Influence of lifestyle, depression, and marital intimacy on quality of life in breast cancer survivors

A study on the impact of marital status on the survival status of prostate cancer patients based on propensity score matching

Marital status is an independent prognostic factor for survival in many types of cancers, but its prognostic impact on patients with prostate cancer (PCa) has not been established. The aim of this study was to explore the independent prognostic factors of PCa and to investigate the effect of marital status on survival outcomes in patients with different stratified by PCa. Using the surveillance, epidemiology, and end results (SEER) database, we collected data on 584,655 PCa patients diagnosed between 1975 and 2019. Marital status was classified as married, divorced, widowed, and single. We used the Kaplan-Meier analysis and single multivariate Cox proportional hazards regression analysis to determine the effect of marital status on overall survival (OS) and cancer-specific survival (CSS). In addition, we performed subgroup analyses for different ages, Gleason score and PSA values, and performed a 1:1 propensity score matching (PSM) to reduce the impact of confounding factors to obtain more accurate matching results. According to our findings, marital status was an independent prognostic factor for the survival of PCa patients and a better prognosis of married patients. Moreover, we also found that factors such as age, TNM stage, Gleason score, and PSA concentration were also considered as important predictors for the prognosis of PCa. The above findings can facilitate early detection and treatment of high-risk PCa patients, prolong their life and reduce family burden.

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.

Body change stress, sexual function, and marital intimacy in korean patients with breast cancer receiving adjuvant chemotherapy: A cross-sectional study

Objective

A crucial factor influencing the quality of life of patients with breast cancer is marital intimacy, which, along with emotional support, helps them overcome difficult treatments. This study aimed to elucidate and confirm the effects of body change stress and sexual function in marital intimacy.

Methods

We conducted a cross-sectional survey on 190 patients with breast cancer. They completed the breast-impact of treatment scale, female sexual function index, and revised dyadic adjustment scale.

Results

The patients' average age was 46.27 (6.84), and the age distribution ranged from 25 to 59 years. These variables showed statistically significant differences according to the chemotherapy period (P ​< ​0.05) and type of surgery (P ​< ​0.05). Body change stress negatively correlated with sexual function (r ​= ​-0.523, P ​< ​0.001) and marital intimacy (r ​= ​-0.545, P ​< ​0.001). Sexual function positively correlated with marital intimacy (r ​= ​0.363, P ​< ​0.001). Marital intimacy was affected by the changes in body stress (β ​= ​-0.473, P ​< ​0.001). Sexual function did not affect marital intimacy (β ​= ​0.084, P ​= ​0.289).

Conclusions

Changes in body stress and chemotherapy treatment should be considered in patients with breast cancer for better marital intimacy. Intervention strategies that consider the characteristics discussed could improve marital intimacy for patients with breast cancer.

Experiences of Forest Healing Instructors Who Met Cancer Patients in Forest Healing Programs: FGI Research

BACKGROUND

Demand for urban forest programs for the healing of cancer survivors is increasing. To develop a forest healing program for the integrated care of cancer patients, it is necessary to analyze the experiences of forest healing instructors who have conducted programs for cancer patients.

METHODS

This qualitative study applied focus group interviews (FGIs; four interviews with sixteen participants) to describe and understand the experiences of forest healing instructors who run forest healing programs for cancer patients.

RESULTS

Four themes were identified: "prepared encounters and unexpected encounters," "yearning for healing," "people who need special care," and "things to prepare for cancer patient programs."

CONCLUSION

Forest healing instructors had difficulty facilitating programs for cancer patients owing to prejudice and a lack of knowledge about the characteristics of cancer patients. Moreover, differentiated programs and places that align with the specific needs of cancer patients are needed. It is necessary to develop an integrated care forest healing program for cancer patients and educate forest healing instructors about the needs of cancer patients.

South Korean Early Cancer Patients' Perceptions of Difficulties in Fighting Their Disease: A Q Methodological Approach

This study applied the Q methodology to explore breast cancer patients' perceived difficulties in their fight against the disease. We used literature analysis and in-depth interviews and selected 162 statements for the Q population. Then, we chose 40 universal and representative statements for the Q samples from the Q population. The P sample included 13 breast cancer patients in the early stage of the disease who participated in the Q sorting. We interviewed the study participants with high factor weights by type of P sample. The study's results showed three types of breast cancer patients' perceptions of difficulties in the initial fight against the disease. Type 1 showed 'fear of the future', Type 2 showed 'helplessness against what cannot be controlled', and Type 3 showed 'frustration due to difficulties in role performance.' Based on these results, we discuss the characteristics, meanings, and significance of individual types of breast cancer patients' perceptions of the disease, including suggestions for follow-up studies.

The development of a lifestyle modification mobile application, "Health for You" for overweight and obese breast cancer survivors in Korea

Purpose

This study aimed to develop a lifestyle modification (LSM) mobile application based on the Android operating system for overweight and obese breast cancer survivors (BCS) in Korea and evaluate its usability.

Methods

The content analysis, design, development, implementation, and evaluation of the LSM intervention mobile application for overweight and obese BCS was conducted by identifying survivors' needs, searching the literature, and reviewing existing mobile applications. The survey was conducted from June 1 to December 28, 2020 at Jeonju city, Korea.

Results

The mobile application for BCS included dietary and exercise information, weight logs, as well as distress and daily achievement check. It also included information and videos on the prevention of breast cancer recurrence and used a communication bulletin board. Expert and user usability evaluation of its content and functions confirmed that it was appropriate and satisfactory for overweight and obese BCS.

Conclusion

This LSM mobile application developed for overweight and obese BCS was found to be appropriate for use. It can be applied for further study of effectiveness on improving their health and maintaining a healthy lifestyle, to ultimately improve quality of life.