[Factors influencing quality of life in patients with breast cancer on hormone therapy]

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.

Factors associated with the quality of work life among working breast cancer survivors

Objective

In South Korea, the incidence and survival rate of breast cancer are high, and the return-to-work rate of breast cancer survivors continues to increase. However, there are various obstacles after returning to work, which can negatively affect long-term quality of life management. Therefore, the purpose of this study is to identify factors associated with the quality of work life, which is a priority factor in managing the quality of life.

Methods

Data were collected from 169 female breast cancer survivors and participants were selected from three different hospitals in the metropolitan city and snowball sampling was used in conjunction. The participants filled out questionnaires about a variety of factors that may associated with quality of work life (QWL); the data were analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson's correlation coefficient, and multiple linear regression.

Results

All participants were women with an average age of 48.9 years after diagnosis of cancer, with 65.7% married. 46.2% of them were in Cancer stage 1, 65.7% had work experience over six years, and most of them were educated managerial workers, fixed duty. Multiple regression analysis indicated perceived health status, social support of superior and colleagues and spiritual well-being were positive predictors and cancer fatigue and distress were negative predictors of QWL, explaining 49.5% (adjusted R²) (F_10,158 ​= ​17,486, P ​< ​0.001).

Conclusions

For increasing the QWL of working breast cancer survivors, decreasing cancer fatigue and distress and increasing perceived health status, social support, and spiritual wellbeing can be considered. The findings can contribute for developing effective and systematic interventions that consider the identified predictors to enhance the QWL and successful returning to work and job retaining.

Unmet Needs and Quality of Life of Cancer Patients and Their Families: Actor-Partner Interdependence Modeling

Unmet needs and quality of life (QOL) are important nursing issues for both patients and their families. However, studies into their direct association, considering the dyadic relationship between them, have not been done. We investigated the associations using the actor–partner interdependence modeling for dyadic data. Data were collected from 115 patient–family dyads at a tertiary teaching hospital. The study variables were assessed using the questionnaires and clinical data. To analyze patient–family dyad data, the actor–partner interdependence modeling and structural equation modeling were used. The cancer patients and their families experienced diverse and high levels of unmet needs that affected their quality of life, both physically and mentally. The cancer patients’ unmet needs decreased their physical and mental quality of life, while those of their families had a negative impact on their own physical and mental quality of life. However, the cancer patients’ unmet needs did not have partner effects on their families’ quality of life, and vice versa. Therefore, unmet needs played important roles in their QOL taking into dyadic relationships in the model. The results suggest that nursing intervention programs to meet the needs of both patients and their families are required to improve their quality of life.

Perceived New Normal and Inner Strength on Quality of Life in Breast Cancer Patients Receiving Adjuvant Endocrine Therapy

Objective:

This study aimed to investigate the differences in symptom experience, inner strength, adherence, and quality of life (QOL) according to the perception of the new normal, and identify the factors related to the QOL of breast cancer patients undergoing adjuvant hormonal therapy based on the theory of inner strength in women.

Methods:

This cross-sectional study recruited patients with breast cancer receiving adjuvant hormonal therapy in the National Cancer Center. Demographic and clinical characteristics were recorded, and patients were assessed using the M. D. Anderson Symptom Inventory, Connor-Davidson Resilience Scale 2, Morisky Medication Adherence Scale 8, and Functional Assessment of Cancer Therapy-General Scale.

Results:

After the breast cancer diagnosis, the perception of the new normal showed a significant dependence on pill count and emotional and functional well-being. The hierarchical regression analysis indicated that the new normal, symptom interference, and inner strength after adjusting for age, time since diagnosis, and receiving chemotherapy were significant predictors of QOL in breast cancer patients receiving adjuvant endocrine therapy. The model accounted for 47.8% of the variance in QOL.

Conclusions:

The theory of inner strength might be a potential pathway in health care to improve patients' QOL during long-term medication. The results of this study have both theoretical and applied implications. The findings can be utilized as evidence for developing an effective intervention that improves the QOL and adherence to adjuvant hormonal therapy of breast cancer patients.

Photovoice-Based Assessment of Weight Management Experiences of Breast Cancer Patients Treated with Tamoxifen

In this study, an in-depth analysis of weight management experiences of breast cancer patients treated with tamoxifen is conducted, thereby providing basic data to help develop a multidimensional strategy to reduce recurrence and increase the survival rate of breast cancer patients. Study participants included nine breast cancer patients who were treated with tamoxifen at Kosin University Hospital and Saegyero Hospital in Busan Metropolitan City, Korea. This study employed the photovoice methodology. Participants described the need for family support and cooperation with weight management, provision of personalized weight management programs by medical institutions, provision of information on weight management programs by the community, and financial support for the weight management programs for breast cancer patients at the national level. This study emphasized the importance of weight management for breast cancer patients treated with tamoxifen and collected and analyzed vivid opinions of these patients using photos taken by them.

Effects of Menopausal Symptoms and Depression on the Quality of Life of Premenopausal Women With Breast Cancer in Korea

INTRODUCTION

As breast cancer survivors have increased, improving quality of life of the survivors becomes an important issue. The purpose of this study was to examine relationships among menopausal symptoms, depression, and quality of life and to identify the factors affecting the quality of life in premenopausal women with breast cancer.

METHOD

This was a descriptive, correlational study using structured questionnaires for 90 premenopausal women with breast cancer attending the outpatient clinic of a tertiary hospital in Korea.

RESULTS

Menopausal symptoms ( r = -0.770, p < .001) and depression ( r = -0.715, p < .001) negatively affected the participants' quality of life. The major factors affecting quality of life were employment ( t = -2.065, p = .042), depression ( t = -2.375, p = .020), and menopausal symptoms ( t = -3.863, p < .001). Menopausal symptoms were the strongest negative factor (β = -.508) affecting quality of life.

DISCUSSION AND CONCLUSIONS

Developing nursing intervention congruent with the culture of Korean breast cancer women with treatment-induced menopausal symptoms is a high priority.

Pain and Menopause Symptoms of Breast Cancer Patients with Adjuvant Hormonal Therapy in Korea: Secondary Analysis

Objective:

The purpose of this study was to describe the prevalence and levels of pain and menopause symptoms of breast cancer patients with adjuvant hormonal therapy (HT).

Methods:

A cross-sectional survey design was used. Secondary analysis was used from the primary data collected in 2013 from a total of 110 breast cancer patients receiving HT for more than 3 months, using questionnaires of the Korean version of brief pain inventory and the menopause rating scale.

Results:

Mean age of the participants was 53.56. Most (88.2%) of the participants reported to have pain and almost (95.5%) of them reported to have menopause symptoms. More pain was reported in participants with aromatase inhibitor (AI) than those with tamoxifen. Adherence to HT showed a significant difference according to the rate of feeling increased pain (P = 0.001). Among the menopause symptoms, fatigue was the most common symptom (97.3%). Sweating/flush was significantly higher in tamoxifen group (P < 0.005), and joint and muscle complaints were higher in AI group (P < 005).

Conclusions:

The results of the study show that the prevalence and levels of pain and menopause symptoms among breast cancer patients receiving HT were high. Thus, oncology professionals need to provide appropriate interventions to relieve pain and menopause symptom to improve adherence to HT.

Predictors of the quality of life in Chinese breast cancer survivors

PURPOSE

Little is known about the importance of various factors which impair the quality of life (QOL) in survivors of breast cancer 1 year after diagnosis and over 1 year after diagnosis in China. Hence, the goal of this article is to quantitatively evaluate the factors which play an active role in impairing QOL 1 year after diagnosis and over 1 year after diagnosing survivors.

METHODS

A population-based cross-sectional study was conducted at 34 Cancer Recovery Clubs across China from May 2014 to January 2015. The simplified Chinese version of the Quality of Life Questionnaire-Core 30 items (EORTC QLQ-C30) and the Breast Cancer-specific module QLQ-23 were used to measure QOL in 10794 Chinese women with breast cancer (1 year after diagnosis: 1029, over 1 year after diagnosis: 9765). Forward stepwise multivariable regression analysis was used to identify the most predictive factors for limitations on QOL. Partial R ² values were calculated to appraise the independent proportion of explained variance within QOL by each factor included in the model.

RESULTS

The participants had higher scores of role functioning, sexual function, sexual enjoyment, and financial difficulties. The uppermost predictors of functional status and QOL were financial difficulties and fatigue for the 1 year after diagnosis, respectively, and fatigue, financial difficulties, and systemic side effects for the long-term survivors. These symptoms explained approximately 28-53% of the variability within the function scores and QOL expect for sexual enjoyment and sexual functioning. Although sociodemographic and clinical factors had a relative importance to sexual function and sexual enjoyment, they were even smaller and had less of an impact on other dimensions.

CONCLUSIONS

People who were more active and had an optimistic attitude towards life had relatively higher function scores. For the breast cancer patients 1 year after diagnosis, reducing the burden of fatigue might be a more preferable way to improve their functional status and QOL. Nevertheless, focusing on fatigue symptoms and systemic therapy side effects synchronously may present an especially worthwhile endeavor to enhance the long-term survivors' functional status and QOL.

How Menopause Symptoms and Attitude Impact Korean Women's Quality of Life After Adjuvant Treatment for Breast Cancer

BACKGROUND

Attitudes toward menopause vary across cultures and influence women's experiences of menopausal symptoms, possibly leading to reduced posttreatment quality of life in breast cancer survivors.

OBJECTIVE

The aim of this study is to examine the effects of menopausal symptoms and attitudes on health-related quality of life in breast cancer survivors who were premenopausal at the time of diagnosis.

METHODS

A total of 139 women receiving chemotherapy with/without endocrine therapy were assessed with self-report questionnaires of established reliability and validity. Hierarchical regression was conducted to assess the impact of menopausal symptoms and attitudes on quality of life, while controlling for demographic characteristics.

RESULTS

Overall, participants endorsed more than half of 46 symptoms, most at the level of mild symptoms, and most reported a less positive attitude toward menopause. Lower quality of life was significantly predicted by more menopausal symptoms endorsed and more negative attitudes when controlling for demographic factors associated with quality of life (R = 26.1%). Most participants experienced change from premenopause to postmenopause after the completion of adjuvant chemotherapy with or without tamoxifen.

CONCLUSIONS

The results suggest that more menopausal symptoms and negative attitudes toward menopause may affect health-related quality of life considerably in chemotherapy-treated Asian breast cancer survivors.

IMPLICATIONS FOR PRACTICE

Healthcare professionals should develop a better understanding of the effects of menopausal symptoms and attitudes on quality of life by using a culturally relevant perspective based on patients' sociocultural backgrounds. Furthermore, these findings help healthcare professionals communicate with their Asian clients in a more informed way and provide culturally appropriate and individualized care.