita Khoury
- Faculty of Pharmacy, Saint-Joseph University of Beirut, Beirut, Lebanon.,Laboratoire de Pharmacologie, Pharmacie Clinique et Contrôle de Qualité des Médicaments, Faculty of Pharmacy, Saint-Joseph University of Beirut, Beirut, Lebanon
| | - Roula Hachem
- Faculty of Pharmacy, Saint-Joseph University of Beirut, Beirut, Lebanon.,Laboratoire de Pharmacologie, Pharmacie Clinique et Contrôle de Qualité des Médicaments, Faculty of Pharmacy, Saint-Joseph University of Beirut, Beirut, Lebanon
| | - Hala Sacre
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
| | - Georges Chahine
- Department of Hemato-Oncology, Hôtel-Dieu de France Hospital, Faculty of Medicine, Saint-Joseph University of Beirut, Beirut, Lebanon
| | - Joseph Kattan
- Department of Hemato-Oncology, Hôtel-Dieu de France Hospital, Faculty of Medicine, Saint-Joseph University of Beirut, Beirut, Lebanon
| | - Lydia Rabbaa Khabbaz
- Faculty of Pharmacy, Saint-Joseph University of Beirut, Beirut, Lebanon.,Laboratoire de Pharmacologie, Pharmacie Clinique et Contrôle de Qualité des Médicaments, Faculty of Pharmacy, Saint-Joseph University of Beirut, Beirut, Lebanon
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8
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Ghanei Gheshlagh R, Mohammadnejad E, Dalvand S, Dehkordi AH. Health-related quality of life in patients with breast cancer: A systematic review and meta-analysis. Breast Dis 2022; 41:191-198. [PMID: 35068434 DOI: 10.3233/bd-210026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND Breast cancer is the most common type of cancer of women across the world, which can affect the quality of life in patients due to complications caused by the disease and related treatments. Various treatments have been designed for these patients to improve their life quality. This study aimed to estimate the mean score of health-related quality of life patients with breast cancer in Iran. METHODS In this study, we searched the national and international databases of SID, MagIran, Google Scholar, ISI/Web of Science, PubMed and Scopus with no time limits using the keywords of "health-related quality of life", "health related quality of life", "quality of life", "breast neoplasm", "breast cancer", and "breast tumors". Data analysis was performed in STATA version 14 based on the heterogeneity state using random effects model. RESULTS In this study, 15 articles with a sample size of 1883 were evaluated, and the mean global quality of life in patients was reported at 72.48 (95% CI: 64.94-79.82). In addition, the worst performance and symptoms were related to emotional functioning (56.70) (95% CI: 49.84-63.55) and financial difficulties (43.57) (95% CI: 31.47-55.67). CONCLUSION According to the results of the present study, the Iranian patients with breast cancer had a moderate quality of life in most dimensions.
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Affiliation(s)
- Reza Ghanei Gheshlagh
- Spiritual Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Esmaeil Mohammadnejad
- Department of Nursing, Faculty of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Sahar Dalvand
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Hasanpour Dehkordi
- Social Determinants of Health Research Center, School of Allied Medical Sciences, Shahrekord University of Medical Sciences, Shahrekord, Iran
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Tamam N, Al-Mugren KS, Alrebdi HI, Sulieman A, Abdelbasset WK. Evaluating the Quality of Life and Sleep Quality in Saudi Women with Breast Cancer-Related Lymphedema: A Cross-Sectional Correlational Study. Integr Cancer Ther 2021; 20:15347354211046192. [PMID: 34541909 PMCID: PMC8450611 DOI: 10.1177/15347354211046192] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background Among the different cancers found in women, breast cancer is the most common. Breast cancer-related lymphedema is a serious health complication affecting the quality of life and sleep quality. This study evaluates the quality of life and sleep quality among Saudi women with different stages of lymphedema following the treatment of breast cancer. Methods This cross-sectional correlational study included 163 Saudi women with breast cancer-related lymphedema (Stages I-III), aged 28 to 56 years. From the patients identified for this study, women who suffered from mental and psychological dysfunctions or other malignant disorders were excluded. Copies of structured questionnaires were given to each participant during their visits to outpatient physiotherapy clinics. Quality of life was assessed using a valid questionnaire (EORTC QLQ-C30), while sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). The differences between the different lymphedema stages have been assessed. Results Of the total number of participants 27 women had been diagnosed with stage I lymphedema, 84 women had been diagnosed with stage II lymphedema, and 52 women had been diagnosed with stage III lymphedema. All participants have shown low scores on both EORTC QLQ-C30 and PSQI. While analyzing the differences between the 3 stages of lymphedema with the Kruskal–Wallis test, noteworthy statistical differences between the 3 stages of lymphedema (P < .05) have been found. The Stage III lymphedema patients have been shown the lowest quality of life values in all scales when compared with the stage I and stage II lymphedema patients. For PSQI scores, the stage III lymphedema patients worse values than the stage I and stage II lymphedema patients (P < .05). Conclusion and Recommendations Both quality of life and quality of sleep have significantly decreased in Saudi women with different stages of breast cancer-related lymphedema. Quality of life and quality of sleep are the worst in stage III lymphedema patients. Future research should consider repeat and enlarge these results as well as assess the risk factors that affect the quality of life and quality of sleep among Saudi women suffering from breast cancer-related lymphedema.
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Affiliation(s)
- Nissren Tamam
- Department of Physics, College of Science, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - K S Al-Mugren
- Department of Physics, College of Science, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - H I Alrebdi
- Department of Physics, College of Science, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Abdelmoneim Sulieman
- Department of Radiology and Medical Imaging, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Walid Kamal Abdelbasset
- Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia.,Department of Physical Therapy, Kasr Al-Aini Hospital, Cairo University, Giza, Egypt
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10
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A Meta-Analysis: Intervention Effect of Mind-Body Exercise on Relieving Cancer-Related Fatigue in Breast Cancer Patients. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:9980940. [PMID: 34285706 PMCID: PMC8275388 DOI: 10.1155/2021/9980940] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 05/12/2021] [Accepted: 06/16/2021] [Indexed: 11/17/2022]
Abstract
Objective This paper aims to systematically evaluate the intervention effect of mind-body exercise on cancer-related fatigue in breast cancer patients. Methods Databases including PubMed, the Cochrane Library, Embase, Web of Science, CNKI, Wanfang Data, and SINOMED were retrieved to collect randomized controlled trials on the effects of mind-body exercise on relieving cancer-related fatigue in breast cancer patients. The retrieval period started from the founding date of each database to January 6, 2021. Cochrane bias risk assessment tools were used to evaluate the methodological quality assessment of the included literature, and RevMan 5.3 software was used for meta-analyses. Results 17 pieces of researches in 16 papers were included with a total of 1133 patients. Compared with the control group, mind-body exercise can improve cancer-related fatigue in breast cancer patients. The combined effect size SMD = 0.59, 95% CI was [0.27, 0.92], p < 0.00001. Doing Tai Chi for over 40 minutes each time with an exercise cycle of ≤6 weeks can improve cancer-related fatigue in breast cancer patients more significantly. Sensitivity analysis shows that the combined effect results of the meta-analysis were relatively stable. Conclusion Mind-body exercise can effectively improve cancer-related fatigue in breast cancer patients.
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11
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Keaver L, McLaughlin C. Applying the thresholds for clinical importance for fourteen key domains of the EORTC QLQ-C30: a latent class analysis of cancer survivors. Support Care Cancer 2021; 29:7815-7823. [PMID: 34173040 PMCID: PMC8232988 DOI: 10.1007/s00520-021-06292-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 05/11/2021] [Indexed: 12/01/2022]
Abstract
A person’s quality of life is impacted from the beginning of their oncology experience. One of the most common tools to measure quality of life is the EORTC QLQ-C30. The absolute scores it produces can be difficult to interpret in the clinical setting, and thresholds to help identify those who require intervention have recently been introduced. The aim of this research was to identify heterogeneity of these thresholds for clinical importance using latent class analysis in cancer survivors (those undergoing and those who have completed treatment) attending a hospital in the northwest of Ireland. We identified 3 distinct classes of cancer survivors, using Mplus 6.11: high clinical impact (13.9%), compromised physical function (40.3%) and low clinical impact (45.9%). The compromised physical function group were slightly more likely to be older (OR = 1.042, p < .05, CI = 1.000–1.086), not employed (OR = 8.347, p < .01, CI = 2.092–33.305), have lower PG-SGA scores (OR = .826, p < .001, CI = .755–.904), and not have been diagnosed in the last 2 years (OR = .325, p < .05, CI = .114–.923) compared to the high clinical impact group. The low clinical impact group were more likely to be female (OR = 3.288, p < .05, CI = 1.281–1.073), not employed (OR = 10.129, p < .01, CI = 2.572–39.882), have a lower BMI (OR = .921, p < .05, CI = .853–.994), and lower PG-SGA scores (OR = .656, p < .001, CI = .573–.750) than the high clinical impact group. Functional and symptom issues impact on quality of life, and therefore, identifying those of clinical importance is crucial for developing supportive care strategies.
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Affiliation(s)
- Laura Keaver
- Department of Health and Nutritional Science, Institute of Technology Sligo, Ash Lane, Sligo, F91 YW50, Ireland.
| | - Christopher McLaughlin
- Department of Global Bus. & Enterprise, Ulster Business School, Magee Campus, Londonderry, BT48 7JL, Ireland
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The Impact of Socioeconomic Determinants on the Quality of Life of Moroccan Breast Cancer Survivors Diagnosed Two Years Earlier at the National Institute of Oncology in Rabat. Obstet Gynecol Int 2021; 2021:9920007. [PMID: 34257668 PMCID: PMC8249154 DOI: 10.1155/2021/9920007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 06/11/2021] [Indexed: 01/30/2023] Open
Abstract
Introduction The objective of this study was to investigate the impact of socioeconomic determinants on the quality of life of Moroccan women with breast cancer two years after their diagnosis who are followed up at the National Institute of Oncology (INO) in Rabat. Methods This is a cross-sectional study that was conducted between May 2019 and September 2020. The sample size was 304 women. Data were collected using the EORTC QLQ-C30 and EORTC QLQ-BR 23 questionnaires in the Moroccan dialect. Results The mean age of participants was 53.5 ± 12.4 years, where the majority resided in urban areas and more than half were illiterate. Moreover, three-quarters of the survivors were not working, and almost all have basic medical coverage. Nearly one-third of the respondents had experienced discrimination from those around them, and nearly half attributed the decrease in income to their state of health. In addition, 38.2 percent of participants stated that they had great difficulty living on their monthly income after the illness, whereas more than half of the survivors had a good quality of life in terms of overall health (GHS/QOL). Besides, social function obtained the highest score, while emotional function obtained the lowest score. Furthermore, financial difficulty was the most distressing symptom. Indeed, income adjustment after the disease, discrimination, distance between home and treatment center, professional status, and medical coverage were correlated with GHS/QOL. Regression analysis revealed that income adjustment after illness and discrimination were significant predictors of GHS/QOL. Conclusion The data suggest establishing a financial support program and the development of education and awareness-raising policies to combat discrimination.
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Maurer T, Thöne K, Obi N, Jung AY, Behrens S, Becher H, Chang-Claude J. Health-Related Quality of Life in a Cohort of Breast Cancer Survivors over More Than 10 Years Post-Diagnosis and in Comparison to a Control Cohort. Cancers (Basel) 2021; 13:cancers13081854. [PMID: 33924513 PMCID: PMC8069882 DOI: 10.3390/cancers13081854] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 03/27/2021] [Accepted: 04/06/2021] [Indexed: 01/19/2023] Open
Abstract
Simple Summary Breast cancer survivors often experience long-term side-effects of the disease and its treatment that negatively impact their quality of life. However, to date only few long-term studies on breast cancer survivor’s quality of life exist and it is unclear whether or not breast cancer survivors experience a worse quality of life than women without breast cancer. We therefore investigated breast cancer survivor’s quality of life before diagnosis, during active treatment as well as 5 and 10 years after diagnosis and compared it to the quality of life in women without breast cancer. We found that breast cancer survivor’s quality of life over all ages improved in the first 5 years and then started to deteriorate. After 10 years it was comparable to women without breast cancer. Yet, we showed that survivors of different ages experience differences in health related quality of life over time. Most importantly, we showed that 10 years after diagnosis younger patients reported a worse quality of life than women of the same age that never had breast cancer. These findings are important when trying to optimize long-term care of breast cancer survivors. Abstract Background: Breast cancer (BC) survivors often suffer from late and long-term residual symptoms of the disease and its treatment. To date, long-term health-related quality of life (HRQoL) in breast cancer survivors has been seldom investigated and rarely compared to unaffected women (controls). Aim: This study aimed to investigate HRQoL over time using patient-reported status before diagnosis, during treatment, 1 year post-surgery, approx. 5 years and ≥10 years post-diagnosis. We also compared survivors’ HRQoL with controls’ still alive 10 years after recruitment. Methods: Data from the German population-based Mamma Carcinoma Risk Factor Investigation (MARIE) cohort of 1123 BC patients aged 50–74 years at diagnosis (2002–2005) and of 3453 matched controls were used for analysis. HRQoL was assessed with the European Organization for Research and Treatment of Cancer (EORTC QLQ-C30) questionnaire. All analyses were conducted for all ages as well as stratified according to three age groups (≤58 years, 59–64 years, ≥64 years). Differences in survivors’ general HRQoL before, during, and after therapy were investigated using a t-test/Wilcoxon signed-rank test. Changes in the HRQoL of survivors stratified by age from FU1 to FU2 were assessed via repeated analysis of variance. The HRQoL of survivors compared to the controls at FU2 was analyzed using an analysis of variance. Results: Over all ages, the general HRQoL in patients improved in the first 5 years post-diagnosis. In the subsequent years, HRQoL slightly deteriorated but was comparable to that of the controls. Younger survivors mostly improved their HRQoL from the 5 to 10-year follow-up but remained negatively affected for most functioning and symptom scales compared to controls. In older survivors, HRQoL hardly changed over time and detriments were less pronounced compared to controls, except for insomnia. Conclusions: Restrictions of HRQoL persist for more than 10 years and are most prominent among younger survivors. Researchers and clinicians should be aware of such potential deteriorations and age-dependent differences in order to optimize/adapt long-term cancer survivor care.
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Affiliation(s)
- Tabea Maurer
- Cancer Epidemiology Group, University Cancer Center Hamburg (UCCH), University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (T.M.); (K.T.)
| | - Kathrin Thöne
- Cancer Epidemiology Group, University Cancer Center Hamburg (UCCH), University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (T.M.); (K.T.)
| | - Nadia Obi
- Institute for Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (N.O.); (H.B.)
| | - Audrey Y. Jung
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany; (A.Y.J.); (S.B.)
| | - Sabine Behrens
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany; (A.Y.J.); (S.B.)
| | - Heiko Becher
- Institute for Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (N.O.); (H.B.)
| | - Jenny Chang-Claude
- Cancer Epidemiology Group, University Cancer Center Hamburg (UCCH), University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (T.M.); (K.T.)
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany; (A.Y.J.); (S.B.)
- Correspondence:
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14
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Lueckmann SL, Kowalski C, Schumann N. Finanzielle Toxizität einer Krebserkrankung. DER ONKOLOGE 2021. [DOI: 10.1007/s00761-021-00931-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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15
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Braun B, Kurosinski MA, Khil L, Tio J, Krause-Bergmann B, Hense HW. The Mode of Detection Is Not Associated with Quality of Life in Women with Breast Cancer. Breast Care (Basel) 2020; 15:498-505. [PMID: 33223993 DOI: 10.1159/000504662] [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: 07/23/2019] [Accepted: 11/10/2019] [Indexed: 12/24/2022] Open
Abstract
Introduction Apart from saving lives, mammography screening programs (MSP) are expected to reduce negative side effects of treatment by detecting cancer earlier, when it is more responsive to less aggressive treatment. This study compared quality of life (QoL) among women with breast cancers that were detected either by screening mammography, as interval cancers, or clinically among women not participating in the MSP. Methods Retrospective study of first-ever invasive breast cancers detected among MSP-eligible women aged 50-69 years between 2006 and 2012 in Münster, Germany. EORTC QLQ-C30 and -BR23 questionnaires were mailed to 1,399 cases still alive in 2015 (response rate 64.1%). Results Women's responses were obtained on average 6.1 years after diagnosis. Mean crude and age-adjusted scores for overall QoL, breast and body image (BBI), and five functional scales (FS) were comparable between groups of detection mode. Clearly lower adjusted means for most scores were observed in women with interval cancers, if time since diagnosis was less than 5 years. Cases younger than 60 years showed lower values for some FS, particularly among interval and screen-detected cases. Discussion/Conclusion In summary, cases with breast cancer showed health-related score values that were similar to the general population of the same age. There was also no indication that mode of detection markedly influenced these scores. However, after adjusting for tumor stage and other influential factors, screening participants appeared more susceptible to score declines after a diagnosis of cancer than non-participants.
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Affiliation(s)
- Bettina Braun
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Marc-André Kurosinski
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Laura Khil
- State Cancer Registry of North Rhine-Westphalia, Bochum, Germany
| | - Joke Tio
- Breast Care Center, Department of Gynecology and Obstetrics, University Hospital Münster, Münster, Germany
| | | | - Hans-Werner Hense
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
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16
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Impact of Time to Initiation of Treatment on the Quality of Life of Women with Breast Cancer. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228325. [PMID: 33187071 PMCID: PMC7696805 DOI: 10.3390/ijerph17228325] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 11/07/2020] [Accepted: 11/09/2020] [Indexed: 12/31/2022]
Abstract
Introduction: Breast cancer is the most common malignancy in women. Due to the large number of women living with breast cancer and the increasing incidence of this cancer, it is very important to understand the factors determining the quality of life (QOL) of patients. The aim of the study. The aim of the study was to determine the impact of time to initiation of treatment on the quality of life of women with breast cancer. Materials and methods. The study involved 324 women with breast cancer, treated at the Podkarpackie Oncology Centre in Brzozów, Poland. The study was conducted using a diagnostic survey, using a standardised questionnaire to measure the quality of life of women treated for breast cancer, i.e., the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC) QLQ-C30 and the QLQ-BR23 module, as well as a proprietary survey questionnaire. Statistical analysis was performed using the Statistica 10.0 software (StatSoft Inc., 2011). A p value of <0.05 was considered statistically significant. Results: The examined women had a reduced overall quality of life and health (M = 53.88). The quality of life was higher in women who consulted a doctor the earliest after noticing initial symptoms of the disease, i.e., up to one week (M = 57.58), compared to patients who delayed the decision (over four weeks; M = 47.8) (p = 0.002). The quality of life was also considered higher by women who received treatment within two weeks of diagnosis (M = 56.79) and was lower for patients who waited for treatment for more than two months (M = 43.68). Statistically significant relationships were demonstrated for functional scales and disease intensity. Conclusions: Women diagnosed with breast cancer had a considerably lower overall quality of life. A relatively higher quality of life was experienced by patients who consulted a doctor the earliest after discovering symptoms of the disease and those whose waiting time for treatment was shorter. In a systematic manner, the individual stages of diagnosis should be maximally reduced and breast cancer treatment initiated without delay.
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17
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Ruiz-Casado A, Álvarez-Bustos A, de Pedro CG, Méndez-Otero M, Romero-Elías M. Cancer-related Fatigue in Breast Cancer Survivors: A Review. Clin Breast Cancer 2020; 21:10-25. [PMID: 32819836 DOI: 10.1016/j.clbc.2020.07.011] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 07/12/2020] [Accepted: 07/21/2020] [Indexed: 02/06/2023]
Abstract
Fatigue has been the most distressing and frequent symptom in breast cancer (BC) survivors after treatment. Although fatigue can occur in other cancer survivors, women with a history of BC might share some distinctive features. The present study aimed to recapitulate the knowledge about risk factors and correlates of cancer-related fatigue (CRF) in BC survivors after oncologic therapy. An electronic data search was conducted in PubMed using the terms "fatigue," "breast," "cancer," and "survivors." Records were included if they were original articles, available in English, had used a quantitative scale, had > 100 participants, and had excluded women with BC relapse. BC survivors were required to have finished their treatments ≥ 2 months before, except for hormonal therapy. The physiopathology and other interventions were considered beyond the scope of our review. The correlates were subsequently classified into 7 main categories: (1) sociodemographic data, (2) physical variables, (3) tumor- and treatment-related variables, (4) comorbidities, (5) other symptoms, (6) psychological issues, and (7) lifestyle factors. Fatigue was consistently greater in younger, obese, and diabetic women. Women reporting fatigue often communicated symptoms such as pain, depression, insomnia, and cognitive dysfunction. Coping strategies such as catastrophizing could play an important role in the persistence of fatigue. However, tumor characteristics, previous treatments received, and physical activity were not consistently reported. CRF was a strong predictor of the quality of life of BC survivors after treatment. In conclusion, we found CRF was a frequent and serious symptom that severely affects the quality of life of BC survivors after treatment. Health practitioners require more awareness and information about CRF.
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Affiliation(s)
- Ana Ruiz-Casado
- Department of Medical Oncology, University Hospital Puerta de Hierro-Majadahonda, Madrid, Spain.
| | | | - Cristina G de Pedro
- Department of Medical Oncology, University Hospital Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Marta Méndez-Otero
- Department of Medical Oncology, University Hospital Puerta de Hierro-Majadahonda, Madrid, Spain
| | - María Romero-Elías
- Department of Sport Sciences, Sport Research Centre, Miguel Hernandez University of Elche, Alicante, Spain
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18
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Feißt M, Heil J, Stolpner I, von Au A, Domschke C, Sohn C, Kieser M, Rauch G, Hennigs A. Psychometric validation of the Breast Cancer Treatment Outcome Scale (BCTOS-12): a prospective cohort study. Arch Gynecol Obstet 2019; 300:1679-1686. [PMID: 31705285 DOI: 10.1007/s00404-019-05362-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 10/25/2019] [Indexed: 12/24/2022]
Abstract
PURPOSE The Breast Cancer Treatment Outcome Scale (BCTOS) is a questionnaire to evaluate the aesthetic and functional outcome after breast conserving surgery (BCS). The original BCTOS with its 22 items on three subscales was refined to a shorter, improved, and easier to administer patient-reported outcome measure, the BCTOS-12. The BCTOS-12 consists of 12 items on two distinct subscales, the Functional Status and the Aesthetic Status. The aim of this study was to validate the BCTOS-12 in a prospective cohort. METHODS For this study, 239 breast cancer patients were included preoperatively, and 204 patients completed the BCTOS-12 and EORTC QLQ C30 BR23 shortly after their BCS, corresponding to a follow-up rate of 85%. The item-factor structure was examined by confirmatory factor analysis. The reliability was calculated by McDonald's Omega for estimating internal consistency. The convergent validity was assessed by Spearman's rank correlation coefficients between the related scales of the questionnaires. RESULTS The BCTOS-12 showed a robust item-factor structure and a good internal consistency with McDonald's Omega of 0.89 for the Aesthetic Status and 0.90 for the Functional Status. A high convergent and divergent validity was indicated by correlations between the subscales of the EORTC QLQ C30 BR23 and the BCTOS-12. CONCLUSION Overall, the results demonstrate a successful psychometric validation of the BCTOS-12. The BCTOS-12 is a refined, improved, and now validated, instrument. It can be used in clinical studies and routine management for the evaluation of the aesthetic and functional outcome after BCS.
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Affiliation(s)
- Manuel Feißt
- Institute of Medical Biometry and Informatics, University of Heidelberg, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany
| | - Jörg Heil
- Department of Gynecology and Obstetrics, University of Heidelberg, Im Neuenheimer Feld 440, 69120, Heidelberg, Germany
| | - Ilona Stolpner
- Department of Gynecology and Obstetrics, University of Heidelberg, Im Neuenheimer Feld 440, 69120, Heidelberg, Germany
| | - Alexandra von Au
- Department of Gynecology and Obstetrics, University of Heidelberg, Im Neuenheimer Feld 440, 69120, Heidelberg, Germany
| | - Christoph Domschke
- Department of Gynecology and Obstetrics, University of Heidelberg, Im Neuenheimer Feld 440, 69120, Heidelberg, Germany
| | - Christof Sohn
- Department of Gynecology and Obstetrics, University of Heidelberg, Im Neuenheimer Feld 440, 69120, Heidelberg, Germany
| | - Meinhard Kieser
- Institute of Medical Biometry and Informatics, University of Heidelberg, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany
| | - Geraldine Rauch
- Institute of Medical Biometry and Informatics, University of Heidelberg, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany.,Institute of Biometry and Clinical Epidemiology, Charité University Hospital Berlin, Berlin, Germany.,Berlin Institute of Health, Berlin, Germany
| | - André Hennigs
- Department of Gynecology and Obstetrics, University of Heidelberg, Im Neuenheimer Feld 440, 69120, Heidelberg, Germany.
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19
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The acceptance and applicability of a patient-reported experience measurement tool in oncological care: a descriptive feasibility study in northern Germany. BMC Health Serv Res 2019; 19:786. [PMID: 31675968 PMCID: PMC6825358 DOI: 10.1186/s12913-019-4646-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 10/16/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) are tools for assessing outcomes of and experiences with health care from the patient's perspective. In Germany, PROMs are widely used in research for evaluating patient outcomes and quality of care. However, the application of PREMs is rather scant, especially in oncology. The study aimed to assess the feasibility of patient-centred quality evaluation in oncological care in Germany using the German adaptation of the Danish National Cancer Patient Questionnaire. This questionnaire is a PREM/PROM-tool addressing patients of all cancer sites and covering the entire cancer patient pathway. METHODS The Danish National Cancer Patient Questionnaire was translated into German via forward-backward translation. Face-validity was tested among three cancer patients in a conventional pre-test. The German adaptation contains 99 questions. A pilot test was carried out among 245 newly diagnosed breast and colorectal cancer patients in the German federal state Schleswig-Holstein. Patients were recruited via clinics participating in the Oncological Care Registry (12 specialised units in seven hospitals) and contacted six to nine months after diagnosis. Response behaviour and response patterns were compared to the Danish study population (n = 1964). RESULTS The willingness among clinicians to support patient recruitment as well as the response rate of patients to the questionnaire was high (65%). Moreover, response behaviour and response patterns of German and Danish patients were consistent. Despite the generally good response behaviour of patients to the single items, the authors observed that questions assessing the diagnostic process did not fully capture German pathways. Only 19.3% of the German patients stated that their diagnostic process was initiated by a visit to a general practitioner (GP) in contrast to 52% in Denmark. The assessment of patient experiences in the diagnostic phase heavily focuses on experiences in general practice, which does not seem appropriate in the German health care setting. CONCLUSION The translation was successful, and the feasibility of a future large-scale study within existing structures is given. However, some modifications of questions heavily related to the Danish health care system, especially referring to the diagnostic phase, are necessary.
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Friedrich M, Zenger M, Hinz A. Response shift effects of quality of life assessments in breast cancer survivors. Eur J Cancer Care (Engl) 2018; 28:e12979. [PMID: 30520193 DOI: 10.1111/ecc.12979] [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] [Received: 08/22/2017] [Revised: 09/10/2018] [Accepted: 11/07/2018] [Indexed: 11/12/2022]
Abstract
Measurements of quality of life (QoL) can be distorted by respondents adapting to new situations between measurement points and consequently having a changed frame of reference. To investigate this bias in breast cancer survivors, we compare their QoL with that of the general population and use two complementary methods for detecting this bias. Breast cancer survivors (n = 308, response rate: 91%) were tested with the QoL questionnaire European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30. Response shift was examined with the thentest (retrospective judgements) and with the structural equation modelling (SEM) approach. Compared with the general population, breast cancer survivors showed impaired QoL in all functioning scales (Hedges' g: -0.56 to -0.93) and symptom scales (Hedges' g: 0.28-0.74).The thentest method indicated recalibration effects in several dimensions including social functioning. The SEM method detected a non-uniform recalibration effect for social functioning from pretest to posttest and from pretest to thentest, but no effect between thentest and posttest. Breast cancer survivors' QoL is clearly diminished. Comparing the two approaches for detecting response shift showed that it is also useful to apply SEM to retrospective judgements and that this can reveal response shift effects that would otherwise be overlooked.
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Affiliation(s)
- Michael Friedrich
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Markus Zenger
- Faculty of Applied Human Studies, University of Applied Sciences Magdeburg-Stendal, Stendal, Germany.,Integrated Research and Treatment Center (IFB) Adiposity Diseases - Behavioral Medicine, Medical Psychology and Medical Sociology, University of Leipzig Medical Center, Leipzig, Germany
| | - Andreas Hinz
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
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21
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Pačarić S, Kristek J, Mirat J, Kondža G, Turk T, Farčić N, Orkić Ž, Nemčić A. The quality of life of Croatian women after mastectomy: a cross-sectional single-center study. BMC Public Health 2018; 18:999. [PMID: 30097040 PMCID: PMC6086072 DOI: 10.1186/s12889-018-5929-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2018] [Accepted: 08/02/2018] [Indexed: 12/31/2022] Open
Abstract
Background Measuring the quality of life (QoL) of women with breast cancer is an important aspect of measuring treatment success. In Croatia, no QoL studies have been carried out with a focus on patients after mastectomy. The aim of this study was to examine QoL 1 month and 1 year after mastectomy. Methods This cross-sectional single-center study of quality of life was conducted in 101 patients, 50 of whom had undergone a mastectomy 1 month prior, and 51 of whom had undergone a mastectomy 1 year prior. The study was conducted from July 2015 to June 2016. The questionnaires used in the study were developed by the European Organisation for Research and Treatment of Cancer (EORTC). The questionnaire EORTC QLQ-C30 assesses the QoL of cancer patients, and the questionnaire EORTC QLQ-BR23 is a disease-specific breast cancer module. A chi square test, Fisher’s exact test, Kolmogorov-Smirnov test, Student’s t-test and Mann-Whitney U test were performed in the statistical analysis using the statistical program SPSS (Inc. Released 2008. SPSS Statistics for Windows, Version 17.0. Chicago: SPSS Inc.). Results Patients who had undergone a mastectomy a year earlier placed a higher value on their health state than did those who had undergone a mastectomy a month earlier. The most affected values of functional status on the EORTC QLQ-C30 scale were emotional functioning (37.5 [95% CI 33.3–61.6]) and sexual functioning (16.67 [95% CI 0–33.3]) 1 month and 1 year after mastectomy, respectively. The most affected symptoms on the EORTC QLQ-C30 scale were hair loss 66.67 [95% CI 33.3–100]) and fatigue 33.33 [95% CI 24–44]) 1 month and 1 year after mastectomy, respectively. Conclusion In our study, both functional and symptom scales were more affected in women 1 month after mastectomy. QoL was considerably improved in women 1 year after the surgery compared to 1 month after mastectomy. The results of this study could contribute to the public awareness of the QoL of breast cancer patients.
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Affiliation(s)
- Stana Pačarić
- Department of Surgery, Faculty of Medicine, University of Osijek, Osijek, Croatia. .,Department of Surgery, University Hospital Osijek, Huttlerova 4, 31000, Osijek, Croatia.
| | - Jozo Kristek
- Department of Surgery, Faculty of Medicine, University of Osijek, Osijek, Croatia.,Department of Surgery, University Hospital Osijek, Huttlerova 4, 31000, Osijek, Croatia
| | - Jure Mirat
- Faculty of Medicine, University of Osijek, Cara Hadrijana 10/E, HR, 31000, Osijek, Croatia
| | - Goran Kondža
- Department of Surgery, Faculty of Medicine, University of Osijek, Osijek, Croatia.,Department of Surgery, University Hospital Osijek, Huttlerova 4, 31000, Osijek, Croatia
| | - Tajana Turk
- Department of Biophysics and Radiology, Faculty of Medicine, University of Osijek, Osijek, Croatia.,Department of Diagnostic and Interventional Radiology, University Hospital Osijek, Huttlerova 4, 31000, Osijek, Croatia
| | - Nikolina Farčić
- Department of Surgery, University Hospital Osijek, Huttlerova 4, 31000, Osijek, Croatia.,Department of Nursing, Medical Ethics and Palliative Medicine, Faculty of Medicine, University of Osijek, Osijek, Croatia
| | - Želimir Orkić
- Department of Surgery, Faculty of Medicine, University of Osijek, Osijek, Croatia.,Department of Surgery, University Hospital Osijek, Huttlerova 4, 31000, Osijek, Croatia
| | - Ana Nemčić
- Department of Surgery, Faculty of Medicine, University of Osijek, Osijek, Croatia.,Department of Surgery, University Hospital Osijek, Huttlerova 4, 31000, Osijek, Croatia
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Quality of life in cancer patients-a comparison of inpatient, outpatient, and rehabilitation settings. Support Care Cancer 2018; 26:3533-3541. [PMID: 29700655 DOI: 10.1007/s00520-018-4211-4] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 04/13/2018] [Indexed: 11/12/2022]
Abstract
PURPOSE The aim of this study was to compare quality of life (QoL) data from cancer patients in different clinical settings with data from the general population. METHODS A sample of 4020 German cancer patients (1735 inpatients, 1324 outpatients, 961 participants in rehabilitation treatment) was tested with the EORTC QLQ-C30. RESULTS Compared with the general population, cancer patients reported markedly worse QoL. There were clinically significant differences on all 15 scales of the EORTC QLQ-C30 (except one). For the sum score, averaging across 13 scales, the effect size of the difference between cancer patients and the general population was d = 1.16. Inpatients reported the greatest detriments to QoL, followed by the rehabilitation patients and the outpatients (mean sum scores 68.6, 71.0, and 72.3, respectively, compared with 89.2 in the general population). Mean scores for different groups of cancer sites are given separately for the three settings. CONCLUSION The detriments to QoL were stronger than in comparable studies conducted on data from clinical trials. Since these detriments were found in all three settings to a similar degree, health care providers should offer their services not only to inpatients but to outpatients and patients treated in rehabilitation clinics as well. The data can be used for QoL comparisons of assessments from different settings.
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Bouya S, Koochakzai M, Rafiemanesh H, Balouchi A, Taheri S, Badakhsh M, Didehvar M. Health-related quality of life of Iranian breast cancer patients: a meta-analysis and systematic review. Breast Cancer Res Treat 2018. [PMID: 29541975 DOI: 10.1007/s10549-018-4750-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
PURPOSE Quality of life is the most important psychological factor affecting breast cancer patients. This study aimed to examine the health related quality of life of breast cancer patients in Iran. METHODS International (PubMed, Web of science, Scopus and Google scholar) and national (SID, Magiran) databases were searched for related studies to September 2017. The quality of the articles was evaluated using the Hoy tool. RESULTS Out of 232 initial studies, 18 studies performed on 2263 people were included in the final stage of the study. Based on the EORTC-QLQ-C30 and random effect method, the pooled mean score of quality of life in 1073 people was 57.88 (95% CI 48.26-67.41, I2 = 97.90%) and the pooled mean score of quality of life based on WHOQOL-BREF in 357 people was 66.79 (95% CI 45.96-87.62, I2 = 99.50%). CONCLUSION According to the results of the study, a moderate level of quality of life in women with breast cancer was indicated. Therefore, the use of multidimensional approaches can improve their quality of life.
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Affiliation(s)
- Salehoddin Bouya
- Clinical Immunology Research Center, Ali-ebne Abitaleb Hospital, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Maryam Koochakzai
- Department of Midwifery, School of Nursing and Midwifery, Zabol University of Medical Science, Zabol, Iran
| | - Hosein Rafiemanesh
- Student Research Committee, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abbas Balouchi
- Zabol University of Medical Sciences, Zabol, Iran.,Student Research Committee, Nursing and Midwifery School, University of Medical Sciences, Tehran, Iran
| | | | - Mahin Badakhsh
- Department of Midwifery, School of Nursing and Midwifery, Zabol University of Medical Science, Zabol, Iran.
| | - Mahnaz Didehvar
- Midwifery Department, School of Nursing and Midwifery, Iranshahr University of Medical Sciences, Iranshahr, Iran
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Hennigs A, Heil J, Wagner A, Rath M, Moosbrugger H, Kelava A, Golatta M, Hug S, Riedel F, Rauch G, Feißt M. Development and psychometric validation of a shorter version of the Breast Cancer Treatment Outcome Scale (BCTOS-12). Breast 2018; 38:58-65. [PMID: 29248875 DOI: 10.1016/j.breast.2017.12.002] [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] [Received: 06/15/2017] [Revised: 09/19/2017] [Accepted: 12/04/2017] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES Aesthetic and functional outcomes after oncoplastic breast-conserving surgery (BCS) are directly related to the patients' quality of life (QoL). The Breast Cancer Treatment Outcome Scale (BCTOS) is a validated but burdensome questionnaire for the assessment of these outcomes. The aim of the study was to strengthen and focus the BCTOS instrument by reducing the number of items and subscales without loss of information and validity. METHODS This study used a dataset of 871 patients with stage 0 - III breast cancer, from a prospective cohort study, who underwent BCS. We investigated correlations and other criteria of homogeneity of the BCTOS items to identify redundancies. An exploratory factor analysis was used to remodel the item-factor structure. Correlation and linear regression analysis with validated QoL subscales assessed the convergent and discriminant validity of the modified BCTOS structure. RESULTS The factor analysis revealed two distinct subscales for aesthetic and functional outcomes. It was possible to reduce the 22 items of the original BCTOS to 12 items, thus the "BCTOS-12". The two new scales had very good internal consistency: Cronbach's α = 0.86 for the new Aesthetic Status subscale and α = 0.81 for the new Functional Status subscale. Bootstrapping confirmed the item-factor structure for all 10,000 samples, remarkably. CONCLUSION The modified BCTOS questionnaire with only 12 items (BCTOS-12) is shorter, easier to interpret, and shows good validity.
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Affiliation(s)
- André Hennigs
- University Breast Unit, Department of Gynecology, University of Heidelberg, Im Neuenheimer Feld 440, 69120, Heidelberg, Germany.
| | - Jörg Heil
- University Breast Unit, Department of Gynecology, University of Heidelberg, Im Neuenheimer Feld 440, 69120, Heidelberg, Germany.
| | - Annette Wagner
- University Breast Unit, Department of Gynecology, University of Heidelberg, Im Neuenheimer Feld 440, 69120, Heidelberg, Germany.
| | - Michelle Rath
- Klinikum Nürnberg, Department of Gynecology, Im Neuenheimer Feld 440, 69120, Nürnberg, Germany.
| | - Helfried Moosbrugger
- Department of Psychology, Johann Wolfgang Goethe University, Theodor-W.-Adorno-Platz 6, 60629, Frankfurt am Main, Germany.
| | - Augustin Kelava
- Department of Education, Center for Educational Science and Psychology, Eberhard Karls University, Europastraße 6, 72072, Tübingen, Germany.
| | - Michael Golatta
- University Breast Unit, Department of Gynecology, University of Heidelberg, Im Neuenheimer Feld 440, 69120, Heidelberg, Germany.
| | - Sarah Hug
- University Breast Unit, Department of Gynecology, University of Heidelberg, Im Neuenheimer Feld 440, 69120, Heidelberg, Germany.
| | - Fabian Riedel
- University Breast Unit, Department of Gynecology, University of Heidelberg, Im Neuenheimer Feld 440, 69120, Heidelberg, Germany.
| | - Geraldine Rauch
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Institute of Biometry and Clinical Epidemiology, Germany; Institute of Medical Biometry and Informatics, University of Heidelberg, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany.
| | - Manuel Feißt
- Institute of Medical Biometry and Informatics, University of Heidelberg, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany.
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Finck C, Barradas S, Zenger M, Hinz A. Quality of life in breast cancer patients: Associations with optimism and social support. Int J Clin Health Psychol 2017; 18:27-34. [PMID: 30487907 PMCID: PMC6220926 DOI: 10.1016/j.ijchp.2017.11.002] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 11/17/2017] [Indexed: 02/08/2023] Open
Abstract
Background/Objective: The purpose of this study was to examine quality of life (QoL) in breast cancer patients from Colombia and to explore the relationship between QoL, habitual optimism, and social support. Method: A sample of 95 breast cancer patients treated in a hospital in Bogotá were administered the QoL instrument EORTC QLQ-C30 and the Life Orientation Test LOT-R. Additionally, they were asked to indicate from whom (physicians, friends, nurses, etc.) they wished and received social support. Reference data for the EORTC QLQ-C30 and the LOT-R were taken from a representative sample of the general Colombian population. Results: The breast cancer patients showed detriments to their QoL on most functioning scales and symptom scales of the EORTC QLQ-C30, while their general assessments of health and QoL were not worse than those of the controls. Optimism was positively correlated with QoL. Most patients wanted and received social support from their physicians and friends/family. Conclusions: The results suggest that optimism helps patients better cope with disease. A general assessment of global QoL cannot replace the more specific assessments of the functioning domains and symptoms.
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Affiliation(s)
- Carolyn Finck
- Departamento de Psicología, Universidad de los Andes, Bogotá, Colombia
| | - Susana Barradas
- Programa de Psicología, Facultad de Ciencias Sociales y Humanas, Universidad Externado de Colombia, Bogotá, Colombia
| | - Markus Zenger
- Faculty of Applied Human Studies, University of Applied Sciences Magdeburg and Stendal, Germany.,Integrated Research and Treatment Center Adiposity Diseases, Leipzig University Medical Center, Germany
| | - Andreas Hinz
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Germany
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Kecke S, Ernst J, Einenkel J, Singer S, Hinz A. Psychometric Properties of the Fatigue Questionnaire EORTC QLQ-FA12 in a Sample of Female Cancer Patients. J Pain Symptom Manage 2017; 54:922-928. [PMID: 28807705 DOI: 10.1016/j.jpainsymman.2017.08.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 08/07/2017] [Accepted: 08/07/2017] [Indexed: 11/17/2022]
Abstract
CONTEXT Cancer patients frequently suffer from fatigue. Recently, the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life group developed a new 12-item fatigue assessment instrument. OBJECTIVES The aim of this study was to psychometrically test this questionnaire in comparison with the three-item fatigue scale of the EORTC QLQ-C30. METHODS A sample of 354 patients who were being treated for breast cancer or gynecologic cancer were examined using the new fatigue questionnaire EORTC QLQ-FA12 and the EORTC QLQ-C30 during their hospital stay (t1) and three months after hospital discharge (t2). Confirmatory factorial analyses, item analyses, test-retest reliability analyses, and correlation analyses were performed. RESULTS The analyses roughly supported the three-factorial structure of the FA12, which comprised the subscales physical, emotional, and cognitive fatigue. The fit indices of the confirmatory factorial analysis were worse than those of the original article but nevertheless acceptable. Cronbach alpha of the total scale was 0.92; the coefficients of the subscales were between 0.79 and 0.93. The correlation between the EORTC QLQ-FA12 total scale and the fatigue scale of the EORTC QLQ-C30 was 0.69 and the correlation between the t1 and t2 scores was 0.45 for the EORTC QLQ-FA12 total scale and between 0.37 and 0.47 for the subscales. CONCLUSION The psychometric coefficients justify the calculation of a sum score, which can be used by clinicians to assess the general degree of fatigue. Although the three-item fatigue scale of the EORTC QLQ-C30 stresses the physical aspect of fatigue, the new EORTC QLQ-FA12 covers its emotional and cognitive aspects as well.
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Affiliation(s)
- Sophie Kecke
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Jochen Ernst
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Jens Einenkel
- Department of Gynecology and Obstetrics, University of Leipzig, Leipzig, Germany
| | - Susanne Singer
- Institute of Medical Biostatistics, Epidemiology, and Informatics, University Medical Centre Mainz, Mainz, Germany
| | - Andreas Hinz
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany.
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27
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Cahir C, Thomas AA, Dombrowski SU, Bennett K, Sharp L. Urban-Rural Variations in Quality-of-Life in Breast Cancer Survivors Prescribed Endocrine Therapy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14040394. [PMID: 28387748 PMCID: PMC5409595 DOI: 10.3390/ijerph14040394] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 03/31/2017] [Accepted: 04/05/2017] [Indexed: 01/13/2023]
Abstract
The number of breast cancer survivors has increased as a result of rising incidence and increased survival. Research has revealed significant urban-rural variation in clinical aspects of breast cancer but evidence in the area of survivorship is limited. We aimed to investigate whether quality of life (QoL) and treatment-related symptoms vary between urban and rural breast cancer survivors prescribed endocrine therapy. Women with a diagnosis of stages I-III breast cancer prescribed endocrine therapy were identified from the National Cancer Registry Ireland and invited to complete a postal survey (N = 1606; response rate = 66%). A composite measure of urban-rural classification was created using settlement size, population density and proximity to treatment hospital. QoL was measured using the Functional Assessment of Cancer Therapy (FACT-G) and an endocrine subscale. The association between urban-rural residence/status and QoL and endocrine symptoms was assessed using linear regression with adjustment for socio-demographic and clinical covariates. In multivariable analysis, rural survivors had a statistically significant higher overall QoL (β = 3.81, standard error (SE) 1.30, p < 0.01), emotional QoL (β = 0.70, SE 0.21, p < 0.01) and experienced a lower symptom burden (β = 1.76, SE 0.65, p < 0.01) than urban survivors. QoL in breast cancer survivors is not simply about proximity and access to healthcare services but may include individual and community level psychosocial factors.
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Affiliation(s)
- Caitriona Cahir
- Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin 2, Ireland.
| | | | | | - Kathleen Bennett
- Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin 2, Ireland.
| | - Linda Sharp
- Institute of Health and Society, Newcastle University, Newcastle NE1 7RU, UK.
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Quality of life in patients with recurrent breast cancer after second breast-conserving therapy in comparison with mastectomy: the German experience. Breast Cancer Res Treat 2017; 163:517-526. [PMID: 28324266 DOI: 10.1007/s10549-017-4208-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 03/15/2017] [Indexed: 12/24/2022]
Abstract
BACKGROUND Although some studies suggest that breast-conserving therapy (BCT) shows better psychosocial outcomes than mastectomy in patients with primary breast cancer, little is known about the outcomes of these surgical options in recurrent breast cancer. We investigated differences in overall survival and re-recurrence rates as well as psychosocial outcomes among patients who underwent BCT or mastectomy after the diagnosis of recurrent breast cancer in a single-center setting. METHODS 124 of 186 eligible patients who underwent surgical treatment for breast cancer recurrence completed the questionnaires on quality of life (EORTC QLQ-C30 and -BR23), fear of progression (PA-F-KF), anxiety and depression (HADS), and body image (BIS). RESULTS Women after breast-conserving surgery (n = 46) showed significantly better outcomes than women after mastectomy (n = 61) with respect to body image (P < 0.001 in BIS and p < 0.001 in BR23), social functioning (p = 0.016), emotional functioning (p = 0.028), and role functioning (p = 0.043). There were no significant group differences regarding anxiety, depression, and fear of progression as well as re-recurrence and survival rates. Predictors of good quality of life were partnership (OR 2.46), higher monthly family income (OR 3.54), and higher professional qualification (OR 4.3) in our group of patients. DISCUSSION Our results indicate that patients treated with breast-conserving therapy after recurrent breast cancer perceive lower impairments in body image and several aspects of quality of life than patients treated with mastectomy.
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Bener A, Alsulaiman R, Doodson L, El Ayoubi HR. An assessment of reliability and validity of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 among breast cancer patients in Qatar. J Family Med Prim Care 2017; 6:824-831. [PMID: 29564271 PMCID: PMC5848406 DOI: 10.4103/jfmpc.jfmpc_17_17] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Introduction Breast cancer has been the most common cancer type that affects women worldwide and subsequent treatment is often associated with considerable psychological and quality of life (QoL). Aim This study aimed to assess psychometric properties of the Arabic version of the European Organization for Research and Treatment of Cancer (EORTC) general QoL questionnaire (QLQ-C30) for breast cancer patients in Qatar. Materials and Methods This is a cross-sectional hospital-based study conducted on 678 breast cancer patients using Arabic version of the EORTC QLQ-C30 tool. Results The mean age of women was 47.7 ± 10.2 years and 33.4% of women had consanguineous parents. Six subscales out of the nine met the standards of reliability with coefficients ranging from 0.55 to 0.89. The mean score of all functioning scales was high >55. Advanced breast cancer stages of III-IV had higher symptomatic scores significantly than those in early stages for the physical function, cognitive, fatigue, insomnia, appetite loss, constipation, and financial difficulties. Correlation coefficients between each item ranged from -0.113 to 0.960, and item 21 (tense) and item 23 (irritable) had strongest negative correlations with their corresponding emotional functioning subscale, whereas items 29 (physical condition) and 30 (overall QoL) had the strongest positive correlation with Global Health/QoL subscale. Item 6 (limited work) showed a higher correlation with fatigue (r = 0.749). Likewise, item 19 (pain interfered with daily activities) of the pain subscale had higher correlations with physical functioning, role functioning, and fatigue subscales. Conclusion Qatari Arabic version of the EORTC QLQ-C30 showed acceptable psychometric properties, which is a reliable and valid instrument, that can be used by oncologists.
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Affiliation(s)
- Abdulbari Bener
- Department of Biostatistics and Medical Informatics, Cerrahpaşa Faculty of Medicine, Istanbul University, İstanbul, Turkey, Turkey.,Department of Evidence for Population Health Unit, School of Epidemiology and Health Sciences, University of Manchester, Manchester, UK.,Department of Public Health, Istanbul Medipol University, International School of Medicine, Dept. Public Health, İstanbul, Turkey, Turkey
| | - Reem Alsulaiman
- Department of Oncology and Hematology, Al Amal Hospital, Hamad Medical Corporation, Qatar, France.,Regent's University London, Scool of Psychoterapy and Psychology, Inner Circle, Regent's Park, London NW1 4NS, UK
| | - Lisa Doodson
- Regent's University London, Scool of Psychoterapy and Psychology, Inner Circle, Regent's Park, London NW1 4NS, UK
| | - Hanadi R El Ayoubi
- Department of Public Health, Istanbul Medipol University, International School of Medicine, Dept. Public Health, İstanbul, Turkey, Turkey.,Department of Clinical Hematologist and A Stem Cell Transplantation, Hospital Saint Louis, Paris, France
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Impact of Cognitive and Psychological Symptoms on Work Productivity and Quality of Life among Breast Cancer Survivors in Hong Kong. Hong Kong J Occup Ther 2016; 28:15-23. [PMID: 30186063 PMCID: PMC6091987 DOI: 10.1016/j.hkjot.2016.11.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2016] [Revised: 11/18/2016] [Accepted: 11/19/2016] [Indexed: 12/21/2022] Open
Abstract
Objective/Background Employed breast cancer survivors (BCS) may experience residual symptoms that
can impact their work productivity and quality of life (QoL), but it is
unclear whether such associations exist among BCS in Hong Kong. Therefore,
this study was designed to explore the symptom burden (cognitive limitation
and psychological distress) of employed BCS in HK, and to investigate
whether such factors are related to work productivity and QoL. Methods A cross-sectional study including employed BCS (n = 30), women with
musculoskeletal conditions (n = 30), and healthy women (n = 30) was
conducted. Participants completed a questionnaire covering their
sociodemographics, the Hospital Anxiety and Depression Scale, Cognitive
Symptom Checklist, Work Limitation Questionnaire, and European Organization
for Research and Treatment of Cancer Quality of Life Questionnaire C30. Results The self-perceived cognitive limitations at work of BCS were significantly
higher than that of the healthy control group (5.33 vs. 2.60; p < .05).
The cognitive limitations in BCS were significantly associated with their
QoL (β = —0.320; p = .032). A negative relationship between depression and
QoL in BCS was also observed in this study. Conclusion This exploratory study provides local evidence that BCS experience greater
work-task related cognitive limitations and that is related to QoL. Similar
to findings in other countries, this provides insight for the consideration
of early identification of cognitive problems in this particular patient
group. Further studies may be needed to further substantiate such findings
and to examine the effectiveness of potential cognitive interventions.
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El Fakir S, El Rhazi K, Zidouh A, Bennani M, Benider A, Errihani H, Mellass N, Bekkali R, Nejjari N. Health-Related Quality of Life among Breast Cancer Patients and Influencing Factors in Morocco. Asian Pac J Cancer Prev 2016; 17:5063-5069. [PMID: 28122435 PMCID: PMC5454637 DOI: 10.22034/apjcp.2016.17.12.5063] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background: Breast cancer is the most common cancer among women in most countries of the world. It is ranked first in females in Morocco (accounting for 33.4% of the total cancer burden) and more than 60% of cases are diagnosed at stage III or IV. During the last decade, health-related quality of life (HRQOL) has become an important aspect of breast cancer treatment. The objective of this study was to describe self-reported HRQOL in patients with breast cancer and to investigate its associations with sociodemographic and clinical variables. Methods: A prospective study was carried out in the main oncology centers in Morocco. Quality of life was measured using the Moroccan Arabic versions of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C 30 (EORTC QLQ C30) and the Breast Cancer-Specific Quality of Life Questionnaire (EORTC QLQ-BR23). Statistical analyses were performed using descriptive statistics and multivariate analyses. Results: A total of 1463 subjects were included in the study, with a mean age of 55.6 (SD. 11.2) years, 70% being married. The majority had stage II (45.9%) and a few cases stage IV (12.9%) lesions. The participants’ global health mean score was 68.5 and in “functional scales”, social functioning scored the highest (Mean 86.2 (SD=22.7)). The most distressing symptom on the symptom scale was financial difficulties (Mean 63.2 (SD=38.2)). Using the disease specific tool, it was found that future perspective scored the lowest (Mean 40.5 (SD=37.3)). On the symptom scale, arm symptoms scored the highest (Mean 23.6 (SD=21.6)). Significant mean differences were noted for many functional and symptom scales. Conclusion: Our results emphasized that the general HRQOL for our study population is lower than for corresponding populations in other countries. This study provided baseline information on the quality of life for a large sample of Moroccan women diagnosed with breast cancer.
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Affiliation(s)
- Samira El Fakir
- Department of epidemiology and public health, Faculty of Medicine, University Sidi Mohammed Ben Abdellah, Fez, Morocco.
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Peters E, Mendoza Schulz L, Reuss-Borst M. Quality of life after cancer-How the extent of impairment is influenced by patient characteristics. BMC Cancer 2016; 16:787. [PMID: 27724890 PMCID: PMC5057271 DOI: 10.1186/s12885-016-2822-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Accepted: 09/29/2016] [Indexed: 11/10/2022] Open
Abstract
Background Although this effect is well known, tailored treatment methods have not yet been broadly adopted. The aim of this study was to identify those patient characteristics that most influence the impairment of quality of life and thus to identify those patients who need and can benefit most from specific intervention treatment. Methods 1879 cancer patients were given the EORTC QLQ C-30 questionnaire at the beginning and end of their inpatient rehabilitation. Patients’ scores were compared to those of 2081 healthy adults (Schwarz and Hinz, Eur J Cancer 37:1345–1351, 2001). Furthermore, differences in quality of life corresponding to sex, age, tumor site, TNM stage, interval between diagnosis and rehabilitation, and therapy method were examined. Results Compared to the healthy population, the study group showed a decreased quality of life in all analyzed domains. This difference diminished with increasing age. Women reported a lower quality of life then men in general. Patients with prostate cancer showed the least impairment in several domains. Patients having undergone chemotherapy as well as radiotherapy were impaired the most. Surprisingly, TNM stage and interval between diagnosis and rehabilitation did not significantly influence quality of life. Global quality of life and all functional domains significantly improved after a 3-week rehabilitation program. Conclusions Despite an individualized and increasingly better tolerable therapy, the quality of life of cancer patients is still considerably impaired. However, systematic screening of psychosocial aspects of cancer, e.g. quality of life, could enable improved intervention.
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Affiliation(s)
- Elisabeth Peters
- Clinic for Oncology and Rheumatology, Kurhausstr. 9, 97688, Bad Kissingen, Germany
| | - Laura Mendoza Schulz
- Clinic for Psychiatry und Psychotherapy, University of Goettingen, von-Siebold-Straße 5, 37075, Goettingen, Germany
| | - Monika Reuss-Borst
- Clinic for Oncology and Rheumatology, Kurhausstr. 9, 97688, Bad Kissingen, Germany. .,Center for Rehabilitation and Prevention Medicine, Frankenstr. 36, 97708, Bad Bocklet, Germany.
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An evaluation study of the determinants of future perspective and global Quality of Life in Spanish long-term premenopausal early-stage breast cancer survivors. Contemp Oncol (Pozn) 2016; 20:165-70. [PMID: 27358597 PMCID: PMC4925738 DOI: 10.5114/wo.2016.60073] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2015] [Accepted: 03/23/2016] [Indexed: 01/15/2023] Open
Abstract
Aim of the study Quality of life (QL) is important in premenopausal long-term breast cancer survivors. In this study we assessed QL and factors associated with future perspective and global QL in premenopausal early-stage long-term breast cancer survivors from Spain. Material and methods 243 premenopausal stage I-IIIA relapse-free breast cancer patients who had received surgery 5–20 years previously completed EORTC QLQ-C30 and QLQ-BR23 questionnaires once during follow-up. Univariate and multivariate logistic regression analyses were performed. Results QL mean scores were high in most areas (> 80 in functioning; < 20 in symptoms). The main factors for future perspective were emotional and social functioning, fatigue, breast symptom, and body image. The main factors for global QL were fatigue, pain and physical functioning, and emotional and social functioning. The best logistic model to explain future perspective associated high emotional and social functioning and low breast symptoms with a lower risk of low future perspective (R2 = 0.56). Higher scores in physical and emotional functioning and lower scores in fatigue were associated with a lower risk of low global QL (R2 = 0.50). Conclusions Psychological, social, and physical factors were found to be possible determinants of global QL and future perspective. QL in premenopausal early-stage long-term breast cancer survivors may benefit from multidisciplinary treatment.
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Almutairi KM, Mansour EA, Vinluan JM. A cross-sectional assessment of quality of life of breast cancer patients in Saudi Arabia. Public Health 2016; 136:117-25. [PMID: 27085319 DOI: 10.1016/j.puhe.2016.03.008] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Revised: 11/12/2015] [Accepted: 03/07/2016] [Indexed: 12/18/2022]
Abstract
OBJECTIVE This aim of this study was to assess the quality of life of Saudi female breast cancer patients and determine the effects of the sociodemographic and clinical characteristics on the quality of life of those patients. STUDY DESIGN This study was designed as a cross-sectional study. METHODS The data were collected from 145 female cancer patients who were recruited from outpatient units in different clinical settings in Riyadh, Saudi Arabia, from September 2014 to February 2015. Questionnaires were distributed to the patients during their visits to the outpatient clinics after obtaining informed consent. Quality of life was assessed using a validated Arabic version of the European Organisation for Research and Treatment of Cancer (EORTC) quality of life. RESULTS Among functional scales, emotional functioning scored the highest (83.25 [95% CI 79.53-86.98]). The most distressing symptom on the symptom scale was insomnia (mean 84.14 [95% CI 79.95-88.32]), followed by appetite loss (mean 80.92 [95% CI 76.51-85.33]) and dyspnoea (mean 80.00 [95% CI 75.51-84.49]). Poor functioning was found in sexual enjoyment (mean 22.52 [95% CI 17.97-27.08]) while future perspective scored the highest (mean 76.32 [95% CI 70.52-82.12]). CONCLUSION This study shows breast cancer survivors in Saudi had a low overall global quality of life. Saudi women showed average scores on all the functional scales but the emotional ones scored the highest. Insomnia, appetite loss, and dyspnoea were the distressing symptoms on symptom scales while future perspective domain scored the highest in item of QLQ-BR23.
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Affiliation(s)
- K M Almutairi
- Department of Community Health Science, College of Applied Medical Sciences, King Saud University, Saudi Arabia.
| | - E A Mansour
- Medical Surgical Nursing, College of Nursing, King Saud University, Riyadh, Saudi Arabia.
| | - J M Vinluan
- Department of Community Health Science, College of Applied Medical Sciences, King Saud University, Saudi Arabia.
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Hinz A, Mehnert A, Dégi C, Reissmann D, Schotte D, Schulte T. The relationship between global and specific components of quality of life, assessed with the EORTC QLQ-C30 in a sample of 2019 cancer patients. Eur J Cancer Care (Engl) 2015; 26. [DOI: 10.1111/ecc.12416] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2015] [Indexed: 11/29/2022]
Affiliation(s)
- A. Hinz
- Department of Medical Psychology and Medical Sociology; University of Leipzig; Leipzig Germany
| | - A. Mehnert
- Section of Psychooncology; Department of Medical Psychology and Medical Sociology; University of Leipzig; Leipzig Germany
| | - C. Dégi
- Faculty of Sociology and Social Work; Babes-Bolyai University; Cluj-Napoca Romania
| | - D.R. Reissmann
- Department of Prosthetic Dentistry; University Medical Center Hamburg-Eppendorf; Hamburg Germany
| | - D. Schotte
- Department of Anesthesiology and Intensive Care Medicine; University of Leipzig; Leipzig Germany
| | - T. Schulte
- Rehabilitation Clinic Bad Oexen; Bad Oeynhausen Germany
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Shuleta-Qehaja S, Sterjev Z, Shuturkova L. Evaluation of reliability and validity of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30, Albanian version) among breast cancer patients from Kosovo. Patient Prefer Adherence 2015; 9:459-65. [PMID: 25834410 PMCID: PMC4372011 DOI: 10.2147/ppa.s78334] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PATIENTS AND METHODS A sample of breast cancer patients (n=62 women) were interviewed for the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) in Albanian. Reliability of the questionnaire was considered acceptable if Cronbach's alpha was ≥0.70. Item convergent-discriminant validity was tested through multitrait scaling analysis. Construct validity was tested under the hypotheses that QLQ-C30 interscale correlations would have an acceptable value of ≥0.40 and as well as by known group comparisons assessing differences of patient subgroups with reference to disease stage and education level. RESULTS The mean age of the patients was 50 years (standard deviation: 10.9 years). Cronbach's alpha ranged from 0.54 for the cognitive functioning scale to 0.96 for the global health quality of life (GH/QoL) scale. In multitrait scaling analysis, the strength of Spearman's correlations between an item and its own subscale was ≥0.40, with the exception of item 5 (ρ=0.22); results for item discriminant validity were satisfactory, with the exception of item 5, which showed higher correlation with other subscales than with its own physical functioning. The Spearman's interscale coefficients generally were correlated with each other. Results of known group comparisons did not show significant differences in terms of disease stage. Regarding education level, patients with high school/university education had better functional scales scores only in certain subscales compared to other subgroups; furthermore, patients with secondary school education had better GH/QoL compared to other subgroups of patients. CONCLUSION The EORTC QLQ-C30 (v3.0) in Albanian was found to be valid and reliable for women with breast cancer and could be considered as a starting point for further evaluation study.
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Affiliation(s)
- Selvete Shuleta-Qehaja
- Kosovo Medicines Agency, Rrethi i spitalit (QKUK), Pristina, Kosovo, Macedonia
- Correspondence: Selvete Shuleta-Qehaja, Kosovo Medicines Agency, Rrethi i spitalit (QKUK), Pristina, Kosovo, Tel +377 44 120 902, Fax +381 38 512 243, Email
| | - Zoran Sterjev
- University ‘Ss Cyril and Methodius’, Faculty of Pharmacy, Skopje, Macedonia
| | - Ljubica Shuturkova
- University ‘Ss Cyril and Methodius’, Faculty of Pharmacy, Skopje, Macedonia
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Nowicki A, Licznerska B, Rhone P. Evaluation of the quality of life of women treated due to breast cancer using amputation or breast conserving surgery in the early postoperative period. POLISH JOURNAL OF SURGERY 2015; 87:174-80. [DOI: 10.1515/pjs-2015-0040] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Indexed: 11/15/2022]
Abstract
AbstractSelection of the treatment method in breast cancer patients and its consequences may affect their quality of life through somatic, psychical, and social factors.The aim of the study was early evaluation of the quality of life of women after mastectomy vs. breast conserving surgery.Material and methods. The study included 100 women aged 31 to 79 years (mean: 57) who underwent surgery due to breast cancer (amputation: 52; breast conserving surgery: 48 women) at the Cancer Centre in Bydgoszcz in 2014. The QLQ C-30 and QLQ BR-23 questionnaires were used to evaluate the quality of life of the patients 3 months after surgery.Results. In the Global Health Status/QoL domain, the mean score for women after amputation and breast conserving surgery was 49 and 53, respectively; for Physical Functioning, the scores were 70 and 75, and for Role Functioning, 62 and 68, respectively. For Cognitive Functioning, the mean score was 74 and 73; for Emotional Functioning - 62 and 68, and for Social Functioning 64 and 60, respectively. The difference in the arm symptoms domain was significant at 46 and 33 points, respectively (p = 0.004). The patients treated with breast conserving surgery had a better body image than women after amputation - the mean score was 52 and 66, respectively (p = 0.01).Conclusions. With respect to Global Health Status/QoL and Physical Functioning, the quality of life of women in the early postoperative period was similar in women after breast amputation and those who underwent breast conserving surgery. Patients treated with breast conserving surgery had a better score for body image, while those who underwent amputation more often suffered from arm symptoms, such as pain, oedema, and problems with raising of the limb.
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Akça M, Ata A, Nayır E, Erdoğdu S, Arıcan A. Impact of Surgery Type on Quality of Life in Breast Cancer Patients. THE JOURNAL OF BREAST HEALTH 2014; 10:222-228. [PMID: 28331675 PMCID: PMC5351519 DOI: 10.5152/tjbh.2014.1919] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Accepted: 07/13/2014] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Breast cancer can lead to alterations in quality of life of the patients. The aim of this study is to evaluate the changes in quality of life of the female patients who had undergone surgical treatment for breast cancer. MATERIALS AND METHODS A total of 250 female patients (breast-preserving surgery (BPS), n=27, 11%; modified radical mastectomy (MRM), n=194, 77%, and simple mastectomy (SM), n=29; 11%) aged between 28-55 years (47.4±6.4 yrs) were included in the study. Patient information, demographic characteristics, income, and treatment modalities applied were recorded. Validated Turkish versions of EORTC QLQ-C30, and EORTC-BR23 questionnaires were used for all patients. RESULTS Breast-preserving surgery has a more favorable impact on general well-being, physical role, cognitive, psychological, and social functions, and symptom scale scores. When the identical parameters were taken into consideration, relatively favorable outcomes of BPS on the patients were observed relative to mastectomized patients. Besides, though not statistically significant, BPS has more patient-friendly effects on sexual function and sexual satisfaction in comparison with mastectomy. Patients with advanced stage disease and elder patients had more unfavorable health related quality of life (HRQoL) scores than younger patients, and those in their early stages of breast cancer. CONCLUSION Quality of life of BPS patients is less adversely affected relative to mastectomized patients. In the decision-making process, quality of life should be taken into consideration.
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Affiliation(s)
- Mustafa Akça
- Department of Internal Medicine, Mersin University, Faculty of Medicine, Mersin, Turkey
| | - Alper Ata
- Clinic of Medical Oncology, Mersin State Hospital, Mersin, Turkey
| | - Erdinç Nayır
- Department of Medical Oncology, Mersin University, Faculty of Medicine, Mersin, Turkey
| | - Süleyman Erdoğdu
- Department of Medical Oncology, Mersin University, Faculty of Medicine, Mersin, Turkey
| | - Ali Arıcan
- Department of Medical Oncology, Mersin University, Faculty of Medicine, Mersin, Turkey
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Abu-Helalah M, Al-Hanaqta M, Alshraideh H, Abdulbaqi N, Hijazeen J. Quality of Life and Psychological Well-Being of Breast Cancer Survivors in Jordan. Asian Pac J Cancer Prev 2014; 15:5927-36. [DOI: 10.7314/apjcp.2014.15.14.5927] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Fuhrmann K, Mehnert A, Geue K, Hinz A. Fatigue in breast cancer patients: psychometric evaluation of the fatigue questionnaire EORTC QLQ-FA13. Breast Cancer 2014; 22:608-14. [DOI: 10.1007/s12282-014-0527-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Accepted: 02/26/2014] [Indexed: 11/12/2022]
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Ivanauskienė R, Padaiga Ž, Šimoliūnienė R, Smailytė G, Domeikienė A. Well-being of newly diagnosed women with breast cancer: which factors matter more? Support Care Cancer 2013; 22:519-26. [DOI: 10.1007/s00520-013-2005-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Accepted: 10/01/2013] [Indexed: 10/26/2022]
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Sautier L, Mehnert A, Höcker A, Schilling G. Participation in patient support groups among cancer survivors: do psychosocial and medical factors have an impact? Eur J Cancer Care (Engl) 2013; 23:140-8. [DOI: 10.1111/ecc.12122] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2013] [Indexed: 11/29/2022]
Affiliation(s)
- L. Sautier
- Department and Outpatient Clinic of Medical Psychology; University Medical Center Hamburg-Eppendorf; Hamburg Germany
| | - A. Mehnert
- Department and Outpatient Clinic of Medical Psychology; University Medical Center Hamburg-Eppendorf; Hamburg Germany
- Division of Psychosocial Oncology; Department of Medical Psychology and Medical Sociology; University Medical Center Leipzig; Leipzig Germany
| | - A. Höcker
- Center for Interdisciplinary Addiction Research; University of Hamburg; Hamburg Germany
- c/o Department of Psychiatry and Psychotherapy; University Medical Center Hamburg-Eppendorf; Hamburg Germany
| | - G. Schilling
- Department of Hematology and Oncology, University Cancer Center Hamburg; University Medical Center Hamburg-Eppendorf; Hamburg Germany
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Koch L, Jansen L, Herrmann A, Stegmaier C, Holleczek B, Singer S, Brenner H, Arndt V. Quality of life in long-term breast cancer survivors - a 10-year longitudinal population-based study. Acta Oncol 2013; 52:1119-28. [PMID: 23514583 DOI: 10.3109/0284186x.2013.774461] [Citation(s) in RCA: 128] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Breast cancer survivors may experience adverse effects of cancer and/or treatment years after completion of therapy, which can considerably decrease quality of life (QoL). Little is known about the time course of QoL in breast cancer survivors beyond the fifth year post-diagnosis, when routine follow-up care has usually terminated. We therefore explored in detail whether and to what extent restrictions in breast cancer survivors persist and whether changes or aggravations in QoL occurred over time. MATERIAL AND METHODS QoL was assessed 1, 3, 5, and 10 years post-diagnosis in a population-based cohort of initially 387 female breast cancer patients from Saarland (Germany), using the EORTC QLQ-C30 and QLQ-BR23. Time course of QoL over 10 years post-diagnosis was assessed for survivors and survivors' QoL was compared cross-sectionally to the German general population after adjustment for age. RESULTS A total of 182 out of 238 patients alive (76.5%) responded in the 10-year, 160 patients (67.2%) participated in all follow-ups. Although breast cancer survivors and controls reported comparable general health and overall QoL, survivors reported significantly more restrictions on most functioning and symptom scales at each follow-up. Detriments in various QoL dimensions (e.g. physical and social functioning; pain, financial difficulties) aggravated from year 5 to 10. Generally, restrictions were largest for the youngest survivors. CONCLUSION Relevant restrictions in QoL persist over years in breast cancer survivors and affect predominantly younger women. The aggravation of restrictions in QoL beyond the fifth year may indicate deficits in health care and psychosocial support of breast cancer patients after completion of routine follow-up care.
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Affiliation(s)
- Lena Koch
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.
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Hutter N, Vogel B, Alexander T, Baumeister H, Helmes A, Bengel J. Are depression and anxiety determinants or indicators of quality of life in breast cancer patients? PSYCHOL HEALTH MED 2013; 18:412-9. [DOI: 10.1080/13548506.2012.736624] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Thong MSY, Mols F, Stein KD, Smith T, Coebergh JWW, van de Poll-Franse LV. Population-based cancer registries for quality-of-life research. Cancer 2013; 119 Suppl 11:2109-23. [PMID: 23695923 DOI: 10.1002/cncr.28056] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2012] [Revised: 01/22/2013] [Accepted: 01/31/2013] [Indexed: 12/22/2022]
Affiliation(s)
- Melissa S. Y. Thong
- Center of Research on Psychology in Somatic Diseases (C o RPS) Tilburg University; Tilburg the Netherlands
- Comprehensive Cancer Center South (CCCS); Eindhoven Cancer Registry; Eindhoven the Netherlands
| | - Floortje Mols
- Center of Research on Psychology in Somatic Diseases (C o RPS) Tilburg University; Tilburg the Netherlands
- Comprehensive Cancer Center South (CCCS); Eindhoven Cancer Registry; Eindhoven the Netherlands
| | - Kevin D. Stein
- Behavioral Research Center; American Cancer Society; Atlanta Georgia
- Rollins School of Public Health; Emory University; Atlanta Georgia
| | - Tenbroeck Smith
- Behavioral Research Center; American Cancer Society; Atlanta Georgia
| | - Jan-Willem W. Coebergh
- Comprehensive Cancer Center South (CCCS); Eindhoven Cancer Registry; Eindhoven the Netherlands
- Department of Public Health; Erasmus University Medical Center; Rotterdam the Netherlands
| | - Lonneke V. van de Poll-Franse
- Center of Research on Psychology in Somatic Diseases (C o RPS) Tilburg University; Tilburg the Netherlands
- Comprehensive Cancer Center South (CCCS); Eindhoven Cancer Registry; Eindhoven the Netherlands
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Jassim GA, Whitford DL. Quality of life of Bahraini women with breast cancer: a cross sectional study. BMC Cancer 2013; 13:212. [PMID: 23622020 PMCID: PMC3644231 DOI: 10.1186/1471-2407-13-212] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2013] [Accepted: 04/23/2013] [Indexed: 01/22/2023] Open
Abstract
Background Breast cancer can impact survivors in many aspects of their life. Scarce information is currently available on the quality of life of cancer survivors in Bahrain. The objective of this study is to describe the quality of life of Bahraini women with breast cancer and its association with their sociodemographic and clinical data. Methods This is a cross sectional study in which the European Organization for Research and Treatment of Cancer Quality of Life Cancer Specific version translated into Arabic was administered to a random sample of 337 Bahraini women with breast cancer. Relevant descriptive statistics were computed for all items. The equality of means across the categories of each categorical independent variable was tested using parametric tests (ANOVA and independent t-test) or non-parametric tests (Kruskal Wallis and Mann Whitney tests) of association where appropriate. Results Of the total sample, 239 consented to participation. The mean and median age of participants were 50.2 (SD ± 11.1) and 48.0 respectively. Participants had a mean score for global health of 63.9 (95% CI 61.21-66.66). Among functional scales, social functioning scored the highest (Mean 77.5 [95% CI 73.65-81.38]) whereas emotional functioning scored the lowest (63.4 [95% CI 59.12-67.71]). The most distressing symptom on the symptom scales was fatigability (Mean 35.2 [95% CI 31.38-39.18]). Using the disease specific tool it was found that sexual functioning scored the lowest (Mean 25.9 [95% CI 70.23-77.90]). On the symptom scale, upset due to hair loss scored the highest (Mean 46.3 [95% CI 37.82-54.84]). Significant mean differences were noted for many functional and symptom scales. Conclusion Bahraini breast cancer survivors reported favorable overall global quality of life. Factors associated with a major reduction in all domains of quality of life included the presence of metastases, having had a mastectomy as opposed to a lumpectomy and a shorter time elapsed since diagnosis. Poorest functioning was noted in the emotional and sexual domains. The most bothersome symptoms were fatigability, upset due to hair loss and arm symptoms. This study identifies the categories of women at risk of poorer quality of life after breast cancer and the issues that most need to be addressed in this Middle East society.
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Affiliation(s)
- Ghufran Ahmed Jassim
- Royal College of Surgeons in Ireland-Medical University of Bahrain, PO Box 15503, Adliya, Bahrain.
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Jafari N, Farajzadegan Z, Zamani A, Bahrami F, Emami H, Loghmani A. Spiritual well-being and quality of life in Iranian women with breast cancer undergoing radiation therapy. Support Care Cancer 2012; 21:1219-25. [PMID: 23138932 DOI: 10.1007/s00520-012-1650-1] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2012] [Accepted: 10/30/2012] [Indexed: 12/12/2022]
Abstract
PURPOSE Psychological distress and morbidity are common consequences of diagnosis and treatment of breast cancer and associated with poor quality of life (QOL). Spiritual well-being is an important aspect of QOL, but little is known about the spiritual well-being and its relationship with QOL in patients of different cultures such as Iranian Muslim patients. The aim of this study was to investigate the association of QOL and spirituality among patients with breast cancer undergoing radiation therapy. METHODS This was a cross-sectional study which was conducted in the Breast Cancer Research Center of St. S. Al-Shohada Hospital, Isfahan, Iran. Spiritual well-being was measured using the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale (FACIT-Sp12). The European Organisation for Research and Treatment of Cancer Quality of Life (EORTC QLQ-C30) and its supplementary breast cancer questionnaire (QLQ-BR23) were used to assess the quality of life of patients. Descriptive analysis, Pearson's correlation, and multiple regression analysis were performed for statistical assessment. RESULTS In all, 68 patients fulfilled the study's inclusion criteria and were interviewed. The mean global QOL was 41.42 (SD = 18.02), and the mean spiritual well-being was 28.41 (SD = 6.95). There was a significant positive correlation between general QOL and total spiritual well-being scores. Also, spiritual well-being, social functioning, pain, and arm symptoms were significant predictors of global QOL. DISCUSSION The results of this study provide evidence that breast cancer survivors in Iran experience a poor quality of life across a broad spectrum of health domains, particularly social, emotional, and spiritual, indicating that psychosocial-spiritual support should be considered in caring for patients with breast cancer.
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Affiliation(s)
- Najmeh Jafari
- Community Medicine Department, School of Medicine, Isfahan University of Medical Sciences, Hezar Jerib St., Isfahan, Iran
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Schleife H, Sachtleben C, Finck Barboza C, Singer S, Hinz A. Anxiety, depression, and quality of life in German ambulatory breast cancer patients. Breast Cancer 2012; 21:208-13. [PMID: 22661104 DOI: 10.1007/s12282-012-0378-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2012] [Accepted: 05/10/2012] [Indexed: 11/29/2022]
Abstract
BACKGROUND The aim of the study was to determine the predictors of health-related quality of life in ambulatory breast cancer patients. METHODS A total of 107 breast cancer outpatients were tested with the Hospital Anxiety and Depression Scale (HADS) and the quality of life instrument EORTC QLQ-C30. Furthermore, the degree of social support and shared decision making (SDM) were assessed. RESULTS In nearly all domains of EORTC QLQ-C30 the patients reported worse mean scores than the general population in a clinically significant range, especially in the symptom scales. Therapy-related factors and the degree of SDM contributed only marginally to quality of life. Social support, however, proved to be predictive of better mental health and better quality of life in many domains. CONCLUSION Irrespective of the therapy, the social network of the patients should be activated to help the patients to cope with the disease. However, the findings do not support the idea that enhanced SDM would have beneficial effects on mental health.
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Jafari N, Zamani A, Farajzadegan Z, Bahrami F, Emami H, Loghmani A. The effect of spiritual therapy for improving the quality of life of women with breast cancer: a randomized controlled trial. PSYCHOL HEALTH MED 2012; 18:56-69. [PMID: 22533516 DOI: 10.1080/13548506.2012.679738] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Diagnosis of breast cancer is a devastating psychological experience for a woman. Also, treatments such as radiation therapy may cause psychosocial distress in these patients and threaten their quality of life (QOL). Among several approaches, spirituality has been shown to be significantly associated with improving the QOL. The aim of this study was to assess the role of spiritual therapy intervention in improving the QOL of patients with breast cancer undergoing radiation therapy. This was a randomized controlled trial study undertaken in a radiotherapy clinic, Isfahan, Iran. Between October 2010 and February 2011, 68 patients under radiation therapy were randomized to either spiritual therapy intervention group or control group who received routine management and educational programs. Before and after six weeks of spiritual therapy sessions, the QOL was evaluated using Cancer quality-of-life questionnaire (QLQ)-C30 and breast cancer-specific questionnaire (BR-23). Multivariate, repeated-measures ANOVA, t-test, and Paired t-test were used for analysis using Predictive Analytic Soft Ware (PASW, version 18) for windows. In all, 65 patients actually completed the six-week intervention and were evaluated for the outcome. The mean Global health status score/QOL reached from 44.37 (SD = 13.03) to 68.63 (SD = 10.86), (p = 0.00). There was a statistically significant difference in all functional scales of QLQ-C30 after intervention (p < 0.05). The results of this trial showed that the spiritual therapy program can improve the overall QOL of women with breast cancer; therefore, it could be adopted in comprehensive care programs for women with breast cancer.
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Affiliation(s)
- Najmeh Jafari
- Community Medicine Department, Isfahan University of Medical Sciences, Isfahan, Iran
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Spore Powder of Ganoderma lucidum Improves Cancer-Related Fatigue in Breast Cancer Patients Undergoing Endocrine Therapy: A Pilot Clinical Trial. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2011; 2012:809614. [PMID: 22203880 PMCID: PMC3236089 DOI: 10.1155/2012/809614] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2011] [Accepted: 09/01/2011] [Indexed: 01/11/2023]
Abstract
The fatigue prevalence in breast cancer survivors is high during the endocrine treatment. However, there are few evidence-based interventions to manage this symptom. The aim of this study was to investigate the effectiveness of spore powder of Ganoderma lucidum for cancer-related fatigue in breast cancer patients undergoing endocrine therapy. Spore powder of Ganoderma lucidum is a kind of Basidiomycete which is a widely used traditional medicine in China. 48 breast cancer patients with cancer-related fatigue undergoing endocrine therapy were randomized into the experimental or control group. FACT-F, HADS, and EORTC QLQ-C30 questionnaires data were collected at baseline and 4 weeks after treatment. The concentrations of TNF-α, IL-6, and liver-kidney functions were measured before and after intervention. The experimental group showed statistically significant improvements in the domains of physical well-being and fatigue subscale after intervention. These patients also reported less anxiety and depression and better quality of life. Immune markers of CRF were significantly lower and no serious adverse effects occurred during the study. This pilot study suggests that spore powder of Ganoderma lucidum may have beneficial effects on cancer-related fatigue and quality of life in breast cancer patients undergoing endocrine therapy without any significant adverse effect.
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