Association Between Fear of Cancer Recurrence, Fatigue, and Healthy Lifestyle Behaviors Among Breast Cancer Survivors in South Korea

BACKGROUND

Improving healthy lifestyle behaviors in breast cancer survivors can promote their physical and mental health, thereby reducing the risk of cancer recurrence. Therefore, it is crucial to identify and control the factors affecting healthy lifestyle behaviors among breast cancer survivors.

OBJECTIVE

This study aimed to examine the effects of physiological, psychological, and situational factors and symptoms on healthy lifestyle behaviors in breast cancer survivors.

METHODS

Data were collected from August to September 2021, and a questionnaire was administered through an online breast cancer patient community's bulletin board. Finally, 162 questionnaires were included in the analysis.

RESULTS

The model was statistically significant, explaining 33.2% of the variance. A decrease in healthy lifestyle behaviors in breast cancer survivors was influenced by an age of 40 years or younger, 5 years or more since a breast cancer diagnosis, low income, fear of cancer recurrence, and fatigue.

CONCLUSIONS

Intervention strategies, such as easily accessible online content that accounts for age and survival period after cancer diagnosis, should be used to promote healthy lifestyle behaviors among breast cancer survivors. Healthcare providers should be given appropriate guidelines on managing patients' fear of cancer recurrence and reducing fatigue to ensure timely access to clinical interventions. Adequate financial support from local communities and governments is needed to promote healthy lifestyle behaviors.

IMPLICATIONS FOR PRACTICE

To improve breast cancer survivors' healthy lifestyle behaviors, an understanding of the influencing factors and a multidimensional approach are required. Nurses play a role in developing and implementing interventions to improve healthy lifestyle behaviors.

Factors Associated With Quality of Life Among Posttreatment Cancer Survivors in Korea: A Meta-analysis

BACKGROUND

Identification of factors associated with quality of life (QOL) among cancer survivors is crucial for identifying potential targets for intervention.

OBJECTIVES

We aimed to provide evidence of factors associated with the QOL among posttreatment cancer survivors in Korea.

METHODS

We performed a systematic literature search from January 2000 to September 2022 using PubMed, EMBASE, CINAHL, PsycINFO, and Korean databases (RISS, SCIENCEON). We evaluated study quality using the Joanna Briggs Institute Quality Appraisal Checklists for Analytical Cross-sectional Studies and performed statistical analysis using the R 3.0 software (R Foundation for Statistical Computing, Vienna, Austria) package. We analyzed the pooled effect sizes of potential QOL correlates by the random-effects model.

RESULTS

This meta-analysis included 31 studies with 8934 participants. The pooled estimates were significantly large for economic status (r = -0.53); significantly medium for fatigue (r = -0.39), anxiety (r = -0.29), depression (r = -0.42), self-efficacy (r = 0.37), and social support (r = 0.30); and significantly small for education level (r = -0.18), job status (r = -0.09), cancer stage (r = -0.20), and time since diagnosis (r = -0.26).

CONCLUSIONS

Low education level, having no job, low economic status, advanced cancer stage, short disease period, fatigue, anxiety, and depression were significantly associated with worse QOL, whereas self-efficacy and social support were significantly associated with better QOL.

IMPLICATIONS FOR PRACTICE

The findings have potential implications for identifying "at-risk survivors" of deteriorated QOL and for suggesting powerful strategies (eg, enhancing self-efficacy or social support) for improving QOL.

Structural Equation Model of the Quality of Working Life among Cancer Survivors Returning to Work

PURPOSE

This study aimed to construct and validate a model of the quality of working life (QWL) among cancer survivors returning to work.

METHODS

A cross-sectional study was developed. Participants included 204 cancer survivors in the extended cancer survivor stage, 6 months after returning to work, who were treated at two tertiary hospital cancer centers. The data were analyzed with SPSS 22.0 and AMOS 20.0 for confirmatory factor analysis to assess the hypothesis fit and verify the hypothesis.

RESULTS

Factors affecting cancer survivors' quality of working liferesulted in cancer stigma and social support (explanatory power was 43.1%) and the model showed acceptable goodness of fit. In the final model, cancer stigma had a significant direct effect on social support and indirect effect on organizational health, employee health, and QWL. Additionally, social support had significant direct effect on organizational health, employee health and QWL.

CONCLUSION

Based on the results of this study, there is a need to develop strategies and effective intervention programs that can increase the support of supervisors and colleagues for improving overall quality of work life. Furthermore, the development of policies and intervention programs to reduce cancer stigma for the purpose of transforming perceptions through education and public relations which are indirect factors that affect the quality of work life, can contribute to improving the quality of work life for cancer survivors.

Cancer site differences in the health-related quality of life of Korean cancer survivors: Results from a Population-based Survey

OBJECTIVES

We investigated cancer site differences in the health-related quality of life (HRQOL) of cancer survivors.

DESIGN AND SAMPLE

A secondary data analysis was conducted using the sixth Korea National Health and Nutrition Examination Survey (2013-2015). Participants were 15,461 adults (664 cancer survivors) with available EuroQol-5 Dimensions (EQ5D) information.

MEASUREMENTS

Constructs from the revised Wilson and Cleary's model were examined. HRQOL status was measured using the EQ5D. EQ5D dimensional problems and indices were compared across cancer sites using multiple linear and quantile regression analyses.

RESULTS

The most common problems across cancer sites were pain/discomfort and mobility. There were differences in EQ5D dimensional problems by cancer site: problems of usual activities in the cervix-cancer group and anxiety/depression in the thyroid cancer group were prevalent. Those with cervix cancer (vs. stomach) had higher EQ5D index scores; however, no significant differences were observed between other site subgroups. Subjective health perception and socioeconomic factors were significant determinants affecting HRQOL among cancer survivors with low EQ5D index scores.

CONCLUSIONS

Subjective health status and socioeconomic characteristics are predicted to have a greater impact on survivors with low (vs. high) HRQOL. Socioeconomic and psychological support is essential to increase cancer survivors' HRQOL, regardless of cancer site.

Impacts of Psychological Distress, Gender Role Attitude, and Housekeeping Sharing on Quality of Life of Gynecologic Cancer Survivors

PURPOSE

To determine impacts of psychological distress, gender role attitude, and housekeeping sharing on quality of life of gynecologic cancer survivors.

METHODS

Subjects completed questionnaires consisting of four measurements: FACT-G (ver. 4) for quality of life, anxiety and depression from SCL-90-R for psychological distress, gender role attitude, and housekeeping sharing. A total of 158 completed data sets were analyzed by descriptive statistics, independent t-test, ANOVA, Pearson's correlation coefficient, and multiple regression analysis using SPSS 21.0 program.

RESULTS

Quality of life was significantly and negatively correlated with psychological distress (r=-0.64, p < .001), but not with gender role attitude (r=-0.14, p=.820) or housekeeping sharing (r=0.08, p=.350). Psychological distress was significantly and positively correlated with gender role attitude (r=0.25, p < .010). Factors that significantly impacted quality of life were type of cancer (t=2.27, p=.025), number of treatment methods (t=2.58, p=.011), education level (t=3.33, p < .001), and psychological distress (t=-9.96, p < .001).

CONCLUSION

Nursing interventions that can relieve psychological distress need to be developed for gynecologic cancer survivors. Nurses need to put priority on ovarian cancer survivors who have low education level with multiple treatment methods when performing nursing interventions to improve the quality of life of gynecologic cancer survivors.

Aspects of Health-Related Factors and Nutritional Care Needs by Survival Stage among Female Cancer Patients in South Korea

PURPOSE

This study examined diet-related problems and needs associated with nutritional care according to survival stage in Korean female cancer survivors.

METHODS

186 outpatients (breast or gynecologic cancer survivors) recruited. Subjects were classified as (1) extended stage (ES, 2-5 years from diagnosis) and (2) long-term stage (LS, ≥5 years from diagnosis). Eating habits, changes in health related factors, nutritional needs, and quality of life were investigated.

RESULTS

43% of ES survivors had diet-related problems (p = .031); ES group reported dyspepsia and LS group reported anorexia/nausea as the major problem. Half of ES survivors had taste change, decreasing amount of intake, and reduced quality of life (p < .05). The LS group had a greater preference for sweet tastes than the ES group. According to their diagnosis, ES survivors with breast cancer gained weight (27.1%), whereas ES survivors with gynecologic cancer lost their body weight (34.5%) significantly. LS breast cancer patients showed great food preference for vegetables, whereas those with gynecologic cancer showed an increased preference for fish, meat and grain. Approximately 90% of survivors demanded nutritional care regarding restricted foods, preventing recurrence, particularly in ES survivors (p < .01). Moreover, main factors for nutritional care needs were body weight control for breast cancer and food environment for gynecologic cancer.

CONCLUSION

Survivors have different aspects of diet-related problems by survival stage as dyspepsia in ES and anorexia in LS. ES stage had changes in dietary patterns and their food consumption have decreased. Most of survivors have demanded nutritional care regardless of survival stage. These features of each stage should be considered to improve their health.