Health-Related Quality of Life among Cancer Survivors Depending on the Occupational Status

The relationship between chronic disease variety and quantity and suicidal ideation: A cross-sectional study of NHANES

BACKGROUND

This cross-sectional study examines the link between chronic diseases and suicidal thoughts in U.S. adults using 2013-2018 National Health and Nutrition Examination Survey (NHANES) data, aiming to identify potential risk factors for suicidal ideation.

METHODS

Using NHANES data, we analyzed the association between various chronic conditions (hypertension, diabetes, asthma, etc.) and suicidal thoughts, employing logistic regression models adjusted for demographics and lifestyle factors.

RESULTS

The analysis of 8891 participants revealed a significant association between suicidal thoughts and chronic diseases such as liver disease, diabetes, and asthma. The risk of suicidal ideation is higher with the number of chronic conditions.

CONCLUSION

Our findings suggest a strong link between the presence and number of chronic diseases and the risk of suicidal thoughts, emphasizing the importance of integrated care approaches that address both physical and mental health needs.

Effectiveness of a mobile-based return to work program for decent return to work, fatigue, stress, and quality of working life among cancer survivors

PURPOSE

This study aimed to develop a smartphone mobile application-based supportive return to work (RTW) program for cancer survivors and evaluate its effects on their RTW, fatigue, stress, and quality of working life. This program was developed through a comprehensive process involving literature review, interviews with cancer survivors, and consultations with experts.

METHODS

A non-equivalent control group pre- and post-test design was used, with 41 participants assigned to the experimental (n = 18) and control (n = 23) groups based on recruitment timing. The experimental group received a 6-week smartphone mobile application-based supportive RTW program comprising "Counseling and Education" and "Self-Management." Participants completed assessments of decent RTW, fatigue, stress, and quality of working life at baseline and 6 months later. The experimental group completed an additional post-program completion survey.

RESULTS

During the 6-week program, no experimental group participants dropped out. The program's impact on decent RTW remains unclear. Fatigue (F = 2.52, p = 0.095) and quality of working life (F = 0.86, p = 0.434) did not show statistically significant differences. However, there was a significant reduction in stress (F = 4.59, p = 0.017).

CONCLUSION

The smartphone application-based RTW program, focusing on self-management and counseling, effectively reduced participants' stress levels. To further evaluate the effectiveness of the program, a more diverse range of interventions and ongoing programs should be implemented.

IMPLICATIONS FOR CANCER SURVIVORS

This study underscores the importance of tailored digital interventions to support the RTW of cancer survivors. The use of mobile smartphone applications allows temporal and spatial flexibility in program participation. Interventions involving various activities should be implemented to ensure ongoing participation.

Effectiveness of Computerized Cognitive Training on Working Memory in Pediatric Cancer Survivors: A Systematic Review and Meta-analysis

BACKGROUND

Interactive features of computerized cognitive training (CCT) may enhance adherence to training, providing a relatively low-cost intervention. A robust systematic review on the effectiveness of CCT for improving working memory (WM) among pediatric survivors with cancer is lacking.

OBJECTIVE

To summarize the available evidence and determine the effectiveness of CCT for WM among pediatric survivors with cancer.

INTERVENTIONS/METHODS

Five databases were searched. The Effective Public Health Practice Project was used to assess the study quality. ReviewerManager was used. The primary outcome was WM performance. Secondary outcomes included processing speed, attention, intervention adherence, and number of adverse events.

RESULTS

Six studies were included. Regarding overall quality, 1 study was weak, and 5 studies were moderate. Five studies reported a significant improvement of WM postintervention (P < .05). The meta-analysis of Cogmed interventions on symbolic WM revealed a significant difference between groups (vs placebo), with an overall pooled effect size of 0.71 (95% confidence interval, 0.02-1.41; P = .04). Two and 4 studies investigated the effects of CCT on processing speed and attention, respectively, with conflicting results. Four studies reported adherence of 80% or greater. Two studies reported no adverse events.

CONCLUSIONS

Computerized cognitive training using Cogmed has a significant positive effect on WM. The effects of CCT on processing speed and attention remain inconclusive.

IMPLICATIONS FOR PRACTICE

More rigorous trials should be conducted to elucidate the cognitive effects of CCT, particularly processing speed and attention, in the pediatric population with cancer. Further studies should consider combining CCT with other existing interventions to strengthen their effectiveness.

Health-related quality of life among patients with esophageal, gastric, and colorectal cancer at Kenyatta National Hospital

BACKGROUND

Despite the advancement of modern treatment approaches, several studies indicated a diminished health-related quality of life (HRQoL) in patients with gastrointestinal cancer. However, there is insufficient data about the HRQoL of gastrointestinal cancer patients in Kenya.

AIMS

The study aimed to investigate HRQoL and its determinants in gastrointestinal cancer patients at Kenyatta National Hospital.

METHODS

A cross-sectional study was employed among 160 esophageal, 103 gastric, and 96 colorectal cancer patients. The patient list, identified by unique hospital identification numbers, was obtained from records. Eligibility was assessed based on predetermined criteria, and the hospital identification numbers were reshuffled. Study participants were then randomly selected daily during the data collection period. Data were collected using a researcher-administered European Organization for Research and Treatment of Cancer quality of life questionnaire. The data entry and analysis were carried out using Statistical Package for the Social Sciences 26.0 statistical software. A bivariate and multivariate binary logistic regression analysis was employed to investigate determinants of HRQoL at a 0.05 level of significance.

RESULTS

Most esophageal (N = 118, 73.7%), gastric (N = 75, 72.8%), and colorectal (N = 72, 75%) cancer patients had poor overall HRQoL. In the social (p = .04) and cognitive (p = .02) domain of HRQoL, esophageal cancer patients had a significantly lower mean score as compared to gastric cancer patients. Colorectal cancer patients had the highest mean score in physical functioning (p = .01) as compared with gastric cancer patients. Nonetheless, gastric cancer patients had the highest mean score in emotional functioning domains of quality of life as compared to esophageal (p = .04) and colorectal (p < .001) cancer patients The study revealed a low mean HRQoL score in the majority of the symptom domains of quality of life. A statistically significant difference in all domains of HRQoL was not observed in various treatment modalities of gastrointestinal cancer. Advanced-stage (stages III and IV) and co-morbidities were significant determinants of poor HRQoL.

CONCLUSIONS

The overall HRQoL of gastrointestinal cancer patients was poor. Advanced-stage cancer and co-morbidities were significant determinants of poor HRQoL. Therefore, intensification of routine monitoring of the disease and the treatments should be actively implemented to improve the HRQoL.

Health utility assessments in individuals undergoing diagnostic and surveillance colonoscopy: improved discrimination with a cancer-specific scale

PURPOSE

To compare the sensitivity and discriminant validity of generic and cancer-specific measures for assessing health-related quality of life (HRQoL) for individuals undergoing diagnostic or surveillance colonoscopy for colorectal cancer.

METHODS

HRQoL was assessed using EQ-5D-5L (generic), and EORTC QLQ-C30 (cancer-specific) scales, 14 days after (baseline) and one-year following colonoscopy (follow-up). Utility scores were calculated by mapping EORTC-QLQ-C30 onto QLU-C10D. Differences between participants with different indications for colonoscopy (positive faecal occult blood test (FOBT), surveillance, or symptoms) and colonoscopy findings (no polyps, polyps, or cancer) were tested using Wilcoxon-Mann-Whitney and Kruskal-Wallis H tests. Sensitivity was assessed by calculating the ceiling effects (proportion reporting the best possible level).

RESULTS

246 adults completed the survey, including those undergoing colonoscopy for symptoms (n = 87), positive FOBT (n = 92) or surveillance (n = 67). Those with symptoms had the lowest HRQoL at both baseline and follow-up, with differences observed within the HRQoL domains/areas of role function, appetite loss and bowel function on the QLU-C10D. No differences were found in HRQoL when stratified by findings at colonoscopy with both measures or when comparing baseline and follow-up responses. Participants reporting full health with EQ-5D-5L (21% at baseline and 16% at follow-up) still had problems on the QLU-C10D, with fatigue and sleep at baseline and with role function and fatigue at follow-up.

CONCLUSION

Patients undergoing colonoscopy for symptoms had lower HRQoL compared to surveillance or positive FOBT. The cancer-specific QLU-C10D was more sensitive and had greater discriminant ability between patients undergoing colonoscopy for different indications.

How will I live this life that I'm trying to save? Being a female breast cancer survivor in Nigeria

OBJECTIVES

Nigeria is experiencing an increasing rate of new cancer cases while marred by a weak health system. As cancer prevalence increases in Nigeria, especially among women, it is crucial to understand the experiences of female cancer survivors, given that their quality of life may be influenced by perceptions of cancer and what it means to be a cancer survivor.

DESIGN

This study employed a qualitative descriptive method. Semi-structured interviews were conducted with a purposive sample of 30 female breast cancer survivors in Abuja, Nigeria.

RESULTS

The three major themes were views about being a cancer survivor, cancer can be stigmatizing, and life after cancer diagnosis and therapy.

CONCLUSION

We argue that cancer-related identity and cancer-related stigma are key factors with help-seeking and quality-of-life implications. Tailored interventions such as cancer health education and social support for cancer survivors may help reduce the burden of cancer in Nigeria.

Exploration of the factors that influence perceived quality of patient centered care among cancer survivors: A systematic review

PURPOSE

The purpose of this study was the estimation of the quality of patient centered care among cancer survivors.

METHODS

Following the PRISMA guidelines, MEDLINE and Google Scholar were systematically searched using the keywords "quality of patient centered care" and "cancer" from 2012 to 2022.

RESULTS

In this systematic review 7 articles were included, from which 5557 patients were derived, 3050 of them being females. The majority of them (2553 patients) suffered from haematological malignancies, while a considerable amount of them suffered from breast cancer. Three studies were conducted in Australia and four studies in Mexico. Factors, such as respect to patients' values and preferences, emotional support, management of psychological needs and integrated and coordinated care received a lower score. The characteristics that were statistically significantly related to the dimensions of person-centered care were numerous and were grouped into two major categories: a) socio-demographic such as gender, age, marital status, professional status, level of education, place of residence, type of insurance and b) clinical factors such as type of malignancy, psychiatric comorbidities, time interval of diagnosis, follow-up center, type of treatment.

CONCLUSIONS

The literature showed that there is a lack of comparative data regarding the perceived quality of patient centered care among cancer survivors. More psychometric tools of quality of patient centered care, or validation of the existed ones among all types of cancer survivors are needed, in order to identify and further improve the aspects of care that are not delivered successfully.

The 6 month interim analysis of a randomized controlled trial assessing the quality of life in patients with breast cancer related lymphedema undergoing lymphaticovenous anastomosis vs. conservative therapy

Breast cancer related lymphedema (BCRL) is a chronic condition with a detrimental impact on psychosocial and physical well-being. Lymphaticovenous anastomosis has shown promising results in alleviating physical symptoms and increasing quality of life in patients with BCRL. The aim of the study is to evaluate the effect on health related quality of life (HrQol) after LVA surgery versus conservative treatment in patients with BCRL. The study is a prospective, multicenter randomized controlled trial. Adult women with unilateral BCRL, with early stage lymphedema and viable lymphatic vessels were included. The primary outcome measure was HrQol measured by the lymphedema functioning disability and health (Lymph-ICF) questionnaire. The secondary outcomes were volume difference measured by the water displacement method; the Upper Extremity Lymphedema (UEL) index; and daily use of the compression garments after 3 and 6 months. For this interim analysis 46 patients per group were included. There was a significant improvement in the domains in physical and mental function in the Lymph-ICF questionnaire in the LVA group after 6 months, (- 16.46 ± 18.5, p < 0.05, - 10.12 ± 29.5, p < 0.05 respectively). However, there was no statistical difference in the total score of the Lymph-ICF after 6 months in both groups (LVA-group; - 8.57 ± 22.6, p > 0.05, CDT-group; - 2.65 ± 18.2, p < 0.05). Furthermore, there was no significant volume reduction in both groups (LVA-group: 20.04 ± 196.40, p = 0.497, CDT: 33.98 ± 189.87, p = 0.236). In the LVA group, 41% partially of completely stopped wearing the compression garments after six months whereas in the CDT group 0% discontinued to use of compression garments. LVA resulted in improvement of the domains physical and mental function of the Lymph-ICF. Limb volume did not significantly improve after 6 months. However, around 42% could completely or partially stopped with the use of compression garments in the LVA group. The current results are promising, however longer follow up is required to assess long term effect of LVA for secondary lymphedema. Clinical Trial Registration: NCT02790021 registered on 03/06/2016.

Longitudinal analysis of quality of life in primary lung cancer patients with chlamydia pneumoniae infection: a time-to-deterioration model

BACKGROUND

Chlamydia pneumoniae (Cpn) IgG and IgA has been strongly linked to lung cancer, but its impact on patients' quality of life remains unclear. Our objective was to investigate the relationship between pre-treatment Cpn IgG and IgA and time to deterioration (TTD) of the HRQoL in patients with primary lung cancer.

METHODS

A prospective hospital-based study was conducted from June 2017 to December 2018, enrolling 82 patients with primary lung cancer admitted to the First Affiliated Hospital of Fujian Medical University for questionnaire surveys. Cpn IgG and IgA was detected by microimmunofluorescence method. HRQoL was assessed at baseline and during follow-up using the EORTC Quality of Life Questionnaire version 3.0 (EORTC QLQ-C30) and EORTC Quality of Life Questionnaire-Lung Cancer (EORTC QLQ-LC13). HRQoL scores were calculated using the QoLR package, and TTD events were determined (minimum clinically significant difference = 5 points). Cox regression analysis was used to evaluate the effect of Cpn IgG and IgA on HRQoL.

RESULTS

We investigated the relationship between Cpn IgG and IgA and quality of life in patients with primary lung cancer. The study was found that 75.61% of cases were Cpn IgG + and 45.12% were Cpn IgA + . Cpn IgA + IgG + was 41.46%. For EORTC QLQ-C30, Physical function (PF) and Pain (PA) TTD events on the functional scale and Symptom scale were the most common during follow-up. After adjusting for gender and smoking status, Pre-treatment Cpn IgA + was found to signifcantly delay TTD of Physical functioning(HR = 0.539, 95% CI: 0.291-0.996, P = 0.048). In addition, Cpn IgG + before treatment significantly delayed TTD in Emotional functioning (HR = 0.310, 95% CI: 0.115-0.836, P = 0.021). For EORTC QLQ-LC13, deterioration of dyspnea (LC-DY) was the most common event. However, Cpn IgG and IgA before treatment had no effect on the TTD of EORTC QLQ-LC13 items.

CONCLUSIONS

According to EORTC QLQ-C30 and EORTC QLQ-LC13, Cpn IgA delayed TTD in Physical functioning and Cpn IgG delayed TTD in Emotional functioning.

Evaluation of job stress and quality of life in individuals returning to work after cancer treatment

PURPOSE

The aim of this study was to investigate the impact of work life on work stress and quality of life in cancer patients returning to work after treatment.

METHODS

This descriptive cross-sectional study was conducted between January 2021 and June 2021 with 302 cancer patients who ad registered at the oncology outpatient clinic of a university hospital and had started or continued work after treatment. Data were collected using a personal information questionnaire, the Perceived Work Stress Scale, and the EORTC QLQ-C30. Results with p < 0.05 were considered statistically significant.

RESULTS

The mean age of the patients was 44.97 ± 10.08 years. They were predominantly women, had a diagnosis of breast cancer, and had received chemotherapy. The patients' perceived work stress score was 2.10 ± 0.68 (level D) and the EORTC QLQ-C30 score was 65.95 ± 20.11. Women, participants who were worried about their jobs, those who worked >36 months after cancer treatment, public and private sector workers, those who considered leaving their jobs after cancer treatment, and those who considered changing jobs had higher work stress scores.

CONCLUSIONS

The results of this study suggest that perceived work stress negatively affects the quality of life in individuals returning to work after cancer treatment. Therefore, individuals should be supported in returning to work and subsequent phases, and future should focus on the concepts of rehabilitation and return to work.

Development Trajectories of Fatigue, Quality of Life, and the Ability to Work among Colorectal Cancer Patients in the First Year after Rehabilitation-First Results of the MIRANDA Study

Cancer-related fatigue, low quality of life (QoL), and low ability to work are highly prevalent among colorectal cancer (CRC) patients after tumor surgery. We aimed to analyze their intercorrelations and trajectories in the first year after in-patient rehabilitation in the German multicenter MIRANDA cohort study. Recruitment is ongoing, and we included the first 147 CRC patients in this analysis. Participants filled out questionnaires at the beginning of in-patient rehabilitation (baseline) and at 3, 6, 9, and 12 months after the baseline. The EORTC-QLQ-C30-General-Health-Status (GHS)/QoL, the FACIT-F-Fatigue Scale, and the FACIT-F-FWB-ability-to-work items were used to evaluate QoL, fatigue, and ability to work, respectively. The fatigue and QoL scales were highly correlated (r = 0.606). A moderate correlation was observed between the fatigue and ability to work scales (r = 0.487) and between the QoL and ability to work scales (r = 0.455). Compared to the baseline, a statistically significant improvement in the QoL, ability to work, and fatigue scales were observed at the 3-month follow-up (Wilcoxson signed rank test, all p < 0.0001). The three scales plateaued afterward until the 12-month follow-up. In conclusion, fatigue, QoL, and ability to work were highly interrelated, improved quickly during/after in-patient rehabilitation, and did not change much afterward in German CRC patients.

Cancer patients' return-to-work adaptation experience and coping resources: a grounded theory study

OBJECTIVE

To explore the return-to-work adaptation experience and coping resources used by cancer patients.

METHODS

With the help of the Nantong Cancer Friends Association, from June 2019 to January 2020, this study recruited 30 cancer patients who had returned to work using purpose sampling, snowball sampling and theoretical sampling. The researchers analyzed the data using initial-, focusing-, and theoretical coding.

RESULTS

The adaptation of cancer patients to return-to-work is a rebuilding process by taking advantage of the available personal and external coping resources. The adaptation experience includes: focusing on rehabilitation, rebuilding self-efficacy, and adjusting plans.

CONCLUSION

Medical staff should help patients mobilize coping resources to adapt to return to work.

Research on Cancer Screening Promotion and Employment Support for Employees with Cancer at Business Establishments

Background

Increasing cancer screening rates among working-age populations and providing employment support for employees with cancer are issues that need to be addressed in Japan. Therefore, this study aimed to clarify the situation regarding cancer screening promotion and employment support for employees with cancer at business establishments and the support they seek from medical professionals regarding these issues.

Methods

This survey covered 1,058 business establishments and included the following items: attributes of the business establishments, cancer screening rate, support for employees to promote cancer screening, support sought by business establishments from medical professionals to promote cancer screening, presence of employees with cancer, support programs for employees with cancer, awareness of the resources available for employment support for employees with cancer, difficulties in supporting employees with cancer in the workplace, and support sought by business establishments from medical professionals in providing employment support for employees with cancer. Data analysis was primarily conducted using summary statistics.

Results

This study included 153 establishments. The median cancer screening rate ranged from 50.00 to 99.15. Employee support for promoting cancer screening ranged from approximately 30% to 40% for "ensuring time for screening" and from 20% to 30% for "providing full subsidies for cancer screening cost." The median screening rate for breast and cervical cancers was 50.00, and support for promoting screening was less than 30% for each. Business establishments sought support from medical professionals regarding cancer and study sessions on cancer prevention to promote cancer screening. Regarding support systems for employees with cancer, 49.7% of the establishments offered sickness benefits, and 42.5% offered paid leave on an hourly basis. Less than 10% were aware of the websites provided by public organizations regarding employment support for patients with cancer. Approximately 50% of the establishments reported difficulties regarding treatment policies and duration uncertainties.

Conclusion

Business establishments sought the provision of relevant knowledge and specific information to increase cancer screening rates and provide employment support for employees with cancer. Furthermore, this study suggests that employees with cancer need to manage the information they provide their establishments.

Associations of Physical Activity and Handgrip Strength with Health-Related Quality of Life in Older Korean Cancer Survivors

Background: Uncertainty exists regarding the associations between physical activity (PA), relative handgrip strength (RHGS), and health-related quality of life (HRQoL) among elderly Korean cancer survivors. This study investigated the moderating effect of RHGS on the relationship between PA and HRQoL in 308 cancer survivors aged ≥65 years using the data from the Korean National Health and Nutrition Examination Survey in 2014−2019. Methods: HRQoL was evaluated with the EuroQol-5-dimension instrument. PA and handgrip strength were assessed with the Global Physical Activity Questionnaire and a hand dynamometer, respectively. Age, sex, body mass index, income, marital status, educational background, heavy alcohol consumption, smoking status, multimorbidity, and hemoglobin were included as covariates. Results: Bivariate logistic regression showed that insufficient PA and no PA were associated with higher odds of a low HRQoL (odds ratio, OR = 2.6, 95% confidence interval, CI = 1.3~5.1, p = 0.005; OR = 2.4, 95% CI = 1.1~5.0, p = 0.024, respectively), compared with sufficient PA (OR = 1). Weak RHGS was associated with high odds of a low HRQoL (OR = 2.6, 95%= 1.530~4.6, p < 0.001) compared with normal RHGS (OR = 1). Particularly, RHGS (β = −0.0573, 95% CI = −0.1033~−0.0112) had a significant moderating effect on the relationship between PA and HRQoL even after adjustments for all the covariates. The negative influence of physical inactivity on HRQoL was observed in cancer survivors with weak RHGS but not in cancer survivors with normal RHGS. Conclusions: The current findings suggest that maintaining or promoting muscular strength through regular exercise is critical for the HRQoL of elderly Korean cancer survivors.

Health-related quality of life and associated factors among cancer patients in Ethiopia: Systematic review and meta-analysis

INTRODUCTION

Cancer is the main cause of morbidity and mortality in every part of the world, regardless of human development. Cancer patients exhibit a wide range of signs and symptoms. Being diagnosed with cancer has a variety of consequences that can affect one's quality of life. The term "health-related quality of life" refers to a multidimensional concept that encompasses a person's whole health. The availability of data on the prevalence of poor quality of life among cancer patients in Ethiopia is critical in order to focus on early detection and enhance cancer treatment strategies. In Ethiopia, however, there is a scarcity of information. As a result, the aim of this study was to determine the pooled estimated prevalence of quality of life among cancer patients in Ethiopia.

MATERIALS AND METHODS

This systematic review and meta-analysis were searched through MEDLINE, Pub Med, Cochrane Library, and Google Scholar by using different search terms on the prevalence of health-related quality of life of cancer patients and Ethiopia. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument was used for critical appraisal of studies. The analysis was done using STATA 14 software. The Cochran Q test and I2 test statistics were used to test the heterogeneity of studies. The funnel plot and Egger's test were used to show the publication bias. The pooled prevalence of health-related quality of life of cancer with a 95% confidence interval was presented using forest plots.

RESULTS

A total of 12 studies with 3, 479 participants were included in this review and the overall pooled estimates mean score of health-related quality of life among cancer patients in Ethiopia was 57.91(44.55, 71.27, I2 = 98.8%, p≤0.001). Average monthly income (AOR:3.70;95%CI:1.31,6.10), Stage of cancer (AOR:4.92;95% CI:2.96,6.87), Physical functioning(AOR:4.11;95%CI:1.53,6.69), Social functioning(AOR:3.91;95% CI:1.68,6.14) were significantly associated with quality of life. Subgroup meta-analysis of health-related quality of life of cancer patients in Ethiopia done by region showed that a higher in Addis Ababa 83.64(78.69, 88.60), and lower in SNNP region16.22 (11.73, 20.71), and subgroup analysis done based on the type of cancer showed that higher prevalence of health-related quality of life among cancer patients was breast cancer 83.64(78.69, 88.60).

CONCLUSION

This review showed that the overall health related quality of life was above an average. Furthermore, average monthly income, cancer stage, physical, and social functioning were all significant determinants in cancer patients' QOL.as a result, this review suggests that quality of life evaluation be incorporated into a patient's treatment routine, with a focus on linked components and domains, as it is a critical tool for avoiding and combating the effects of cancer and considerably improving overall health. In general, more research is needed to discover crucial determining elements utilizing more robust study designs.