Quality of life of Chinese patients newly diagnosed with gastrointestinal cancer: a longitudinal study

Cancer of the gastrointestinal (GIT) tract is a major health problem in China. The aims of the study were to investigate quality of life of Chinese patients newly diagnosed with gastrointestinal (GIT) cancer, identify factors predicting quality of life, and to examine the pattern of stability and change in symptoms, psychosocial measures and quality of life over a 6 months period. A convenience sample of 146 newly diagnosed GIT cancer patients recruited from three major hospitals in Shanghai completed a self-report questionnaire initially and 6 months later. Results indicated that Chinese patients newly diagnosed with GIT cancer experience a range of symptoms associated with cancer and its treatment that resulted in varying degrees of symptom distress, anxiety and depression, and decreased quality of life. Findings from this research give insights into the importance of ongoing quality of life assessment, symptom management, and intervention to improve quality of life of Chinese cancer patients. It also raised questions about measures of quality of life that are culturally relevant.     

Quality of life among women with breast cancer living in Wuhan,China

BackgroundQuality of life is an important indicator in patients with breast cancer. Studies here reported that the quality of life in patients with breast cancer is low and many factors contribute to this poor quality of life.PurposeTo examine the relationships among demographic characteristics, optimism, social support, illness related factors, appraisal of illness, coping strategies and the quality of life of Chinese women with breast cancer residing in Wuhan, China.MethodsA convenience sample of 156 Chinese women with breast cancer was recruited from five teaching hospitals in Wuhan, China. Participants completed the Revised Life Orientation Test, the Perceived Social Support Scale, the Symptom Distress Scale, the Appraisal of Illness Scale, the Medical Coping Modes Questionnaire, and the Functional Assessment of Cancer Therapy-Breast. Path analysis was used to examine factors influencing quality of life.ResultsSignificant relationships were found between optimism, symptom distress, social support, appraisal of illness, a give-in coping mode and quality of life. Optimism, social support, symptom distress, lymph node status, appraisal of illness, and a give-in coping mode accounted for 66.6% of the variance in quality of life.ConclusionsThe findings of this study underscore the importance of helping women reduce symptoms distress, appraise their illness positively, use less negative coping modes, and maintain optimism, maintain good social support, because all of these factors indirectly or directly affect their quality of life.     

Quality of life of cancer patients receiving inpatient and home-based palliative care

AIMS: This paper reports a comparative study of the symptom experience, physical and psychological health, perceived control of the effects of cancer and quality of life of terminally ill cancer patients receiving inpatient and home-based palliative care, and the factors that predict quality of life. BACKGROUND: Quality of life is a major goal in the care of patients with terminal cancer. In addition to symptom management, psychological care and provision of support, being cared for at home is considered an important determinant of patient well-being. A more comprehensive understanding of the impact of cancer on patients and their families will inform the delivery of palliative care services. METHODS: Fifty-eight patients with terminal cancer (32 inpatients, 26 home-based) were recruited from major palliative care centres in Australia in 1999. A structured questionnaire designed to obtain sociodemographic information, medical details and standard measures of symptoms, physical and psychological health, personal control and quality of life was administered by personal interview. RESULTS: The two groups were similar on most demographic measures, although more home-care patients were married, of Australian descent and had private health insurance cover. The most prevalent symptoms reported were weakness, fatigue, sleeping during the day and pain. Patients receiving home-based services had statistically significantly less symptom severity and distress, lower depression scores, and better physical health and quality of life than those receiving inpatient care. Home-care patients also reported statistically significantly more control over the effects of their illness, medical care and treatment received, and the course of the disease. Multiple regression analyses showed that better global physical health, greater control over the effects of cancer and lower depression scores were statistically significant predictors of higher quality of life. CONCLUSIONS: The main issues arising from the findings for nurses are the early detection and management of both physical and psychological symptoms, particularly fatigue, pain, anxiety and depression, and the need to use strategies that will empower patients to have a greater sense of control over their illness and treatment. Research is needed to identify other factors that may impact on quality of life, and to establish the extent to which inpatient and home-based care meets the needs of both the patient with terminal cancer and their family.     

社会心理因素与乳腺癌患者生活质量相关性的研究

目的探讨社会心理因素与乳腺癌患者生活质量的相关性。方法对30例乳腺癌患者采用中国癌症患者生活质量表（The Quality of life questionnaire for chinese cancer patients receiving chemotherapy,QLQ-CCC）,Zung焦虑自评量表（Self-rating anxiety scale,SAS）、Beck抑郁问卷（Beck depression inventory,BDI）、社会支持评定量表进行调查,了解患者社会心理因素与生活质量的相关性。结果患者的年龄、婚姻状况及社会支持与生活质量呈正相关;而文化程度、焦虑、抑郁状态与生活质量呈负相关。结论乳腺癌患者生活质量受多种因素影响,应采取针对性措施,减轻患者焦虑、抑郁不良情绪,提供各种社会支持,从而提高患者的生活质量。     

癌症化疗病人睡眠质量与症状困扰、心理状态的相关性研究

[目的]探讨癌症化疗病人住院期间睡眠现状及与化疗期间症状困扰和心理状态的相关性,为癌症化疗病人的临床护理提供参考和指导。[方法]应用一般人口学资料问卷、匹兹堡睡眠质量指数量表、安德森症状评估表（MDASI C）及综合医院焦虑抑郁量表（HADS）对北京市某2所三级甲等医院胸外科、肿瘤科、妇科的95例癌症化疗病人进行调查,并对睡眠质量与症状困扰、心理状态的相关性进行分析。[结果]癌症化疗病人住院期间睡眠质量好者3例（3.2%）,一般16例（16.8%）,差者76例（80.0%）;癌症化疗病人住院期间睡眠质量指数与化疗症状困扰、心理状态呈正相关（P=0.000）。[结论]大多数癌症化疗病人住院期间睡眠质量差,睡眠质量与化疗症状困扰和焦虑抑郁程度呈正相关。临床工作中应考虑症状和心理状态对病人睡眠的影响,有针对性地对病人的睡眠进行健康教育。     

Symptom prevalence, characteristics, and distress in AIDS outpatients.

Symptom distress is an important but poorly characterized aspect of quality of life in AIDS patients. To assess and characterize the symptoms and symptom distress associated with AIDS, 504 ambulatory patients with AIDS were evaluated between December, 1992 and December, 1995. The assessment included measures of symptom distress, physical and psychosocial functioning, and demographic and disease-related factors. Patients described symptoms during the previous week using the Memorial Symptom Assessment Scale Short Form (MSAS-SF), a validated measure of physical and psychological symptom distress. The mean age was 38.6 years (range 18-69); 56% were male. African-Americans comprised 40% of the sample, Caucasians 35%, and Hispanics 23%. Ninety-three percent had CD4+ T-cell counts below 500, and 66% had counts below 200; 69% were classified in CDC category C (history of AIDS-defining conditions). Fifty-two percent reported intravenous drug use. Karnofsky performance status was > or = 70 in 80% of the patients. No patients were taking protease inhibitors. The mean (+/- SD) number of symptoms was 16.7 +/- 7.3. The most prevalent symptoms were worrying (86%), fatigue (85%), sadness (82%), and pain (76%). Patients with Karnofsky performance scores < 70 had more symptoms and higher symptom distress scores than patients with scores > or = 70 (21.2 +/- 6.5 vs. 15.6 +/- 7.1 symptoms/patient; 2.3 +/- 0.8 vs. 1.6 +/- 0.8 on the Global Distress Index [GDI] of the MSAS-SF; P < 0.0001 for both). Patients who reported intravenous drug use as an HIV transmission factor reported more symptoms and higher overall and physical symptom distress than those who reported homosexual or heterosexual contact as their transmission factor (17.8 +/- 7.5 vs. 15.4 +/- 6.9 symptoms/patient, P = 0.0002; 1.9 +/- 0.9 vs. 1.6 +/- 0.8 on the MSAS-GDI, P = 0.002). Both the number of symptoms and symptom distress were highly associated with psychological distress and poorer quality of life; for example, r = -0.69 (P < 0.0001) between GDI scores and scores on a validated measure of quality of life. Neither gender nor CD4+ T-cell count was associated with symptom number or distress. Responses from this self-referred sample of AIDS outpatients indicate that AIDS patients experience many distressing physical and psychological symptoms and a high level of distress. Both the number of symptoms and the distress associated with them are associated with a variety of disease-related factors and disturbances in other aspects of quality of life. Symptom assessment provides information that may be valuable in evaluating AIDS treatment regimens and defining strategies to improve quality of life.     

Quality of life and related factors for people living with HIV/AIDS in Northern Taiwan

The purpose of this study was to identify the variables related to quality of life in the population of individuals living with HIV/AIDS (PLWHA) in Taiwan. Purposive sampling was used to identify subjects from the outpatient departments (OPD) of three teaching hospitals and one sexually transmitted disease (STD) clinic in the Taipei area. For this study, the questionnaire included a demographic data sheet, physical-symptom distress and mood-disturbance scales, a personal-resource questionnaire (PRQ85-II) and a quality-of-life index (QLI). A total of 114 subjects completed the questionnaire. The results revealed that higher quality of life was associated with less mood disturbance (r = -.72; p <.001), reduced physical-symptom distress (r = -.47; r <.001), and higher levels of social support (r =.57; p <.001). PLWHA life quality was reflected accurately by mood disturbance, social support, physical-symptom distress, self-perceived mode of HIV transmission, and major source of financial support. These variables accounted for 60.9 % of QOL variance. As mood disturbance was the strongest predictor of quality of life, psychosocial intervention for mood disturbance should be emphasized and developed in future studies.     

Symptom clusters and quality of life in Chinese patients with heart failure

BackgroundEffective symptom assessment and management can improve quality of life in patients with heart failure. However, how psychological symptom cluster, physical symptom cluster and heart failure symptom cluster influence the quality of life of patients with heart failure remains unknown.Aims(a) To describe the symptom clusters among Chinese patients with heart failure (HF), (b) explore the relationship between symptom clusters and quality of life (QOL), and (c) detect if physical and psychological symptoms are mediators of the association between heart failure symptom and QOL.MethodsThree hundred and one patients with heart failure completed measures of symptom (MSAS), QOL and demographic and clinical characteristics. Multiple regression analysis was used to analyse the data.FindingsThe mean age of participants was 72.19 years (range 31–96 years). Each patient was approximately accompanied by an average of 11.19 symptoms (range 0–31), and the top six most common symptoms of Chinese HF patients were shortness of breath, difficulty sleeping, difficulty breathing when lying flat, lack of energy, lack of appetite and cough. Both physical symptom cluster and psychological symptom cluster were the mediators of the relationship between heart failure symptom cluster and QOL.ConclusionsThere were mediating effects of physical symptom cluster and psychological symptom cluster between heart failure symptom cluster and QOL in Chinese patients with HF. Operative assessment, management and alleviation of physical symptoms and psychological symptoms should be prioritised in symptom management strategies for the clinical caregivers.     

Health-related quality of life in elderly Chinese patients with heart failure

Heart failure (HF) has a profound impact on patients' health-related quality of life (HRQL). Little is known about factors relating to HRQL in elderly Chinese HF patients. The objective of this cross-sectional correlational study was to identify the demographic, psychosocial, and clinical factors associated with HRQL in this group of patients. Cross-sectional data were obtained from a consecutive sample of hospitalized HF patients (n = 227) with measures of HRQL, psychological distress, perceived social support, and health perception. Functional status was measured with the New York Heart Association Classification (NYHA). In stepwise regression analysis, four variables, including psychological distress, health perception, NYHA classification, and educational level explained 51.8% (p =.01) of the variance in HRQL. These findings suggest that improving HRQL of HF patients entails improving their psychological status, functional status, and health perception.     

Symptoms and symptom distress in localized prostate cancer

For over a decade, symptom distress has been a key concept in several studies of cancer. However, the definition of symptom distress is still unclear, and there are few measures targeting symptom distress, in general, and specific cancers, in particular. Prostate cancer is the sixth most common cancer worldwide and the second leading cause of death in American men. Many men with clinically localized prostate cancer may experience unique and multidimensional symptoms that occur from diagnosis through treatment, and thereafter. These symptoms associated with the disease and its treatments are in the form of physical and psychological sequelae such as urinary and bowel problems and sexual dysfunction. The purposes of this article are to (1) systematically review literature on symptoms and symptom distress in localized prostate cancer and (2) synthesize evidence of symptom distress applications and measurement in this group. A comprehensive, systematic review was conducted to identify original, data-based studies of symptoms and symptom distress in localized prostate cancer. Clarification of symptom distress and more comprehensive information about symptoms and symptom distress will provide nurses with a better foundation for developing self-management interventions aimed at ameliorating symptom distress and, ultimately, enhancing the quality of life of patients with localized prostate cancer.     

Community Nurse Executives''Psychologic Weil-Being: Relationships Among Stressors, Social Support, Coping, and Optimism

The purposes of this study were to (1) determine the occupational stressors, coping strategies, and sources and types of social support of nurse executives; (2) compare the sample's level of psychologic symptomatology with norms; and (3) examine the effects of stress, social support, and optimism in predicting psychologic well-being. Public health nursing directors located throughout California participated in the study. Mailed questionnaire booklets were used to collect data from the target population. A subset of the sample participated in face-to-face, taped, structured interviews that elicited additional data on nurse executives' work stress, coping strategies, and social support dimensions. Several significant findings emerged. The mean psychologic symptom score for the subjects was greater than the published norm, suggesting psychologic distress. In regression analysis, total number of years in nursing accounted for 14.8% of the variance in psychologic symptoms, the dependent variable. Level of optimism accounted for an additional 29.8% of the variance. Total hassles and co-worker social support together accounted for 6.57% of the variance in the last step, but were not statistically significant. Interview data identified the major occupational stressors, coping strategies, and sources and types of social support for this group of nursing directors.     

卵巢癌患者可修饰性心理困扰影响因素及其与生存质量的相关性分析

目的分析卵巢癌患者可修饰性心理困扰影响因素及其与生存质量相关性。方法采用便利抽样法,选取2017年9月~2019年3月我院收治的卵巢癌患者262例,分析患者可修饰性心理困扰率、困扰程度、生存质量及心理困扰与生存质量的相关性。采用多因素Logistic回归分析可修饰性心理困扰影响因素。结果262例卵巢癌患者中,可修饰性心理困扰低状态126例(48.09%)、中等状态108例(41.22%)、高等状态28例(10.69%),生存质量良好118例(45.04%)、不佳144例(54.96%)。单因素分析结果显示,文化程度、独居、家庭月收入、肿瘤分期、社会支持度、疾病认知度、自我效能感、应对方式、生存质量比较,差异有统计学意义(P<0.05)。多因素Logistic分析结果显示,社会支持度、疾病认知度、自我效能感、应对方式、生存质量是卵巢癌患者可修饰性心理困扰处于中高状态的风险因素(P<0.05)。且可修饰性心理困扰状态与生存质量互为负相关关系(P<0.05)。结论卵巢癌患者可修饰性心理困扰影响因素多样,而弱化或消除影响因素利于减轻心理困扰,有助于改善生存质量,生存质量的改善又可缓解可修饰性心理困扰,促进良性循环形成。     

Stress, social support, and psychological distress of family caregivers of the elderly

The effects of stress and social support and their interaction with the psychological well-being of 87 family caregivers of impaired elderly were examined. Perceived stress and satisfaction with support accounted for 32% to 36% of the variance in psychological distress or depression, p less than .001; however, when characteristics of the caregiver situation were included in the models, the effects of perceived stress were found to be spurious. The revised models accounted for 44% to 48% of the variance in psychological distress or depression, p less than .000, and included years of caregiving and mental impairment of the elder instead of perceived stress. Although there were no buffering effects for social support, main effects accounted for 19% to 22% of the variance in psychological distress or depression. The findings indicate that caregivers who are caring for a mentally impaired elder, who have been providing care for an extended time, and who have low social support are at high risk for psychological distress or depression.     

Psychosocial factors associated with pain intensity, pain-related interference, and psychological functioning in persons with multiple sclerosis and pain

Biopsychosocial models of chronic pain that recognize psychological and environmental factors as important aspects of adjustment to pain have been proposed for understanding chronic pain and related suffering in persons with multiple sclerosis (MS), but such models have not been empirically tested. The objective of this study was to test such a model by evaluating the associations of several psychosocial variables (i.e., pain-related catastrophizing, perceived social support, pain beliefs, and pain coping) with pain intensity, pain interference with functioning, and psychological functioning in persons with chronic pain and MS, after controlling for demographic and disease-related factors. Participants were 125 community-dwelling persons with MS and pain who completed a mailed questionnaire that included measures of pain intensity and interference, psychological functioning, catastrophizing, social support, and pain beliefs and coping. The psychosocial variables accounted for an additional 25% of the variance in average pain intensity after controlling for demographic and disease-related variables (p<.001). These variables explained an additional 22% of the variance in pain-related interference (p<.001) and 43% of the variance in psychological functioning (p<.001), after adjusting for demographic and MS-related variables and average pain intensity. Catastrophizing was consistently and independently associated with all criterion measures, whereas social support, pain beliefs, and pain coping were associated with some criterion measures but not others. The results provide empirical support for a biopsychosocial understanding of chronic pain in MS and suggest that specific psychosocial factors (e.g., catastrophizing) may be important regarding adjustment to pain in persons with MS.     

Symptom distress, spirituality, and quality of life in African American breast cancer survivors

This study examined the relationships among the demographic characteristics, symptom distress, spirituality, and quality of life (QOL) of African American breast cancer survivors. A convenience sample of 30 survivors with a mean age of 56 years and a mean survival of 6 years was recruited from African American breast cancer support groups and churches in the Southeastern United States. Data were collected through face-to-face interviews using a demographic questionnaire, the Quality of Life Index-Cancer Version, the Symptom Distress Scale, and the Spiritual Perspective Scale. Statistically significant relationships were found between symptoms and QOL (r = -0.62, P < .05) and between spirituality and QOL (r = 0.70, P < .05). No statistically significant relationships were found between age at diagnosis, income, or education and QOL. This research suggests that symptoms and spirituality are associated with QOL. Culturally appropriate care should be provided to these women to reduce health disparities and to improve their QOL.     

196例乳腺癌化疗患者尊严现状及影响因素分析

目的了解乳腺癌化疗患者的尊严现状,分析其影响因素。方法采用方便抽样法,2019年4—6月抽取北京市7所三级甲等医院的乳腺癌化疗患者作为研究对象。采用一般资料调查问卷、患者尊严量表、心理痛苦温度计及领悟社会支持量表,对其进行调查。采用多元线性回归分析乳腺癌化疗患者尊严的影响因素。结果本组乳腺癌化疗患者尊严得分为(38.21±12.98)分;多元线性回归分析结果显示,治疗方案、心理痛苦、社会支持进入回归方程(P<0.01),共解释乳腺癌化疗患者尊严总变异的41.6%。结论本组乳腺癌化疗患者的尊严处于轻度受损水平,建议医护人员重点关注有乳腺切除术史、心理痛苦评分较高及社会支持得分较低的乳腺癌化疗患者,根据其情况进行个性化指导,鼓励乳腺癌化疗患者之间多交流,鼓励亲友多向患者表达关心和爱,从而提高患者的尊严水平。     

Psychosocial adjustment to breast cancer in unmarried women

Breast cancer is a significant health problem that can affect many aspects of a woman's life. Although there is growing evidence that women with supportive husbands seem to adjust reasonably well, little is known about the impact of breast cancer among unmarried women. Relationships among primary treatment alternatives, symptom distress, perceived social support, and psychosocial adjustment to breast cancer in 101 unmarried women were investigated using data collected during the late postoperative recovery phase. The women experienced relatively low levels of psychosocial adjustment problems and perceived moderately high levels of social support. Social support and symptom distress each accounted for significant proportions of the variance in psychosocial adjustment, whereas primary treatment alternatives did not. Symptom distress emerged as the variable accounting for the most variance in psychosocial adjustment to breast cancer. Implications for health care providers to facilitate positive adjustment to breast cancer in unmarried women and directions for future studies are suggested. © 1998 John Wiley & Sons, Inc. Res Nurs Health 21: 155–166, 1998     

Factors correlated with fatigue in disease-free breast cancer patients: application of the Cancer Fatigue Scale

 Fatigue is one of the most frequent symptoms in cancer patients. However, the precise causes of this fatigue are still unknown, and this situation makes it difficult to combat the problem. The present study was conducted to investigate factors correlated with fatigue in disease-free breast cancer patients. A group of 134 randomly selected ambulatory breast cancer patients who had undergone successful surgical treatment participated. They completed the Cancer Fatigue Scale, the Hospital Anxiety and Depression Scale, the Mental Adjustment to Cancer Scale, and an ad hoc questionnaire detailing physical symptoms, social support, and demographic variables at home and returned them by mail the following day. Multiple regression analysis revealed that fatigue was significantly correlated with dyspnea, insufficient sleep, and depression, and that these three variables accounted for a total of 46% of variance in fatigue. Factors concerned with the cancer and treatment, such as disease stage, lymph node metastasis, number of days since operation, past intravenous chemotherapy, radiotherapy, current use of fluoropyrimidine compounds, and current use of tamoxifen citrate were not correlated with fatigue. The results suggest that fatigue in this population is determined by current physical and psychological distress rather than by the cancer itself and prior cancer treatments, and that the management of dyspnea, insomnia, and depression might be important in reducing fatigue in this population. Published online: 17 January 2000     

Catastrophizing is associated with pain intensity,psychological distress,and pain-related disability among individuals with chronic pain after spinal cord injury

Little research has examined the role of patient cognitive and behavioral responses, including catastrophizing, in adjustment to chronic pain associated with spinal cord injury (SCI). The objective of this study was to examine the associations of catastrophizing and specific pain coping strategies with pain intensity, psychological distress, and pain-related disability among individuals with chronic pain and SCI, after controlling for important demographic and SCI-related variables that might affect outcomes. Participants in this study were 174 community residents with SCI and chronic pain who completed a mailed questionnaire that included the SF-36 Mental Health scale, Coping Strategies Questionnaire, and Graded Chronic Pain Scale. The pain coping and catastrophizing measures explained an additional 29% of the variance in pain intensity after adjusting for the demographic and SCI variables (P<0.001). The coping and catastrophizing scales accounted for an additional 30% of the variance in psychological distress (P<0.001) and 11% of the variance in pain-related disability (P<0.001), after controlling for pain intensity and demographic and SCI variables. Catastrophizing, but not any other single pain coping strategy, was consistently strongly and independently associated with the outcome measures. Potentially, the assessment and treatment of catastrophizing may reduce psychological distress and pain-related disability among individuals with chronic pain and SCI.