Association of Coping Styles with Quality of Life in Cancer Patients

Methods:The study was performed on 150 cancer patients (71 females and 79 males) admitted to the hospitals affiliated with Kermanshah University of Medical Sciences. Endler and Parker Coping Inventory for Stressful Situations, and World Health Organization''s Quality of Life Questionnaire were used to evaluate their coping style and QOL, respectively.Results:The Present study showed in cancer patients being male, single, having higher salary and education, and lower age are related to higher QOL. Furthermore, in general, QOL of cancer patients was positively correlated with avoidant coping style (P < 0.05, r : 0.170) and negatively associated with emotion-focused coping styles (P < 0.01, r : −0.378).Conclusion:The results suggested that focusing on a patient''s coping style, predominantly on an emotion-focused coping style, is essential to improve patient''s QOL, and that patients possibly to employ a more emotion-oriented coping style should receive enough notice, particularly before discharge.     

Social Support, Intrusive Thoughts, and Quality of Life in Breast Cancer Survivors

This study explores the moderating effect of social support on the relationship between cancer-related intrusive thoughts and quality of life. Sixty-four breast cancer survivors completed self-report measures of appraisal social support (the disclosure of thoughts and feelings to significant others), cancer-related intrusive thoughts, and quality of life. Controlling for demographic and treatment variables, the negative impact of cancer-related intrusive thoughts on both physical and mental quality of life measures was moderated by appraisal social support. For women with high levels of appraisal support, cancer-related intrusive thoughts had no significant relationship with quality of life. However, for women with low levels of appraisal support, the relationship between cancer-related intrusive thoughts and quality of life was significant and negative. These results suggest that appraisal social support can mitigate the impact of traumatic life events.     

住院癌症患者生活质量与社会支持、应对方式的相关性研究

目的探讨住院癌症患者的生活质量及其与应对方式和社会支持的相关性。方法应用生活质量问卷(QLQ-C30)、应付方式评定量表(YFFS)、社会支持问卷(ISSI)对238例癌症患者进行调查。结果癌症患者中女性、不知病情、老年人、文化程度低、低收入患者的生活质量状况较差;癌症患者的积极应对和社会支持3个维度与其生活质量呈正相关(P<0.05,P<0.01),消极应对与生活质量呈负相关(P<0.05,P<0.01)。结论医务人员应在重视患者生物属性的同时,重视他们的社会属性和心理状况,指导癌症患者采取积极的应对方式,增强其社会支持,以提高患者的生活质量。     

Perceived Social Support Mediates the Longitudinal Relations between Ambivalence over Emotional Expression and Quality of Life among Chinese American Breast Cancer Survivors

Purpose

The present study examined perceived social support as a mediator of the longitudinal link between ambivalence over emotional expression (AEE) and quality of life among a sample of Chinese breast cancer survivors.

Methods

Ninety-six Chinese breast cancer survivors recruited from Southern California completed four surveys in total: (1) a baseline survey (T1), 1-month follow-up (T2), 3-month follow-up (T3), and 6-month follow-up (T4). Participants filled out a paper-pen questionnaire containing the Ambivalence over Emotional Expression Questionnaire (AEQ), the Functional Assessment of Cancer Therapy-General (FACT-G), and the Medical Outcomes Study Social Support Scale (MOS-SSS).

Results

Higher T1 AEE was associated with lower T1 social support (B?=??0.01, SE?=?0.004, p?<?0.01) which in turn was associated with lower quality of life at T2 (B?=?2.98, SE?=?0.64, p?<?0.01), T3 (B?=?2.14, SE?=?0.54, p?<?0.01), and T4 (B?=?2.08, SE?=?0.68, p?<?0.01).

Conclusions

These results suggest that the harmful effect of AEE on quality of life is explained by reduced social support. Given the detrimental effects of AEE on social support and quality of life, future research on interventions that facilitate emotional disclosure is needed. Implications for the effects of Chinese culture on AEE are discussed.

     

乳腺癌化疗患者癌性疲乏、应对方式与生活质量的相关性

目的:探讨乳腺癌化疗患者癌性疲乏、应对方式与生活质量之间的相关性.方法:本研究是横断面研究,采用方便抽样法选择乳腺癌改良根治术后行药物化疗的女性患者120例,用癌性疲乏自评量表 (the Revised Piper Fatigue Scale,PFS)、Jalowiec的应对量表 (Jalowiec Coping Scale,JCS)和欧洲癌症研究与治疗组织开发的癌症患者生命质量测定系列量表的核心问卷[Quality of Life Questionnaire-Core 30,QLQ-C30(V3.0)]和针对乳腺癌人群的特异性问卷 (Quality of Life Questionnaire-Breast 23,QLQ-BR23),分别测评患者的癌性疲乏水平、应对方式和生活质量状况.采用Spearman相关分析患者癌性疲乏状况、应对方式以及生活质量三者之间的相关性.结果:乳腺癌化疗患者的癌性疲乏总分与QLQ-C30的功能和总体健康状况呈负相关(r＝-0.24,-0.39;均P<0.01);积极的应对方式如勇敢面对、乐观与PFS的感知维度呈负相关(r＝-0.25,-0.18;均P<0.05),与QLQ-BR23的功能维度呈正相关(r＝0.35,0.21;均P<0.05);消极应对方式如情感、听天由命与PFS的认知维度呈正相关(r＝0.33,0.18;均P<0.05),与QLQ-BR23的功能维度呈负相关(r＝-0.40,-0.32;均P<0.05),与QLQ-BR23症状维度呈正相关(r＝0.40,0.28;均P<0.05).结论:乳腺癌化疗患者所经历的癌性疲乏状况、采取的应对方式及其生活质量三者间存在一定程度的关联,此发现对临床护理有指导意义.     

癌症患者生活质量状况及影响因素研究

目的：探讨中国癌症病人的生活质量状况及影响因素;评估疾病和治疗给病人的生活带来的影响。方法：对２８９名放,化疗癌症病人,采用生活质量问卷（ＱＬＱ－Ｃ３００和卡氏功能量表（ＫＰＳ）于治疗前,中后测查３次。结果ＱＬＱ－Ｃ３０各指标和ＫＰＳ得分均以治疗中最差,多因素分析获得１１个因子对生活质量作用明显,其中居前３位的因子是症状的治疗,情绪及经济历子,并且方差分析发现相互之间交互作用明显。     

Quality of Life in Cancer Patients with Disfigurement due to Cancer and its Treatments

Aim:

The aim of this study was to evaluate the effect of disfigurement due to cancer and its treatments on quality of life.

Materials and Methods:

A total of 120 patients from the inpatient/outpatient department of oncology who had undergone various forms of treatment for cancer were included in this study. The WHOQuality of Life BREF (WHOQL-BREF) version was administered to the patients to assess their quality of life.

Results:

Patients’ overall quality of life score ranged from 34 to 79 with an average of 53.18 (SD 11.94) and a large number of patients had scored from 40 to 54 on the WHOQOL-BREF.The study showed a significant difference between gender groups (t = 3.899, P < 0.05), with a significant difference in the mean quality of life between different categories of the prominent stigma (f = 4.018, P < 0.05) and the nature of stigma. Disfigurement clearly was a stressful experience for both sexes, but substantially more distressing for women. Majority of the patients experienced poor quality of life in all dimensions, namely, physical health, psychological health, social relationships, environmental health, and other sociodemographic variables.

Conclusion:

Living with a disfiguring body which is visibly different is not always easy. A sudden change either due to cancer or its treatment or due to side effects leads to significant social maladjustment, elevated anxiety, depression, and poor quality of life among the cancer survivors with body disfigurement which calls for multiprofessional involvement in addressing various psychosocial issues.     

我国宫颈癌患者配偶生活质量评价的研究现状

随着肿瘤治疗从单纯的“生物学”模式向“生物-心理-社会学”模式转变,治疗的目的已不仅是单纯的延长患者生存时限,如何在保证患者生存的同时提高其生活质量已变得同样重要。国内已有大量针对宫颈癌患者的生活质量的研究,同时,其照顾者的生活质量也开始得到多方面的关注,世界卫生组织将家庭照顾者及其需求定义为舒缓护理中的主要客观因素之一,美国及欧洲各国对患者照顾者的生活质量进行了广泛研究,而我国对宫颈癌患者配偶的生活质量研究相对较少、起步晚、发展慢。本文通过对我国宫颈癌患者其配偶生活质量评价的研究现状进行综述,研究其评价工具,探讨局限性,以期为临床护理干预提供指导,提高宫颈癌患者及配偶的生活质量。     

Quality of Life and its Related Factors Among Iranian Patients with Metastatic Gastrointestinal Tract Cancer: A Cross-sectional Study

Context:

Quality of life (QoL) is an important issue in all cancer patients; especially in patients with metastatic cancer. But there is very little information available about QoL in patients with metastatic gastrointestinal cancer.

Aims:

The aim of this study was to evaluate the quality of life and its associated factors among Iranian patients with metastatic gastrointestinal tract cancer.

Materials and Methods:

In this cross-sectional study, a total of 250 patients with metastatic gastrointestinal tract cancer were recruited from the one oncology center related to the Mazandaran University of Medical Sciences, Sari, between March 2012 and August 2013. Their QoL was evaluated using the EORTC QLQ-C30 questionnaire (Persian version).

Results:

In this study, the overall QoL score of patients with gastrointestinal tract cancer was 57.63, which was relatively optimal. There was a statistically significant relationship between symptoms scale and general health status domains of quality of life with age (P < 0.05). Also, there was a significant association between patients’ gender and their social functioning (P = 0.017) and also their emotional functioning (P = 0.015).

Conclusions:

The findings suggest that in patients with metastatic gastrointestinal cancers, the most affected functions in their QoL were social and emotional functioning which get worse with age. Thus, providing psychological counseling and psychotherapy services to deliver culturally appropriate mental health care and social support for these patients and their families’ which can lead to the improvement of QoL in these patients is strongly recommended.     

Self-regulatory Fatigue in Hematologic Malignancies: Impact on Quality of Life, Coping, and Adherence to Medical Recommendations

Background

Hematopoietic stem cell transplantation (HSCT) is an intensive cancer therapy entailing numerous physical, emotional, cognitive, and practical challenges. Patients’ ability to adjust and cope with such challenges may depend on their ability to exert control over cognitive, emotional, and behavioral processes, that is, ability to self-regulate. Self-regulatory capacity is a limited resource that can be depleted or fatigued (i.e., “self-regulatory fatigue”), particularly in the context of stressful life events such as cancer diagnosis and treatment.

Purpose

This is one of the first studies to examine self-regulatory fatigue in a cancer population. The current study aimed to (1) extract items for a specific scale of self-regulatory capacity and (2) examine the impact of such capacity on adaptation in patients with hematologic malignancies preparing for HSCT.

Methods

Factor analysis of four existing scales gauging psychological adjustment and well-being in 314 patients preparing for HSCT (63% male and 89% Caucasian) identified 23 items (α?=?0.85) related to self-regulatory control or fatigue. This measure was then examined using existing clinical data obtained from 178 patients (57% male and 91% Caucasian) undergoing treatment for hematologic malignancies in relationship to quality of life, coping, and self-reported adherence to physicians’ recommendations.

Results

Controlling for pain severity, physical fatigue, and depression, self-regulatory fatigue scores were incrementally associated with decreased quality of life, use of avoidance coping strategies, and decreased adherence to physicians’ recommendations.

Conclusion

These results emphasize the potential role of self-regulatory capacity in coping with and adjusting to hematologic cancers and future research is warranted.     

Prevalence of Fatigue Among Cancer Patients Receiving Various Anticancer Therapies and its Impact on Quality of Life: A Cross-Sectional Study

Background:

Fatigue is disabling and continuous phenomenon in cancer patients during and after various anticancer treatments which can continue for many years after treatment and definitely it has profound effect on Quality of Life (QOL). However, determining its severity is still underestimated among the cancer patients and also very few studies in the literature exist reporting on Cancer-Related Fatigue (CRF) among Indian population.

Aims:

To find out the prevalence of rate of fatigue in cancer patient receiving various anti cancer therapies. To find out the relative impact of fatigue on QOL.

Materials and Methods:

This cross-sectional observational study included a total 121 cancer patients receiving radiotherapy, chemotherapy, and concurrent chemo-radiation with the age group of above 15 years who fulfilled the inclusion and exclusion criteria. All the patients were assessed for severity of fatigue using Brief Fatigue Inventory (BFI) and for QOL using FACT-G scale while they were receiving the anticancer therapies as an in-patient in the regional cancer centers in Madhya Pradesh, India.

Results:

The severe fatigue was more prevalent in chemotherapy [58/59 (98.30%)], and concurrent chemo-radiation (33/42 (78.57%)) as compared to radiotherapy (Moderate-9/20 (45%) and Severe-9/20 (45%)). Moderate correlations were exhibited between fatigue due to radiotherapy and QOL (r = -0.71, P < 0.01), whereas weak correlation was found between fatigue due to chemotherapy and concurrent chemo-radiation (r = -0.361, P < 0.01 and r = -0.453, P < 0.01, respectively).

Conclusion:

Severity of fatigue was found more after chemotherapy and concurrent chemo-radiation therapy while impact on QOL was more after the radiotherapy.     

Exploring barriers and enablers to the delivery of Making Every Contact Count brief behavioural interventions in Ireland: A cross-sectional survey study

Objectives

The public health impact of the Irish Making Every Contact Count (MECC) brief intervention programme is dependent on delivery by health care professionals. We aimed to identify enablers and modifiable barriers to MECC intervention delivery to optimize MECC implementation.

Design

Online cross-sectional survey design.

Methods

Health care professionals (n = 4050) who completed MECC eLearning were invited to complete an online survey based on the Theoretical Domains Framework (TDF). Multiple regression analysis identified predictors of MECC delivery (logistic regression to predict delivery or not; linear regression to predict frequency of delivery). Data were visualized using Confidence Interval-Based Estimates of Relevance (CIBER).

Results

Seventy-nine per cent of participants (n = 283/357) had delivered a MECC intervention. In the multiple logistic regression (Nagelkerke's R² = .34), the significant enablers of intervention delivery were ‘professional role’ (OR = 1.86 [1.10, 3.15]) and ‘intentions/goals’ (OR = 4.75 [1.97, 11.45]); significant barriers included ‘optimistic beliefs about consequences’ (OR = .41 [.18, .94]) and ‘negative emotions’ (OR = .50 [.32, .77]). In the multiple linear regression (R² = .29), the significant enablers of frequency of MECC delivery were ‘intentions/goals’ (b = 10.16, p = .02) and professional role (b = 6.72, p = .03); the significant barriers were ‘negative emotions’ (b = −4.74, p = .04) and ‘barriers to prioritisation’ (b = −5.00, p = .01). CIBER analyses suggested six predictive domains with substantial room for improvement: ‘intentions and goals’, ‘barriers to prioritisation’, ‘environmental resources’, ‘beliefs about capabilities’, ‘negative emotions’ and ‘skills’.

Conclusion

Implementation interventions to enhance MECC delivery should target intentions and goals, beliefs about capabilities, negative emotions, environmental resources, skills and barriers to prioritization.     

中西医结合护理改善乳腺癌化疗患者生活质量的临床观察

目的 探讨中西医结合护理对乳腺癌化疗患者的应用效果。方法 选取2017年1月~2018年7月收治的90例乳腺癌化疗患者,随机分为对照组30例和实验组60例。对照组在化疗期间采用常规护理,实验组在此基础上配合中医辨证施护干预,比较两组的生活质量评分和护理总满意度。结果 实验组生活质量评分中,生理状况、情感状况、功能状况、附加关注低于对照组,实验组社会/家庭状况高于对照组,差异具有统计学意义（P＜0.05）。实验组的护理总满意度高于对照组（91.67% vs 73.33%）,差异具有统计学意义（P＜0.05）。结论 中西医结合护理可改善乳腺癌化疗患者的生活质量,提高患者的护理满意度。     

癌症患者生活质量指数量表的修订

目的：引进、翻译、修订ＳｐｉｔｚｅｒＷＯ等编制、发表的生活质量指数量表（ＱｕａｌｉｔｙｏｆＬｉｆｅＩｎｄｅｘ,ＱＬＩ）,并在中国癌症人群中进行小样本调研以评估其实用性。结果：初表表明（１）ＱＬＩ量表中文版（３点量表,ＱＬＩ３）具有良好的信度、效度、灵敏度及适用性,可以应用于中国癌症人群;（２）ＱＬＩ量表中文修订版（５点量表,ＱＬＩ５）具有更好的心理测验学特征,更易被我国癌症人群所接受;（３）量表不仅可用作医护人员评定患者ＱＯＬ的工具（他评量表）,而且可作为患者自评其ＱＯＬ的有效工具（自评量表）;（４）由于本次调研对象（主要为接受化学生物免疫治疗的癌症患者）及调研规模（小样本人群）的局限性,ＱＬＩ量表的实用性有待进一步验证。     

Chronotype Differences in Health Behaviors and Health-Related Quality of Life: A Population-Based Study Among Aged and Older Adults

This study investigates health behaviors, health-related quality of life (HRQOL) and sleep among chronotypes in a community-based sample (n = 2,976). Analysis of covariance indicated evening types (E-types) had a significantly higher percentage of current smokers and more sleep-interfering behaviors compared to intermediate and morning types (M-type), and also lower physical activity and more sleep disturbance compared to M-types. E-types also had worse mental HRQOL compared to both chronotypes, and worse physical HRQOL compared to M-types. Exploratory analyses indicated E-types consumed more caffeinated beverages at night, smoked or ate heavy meals before bedtime, kept irregular sleep-wake schedules, and took more naps. Mediational analyses indicated that sleep-interfering behavior partially mediated the relationship between chronotype and sleep disturbance, and physical activity partially mediated the relationship between chronotype and mental HRQOL. E-types had more unhealthy behaviors, which may subsequently place them at higher risk for health problems.     

Exposure to a Patient-Centered,Web-Based Intervention for Managing Cancer Symptom and Quality of Life Issues: Impact on Symptom Distress

Background

Effective eHealth interventions can benefit a large number of patients with content intended to support self-care and management of both chronic and acute conditions. Even though usage statistics are easily logged in most eHealth interventions, usage or exposure has rarely been reported in trials, let alone studied in relationship to effectiveness.

Objective

The intent of the study was to evaluate use of a fully automated, Web-based program, the Electronic Self Report Assessment-Cancer (ESRA-C), and how delivery and total use of the intervention may have affected cancer symptom distress.

Methods

Patients at two cancer centers used ESRA-C to self-report symptom and quality of life (SxQOL) issues during therapy. Participants were randomized to ESRA-C assessment only (control) or the ESRA-C intervention delivered via the Internet to patients’ homes or to a tablet at the clinic. The intervention enabled participants to self-monitor SxQOL and receive self-care education and customized coaching on how to report concerns to clinicians. Overall and voluntary intervention use were defined as having ≥2 exposures, and one non-prompted exposure to the intervention, respectively. Factors associated with intervention use were explored with Fisher’s exact test. Propensity score matching was used to select a sample of control participants similar to intervention participants who used the intervention. Analysis of covariance (ANCOVA) was used to compare change in Symptom Distress Scale (SDS-15) scores from pre-treatment to end-of-study by groups in the matched sample.

Results

Radiation oncology participants used the intervention, overall and voluntarily, more than medical oncology and transplant participants. Participants who were working and had more than a high school education voluntarily used the intervention more. The SDS-15 score was reduced by an estimated 1.53 points (P=.01) in the intervention group users compared to the matched control group.

Conclusions

The intended effects of a Web-based, patient-centered intervention on cancer symptom distress were modified by intervention use frequency. Clinical and personal demographics influenced voluntary use.

Trial Registration

Clinicaltrials.gov {"type":"clinical-trial","attrs":{"text":"NCT00852852","term_id":"NCT00852852"}}NCT00852852; http://clinicaltrials.gov/ct2/show/{"type":"clinical-trial","attrs":{"text":"NCT00852852","term_id":"NCT00852852"}}NCT00852852 (Archived by WebCite at http://www.webcitation.org/6YwAfwWl7).     

Digital Inequalities of Family Life Information Seeking and Family Well-Being Among Chinese Adults in Hong Kong: A Population Survey

Background

Inequalities in Internet use and health information seeking are well documented, but less is known about information for family life activities.

Objective

We investigated the social determinants of online family life information seeking behaviors and its associations with family well-being among Chinese adults in Hong Kong.

Methods

A probability-based telephone survey was conducted in 2012 to record family life information seeking behaviors, including frequency of seeking and paying attention to family life information, levels of trust, and perceived usefulness of family life information. Family well-being was assessed using 3 single items on perceived family harmony, happiness, and health, with higher scores indicating greater well-being. Adjusted odds ratios for family life information seeking behaviors by socioeconomic characteristics and lifestyle behaviors, and adjusted beta coefficients for family well-being by family life information seeking behaviors were calculated.

Results

Of 1537 respondents, 57.57% (855/1537) had ever and 26.45% (407/1537) sought monthly family life information through the Internet. Lower educational attainment and household income, smoking, and physical inactivity were associated with less frequent seeking and paying attention (all P<.05). Greater perceived family health was associated with more frequent attention (adjusted β=.32, 95% CI.11-.52), greater levels of trust (adjusted β=.28, 95% CI .07-.48), and perceived usefulness (adjusted β=.23, 95% CI .01-.45) of family life information. Frequent attention and higher level of trust were also associated with greater family harmony (adjusted β=.22, 95% CI .002-.41) and happiness (adjusted β=.23, 95% CI .003-.42), respectively.

Conclusions

This is the first study investigating family life information seeking behaviors and suggested inequalities of online family life information seeking behaviors. The association between family life information seeking behavior and family well-being needs to be confirmed in prospective studies.     

Symptom Burden and Quality of Life in Advanced Head and Neck Cancer Patients: AIIMS Study of 100 Patients

Aim:

Head and neck cancers (HNCa) are the most common cancers among males in India and 70-80% present in advanced stage. The study aims to assess symptom burden and quality of life (QOL) in advanced incurable HNCa patients at presentation.

Materials and Methods:

One hundred patients were asked to fill EORTC QLQ-C15-PAL questionnaire, which consisted of Global QOL, physical functioning (PF), emotional functioning (EF), fatigue (FA), nausea-vomiting (NV), pain (PA), dyspnea (DY), sleep (SL), appetite (AP), and constipation (CO). Additional questions pertaining to swallowing (SW), hoarseness (HO), cough (CG), weight loss (WL), using pain killers (PK), taste (TA), bleeding (BL), hearing (HE), pain in neck lump (PALMP), opening mouth (OM), and oral secretions (OS) were asked based on a modified EORTC-HN35 questionnaire. Scoring was according to EORTC scoring manual. Mean, median and range were calculated for each item for the entire cohort.

Results:

The female:male ratio was 17:83.42% of them were ≥60 years of age. Sixty-six patients had T4, 25 had T3, 36 had N2, and 33 had N3 disease. Median QOL was 50 (range 0-83.33) and PF was 77.78 (0-100). Median score for EF and FA was 50. Median score for PA, PK, and SL was 66.67 while that for AP was 33.33. Median value for SW, HO, WL, BL, PALMP, OM, and OS was 33.33 (100-0) while TA, CG, NV, DY, and HE had a median score of 0.00.

Conclusion:

Advanced HNCa has a significant burden of symptoms. These results would help in giving patients better symptom directed therapies and improve their QOL.