File Name: cancer and quality of life .zip
International Journal of Clinical and Health Psychology publishes manuscripts with a basic and applied emphasis, involving both theoretical and experimental areas contributing to the advancement of Clinical and Health Psychology. Papers including psychopathology, psychotherapy, behaviour therapy, cognitive therapies, behavioural medicine, health psychology, community mental health, sexual health, child development, psychological assessment, psychophysiology, neuropsychology, etc. On exception the Journal publishes articles on science evaluation.
Objectives: Identify the main changes in the health-related quality of life HRQoL of women diagnosed with breast cancer BC undergoing chemotherapy. Methods: Prospective cohort study that included 33 women diagnosed with clinical stages I—III BC and who underwent adjuvant chemotherapy. We also observed an increase in side effects related to the systemic therapy, fatigue, nausea and vomiting, insomnia, appetite loss and diarrhoea, despite a decrease in breast symptoms and arm symptoms. Conclusions: HRQoL was negatively affected during chemotherapy. Since side effects are very often underestimated, we consider that the evaluation of HRQoL parameters should be done for BC patients treated with chemotherapy.
Living with cancer
Background: This study is a comparison of quality of life QOL of current and previous cancer victims with people who never had experienced cancer in samples from the general population from the 19 countries in the European Social Survey ESS Methods : The study was based on the ESS with representative samples from 19 countries. Multilevel modelling was used to examine whether the relationship between cancer status and QOL varies between countries in general and by welfare state regimes in particular.
Results: People with cancer at the time of the interview, showed lower general QOL than both people who previously have had cancer and people who never have experienced cancer. The welfare state classification was a strong predictor of country differences in QOL, but there was no significant statistical interaction effect between cancer status and the welfare state classification. The study also replicated well-documented findings on differences in QOL by education and social support.
Conclusion: The QOL of people with a cancer disease is significantly impaired. People who previously have had cancer, scored only slightly lower on the QOL scale than people who never had experienced cancer.
We found evidence indicating that these differences may vary between the countries, but this variation cannot be explained by the welfare state classification. In this study we compare quality of life QOL of people living with cancer, either currently or as a past experience with people who have not experienced cancer in 19 European countries. We further use multilevel modelling to examine whether the relationship between cancer status and QOL varies between countries in general, and by welfare state regimes in particular.
QOL has been defined and measured in different ways. Whereas HRQOL instruments may be more valuable and precise in measuring the effects of treatments, they mostly tap into negative aspects of functioning rather than general experiences of QOL in terms of life satisfaction and happiness as used in our study. Research concur with the common sense expectation in that experiencing a cancer disease is likely to have a deteriorating effect on QOL. We will also use multilevel modelling to test whether the differences in QOL between the groups by cancer status varies across countries.
Welfare state typologies group countries with similar features into a number of welfare state regime based on criteria such as the generosity of social benefits and services and whether entitlement is universal or means tested. Esping-Andersen 15 classified welfare states into Liberal, Conservative and Social Democratic welfare regimes. Ferrera added a Southern regime.
The Scandinavian Social Democratic regime is characterized by a generous and universal social protection. The Bismarckian Conservative regime has a strong link between work position and entitlement. In the Anglo-Saxon Liberal regime, social benefits and services are means tested, but fairly generous.
The Southern regime is a fragmented system of income guarantees linked to the work position. They are relatively poor with limited health services. Welfare regimes have been shown to be related to both happiness and subjective general health. Furthermore, the differences in level of welfare provision and medical services between welfare regimes may affect the differences in QOL by cancer status.
However, since the physical experience of cancer diseases most likely is uniform across countries, this may be more important for the QOL of cancer patients than the differences in welfare provision. Based on current research, 17—19 we control for confounding by adding socio-demographic variables age, gender, education and two indicators of social support, which is well known to be associated with QOL as well as health.
The net sample was restricted to respondents aged 25— The youngest was excluded because of very low prevalence of cancer and the upper age limit of 75 was set rather arbitrary to avoid the sample selection bias for respondents with advanced age. The main explanatory variable is the threefold classification of cancer status. The following health problems were listed on the showcard: Cancer affecting any part of the body; Leukaemia; Malignant tumour; Malignant lymphoma; Melanoma, carcinoma, or other skin cancer.
The estimated cancer prevalence for the net sample, and for groups by age, gender and country are shown in Table 1.
An estimated 4. Another 6. The prevalence varied by age and slightly by gender and the welfare state classification. Y ij , the continuous QOL scale, is the dependent variables in two-level regression model, and L ij , the logit of the probability of poor QOL, is the dependent variable in the two-level logit model. The constants intercepts in both model may vary randomly across countries.
Our analytical strategy for the multilevel modelling was to start with the null model without explanatory variables , that allows for the estimation of the intra-correlation coefficient ICC.
Next, we examined whether a model where the coefficients pertaining to cancer status showed between-country variation. Finally, we tested whether the interaction between cancer status and the welfare state classification was statistically significant.
Since, the test was negative the final model Table 3 includes only the main effects of cancer status and the welfare state classification. Next, we estimated the unadjusted effects of cancer status and the welfare state classification Table 2.
The unadjusted difference on the QOL scale between those currently with cancer and people without the experience with cancer was around 0. Table 2 QOL, means and percentages below cut-point, unadjusted predictions. As expected there were substantial differences in QOL among the welfare regimes, with the highest QOL-score for the Scandinavian regime and the lowest for the Eastern one. Having established that both our explanatory variables were related to the two indicators of general QOL, the next step was to establish whether the effects of cancer status on QOL varied across countries, or more specifically between the welfare state regimes.
The first way of doing this was to test whether the two coefficients for cancer status in the regression and the logit models showed significant between-country variation. This was followed by adding terms representing the statistical interaction between cancer status and the welfare state classification to the full model with controls for confounding. This was a direct test of whether people with the experience of cancer in welfare regimes with higher levels of welfare provision, such as the Scandinavian regime, would report higher QOL scores than cancer victims in the Southern and Eastern welfare state regimes.
Thus, the final models reported in Table 3 are without the statistical interaction between cancer status and welfare regimes. Table 3 QOL by cancer status and welfare state classification, adjusted for demographic variables, multilevel regression and multilevel logistic regression.
QOL by cancer status and welfare state classification, adjusted for demographic variables, multilevel regression and multilevel logistic regression. Table 3 also describes the general QOL in groups by age, gender and levels of education. Levels of education and the two indicators of social support were strong predictors of QOL, whereas there were only minor differences in QOL by age and gender.
We have compared three groups in terms of QOL: people who currently have cancer, people who previously have had cancer, and people who never had experienced cancer. Those currently with cancer scored about 0. The multilevel analysis of the QOL scale indicated that these group differences may vary among the countries. Although the welfare state classification was a powerful predictor of QOL, the multilevel analysis indicated that the variation in the differences between the groups by cancer status cannot be explained by the welfare state classification.
In other words, our study does not indicate that people with a cancer disease fare better in terms of QOL in welfare state regimes with high level of provisions compared with regimes with a more basic services.
This needs to be further explored, however, since the statistical power of our data to reveal such differences is limited. Quinten et al. Some American studies based on large-scale data from the Medicare Health Outcomes Survey 9—12 show that cancer patients reported significantly poorer physical and mental health compared with patients without cancer.
Three European studies based on small samples reported findings largely consistent with the large-scale American studies. Studies of long-term cancer survivors compared with various control groups have similarity with our comparison of people who previously have had cancer and the general population. However, the other studies 3—4 , 7 did not indicate significant differences in QOL between long-time cancer survivors and various reference samples.
This is largely consistent with our results comparing people who reported to have cancer and those who never had experienced cancer. Also, consistent with earlier studies, we found only minor differences in QOL between persons who previously have had cancer survivors and those who never have had cancer.
Leaning on the study of Baker et al. Our study has limitations. First, the cancer status classification is a crude self-reported measurement not based upon clinical diagnoses and we do not have information on the type of cancer.
Therefore, it is only possible to provide a general picture of the cancer population, although there may be differences in QOL between cancer types with good prognoses, such as breast cancer and types with poorer prognoses such as liver- and lung cancer. We do not have information on other serious diseases that might affect QOL.
For those who reported to have had cancer previously, we lack information on when they became cancer-free. In sum, although the data set has limitations in the level of details, we do not think these limitations bias our findings in any particular direction. Finally, although we cannot conclusively exclude the possibility that cultural traits may explain some of the between-country differences in QOL, a study on potential cultural measurement bias in happiness does indicate this is not the case.
To our knowledge our study is the first one to compare the general QOL by cancer status in a large scale cross-national dataset, which also enabled us to examine whether the differences in QOL by cancer status varied by welfare state regimes.
Our study showed that the QOL of people with a cancer disease is significantly impaired. People who previously have had cancer, however, scored only slightly lower on the QOL scale than people who never had experienced cancer. We found evidence indicating that these differences may show variation among the countries, but this variation cannot be explained by the welfare state classification. Cancer patients are generally impaired in terms of QOL, about equally so in all countries.
Our study also indicates that social support living with a partner, having persons to discuss intimate matters with is important for QOL.
This implies that health care personnel would do well to follow up patients throughout the disease period and work to maintain and strengthen their social networks. Terje A. Haas BK. Clarification and integration of similar quality of life concepts.
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The relationship of quality of life and distress in prostate cancer patients compared to the general population.
Psycho-Soc Med ; 7 : Doc Hammerlid E Taft C. Health-related quality of life in long-term head and neck cancer survivors: a comparison with general population norms. Br J Cancer ; 84 : — Support Care Cancer ; 16 : —
Assessing quality of life in cancer patients.
Receiving a cancer diagnosis can be difficult to cope with. Many people experience feelings of shock, fear and confusion. Sharing a cancer diagnosis is also not easy. You may worry about how cancer will change your way of life and how it will impact family and friends. Cancer Council can help you and your family cope with cancer. Call us on 13 11 20 — our specially trained staff can answer your questions and offer emotional and practical support.
PDF | Over the last decade, clinicians have accepted that while survival and disease-free survival are critical factors for cancer patients, overall.
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APJON is a peer-reviewed, open access journal. APJON is a Bimonthly issue which addresses different spectrums in relation to oncology nursing for cancer patients--prevention, screening and early detection, geriatric and pediatric cancer nursing, medical and surgical oncology, ambulatory care, nutritional support, cancer related psychosocial issues and support, management of cancer symptom and side effects caused by different types of cancer treatment, palliative care and end of life care, long term survivorship and other issues and care related to cancer patients, especially nursing innovations and the research findings in these areas. The journal covers different and up-to-date information which is divided into AONS news, editorial, review, original article, case report, letter to editor, short report, technical notes, nurse education, etc.
Background: Breast cancer is the most common cancer in women globally. Over the last decade, Quality of life QOL has become an important outcome measure in the treatment of cancer patients. Aim and Objective-.
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Quality of life QOL , according to Britannica , is the degree to which an individual is healthy, comfortable, and able to participate in or enjoy life events. One approach, called engaged theory , outlined in the journal of Applied Research in the Quality of Life , posits four domains in assessing quality of life: ecology, economics, politics and culture. Also frequently related are concepts such as freedom, human rights , and happiness. However, since happiness is subjective and difficult to measure, other measures are generally given priority. It has also been shown that happiness, as much as it can be measured, does not necessarily increase correspondingly with the comfort that results from increasing income. As a result, standard of living should not be taken to be a measure of happiness.
The authors included articles from 3 high-impact oncology journals from July to July that assessed QoL as an outcome variable in intervention trials. They included both clinical trials and other psychological intervention studies and reported that most studies measured QoL during the intervention period only.
Background: This study is a comparison of quality of life QOL of current and previous cancer victims with people who never had experienced cancer in samples from the general population from the 19 countries in the European Social Survey ESS Methods : The study was based on the ESS with representative samples from 19 countries. Multilevel modelling was used to examine whether the relationship between cancer status and QOL varies between countries in general and by welfare state regimes in particular. Results: People with cancer at the time of the interview, showed lower general QOL than both people who previously have had cancer and people who never have experienced cancer. The welfare state classification was a strong predictor of country differences in QOL, but there was no significant statistical interaction effect between cancer status and the welfare state classification.
Ferrell, B. R, Dow, K. Measurement of the quality of life in cancer survivors. Qual Life Res, 4 6 ,
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