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Hinnen C, Mols F. Fluctuations in core depressive symptoms in colorectal cancer patients. A prospective, population-based PROFILES-registry study. Psychol Health 2024; 39:1411-1427. [PMID: 36511583 DOI: 10.1080/08870446.2022.2155670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 11/21/2022] [Accepted: 11/30/2022] [Indexed: 12/15/2022]
Abstract
PURPOSE Research investigating depressive symptoms among cancer patients rarely distinguish between core symptoms of depression (motivational and consummatory anhedonia, and negative affect). This distinction is important as these symptoms may show different trajectories during the course of the illness and require different treatment approaches. The aim of the present study is to investigate fluctuations in core depressive symptoms in patients with colorectal cancer (CRC). It is hypothesized that these core depressive symptoms fluctuate differently during the course of the illness and depend on the phase of the illness (diagnostic, treatment, recovery and palliative phase). METHOD This study is based on data from the PROCORE study. PROCORE is a prospective, population-based study aimed to examine the longitudinal impact of CRC and its treatment on patient-reported outcomes. Eligible patients completed self-report questionnaires (i.e. Multifactorial Fatigue Index, Hospital Anxiety and Depression scale, EORTC-C30) after diagnosis, after surgery and at one and two years after diagnosis. RESULTS In total, 539 patients participated of whom 68 have died until March 1ste 2021. Core depressive symptoms fluctuated differently during the course of the illness with higher levels of motivational anhedonia during treatment and palliative phase (P<.001), consummatory anhedonia at the palliative phase (p < .001) and negative affect at the diagnostic and palliative phase (P<.001). CONCLUSION It is important to distinguish between different core depressive symptoms as they fluctuate differently during the course of an illness like CRC. The various depressive symptoms may require a different treatment approach at specific moments during the illness process.
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Affiliation(s)
- Chris Hinnen
- Department of Psycho-Oncology, LUMC Oncology Center, Leiden, the Netherlands
| | - Floortje Mols
- CoRPS - Center of Research on Psychological disorders and Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands
- Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands
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Antoniadis D, Giakoustidis A, Paramythiotis D, Michalopoulos A, Mandanas ZN, Papadopoulos VN. Mental health well-being and functional adjustment in colorectal cancer patients: a prospective cohort study. Acta Chir Belg 2024; 124:20-27. [PMID: 36369863 DOI: 10.1080/00015458.2022.2145725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 11/05/2022] [Indexed: 11/14/2022]
Abstract
BACKGROUND Colorectal cancer significantly affects the quality of life of patients, while at the same time contributing to the development of symptoms of psychopathology. The aim of this prospective study, is to investigate the role of the disease in the quality of life of patients with colon cancer and in the appearance of symptoms of anxiety and depression, as well as the connection of the above characteristics during the recovery process, given the distress symptoms experienced by the patients. METHODS In the present study, HADS, FACT - C, well as the DT are use, in a sample of 118 patients of an average age of 70.5 ± 8.5 years, which were submitted to partial or total colectomy surgery. RESULTS Moderate levels of anxiety (M = 8.25, SD = 3.87) and low levels of depression (M = 6.90, SD = 2.97) and distress (M = 5.84, SD = 2.60) emerged preoperatively, while the improvement was significant of patients' quality of life level 6 months after surgery. At the same time, a significant negative effect of the patients' distress level preoperatively on their quality of life, during the recovery process was observed. CONCLUSION Preoperative anxiety is not considered to be an element that affects the functionality and the psychological and physical adaptation to the disease of patients with colon cancer. On the contrary, the feelings of distress they experience can be a predictive factor of their quality of life after the partial or total colectomy surgery.
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Affiliation(s)
- Diomidis Antoniadis
- Post-doctoral researcher, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Alexander Giakoustidis
- 1st Department of Surgery, School of Medicine, Aristotle University of Thessaloniki, General Hospital Papageorgiou, Thessaloniki, Greece
| | - Daniel Paramythiotis
- 1st Propaedeutic Surgery Department, School of Medicine, Aristotle University of Thessaloniki, General Hospital AHEPA, Thessaloniki, Greece
| | - Antonios Michalopoulos
- 1st Propaedeutic Surgery Department, School of Medicine, Aristotle University of Thessaloniki, General Hospital AHEPA, Thessaloniki, Greece
| | | | - Vasileios N Papadopoulos
- 1st Department of Surgery, School of Medicine, Aristotle University of Thessaloniki, General Hospital Papageorgiou, Thessaloniki, Greece
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Mendorf S, Heimrich KG, Mühlhammer HM, Prell T, Schönenberg A. Trajectories of quality of life in people with diabetes mellitus: results from the survey of health, ageing and retirement in Europe. Front Psychol 2024; 14:1301530. [PMID: 38274698 PMCID: PMC10808439 DOI: 10.3389/fpsyg.2023.1301530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 12/29/2023] [Indexed: 01/27/2024] Open
Abstract
Introduction Previous longitudinal studies identified various factors predicting changes in Quality of Life (QoL) in people with diabetes mellitus (PwDM). However, in these studies, the stability of QoL has not been assessed with respect to individual differences. Methods We studied the predictive influence of variables on the development of QoL in PwDM across three waves (2013-2017) from the cross-national panel dataset Survey of Health, Ageing, and Retirement in Europe (SHARE). To determine clinically meaningful changes in QoL, we identified minimal clinically important difference (MCID). Linear regressions and Linear Mixed Models (LMM) were conducted to determine factors associated with changes in QoL. Results On average, QoL remained stable across three waves in 2989 PwDM, with a marginal difference only present between the first and last wave. However, when looking at individual trajectories, 19 different longitudinal patterns of QoL were identified across the three time-points, with 38.8% of participants showing stable QoL. Linear regression linked lower QoL to female gender, less education, loneliness, reduced memory function, physical inactivity, reduced health, depression, and mobility limitations. LMM showed that the random effect of ID had the strongest impact on QoL across the three waves, suggesting highly individual QoL patterns. Conclusion This study enhances the understanding of the stability of QoL measures, which are often used as primary endpoints in clinical research. We demonstrated that using traditional averaging methods, QoL appears stable on group level. However, our analysis indicated that QoL should be measured on an individual level.
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Affiliation(s)
- Sarah Mendorf
- Department of Neurology, University Hospital Jena, Jena, Germany
| | - Konstantin G. Heimrich
- Department of Neurology, University Hospital Jena, Jena, Germany
- Department of Geriatrics, University Hospital Jena, Jena, Germany
| | - Hannah M. Mühlhammer
- Department of Neurology, University Hospital Jena, Jena, Germany
- Department of Geriatrics, University Hospital Halle, Halle, Germany
| | - Tino Prell
- Department of Neurology, University Hospital Jena, Jena, Germany
- Department of Geriatrics, University Hospital Halle, Halle, Germany
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Li H, Lyu M, Wang A, Yin Y, Zhang J, Li P. Social Support and Life Satisfaction in Women With Cervical Cancer: A Serial Multiple Mediation Model. Cancer Nurs 2024; 47:64-71. [PMID: 36322694 DOI: 10.1097/ncc.0000000000001146] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Although the number of studies focusing on life satisfaction in women with cervical cancer is increasing, there are limited studies on the pathway between social support and life satisfaction in this population. OBJECTIVE This study explored the pathway between social support and life satisfaction in women with cervical cancer by examining the serial mediating effects of self-care self-efficacy, coping strategies, and depressive symptoms. METHODS In this cross-sectional study, a total of 292 women with cervical cancer completed a questionnaire for assessing social support, self-efficacy, coping strategies, depressive symptoms, and life satisfaction. Structural equation modeling was used to test the direct and/or indirect effects of the variables on life satisfaction. RESULTS Structural equation modeling analysis indicated that self-efficacy, coping strategies, and depressive symptoms mediates the effect of social support on life satisfaction. Direct paths from social support to life satisfaction, social support to self-efficacy, self-efficacy to coping strategies, coping strategies to depressive symptoms, and depressive symptoms to life satisfaction were significant ( P < .05). Moreover, indirect paths from social support to life satisfaction, self-efficacy to life satisfaction, and coping strategies to life satisfaction were also significant ( P < .05). CONCLUSIONS Self-care self-efficacy, coping strategies, and depressive symptoms are potential pathways through which social support may affect life satisfaction in women with cervical cancer. IMPLICATION Healthcare providers, family, and friends should offer more social support to the patients and make efforts to strengthen their self-care self-efficacy, facilitate active coping, and alleviate depressive symptoms to improve women's life satisfaction.
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Affiliation(s)
- Hui Li
- Author Affiliations: Department of Orthopedics, West China Hospital/Sichuan University West China School of Nursing, Sichuan University (Ms H. Li and Ms P. Li), Chengdu, Sichuan, PR China; Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore (Dr Lyu), Singapore, Singapore; School of Nursing, Fudan University (Dr Wang), Shanghai, PR China; Xiangya Nursing School, Central South University (Drs Yin and Zhang), Changsha, Hunan, PR China
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Brajković L, Milat-Panža K, Kopilaš V. Subjective Well-Being in Cancer Patients: The Roles of Social Support, Purpose in Life, Resilience, and Informativeness. Healthcare (Basel) 2023; 11:3181. [PMID: 38132071 PMCID: PMC10742701 DOI: 10.3390/healthcare11243181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 12/07/2023] [Accepted: 12/15/2023] [Indexed: 12/23/2023] Open
Abstract
The aim of this research was to determine the relationship between subjective well-being (life satisfaction, positive and negative experiences, and prosperity) and various psychosocial factors (social support received from family members and partners, purpose in life, resilience and information) in cancer patients and to examine the possibility of predicting components of subjective well-being based on these mentioned factors in cancer patients. A total of 338 adult cancer patients from Croatia participated in the study (41.1% male and 58.9% female). To measure the constructs, the Diener Subjective Well-Being Scale, the Social Support Scale at work and in the family, the Purpose in Life Scale, the Short Resilience Scale, and the EORTC-QLQ information questionnaire were used. Results showed a high level of life satisfaction and prosperity, as well as more frequent positive compared to negative experiences. A medium to high level of social support received from family members and from the partner was determined. High levels of purpose in life and medium levels of resilience and information were found. A high correlation was found among the components of the construct of subjective well-being, and a low to medium correlation among the predictors. Positive associations were found between the criteria of life satisfaction and prosperity with psychosocial factors. Negative associations were established between the positive/negative experience variables and the factors. Furthermore, the purpose in life was determined as an important predictor of all three components of subjective well-being, social support (both sources) as important for predicting life satisfaction, resilience for experiencing positive and negative experiences, and social family support for predicting the prosperity of cancer patients.
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Affiliation(s)
| | | | - Vanja Kopilaš
- Faculty of Croatian Studies, University of Zagreb, 10000 Zagreb, Croatia; (L.B.)
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Zhang Q, Tang L, Chen H, Chen S, Luo M, He Y, Liu M. Psychological outcomes of the systematic interventions based on the stress-induced situation, affective, bodily, and cognitive reactions framework for patients with lung cancer: A randomized clinical trial. Int J Nurs Stud 2023; 146:104566. [PMID: 37544148 DOI: 10.1016/j.ijnurstu.2023.104566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 07/09/2023] [Accepted: 07/17/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND Psychological distress is a multi-factorial unpleasant experience of a psychological, social, spiritual, and/or physical nature that may interfere with one's ability to cope effectively with cancer, physical symptoms and treatment. Psychological distress is common and affects the prognosis of cancer patients. Lung cancer accounted for 11.4 % of all new cancer cases and 18 % of all cancer mortality for 36 cancers in 185 countries. The prevalence of distress among Chinese lung cancer patients ranged from 10.1 % to 61.29 %. However, the existing intervention studies on the psychological distress in lung cancer patients are limited and intervention results may be different. OBJECTIVES To explore the psychological outcomes of a nurse-led systematic intervention program based on the stress-induced situation, affective, bodily, and cognitive reactions framework for patients with lung cancer undergoing operation at anxiety and depression. DESIGN A randomized clinical trial. SETTING Thoracic surgery ward in a tertiary hospital in China. PARTICIPANTS Lung cancer patients undergoing surgery. METHODS This is a 12-month longitudinal randomized controlled study in a tertiary hospital in China. A total of 240 lung cancer patients were randomly divided into either the control group or the intervention group. The nurse-led systematic intervention contents include psychological education, intervention measures based on the stress-induced situation, affective, bodily, and cognitive reactions framework, issuance of daily lifestyle cards, and regular follow-ups. The Hospital Anxiety and Depression Scale, Functional Assessment of Chronic Illness Therapy-Fatigue Scale, and Satisfaction with Life Scale were used for the baseline assessment within 48 h upon admission. The same assessment was performed respectively at 1, 3, 6 and 12 months after the intervention started. The effects of the systematic interventions on depression, anxiety, fatigue, and life satisfaction were tested by a linear mixed effects model. RESULTS Overall time-by-group interaction effects were significantly different with regard to anxiety, depression, and fatigue after controlling for the covariates, while a significant time-by-group interaction effect was not found for life satisfaction. Changes for anxiety and depression scores at 6 and 12 months after initiation of the intervention were significantly greater in the intervention group compared with those in the control group (t = 3.046, p = 0.002, t = 3.190, p = 0.001; t = 3.735, p = 0.000, t = 2.979, p = 0.002), whereas scores for fatigue were significantly higher in the intervention group at 6 and 12 months (t = -3.096, p = 0.002, t = -2.784, p = 0.005). CONCLUSION The systematic intervention program based on the stress-induced situation, affective, bodily, and cognitive reactions framework may effectively relieve anxiety, depression, and fatigue in lung cancer patients undergoing surgery. REGISTRATION This study was registered on December 22, 2019 with the registration number ChiCTR1900028487, and the date of first recruitment was Jan 5, 2020.
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Affiliation(s)
- Qingling Zhang
- Department of Medical Psychology, The Second Affiliated Hospital of Army Medical University, Chongqing 400037, China
| | - Lili Tang
- Department of Thoracic Surgery, The Second Affiliated Hospital of Army Medical University, Chongqing 400037, China
| | - Hui Chen
- Digestive Department, The Second Affiliated Hospital of Army Medical University, Chongqing 400037, China
| | - Shuanghong Chen
- Department of Medical Psychology, The Second Affiliated Hospital of Army Medical University, Chongqing 400037, China
| | - Maoyu Luo
- Department of Thoracic Surgery, The Second Affiliated Hospital of Army Medical University, Chongqing 400037, China
| | - Yuexia He
- Department of Thoracic Surgery, The Second Affiliated Hospital of Army Medical University, Chongqing 400037, China
| | - Minghua Liu
- Emergency Department, The First Affiliated Hospital of Army Medical University, Chongqing 400038, China.
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Yang Q, Xia L, Feng LF, Gong WJ, Zhu YY, Wang WX, Hua YJ, Li JB. Multi-trajectories of health-related quality of life and their associated factors in patients with nasopharyngeal carcinoma: A longitudinal study. Radiother Oncol 2023; 186:109743. [PMID: 37315581 DOI: 10.1016/j.radonc.2023.109743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 05/30/2023] [Accepted: 06/04/2023] [Indexed: 06/16/2023]
Abstract
BACKGROUND The trajectories of health-related quality of life (HRQoL) of nasopharyngeal carcinoma (NPC) during and after the treatment along with their associated factors are seldom investigated in longitudinal studies. This study aims to investigate the longitudinal trajectories of HRQoL over time and their associated factors in patients with newly diagnosed NPC. METHODS Between July 2018 and September 2019, a total of 500 patients were finally involved in this study. HRQoL was measured at four time points, from before treatment to the follow-up period after treatment. Group-based multi-trajectory modeling was applied to identify trajectories of five HRQoL functioning domains during the longitudinal period. Multinomial logistic regression models were applied to investigate potential independent factors associated with the multi-trajectory groups. RESULTS We identified four distinct multi-trajectory groups, including the "initially lowest functioning" group (19.8%), the "initially lower functioning" group (20.8%), the "initially higher functioning" group (46.0%), and the "consistently highest functioning" group (13.4%). Patients who were older than 45 years or had T4 stage disease were more likely to be in the "initially lowest functioning" group, while those with EBV DNA ≥ 1500 copies/mL before the treatment were more likely to be in the "initially lowest functioning" or the "initially lower functioning" groups. CONCLUSIONS We report the presence of heterogeneity in HRQoL trajectories among patients with NPC, and found that older age, advanced T stage, and higher EBV DNA level before treatment were significantly associated with poor HRQoL trajectories. Further studies are needed to examine the generalizability of these identified HRQoL trajectories and their associations with psychosocial and survival outcomes.
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Affiliation(s)
- Qi Yang
- Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, PR China; State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, PR China
| | - Le Xia
- Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, PR China; State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, PR China
| | - Li-Fen Feng
- Department of Statistics, Government Affairs Service Center of Health Commission of Guangdong Province, Guangzhou, PR China
| | - Wei-Jie Gong
- Department of General Practice, Health Science Center, Shenzhen University, Shenzhen 518037, China
| | - Ying-Ying Zhu
- Clinical Research Design Division, Clinical Research Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, PR China
| | - Wen-Xuan Wang
- School of Public Health, Sun Yat-sen University, Guangzhou, PR China; Department of Clinical Research, Sun Yat-sen University Cancer Center, Guangzhou, PR China
| | - Yi-Jun Hua
- Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, PR China; State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, PR China
| | - Ji-Bin Li
- State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, PR China; Department of Clinical Research, Sun Yat-sen University Cancer Center, Guangzhou, PR China.
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Tsai TC, Lee GG, Ting A, Antoni MH, Mendez A, Carver CS, Kim Y. Roles of benefit finding in psychological and inflammatory adjustments in persons with colorectal cancer: a prospective analysis on the multidimensionality of benefit finding. Psychol Health 2023:1-19. [PMID: 37488833 PMCID: PMC10805970 DOI: 10.1080/08870446.2023.2238280] [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] [Received: 12/21/2022] [Revised: 05/03/2023] [Accepted: 07/14/2023] [Indexed: 07/26/2023]
Abstract
OBJECTIVE This study examined the unique associations of different dimensions of the resilience factor, benefit finding, on concurrent and prospective psychological and biological adjustment outcomes over the first year after a colorectal cancer diagnosis. METHODS AND MEASURES Individuals newly diagnosed with colorectal cancer (n = 133, mean age = 56 years old, 59% female, 46% Hispanic) completed questionnaires assessing the multidimensional aspects of benefit finding around 4 months post-diagnosis (T1). Psychological (depressive symptoms and life satisfaction) and biological [C-reactive protein (CRP) and interleukin-10 (IL-10)] adjustments were assessed at T1 and one-year post-diagnosis (T2). RESULTS Structural equation modeling revealed that at T1, greater reprioritization was concurrently related to higher depressive symptoms (p=.020). Lower acceptance, lower empathy, and greater positive self-view predicted higher life satisfaction at T2 (ps<.010). Additionally, lower empathy and greater family valuation predicted higher CRP at T2 (ps<.004), whereas greater positive self-view predicted higher IL-10 at T2 (p=.039). Greater overall benefit finding was associated with lower IL-10 at T1 (p=.013). CONCLUSION Various aspects of benefit finding differentially relate to psychological and inflammatory markers during the first year after diagnosis in persons with colorectal cancer. Interventions designed to specifically enhance positive self-view may promote both the psychological and biological health of individuals with cancer.
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Affiliation(s)
- Thomas C. Tsai
- University of Miami, 5665 Ponce de Leon Blvd., Coral Gables, FL, United States 33146
| | - Gabriela G. Lee
- University of Miami, 5665 Ponce de Leon Blvd., Coral Gables, FL, United States 33146
| | - Amanda Ting
- VA Palo Alto Health Care, 3801 Miranda Ave., Palo Alto, CA 94304
| | - Michael H. Antoni
- University of Miami, 5665 Ponce de Leon Blvd., Coral Gables, FL, United States 33146
| | - Armando Mendez
- University of Miami Miller School of Medicine, 1600 NW 10 Ave., Miami, FL, United States 33136
| | - Charles S. Carver
- University of Miami, 5665 Ponce de Leon Blvd., Coral Gables, FL, United States 33146
| | - Youngmee Kim
- University of Miami, 5665 Ponce de Leon Blvd., Coral Gables, FL, United States 33146
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Thong MSY, Doege D, Weißer L, Koch-Gallenkamp L, Jansen L, Bertram H, Eberle A, Holleczek B, Nennecke A, Waldmann A, Zeissig SR, Brenner H, Arndt V. Persisting Deficits in Health-Related Quality of Life of Colorectal Cancer Survivors 14–24 Years Post-Diagnosis: A Population-Based Study. Curr Oncol 2023; 30:3373-3390. [PMID: 36975470 PMCID: PMC10047200 DOI: 10.3390/curroncol30030257] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 03/07/2023] [Accepted: 03/10/2023] [Indexed: 03/15/2023] Open
Abstract
(1) Background: The health-related quality of life (HRQOL) of colorectal cancer (CRC) survivors >10 years post-diagnosis is understudied. We aimed to compare the HRQOL of CRC survivors 14–24 years post-diagnosis to that of age- and sex-matched non-cancer controls, stratified by demographic and clinical factors. (2) Methods: We used data from 506 long-term CRC survivors and 1489 controls recruited from German population-based multi-regional studies. HRQOL was assessed with the European Organization for Research and Treatment of Cancer Quality of Life Core-30 (EORTC QLQ-C30) questionnaire. We estimated differences in the HRQOL of CRC survivors and controls with multiple regression, adjusted for age at survey, sex, and education, where appropriate. (3) Results: CRC survivors reported poorer social functioning but better health status/QOL than controls. CRC survivors, in general, had higher levels of symptom burden, and in particular diarrhea and constipation, regardless of demographic or clinical factors. In stratified analyses, HRQOL differed by age, sex, cancer type, and having a permanent stoma. (4) Conclusions: Although CRC survivors may have a comparable health status/QOL to controls 14–24 years after diagnosis, they still live with persistent bowel dysfunction that can negatively impact aspects of functioning. Healthcare providers should provide timely and adapted follow-up care to ameliorate potential long-term suffering.
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Affiliation(s)
- Melissa S. Y. Thong
- Unit of Cancer Survivorship, Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
- Correspondence: ; Tel.: +49-6221-42-2334
| | - Daniela Doege
- Unit of Cancer Survivorship, Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Linda Weißer
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Lena Koch-Gallenkamp
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Lina Jansen
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Heike Bertram
- Cancer Registry of North Rhine-Westphalia, 44801 Bochum, Germany
| | - Andrea Eberle
- Bremen Cancer Registry, Leibniz Institute for Prevention Research and Epidemiology—BIPS, 28359 Bremen, Germany
| | | | | | - Annika Waldmann
- Institute for Social Medicine and Epidemiology, University of Lübeck, 23538 Lübeck, Germany
| | - Sylke Ruth Zeissig
- Institute of Clinical Epidemiology and Biometry (ICE-B), Julius Maximilian University of Würzburg, 97080 Würzburg, Germany
- Cancer Registry of Rhineland-Palatinate, 55116 Mainz, Germany
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
- Division of Preventive Oncology, German Cancer Research Center (DKFZ), National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Volker Arndt
- Unit of Cancer Survivorship, Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
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Wang YF, Wang TY, Liao TT, Lin MH, Huang TH, Hsieh MC, Chen VCH, Lee LW, Huang WS, Chen CY. Quality of life and symptom distress after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. World J Clin Cases 2022; 10:11775-11788. [PMID: 36405273 PMCID: PMC9669838 DOI: 10.12998/wjcc.v10.i32.11775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 08/09/2022] [Accepted: 10/17/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/ HIPEC) for peritoneal surface malignancy can effectively control the disease, however it is also associated with adverse effects which may affect quality of life (QoL).
AIM To investigate early perioperative QoL after CRS/HIPEC, which has not been discussed in Taiwan.
METHODS This single institution, observational cohort study enrolled patients who received CRS/HIPEC. We assessed QoL using the Taiwanese version of the MD Anderson Symptom Inventory (MDASI-T) and European Organization Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30). Participants completed the questionnaires before CRS/HIPEC (S1), at the first outpatient follow-up (S2), and 3 mo after CRS/HIPEC (S3).
RESULTS Fifty-eight patients were analyzed. There was no significant perioperative difference in global health status. Significant changes in physical and role functioning scores decreased at S2, and fatigue and pain scores increased at S2 but returned to baseline at S3. Multiple regression analysis showed that age and performance status were significantly correlated with QoL. In the MDASI-T questionnaire, distress/feeling upset and lack of appetite had the highest scores at S1, compared to fatigue and distress/feeling upset at S2, and fatigue and lack of appetite at S3. The leading interference items were working at S1 and S2 and activity at S3. MDASI-T scores were significantly negatively correlated with the EORTC QLQ-C30 results.
CONCLUSION QoL and symptom severity improved or returned to baseline in most categories within 3 mo after CRS/HIPEC. Our findings can help with preoperative consultation and perioperative care.
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Affiliation(s)
- Ya-Fen Wang
- Cancer Center, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Ting-Yao Wang
- Division of Hematology and Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Tzu-Ting Liao
- Division of Case Management, Cancer Center, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Meng-Hung Lin
- Health Information and Epidemiology Laboratory, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Tzu-Hao Huang
- Division of General Surgery, Department of Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Meng-Chiao Hsieh
- Division of Colorectal Surgery, Department of Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Vincent Chin-Hung Chen
- Department of Psychiatry, Chang Gung Memorial Hospital, Chiayi and Chang Gung University, Taoyuan, Taiwan
| | - Li-Wen Lee
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Chiayi, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Wen-Shih Huang
- Division of Colorectal Surgery, Department of Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Chao-Yu Chen
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Chiayi, Taiwan
- Department of Early Childhood Care and Education, Shu-Zen Junior College of Medicine and Management, Kaohsiung, Taiwan; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Chiayi, Taiwan
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11
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Cieślak M, Kozaka J, Golińska PB, Bidzan M. Mentalization and Its Relation to Life Satisfaction and the Level of Mental Adjustment to Illness in Women with Breast Cancer-A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10323. [PMID: 36011957 PMCID: PMC9408050 DOI: 10.3390/ijerph191610323] [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] [Received: 06/29/2022] [Revised: 08/17/2022] [Accepted: 08/18/2022] [Indexed: 06/15/2023]
Abstract
This study's aim was assessing of the relationship between mentalization and life satisfaction and the level of adaptation to oncological disease in patients with breast cancer. The study involved 41 women (M = 59.88; SD = 8.81) with breast cancer who completed their treatments and participated in a cancer rehabilitation program. In the study, we used the Mentalization Questionnaire (MZQ), the Satisfaction Life Scale (SWLS), and the Mini-Mental Adjustment to Cancer Scale (Mini-MAC). The mean of declared level of mentalization was 45.54 (SD = 11.65). The significant correlation between mentalization (its general value and individual dimensions) and satisfaction with life/mental adjustment to cancer was observed. The strongest positive correlations were noted between refusing self-reflection, helplessness-hopelessness, and anxious preoccupation and the negative correlation between mentalization and satisfaction with life. Mentalization was a predictor of satisfaction with life and mental adjustment to illness. Mentalization was related with life satisfaction and adjustment to cancer in patients with breast cancer, which is in line with previous studies suggesting the crucial role of subjective psychological factors in maintaining mental health.
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Affiliation(s)
- Mariusz Cieślak
- Institute of Psychology, University of Lodz, 90-136 Lodz, Poland
| | - Joanna Kozaka
- Private Counseling Services Joanna Kozaka, 80-414 Gdansk, Poland
| | | | - Mariola Bidzan
- Department of Clinical and Health Psychology, University of Gdansk, 80-309 Gdansk, Poland
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12
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Cummings A, Foster R, Calman L, Permyakova NV, Bridges J, Wiseman T, Corbett T, Smith PWF, Foster C. Quality of life and health status in older adults (≥65 years) up to five years following colorectal cancer treatment: Findings from the ColoREctal Wellbeing (CREW) cohort study. PLoS One 2022; 17:e0270033. [PMID: 35834525 PMCID: PMC9282586 DOI: 10.1371/journal.pone.0270033] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 06/02/2022] [Indexed: 11/18/2022] Open
Abstract
Objective Colorectal cancer (CRC) is common in older adults, with more than 70% of diagnoses in people aged ≥65 years. Despite this, there is a knowledge gap regarding longer-term outcomes in this population. Here, we identify those older people most at risk of poor quality of life (QoL) and health status in the five years following CRC treatment. Materials and methods CREW is a UK longitudinal cohort study investigating factors associated with health and wellbeing recovery following curative-intent CRC surgery. Participants completed self-report questionnaires pre-surgery, then at least annually up to five years. Longitudinal analyses explored the prevalence and pre-surgery risk factors of poor QoL (QLACS-GSS) and health status (EQ-5D: presence/absence of problems in five domains) in older (≥65 years) participants over five years. Results 501 participants aged ≥65years completed questionnaires pre-surgery; 45% completed questionnaires five years later. Oldest-old participants (≥80 years) reported poorer QoL (18% higher QLACS-GSS) and 2–4 times higher odds of having problems with mobility or usual activities, compared with the youngest-old (65–69 years) over follow-up. Baseline higher self-efficacy was significantly associated with better QoL (10–30% lower QLACS-GSS scores compared to those with low self-efficacy) and lower odds of problems in all EQ-5D domains. Adequate social support was significantly associated with better QoL (8% lower QLACS-GSS) and lower odds of problems with usual activities (OR = 0.62) and anxiety/depression (OR = 0.56). Conclusion There are important differences in QoL and health status outcomes for the oldest-old during CRC recovery. CREW reveals pre-surgery risk factors that are amenable to intervention including self-efficacy and social support.
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Affiliation(s)
- Amanda Cummings
- Macmillan Survivorship Research Group, School of Health Sciences, University of Southampton, Southampton, United Kingdom
| | - Rebecca Foster
- Macmillan Survivorship Research Group, School of Health Sciences, University of Southampton, Southampton, United Kingdom
| | - Lynn Calman
- Macmillan Survivorship Research Group, School of Health Sciences, University of Southampton, Southampton, United Kingdom
| | - Natalia V. Permyakova
- Southampton Clinical Trials Unit, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
- NIHR Research Design Service South Central, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Jackie Bridges
- NIHR ARC Wessex, School of Health Sciences, University of Southampton, Southampton, United Kingdom
| | - Theresa Wiseman
- The Royal Marsden NHS Foundation Trust and University of Southampton, Southampton, United Kingdom
| | - Teresa Corbett
- Faculty of Sport, Health, & Social Sciences, Solent University, Southampton, United Kingdom
| | - Peter W. F. Smith
- Social Statistics and Demography, Social Sciences, University of Southampton, Southampton, United Kingdom
| | - Claire Foster
- Macmillan Survivorship Research Group, School of Health Sciences, University of Southampton, Southampton, United Kingdom
- * E-mail:
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The efficacy and mechanism of positive psychological intervention on well-being for colostomy patients: a randomized controlled trial. Support Care Cancer 2022; 30:5747-5757. [PMID: 35332374 DOI: 10.1007/s00520-022-06951-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 03/02/2022] [Indexed: 11/12/2022]
Abstract
AIMS The positive psychology intervention (PPI) is an effective therapy designed to motivate individuals' positive quality and power, to help them survive in an adverse situation, and to establish a high-quality personal and social life. This study aims to evaluate the efficacy and mechanism of PPI on the psychological capital, psychological distress, and life satisfaction among colostomy patients. METHODS Patients (n = 120) with permanent stomas were recruited and randomly assigned into two groups. Patients in the experimental group (n = 60) received standard care and PPI, whereas patients in the control group (n = 60) only received standard care. The psychological capital, psychological distress, and life satisfaction were measured and compared between two groups before the intervention, the immediate post-intervention, and follow-up. RESULTS All 120 patients completed the study. The hope, optimism, resilience, psychological distress, and life satisfaction score of the experimental group were significantly higher than those of the control group at T1 and T2 (P < 0.05). Self-efficacy score of the experimental group had no significant difference at the two time points after the intervention than the control group (P > 0.05). Changes in hope and resilience which belong to psychological capital mediated the intervention's efficacy on changes in PPI on life satisfaction (β = 0.265, P = 0.005; β = 0.686, P = 0.002). CONCLUSIONS PPI could effectively improve psychological capital, psychological distress, and life satisfaction among patients with stomas. Besides, our findings add novel support that increased hope and resilience are the active ingredients that promote intervention change.
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Health-Related Quality of Life Trajectories Among Older Adults With Diabetes Mellitus: A Group-Based Modeling Approach. THE JOURNAL OF NURSING RESEARCH : JNR 2022; 30:e199. [PMID: 35234212 DOI: 10.1097/jnr.0000000000000480] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Health-related quality of life (HR-QoL) is an important issue among older adults with diabetes mellitus. However, information on longitudinal changes in HR-QoL over time using the illness trajectory model is limited. PURPOSE The purpose of this study was to identify patterns of temporal change in HR-QoL and their predictors using longitudinal data and a group-based modeling approach. METHODS European Quality of Life-5 Dimensions data for 440 older adults with diabetes mellitus were drawn from the nationwide Korea Health Panel Survey conducted from 2009 to 2013. Latent class growth analysis and multinomial logistic regression models were used to identify the predictors of HR-QoL trajectories. RESULTS Four distinct classes of HR-QoL trajectory were identified: high decrease (n = 46, 10.5%), high stable (n = 232, 52.7%), medium stable (n = 157, 35.7%), and low increase (n = 5, 1.1%). Participants in ``high decrease" and ``high-stable" classes tended to be men who were highly educated, physically active, and adherent to their medication regimen. High economic status, few chronic diseases, independence in activities of daily living, and high self-rated health status were also identified as indicators of being in the ``high-decrease" and ``high-stable" class group. CONCLUSIONS/IMPLICATIONS FOR PRACTICE A salient finding of this study is that HR-QoL trajectories in older adults with diabetes mellitus are not homogeneous but instead diverge into four distinct classes. Most participants showed no major changes in HR-QoL across the 5-year period, regardless of HR-QoL level. To prevent patients with diabetes from experiencing chronically low levels of HR-QoL, comprehensive assessment and individualized care based on HR-QoL are necessary.
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15
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White VM, Lisy K, Ward A, Ristevski E, Clode M, Webber K, Emery J, Ijzerman MJ, Afshar N, Millar J, Gibbs P, Evans S, Jefford M. Disparities in quality of life, social distress and employment outcomes in Australian cancer survivors. Support Care Cancer 2022; 30:5299-5309. [PMID: 35279769 PMCID: PMC9046289 DOI: 10.1007/s00520-022-06914-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 02/12/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE To examine how socio-demographic, comorbidities and information needs influence quality of life (QoL) outcomes of survivors of breast, colorectal, or prostate cancer, non-Hodgkin lymphoma or melanoma. METHODS Cross-sectional postal survey with eligible participants identified through a population-based cancer registry. QoL outcomes were assessed by EQ-5D-5L, social difficulties index (SDI) and, for those employed at diagnosis, current employment. Regression analyses explored associations between outcome variables and cancer type, age, time since diagnosis, residential location, socio-economic disadvantage, comorbidities and unmet information needs. Mediation analyses examined whether comorbidities and information needs explained relationships between outcome variables and socio-economic disadvantage. RESULTS 2115 survivors participated. Mean EQ-5D-5L scores (mean = 0.84) were similar to population averages and SDI scores were low for the entire sample (mean = 3.80). In multivariate analyses, being aged over 80, greater socio-economic disadvantage, comorbidities and unmet information needs decreased EQ-5D-5L scores. Higher SDI scores were associated with socio-economic disadvantage, comorbidities and unmet information needs. Not being employed was associated with being aged over 50, more comorbidities and socio-economic disadvantage. Comorbidities but not information needs partially mediated the impact of socio-economic disadvantage on EQ-5D-5L and SDI accounting for 17% and 14% of the total effect of socio-economic disadvantage respectively. Neither comorbidities nor information needs mediated the association between socio-economic disadvantage and employment outcomes. CONCLUSIONS To improve quality of life, survivorship care should be better tailored to address the needs of individuals given their overall health and impact of comorbidities, their age and type of cancer and not simply time since diagnosis.
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Affiliation(s)
- Victoria M. White
- grid.1021.20000 0001 0526 7079School of Psychology, Faculty of Health, Deakin University, Geelong, VIC Australia ,grid.3263.40000 0001 1482 3639Cancer Council Victoria, Melbourne, VIC Australia
| | - Karolina Lisy
- grid.1055.10000000403978434Australian Cancer Survivorship Centre, Peter MacCallum Cancer Centre, Melbourne, VIC Australia ,grid.1055.10000000403978434Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, VIC Australia ,grid.1008.90000 0001 2179 088XSir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC Australia
| | - Andrew Ward
- The Social Research Centre, Melbourne, VIC Australia
| | - Eli Ristevski
- grid.1002.30000 0004 1936 7857Monash Rural Health, Monash University, Warragul, VIC Australia
| | - Melanie Clode
- grid.1055.10000000403978434Australian Cancer Survivorship Centre, Peter MacCallum Cancer Centre, Melbourne, VIC Australia
| | - Kate Webber
- grid.1002.30000 0004 1936 7857School of Clinical Sciences, Monash University, Clayton, VIC Australia ,grid.419789.a0000 0000 9295 3933Department of Oncology, Monash Health, Clayton, VIC Australia
| | - Jon Emery
- grid.1008.90000 0001 2179 088XDepartment of General Practice and Centre for Cancer Research, University of Melbourne, Melbourne, Australia
| | - Maarten J. Ijzerman
- grid.1008.90000 0001 2179 088XSir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC Australia
| | - Nina Afshar
- grid.3263.40000 0001 1482 3639Cancer Council Victoria, Melbourne, VIC Australia ,grid.1008.90000 0001 2179 088XCentre for Epidemiology and Biostatistics, School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Jeremy Millar
- grid.267362.40000 0004 0432 5259Alfred Health Radiation Oncology, Alfred and LaTrobe Regional Hospital, Melbourne, VIC 3004 Australia ,grid.1002.30000 0004 1936 7857School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004 Australia
| | - Peter Gibbs
- Department of Medical Oncology, Western Health, St. Albans, Victoria, Australia ,grid.1042.70000 0004 0432 4889Personalised Oncology Division, Walter and Eliza Hall Institute of Medical Research, Parkville, VIC Australia
| | - Sue Evans
- grid.3263.40000 0001 1482 3639Cancer Council Victoria, Melbourne, VIC Australia ,grid.1002.30000 0004 1936 7857School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004 Australia
| | - Michael Jefford
- grid.1055.10000000403978434Australian Cancer Survivorship Centre, Peter MacCallum Cancer Centre, Melbourne, VIC Australia ,grid.1055.10000000403978434Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, VIC Australia ,grid.1008.90000 0001 2179 088XSir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC Australia
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Qaderi SM, van der Heijden JAG, Verhoeven RHA, de Wilt JHW, Custers JAE. Trajectories of health-related quality of life and psychological distress in patients with colorectal cancer: A population-based study. Eur J Cancer 2021; 158:144-155. [PMID: 34666216 DOI: 10.1016/j.ejca.2021.08.050] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 08/16/2021] [Accepted: 08/29/2021] [Indexed: 11/12/2022]
Abstract
BACKGROUND The aim of this nationwide cohort study was to examine the course of symptoms and trajectories of health-related quality of life (HR-QoL) and psychological distress during follow-up and to identify vulnerable patients. METHODS Patients with pathological stage I-III colorectal cancer (CRC) between 2013 and 2018 were included. Baseline characteristics were collected from the Netherlands Cancer Registry, and patients completed the European Organisation for Research and Treatment of Cancer QLQ-C30/CR29, Hospital Anxiety and Depression Scale and low anterior resection syndrome (LARS) questionnaires at the baseline and subsequently at 3, 6, 12, 18 and 24 months. Latent class growth and multinomial logistic regression analyses were performed to outline 24-month trajectories in HR-QoL and distress and to identify predictive factors. RESULTS A total of 1535 patients with colon cancer or rectal cancer were included. Trajectory analysis of HR-QoL identified three patient classes: high HR-QoL (62.7%), improving HR-QoL (29.0%) and low HR-QoL (8.3%). The following patient groups were identified with having low distress (64.0%), moderate distress (26.9%) and high distress (9.1%). Around 13% of the total cohort had either persistent low HR-QoL or high psychological distress throughout follow-up. Patients belonging to this vulnerable group were significantly more likely to be female, to be younger aged, to have lower education, to have disease stage II-III or to have major LARS. CONCLUSIONS Although most patients treated for stage I-III CRC fared well, a small but significant proportion of around 13% did not recover during follow-up and reported low HR-QoL and/or high psychological distress levels throughout. This study's findings should be taken into account when organising and selecting patients for tailored follow-up.
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Affiliation(s)
- Seyed M Qaderi
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Surgical Oncology, Nijmegen, the Netherlands.
| | - Joost A G van der Heijden
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Surgical Oncology, Nijmegen, the Netherlands
| | - Rob H A Verhoeven
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Surgical Oncology, Nijmegen, the Netherlands; Department of Research & Development, Netherlands Comprehensive Cancer Organization, Utrecht, the Netherlands; Amsterdam UMC, Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam, the Netherlands
| | - Johannes H W de Wilt
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Surgical Oncology, Nijmegen, the Netherlands
| | - Jose A E Custers
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Medical Psychology, Nijmegen, the Netherlands
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Roy DC, Lun R, Wang TF, Chen Y, Wells P. Life dissatisfaction in Canadians aged 40 and above with cancer and mental health disorders: A cross-sectional study using the Canadian Community Health Survey. Cancer Med 2021; 10:7601-7609. [PMID: 34582119 PMCID: PMC8559453 DOI: 10.1002/cam4.4287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 09/01/2021] [Accepted: 09/02/2021] [Indexed: 12/02/2022] Open
Abstract
Background Life dissatisfaction varies with different factors––particularly in the presence of chronic conditions, such as cancer. The combination of cancer and mental health disorders may increase life dissatisfaction due to lowered resilience against stress. We sought to determine if life dissatisfaction is higher in Canadians aged 40 and above with cancer compared to the cancer‐free population and if there is a synergistic effect between cancer and mental health disorder on life dissatisfaction. Methods We conducted a cross‐sectional study using the 2015–2016 Canadian Community Health Survey. We included 67,294 subjects aged 40+, and evaluated the association between cancer, mental health disorders, and life dissatisfaction using logistic regression and odds ratios (ORs) while adjusting for age, sex, marital status, education level, and chronic conditions. Relative excess risk due to interaction (RERI), attributional proportion due to interaction (AP), and Synergy index (S‐index), were calculated to determine the significance of additive interaction. Results Compared to the cancer‐free population, life dissatisfaction was higher in patients with cancer (OR 2.44, 95% CI: 1.88–3.16) and mental health disorders (OR 5.17, 95% CI: 4.56–5.85). The adjusted ORs for life dissatisfaction were 2.45 (95% CI: 1.74–3.43) and 5.17 (95% CI: 4.55–5.87) for cancer and mental health disorders, respectively, but when both conditions were present, the OR increased to 12.50 (95% CI: 8.40–18.62). The results suggested a synergistic interaction (RERI: 5.89 [95% CI: 0.91–10.87]; AP: 0.47 [95% CI: 0.25–0.69]; and S‐index: 2.05 [95% CI: 1.30–3.23]). Conclusion This study showed higher life dissatisfaction in cancer and mental health disorder patients. A synergistic effect was detected between cancer and mental health disorder on life dissatisfaction. These results suggest cancer patients with mental health disorders require additional support and psychological resources to improve their quality of life.
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Affiliation(s)
- Danielle Carole Roy
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Ronda Lun
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.,Department of Medicine, University of Ottawa, and The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Tzu-Fei Wang
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.,Department of Medicine, University of Ottawa, and The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Yue Chen
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Philip Wells
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.,Department of Medicine, University of Ottawa, and The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
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Validation of the Persian version of the satisfaction with life scale (SWLS) in Iranian women with breast Cancer. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01662-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Lim CYS, Laidsaar-Powell RC, Young JM, Kao SCH, Zhang Y, Butow P. Colorectal cancer survivorship: A systematic review and thematic synthesis of qualitative research. Eur J Cancer Care (Engl) 2021; 30:e13421. [PMID: 33733545 DOI: 10.1111/ecc.13421] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 12/06/2020] [Accepted: 01/15/2021] [Indexed: 12/24/2022]
Abstract
INTRODUCTION With rapid changes in treatments for colorectal cancer (CRC), qualitative research into CRC survivorship requires greater synthesis. This paper aims to fill this gap through a systematic review (PROSPERO CRD42019131576) and thematic synthesis of the qualitative literature on survivorship experiences across early-stage and advanced CRC survivors. METHODS CINAHL, Embase, MEDLINE, PsycINFO and PubMed were searched for qualitative CRC survivorship papers. Titles, abstracts and full texts were screened. Included articles (n = 81) underwent data extraction, CASP qualitative bias ratings and thematic synthesis. RESULTS Bowel dysfunction caused functional limitations and negative quality of life (QoL), while stomas posed threats to body image and confidence. Physical symptoms hindered return to work, increasing financial burdens. Survivors' unmet needs included information regarding symptom expectations and management, and ongoing support throughout recovery. Advanced and early-stage survivors shared similar experiences. Advanced survivors struggled with fear of cancer recurrence/progression and feelings of powerlessness. Functional limitations, financial impacts and sexuality in advanced survivors were underexplored areas. CONCLUSION CRC and its treatments impact survivors' QoL in all areas. A coordinated supportive care response is required to address survivors' unmet needs. Future qualitative studies should explore advanced CRC subpopulations, treatment-specific impacts on QoL and long-term (>5 years) impacts on CRC survivors.
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Affiliation(s)
- Chloe Yi Shing Lim
- Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
| | - Rebekah Clare Laidsaar-Powell
- Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
| | - Jane M Young
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.,RPA Institute of Academic Surgery (IAS) and Surgical Outcomes Research Centre (SOuRCe), Sydney Local Health District, Sydney, NSW, Australia
| | - Steven Chuan-Hao Kao
- Department of Medical Oncology, Chris O'Brien Lifehouse, Sydney, NSW, Australia.,Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Yuehan Zhang
- National Centre for Epidemiology and Population Health, Australian National University Research School of Population Health, Canberra, ACT, Australia
| | - Phyllis Butow
- Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
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Lo PS, Lin YP, Hsu HH, Chang SC, Yang SP, Huang WC, Wang TJ. Health self-management experiences of colorectal cancer patients in postoperative recovery: A qualitative study. Eur J Oncol Nurs 2021; 51:101906. [PMID: 33601194 DOI: 10.1016/j.ejon.2021.101906] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 01/28/2021] [Accepted: 02/02/2021] [Indexed: 12/09/2022]
Abstract
PURPOSE Health self-management helps improve health-related quality of life and life satisfaction, as well as cancer survival. The study aim was to explore the essence of the health self-management experiences and support needs of colorectal cancer patients after surgeries. METHODS The study was based on phenomenology research methodology. Purposive sampling was used to obtain a heterogeneous sample to provide rich information regarding the research questions. Participants were recruited from colorectal surgery outpatient clinics in a hospital in Taiwan. Data were collected by semi-structured in-depth interviews and analyzed by thematic content analysis. Strategies adapted from Lincoln and Guba were used to enhance the trustworthiness of the study. RESULTS Ten participants, 5 males and 5 females, were interviewed. Their health self-management experience fell into 3 overarching themes and 9 related subthemes. Our results show that (1) seeking support when experiencing discomfort, (2) when life changes, re-adjust accordingly, and (3) staying positive and self-perseverance are the essences of the health self-management experiences and support needs of postoperative colorectal cancer patients. CONCLUSIONS Postoperative colorectal cancer patients experienced tremendous physical and psychosocial challenges after returning home from the hospital. Although burdened with multiple stressors, these patients were able to seek support, learning to practice self-care, facing cancer positively, and exhibit positive growth in life. Patients with colorectal cancer have to constantly adjust to the impacts of their diseases. The study results may provide as a reference for supporting postoperative adjustment and promoting health self-management among patients with colorectal cancer.
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Affiliation(s)
- Pei-Shan Lo
- Cultivation and Management Center, MacKay Memorial Hospital, New Taipei City, Taiwan, ROC.
| | - Yu-Ping Lin
- Nursing Department, Oriental Institution of Technology, New Taipei City, Taiwan.
| | - His-Hsien Hsu
- Department of Colorectal Surgery, MacKay Memorial Hospital, Taipei, Taiwan.
| | - Shih-Chang Chang
- Davison of Colorectal Surgery, Cathay General Hospital, Taipei, Taiwan.
| | - Shu-Ping Yang
- Nursing Department, Cathay General Hospital, Taipei, Taiwan.
| | - Wen-Chien Huang
- Department of Thoracic Surgery, Mackay Memorial Hospital, Taiwan.
| | - Tsae-Jyy Wang
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan, ROC.
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Malcolm FL, Adiamah A, Banerjea A, Whitehead D, Gupta A, West J, Humes DJ. Long-term health-related quality of life following colorectal cancer surgery: patient-reported outcomes in a remote follow-up population. Colorectal Dis 2021; 23:213-225. [PMID: 33021013 DOI: 10.1111/codi.15393] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 08/03/2020] [Accepted: 09/20/2020] [Indexed: 01/18/2023]
Abstract
AIM Remote follow-up (RFU) after colorectal cancer (CRC) surgery allows delivery of surveillance tests without the need for regular outpatient clinical appointments. However, little is known about health-related quality of life (HRQoL) in RFU patients. The main aim of this study was to quantify HRQoL in our RFU population to identify particular patient groups that may benefit from a more personalised approach to follow-up, including access to a survivorship clinic. METHOD EQ-5D, QLQ-C30 and QLQ-C29 questionnaires were distributed to CRC patients enrolled in a RFU programme. The primary outcome of HRQoL scores was analysed by year of RFU, demographics, operation type, stoma and adherence to RFU protocols. RESULTS A total of 428 respondents were included, with a mean age of 71 years (SD 10.1 years) and a median RFU time of 2.6 years [interquartile range (IQR) 1.6-4.8 years]. 'Perfect health' was reported by 26.6% of patients. The median EQ-5D index score was 0.785 (IQR 0.671-1) and the median QLQ-C30 Global HRQoL score was 75 (IQR 58.3-83.3). Women had a significantly lower EQ-5D median score of 0.767 (IQR 0.666-0.879, P = 0.0088). Lower QLQ-C30 HRQoL scores were seen in stoma patients (median 66.6, IQR 58.3-83.3, P = 0.0029). Erectile dysfunction (P = 0.0006) and poor body image (P = 0.001) were also reported more frequently in stoma patients. Patients undergoing right-sided resection reported a lower median EQ-5D score of 0.765 (IQR 0.666-0.879, P = 0.028) and higher pain severity (P = 0.0367) compared with left-sided resections. There were 128 (29.4%) patients who breached RFU protocol and were seen in ad hoc colorectal clinics. However, there was no statistical difference in HRQoL between patients who adhered to or breached RFU protocols. CONCLUSION Overall HRQoL in patients in RFU is good, with no difference in those strictly followed up remotely. However, women, patients with right-sided resection and patients with a stoma may require additional clinical reviews.
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Affiliation(s)
- Francesca Ligori Malcolm
- National Institute for Health Research Nottingham Biomedical Research Centre (BRC, Nottingham University Hospitals NHS Trust, The University of Nottingham, Nottingham, UK.,Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Alfred Adiamah
- National Institute for Health Research Nottingham Biomedical Research Centre (BRC, Nottingham University Hospitals NHS Trust, The University of Nottingham, Nottingham, UK.,Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Ayan Banerjea
- National Institute for Health Research Nottingham Biomedical Research Centre (BRC, Nottingham University Hospitals NHS Trust, The University of Nottingham, Nottingham, UK.,Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Denyse Whitehead
- National Institute for Health Research Nottingham Biomedical Research Centre (BRC, Nottingham University Hospitals NHS Trust, The University of Nottingham, Nottingham, UK.,Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Alisha Gupta
- National Institute for Health Research Nottingham Biomedical Research Centre (BRC, Nottingham University Hospitals NHS Trust, The University of Nottingham, Nottingham, UK.,Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Joe West
- National Institute for Health Research Nottingham Biomedical Research Centre (BRC, Nottingham University Hospitals NHS Trust, The University of Nottingham, Nottingham, UK.,Nottingham University Hospitals NHS Trust, Nottingham, UK.,Division of Epidemiology and Public Health, School of Medicine, City Hospital, University of Nottingham, Nottingham, UK
| | - David J Humes
- National Institute for Health Research Nottingham Biomedical Research Centre (BRC, Nottingham University Hospitals NHS Trust, The University of Nottingham, Nottingham, UK.,Nottingham University Hospitals NHS Trust, Nottingham, UK
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22
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Deemer DA, Byrne JM, Loo LK, Puder D, Torralba KD, Lee SC, Kashner TM. Calibration Bias and the Interpretation of Clinical Learning Environment Perceptions Surveys. J Grad Med Educ 2020; 12:727-736. [PMID: 33391597 PMCID: PMC7771586 DOI: 10.4300/jgme-d-20-00237.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 07/28/2020] [Accepted: 09/21/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The clinical learning environment (CLE) is frequently assessed using perceptions surveys, such as the AAMC Graduation Questionnaire and ACGME Resident/Fellow Survey. However, these survey responses often capture subjective factors not directly related to the trainee's CLE experiences. OBJECTIVE The authors aimed to assess these subjective factors as "calibration bias" and show how it varies by health professions education discipline, and co-varies by program, patient-mix, and trainee factors. METHODS We measured calibration bias using 2011-2017 US Department of Veterans Affairs (VA) Learners' Perceptions Survey data to compare medical students and physician residents and fellows (n = 32 830) with nursing (n = 29 758) and allied and associated health (n = 27 092) trainees. RESULTS Compared to their physician counterparts, nursing trainees (OR 1.31, 95% CI 1.22-1.40) and allied/associated health trainees (1.18, 1.12-1.24) tended to overrate their CLE experiences. Across disciplines, respondents tended to overrate CLEs when reporting 1 higher level (of 5) of psychological safety (3.62, 3.52-3.73), 1 SD more time in the CLE (1.05, 1.04-1.07), female gender (1.13, 1.10-1.16), 1 of 7 lower academic level (0.95, 1.04-1.07), and having seen the lowest tercile of patients for their respective discipline who lacked social support (1.16, 1.12-1.21) and had low income (1.05, 1.01-1.09), co-occurring addictions (1.06, 1.02-1.10), and mental illness (1.06, 1.02-1.10). CONCLUSIONS Accounting for calibration bias when using perception survey scores is important to better understand physician trainees and the complex clinical learning environments in which they train.
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Affiliation(s)
| | - John M Byrne
- Associate Chief of Staff for Education and Informatics, VA Loma Linda Healthcare System
| | - Lawrence K Loo
- Staff Physician, VA Loma Linda Healthcare System, and Vice Chair for Education and Faculty Development, Department of Medicine
| | - David Puder
- Assistant Professor, Departments of Psychiatry and Internal Medicine, Loma Linda University School of Medicine
| | | | - Sonny C Lee
- Program Director, Loma Linda University Health Education Consortium Internal Medicine Residency
| | - T Michael Kashner
- Health Science Specialist, Office of Academic Affiliations, Department of Veterans Affairs
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23
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Siembida EJ, Reeve BB, Zebrack BJ, Snyder MA, Salsman JM. Measuring health-related quality of life in adolescent and young adult cancer survivors with the National Institutes of Health Patient-Reported Outcomes Measurement Information System ® : Comparing adolescent, emerging adult, and young adult survivor perspectives. Psychooncology 2020; 30:303-311. [PMID: 33073416 DOI: 10.1002/pon.5577] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 09/10/2020] [Accepted: 10/13/2020] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Our knowledge of symptom burden and functioning among adolescent and young adult (AYA; diagnosed ages 15-39) cancer survivors has been hindered by variability in health-related quality of life (HRQOL) measurement associated with developmental and disease heterogeneity among AYAs. We aimed to examine the variability in domain-specific aspects of HRQOL as a function of cancer type and developmental stage to clarify commonalities and differences using the NIH Patient-Reported Outcome Measurement Information System® . METHODS Five hundred seventy-two AYAs were recruited by an online research panel using stratified sampling (treatment status: on vs. off; developmental stage: adolescents, emerging adults, young adults). Participants completed questionnaires that included sociodemographic characteristics, clinical history, and the adult version of the Patient-Reported Outcomes Measurement Information System® -29 (PROMIS-29). Generalized linear models were run for each HRQOL domain and included treatment status, developmental stage, and cancer type (hematologic vs. solid tumor) and their interactions as independent variables. RESULTS There were no significant differences in any HRQOL domain by cancer type, and few significant differences were observed in PROMIS domains between developmental groups among on-treatment AYA survivors. In contrast, off-treatment emerging adults and young adults reported significantly higher symptoms and worse functioning compared to adolescents (all ps ≤ 0.003). CONCLUSIONS AYAs diagnosed in different developmental stages, particularly among off-treatment survivors, experienced diverse constellations of symptoms and functioning, and developmental stage was a more critical predictor of HRQOL than cancer type. These results suggest that supportive care interventions developed for AYA cancer survivors must be tailored and flexible by developmental stage and treatment status.
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Affiliation(s)
- Elizabeth J Siembida
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland, USA
| | - Bryce B Reeve
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Brad J Zebrack
- School of Social Work, University of Michigan, Ann Arbor, Missouri, USA
| | - Mallory A Snyder
- Office of Research and National Laboratories, The University of Chicago, Illinois, Chicago, USA
| | - John M Salsman
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine & the Wake Forest Baptist Comprehensive Cancer Center, North Carolina, Winston-Salem, USA
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24
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25
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Yoon S, Chua TB, Tan IB, Matchar D, Ong MEH, Tan E. Living with long‐term consequences: Experience of follow‐up care and support needs among Asian long‐term colorectal cancer survivors. Psychooncology 2020; 29:1557-1563. [DOI: 10.1002/pon.5452] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 05/19/2020] [Accepted: 06/22/2020] [Indexed: 12/24/2022]
Affiliation(s)
- Sungwon Yoon
- Health Services and Systems Research, Duke‐NUS Medical School Singapore Singapore
| | | | - Iain Beehuat Tan
- Department of Medical Oncology National Cancer Centre Singapore Singapore Singapore
| | - David Matchar
- Health Services and Systems Research, Duke‐NUS Medical School Singapore Singapore
- Department of Medicine (General Internal Medicine) Duke University Medical Center Durham North Carolina USA
| | - Marcus Eng Hock Ong
- Health Services and Systems Research, Duke‐NUS Medical School Singapore Singapore
- Department of Emergency Medicine Singapore General Hospital Singapore
| | - Emile Tan
- Duke‐NUS Medical School Singapore Singapore
- Department of Colorectal Surgery Singapore General Hospital Singapore Singapore
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26
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Kessler TA. The Role of Cognitive Appraisal in Quality of Life Over Time in Patients With Cancer. Oncol Nurs Forum 2020; 47:292-304. [PMID: 32301930 DOI: 10.1188/20.onf.292-304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To better understand how personal factors, contextual factors, and cognitive appraisals predict quality of life. SAMPLE & SETTING 81 patients with a new diagnosis of cancer were recruited from two oncologists' offices in the midwestern United States. METHODS & VARIABLES A longitudinal design was used to collect data at three time points. RESULTS Individuals identified a variety of primary appraisals at the same time and more consistently identified their cancer as a challenge rather than a harm/loss or a threat. The greatest variation in appraisals and quality of life occurred about six months after diagnosis. Hierarchical regression analyses demonstrated that age and primary and secondary appraisals explained a significant amount of variance in quality of life at all three time points. IMPLICATIONS FOR NURSING Interventions to improve quality of life for individuals newly diagnosed with cancer are needed and may be more helpful if they target cognitive appraisals. Nurses should assess what matters to the individual; it is important to evaluate how each person appraises a cancer diagnosis so providers can support coping and adjustment from diagnosis through individual treatment trajectories.
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27
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Yu YL, Yeo H, Kang S. The impact of depressive symptoms on health value in patients with gynecologic cancer: A comparison with physical symptoms and performance status. Gynecol Oncol 2020; 157:733-739. [PMID: 32307127 DOI: 10.1016/j.ygyno.2020.04.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 04/03/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The importance of managing depressive symptoms is frequently underestimated in the clinic. In this study, the effects of depressive symptoms on health utility value (HUV) in gynecologic cancer patients are evaluated. In addition, the effects were compared with those of performance status and physical symptoms. METHODS Patient-reported outcome data from 274 gynecologic cancer patients were prospectively collected. HUV was measured using the 3-level version of the EuroQoL 5-dimension descriptive system (EQ-5D-3L) and the EuroQoL visual analog scale (EQ-VAS). The Patient Health Questionnaire-9 (PHQ-9) was used to measure the severity of depressive symptoms. The impact of depressive symptoms on HUV was analyzed using the generalized linear model. RESULTS Moderate-severe depressive symptoms were significantly associated with a decrease in HUV in gynecologic cancer patients (p < 0.0001 for the EQ-5D-3L and EQ-VAS). Severe fatigue and severe pain were also associated with a decrease in HUV (p = 0.018 and p < 0.0001 for the EQ-5D-3L and EQ-VAS; p < 0.0001 for the EQ-5D-3L, respectively), and the effect sizes were comparable to that of moderate-severe depressive symptoms. In addition to the patients with moderate-severe depressive symptoms, the patients with mild depressive symptoms also experienced a significant decrease in HUV (p < 0.0001 for the EQ-5D-3L and EQ-VAS). The effect size for mild depressive symptoms was comparable to those for mild fatigue or mild pain. CONCLUSIONS Even mild depressive symptoms may significantly compromise HUV in gynecologic cancer patients, and the effect is comparable to that of performance status or physical symptoms. Gynecologic oncologists should put more effort into properly preventing, detecting, and managing depressive symptoms.
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Affiliation(s)
- Ye Lee Yu
- Division of Precision Medicine, National Cancer Center Korea, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, Republic of Korea.
| | - Hyemin Yeo
- Graduate School of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, Republic of Korea
| | - Sokbom Kang
- Division of Precision Medicine, National Cancer Center Korea, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, Republic of Korea.
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28
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Wheelwright S, Permyakova NV, Calman L, Din A, Fenlon D, Richardson A, Sodergren S, Smith PWF, Winter J, Foster C. Does quality of life return to pre-treatment levels five years after curative intent surgery for colorectal cancer? Evidence from the ColoREctal Wellbeing (CREW) study. PLoS One 2020; 15:e0231332. [PMID: 32271835 PMCID: PMC7145191 DOI: 10.1371/journal.pone.0231332] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 03/20/2020] [Indexed: 01/07/2023] Open
Abstract
Background The ColoREctal Wellbeing (CREW) study is the first study to prospectively recruit colorectal cancer (CRC) patients, carry out the baseline assessment pre-treatment and follow patients up over five years to delineate the impact of treatment on health and wellbeing. Methods CRC patients received questionnaires at baseline (pre-surgery), 3, 9, 15, 24, 36, 48 and 60 months. The primary outcome was Quality of Life in Adult Cancer Survivors (QLACS); self-efficacy, mental health, social support, affect, socio-demographics, clinical and treatment characteristics were also assessed. Representativeness was evaluated. Predictors at baseline and at 24 months of subsequent worsened quality of life (QOL) were identified using multivariable regression models. Results A representative cohort of 1017 non-metastatic CRC patients were recruited from 29 UK cancer centres. Around one third did not return to pre-surgery levels of QOL five years after treatment. Baseline factors associated with worsened QOL included >2 comorbidities, neoadjuvant treatment, high negative affect and low levels of self-efficacy, social support and positive affect. Predictors at 24 months included older age, low positive affect, high negative affect, fatigue and poor cognitive functioning. Conclusions Some risk factors for poor outcome up to five years following CRC surgery, such as self-efficacy, social support and comorbidity management, are amenable to change. Assessment of these factors from diagnosis to identify those most likely to need support in their recovery is warranted. Early intervention has the potential to improve outcomes.
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Affiliation(s)
- Sally Wheelwright
- Macmillan Survivorship Research Group, School of Health Sciences, University of Southampton, Southampton, United Kingdom
| | - Natalia V. Permyakova
- Macmillan Survivorship Research Group, School of Health Sciences, University of Southampton, Southampton, United Kingdom
| | - Lynn Calman
- Macmillan Survivorship Research Group, School of Health Sciences, University of Southampton, Southampton, United Kingdom
| | - Amy Din
- Macmillan Survivorship Research Group, School of Health Sciences, University of Southampton, Southampton, United Kingdom
| | - Deborah Fenlon
- College of Health and Human Sciences, Swansea University, Swansea, United Kingdom
| | - Alison Richardson
- University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
- School of Health Sciences, University of Southampton, Southampton, United Kingdom
| | - Samantha Sodergren
- Macmillan Survivorship Research Group, School of Health Sciences, University of Southampton, Southampton, United Kingdom
| | - Peter W. F. Smith
- Social Statistics and Demography, Social Sciences, University of Southampton, Southampton, United Kingdom
| | - Jane Winter
- Macmillan Survivorship Research Group, School of Health Sciences, University of Southampton, Southampton, United Kingdom
- School of Health Sciences, University of Southampton, Southampton, United Kingdom
| | - Claire Foster
- Macmillan Survivorship Research Group, School of Health Sciences, University of Southampton, Southampton, United Kingdom
- * E-mail:
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29
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Breedveld-Peters JJL, Bours MJL, Cords CI, Ditters IAM, Habraken V, Jongen MWJ, Weijenberg MP. The impact of participation restrictions on everyday life in long-term colorectal cancer survivors in the EnCoRe study: A mixed-method study. Eur J Oncol Nurs 2020; 45:101724. [PMID: 32044722 DOI: 10.1016/j.ejon.2020.101724] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 01/22/2020] [Accepted: 01/23/2020] [Indexed: 11/12/2022]
Abstract
PURPOSE Knowledge about long-term colorectal cancer (CRC) or treatment related health and functioning problems and on its impact on participation of CRC survivors in domestic life and in society is limited. We aimed to explore the nature and impact of cancer (treatment) related participation restrictions on everyday life of long-term CRC survivors, their current satisfaction with participation, and associations of health and functioning problems with participation satisfaction, using the International Classification of Functioning, Disability and Health (ICF) to comprehensively study participation. METHOD Mixed-method study in 2-10 years post-diagnosis stage I-III CRC survivors (n = 151) from the cross-sectional part of the EnCoRe study. Participation restrictions were explored by semi-structured interviews in a subsample reporting participation restrictions (n = 10). Role functioning (SF36-Health Survey), fatigue (Checklist Individual Strength), and peripheral neuropathy symptoms (EORTC QLQ-CIPN20) were assessed in all participants and associations with self-reported participation satisfaction were analyzed by multivariable logistic regression models. RESULTS 19% of CRC survivors reported dissatisfaction with participation. Participation restrictions were reported for interpersonal relationships, work/employment, and social/civic life. CRC survivors reporting better physical and emotional role functioning were significantly less likely to be dissatisfied with their participation, whereas survivors reporting higher levels of fatigue or more peripheral neuropathy symptoms were more likely to be dissatisfied with participation. CONCLUSIONS Colorectal cancer (treatment) related health and functioning problems negatively impacts the ability of nearly 1 in 5 long-term CRC survivors to participate in everyday life situations and their satisfaction with participation. Follow-up care needs to be able to identify and address these problems.
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Affiliation(s)
- Jose J L Breedveld-Peters
- Department of Epidemiology, GROW-School for Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands.
| | - Martijn J L Bours
- Department of Epidemiology, GROW-School for Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands.
| | - Charlotte I Cords
- Department of Epidemiology, GROW-School for Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands.
| | - Imke A M Ditters
- Department of Epidemiology, GROW-School for Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands.
| | - Vera Habraken
- Department of Epidemiology, GROW-School for Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands.
| | - Michelle W J Jongen
- Department of Epidemiology, GROW-School for Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands.
| | - Matty P Weijenberg
- Department of Epidemiology, GROW-School for Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands.
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30
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Tran BT, Pham NH, Nguyen TX, Choi KS, Sohn DK, Kim SY, Suh JK, Nguyen TD, Phan VS, Tran DT, Nguyen TT, Nguyen TTB, Nguyen MT, Oh JK. Measurement of Health-Related Quality of Life Among Colorectal Cancer Patients Using the Vietnamese Value Set of the EQ-5D-5L. Patient Prefer Adherence 2020; 14:2427-2437. [PMID: 33304097 PMCID: PMC7723232 DOI: 10.2147/ppa.s281500] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 11/20/2020] [Indexed: 11/30/2022] Open
Abstract
PURPOSE Health-related quality of life (HRQoL) is an important construct in clinical settings, and it is crucial that it should be properly measured. As the EuroQol-5-dimensions-5 levels (EQ-5D-5L) is more effective for such measurement than the 3-level model, data on economic models, clinical studies, and public health evaluations previously collected through the EQ-5D-3L need to be revaluated using the EQ-5D-5L. This study evaluated colorectal cancer (CRC) patients' HRQoL scores using the Vietnamese EQ-5D-5L value set. PATIENTS AND METHODS The cross-sectional study included CRC patients treated at a tertiary public hospital. HRQoL was assessed using the EQ-5D-5L, and HRQoL utility scores were calculated using the Vietnamese value set. Tobit regression examined factors associated with HRQoL. RESULTS The analysis included 197 CRC patients. Ages ranged from 20 to 87 years (M = 57.64, SD = 13.5); 42.2% and 57.8% were diagnosed with cancer of the colon or rectum/anus, respectively. Mean EQ-5D-5L was 0.561 (range, -0.5115 to 1). Most participants experienced anxiety/depression (88%), followed by pain/discomfort (87%), mobility (71%), usual activity (69%), and self-care (67%). Advanced CRC stage (stage II: β -0.303, se 0.08; stage III: β -0.305, se 0.07; stage IV: β -0.456, se 0.07) and surgery (β -0.113, se 0.05) were negatively associated with EQ-5D-5L scores. Advanced education (high school: β 0.273, se 0.07); college/vocational: β 0.134se 0.05; university/higher: Coef 0.213, se 0.08;) and older age (age group 35-44: β 0.253, se 0.10; 45-54: β 0.327, se 0.09; 55-64: β 0.355 se 0.09; 65+ β 0.204, se 0.09) were positively associated with EQ-5D-5L scores. CONCLUSION Patients in advanced CRC stages or undergoing surgery experienced lower HRQoL and higher prevalence of anxiety/depression and pain/discomfort. Older age and high educational attainment predicted high HRQoL. This study provides information on CRC patients' health utility based on various patient characteristics, which can be used in future economic evaluations.
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Affiliation(s)
- Binh Thang Tran
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Republic of Korea
- Faculty of Public Health, Hue University of Medicine and Pharmacy, Hue University, Hue City, Vietnam
| | - Nhu Hiep Pham
- Department of Abdominal Emergency and Pediatric Surgery, Hue Central Hospital, Hue City, Vietnam
| | - Thanh Xuan Nguyen
- Department of Abdominal Emergency and Pediatric Surgery, Hue Central Hospital, Hue City, Vietnam
| | - Kui Son Choi
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Republic of Korea
- National Cancer Control Institute; National Cancer Center, Goyang, Republic of Korea
| | - Dae Kyung Sohn
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Republic of Korea
- Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Goyang, South Korea
| | - Sun-Young Kim
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Republic of Korea
| | - Jae Kyung Suh
- Division of Healthcare Technology Assessment Research, National Evidence-Based Healthcare Collaborating Agency, Seoul, Korea
| | - Thuy Duyen Nguyen
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Republic of Korea
- Center for Population Health Sciences, Hanoi University of Public Health, Hanoi, Vietnam
| | - Van Sang Phan
- Faculty of Public Health, Hue University of Medicine and Pharmacy, Hue University, Hue City, Vietnam
| | - Dinh Trung Tran
- Faculty of Public Health, Da Nang University of Medical Technology and Pharmacy, Da Nang City, Vietnam
| | - The Thanh Nguyen
- Department of Endoscopy and Functional Exploration, Da Nang Oncology Hospital, Da Nang City, Vietnam
| | - Thi Thanh Binh Nguyen
- Department of Pediatrics, Hue University of Medicine and Pharmacy, Hue University, Hue City, Vietnam
| | - Minh Tu Nguyen
- Undergraduate Training Office, Hue University of Medicine and Pharmacy, Hue University, Hue City, Vietnam
| | - Jin-Kyoung Oh
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Republic of Korea
- Division of Cancer Prevention & Early Detection, National Cancer Center, Goyang, Republic of Korea
- Correspondence: Jin-Kyoung Oh Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, 323 Ilsan-Ro, Ilsandong-Gu, Goyang-si, Gyeonggi-do410-769, Republic of KoreaTel +82-31-920-2921Fax +82-31-920-2929 Email
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31
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Versteeg AL, Sahgal A, Kawahara N, Rhines LD, Sciubba DM, Weber MH, Lazary Á, Fehlings MG, Schuster JM, Clarke MJ, Arnold PM, Boriani S, Bettegowda C, Gokaslan ZL, Fisher CG. Patient satisfaction with treatment outcomes after surgery and/or radiotherapy for spinal metastases. Cancer 2019; 125:4269-4277. [PMID: 31490548 PMCID: PMC6900159 DOI: 10.1002/cncr.32465] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 07/18/2019] [Accepted: 07/26/2019] [Indexed: 11/17/2022]
Abstract
Background Patient satisfaction is infrequently investigated despite its importance in assessing efficacy and patient comprehension. The purpose of this study was to investigate patient satisfaction with treatment outcomes after surgery and/or radiotherapy for spinal metastases and to evaluate how health‐related quality of life (HRQOL) is related to patient satisfaction. Methods Patients with spinal metastases treated with surgery and/or radiotherapy were enrolled in a prospective, international, observational study. Demographic, histologic, treatment, and HRQOL data were collected. HRQOL was evaluated with the Numeric Rating Scale pain score, the 3‐level version of the EuroQol 5‐Dimension (EQ‐5D‐3L) instrument, and the Spine Oncology Study Group Outcomes Questionnaire (SOSGOQ2.0). Patient satisfaction was derived from the SOSGOQ2.0 at 6, 12, and 26 weeks after treatment. Patients were classified as satisfied, neutral, or dissatisfied. Results Twelve weeks after treatment, 183 of the surgically treated patients (84%) were satisfied, and only 11 (5%) were dissatisfied; in contrast, 101 of the patients treated with radiotherapy alone (77%) were satisfied, and only 7 (5%) were dissatisfied. Significant improvements in pain, physical function, mental health, social function, leg function, and EQ‐5D were associated with satisfaction after surgery. Satisfaction after radiotherapy was associated with significant improvements in pain, mental health, and overall SOSGOQ2.0 scores. Dissatisfaction after treatment was associated with lower baseline values for leg strength and lower social functioning scores for surgically treated patients and with lower social functioning scores and being single for patients treated with radiotherapy. Conclusions High levels of satisfaction with treatment outcomes are observed after surgery and/or radiotherapy for spinal metastases. Posttreatment satisfaction is associated with significant improvements in pain and different dimensions of HRQOL. High levels of satisfaction with treatment outcomes are observed after surgery and/or radiotherapy for spinal metastases. Posttreatment satisfaction is associated with significant improvements in pain and different dimensions of health‐related quality of life.
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Affiliation(s)
- Anne L Versteeg
- Department of Orthopedics, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Arjun Sahgal
- Department of Radiation Oncology, Sunnybrook Odette Cancer Centre and University of Toronto, Toronto, Ontario, Canada
| | - Norio Kawahara
- Department of Orthopedic Surgery, Kanazawa Medical University Hospital, Kanazawa, Japan
| | - Laurence D Rhines
- Department of Neurosurgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Daniel M Sciubba
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Michael H Weber
- Division of Surgery, McGill University and Montreal General Hospital, Montreal, Quebec, Canada
| | - Áron Lazary
- National Center for Spinal Disorders, Buda Health Center, Budapest, Hungary
| | - Michael G Fehlings
- Division of Neurosurgery and Spine Program, University of Toronto and Toronto Western Hospital, Toronto, Ontario, Canada
| | - James M Schuster
- Department of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | | | - Paul M Arnold
- Department of Neurosurgery, University of Kansas Hospital, Kansas City, Kansas
| | - Stefano Boriani
- Institutes for Care and Scientific Research (IRCCS) Galeazzi Orthopedic Hospital, Milan, Italy
| | - Chetan Bettegowda
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Ziya L Gokaslan
- Department of Neurosurgery, Warren Alpert Medical School of Brown University, Rhode Island Hospital, and Miriam Hospital, Providence, Rhode Island
| | - Charles G Fisher
- Division of Spine Surgery, Department of Orthopaedics, University of British Columbia and Vancouver General Hospital, Vancouver, British Columbia, Canada
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Curtin S, Galvin R, Robinson K. The relationship between cancer survivors’ well-being and participation in work, activities of daily living and social engagement: Findings from the European Social Survey (2014). Scand J Occup Ther 2019; 28:531-541. [DOI: 10.1080/11038128.2019.1695932] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- Sara Curtin
- School of Allied Health, University of Limerick, Limerick, Ireland
| | - Rose Galvin
- School of Allied Health, University of Limerick, Limerick, Ireland
- Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Katie Robinson
- School of Allied Health, University of Limerick, Limerick, Ireland
- Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
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Pattamatta M, Smeets BJJ, Evers SMAA, Peters EG, Luyer MDP, Hiligsmann M. Quality of life and costs of patients prior to colorectal surgery. Expert Rev Pharmacoecon Outcomes Res 2019; 20:193-198. [PMID: 31190575 DOI: 10.1080/14737167.2019.1628641] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objective: To assess the quality of life and societal costs of patients prior to colorectal surgery in the Netherlands.Methods: This study is embedded in a previous randomized controlled trial (SANICS II). The quality of life was measured using EQ-5D-5L questionnaires. The iMTA medical consumption questionnaire (iMCQ) and the iMTA productivity costs questionnaire (iPCQ) were used to identify and measure healthcare and productivity costs. Subgroup analyses were performed based on age and gender.Results: A total of 178 patients were included in the cost analysis and a total of 161 patients in the quality of life analysis. The three-month mean societal cost per patient amounted to €3,211 of which €1,459 was due to productivity losses. The mean utility was 0.88 per patient. Gender was an important predictor in quality of life with men scoring significantly higher than women (0.92 versus 0.82) at p < 0.0001.Conclusion: Colorectal cancer represents a high economic burden in the Netherlands. Further research with repeated cost and quality of life measurements would be needed to explore the change over time and the effects of surgery.
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Affiliation(s)
- M Pattamatta
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands.,Department of Surgery, Catharina Hospital, Eindhoven, The Netherlands
| | - B J J Smeets
- Department of Surgery, Catharina Hospital, Eindhoven, The Netherlands.,GROW school of oncology and developmental biology, Maastricht University, Maastricht, The Netherlands
| | - S M A A Evers
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands.,Center for Economic Evaluations, Trimbos Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - E G Peters
- Department of Surgery, Catharina Hospital, Eindhoven, The Netherlands.,Tytgat Institute of Liver and Intestinal Research, University of Amsterdam, Amsterdam, The Netherlands
| | - M D P Luyer
- Department of Surgery, Catharina Hospital, Eindhoven, The Netherlands
| | - M Hiligsmann
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
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Crawford-Williams F, March S, Goodwin BC, Ireland MJ, Chambers SK, Aitken JF, Dunn J. Geographic variations in stage at diagnosis and survival for colorectal cancer in Australia: A systematic review. Eur J Cancer Care (Engl) 2019; 28:e13072. [PMID: 31056787 DOI: 10.1111/ecc.13072] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 02/12/2019] [Accepted: 04/08/2019] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Australia has one of the highest incidence rates of colorectal cancer (CRC) in the world. Residents in rural areas of Australia experience disadvantage in health care and outcomes. This review investigates whether patients with CRC in rural areas demonstrate poorer survival and more advanced stages of disease at diagnosis. METHODS Systematic review of peer-reviewed articles and grey literature. Studies were included if they provided data on survival or stage of disease at diagnosis across multiple geographical locations; focused on CRC patients; and were conducted in Australia. RESULTS Twenty-six articles met inclusion criteria. Twenty-three studies examined survival, while five studies investigated stage at diagnosis. The evidence suggests that non-metropolitan patients are less likely to survive CRC for five years compared to patients living in metropolitan areas, yet there was limited evidence to suggest geographical disparity in stage of diagnosis. CONCLUSIONS While five-year survival disparities are apparent, these patterns appear to vary as a function of specific region and health jurisdiction, cancer type and year/s of data collection. Future research should examine current data using consistent and robust methods of reporting survival and classifying geographical location. The impact of population-level screening programmes on survival and stage at diagnosis also needs to be thoroughly explored.
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Affiliation(s)
- Fiona Crawford-Williams
- Institute for Resilient Regions, University of Southern Queensland, Springfield Central, Queensland, Australia
| | - Sonja March
- Institute for Resilient Regions, University of Southern Queensland, Springfield Central, Queensland, Australia.,School of Psychology, University of Southern Queensland, Springfield Central, Queensland, Australia
| | - Belinda C Goodwin
- Institute for Resilient Regions, University of Southern Queensland, Springfield Central, Queensland, Australia
| | - Michael J Ireland
- Institute for Resilient Regions, University of Southern Queensland, Springfield Central, Queensland, Australia.,School of Psychology, University of Southern Queensland, Springfield Central, Queensland, Australia
| | - Suzanne K Chambers
- Institute for Resilient Regions, University of Southern Queensland, Springfield Central, Queensland, Australia.,Cancer Research Centre, Cancer Council Queensland, Fortitude Valley, Queensland, Australia.,Menzies Health Institute Queensland, Griffith University, Southport, Queensland, Australia.,Health and Wellness Institute, Edith Cowan University, Joondalup, Western Australia, Australia.,Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Joanne F Aitken
- Institute for Resilient Regions, University of Southern Queensland, Springfield Central, Queensland, Australia.,Cancer Research Centre, Cancer Council Queensland, Fortitude Valley, Queensland, Australia.,School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Jeff Dunn
- Institute for Resilient Regions, University of Southern Queensland, Springfield Central, Queensland, Australia.,Cancer Research Centre, Cancer Council Queensland, Fortitude Valley, Queensland, Australia.,Health and Wellness Institute, Edith Cowan University, Joondalup, Western Australia, Australia.,Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia.,School of Social Science, The University of Queensland, Brisbane, Queensland, Australia
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Psychometric properties and factorial analysis of invariance of the Satisfaction with Life Scale (SWLS) in cancer patients. Qual Life Res 2019; 28:1255-1264. [PMID: 30644028 DOI: 10.1007/s11136-019-02106-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2019] [Indexed: 12/25/2022]
Abstract
PURPOSE The purpose of this study was to assess the psychometric properties of the Satisfaction with Life Scale (SWLS), evaluate the measurement invariance with respect to sex, age, and tumor location, as well as analyze associations between life satisfaction and socio-demographic and clinical variables among individuals with resected, non-advanced cancer. METHODS A confirmatory factor analysis was conducted to explore the dimensionality of the scale and test invariance across gender, age, and tumor localization in a prospective, multicenter cohort of 713 patients who completed the following scales: SWLS, Health-related Quality of Life Questionnaire (EORTC QLQ-C30), Brief Symptom Inventory (BSI-18). RESULTS Confirmatory factor analysis results indicated that the SWLS is an essentially unidimensional instrument, providing accurate scores: both McDonald's omega and Cronbach's alpha estimates were 0.91. Strong measurement invariance was found to hold across gender, age, and tumor localization. Low satisfaction with life was associated with psychological symptoms (anxiety, depression, and somatization), and decreased quality of life (malfunction, symptoms, poor global QoL). CONCLUSION The SWLS is a reliable, valid satisfaction with life measurement among people with cancer and should be recommended as an indicator of psychological adjustment in oncological patients.
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Chambers SK, Ritterband LM, Thorndike F, Nielsen L, Aitken JF, Clutton S, Scuffham PA, Youl P, Morris B, Baade PD, Dunn J. Web-Delivered Cognitive Behavioral Therapy for Distressed Cancer Patients: Randomized Controlled Trial. J Med Internet Res 2018; 20:e42. [PMID: 29386173 PMCID: PMC5812983 DOI: 10.2196/jmir.8850] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 11/08/2017] [Accepted: 11/16/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Web-based interventions present a potentially cost-effective approach to supporting self-management for cancer patients; however, further evidence for acceptability and effectiveness is needed. OBJECTIVE The goal of our research was to assess the effectiveness of an individualized Web-based cognitive behavioral therapy (CBT) intervention on improving psychological and quality of life outcomes in cancer patients with elevated psychological distress. METHODS A total of 163 distressed cancer patients (111 female, 68.1%) were recruited through the Queensland Cancer Registry and the Cancer Council Queensland Cancer Helpline and randomly assigned to either a Web-based tailored CBT intervention (CancerCope) (79/163) or a static patient education website (84/163). At baseline and 8-week follow-up we assessed primary outcomes of psychological and cancer-specific distress and unmet psychological supportive care needs and secondary outcomes of positive adjustment and quality of life. RESULTS Intention-to-treat analyses showed no evidence of a statistically significant intervention effect on primary or secondary outcomes. However, per-protocol analyses found a greater decrease for the CancerCope group in psychological distress (P=.04), cancer-specific distress (P=.02), and unmet psychological care needs (P=.03) from baseline to 8 weeks compared with the patient education group. Younger patients were more likely to complete the CancerCope intervention. CONCLUSIONS This online CBT intervention was associated with greater decreases in distress for those patients who more closely adhered to the program. Given the low costs and high accessibility of this intervention approach, even if only effective for subgroups of patients, the potential impact may be substantial. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12613001026718; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=364768&isReview=true (Archived by WebCite at http://www.webcitation.org/6uPvpcovl).
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Affiliation(s)
- Suzanne K Chambers
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
- Cancer Council Queensland, Brisbane, Australia
- Prostate Cancer Foundation of Australia, Sydney, Australia
- Health and Wellness Institute, Edith Cowan University, Perth, Australia
- Centre for Clinical Research, The University of Queensland, Brisbane, Australia
| | - Lee M Ritterband
- University of Virginia, Charlottesville, VA, United States
- BeHealth Solutions, Charlottesville, VA, United States
| | | | | | - Joanne F Aitken
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
- Cancer Council Queensland, Brisbane, Australia
- Institute for Resilient Regions, University of Southern Queensland, Springfield, Australia
| | | | - Paul A Scuffham
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
| | - Philippa Youl
- University of Sunshine Coast, Sippy Downs, Australia
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | | | - Peter D Baade
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
- Cancer Council Queensland, Brisbane, Australia
- School of Mathematical Sciences, Queensland University of Technology, Brisbane, Australia
| | - Jeff Dunn
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
- Cancer Council Queensland, Brisbane, Australia
- Institute for Resilient Regions, University of Southern Queensland, Springfield, Australia
- School of Social Science, The University of Queensland, Brisbane, Australia
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Short CE, Finlay A, Sanders I, Maher C. Development and pilot evaluation of a clinic-based mHealth app referral service to support adult cancer survivors increase their participation in physical activity using publicly available mobile apps. BMC Health Serv Res 2018; 18:27. [PMID: 29338722 PMCID: PMC5771037 DOI: 10.1186/s12913-017-2818-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Accepted: 12/22/2017] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Participation in regular physical activity holds key benefits for cancer survivors, yet few cancer survivors meet physical activity recommendations. This study aimed to develop and pilot test a mHealth app referral service aimed at assisting cancer survivors to increase their physical activity. In particular, the study sought to examine feasibility and acceptability of the service and determine preliminary efficacy for physical activity behaviour change. METHODS A systematic search identified potentially appropriate Apple (iOS) and Android mHealth apps. The apps were audited regarding the type of physical activity encouraged, evidence-based behavioural strategies and other characteristics, to help match apps to users' preferences and characteristics. A structured service was devised to deliver the apps and counselling, comprising two face-to-face appointments with a mid-week phone or email check-up. The mHealth app referral service was piloted using a pre-post design among 12 cancer survivors. Participants' feedback regarding the service's feasibility and acceptability was sought via purpose-designed questionnaire, and analysed using inductive thematic analysis and descriptive statistics. Change in physical activity was assessed using a valid and reliable self-report tool and analysed using paired t-tests. In line with recommendations for pilot studies, confidence intervals and effect sizes were reported to aid interpretation of clinical significance, with an alpha of 0.2 used to denote statistical significance. RESULTS Of 374 mHealth apps identified during the systematic search, 54 progressed to the audit (iOS = 27, Android = 27). The apps consistently scored well for aesthetics, engagement and functionality, and inconsistently for gamification, social and behaviour change features. Ten participants completed the pilot evaluation and provided positive feedback regarding the service's acceptability and feasibility. On average, participants increased their moderate-vigorous physical activity by 236 min per week (d = 0.73; 95% CI = -49 to 522; p = 0.09). CONCLUSION This study offered initial evidence that a mHealth app referral service for cancer survivors is feasible and acceptable and may increase physical activity levels. The large increase in physical activity is promising, but should be interpreted with caution given the small sample size and lack of control group. Further research is warranted on a larger scale to investigate generalisability, long-term compliance and application in clinical settings.
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Affiliation(s)
- Camille E. Short
- School of Medicine, Freemasons Foundation Centre for Men’s Health, University of Adelaide, Adelaide, Australia
| | - Amy Finlay
- School of Medicine, Freemasons Foundation Centre for Men’s Health, University of Adelaide, Adelaide, Australia
| | - Ilea Sanders
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Sansom Institute, School of Health Sciences, University of South Australia, Adelaide, Australia
| | - Carol Maher
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Sansom Institute, School of Health Sciences, University of South Australia, Adelaide, Australia
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Haviland J, Sodergren S, Calman L, Corner J, Din A, Fenlon D, Grimmett C, Richardson A, Smith PW, Winter J, Foster C. Social support following diagnosis and treatment for colorectal cancer and associations with health-related quality of life: Results from the UK ColoREctal Wellbeing (CREW) cohort study. Psychooncology 2017; 26:2276-2284. [PMID: 29094430 PMCID: PMC6220760 DOI: 10.1002/pon.4556] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 08/11/2017] [Accepted: 09/09/2017] [Indexed: 01/09/2023]
Abstract
Objective Social support is acknowledged as important in cancer survivorship, but little is known about change in support after cancer diagnosis and factors associated with this, particularly in colorectal cancer. The CREW cohort study investigated social support up to 2 years following curative intent surgery for colorectal cancer. Methods A total of 871 adults recruited pre‐treatment from 29 UK centres 2010 to 2012 consented to follow‐up. Questionnaires at baseline, 3, 9, 15, and 24 months post‐surgery included assessments of social support (Medical Outcomes Study‐Social Support Survey, MOS‐SSS) and health‐related quality of life (HRQoL). Socio‐demographic, clinical and treatment details were collected. Longitudinal analyses assessed social support over follow‐up, associations with participant characteristics, and HRQoL. Results Around 20% were living alone and 30% without a partner. Perceived social support declined in around 29% of participants, with 8% of these reporting very low levels overall from baseline to 2 years (mean MOS‐SSS overall score < 40 on a scale from 0 to 100). Older age, female gender, greater neighbourhood deprivation, presence of co‐morbidities, and rectal cancer site were significantly associated with reductions in perceived support. Poorer HRQoL outcomes (generic health/QoL, reduced wellbeing, anxiety, and depression) were significantly associated with lower levels of social support. Conclusions Levels of social support decline following colorectal cancer diagnosis and treatment in nearly a third of patients and are an important risk factor for recovery of HRQoL. Assessment of support early on and throughout follow‐up would enable targeted interventions to improve recovery, particularly in the more vulnerable patient groups at risk of poorer social support.
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Affiliation(s)
- Joanne Haviland
- Institute of Cancer Research Clinical Trials and Statistics Unit, Division of Clinical Studies, The Institute of Cancer Research, London, UK
| | - Samantha Sodergren
- Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Lynn Calman
- Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Jessica Corner
- Executive Office, University of Nottingham, Nottingham, UK
| | - Amy Din
- Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Deborah Fenlon
- College of Health and Human Sciences, Swansea University, Swansea, Wales, UK
| | - Chloe Grimmett
- Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Alison Richardson
- Faculty of Health Sciences, University of Southampton, Southampton, UK.,University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Peter W Smith
- Social Statistics and Demography, Social Sciences, University of Southampton, Southampton, UK
| | - Jane Winter
- Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Southampton, UK.,University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | | | - Claire Foster
- Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Southampton, UK
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Reese JB, Lepore SJ, Handorf EA, Haythornthwaite JA. Emotional approach coping and depressive symptoms in colorectal cancer patients: The role of the intimate relationship. J Psychosoc Oncol 2017; 35:578-596. [PMID: 28511030 PMCID: PMC5804335 DOI: 10.1080/07347332.2017.1331492] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
This study examined whether emotional approach coping was associated with lower depressive symptoms, and whether intimacy moderated this association, in 121 married/partnered colorectal cancer (CRC) outpatients. Prospective analyses of survey data on emotional approach coping, depressive symptoms, and intimacy measured at baseline and 6-month follow-up showed that depressive symptoms were inversely related to processing, expression, and intimacy. At baseline, the association between processing and depressive symptoms was moderated by intimacy: greater processing was associated with lower depressive symptoms only for those in relatively high-intimacy relationships. Enhancing emotional approach coping efforts and relationship quality may benefit CRC patients' adjustment.
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Affiliation(s)
- Jennifer Barsky Reese
- a Cancer Prevention and Control Program , Fox Chase Cancer Center , Philadelphia , PA , USA
| | - Stephen J Lepore
- b Department of Social and Behavioral Sciences , College of Public Health, Temple University , Philadelphia , PA , USA
| | - Elizabeth A Handorf
- c Department of Biostatistics and Bioinformatics , Fox Chase Cancer Center , Philadelphia , PA , USA
| | - Jennifer A Haythornthwaite
- d Department of Psychiatry and Behavioral Sciences , Johns Hopkins School of Medicine , Baltimore , MD , USA
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López V, Oyanedel JC, Bilbao M, Torres J, Oyarzún D, Morales M, Ascorra P, Carrasco C. School Achievement and Performance in Chilean High Schools: The Mediating Role of Subjective Wellbeing in School-Related Evaluations. Front Psychol 2017; 8:1189. [PMID: 28769838 PMCID: PMC5509788 DOI: 10.3389/fpsyg.2017.01189] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2017] [Accepted: 06/29/2017] [Indexed: 11/13/2022] Open
Abstract
School achievement gaps and school failure are problematic issues in Latin America, and are mainly explained by the socio-economic status (SES) of the students. What schools can do to improve school achievement and reduce school failure is a critical issue, both for school management and teacher training. In this study, we present the association of individual and school-related socio-emotional variables with school achievement and performance, controlling for the effects of SES. A probabilistic sample of 4,964 students, drawn from 191 schools enrolled in year 10 in urban areas of Chile, answered questionnaires assessing subjective wellbeing, social wellbeing in school, school climate, school social wellbeing and students’ perceptions of teachers’ wellbeing. Using structural equation modeling, and controlling for SES, we modeled subjective wellbeing as a mediator of the relationship between school-related variables, such as school climate and perception of teacher’s wellbeing, and (a) school achievement, and (b) school performance. School achievement was computed as a product of (a) the probability of passing the school year, and (b) the percentage of yearly attendance at school. Data on school achievement was drawn from administrative registries from the Chilean Ministry of Education. School performance was computed as the estimated grade point average (GPA) at the end of the school year, based on the students’ previous 5-year GPAs, and was also obtained through administrative data of the last 5 years. Findings reveal the mediating role of subjective wellbeing in the relationship between school-related evaluations (students’ social wellbeing at school, their perception of teachers’ wellbeing and school climate) and school achievement. For school achievement, two variables were mediated (students’ social wellbeing at school and school climate). However, for school performance, no significant mediations were found. We conclude that, on the one hand, after controlling for SES, students’ individual subjective wellbeing is associated with their achievement and performance in school. We discuss the importance of improving school experiences that may protect and promote students’ subjective experience and school achievement and performance, and reduce the probability of school failure and dropout.
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Affiliation(s)
- Verónica López
- School of Psychology, Pontificia Universidad Católica de ValparaísoValparaíso, Chile.,Centro de Investigación para la Educación InclusivaValparaíso, Chile
| | - Juan C Oyanedel
- Faculty of Education, Universidad Andrés BelloSantiago, Chile
| | - Marian Bilbao
- School of Psychology, Universidad de Santiago de ChileSantiago, Chile
| | - Javier Torres
- School of Psychology, Pontificia Universidad Católica de ValparaísoValparaíso, Chile.,Universidad Tecnológica de Chile INACAPVitacura, Chile
| | - Denise Oyarzún
- School of Psychology, Pontificia Universidad Católica de ValparaísoValparaíso, Chile
| | - Macarena Morales
- School of Psychology, Pontificia Universidad Católica de ValparaísoValparaíso, Chile
| | - Paula Ascorra
- School of Psychology, Pontificia Universidad Católica de ValparaísoValparaíso, Chile.,Centro de Investigación para la Educación InclusivaValparaíso, Chile
| | - Claudia Carrasco
- School of Psychology, Pontificia Universidad Católica de ValparaísoValparaíso, Chile
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Ireland MJ, March S, Crawford-Williams F, Cassimatis M, Aitken JF, Hyde MK, Chambers SK, Sun J, Dunn J. A systematic review of geographical differences in management and outcomes for colorectal cancer in Australia. BMC Cancer 2017; 17:95. [PMID: 28152983 PMCID: PMC5290650 DOI: 10.1186/s12885-017-3067-1] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 01/18/2017] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Australia and New Zealand have the highest incidence of colorectal cancer (CRC) in the world, presenting considerable health, economic, and societal burden. Over a third of the Australian population live in regional areas and research has shown they experience a range of health disadvantages that result in a higher disease burden and lower life expectancy. The extent to which geographical disparities exist in CRC management and outcomes has not been systematically explored. The present review aims to identify the nature of geographical disparities in CRC survival, clinical management, and psychosocial outcomes. METHODS The review followed PRISMA guidelines and searches were undertaken using seven databases covering articles between 1 January 1990 and 20 April 2016 in an Australian setting. Inclusion criteria stipulated studies had to be peer-reviewed, in English, reporting data from Australia on CRC patients and relevant to one of fourteen questions examining geographical variations in a) survival outcomes, b) patient and cancer characteristics, c) diagnostic and treatment characteristics and d) psychosocial and quality of life outcomes. RESULTS Thirty-eight quantitative, two qualitative, and three mixed-methods studies met review criteria. Twenty-seven studies were of high quality, sixteen studies were of moderate quality, and no studies were found to be low quality. Individuals with CRC living in regional, rural, and remote areas of Australia showed poorer survival and experienced less optimal clinical management. However, this effect is likely moderated by a range of other factors (e.g., SES, age, gender) and did appear to vary linearly with increasing distance from metropolitan centres. No studies examined differences in use of stoma, or support with stomas, by geographic location. CONCLUSIONS Overall, despite evidence of disparity in CRC survival and clinical management across geographic locations, the evidence was limited and at times inconsistent. Further, access to treatment and services may not be the main driver of disparities, with individual patient characteristics and type of region also playing an important role. A better understanding of factors driving ongoing and significant geographical disparities in cancer related outcomes is required to inform the development of effective interventions to improve the health and welfare of regional Australians.
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Affiliation(s)
- Michael J. Ireland
- Institute of Resilient Regions, University of Southern Queensland, Springfield Central, Australia
- School of Psychology and Counselling, University of Southern Queensland, Springfield Central, Australia
| | - Sonja March
- Institute of Resilient Regions, University of Southern Queensland, Springfield Central, Australia
- School of Psychology and Counselling, University of Southern Queensland, Springfield Central, Australia
| | - Fiona Crawford-Williams
- Institute of Resilient Regions, University of Southern Queensland, Springfield Central, Australia
- School of Psychology and Counselling, University of Southern Queensland, Springfield Central, Australia
| | - Mandy Cassimatis
- Non-communicable Disease Control Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC Australia
| | - Joanne F. Aitken
- Institute of Resilient Regions, University of Southern Queensland, Springfield Central, Australia
- Cancer Research Centre, Cancer Council Queensland, Fortitude Valley, 4006 QLD Australia
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
- Menzies Health Institute Queensland, Griffith University, Brisbane, QLD Australia
| | - Melissa K. Hyde
- Cancer Research Centre, Cancer Council Queensland, Fortitude Valley, 4006 QLD Australia
- Menzies Health Institute Queensland, Griffith University, Southport, QLD Australia
| | - Suzanne K. Chambers
- Institute of Resilient Regions, University of Southern Queensland, Springfield Central, Australia
- Cancer Research Centre, Cancer Council Queensland, Fortitude Valley, 4006 QLD Australia
- Menzies Health Institute Queensland, Griffith University, Southport, QLD Australia
- Prostate Cancer Foundation of Australia, St Leonards, NSW Australia
- Exercise Medicine Research Institute, Edith Cowan University, Perth, WA Australia
| | - Jiandong Sun
- Institute of Resilient Regions, University of Southern Queensland, Springfield Central, Australia
| | - Jeff Dunn
- Institute of Resilient Regions, University of Southern Queensland, Springfield Central, Australia
- Cancer Research Centre, Cancer Council Queensland, Fortitude Valley, 4006 QLD Australia
- School of Social Science, University of Queensland, Brisbane, Australia
- School of Medicine, Griffith University, Brisbane, QLD Australia
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Health-related quality of life and psychological distress among cancer survivors in Southeast Asia: results from a longitudinal study in eight low- and middle-income countries. BMC Med 2017; 15:10. [PMID: 28081724 PMCID: PMC5234136 DOI: 10.1186/s12916-016-0768-2] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 12/08/2016] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND A better understanding of health-related quality of life (HRQoL) and psychological distress in cancer survivors can raise awareness, promote the development of policies in cancer survivorship care, and facilitate better targeted use of limited resources in low- and middle-income countries (LMICs). The main objectives of this paper were therefore to assess HRQoL and the prevalence of psychological distress amongst cancer survivors in Southeast Asia and identify risk factors of these outcomes. METHODS The ACTION study was a longitudinal study in eight LMICs in Southeast Asia with 5249 first time cancer survivors followed up at 1 year after diagnosis. HRQoL was assessed using the EORTC QLQ-C30 and EQ-5D. Psychological distress (anxiety and depression) was assessed using the Hospital Anxiety and Depression Scale. General linear models and multiple logistic regression were used to identify independent predictors of HRQoL and psychological distress. RESULTS One year after diagnosis, the mean EORTC QLQ-C30 global health score for survivors was 66.2 out of 100 (SD 22.0), the mean index score on the EQ-5D was 0.74 (SD 0.23), 37% of survivors had at least mild levels of anxiety, and 46% showed at least mild levels of depression. Poorest HRQoL and highest prevalence of anxiety and depression were seen in patients with lung cancer and lymphomas, while highest scores and least psychological distress were seen in female patients with breast and cervical cancer. The most significant predictor of poor HRQoL and psychological distress outcomes was cancer stage at diagnosis. Age, co-morbidities, treatment, and several socioeconomic factors were associated with HRQoL and psychological distress. CONCLUSIONS Cancer survivors in LMICs in Southeast Asia have impaired HRQoL and substantial proportions have psychological distress. Patients with advanced cancer stages at diagnosis and those in a poor socioeconomic position were most at risk of such poor outcomes. Supportive interventions for cancer patients that address wider aspects of patient wellbeing are needed, as well as policies that address financial and other barriers to timely treatment.
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Chambers SK, Ng SK, Baade P, Aitken JF, Hyde MK, Wittert G, Frydenberg M, Dunn J. Trajectories of quality of life, life satisfaction, and psychological adjustment after prostate cancer. Psychooncology 2017; 26:1576-1585. [PMID: 27943512 PMCID: PMC5655930 DOI: 10.1002/pon.4342] [Citation(s) in RCA: 88] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2016] [Revised: 12/05/2016] [Accepted: 12/06/2016] [Indexed: 01/07/2023]
Abstract
Background To describe trajectories of health‐related quality of life (QoL), life satisfaction, and psychological adjustment for men with prostate cancer over the medium to long term and identify predictors of poorer outcomes using growth mixture models. Methods One‐thousand sixty‐four (82.4% response) men diagnosed with prostate cancer were recruited close to diagnosis and assessed over a 72‐month (6‐year) period with self‐report assessment of health‐related QoL, life satisfaction, cancer‐related distress, and prostate specific antigen anxiety. Urinary, bowel, and sexual function were also assessed using validated questionnaires. Results Poorer physical QOL was predicted by older age, lower education, lower income, comorbidities, and receiving hormone therapy. Lower life satisfaction was related to younger age, lower income, not being partnered, and comorbidities. Poorer psychological trajectories were predicted by younger age, lower income, comorbidities, and receiving radical prostatectomy or brachytherapy. Better urinary, bowel, and sexual function were related to better global outcomes over time. Anxiety about prostate specific antigen testing was rare. Conclusions Distinct trajectories exist for medium‐ to long‐term QoL, life satisfaction, and psychological adjustment after prostate cancer; with age and socioeconomic deprivation playing a differential role in men's survivorship profile and the impact of functional status on outcomes increasing over time. These results reinforce the need for an appraisal of men's life course in addition to treatment side effects when planning survivorship care after cancer.
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Affiliation(s)
- Suzanne K Chambers
- Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia.,Cancer Council Queensland, Brisbane, QLD, Australia.,Prostate Cancer Foundation of Australia, Sydney, NSW, Australia.,Exercise Medicine Research Institute, Edith Cowan University, Perth, WA, Australia.,Institute for Resilient Regions, University of Southern Queensland, Toowoomba, QLD, Australia
| | - Shu Kay Ng
- Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - Peter Baade
- Cancer Council Queensland, Brisbane, QLD, Australia.,School of Mathematical Sciences, Queensland University of Technology, Brisbane, QLD, Australia.,Menzies School of Health Research, Brisbane, QLD, Australia
| | - Joanne F Aitken
- Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia.,Cancer Council Queensland, Brisbane, QLD, Australia.,Institute for Resilient Regions, University of Southern Queensland, Toowoomba, QLD, Australia.,School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia
| | - Melissa K Hyde
- Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia.,Cancer Council Queensland, Brisbane, QLD, Australia
| | - Gary Wittert
- Freemasons Foundation Centre for Men's Health, School of Medicine, University of Adelaide, Adelaide, SA, Australia
| | - Mark Frydenberg
- Department of Surgery, Faculty of Medicine, Monash University, Melbourne, VIC, Australia.,Department of Urology, Monash Health, Melbourne, VIC, Australia
| | - Jeff Dunn
- Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia.,Cancer Council Queensland, Brisbane, QLD, Australia.,Institute for Resilient Regions, University of Southern Queensland, Toowoomba, QLD, Australia
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Does the relationship between health-related quality of life and subjective well-being change over time? An exploratory study among breast cancer patients. Soc Sci Med 2016; 174:96-103. [PMID: 28013110 DOI: 10.1016/j.socscimed.2016.12.021] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 12/05/2016] [Accepted: 12/16/2016] [Indexed: 12/25/2022]
Abstract
It has been suggested recently that measures of Subjective Well-Being (SWB) instead of preferences could be employed to determine relative weights for the dimensions of health-related quality of life (HRQol) with the aim of developing health utility indexes for economic evaluation purposes. In this context, this paper addresses the possibility of reprioritization response shift in SWB. It examines whether the association between dimensions of HRQol and SWB changes over time in chronically ill patients. 215 women newly diagnosed for breast cancer in a French hospital between 2010 and 2012 completed the Satisfaction with Life Scale (SWLS) and the EORTC QLQ-C30 HRQol questionnaires over a two-year period. We estimated hierarchical random coefficients models for the repeated SWLS measures while allowing for time-varying parameters for the scales of the QLQ-C30 to test for reprioritization. Our findings suggest that women adapt to breast cancer by giving greater weight over time to the social dimension of HRQol. This possibility of reprioritization response shift should be considered in researches trying to develop SWB-based health utility values to inform the allocation of resources in health care.
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45
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Experiences of colorectal cancer patients in the 2-years post-diagnosis and patient factors predicting poor outcome. Support Care Cancer 2016; 24:4921-4928. [DOI: 10.1007/s00520-016-3348-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Accepted: 07/10/2016] [Indexed: 11/12/2022]
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46
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Calvo R, Carr DC, Matz-Costa C. Another Paradox? The Life Satisfaction of Older Hispanic Immigrants in the United States. J Aging Health 2016; 29:3-24. [DOI: 10.1177/0898264315624901] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Objective: To investigate disparities in life satisfaction among older Hispanic immigrants in the United States relative to their native-born Hispanic and non-Hispanic White counterparts, and to identify factors associated with such disparities. Method: Cross-sectional data from 9,798 individuals age 60 and above from the Health and Retirement Study (HRS) were used to estimate ordinary least squares (OLS) regression models. Results: Hispanic immigrants reported the highest levels of life satisfaction of all groups. Wealthier older adults, who were socially engaged, had social support, and experienced fewer functional limitations and lower exposure to discrimination, were more satisfied with their lives in the overall sample. Interaction effects revealed that although education was associated with greater life satisfaction only among non-Hispanic Whites, co-residing with children was associated with greater life satisfaction only among Hispanics. Discussion: Although older Hispanic immigrants had the least amount of socioeconomic resources of all groups in our study, they were the most satisfied with their lives. Possible explanations and directions for future research are discussed.
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Affiliation(s)
- Rocío Calvo
- Boston College School of Social Work, Chestnut Hill, MA, USA
- Harvard Center for Population and Development Studies, Cambridge, MA, USA
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Alabbas FF, Al-Otaibi SM, Pasha MHC, Alghamdi AM, Al-Hindi HM, Al-Ahwal MS, El-Deek BS. Impact of Physiological Symptoms and Complications of Colorectal Cancer on the Quality of Life of Patients at King Abdulaziz University Hospital. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2016; 31:221-227. [PMID: 25948411 DOI: 10.1007/s13187-015-0839-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Colorectal cancer (CRC) is common worldwide. The high prevalence of the disease raises concerns about how CRC influences the health-related quality of life (QoL). To explore the impact of physiological symptoms and complications of CRC on patients' QoL, we conducted a cross-sectional survey using the FACT-C self-report instrument. The chi-square test was used to compare qualitative data. We found that pain was reported by most of the patients (n = 31; 77.5 %). Furthermore, male patients were more likely to complain of pain "mostly" as compared with females (P = .032). We found no significant differences between genders regarding general health-related questions. A greater proportion of male patients often complained of abdominal cramps (P = .542), weight loss (P = .086), and diarrhea (P = .408). More than half of the patients (n = 26; 65 %) reported having a good appetite; a greater proportion of males reported having a good appetite "mostly" (P = .014). Social and psychological qualities of life were not significantly different between male and female patients. Male and female patients did not differ in their report of disease acceptance (P = .420) and ability to enjoy life (P = .744). No difference was also found between genders regarding contentment with QoL (P = .793) or ability to sleep well (P = .695). Furthermore, there were no differences between genders regarding job fulfillment (P = .272). Our results add to the growing body of knowledge about the effect of CRC on QoL. Importantly, the differences in self-reported pain and appetite between male and female patients in our study suggest the importance of gender-based treatments in improving patients' QoL.
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Affiliation(s)
| | | | | | | | | | - Mahmoud S Al-Ahwal
- Faculty of Medicine, King Abdulaziz University (KAU), Jeddah, Saudi Arabia
| | - Basem S El-Deek
- Community Medicine, King Abdulaziz University (KAU), Jeddah, Saudi Arabia
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Foster C, Haviland J, Winter J, Grimmett C, Chivers Seymour K, Batehup L, Calman L, Corner J, Din A, Fenlon D, May CM, Richardson A, Smith PW. Pre-Surgery Depression and Confidence to Manage Problems Predict Recovery Trajectories of Health and Wellbeing in the First Two Years following Colorectal Cancer: Results from the CREW Cohort Study. PLoS One 2016; 11:e0155434. [PMID: 27171174 PMCID: PMC4865190 DOI: 10.1371/journal.pone.0155434] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 04/28/2016] [Indexed: 12/05/2022] Open
Abstract
Purpose This paper identifies predictors of recovery trajectories of quality of life (QoL), health status and personal wellbeing in the two years following colorectal cancer surgery. Methods 872 adults receiving curative intent surgery during November 2010 to March 2012. Questionnaires at baseline, 3, 9, 15, 24 months post-surgery assessed QoL, health status, wellbeing, confidence to manage illness-related problems (self-efficacy), social support, co-morbidities, socio-demographic, clinical and treatment characteristics. Group-based trajectory analyses identified distinct trajectories and predictors for QoL, health status and wellbeing. Results Four recovery trajectories were identified for each outcome. Groups 1 and 2 fared consistently well (scores above/within normal range); 70.5% of participants for QoL, 33.3% health status, 77.6% wellbeing. Group 3 had some problems (24.2% QoL, 59.3% health, 18.2% wellbeing); Group 4 fared consistently poorly (5.3% QoL, 7.4% health, 4.2% wellbeing). Higher pre-surgery depression and lower self-efficacy were significantly associated with poorer trajectories for all three outcomes after adjusting for other important predictors including disease characteristics, stoma, anxiety and social support. Conclusions Psychosocial factors including self-efficacy and depression before surgery predict recovery trajectories in QoL, health status and wellbeing following colorectal cancer treatment independent of treatment or disease characteristics. This has significant implications for colorectal cancer management as appropriate support may be improved by early intervention resulting in more positive recovery experiences.
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Affiliation(s)
- Claire Foster
- Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom
- Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom
- * E-mail:
| | - Joanne Haviland
- Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom
- Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom
| | - Jane Winter
- Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom
- University Hospital Southampton NHS Foundation Trust, Southampton, SO16 6YD, United Kingdom
| | - Chloe Grimmett
- Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom
- Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom
| | - Kim Chivers Seymour
- Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom
| | - Lynn Batehup
- Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom
| | - Lynn Calman
- Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom
- Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom
| | - Jessica Corner
- Executive Office, University of Nottingham, Nottingham, NG7 2RD, United Kingdom
| | - Amy Din
- Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom
- Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom
| | - Deborah Fenlon
- Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom
| | - Christine M. May
- Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom
- Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom
| | - Alison Richardson
- Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom
- University Hospital Southampton NHS Foundation Trust, Southampton, SO16 6YD, United Kingdom
| | - Peter W. Smith
- Social Statistics and Demography, Social Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom
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Alexander KE, Cooper BA, Paul SM, Yates P, Aouizerat BE, Miaskowski C. Phenotypic and molecular characteristics associated with various domains of quality of life in oncology patients and their family caregivers. Qual Life Res 2016; 25:2853-2868. [PMID: 27160108 DOI: 10.1007/s11136-016-1310-x] [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: 04/29/2016] [Indexed: 12/12/2022]
Abstract
PURPOSE Not all oncology patients and their family caregivers (FCs) experience the same quality of life (QOL). The purposes of this study were to identify latent classes of oncology patients (n = 168) and their FCs (n = 85) with distinct physical, psychological, social, and spiritual well-being trajectories from prior to through 4 months after the completion of radiation therapy and to evaluate for demographic, clinical, and genetic characteristics that distinguished between these latent classes. METHODS Using growth mixture modeling, two latent classes were found for three (i.e., physical, psychological, and social well-being) of the four QOL domains evaluated. RESULTS Across these three domains, the largest percentage of participants reported relatively high well-being scores across the 6 months of the study. Across these three QOL domains, patients and FCs who were younger, female, belonged to an ethnic minority group, had children at home, had multiple comorbid conditions, or had a lower functional status, were more likely to be classified in the lower QOL class. The social well-being domain was the only domain that had a polymorphism in nuclear factor kappa beta 2 (NFKB2) associated with latent class membership. Carrying one or two doses of the rare allele for rs7897947 was associated with a 54 % decrease in the odds of belonging to the lower social well-being class [OR (95 % CI) = .46 (.21, .99), p = .049]. CONCLUSIONS These findings suggest that a number of phenotypic and molecular characteristics contribute to differences in QOL in oncology patients and their FCs.
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Affiliation(s)
- Kimberly E Alexander
- School of Nursing, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Brisbane, Australia
| | - Bruce A Cooper
- Department of Physiological Nursing, School of Nursing, University of California, 2 Koret Way - N631Y, San Francisco, CA, 94143-0610, USA
| | - Steven M Paul
- Department of Physiological Nursing, School of Nursing, University of California, 2 Koret Way - N631Y, San Francisco, CA, 94143-0610, USA
| | - Patsy Yates
- School of Nursing, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Brisbane, Australia
| | | | - Christine Miaskowski
- Department of Physiological Nursing, School of Nursing, University of California, 2 Koret Way - N631Y, San Francisco, CA, 94143-0610, USA.
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Shieh SI, Lin YH, Huang CY, Kao CC, Hung SL, Yang HY, Tung HY. Sexual dysfunction in males following low anterior resection. J Clin Nurs 2016; 25:2348-56. [PMID: 27080210 DOI: 10.1111/jocn.13172] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2015] [Indexed: 12/24/2022]
Abstract
AIMS AND OBJECTIVES The purpose of this study was to explore the prevalence of sexual dysfunction in males one year after undergoing low anterior resection and to determine whether health care professionals discuss sexual issues with patients after surgery. BACKGROUND Sexual dysfunction in males may be a complication after low anterior resection for rectal cancer, but few studies have explored this issue in Taiwan. DESIGN A descriptive comparison study design. METHODS A descriptive comparison design was used, and a group of 133 participants underwent a low anterior resection procedure for rectal cancer. The results were compared with those of a group of males who underwent colectomy (n = 58) for colon cancer. The following instruments were used: the five-item version of the International Index of Erectile Function, personal demographics and medical variables. RESULTS The results showed that the prevalence of erectile dysfunction among the low anterior resection patients was 97·0% (129/133), and the erectile dysfunction prevalence was 75·9% (44/58) for the males who underwent colectomy. The generalised linear model showed that after controlling for hypertension and stoma, the low anterior resection group had worse sexual function than those in the colectomy group, and stoma was also a factor that impacted patients' sexual function. The results also revealed that only 32·8-35·3% of health care providers talked about sexual dysfunction with people who have rectal cancer prior to surgery. CONCLUSION This study demonstrated that men who have undergone low anterior resection have a high risk of sexual dysfunction and that health care professionals infrequently discuss these issues with patients. RELEVANCE TO CLINICAL PRACTICE When patients are diagnosed with rectal cancer and before they undergo surgery, an assessment and discussion of sexual function issues should be incorporated into standard care. Continued follow-up after hospital discharge and evaluations of sexual function are vital factors for male postoperative rectal cancer patients.
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Affiliation(s)
- Show-Ing Shieh
- College of Liberal Education, Shu-Te University, Kaohsiung, Taiwan
| | - Yu-Hua Lin
- Nursing Department, I-Shou University, Kaohsiung, Taiwan
| | | | - Chia-Chan Kao
- Nursing Department, I-Shou University, Kaohsiung, Taiwan
| | - Shu-Ling Hung
- Department of Nursing, National Tainan Junior College of Nursing, Tainan, Taiwan
| | - Hsing-Yu Yang
- Department of Nursing, Mackay Medical College, Taipei, Taiwan
| | - Hong-Yu Tung
- Medical Education & Research Department, Yuan's General Hospital, Kaohsiung, Taiwan
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