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Finlayson CS, Rosa WE, Mathew S, Applebaum A, Squires A, Fu MR. Awareness of Disease Status Among Patients With Cancer: An Integrative Review. Cancer Nurs 2023; 47:00002820-990000000-00091. [PMID: 36728162 PMCID: PMC10349894 DOI: 10.1097/ncc.0000000000001170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND As the quality of cancer care improves, oncology patients face a rapidly increasing number of treatment options. Thus, it is vital that they are full and active partners in the treatment decision-making process. Awareness of disease status has been investigated in the literature; it has been inconsistently conceptualized and operationalized. OBJECTIVE The aim of this integrative review was to develop a conceptual definition and model of the awareness of disease status among patients with cancer. METHODS Whittemore and Knafl's integrative review methodology guided this article. We obtained data through a systematic search of 8 databases. Key terms utilized were awareness, perception, truth disclosure, diagnosis, prognosis, terminal illness, status, neoplasm, and metastasis. Dates through January 2020 were searched to capture all relevant articles. Sixty-nine articles met inclusion criteria. RESULTS The integrative review methodology guided the development of a conceptual definition and model. The concept of "awareness of disease status" was defined as the individual patient's understanding of being diagnosed and treated for cancer based on the multifactorial components of individual patient characteristics and contextually driven communication practices of healthcare providers. This understanding is dynamic and changes throughout the disease trajectory. CONCLUSION These findings will inform consistency in the literature. Such consistency may improve person-centered clinical communication, care planning practices, and, ultimately, cancer-related outcomes. IMPLICATIONS FOR PRACTICE With a greater understanding of the complexity of patients' awareness of disease status, nurses will be able to guide their patients to make informed decisions throughout their disease trajectory.
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Affiliation(s)
- Catherine S Finlayson
- Author Affiliations: Department of PhD in Nursing, Pace University Lienhard School of Nursing, Pleasantville (Dr Finlayson and Ms Mathew); and Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center (Drs Rosa and Applebaum); New York University Rory Meyers College of Nursing (Dr Squires), New York; and Rutgers, The State University of New Jersey School of Nursing, New Brunswick, New Jersey (Dr Fu)
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Al Qadire M, Al Omari O, Alharrasi M, Al Sabei S, Aljezawi M, Khalaf A. Public information needs and attitudes regarding cancer and cancer patients in Oman: a cross-sectional survey. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2022; 31:S34-S40. [PMID: 35648668 DOI: 10.12968/bjon.2022.31.10.s34] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Exploring public information needs and attitudes towards cancer patients might be the first step in developing an intervention that encourages public engagement in early detection and cancer prevention programmes. AIM To explore Omani public information needs and attitudes towards cancer in Oman. METHODS A cross-sectional survey design was used. FINDINGS Of the 569 participants, 369 (64.9%) were female; the mean age was 30.9 (SD=9.5) years. Of the participants, 94.4% wanted to be informed if they were found to have cancer in the future. The mean total attitudes score was 40.2 (SD=4.7) out of a maximum 48. Further, being employed, preferring to be informed about cancer diagnosis and having positive attitudes towards cancer and cancer patients predicted higher information needs. CONCLUSIONS The current paternalistic approach seems to be no longer appropriate for cancer patients in Oman, and more active patient involvement in decision-making is needed.
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Affiliation(s)
- Mohammad Al Qadire
- Associate Professor, College of Nursing, Sultan Qaboos University, Muscat, Sultanate of Oman, and Professor, Adult Health Department, Faculty of Nursing, Al Al-Bayt University, Jordan
| | - Omar Al Omari
- Associate Professor, College of Nursing, Sultan Qaboos University, Muscat, Sultanate of Oman
| | - Maryam Alharrasi
- Associate Professor, College of Nursing, Sultan Qaboos University, Muscat, Sultanate of Oman
| | - Sulaiman Al Sabei
- Associate Professor, College of Nursing, Sultan Qaboos University, Muscat, Sultanate of Oman
| | - Ma'en Aljezawi
- Associate Professor, Community Health Department, Faculty of Nursing, Al Al-Bayt University, Jordan
| | - Atika Khalaf
- Associate Professor, Faculty of Health Sciences, Kristianstad University, Sweden; and Assistant Professor, College of Nursing, Sultan Qaboos University, Muscat, Sultanate of Oman
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Mon SW, Ozdemir S, Zu WWM, Win H, Maw MM, Win KC, Thant KZ, Teo I, Krishnan A, Goh CR, Finkelstein EA, Malhotra C. End of life experiences of patients with advanced cancer in Myanmar: Results from the APPROACH study. Asia Pac J Clin Oncol 2020; 16:333-339. [PMID: 32573100 DOI: 10.1111/ajco.13373] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Accepted: 05/05/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Access to palliative care services is essential for attaining universal health coverage for patients with a terminal cancer. Despite this, many patients with advanced cancer in low-income countries, such as Myanmar, suffer at the end of life (EOL) due to little or no access to palliative care. However, actual evidence on EOL experiences of cancer patients in Myanmar is lacking. This paper aims to describe various dimensions of EOL experiences among patients with an advanced cancer from the largest public hospital in Myanmar. METHODS We surveyed 195 patients with stage IV cancer seeking care from outpatient oncology clinics to assess their quality of life, pain severity, pain medications taken, quality of communication with doctors, nursing care and health care coordination, and desire to end life sooner. We assessed socioeconomic status (SES) differences in each patient outcome using separate multivariate linear/logistic regressions. RESULTS Forty-one percent of the patients in our sample reported that they wish their life would end sooner. Low SES cancer patients had significantly worse quality of life, reported poor health care coordination and were more likely to report severe pain compared to high SES cancer patients visiting the same hospital. CONCLUSION To improve quality of life and pain management and to reduce EOL distress among patients with advanced cancer, there is a pressing need to develop and invest in hospital and community-level palliative care services in Myanmar.
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Affiliation(s)
- Ssu Wynn Mon
- Clinical Research Division, Department of Medical Research, Yangon, Myanmar
| | - Semra Ozdemir
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Singapore
| | - Wah Wah Myint Zu
- Department of Radiotherapy, Yangon General Hospital, Yangon, Myanmar
| | - Han Win
- Clinical Research Division, Department of Medical Research, Yangon, Myanmar
| | - Myo Myint Maw
- Department of Medical Oncology, Yangon General Hospital, Yangon, Myanmar
| | - Khin Cho Win
- Department of Radiotherapy, Yangon General Hospital, Yangon, Myanmar
| | - Kyaw Zin Thant
- Clinical Research Division, Department of Medical Research, Yangon, Myanmar
| | - Irene Teo
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Singapore
| | - Anirudh Krishnan
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Singapore
| | - Cynthia Ruth Goh
- Department of Palliative Medicine, National Cancer Centre, Singapore, Singapore
| | - Eric A Finkelstein
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Singapore
| | - Chetna Malhotra
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Singapore
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Khazaee-Pool M, Shoghli A, Pashaei T, Ponnet K. Psychometric properties of the Persian version of the Cancer attitude inventory. BMC Public Health 2019; 19:1402. [PMID: 31664966 PMCID: PMC6819595 DOI: 10.1186/s12889-019-7756-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 10/03/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Cancer Attitude inventory (CAI) was developed to measure attitudes toward cancer. The aim of the present study was to describe the development of the Persian version of the CAI and to evaluate its psychometric properties in an Iranian sample. METHODS The forward-backward method was used to translate the CAI scale from English into Persian. After linguistic validation and a pilot check, a cross-sectional study was performed and psychometric properties of the Iranian version of the questionnaire were assessed. The scale validation was conducted with a convenience sample of 820 laypeople. Construct validity was assessed through both exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Internal consistency was assessed through Cronbach's alpha analysis and test-retest analysis. RESULTS Five factors were identified in CAI: isolation, helplessness, fear of consequence, belief of control and independence, and fear of death. The results achieved from the CFA displayed that the data fit the model: the relative chi-square (× 2/df) = 2.98 (p < .001), and the root mean square error of approximation (RMSEA) = .07 (90% CI = .06-.07). All comparative indices of the model had scores greater than .80, demonstrating a good fit to the data. Cronbach's Alpha and the intra-class correlation coefficient (ICC) were .97, which is well above the acceptable threshold. CONCLUSIONS The results indicate that the Persian version of the CAI is practical, reliable and valid. Consequently, the instrument could be used in plans to create positive attitudes about cancer control and treatment among Persian people.
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Affiliation(s)
- Maryam Khazaee-Pool
- Department of Public Health, School of Health, Mazandaran University of Medical Sciences, Sari, Iran.,Health Sciences Research Center, Addiction Research Institutes, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Health Education and Promotion, School of Health, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Alireza Shoghli
- Social Medicine Department, School of Medicine, Social Determinants of Health Research Center, Zanjan University of Medical Sciences, Zanjan, Iran.
| | - Tahereh Pashaei
- Environmental Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.,Department of Public Health, Faculty of Health, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Koen Ponnet
- Department of Communication Sciences, imec-mict-Ghent University, Ghent, Belgium
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Hoang JM, Upadhyay N, Dike DN, Lee J, Johnson ML, Cleeland CS, Mendoza T, Chen H, Trivedi MV. Patient-reported outcomes in light of supportive medications in treatment-naïve lung cancer patients. Support Care Cancer 2019; 28:1809-1816. [PMID: 31338641 DOI: 10.1007/s00520-019-05004-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 07/17/2019] [Indexed: 11/27/2022]
Abstract
PURPOSE The impact of supportive medications on patient-reported outcomes (PROs) has not been systematically evaluated. We describe the supportive medications used by treatment-naïve lung cancer patients and assess their association with PROs from MD Anderson Symptom Inventory (MDASI). METHODS Treatment-naïve lung cancer patients who completed PROs from MDASI at the initial visit to MD Anderson Cancer Center were included. Medications from the initial visit were abstracted from the electronic medical records system and categorized into therapeutic classes based on U.S. Pharmacopeia v7.0. A chi-square or Mann-Whitney U test was conducted as appropriate. RESULTS Among 459 patients, ~ 50% took any analgesics and 25% were on opioids. One-third of patients with moderate-severe pain were not on any analgesics. Patients taking opioids had significantly worse median pain scores (6 vs. 0) compared with those not taking any analgesics (p < 0.0001). Higher proportion of patients with moderate-severe pain took opioids compared with those with mild pain (52% vs. 16%, p < 0.0001). Patients on opioids also reported significantly worse scores for five other cancer-specific core symptoms and all six symptoms rating interference with daily life. Only 15% of patients with higher composite score for depression-related symptoms were on antidepressants. However, patients taking antidepressants did not significantly differ in any individual MDASI symptom scores compared with those not on antidepressants (p = 0.4858). CONCLUSIONS Our results suggest a need for better screening for pain and depression and optimization of pain management in treatment-naïve lung cancer patients since their poor functional status may result in suboptimal cancer therapy.
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Affiliation(s)
- Johnny M Hoang
- Department of Pharmacy Practice and Translational Research, University of Houston College of Pharmacy, Health Building-2, 4849 Calhoun Rd., Houston, TX, 77204, USA
| | - Navneet Upadhyay
- Department of Pharmaceutical Health Outcomes and Policy, University of Houston College of Pharmacy, Health Building-2, 4849 Calhoun Rd., Houston, TX, 77204, USA
| | - Dozie N Dike
- Department of Pharmacy Practice and Translational Research, University of Houston College of Pharmacy, Health Building-2, 4849 Calhoun Rd., Houston, TX, 77204, USA
| | - Jaekyu Lee
- Department of Pharmacy Practice and Translational Research, University of Houston College of Pharmacy, Health Building-2, 4849 Calhoun Rd., Houston, TX, 77204, USA
| | - Michael L Johnson
- Department of Pharmaceutical Health Outcomes and Policy, University of Houston College of Pharmacy, Health Building-2, 4849 Calhoun Rd., Houston, TX, 77204, USA
| | - Charles S Cleeland
- Department of Symptom Research, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX, 77030, USA
| | - Tito Mendoza
- Department of Symptom Research, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX, 77030, USA
| | - Hua Chen
- Department of Pharmaceutical Health Outcomes and Policy, University of Houston College of Pharmacy, Health Building-2, 4849 Calhoun Rd., Houston, TX, 77204, USA
| | - Meghana V Trivedi
- Department of Pharmacy Practice and Translational Research, University of Houston College of Pharmacy, Health Building-2, 4849 Calhoun Rd., Houston, TX, 77204, USA.
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Peerawong T, Phenwan T, Mahattanobon S, Tulathamkij K, Pattanasattayavong U. Body image transformation after breast cancer diagnosis and treatment in southern Thai women. SAGE Open Med 2019; 7:2050312119829985. [PMID: 30800300 PMCID: PMC6378460 DOI: 10.1177/2050312119829985] [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: 10/09/2018] [Accepted: 01/14/2019] [Indexed: 11/23/2022] Open
Abstract
Objective: To understand the transition of changed body image after the diagnosis and surgery in women with breast cancer. Methods: Semi-structured interview and focus group with narrative approach. Thematic analysis was performed using methodological and investigator triangulation methods. Results: Participants’ body image transformation was categorized into three phases: (1) the moment of diagnosis and changed self, (2) transition and recovery, and (3) normalization. Conclusion: The truth-telling process of breast cancer diagnosis and the freedom to choose their treatment options have a profound impact on body image transformation of women with breast cancer. Family support, social construction, and social support could help women with breast cancer pass through these transitional process faster, while inappropriate truth-telling by their surgeons and not having any choice in their treatment options will delay the transitional process.
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Affiliation(s)
- Thanarpan Peerawong
- Department of Radiology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Tharin Phenwan
- School of Medicine, Walailak University, Nakhon Si Thammarat, Thailand.,School of Nursing and Health Science, University of Dundee, Dundee, UK
| | - Somrit Mahattanobon
- Department of Surgery, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Kandawsri Tulathamkij
- Department of Radiology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.,School of Medicine, Walailak University, Nakhon Si Thammarat, Thailand.,School of Nursing and Health Science, University of Dundee, Dundee, UK.,Department of Surgery, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.,Health Promotion Unit, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
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Finlayson CS, Fu MR, Squires A, Applebaum A, Van Cleave J, O'Cearbhaill R, DeRosa AP. The Experience of Being Aware of Disease Status in Women with Recurrent Ovarian Cancer: A Phenomenological Study. J Palliat Med 2018; 22:377-384. [PMID: 30407108 DOI: 10.1089/jpm.2018.0127] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Awareness of disease status has been identified as a factor in the treatment decision-making process. Women with recurrent ovarian cancer are facing the challenge of making treatment decisions throughout the disease trajectory. It is not understood how women with ovarian cancer perceive their disease and subsequently make treatment decisions. PURPOSE The purpose of this phenomenological study was to understand the lived experience of women with recurrent ovarian cancer, how they understood their disease and made their treatment decisions. METHODS A qualitative design with a descriptive phenomenological method was used to conduct 2 in-depth interviews with 12 women (n = 24 interviews). Each interview was ∼60 minutes and was digitally recorded and professionally transcribed. Data collection focused on patients' understanding of their disease and how patients participated in treatment decisions. A modified version of Colaizzi's method of phenomenological reduction guided data analysis. RESULTS Three themes emerged to describe the phenomenon of being aware of disease status: (1) perceiving recurrent ovarian cancer as a chronic illness, (2) perceived inability to make treatment decisions, and (3) enduring emotional distress. CONCLUSIONS AND IMPLICATIONS This study revealed how 12 women conceptualized recurrent ovarian cancer as a chronic disease and their perceived inability to make treatment decisions because of lack of information and professional qualifications, resulting in enduring emotional distress. Future research should replicate the study to confirm the persistence of the themes for racially, ethnically, and religiously diverse patient samples and to improve understanding of awareness of disease status and decision-making processes of patients.
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Affiliation(s)
| | - Mei R Fu
- 1 New York University Rory Meyers College of Nursing , New York, New York
| | - Allison Squires
- 1 New York University Rory Meyers College of Nursing , New York, New York
| | | | - Janet Van Cleave
- 1 New York University Rory Meyers College of Nursing , New York, New York
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Aggarwal AN, Singh N, Gupta D, Behera D. Does awareness of diagnosis influence health related quality of life in north Indian patients with lung cancer ? Indian J Med Res 2017; 143:S38-S44. [PMID: 27748276 PMCID: PMC5080927 DOI: 10.4103/0971-5916.191757] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background & objectives: Several patients with cancer in India are not aware of their diagnosis. We evaluated the impact of awareness of cancer diagnosis on health-related quality of life (HRQL) in newly diagnosed patients with lung cancer. Methods: A total of 391 treatment-naïve patients with lung cancer, seen at the Lung Cancer Clinic of a tertiary care hospital in north India, were categorized into those aware of their diagnosis (group A) and those not aware (group B). All patients answered Hindi versions of abbreviated World Health Organization Quality of Life questionnaire (WHOQOL-Bref) and European Organization for Research and Treatment of Cancer Quality of Life questionnaire (EORTC QLQ-C30), and its lung cancer module, EORTC QLQ-LC13. Various domain scores were computed and compared between the two groups. Analysis of covariance was used to determine significance of differences after adjustment for potential confounding factors. Results: Only 117 (29.9%) patients were aware of their diagnosis. Of all, 302 (77.2%) patients had non-small cell lung cancer, and 301 (77.0%) had advanced disease. All HRQL domain scores were similar between the two groups, except that group B patients had significantly poorer median (interquartile range) Physical [39.3 (28.6-50.0) vs 46.4 (28.6-57.1)] and Environment [46.9 (40.6-56.3) vs 53.1 (0.6-65.6)] domain scores of WHOQOL-Bref, and Physical function [60.0 (40.0-73.3) vs 66.7 (46.7-80.0)] and Fatigue [66.7 (55.6-77.8) vs 66.7 (44.4-66.7)] scores of QLQ-C30. After adjusting for gender, age, education, family income, and tumour extent, these differences were not significant. Interpretation & conclusions: Disclosure of cancer diagnosis, or lack of it, had no significant impact on HRQL in patients with lung cancer after adjustment of potential confounders.
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Affiliation(s)
- Ashutosh Nath Aggarwal
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Navneet Singh
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Dheeraj Gupta
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Digambar Behera
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education & Research, Chandigarh, India
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Moseholm E, Rydahl-Hansen S, Lindhardt BØ, Fetters MD. Health-related quality of life in patients with serious non-specific symptoms undergoing evaluation for possible cancer and their experience during the process: a mixed methods study. Qual Life Res 2016; 26:993-1006. [PMID: 27704305 DOI: 10.1007/s11136-016-1423-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2016] [Indexed: 01/24/2023]
Abstract
PURPOSE The purpose of this research was to measure changes in HRQoL during the diagnostic evaluation of patients presenting with non-specific symptoms possibly attributable to cancer, to describe their experiences of HRQoL and to merge these findings with intent to obtain a more comprehensive understanding of their HRQoL experience during this stressful life event. METHODS A convergent mixed methods (MM) design was used and involved quantitative data about HRQoL measured by the EORTC-QLQ-C30 instrument and qualitative interview data about patients' HRQoL experiences. Participants completed the EORTC-QLQ-C30 questionnaire prior to and after evaluation. The baseline questionnaire informed the purposive sampling for the qualitative interview study, and open-end questions matched to the EORTC-QLQ-C30 constructs were used in the semi-structured interviews. RESULTS A total of 838 patients were enrolled in the quantitative study; 680 (81 %) also completed follow-up. Twenty-one patients participated in interviews. The MM findings are the meta-inferences drawn by looking across the matched quantitative and qualitative findings: physical function, social function, role function, emotional function, cognitive function, social function, symptoms and quality of life. CONCLUSION The survey results illustrate that HRQoL improved over time and the qualitative findings confirmed and further expanded the survey results. The MM analysis underlines that the HRQoL experience cannot be observed independently from context. Participants adapted to their situation over time, and this may change their perceptions of HRQoL. These findings can be used to enhance evidence-based care as clinicians need to be aware of how the context influences the HRQoL experience.
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Affiliation(s)
- E Moseholm
- Department of Pulmonary and Infectious Diseases, University Hospital of Copenhagen, Nordsjælland, Dyrehavevej 29, Building 10, 3400, Hillerød, Denmark.
| | - S Rydahl-Hansen
- Research Unit of Clinical Nursing, Bispebjerg and Frederiksberg University Hospital, Bispebjerg Bakke 23, 20E, 2400, Copenhagen NV, Denmark.,Department of Public Health, Section for Nursing, Aarhus University, Århus, Denmark
| | - B Ø Lindhardt
- Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Kettegård Alle 30, Department 144, 2650, Hvidovre, Denmark
| | - M D Fetters
- Department of Family Medicine, University of Michigan, 1018 Fuller St, Ann Arbor, MI, 48104, USA
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Moseholm E, Rydahl-Hansen S, Overgaard D, Wengel HS, Frederiksen R, Brandt M, Lindhardt BØ. Health-related quality of life, anxiety and depression in the diagnostic phase of suspected cancer, and the influence of diagnosis. Health Qual Life Outcomes 2016; 14:80. [PMID: 27206557 PMCID: PMC4873991 DOI: 10.1186/s12955-016-0484-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 05/12/2016] [Indexed: 11/20/2022] Open
Abstract
Background Undergoing diagnostic evaluation for cancer has been associated with a high prevalence of anxiety and depression and affected health-related quality of life (HRQoL). The aims of this study were to assess HRQoL, anxiety, and depression pre- and post-diagnosis in patients undergoing diagnostic evaluations for cancer due to non-specific symptoms; to examine changes over time in relation to final diagnosis (cancer yes/no); and to assess the predictive value of pre-diagnostic psychological, socio-demographic and clinical factors. Methods A prospective, multicenter survey study of patients suspected to have cancer based on non-specific symptoms was performed. Participants completed the EORTC-QLQ-C30 quality of life scale, HADS, SOC-13 and self-rated health before and after completing diagnostic evaluations. Intra- and inter-group differences between patients diagnosed with cancer versus patients with non-cancer diagnoses were calculated. The impact of baseline psychological, socio-demographic, and medical factors on HRQoL, anxiety and depression at follow-up was explored by bootstrapped multivariate linear regression analyses and logistic regression analyses. Results A total of 838 patients participated in this study; 679 (81 %) completed the follow-up. Twenty-two percent of the patients received a cancer diagnosis at the end of the follow-up. Patients presented initially with a high burden of symptoms and affected role and emotional functioning and global health/QL, irrespective of diagnosis. The prevalence of clinical anxiety prior to knowledge of the diagnosis was 32 % in patients with cancer and 35 % in patients who received a non-cancer diagnosis. HRQoL and anxiety improved after diagnosis, and a larger improvement was seen in patients who received a non-cancer diagnosis. There were no intra- or inter-group differences in the depression scores. The strongest predictors of global QL, anxiety, and depression after a known diagnosis were baseline scores, co-morbidity and poor self-rated health. Conclusions Patients undergoing diagnostic evaluations for cancer based on non-specific symptoms experience a high prevalence of anxiety and affected quality of life prior to knowledge of the diagnosis. The predictive value of the baseline scores is important when assessing the psychological impact of undergoing diagnostic evaluations for cancer.
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Affiliation(s)
- Ellen Moseholm
- Department of Pulmonary and Infectious Diseases, University Hospital of Copenhagen, Nordsjælland, Dyrehavevej 29, DK - 3400, Hillerød, Denmark.
| | - Susan Rydahl-Hansen
- Research Unit of Clinical Nursing, Bispebjerg and Frederiksberg University Hospital, and Department of Public Health, Section for Nursing, Aarhus University, Bispebjerg Bakke 23, 20D, Copenhagen, NV, DK- 2400, Denmark
| | - Dorthe Overgaard
- Department of Nursing, Metropolitan University College, Tagensvej 86, Copenhagen, N, DK - 2200, Denmark
| | - Hanne S Wengel
- Department of Pulmonary and Infectious Diseases, University Hospital of Copenhagen, Nordsjælland, Dyrehavevej 29, DK - 3400, Hillerød, Denmark
| | - Rikke Frederiksen
- Department of Endocrinology, Copenhagen University Hospital, Herlev, Herlev Ringvej 75, Building 64, Herlev, DK-2730, Denmark
| | - Malene Brandt
- Department of Gastroenterology, Bispebjerg and Frederiksberg University Hospital, Bispebjerg Bakke 23, 60, Copenhagen, NV, DK- 2400, Denmark
| | - Bjarne Ø Lindhardt
- Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Kettegård Alle 30, Department 144, Hvidovre, DK- 2650, Denmark
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Huang B, Chen H, Deng Y, Yi T, Wang Y, Jiang Y. Diagnosis, disease stage, and distress of Chinese cancer patients. ANNALS OF TRANSLATIONAL MEDICINE 2016; 4:73. [PMID: 27004220 DOI: 10.3978/j.issn.2305-5839.2016.02.08] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND The objective is to assess how cancer patients know about their diagnosis what they know about their real stage, and the relationship between cancer stage and psychological distress. METHODS A questionnaire including the Distress Thermometer was delivered to 422 cancer inpatients. Multivariate logistic regression analysis was used to estimate odds ratios (OR) and 95% confidence intervals (CI). RESULTS Most of patients (68.7%) knew the bad news immediately after diagnosis. Half of patients knew their diagnosis directly from medical reports. Nearly one third of patients were informed by doctors. Cancer stages, which patients believed, differed significantly from their real disease stages (P<0.001). Over half of patients did not know their real disease stages. Patients with stage I-III cancer were more likely to know their real disease stage than patients with stage IV cancer (P<0.001). Distress scores of cancer patients were determined by the real cancer stage (P=0.012), not the stage which patients believed. CONCLUSIONS Although most of participants knew the bad news immediately after diagnosis, less than half of them knew their real disease stage. Patient with stage I-III cancer was more likely to know the real disease stage and had a DT score <4 than patient with stage IV disease.
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Affiliation(s)
- Boyan Huang
- 1 Department of Medical Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, China ; 2 Department of Medical Oncology, Chongqing Hospital of Traditional Chinese Medicine, Chongqing 400021, China ; 3 Department of Palliative Medicine, West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - Huiping Chen
- 1 Department of Medical Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, China ; 2 Department of Medical Oncology, Chongqing Hospital of Traditional Chinese Medicine, Chongqing 400021, China ; 3 Department of Palliative Medicine, West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - Yaotiao Deng
- 1 Department of Medical Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, China ; 2 Department of Medical Oncology, Chongqing Hospital of Traditional Chinese Medicine, Chongqing 400021, China ; 3 Department of Palliative Medicine, West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - Tingwu Yi
- 1 Department of Medical Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, China ; 2 Department of Medical Oncology, Chongqing Hospital of Traditional Chinese Medicine, Chongqing 400021, China ; 3 Department of Palliative Medicine, West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - Yuqing Wang
- 1 Department of Medical Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, China ; 2 Department of Medical Oncology, Chongqing Hospital of Traditional Chinese Medicine, Chongqing 400021, China ; 3 Department of Palliative Medicine, West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - Yu Jiang
- 1 Department of Medical Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, China ; 2 Department of Medical Oncology, Chongqing Hospital of Traditional Chinese Medicine, Chongqing 400021, China ; 3 Department of Palliative Medicine, West China Fourth Hospital, Sichuan University, Chengdu 610041, China
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Undergoing Diagnostic Evaluation for Possible Cancer Affects the Health-Related Quality of Life in Patients Presenting with Non-Specific Symptoms. PLoS One 2016; 11:e0148463. [PMID: 26840866 PMCID: PMC4739588 DOI: 10.1371/journal.pone.0148463] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Accepted: 01/17/2016] [Indexed: 01/23/2023] Open
Abstract
AIM Undergoing diagnostic evaluation for possible cancer can affect health-related quality of life (HRQoL). The aims of this study were to examine the HRQoL in patients undergoing a diagnostic evaluation for possible cancer due to non-specific symptoms and further to investigate the impact of socio-demographic and medical factors associated with HRQoL at the time of diagnosis. METHODS This was a prospective, multicenter survey study that included patients who were referred for a diagnostic evaluation due to non-specific cancer symptoms. Participants completed the EORTC-QLQ-C30 quality of life scale before and after completing the diagnostic evaluation. The baseline and follow-up EORTC-QLQ-C30 scores were compared with reference populations. The impact of socio-demographic and medical factors on HRQoL at follow-up was explored by bootstrapped multivariate linear regression. RESULTS A total of 838 patients participated in the study; 680 (81%) also completed follow-up. Twenty-two percent of the patients received a cancer diagnosis at the end of follow-up. Patients presented initially with a high burden of symptoms, less role and emotional functioning and a lower global health/QoL. Most domains improved after diagnosis and no clinically important difference between baseline and follow-up scores was found. Patients reported effects on HRQoL both at baseline and at follow-up compared with the Danish reference population and had similar scores as a cancer reference population. Co-morbidity, being unemployed and receiving a cancer diagnosis had the greatest effect on HRQoL around the time of diagnosis. CONCLUSIONS Patients with non-specific symptoms reported an affected HRQoL while undergoing a diagnostic evaluation for possible cancer. Morbidity, being unemployed and receiving a cancer diagnosis had the greatest effect on HRQoL around the time of diagnosis.
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Bayly JL, Lloyd-Williams M. Identifying functional impairment and rehabilitation needs in patients newly diagnosed with inoperable lung cancer: a structured literature review. Support Care Cancer 2016; 24:2359-2379. [DOI: 10.1007/s00520-015-3066-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 12/21/2015] [Indexed: 01/01/2023]
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14
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Koller M, Warncke S, Hjermstad MJ, Arraras J, Pompili C, Harle A, Johnson CD, Chie WC, Schulz C, Zeman F, van Meerbeeck JP, Kuliś D, Bottomley A. Use of the lung cancer-specific Quality of Life Questionnaire EORTC QLQ-LC13 in clinical trials: A systematic review of the literature 20 years after its development. Cancer 2015; 121:4300-23. [PMID: 26451520 DOI: 10.1002/cncr.29682] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 06/24/2015] [Accepted: 07/02/2015] [Indexed: 12/19/2022]
Abstract
The European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Lung Cancer 13 (QLQ-LC13) covers 13 typical symptoms of lung cancer patients and was the first module developed in conjunction with the EORTC core quality-of-life (QL) questionnaire. This review investigates how the module has been used and reported in cancer clinical trials in the 20 years since its publication. Thirty-six databases were searched with a prespecified algorithm. This search plus an additional hand search generated 770 hits, 240 of which were clinical studies. Two raters extracted data using a coding scheme. Analyses focused on the randomized controlled trials (RCTs). Of the 240 clinical studies that were identified using the LC13, 109 (45%) were RCTs. More than half of the RCTs were phase 3 trials (n = 58). Twenty RCTs considered QL as the primary endpoint, and 68 considered it as a secondary endpoint. QL results were addressed in the results section of the article (n = 89) or in the abstract (n = 92); and, in half of the articles, QL results were presented in the form of tables (n = 53) or figures (n = 43). Furthermore, QL results had an impact on the evaluation of the therapy that could be clearly demonstrated in the 47 RCTs that yielded QL differences between treatment and control groups. The EORTC QLQ-LC13 fulfilled its mission to be used as a standard instrument in lung cancer clinical trials. An update of the LC13 is underway to keep up with new therapeutic trends and to ensure optimized and relevant QL assessment in future trials.
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Affiliation(s)
- Michael Koller
- Center for Clinical Studies, University Hospital Regensburg, Regensburg, Germany
| | - Sophie Warncke
- Center for Clinical Studies, University Hospital Regensburg, Regensburg, Germany
| | - Marianne J Hjermstad
- Regional Centre for Excellence in Palliative Care, Department of Oncology, Oslo University Hospital and European Palliative Care Research Centre, Department of Cancer and Molecular Medicine, Norwegian University of Science and Technology, Norway
| | - Juan Arraras
- Oncology Departments, Navarra Hospital Complex, Pamplona, Spain
| | - Cecilia Pompili
- Division of Thoracic Surgery, St. James's University Hospital, Leeds, United Kingdom
| | - Amelie Harle
- The Christie National Health Service Foundation Trust, Manchester, United Kingdom
| | - Colin D Johnson
- University Surgical Unit, University Hospital Southampton, Hampshire, United Kingdom
| | - Wei-Chu Chie
- Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan
| | - Christian Schulz
- Department of Internal Medicine II, University Hospital Regensburg, Regensburg, Germany
| | - Florian Zeman
- Center for Clinical Studies, University Hospital Regensburg, Regensburg, Germany
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Abt Sacks A, Perestelo-Perez L, Rodriguez-Martin B, Cuellar-Pompa L, Algara López M, González Hernández N, Serrano-Aguilar P. Breast cancer patients’ narrative experiences about communication during the oncology care process: a qualitative study. Eur J Cancer Care (Engl) 2015; 25:719-33. [DOI: 10.1111/ecc.12384] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2015] [Indexed: 10/23/2022]
Affiliation(s)
- A. Abt Sacks
- Canary Islands Foundation for Health Research (FUNCANIS); Tenerife Spain
- National Institute of Health Carlos III; Health Services Research on Chronic Patients Network (REDISSEC); Madrid Spain
| | - L. Perestelo-Perez
- Evaluation Unit of the Canary Islands Health Service (SESCS); Tenerife Spain
- Health Services Research on Chronic Patients Network (REDISSEC); Madrid Spain
| | - B. Rodriguez-Martin
- Faculty of Occupational Therapy, Speech Therapy and Nursing; University of Castilla-La Mancha; Talavera de la Reina (Toledo) Spain
| | - L. Cuellar-Pompa
- Canary Islands Foundation for Health Research (FUNCANIS); Tenerife Spain
| | - M. Algara López
- Radiation Oncology; L'Esperança Hospital; Municipal Healthcare Institute (IMAS); Barcelona Spain
| | - N. González Hernández
- Research Unit / Health Services Research on Chronic Patients Network (REDISSEC); Galdakao-Usansolo Hospital; Barrio Labeaga, s/n, 48960 Usansolo Bilbao Spain
| | - P. Serrano-Aguilar
- National Institute of Health Carlos III; Health Services Research on Chronic Patients Network (REDISSEC); Madrid Spain
- Evaluation Unit of the Canary Islands Health Service (SESCS); Tenerife Spain
- Centre for Biomedical Research of the Canary Islands (CIBICAN); Tenerife Spain
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Parvan K, Jabbarzadeh Tabrizi F, Rahmani A, Ghojazadeh M, Azadi A, Golchin M. The Relationship between Hope and Self-Esteem in Patients with Leukemia. J Caring Sci 2015; 4:217-23. [PMID: 26464838 DOI: 10.15171/jcs.2015.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2014] [Accepted: 01/08/2015] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION Patients with hematologic malignancies often experience many emotional reactions which are different based on patient's culture. Indeed culture determines the different ways that patients understand cancer. Accordingly, the aim of this study was to determine the relationship of self-esteem and hope among Iranian cancer patients. METHODS This descriptive-correlational study was undertaken among 85 leukemic patients admitted to Shahid Ghazi hospital in East-Azerbaijan province, Iran. They were selected using consecutive sampling method. Persian form of Hearth Hope Index and Coppersmith Self-Esteem Inventory were used to identify patients' hope and self-esteem. The data were analyzed using SPSS version 13.0. RESULTS The overall scores of hope and self-esteem were 33.05 (5.24) and 94.61 (11.51), respectively. There was a positive correlation between hope and self-esteem (rs = 0.73, n = 85, P < 0.001). CONCLUSION Although culture determines the different ways that patients understand cancer, but it seems that the self-esteem and hope relationship could be similar in different cultures. The findings of this study indicate that nurses could be helpful through designing and implementing appropriate educational programs in order to enhance hope and self-esteem of leukemia patients.
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Affiliation(s)
- Kobra Parvan
- Department of Medic1Department of Medical-Surgical Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iranal-Surgical Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Faranak Jabbarzadeh Tabrizi
- Department of Medical-Surgical Nursing, Hematology and Oncology Research Center, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Azad Rahmani
- Department of Medical-Surgical Nursing, Hematology and Oncology Research Center, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Morteza Ghojazadeh
- Liver and Gastrointestinal, Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Arman Azadi
- Department of Nursing, Faculty of Nursing and Midwifery, Ilam University of Medical Sciences, Ilam, Iran
| | - Mehri Golchin
- Department of Medical-Surgical Nursing, Hematology and Oncology Research Center, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
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Finlayson CS, Chen YT, Fu MR. The impact of patients' awareness of disease status on treatment preferences and quality of life among patients with metastatic cancer: a systematic review from 1997-2014. J Palliat Med 2014; 18:176-86. [PMID: 25259624 DOI: 10.1089/jpm.2014.0222] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Advances in cancer treatment present challenges to patients with metastatic cancer who have to make treatment decisions in the face of newer and more effective treatments. Patients' awareness of disease status has been an important factor in making treatment choices. We conducted a systematic review of the published literature from 1997-2014 to evaluate the evidence of the impact of patients' awareness of disease status on treatment preferences and quality of life among patients with metastatic cancer. METHODS Nine major electronic databases were searched and 490 articles were retrieved; 15 met inclusion criteria. An established quality assessment tool was used to assess the quality of the included studies. RESULTS The overall quality of the included 15 quantitative studies was adequate. A critical limitation of current literature is the lack of consistent conceptual or operational definitions for the concept of patients' awareness of disease status. The included studies conceptualized patients' awareness of disease status either as being informed or understanding one's disease prognosis. Significantly more patients who were aware of their disease status were less likely to choose life-extending treatment or measures. Mixed findings were shown regarding the impacts of patients' awareness of disease status on quality of life. Absence of qualitative studies limited the review's ability to critically synthesize the concept of awareness of disease status. Well-designed qualitative studies are needed to shed light on the conceptualization and operationalization of the concept to better capture the impact of patients' awareness of disease status on treatment preferences and quality of life.
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Wang DC, Guo CB, Peng X, Su YJ. Psychological morbidity and health-related quality of life in patients with differing awareness of cancer diagnosis: a cross-sectional study. Psychooncology 2014; 23:975-80. [PMID: 24577849 DOI: 10.1002/pon.3512] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Revised: 12/08/2013] [Accepted: 02/04/2014] [Indexed: 11/11/2022]
Affiliation(s)
- Dian Can Wang
- Department of Oral and Maxillofacial Surgery; Peking University School and Hospital of Stomatology; Beijing China
| | - Chuan Bin Guo
- Department of Oral and Maxillofacial Surgery; Peking University School and Hospital of Stomatology; Beijing China
| | - Xin Peng
- Department of Oral and Maxillofacial Surgery; Peking University School and Hospital of Stomatology; Beijing China
| | - Yan Jie Su
- Department of Psychology; Peking University; Beijing China
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Abstract
The evaluation of the outcomes of total knee arthroplasty requires measurement tools that are valid, reliable, and responsive to change. However, the accuracy of any outcome measurement is determined by the validity and reliability of the instrument used. To ensure this accuracy, it is imperative that each instrument used in orthopaedics is free of biases leading to inaccurate estimates of treatment effects. WHERE ARE WE NOW?: Many patient-derived outcome instruments have been developed and tested through the application of the standard assessments that form the basis of classical test theory: validity, reliability, and responsiveness. These assessments determine if the instrument reliably measures what it is intended to measure, and if it captures differences among groups of patients or changes over time. WHERE DO WE NEED TO GO?: Thorough evaluation of the outcome instruments used in orthopaedics is a critical prerequisite for the continued improvement of effective patient care. Additional steps of psychometric testing that are sometimes overlooked include testing for differential item functioning (DIF) and the effects of the mode of administration of the outcome instrument. The use of suitable approaches to test for these potential sources of bias would facilitate the development of more robust outcome assessment in research and clinical practice. HOW DO WE GET THERE?: Testing for DIF, including the effects of mode of administration, may be performed using several analytical approaches. This will allow optimal application of each outcome instrument with respect to patient characteristics, time and mode of the administration, and modification, as necessary.
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Lee MK, Baek SK, Kim SY, Heo DS, Yun YH, Park SR, Kim JS. Awareness of incurable cancer status and health-related quality of life among advanced cancer patients: a prospective cohort study. Palliat Med 2013; 27:144-54. [PMID: 22143041 DOI: 10.1177/0269216311429042] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Many patients near death report an interest in knowing their prognoses. Patients' awareness of disease status may lead to more appropriate care and maintained or improved quality of life. However, it is not known whether advanced cancer patients' awareness of disease status is associated with patients' quality of life. AIM We aimed to examine the effect of patients' awareness of disease status on the health-related quality of life (HRQOL) among advanced cancer patients undergoing palliative chemotherapy. DESIGN In this prospective cohort study, patients were followed-up at 4-6 weeks and 2-3 months after the initial palliative chemotherapy. Patients' awareness of disease status, and demographic and clinical characteristics were assessed at baseline, and depression and anxiety using the Hospital Anxiety and Depression Scale (HADS) and HRQOL using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) were assessed three times. SETTING / PARTICIPANTS In total, 100 patients with advanced cancer starting palliative chemotherapy were recruited from two tertiary university hospitals and from the Korea National Cancer Center. RESULTS Patients with advanced cancer undergoing palliative chemotherapy experienced deteriorated HRQOL. Of these, the patients who were aware of their disease status as incurable had significantly higher role (p=0.002), emotional (p=0.025), and social functioning (p=0.002), and lower fatigue (p=0.008), appetite loss (p=0.039), constipation (p=0.032), financial difficulties (p=0.019), and anxiety (p=0.041) compared with patients unaware of disease status. CONCLUSION Our findings demonstrate the importance of patients' awareness of disease status to HRQOL.
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Affiliation(s)
- Myung Kyung Lee
- Division of Cancer Control, Research Institute, National Cancer Center, Goyang, Gyeonggi, Korea
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Brocken P, Prins JB, Dekhuijzen PNR, van der Heijden HFM. The faster the better?—A systematic review on distress in the diagnostic phase of suspected cancer, and the influence of rapid diagnostic pathways. Psychooncology 2012; 21:1-10. [PMID: 22905349 DOI: 10.1002/pon.1929] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To perform a systematic review of articles published in the last 25 years on prevalence and course of distress and quality of life surrounding the diagnostic process of suspected cancer, and the influence of rapid diagnostic programs. METHODS Twenty-three articles were identified via Pubmed, PsycINFO, and reference lists of articles. Except for three randomized clinical trials and one case control study all studies were uncontrolled cohort studies. RESULTS Most studies involved patients with suspected breast cancer and therefore had a sex selection bias. Four studies on the effect of rapid outpatient diagnostic programs were found.Studies showed very high prevalence of anxiety, decreasing in case of a benign diagnosis but increasing or sustaining in patients waiting for results or after cancer diagnosis though not significantly more in rapid programs. Quality of life was low and showed varying patterns. CONCLUSIONS Distress in the diagnostic phase of cancer is a major problem and the rapid decrease of anxiety in patients eventually not diagnosed with cancer suggests a benefit of rapid diagnostic programs. The available evidence however is limited and shows some inconsistencies. Studies differ in subjects, objective and are limited by quality and quantity. Conflicting results prohibit a conclusion on patients ultimately diagnosed with cancer.
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Affiliation(s)
- Pepijn Brocken
- Department of Pulmonary Diseases, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
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Zamanzadeh V, Rahmani A, Valizadeh L, Ferguson C, Hassankhani H, Nikanfar AR, Howard F. The taboo of cancer: the experiences of cancer disclosure by Iranian patients, their family members and physicians. Psychooncology 2011; 22:396-402. [DOI: 10.1002/pon.2103] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2011] [Revised: 10/04/2011] [Accepted: 10/26/2011] [Indexed: 01/06/2023]
Affiliation(s)
- Vahid Zamanzadeh
- Nursing and Midwifery Faculty; Tabriz University of Medical Sciences; Tabriz Iran
| | - Azad Rahmani
- Nursing and Midwifery Faculty; Tabriz University of Medical Sciences; Tabriz Iran
- Hematology and Oncology Research Center; Tabriz University of Medical Sciences; Tabriz Iran
| | - Leila Valizadeh
- Nursing and Midwifery Faculty; Tabriz University of Medical Sciences; Tabriz Iran
| | - Caleb Ferguson
- Faculty of Nursing, Midwifery and Health; University of Technology Sydney; Sydney Australia
| | - Hadi Hassankhani
- Nursing and Midwifery Faculty; Tabriz University of Medical Sciences; Tabriz Iran
| | - Ali-Reza Nikanfar
- Hematology and Oncology Research Center; Tabriz University of Medical Sciences; Tabriz Iran
| | - Fuchsia Howard
- School of Population and Public Health, Faculty of Medicine; The University of British Columbia; Vancouver Canada
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Fan X, Huang H, Luo Q, Zhou J, Tan G, Yong N. Quality of life in Chinese home-based advanced cancer patients: does awareness of cancer diagnosis matter? J Palliat Med 2011; 14:1104-8. [PMID: 21966988 DOI: 10.1089/jpm.2011.0111] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
The aim of this study was to assess the quality of life (QOL) of Chinese home-based advanced-stage cancer patients and to evaluate the association between the disclosure of cancer diagnosis and QOL. An interview-based survey was conducted from December 2009 to June 2010 in the home-based hospice of the First Affiliated Hospital of Chongqing Medical University, China. The principal finding of this study demonstrated that patients who did not have knowledge of their diagnosis exhibited better physical and emotional QOL compared with those who had knowledge of their diagnosis.
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Affiliation(s)
- Xiaoping Fan
- Neurology Department, The First Affiliated Hospital of Chongqing Medical University, Chongqing City, China
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Mitchison D, Butow P, Sze M, Aldridge L, Hui R, Vardy J, Eisenbruch M, Iedema R, Goldstein D. Prognostic communication preferences of migrant patients and their relatives. Psychooncology 2011; 21:496-504. [DOI: 10.1002/pon.1923] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2010] [Revised: 11/23/2010] [Accepted: 12/27/2010] [Indexed: 11/12/2022]
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Papadopoulos A, Vrettos I, Kamposioras K, Anagnostopoulos F, Giannopoulos G, Pectasides D, Niakas D, Economopoulos T. Impact of cancer patients' disease awareness on their family members' health-related quality of life: a cross-sectional survey. Psychooncology 2011; 20:294-301. [DOI: 10.1002/pon.1731] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Lee LJH, Chung CW, Chang YY, Lee YC, Yang CH, Liou SH, Liu PH, Wang JD. Comparison of the quality of life between patients with non-small-cell lung cancer and healthy controls. Qual Life Res 2010; 20:415-23. [PMID: 20953907 DOI: 10.1007/s11136-010-9761-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2010] [Indexed: 01/26/2023]
Abstract
PURPOSE We explored covariates of the quality of life (QOL) in non-small-cell lung cancer (NSCLC) patients and made a comparison with healthy controls. METHODS We assessed the QOL of 220 consecutive NSCLC patients at a university hospital. The QOL data were measured by the brief version of the World Health Organization's Quality of Life and by utility using the standard gamble method. We selected demographically matched healthy controls from the 2001 National Health Interview Survey for comparison. Multiple linear regression models were constructed to explore significant factors of QOL after controlling for covariates. RESULTS Patients with more advanced stages of NSCLC had poorer scores than did the healthy controls in the physical and psychological domains. Patients with disease duration of longer than 1 year tended to report higher physical and environment QOL than did those with NSCLC diagnosed for less than 1 year. Insight into one's own illness was associated with a higher utility, better social support, and improved financial resources. CONCLUSIONS QOL was significantly associated with staging and duration of NSCLC. Disease insight appears to be a positive factor for operable NSCLC patients of the Taiwanese culture, which implies that clinicians should respect patient autonomy in diagnosis disclosure.
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Affiliation(s)
- Lukas Jyuhn-Hsiarn Lee
- Division of Environmental Health and Occupational Medicine, National Health Research Institutes, Miaoli, Taiwan.
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Machado L, Saad IAB, Honma HN, Morcillo AM, Zambon L. Evolução do status de performance, índice de massa corpórea e distância percorrida no teste de caminhada de seis minutos em pacientes com câncer de pulmão avançado submetidos à quimioterapia. J Bras Pneumol 2010; 36:588-94. [DOI: 10.1590/s1806-37132010000500010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2009] [Accepted: 04/26/2010] [Indexed: 11/22/2022] Open
Abstract
OBJETIVO: Avaliar o efeito da quimioterapia sobre a condição física de pacientes com câncer de pulmão avançado. MÉTODOS: Foram avaliados 50 pacientes com câncer de pulmão não pequenas células nos estágios IIIB e IV e com status de performance segundo a escala do Eastern Cooperative Oncology Group (ECOG) entre zero e dois. Todos receberam quimioterapia com as drogas paclitaxel e derivados da platina e foram avaliados em três momentos (pré-quimioterapia, pós-quimioterapia e seis meses após o início do tratamento), nos quais a escala ECOG, o índice de massa corpórea (IMC) e a Distância percorrida no Teste de Caminhada de Seis minutos (DTC6) foram avaliados. RESULTADOS: Dos 50 pacientes incluídos, 14 foram a óbito, 5 foram excluídos do estudo por apresentar piora do status de performance, e 31 concluíram o seguimento de seis meses. Não houve diferença estatisticamente significativa para o IMC (p = 1,00, pré-quimioterapia vs. pós-quimioterapia; e p = 0,218, pré-quimioterapia vs. seis meses após) ou para a DTC6 entre os momentos de avaliação. O status de performance melhorou, principalmente com o aumento do número de pacientes assintomáticos após seis meses de acompanhamento (p = 0,031). CONCLUSÕES: O uso de quimioterapia teve um efeito benéfico no status de performance dos pacientes. Não houve alterações no IMC ou na DTC6 durante o período do estudo, o que pode sugerir a manutenção da condição física dos pacientes.
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Family physician involvement in cancer care and lung cancer patient emotional distress and quality of life. Support Care Cancer 2010; 19:1719-27. [PMID: 20882393 DOI: 10.1007/s00520-010-1010-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2010] [Accepted: 09/14/2010] [Indexed: 12/25/2022]
Abstract
PURPOSE This study aims to describe emotional distress and quality of life (QoL) of patients at different phases of their lung cancer and the association with their family physician (FP) involvement. METHODS A prospective study on patients with lung cancer was conducted in three regions of Quebec, Canada. Patients completed, at baseline, several validated questionnaires regarding their psychosocial characteristics and their perceived level of FP involvement. Emotional distress [profile of mood states (POMS)] and QoL [European Organization for Research and Treatment of Cancer Quality of Life Core 30 (EORTC QLQ-C30)] were reassessed every 3-6 months, whether patients had metastasis or not, up to 18 months. Results were regrouped according to cancer phase. Mixed models with repeated measurements were performed to identify variation in distress and QoL. RESULTS In this cohort of 395 patients, distress was low at diagnosis (0.79 ± 0.7 on a 0-4 scale), raising to 1.36 ± 0.8 at the advance phase (p < 0.0001). Patient's global QoL scores significantly decreased from the diagnosis to the advance phase (from 66 to 45 on a 0-100 scale; p < 0.0001). At all phases of cancer, FP involvement was significantly associated with patients' distress (p = 0.0004) and their global perception of QoL (p = 0.0080). These associations remained statistically significant even after controlling for age, gender, and presence of metastases. CONCLUSIONS This study provides new knowledge on patients' emotional distress and QoL with cancer evolution and, particularly, their association with FP involvement. Other studies should be conducted to further explore FP role in cancer supportive care.
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Husson O, Mols F, van de Poll-Franse LV. The relation between information provision and health-related quality of life, anxiety and depression among cancer survivors: a systematic review. Ann Oncol 2010; 22:761-772. [PMID: 20870912 PMCID: PMC3065875 DOI: 10.1093/annonc/mdq413] [Citation(s) in RCA: 341] [Impact Index Per Article: 24.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Providing information that is congruent with patients' needs is an important determinant for patient satisfaction and might also affect health-related quality of life (HRQoL) and anxiety and depression levels of cancer survivors. DESIGN The authors systematically reviewed the available literature on the relationship between information provision and HRQoL, anxiety and depression. A PubMed literature search for original articles published until February 2010 was carried out. Twenty-five articles, all conducted between 1996 and 2009, which met the predefined inclusion criteria, were subjected to a quality checklist. RESULTS Satisfied patients, patients with fulfilled information needs, and patients who experience less information barriers, in general have a better HRQoL and less anxiety and depression. Out of eight intervention studies that aimed to improve information provision, only one showed a positive association with better HRQoL. CONCLUSION Health care providers must pay more attention to patient-centred information provision. Additional research is needed to make definitive conclusions about information interventions as most results did not reach statistical significance due to methodological constraints. The quick development of the relatively young research field of patient-reported outcomes in cancer survivorship will make it possible to conduct better quality studies in the future.
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Affiliation(s)
- O Husson
- Department of Medical Psychology and Neuropsychology, CoRPS-Center of Research on Psychology in Somatic Diseases, Tilburg University, Tilburg; Comprehensive Cancer Centre South (CCCS), Department of Research, Eindhoven Cancer Registry, Eindhoven, The Netherlands.
| | - F Mols
- Department of Medical Psychology and Neuropsychology, CoRPS-Center of Research on Psychology in Somatic Diseases, Tilburg University, Tilburg; Comprehensive Cancer Centre South (CCCS), Department of Research, Eindhoven Cancer Registry, Eindhoven, The Netherlands
| | - L V van de Poll-Franse
- Department of Medical Psychology and Neuropsychology, CoRPS-Center of Research on Psychology in Somatic Diseases, Tilburg University, Tilburg; Comprehensive Cancer Centre South (CCCS), Department of Research, Eindhoven Cancer Registry, Eindhoven, The Netherlands
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Solitary pulmonary nodules: consequences for patient quality of life. Qual Life Res 2010; 20:101-9. [DOI: 10.1007/s11136-010-9719-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2010] [Indexed: 12/13/2022]
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Disclosure of cancer diagnosis and quality of life in cancer patients: should it be the same everywhere? BMC Cancer 2009; 9:39. [PMID: 19178719 PMCID: PMC2639611 DOI: 10.1186/1471-2407-9-39] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2008] [Accepted: 01/29/2009] [Indexed: 11/24/2022] Open
Abstract
Background Evidence suggests that truth telling and honest disclosure of cancer diagnosis could lead to improved outcomes in cancer patients. To examine such findings in Iran, this trial aimed to study the various dimensions of quality of life in patients with gastrointestinal cancer and to compare these variables among those who knew their diagnosis and those who did not. Methods A consecutive sample of patients with gastrointestinal cancer being treated in Cancer Institute in Tehran, Iran was prospectively evaluated. A psychologist interviewed patients using the Iranian version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). Patients were categorized into two groups: those who knew their diagnosis and those who did not. Independent sample t-test was used for group comparisons. Results In all 142 patients were interviewed. A significant proportion (52%) of patients did not know their cancer diagnosis and 48% of patients were aware that they had cancer. They were quite similar in most characteristics. The comparison of quality of life between two groups indicated that those knew their diagnosis showed a significant lower degree of physical (P = 0.001), emotional (P = 0.01) and social functioning (P < 0.001), whereas the global quality of life and other functional scales including role functioning and cognitive functioning did not show significant result. There were no statistically significant differences between symptoms scores between two groups, except for fatigue suggesting a higher score in patients who knew their diagnosis (P = 0.01). The financial difficulties were also significantly higher in patients who knew their cancer diagnosis (P = 0.005). Performing analysis of variance while controlling for age, educational status, cancer site, and knowledge of cancer diagnosis, the results showed that the knowledge of cancer diagnosis independently still contributed to the significant differences observed between two groups. Conclusion Contrary to expectation the findings indicated that patients who did not know their cancer diagnosis had a better physical, social and emotional quality of life. It seems that due to cultural differences between countries cancer disclosure guidelines perhaps should be differing.
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Contribution of the geriatrician to the management of cancer in older patients. Eur J Cancer 2007; 43:2153-60. [PMID: 17855073 DOI: 10.1016/j.ejca.2007.07.032] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2007] [Revised: 07/24/2007] [Accepted: 07/31/2007] [Indexed: 10/22/2022]
Abstract
With an increasingly aged population, many patients will present with cancer in their 80s and 90s. Although some may be very fit, frail individuals will require the input of geriatricians to aid in the assessment of co-existing morbidity, in an attempt to assess those most likely to benefit from active treatment of their cancer, and those in whom the 'giants of geriatric medicine' require special consideration before undergoing definitive cancer therapy. The role of the geriatrician in assessment and management of such patients, together with communication and end of life care, may be more important in ensuring a good quality of life, than the cancer therapy itself. Whilst numbers of geriatricians will not be adequate to care for all elderly patients with cancer, a variety of assessment scales will help target financial and manpower resources to those most at risk.
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Le Guen Y, Gagnadoux F, Hureaux J, Jeanfaivre T, Meslier N, Racineux JL, Urban T. Sleep disturbances and impaired daytime functioning in outpatients with newly diagnosed lung cancer. Lung Cancer 2007; 58:139-43. [PMID: 17614157 DOI: 10.1016/j.lungcan.2007.05.021] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2007] [Revised: 05/21/2007] [Accepted: 05/28/2007] [Indexed: 10/23/2022]
Abstract
BACKGROUND Clinical experience suggests that lung cancer (LC) is associated with sleep disturbances that may contribute to impaired daytime functioning and quality of life. Using questionnaires and home actigraphic recordings, we tried to determine whether sleep quality and daytime alertness are impaired in patients with newly diagnosed LC. PATIENTS AND METHODS Twenty-nine outpatients with newly diagnosed LC and an Eastern Cooperative Oncology Group performance status </=2 and 14 age- and sex-matched non-cancer (NC) patients with successfully treated sleep apnea were enrolled in the study. Sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI) and by night actigraphic data. Daytime alertness was assessed by the Epworth Sleepiness Scale (ESS) and day actigraphic data. The medical outcomes study 36-item short form (SF-36) was used for quality of life assessment. RESULTS LC patients had higher PSQI (9.6+/-3.7 versus 5.6+/-3.2; p<0.001) and higher ESS (8.6+/-3.7 versus 5.6+/-3.2; p=0.01) than NC patients indicating worse quality of sleep and more excessive daytime sleepiness. Both physical and mental components score of SF-36 were lower in LC patients (p<0.001) indicating lower quality of life. Wrist actigraphy data showed significantly lower sleep efficiency and a higher sleep fragmentation during the night and lower mean activity during the day in LC patients. CONCLUSIONS Patients with newly diagnosed LC and performance status </=2 present marked sleep disturbances, excessive daytime sleepiness and impaired quality of life. Further studies are required to determine the etiologic factors of sleep disturbances in LC patients and the impact of pharmacologic and non-pharmacologic interventions on sleep and daytime functioning.
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Balduyck B, Hendriks J, Lauwers P, Van Schil P. Quality of life evolution after lung cancer surgery: A prospective study in 100 patients. Lung Cancer 2007; 56:423-31. [PMID: 17306905 DOI: 10.1016/j.lungcan.2007.01.013] [Citation(s) in RCA: 103] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2006] [Revised: 12/15/2006] [Accepted: 01/15/2007] [Indexed: 01/14/2023]
Abstract
OBJECTIVE To evaluate quality of life (QoL) evolution after thoracic surgery for lung cancer with the European Organisation for Research and Treatment of Cancer (EORTC) QoL Questionnaire-C30 and the lung cancer specific module LC13. METHODS A prospective QoL registration started in 2002 for all patients undergoing major pulmonary surgery for malignant disease. Between January 2002 and November 2004, 100 patients were included. Questionnaires were administered pre-operatively and 1, 3, 6 and 12 months post-operatively (MPO) with response rates of 100%, 71%, 77%, 83% and 76%, respectively. PROCEDURES lobectomy 61%, pneumonectomy 17%, and wedge resection 22%. Approaches: anterolateral thoracotomy 79%, posterolateral thoracotomy 13% and video-assisted thoracic surgery (VATS) 8%. RESULTS Lobectomy and wedge resection are comparable in QoL evolution. Both resections are characterized by a 1 month temporary decrease in QoL functioning scores and an increase in pain symptoms. Lobectomy patients report an increase in dyspnea in the first month post-operatively, not seen after wedge resection. With exception of thoracic pain after lobectomy, QoL scores approximated baseline values 3MPO indicating good recovery. After pneumonectomy, there is no return to baseline in physical functioning, role functioning, pain, shoulder function and dyspnea in a 12 months follow-up period. Other QoL scores were comparable with baseline values. Pneumonectomy was significantly associated with a less favorable QoL score evolution when compared with lobectomy. Comparing antero- and posterolateral thoracotomy, significant differences in pain and dyspnea were seen in favor of the anterolateral technique. Comparing thoracotomy to VATS, significant differences were seen in physical functioning, QoL and thoracic pain in favor of VATS. CONCLUSIONS The present study documented QoL evolution profiles comparing pre-operative status with deficits and changes at 1, 3, 6 and 12 months after pulmonary surgery. Lung cancer surgery is well tolerated by the majority of patients. Lobectomy patients have a more favorable physical functioning and less thoracic pain, compared to pneumonectomy. Antero- and posterolateral thoracotomy are comparable for QoL evolution. After posterolateral thoracotomy more post-operative pain and dyspnea was seen. Post-operative physical functioning, pain and QoL are in favor of VATS.
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Affiliation(s)
- B Balduyck
- Department of Thoracic and Vascular Surgery, University Hospital of Antwerp, Wilrijkstraat 10, B-2650 Edegem, Belgium.
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Saad IAB, Botega NJ, Toro IFC. Predictors of quality-of-life improvement following pulmonary resection due to lung cancer. SAO PAULO MED J 2007; 125:46-9. [PMID: 17505685 PMCID: PMC11014704 DOI: 10.1590/s1516-31802007000100009] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2006] [Revised: 04/06/2006] [Accepted: 12/01/2006] [Indexed: 11/21/2022] Open
Abstract
CONTEXT AND OBJECTIVE There is increasing involvement of health professionals in organizing protocols to determine the impact of lung surgery on functional state and activities of daily living, with the aim of improving quality of life (QoL). The objective of this study was to investigate predictors of QoL improvement among patients undergoing parenchyma resection due to lung cancer. DESIGN AND SETTING Prospective study, at teaching hospital of Universidade Estadual de Campinas (Unicamp). METHODS 36 patients with lung cancer diagnosis were assessed before surgery and on the 30th, 90th and 180th days after surgery. The Short-Form Health Survey (SF-36) was used as the dependent variable. The independent variables were the Hospital Anxiety and Depression (HAD) scale, a six-minute walking test (6-MWT), a visual analogue scale for pain, forced vital capacity (FVC), type of surgery and use of radiotherapy and chemotherapy. Generalized estimation equations (GEE) were utilized. RESULTS The median age for these 20 men and 16 women was 55.5 +/- 13.4 years. Both FVC and 6-MWT were predictors of improvement in the physical dimensions of QoL (p = 0.011 and 0.0003, respectively), as was smaller extent of surgical resection (p = 0.04). The social component of QoL had improved by the third postoperative month (p = 0.0005). CONCLUSION The predictors that affected QoL positively were better FVC and 6-MWT results and less extensive lung resection. Three months after the surgery, an improvement in social life was already seen.
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Affiliation(s)
- Ivete Alonso Bredda Saad
- Hospital das Clínicas, Universidade Estadual de Campinas, Rua Maria José Ferreira 116, Campinas (SP), CEP 13085-085, Brazil.
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Yoo H, Suh C, Kim S, Eremenco S, Kim H, Kim S. Korean translation and validation of the functional assessment of cancer therapy-lung (FACT-L) version 4. Qual Life Res 2006; 15:161-6. [PMID: 16411040 DOI: 10.1007/s11136-005-8752-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2005] [Indexed: 11/28/2022]
Abstract
In this study, we have translated and cross-culturally adapted the Functional Assessment of Cancer Therapy-Lung (FACT-L) version 4 into Korean, and we have evaluated its reliability and validity. The FACT-L version 4 was translated into Korean following the standard Functional Assessment of Chronic Illness Therapy (FACIT) translation methodology. The psychometric properties of the FACT-L were evaluated in 122 lung cancer patients (mean age, 60.88 years). Pre-testing was performed in 22 patients, and these results indicated good content coverage and overall comprehensibility. In validating the FACT-L version 4, our results indicated high internal consistency of the FACT-L scales, with Cronbach's alpha coefficients ranging from 0.52 to 0.84. The FACT-L also demonstrated good convergent and divergent validity when correlated with the Functional Living Index-Cancer (FLIC) and the shortened forms of the Profile of Mood States (POMS). This reliable and valid instrument can now be used to properly evaluate the quality of life of Korean lung cancer patients.
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Affiliation(s)
- Heejung Yoo
- Department of Psychiatry, University of Ulan College of Medicine, Asan Medical Center, Seoul, Korea.
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