Sexual Quality of Life in Gynecological Cancer Survivors in Iran

Objective: Patients with gynecological cancer might suffer from suboptimal sexual quality of life. This cross sectional study aimed to assess the sexual quality of life in the survivors of gynecological cancers and was recruited in a teaching hospital affiliated to Tehran University of Medical Sciences between 2018 and 2020. Material and methods: The data was collected by a web-based platform with validated self-administered questionnaires including demographic information, and the Sexual Quality of Life-Female (SQOL-F) questionnaire. The data were analyzed using appropriate tests. Results: Totally, 42% (106) of the participants had a sexual relationship in the last 6 months. The mean (SD) of sexual quality of life score was 46.84 (11.86) with the range of 0-90. The patients with cervical cancer had a worse sexual quality of life in Psychosexual Feelings (P=0.048) and Self-Worthlessness (p=0.036) compared with other gynecological cancers. Sexual quality of life did not improve or worsen over time. Conclusion: It is concluded poor sexual quality of life need further attention in the traditional societies and healthcare providers are urged to improve their sexual quality of life.     

Quality of Life in Patients with Gynecological Cancers: A Web-Based Study

Introduction: Gynecological cancers are common in adult women. One of the most important goals in the management of these patients is to improve quality of life, along with survival as a traditional outcome. The aim of this study was to evaluate quality of life in gynecological cancers in Iran. Methods: This cross-sectional study was performed on a sample of patients with gynecological cancers including uterine, ovarian, cervical, and vulvovaginal attending a teaching hospital affiliated to Tehran University of Medical Sciences between 2014 and 2019. The data was collected by a web-based platform with validated self-administered questionnaires including demographic information, the EORTC QLQ-C30 and the Hospital Anxiety and Depression (HADS). The data were analyzed using appropriate tests. Results: In all 251 patients were studied. The mean age of patients was 52.8±12.4 years and 43% had uterine, 30% had ovarian, 25% had cervical, and 2% had vulvovaginal cancer. The mean global quality of life score as measured by the EORTC QLQ-C30 was 59.8 ± 24.9. Women with ovarian cancer had the highest and women with cervical cancer had the lowest global quality of life score. There were significant differences in emotional, cognitive and global quality of life by cancer diagnosis (p <0.05). Although not significant, overall physical, role, cognitive and social functioning was found to be better in women who had been treated with surgery. The mean anxiety and depression score were 8.7± 5.0 and 7.1 ± 5.2, respectively. Conclusion: The results demonstrated that patients with gynecological cancers had a low quality of life, and experience higher anxiety and depression.     

全程护理干预对肺癌化疗患者生活质量的影响

目的：探讨全程护理干预对肺癌化疗患者生活质量的影响。方法：将76例接受含铂双药联合化疗方案的肺癌患者随机分为对照组（n=38）和观察组（n=38）。对照组采用化疗常规护理,观察组采用常规护理及全程护理干预。两组患者在治疗前和治疗后采用欧洲癌症化疗患者生活质量量表进行问卷调查。评估全程护理干预对肺癌化疗患者生活质量的影响。结果：两组患者化疗后功能子量表和总体生活质量评分较化疗前均降低。但观察组较对照组降幅小,两组评分变化比较具有统计学意义（P〈0.05）。两组患者化疗后症状子量表及反映症状和经济状况的特异性项目评分较化疗前均有升高,除呼吸困难、便秘症状和经济状况外,其他项目评分观察组升高值小于对照组,两组评分变化比较差异有统计学意义（P〈0.05）。结论：对肺癌化疗患者实施全程护理干预,能有效改善化疗后生活质量,减轻化疗相关症状,值得临床推广。     

Effectiveness of a Self-Monitoring Quality of Life Intervention For Patients with Cancer Receiving Palliative Care: A Randomized Controlled Clinical Trial

Background: Use of patient-reported outcome measures in routine clinical practice has important benefits forpatients with cancer. To examine the effect of a self-monitoring quality of life (QOL) intervention on global QOL andphysical and emotional function in patients with cancer receiving palliative care. Methods: Prospective randomizedstudy had been undertaken at Toshima Hospital, Japan. This study compared an intervention group that completed theshortened Care Notebook booklet versus a control group that received usual care. The primary outcome was global QOLand secondary outcomes were physical and emotional function. Participants completed the European Organization forResearch and Treatment of Cancer Quality of Life Questionnaire Core 15 Palliative at baseline, and at 1 and 3 weeks.The effects of the intervention were evaluated with a linear mixed-effects model. Results: Forty-three patients wererandomized. One patient in each group could not receive the allocated intervention, leaving 41 patients for inclusionin the modified intention-to-treat (ITT) analysis for the primary outcome. Twenty-seven patients were analyzed for thesecondary outcomes using per protocol set (PPS). The ITT analysis showed no significant overall effect on global QOL(P=0.285), but the PPS analysis showed a significant overall effect on global QOL (P=0.034) and physical function(P=0.047) for group difference over time in the linear mixed-effects model. Conclusions: Use of the Care Notebookmight have beneficial effects. The results could be interpreted as the effectiveness of the intervention of the CareNotebook for with cancer receiving palliative care.     

Effects of a Self-Monitoring Quality of Life Intervention for Patients with Cancer Receiving Palliative Care in Japan: Study Protocol for a Randomized Controlled Trial

Background: Previous studies suggest the use of patient-reported outcome measures in routine clinical practice hasimportant benefits for patients with cancer, particularly as feedback regarding patients’ quality of life (QOL) improvesdoctor-patient communication and clinical decision making. This study aimed to examine the effect of using the CareNotebook as a routine self-monitoring QOL intervention in clinical practice for patients with cancer receiving palliativecare. The results are expected to clarify the practical use of the Care Notebook in this population. Methods: Thisprospective randomized study is being undertaken at Toshima Hospital, Japan. Participating patients who are randomlyassigned to the intervention group will be asked to complete the shortened Care Notebook booklet for patients withcancer in palliative care once each day. A control group will receive usual care. The primary outcome is global healthstatus/QOL (Global QOL), as assessed by the European Organization for Research and Treatment of Cancer Quality ofLife Questionnaire Core 15 Palliative. Data will be collected at baseline (after allocation), and at 1 week and 3 weeksin both the control and intervention groups. The effects of the intervention will be evaluated with a mixed randomeffects model. The required sample size is 200 patients. We obtained approval from Toshima Hospital (No 26-11) andthe Tokyo Medical and Dental University Ethics Committee (No 1756). The findings will be disseminated throughpublications in peer-reviewed journals and attendance at domestic and international conferences. The trial was registeredwith the UMIN clinical trials registry (Trial registration number: UMIN000025322). Conclusions: This study willprovide evidence on whether medical staff can use the Care Notebook as a routine self-monitoring QOL intervention inclinical practice for patients with cancer receiving palliative care. We expect that a routine Care Notebook interventionfor patients with cancer will be recommended in healthcare facilities.     

Effect of Group Therapy on Psychological Symptoms and Quality of Life in Turkish Patients with Breast Cancer

Purpose: The aim of this study was to evaluate the effects of the group therapy on psychological symptomsand quality of life of patients with early stage breast cancer. Methods: This study was performed on 16 breastcancer patients who completed treatments. The total group therapy program involved a weekly session of 2-3hours, for 16 weeks. The group therapy sessions were given to women in the oncology department by a clinicalpsychologist and also given training sections by the different professional teams. All the required assessments forthe study were performed after and before 16 week group therapy intervention. Results: Initially we had taken21 women but 16 participated in all therapy programs and submitted questionnaires. The mean age was 47.8years. There were significant differences between before and after group therapy program. Anxiety, depression,and distress showed significant improvements. Hopelessness scale was detected at the border of significance.There was no change in sleep problems and quality of life. According to the analysis of correlation, consideringthe age factor and year of diagnosis, there was found no statistically significant relationship between anxiety,distress, depression, hopelessness, sleeplessness, and quality of life. Conclusions: This pilot study demonstratedthat brief, predominantly group therapy is feasible for patients with breast cancer and, also it may be helpfulto cope with emotional and physical distress     

Assessment of Quality of Life in Patients with Colorectal Cancer in Kazakhstan

Background: The problem of quality of life (QOL) of patients with colorectal cancer (CRC) is particularly relevant due to the dynamics of CRC incidence growth. This study aims to assess QOL of patients with CRC in the Republic of Kazakhstan in order to give an idea about the impact of burden on QOL of patients. Methods: A total of 319 patients diagnosed with CRC participated in this one-stage cross-sectional study. The survey was conducted between November 2021 and June 2022 at cancer centers in Kazakhstan.  Data were collected using the valid and reliable European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30, version 3.0). Results: The average age of respondents was 59, 23 (SD=10,604) years. The main age group 50-69 years old accounted for 62.1% of the total sample. Among all ill respondents, 153 (48%) were male and 166 (52%) were female. The mean global health status was 59.24 ± 22.62. Two of the five functional scales were below the ≥66.7% threshold, namely, emotional functioning 61.65 (28.04) and social functioning 61.96 (31.84); while scores for the other three were: physical functioning 69.38 (22.06), role functioning 69.69 (26.45), and cognitive functioning 74.60 (25.07). Conclusions: This study gives an indication of good life functioning among our participants on the functional and symptom scales. However, they reported inadequate global health status.     

The Effect of Exercise on Life Quality and Depression Levels of Breast Cancer Patients

Introduction: The aim of this study is to determine the effects of aerobic and stretching exercises on quality of life and depression levels of breast cancer patients. Methods: A total of 48 women (mean age 45.0±2.2 years) who were previously diagnosed with breast cancer and completed their treatment with no metastasis, were included in the study. Of these, 24 women who received the exercise program were assigned as the study group, while the remaining 24 women who did not receive the exercise program were assigned as the control group. The study group received a 12-week aerobic exercise program at the fitness club and home-based resistance exercise program designed by a sport scientist at the doctoral level. The control group was encouraged to maintain their normal level of physical activity and exercise habits throughout the study. The WHOQOL-BREF, EORTC-QLQ-C30 quality of life assessments and Beck depression inventory (BDI) were used to evaluate quality of life and the severity of depression before and after 12-week exercise programs. Results: EORTC QLQ-C30 scoring showed that in the study group aerobic exercise positively impacted quality of life on the functional scales (physical p=0.001, role p=0.039, emotional p=0.031, social functioning p=0.010) and symptoms (fatigue p=0.001, pain p=0.001, sleep disturbance p=0.038 and financial impact p=0.015). WHOQOL-BREF assessment areas, (general p=0.001, physical p=0.02, mental p=0.001 and social health p=0.017) relationships also improved as a result of exercise. BDI showed that severity of depression in the study group decreased significantly (p=0.001). Conclusion: This study showed that aerobic and resistance exercises improved quality of life and decreased depression levels of women who previously received breast cancer treatments.     

Comparison of the JCAHO Scoring System and the ESAS Scoring System in Determining the Palliative Care Needs of Gynecological Cancer Patients Treated at Hasan Sadikin Hospital

Objective: The purpose of this study was to analyze the relationship between quality of life with the JCAHO and the ESAS scoring system, and to compare the JCAHO and the ESAS scoring system in determining the palliative care needs of gynecological cancer patients treated at RSHS. Method: The subjects of this study were all gynecological cancer patients who were treated at RSHS in May-August 2020. This study was an analytic study with a cross sectional design. The data of this study were obtained from interviews, questionnaires and patient medical records, the study was analyzed bivariate using chi square with α = 0.05. Results: The results showed that the quality of life of patients with gynecological cancer was associated with the JCAHO palliative score (p <0.05), the better the patient’s quality of life, the better the JCAHO palliative score. The quality of life of gynecological cancer patients was related to ESAS (p <0.05), the better the patient’s quality of life, the better the ESAS. There was difference between the JCAHO palliative score and the ESAS in determining the palliative care needs of gynecological cancer patients (p< 0.05). Conclusion: Quality of life has correlation with palliative scores, the lower the palliative score, the better the quality of life. This study showed significant difference between the JCAHO palliative score and the ESAS in determining the palliative care needs of gynecological cancer patients. The JCAHO palliative score measures objectively how the patient is on admission for treatment, this score not only measures the intensity of symptoms but measures the underlying disease, comorbid disease, functional status of the patient and other criteria for the patient.  ESAS assesses the intensity of symptoms, the assessment of palliative care needed can change rapidly if the intensity of symptoms in patients changes.     

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 withgynecologic cancer using a cross-sectional survey design. A total of 108 patients admitted to the gynecologiconcology clinic at a university hospital from September 2011 to January 2012 were included. Data werecollected 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 wasdetermined that 65.7% of patients had ovarian cancer and 19.4% had cervical cancer. The total QOL-CS meanscore was 5.59±1.10. Average score of total MSPSS was found to be 69.7±14.64. Comparing socio-demographicand clinical characteristics of patients and average scores of QOL-CS and MSPSS, it was found that there wasnot a statisticaly significant corelation (p>0.05). Statistically significant relation was found between the averagescores of QOL-CS and MSPSS. These results showed that quality of life was moderate and perceived socialsupport was high in Turkish patients with gynecologic cancer.     

Factors Affecting Quality of Life of Cancer Patients in North India

Introduction: Cancer is the second leading reason of death in many countries, and its burden and prognosis are highly dependent on disease stage at diagnosis. Lack of perception of the population about cancer and its related risk factors usually sequel in defer/delayed presentation and increased treatment morbidity and decrease survival chances. Quality of life (QOL) is defined as Individual view of life, merits, intentions, standards and interests in the framework of culture. Aims and objectives: To study the socio-demographic profile and factors affecting quality of life of cancer patients. Material and Method: Using a cross-sectional study, between 1 January 2021 to 31 December 2021, 192 cancer confirmed patients at cancer registry centre at District civil hospital, Ambala cantt. were interviewed using a pre tested semi-structured questionnaire along with EORTC QLQ-C30 (version 3) questionnaire scale for QOL. The data was entered into an excel sheet and was analysed using IBM SPSS version 28. Results: Out of 192 patients, 95 were male and 97 were female. Results shows that female (60.05±19.167) had better mean score of QL2 than male (58.68±18.906) with P value=0.619. Overweight (BMI25.0-29.9) had better mean QL2 score (65.50±18.147) than obese (BMI>30.0) mean QL2 score (61.67±14.803), normal weight (BMI 18.0-24.9) mean QL2 score (59.57±18.575) and underweight (BMI<18.0) mean QL2 score (49.46±19.595) with P value of 0.004. Conclusion: Present study found that QOL had significant association with BMI, type of cancer, history of smoking, lost income after cancer diagnosis and stage of cancer at the time of diagnosis. While gender, occupation, age group, religion, residence, marital status, type of family, income, tobacco alcohol and physical activity showed no significance association with QOL.     

Factors Predictive of Quality of Life among Breast Cancer Patients

Background: Due to progress in medical care, the number of survivors from cancer has increased significantlyduring recent years and this raises the question of the quality of life (QoL), especially of the many women treatedfor a breast cancer. This paper focuses on correlations of QoL with anxiety and depression on the one hand and withsocio demographic, anatomo-clinical and therapeutic parameters on the other. Methods: In this cross-sectional study,seventy patients were enrolled and filled in two auto-questionnaires, both in validated Arabic versions: The SF-36 forassessment of QoL and the Hospital Anxiety and Depression Scale (HAD-S) for evaluation of anxiety and depression.The statistical approaches used to determine predictive factors were bivariate correlations to determine relationshipsbetween quantitative variables, and T-tests and one-way Anova to analyze links between qualitative and quantitativevariables. Results: The QoL of patients was altered with an SF-36 mean total score of 54.0 ± 22.7, and the alterationaffects the different aspects. The mean scores for anxiety and depression in patients were 6.91 ± 4.72 and 6.24 ± 3.88,respectively. The results of this study suggested an association between the QoL and chemotherapy (p= 0.014) and itsadverse effects (p=0.01), as well as anxiety (p= 0.0001) and depressive symptoms (p= 0.0001). Socio-demographicfactors, the stage of the cancer, and surgery, radiotherapy or hormone therapy did not appear to have significanteffects. Conclusion: The management of breast cancer patients needs a collaborative approach between oncologists,gynecologists, psychologist and psychiatrists.     

Effect of a Pedometer-based Exercise Program on Cancer Related Fatigue and Quality of Life amongst Patients with Breast Cancer Receiving Chemotherapy

Background: Breast cancer is the most common cancer amongst Indian women. Cancer treatments leads to various side effects out of which Cancer-Related fatigue (CRF) is one of the most under-addressed side-effects. It is experienced the most in patients receiving chemotherapy. Exercise has been proven to be a beneficial intervention to manage CRF but the benefits of pedometer-based exercise programs is under-studied in patients with breast cancer. Hence, we set out to investigate the effects of a pedometer-based exercise program for patients with breast receiving chemotherapy. Methods: The current study was a non-randomized controlled trial with 22 patients each in exercise and control group. The exercise group received a pedometer-based walking program, whereas the control group received standard physical activity advice. Fatigue, quality of life, functional capacity and body composition were assessed at baseline, 3rd week and 7th week. Results: At the end of 7 weeks intervention, functional capacity, quality of life and skeletal mass were found to have improved with statistical significance, while the fatigue and changes in total fat did improve but were not statistically significant. Conclusion: A 7-week pedometer-based exercise program improved functional capacity, quality of life and percentage of skeletal mass and also shows to have prevented deterioration in fatigue levels in patients with breast cancer receiving chemotherapy.     

Home-based Palliative Intervention to Improve Quality of Life in Children with Cancer: A Randomized Controlled Trial

Objective: Over the past few years, an integrated approach of palliative care (PC) to chronic and/or life-threatening conditions care has been widely used. Home-based PC (HBPC) service is developed to meet the needs of patients at home; however, it has not been used widely. This study is aimed at determining the benefits of integrated HBPC for the quality of life (QoL) and symptoms intensity in Indonesian children with malignancies. Method: A randomized controlled trial was carried out to compare the quality of life between patients who were given PC (a three-month home visit) and those who did not receive PC (control group). Each group was constituted of thirty children with cancer and aged 2-18 years old and were consulted by a palliative team. The participants were randomly allocated to two groups. In the first and twelfth weeks of the intervention, all patients were assessed using the Pediatric Quality of Life Inventory (PedsQLTM) questionnaire cancer module 3.0 (report by proxy or self-report). Symptoms intensity (pain, anorexia, sleep disturbance) were scored by using Edmonton Symptoms Assessment Scale (ESAS). The mean score and each dimension score of both groups were compared and analyzed using bivariate analysis. Results: In total, fifty participants were included in the study. A significant difference was found between the two groups in terms of the mean total score in control group 62.39 and intervention group 81.63 (p<0.001). The QoL was improved in the intervention group, while it was declined in the control group as the disease progressed. The main improvements were in the pain and nausea aspects (p<0.001), followed by procedural anxiety (p=0.002), treatment anxiety (p=0.002), and worry (p=0.014). Palliative intervention significantly reduced sleep disturbances (p=0.003) and anorexia (p<0.001). Conclusion: Home-based PC improved several aspects of QoL and caused better symptom management in children with malignancies. An early intervention concurrent with the underlying treatment can improve QoL in these children.     

Quality of Life among Breast Cancer Patients Undergoing Treatment in National Cancer Centers in Nepal

Purpose: To study the quality of life and to identify associated factors among breast cancer patients undergoingtreatment in national cancer centers in Nepal. Materials and Methods: One hundred breast cancer patients wereselected and interviewed using a structured questionnaire. European Organization of Research and Treatmentof Cancer EORTC-QLQ-C30 and EORTC-QLQ-BR23 were used to assess quality of life and modified MedicalOutcome Study -Social Support survey(mMOS-SS) was used to assess social support. Only multi-item scales ofEORTC C30 and BR23 were analyzed for relationships. Independent sample T-tests and ANOVA were appliedto analyze differences in mean scores. Results: The score of global health status/quality of life (GHS/GQoL) wasmarginally above average (mean=52.8). The worst performed scales in C-30 were emotional and social functionwhile best performed scales were physical and role function. In BR-23, most of the patients fell into the problematicgroup regarding sexual function and enjoyment. Almost 90% had financial difficulties. Symptom scales did notdemonstrate many problems. Older individuals, patients with stage I breast cancer and thosewith good socialsupport were found to have good GHS/GQoL. Of all the influencing factors, social support was established tohave strong statistical associations with most of the functional scales: GHS/GQoL (0.003), emotional function(<0.001), cognitive function (0.020), social function (<0.001) and body image function (0.011). Body image wassignificantly associated with most of the influencing factors: monthly family income (0.003), type of treatment(<0.001), type of surgery (<0.001), stage of cancer (0.017) and social support (0.011). Conclusions: Strategies toimprove social support of the patients undergoing treatment should be given priority and financial difficultiesfaced by breast cancer patients should be well addressed from a policy making level by initiating health financingsystem.     

Measuring Quality of Life in Thai Women with Breast Cancer

Breast cancer has become a commonly diagnosed disease among Thai women in the last decade, despite thefact that Thai women generally have a lower rates than their Western counterparts. With the rising incidenceand survival rates, it is crucial for nurses to look at the long term quality of life of these patients. A broad rangeof instruments have been used in clinical trials among breast cancer patients in oncology, like the EORTCquestionnaire including the general quality of life questions (QLQ-C30) and the breast cancer module (QLQBR23),and the FACT-B questionnaire consisting of both a generic part (FACT-G) and a breast cancer specificmodule. They have been shown to have good validity and reliability properties both for the English original andtranslations into various languages including Thai. A few studies on quality of life in Thai context exist, coveringquality of life in women with breast cancer. Therefore, the purpose of this study was to find which standardmeasure of common Western quality of life scales is appropriate to assess quality of life in Thai women withbreast cancer. Results revealed the Thai version of EORTC QLQ-C30 and FACT-G questionnaires to be reliableand valid to assess quality of life in general. The best fit for measuring quality of life in Thai women with breastcancer during adjuvant treatment should be the EORTC QLQ-C30/-BR23.     

Quality of Life of Family Caregivers of Cancer Patients in a Developing Nation

Background: Quality of life (QOL) of family caregivers of cancer patients is usually affected due to increase in caregiver burden. Their QOL has not garnered much attention by many including the health professionals and community. This study aims to explore the QOL of family caregivers of cancer patients in a multi-ethnic country in Asia and to investigate its associate factors. Methods: This is a cross-sectional study where family caregivers and patients who were diagnosed of cancers within 12 months were recruited. QOL of caregivers were measured using The Caregiver Quality of Life Index-Cancer (CQOLC). Psychological distress was measured using Hospital anxiety and depressive scale. Logistic regression analysis was performed to determine the related factors of QOL of caregivers. Results: A total of 458 patients/caregiver pairs were included. Symptoms of anxiety and depression reported by caregivers were 24.9% and 24.2% respectively. Caregivers of patients with solid tumors have better CQOLC score compared to those who cared for patients with hematological cancers (91.25 vs 86.75). Caregivers of non-Malay ethnicity, those caring for patients with advanced stage cancer and with hematological cancers had significantly poorer QOL. QOL of caregivers are also significantly affected when patients demonstrated anxiety symptoms. Conclusion: This study provides detailed evaluation of the QOL of caregivers of cancer patients in Malaysia. The significant psychological distress and low caregiver QOL indicate the urgent need for comprehensive supports for caregivers with cancer patients, especially those caring for patients with haematological cancers.