Adherence to health-related lifestyle behavior recommendations and association with quality of life among cancer survivors and age-matched controls in Korea

Prevalence and Correlates of Physical Activity and Sitting Time in Cancer Survivors: 2009-2013 Korea National Health and Nutrition Examination Survey

Objectives:

A physically active lifestyle is important for cancer survivors. Therefore, this study was conducted to 1) provide population-based estimates of the prevalence of physical activity and sitting time, and 2) their correlates in Korean cancer survivors.

Materials and Methods:

This study analyzed a cancer survivor subsample (N=1,482) from 2008-2013 Korea National Health and Nutrition Examination Survey (KNHANES), data selected with a complex sampling design. Overall and subgroup-specific prevalences of physical activity and sitting time were estimated. Correlates of moderate- to vigorous-intensity physical activity (MVPA) and sitting time were tested using age-group-specific hierarchical multiple regression models.

Results:

Overall adherence rate to physical activity guidelines was 34.9% (95% CI=31.5-38.4). Age-group-specific adherence rates were 41.1% (95% CI=36.3-45.9) in adults (30-64 years old), and 25.3% (95% CI=21.0-25.3) in older adults (65 years or older). Adults spent 213.33 minutes (95% CI=172.4-254.3) per week on MVPA and 55.3 minutes (95% CI=36.4-64.6) on sitting time per day. In adults, sitting time was significantly associated with employed status (B=28.0, p=0.046), smoking (B=-47.4, p=0.020), and number of comorbidity conditions (B=-13, p=.037). MVPA was significantly associated with marital status (B=134.9, p<0.001), employment status (B=98.12, p=.046), and years since cancer diagnosis (B=104.7, p=0.015). Older adults spent 162.2 minutes (95% CI=119.5-204.8) per week on MVPA and 63.0 minutes (95% CI=45.0-89.5) on sitting time per day. Their significant correlates were sex (B= -45.2, p=0.014), smoking (B=-70.14, p<0.001), and years since cancer diagnosis (B=37.0, p=0.024). Age (B=5.8, p=0.042) and marital status (B=83.8, p=0.033) were also significantly associated with MVPA in older adults.

Conclusion:

A majority of Korean cancer survivors do not sufficiently participate in physical activity. In general, older, unhealthier, non-working, and being unmarried were risk factors for physical inactivity. While this study informs public health policy makers and practitioners about physical activity intervention demand for cancer survivors, future investigations should address psychosocial mediators to better inform intervention programs.

Health promoting behavior and influencing factors in Iranian breast cancer survivors

BACKGROUND

The purpose of this study was to investigate the associations among the internal health locus of control, depression, perceived health status, self efficacy, social support, and health-promoting behavior in Iranian breast cancer survivors and to determine influential variables.

MATERIALS AND METHODS

A predictive design was adopted. By convenient sampling the data of 262 breast cancer survivors in Iran were collected by questionnaires during 2014. Data were analyzed applying descriptive statistics, t-tests, one-way ANOVA, Pearson's correlation coefficients, and stepwise multiple regression.

RESULTS

The internal health locus of control, depression, perceived health status, self efficacy, social support and undergoing chemotherapy all correlated significantly with the health-promoting lifestyle. Stepwise multiple regression analysis revealed that social internal health locus of control, depression, perceived health status, self efficacy and social support and chemotherapy accounted for about 39.8% of the variance in health promoting lifestyle. The strongest influence was social support, followed by self efficacy, perceived health status, chemotherapy and depression.

CONCLUSIONS

The results of the study clarifed the seriousness of social support, self efficacy, perceived health status and depression in determining the health-promoting lifestyle among Iranian breast cancer survivors. Health professionals should concentrate on these variables in designing plans to promoting a healthy lifestyle.

The Association between Short or Long Sleep Times and Quality of Life (QOL): Results of the Korea National Health and Nutrition Examination Survey (KNHANES IV-V)

STUDY OBJECTIVES

Sleep can affect quality of life (QOL). We examined the association between self-reported sleep time and QOL independent of perceived health status and depressive disorder using the EuroQol-5 Dimension (EQ-5D) and a visual analog scale (VAS).

METHODS

We used the nationwide cross-sectional survey data of 28,178 subjects from the Korea National Health and Nutrition Examination Survey (KNHANES) IV-V. Self-reported sleep time was assessed by average hours of sleep per day. QOL was measured using the EQ-5D and VAS. A generalized additive model and multiple linear regression analysis were used to estimate the effect of sleep time on the QOL while adjusting for potential confounding variables.

RESULTS

We found a significant inverted U-shaped relationship between sleep time and QOL using both the EQ-5D and VAS indices. Compared with subjects who slept 7 h/day, Korean men whose sleep time was very short (≤ 4 h/ day) or very long (≥ 10 h/day) had substantially worse QOL (-3.125 in EQ-5D, p < 0.001 and -4.387 on the VAS, p = 0.000 for ≤ 4 h/day; -1.763 in EQ-5D, p = 0.001 and -1.944 on the VAS for ≥ 10 h/day, all p = 0.038). A similar inverted U-shape was observed between sleep time and QOL in Korean women.

CONCLUSIONS

Inappropriate sleep time (either short or long) in both men and women was significantly associated with lower QOL. In particular, such an association was more apparent among persons whose perceived health status was poor.

Living experiences of Indian adult cancer survivors--a brief report

BACKGROUND

This pilot study looked into the physical, social, psychological and economic issues of Indian adult cancer survivors.

MATERIALS AND METHODS

Assumed cancer free patients, after cancer directed therapy (CDT), were assessed on the basis of a questionnaire developed by the investigators. The mental status of the survivors was elicited by modified MINI international neuro-psychiatric interview. This cross sectional assessment was conducted as a direct interaction with each patient for 30 to 45 minutes at a cancer hospital in 2012.

RESULTS

Thirty one adult cancer survivors participated in this study. Median age was 53 years with a median follow up duration of 21.8 months (Range 2.3-194.1 months). The majority (68%) did not receive financial support for treatment. Median interval after CDT to start of activity of daily living was 1.5 months (range: 0-24 months). Fatigue and loss of appetite were reported by 52% and 29% respectively. The cancer diagnosis and its treatment adversely impacted the financial condition in 42% of patients. Nineteen percent each showed social anxiety and post-traumatic stress disorder and another 13% patients reported depression.

CONCLUSIONS

This prospective assessment highlights survivorship issues and the need to address those issues particularly in the context of developing countries where resources and manpower are limited.

Social support and quality of life in Turkish patients with gynecologic cancer

The aim of this study was to determine the level of social support and quality of life in Turkish patients with gynecologic cancer using a cross-sectional survey design. A total of 108 patients admitted to the gynecologic oncology clinic at a university hospital from September 2011 to January 2012 were included. Data were collected using patient information forms, the Multidimensional Scale of Perceived Social Support (MSPSS) and The Quality of Life-Cancer Survivors Instrument (QOL-CS). Average age was 54.5±10.8 years and it was determined that 65.7% of patients had ovarian cancer and 19.4% had cervical cancer. The total QOL-CS mean score was 5.59±1.10. Average score of total MSPSS was found to be 69.7±14.64. Comparing socio-demographic and clinical characteristics of patients and average scores of QOL-CS and MSPSS, it was found that there was not a statisticaly significant corelation (p>0.05). Statistically significant relation was found between the average scores of QOL-CS and MSPSS. These results showed that quality of life was moderate and perceived social support was high in Turkish patients with gynecologic cancer.

Prevalence of and factors associated with osteoporosis among Korean cancer survivors: a cross-sectional analysis of the Fourth and Fifth Korea National Health and Nutrition Examination Surveys

BACKGROUND

Identifying and managing osteoporosis among cancer survivors is an important issue, yet little is known about the bone health of cancer survivors in Korea. This study was designed to measure the prevalence of osteoporosis and to assess related factors among Korean cancer survivors.

MATERIALS AND METHODS

This study was designed as a cross-sectional analysis. Data were obtained from dual energy X-ray absorptiometry measurement of the lumbar vertebrae and femoral neck, and from standardized questionnaires among 556 cancer survivors and 17,623 non-cancer controls who participated in the Fourth and Fifth Korea National Health and Nutrition Examination Surveys (2008-2011). We calculated adjusted proportions of osteoporosis in non-cancer controls vs. cancer survivors, and we performed multivariate logistic regression analysis.

RESULTS

The prevalence of osteoporosis among cancer survivors was significant higher than that of the non-cancer controls after adjusting for related factors. Furthermore, osteoporosis among cancer survivors was higher in elderly subjects (60-69 years : adjusted odds ratio (aOR) 3.04, 95% CI : 1.16-8.00, ≥70 years : aOR 6.60, 95% CI 2.20-19.79), in female cancer survivors (aOR: 7.03, 95% CI: 1.88-26.28), and in a group with lower monthly income (aOR: 3.38, 95% CI: 1.31-8.71). In male cancer survivors, underweight and lower calcium intake were risk factors.

CONCLUSIONS

These data suggest that the osteoporosis among cancer survivors varies according to non-oncologic and oncologic factors. Effective screening should be applied, and a sufficient and comprehensive management should be matched to individual cancer survivors early after cancer treatment.

Optimizing nutrition support in cancer care

Involvement of a multidisciplinary team in cancer care may have added benefits over the existing system of patient management. A paradigm shift in the current patient management would allow more focus on nutritional support, in addition to clinical care. Malnutrition, a common problem in cancer patients, needs special attention from the early days of cancer care to improve quality of life and treatment outcomes. Patient management teams with trained oncology dietitians may provide quality personalized nutritional care to cancer patients.

Health behaviors among breast, prostate, and colorectal cancer survivors: a US population-based case-control study, with comparisons by cancer type and gender

PURPOSE

The aim of this study is to compare health behaviors between breast, prostate, female, and male colorectal cancer survivors to noncancer controls, stratified by short- and long-term survivors, and between cancer types and genders.

METHODS

A 3:1 population-based sample of breast (6,259), prostate (3,609), female colorectal (1,082), and male colorectal (816) cancer survivors from the 2009 Behavioral Risk Factor Surveillance System survey were matched to noncancer controls on age, gender, race/ethnicity, income, insurance, and region of the US. The likelihood of flu immunization, physical check-up, cholesterol check, body mass index (BMI), physical activity, diet (5-A-Day), smoking, and alcohol use were compared between groups using binomial logistic regression models.

RESULTS

Short-term breast cancer survivors were significantly more likely to meet multiple behavioral recommendations, than controls, but the likelihood decreased in the long term. Breast and female colorectal cancer survivors were up to 2.27 (95 % CI 1.90, 2.71) and 1.89 times more likely (95 % CI 1.60, 2.24) to meet the 5-A-Day and BMI recommendations, up to 0.54 times less likely (95 % CI 0.46, 0.64) to drink any alcohol, but were 0.68 times less likely (95 % CI 0.49, 0.95) to meet the physical activity recommendation, compared to prostate and male colorectal cancer survivors.

CONCLUSIONS

Some cancer survivors may engage in better health behaviors shortly after diagnosis, but the majority of cancer survivors do not have better health behaviors than individuals without a history of cancer. However, a consistent pattern of behavioral differences exist between male and female cancer survivors.

IMPLICATIONS FOR CANCER SURVIVORS

Gender differences in health behaviors among cancer survivors may be influenced by perceptions of masculinity/femininity and disease risk. Ongoing health behavioral promotion and disease prevention efforts could be improved by addressing these perceptions.

El consumo de alcohol en los supervivientes al cáncer: estado de la cuestión y propuestas para el desarrollo de intervenciones psicológicas

Objetivo: El consumo de alcohol se ha establecido como un factor de riesgo para el desarrollo del cáncer de forma consistente a lo largo de los años. En los supervivientes al cáncer el consumo de alcohol después del tratamiento alcanza valores significativos y además el alcohol se ha asociado con aspectos relevantes de la supervivencia, como una mayor depresión y una peor calidad de vida. Sin embargo, no hay una gran variedad de intervenciones cuyo objetivo sea reducir el consumo de alcohol en este grupo de pacientes. Método: Se llevó a cabo una revisión sobre el consumo de alcohol en los pacientes y supervivientes al cáncer y las intervenciones psicológicas disponibles para reducir el consumo, en los últimos 10 años, del año 2007 al 2017. Las bases de datos consultadas fueron PubMed, Web of Science (WOS) y PsycInfo. Se utilizaron los siguientes descriptores: alcohol, cancer patients, survivors, psychological treatment. Resultados: no se observan intervenciones psicológicas diseñadas específicamente para reducir el consumo de alcohol en los supervivientes al cáncer en la literatura previa. La mayoría tienen como objetivo el aumento de las conductas de salud utilizando intervenciones de tipo psicosocial o proporcionando información sobre el alcohol. Solamente una intervención mostró resultados significativos para reducir el consumo de alcohol, en una intervención diseñada para reducir el peso en supervivientes al cáncer de mama. Conclusiones: la relevancia del consumo de alcohol en este grupo de pacientes sugiere la necesidad de que se desarrollen una mayor variedad de intervenciones psicológicas que tengan como objetivo específico la reducción del consumo de alcohol en los pacientes que han superado la enfermedad.