Health-related quality of life and associated factors in Jordanian cancer patients: A cross-sectional study

Self-rated health and health-related quality of life among cancer patients: the serial multiple mediation of anxiety and depression

BACKGROUND

Health-related quality of life (HRQOL) in cancer patients has attracted increasing attention, which may be associated with self-rated health (SRH), anxiety, and depression. However, limited studies have focused on the mediating role of anxiety and depression in the relationship between SRH and HRQOL among cancer patients. Therefore, this study aims to explore the serial multiple mediating effects of anxiety and depression between SRH and HRQOL in cancer patients.

METHODS

This cross-sectional study investigated a total of 565 hospitalized cancer patients in Anhui province in China from November 2020 to October 2021. SRH was assessed using a single-item measure, anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS) and HRQOL was assessed using the EuroQol-5 Dimension (EQ-5D, three-level version). Socio-demographic and clinical characteristics were analyzed using descriptive statistics. The relationships between SRH, anxiety, depression, and HRQOL were evaluated by Pearson correlation analysis. The serial multiple mediation of anxiety and depression was assessed by SPSS PROCESS macro.

RESULTS

SRH, anxiety, depression and HRQOL were significantly correlated(P < 0.001). In comparison to the fair SRH, the good SRH exhibited a significantly positive direct effect (Effect = 0.2366, Bootstrap 95%CI: 0.0642 ~ 0.4090) and total effect on HRQOL (Effect = 0.4761, Bootstrap 95%CI: 0.2975 ~ 0.6546). Conversely, the poor SRH demonstrated a significantly negative total effect on HRQOL (Effect= -0.4321, Bootstrap 95%CI: -0.7544~ -0.1099). When considering the fair SRH as the reference group, the poor SRH displayed a negative indirect effect on HRQOL through the single mediation of anxiety (Effect= -0.1058, Bootstrap 95%CI: -0.2217~ -0.0107) and the serial mediation of anxiety and depression (Effect= -0.0528, Bootstrap 95%CI: -0.1233~ -0.0035). Conversely, the good SRH had a positive indirect impact on HRQOL through the single mediation of anxiety (Effect = 0.1153, Bootstrap 95%CI: 0.0583 ~ 0.1900) and depression (Effect = 0.0667, Bootstrap 95%CI: 0.0206 ~ 0.1234), as well as the serial mediation of anxiety and depression (Effect = 0.0575, Bootstrap 95%CI: 0.0192 ~ 0.1030).

CONCLUSION

SRH can improve HRQOL through the decrease of anxiety and depression in cancer patients. Focusing on SRH would be beneficial for their mental health and HRQOL in cancer patients.

Quality of Life among Ethiopian Cancer Patients: A Systematic Review of Literatures

Background

Assessment of quality of life (QoL) in cancer patients can provide an overall picture of the patient's adaptation to the disease and maintain long-term health and well-being. Determining the QoL in cancer patients could help with better care and could be as prognostic as medical factors and the survival benefit that pharmacological treatment could provide. The main objective of this review was to determine the prevalence of QoL among Ethiopian adult cancer patients.

Methods

A systematic review was conducted using the "Preferred Reporting Results of Systematic Reviews and Meta-Analyses" guidelines. Databases such as PubMed/Medline, CINAHL, AMED, Embase, the Cochrane Library, ScienceDirect, World Health Organization's Hinari portal, and African Journals Online databases were searched from January 2022 to June 2022. Google, Google Scholar, and university repositories were used to access unpublished studies. Two reviewers independently screened the data using a standardized data extraction format and appraised their quality using the Newcastle-Ottawa Scale.

Results

In this review, 10 studies were included. The prevalence of poor QoL ranged from 52 to 89.6. The physical, role, social, and emotional functioning were the most affected domains of QoL and have been significantly associated with QoL. Financial difficulty was the most important predictor of QoL among Ethiopian cancer patients. Pain, dyspnea, nausea, vomiting, and poor appetite were also reported as predictors of QoL. Low income, lower educational status, unmarried status, underweight, anxiety, and depression, advanced stage of cancer, patients with ≤2 cycles of chemotherapy, and the presence of comorbid diseases were significantly correlated with QoL.

Conclusions

The QoL of an Ethiopian cancer patient was low. Quality of life assessments, appropriate symptom management, integration of psycho-oncology care, and providing economic support shall be considered to improve their QoL.

Lived Experiences of Adult Cancer Patients Undergoing Chemotherapy Treatment at University of Gondar Specialized Hospital, North West Ethiopia, 2021

Cancer is a global public health problem and it exposes patients with a wide range of physical, psychological, social, and financial problems. Experiences, feelings and thoughts patients have during the course of the disease are the determining factors of disease management. However, most of the studies analyzing cancer patients' experiences have been performed only in high-income countries and the situation for cancer patients in Ethiopia is largely unknown. This study aimed to explore the lived experiences of adult cancer patients undergoing Chemotherapy treatment at University of Gondar specialized Hospital, Ethiopia. A phenomenological study design was conducted among adult cancer patients undergoing chemotherapy treatment at University of Gondar specialized Hospital. In-depth interview was conducted with 13 participants by using purposive sampling technique from March 15 to April 15, 2021. The data collection process facilitated by using semi-structured Amharic interview guide. After transcription and translation, data were analyzed by using a thematic analysis method. The ATLAS.ti software version 9 was used for coding and categorization. The result was reported using narrative and mentioned indirect quotation. The findings of the study revealed four main themes: "psychological discomfort," "functional status impairment," "experiences about chemotherapy treatment," and "coping mechanism." The findings revealed that being diagnosed with cancer is the most traumatic experience and affect all aspect of a patient life. Despite the side effects, the treatment gives hope for a new life. Social and spiritual supports have importance in coping the negative effects of living with cancer. Therefore, health care providers should provide psychosocial care to cancer patients from there diagnosis and in there treatment in dealing with this difficult process.

Quality of Life and Associated Factors Among Adult Cancer Patients Undergoing Chemotherapy Treatment at Amhara National, Regional State, Ethiopia, 2021

Background

In cancer, quality of life (QoL) is an important patient-reported metric; evaluating how patients feel physically and emotionally while fighting the disease could lead to better treatment. Despite its therapeutic effects, chemotherapy treatment causes a plethora of side effects that can affect QoL. Factors affecting the QoL of cancer patients undergoing chemotherapy treatment in Ethiopia have not been thoroughly investigated. As a result, this study assesses QoL and associated characteristics among adult cancer patients receiving chemotherapy at Amhara Region, Ethiopia in 2021.

Martials and Methods

From February 15 to May 15, 2021, an institutional based cross-sectional study was done in Amhara region. Three hundred fourteen patients were included in the study. The data was gathered using Amharic version of European organization for research and treatment of cancer quality of life questionnaire (EORTC QLQ C-30) through a face-to-face interview. Epi Data 4.6 was used to enter the data, which was then exported to SPSS version 23 for statistical analysis. Multivariable logistic regression analysis was used to determine the relationship between independent and dependent variables. The statistical significance was determined by a p-value of less than .05.

Result

Cancer patients in Amhara Region had a 44.32 average QoL. Emotional functioning AOR 1.01 (1.0-1.04), social functioning AOR 1.02 (1.01-1.03), nausea and vomiting AOR 0.95 (0.93-0.98), pain AOR 0.95 (0.93-0.98), financial difficulty 0.97 (0.95-0.99), education AOR 4.3 (1.49-12.32), underweight AOR 0.45 (0.24-0.84),  > 5th cycle of chemotherapy AOR 4 (1.78-9.11), stage IV cancer AOR 0.21 (0.06-0.71), comorbidity AOR 0.28 (0.14-0.57), anxiety AOR 0.32 (0.12-0.84), and depression AOR 0.29 (0.13-0.63) were all significantly associated with QoL in multivariable logistic regression.

Conclusion

Adult cancer patients receiving chemotherapy in the Amhara region had a poor QoL. Emotional functioning, social functioning, nausea and vomiting, pain, financial difficulty, education, body mass index, cancer stage, chemotherapy cycle, comorbidity, anxiety, and depression all had association with QoL. To improve the QoL of cancer patients, QoL assessments, proper symptom management, nutritional support, and integration of psycho-oncology treatment should be considered.

Quality of Life in Hematologic Malignancy in the Eastern Mediterranean Region: A Systematic Review

Health-related quality of life (HRQoL) indicates patients' overall health and is an essential aspect of cancer care. Although multiple studies have addressed the various aspects of HRQoL in cancer patients, few studies have investigated HRQoL in hematologic malignancy patients in the Eastern Mediterranean region (EMR). This review conducted an electronic search using OVID-Medline to identify HRQoL-related articles involving hematologic malignancy patients in the EMR. Eight studies met the inclusion criteria. Two studies validated translated QoL psychometric instruments, three were observational studies, and three were interventional studies. Except for the validation studies, all studies discussed HRQoL in leukemia patients. Our review highlighted a scarcity in the number of studies focusing on patients with hematological malignancies in this region. The included studies demonstrated the negative impact of hematological malignancies and therapies on patients' HRQoL. In addition, the studies displayed the association between physical symptoms and QoL of cancer patients, necessitating the importance of addressing these symptoms. The studies were limited by publication year, the number of patients, geographical locations, and disease entities. Future studies in this area are encouraged to help understand factors affecting HRQoL in the EMR region and ways to improve it. Consequently, further research is needed to establish translated and validated QoL assessment instruments that target patients in the EMR using the most common tools including the Short-Form 36-item Health Survey and the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire.

Relationship between resilience and health-related quality of life among patients with a permanent colostomy

BACKGROUND

The assessment of health-related quality of life (HRQoL) and resilience are important aspects of colorectal cancer care, as well as an indicator of patients' health status. This study was conducted to investigate the relationship between resilience and HRQoL among patients with a permanent colostomy.

METHOD

A cross-sectional descriptive correlational design employing the City of Hope Quality of Life Ostomy Questionnaire and the Resilience Scale was adopted. A purposive sample population was recruited.

RESULTS

The study enrolled 158 colostomy patients. Half the participants (50.6%) were female and the mean age was 58.20 years [standard deviation (SD)=8.70]. Colostomy patients had a mean HRQoL score of 129.61 (SD)=98 (interquartile range: 109-148), with a spiritual domain that was lower than any other HRQoL domain. The Resilience Scale mean score was 106 (interquartile range: 82-126).

CONCLUSION

This study observed a general low score on the HRQoL Questionnaire and this was reflected in the Resilience Scale score of this group of patients with a colostomy.

The impact on quality of life from informing diagnosis in patients with cancer: a systematic review and meta-analysis

Background

The aim of this study was to assess the impact on quality of life from informing patients with cancer of their diagnosis and disease status.

Method

We searched the follow databases, PubMed, CENTRAL (Cochrane Central Register of Controlled Trials), PsycINFO, WEB OF SCIENCE, Embase, CBM (Chinese Biomedical Literature database), WANFANG database (Chinese Medicine Premier), and CNKI (China National Knowledge Infrastructure), using the following terms: neoplasm, cancer, tumor, tumor, carcinoma, disclosure, truth telling, breaking bad news, knowledge, knowing, awareness, quality of life, QOL. Pairs of reviewers independently screened documents and extracted the data, and the meta-analysis was performed using Revman 5.0 software.

Results

Eleven thousand seven hundred forty records retrieved from the databases and 23 studies were included in the final analysis. A meta-analysis revealed that there were no differences in either the general quality of life and symptoms of fatigue, pain, dyspnea, insomnia, appetite loss, and diarrhea, between informed and uniformed cancer patients (P > 0.05). There were also no differences found between the patient groups in physical function, role function, cognitive activity, and emotional function (P > 0.05). In terms of vitality, patients who were completely informed about their diagnosis showed higher vitality than uniformed patients. Uninformed patients seemed to have lower social function scores. Between partly informed and uninformed cancer patients, no differences were found in their general quality of life, function domains, and disease-related symptoms (P > 0.05).

Conclusion

Informing cancer patients of their diagnosis may not have a detrimental effect on their quality of life.

Trial registration

CRD42017060073.