Quality of life in breast cancer patients: Associations with optimism and social supportCalidad de vida en pacientes con cáncer de mama: asociación con optimismo y apoyo social

Background/Objective: The purpose of this study was to examine quality of life (QoL) in breast cancer patients from Colombia and to explore the relationship between QoL, habitual optimism, and social support. Method: A sample of 95 breast cancer patients treated in a hospital in Bogotá were administered the QoL instrument EORTC QLQ-C30 and the Life Orientation Test LOT-R. Additionally, they were asked to indicate from whom (physicians, friends, nurses, etc.) they wished and received social support. Reference data for the EORTC QLQ-C30 and the LOT-R were taken from a representative sample of the general Colombian population. Results: The breast cancer patients showed detriments to their QoL on most functioning scales and symptom scales of the EORTC QLQ-C30, while their general assessments of health and QoL were not worse than those of the controls. Optimism was positively correlated with QoL. Most patients wanted and received social support from their physicians and friends/family. Conclusions: The results suggest that optimism helps patients better cope with disease. A general assessment of global QoL cannot replace the more specific assessments of the functioning domains and symptoms.     

Assessment of quality of life in a multicultural cancer patient population

Quality of life (QOL) is increasingly assessed in cancer patients. In this article, the authors examined the psychometric performance of a commonly used QOL questionnaire, the Quality of Life Questionnaire--Cancer 30 (QLQ-C30; N. K. Aaronson et al., 1993), in multiethnic cancer patients. Content validation studies in patients and clinicians identified possible new items. Multiple-group confirmatory factor analysis supported equivalent structure across ethnic groups (Caucasians and Asian/Pacific Islanders [APIs]). A higher order QOL factor appeared to directly affect functioning scales and symptom count. Exploratory factor analysis examined effects of new items. Ten factors were extracted, 6 consistent with the original instrument and 4 reflecting potentially new aspects of QOL: Positive Social Support, Coping, Existential Well-Being, and Sexuality/Intimacy. The QLQ-C30 appears appropriate for use in API cancer patients. Further work needs to ensure that it includes all important domains.     

癌症生存者生活质量及影响因素的调查分析

探讨不同癌症生存者的生活质量状况及其影响因素,对癌症部位、患病时间不同的癌症生存者148名,采用生活质量问卷(EORTCQLQ-30)进行测量。结果:不同年龄组之间RF、EF、SL和FI得分有统计学差异;男女患者在SF、AP和QOL方面有统计学差异。不同文化程度患者之间PF、RF、FA、NV和AP有统计学差异。患病时间与总体生活质量(QOL)之间相关性有统计学意义。不同种类癌症患者之间SF、DY、AP得分有统计学差异。有无复发或转移、是否接受手术治疗以及目前是否正在进行化疗均会对癌症生存者的生活质量产生影响。结论:人口学特征及疾病等因素均会不同程度的影响到癌症生存者的生活质量,提示医务人员应根据癌症生存者不同的特点进行有的放矢的治疗和护理,在延长其生存时间的同时也应注意提高其生活质量。     

Development and Psychometric Evaluation of an Item Bank for Computerized Adaptive Testing of the EORTC Insomnia Dimension in Cancer Patients (EORTC CAT-SL)

To further advance assessment of patient-reported outcomes, the European Organisation of Research and Treatment of Cancer (EORTC) Quality of Life Group has developed computerized adaptive test (CAT) versions of all EORTC Quality of Life Core Questionnaire (QLQ-C30) scales/items. The aim of this study was to develop and evaluate an item bank for CAT measurement of insomnia (CAT-SL). In line with the EORTC guidelines, the developmental process comprised four phases: (I) defining the concept insomnia and literature search, (II) selection and formulation of new items, (III) pre-testing and (IV) field-testing, including psychometric analyses of the final item bank. In phase I, the literature search identified 155 items that were compatible with our conceptualisation of insomnia, including both quantity and quality of sleep. In phase II, following a multistep-approach, this number was reduced to 15 candidate items. Pre-testing of these items in cancer patients (phase III) resulted in an item list of 14 items, which were field-tested among 1094 patients in phase IV. Psychometric evaluations showed that eight items could be retained in a unidimensional model. The final item bank yielded greater measurement precision than the original QLQ-C30 insomnia item. It was estimated that administering two or more items from the insomnia item bank with CAT results in a saving in sample size between approximately 15–25%. The 8-item EORTC CAT-SL item bank facilitates precise and efficient measurement of insomnia as part of the EORTC CAT system of health-related quality life assessment in both clinical research and practice.

     

中国癌症病人生活质量的测定──EORTC QLQ—C30在中国的试用

引进EORTCQLQ-C30,验证其在中国大陆的应用情况,为中国肿瘤学领域生活质量研究提供有效和实用的评定工具.运用随机对照实验设计,测查了289名癌症病人,结果显示各分量表中项目与所属量表的相关均高于与其他量表的相关,各分量表间呈中等偏下相关,量表因子结构分析与EORTC结果大体相似,三种方法检验的临床效度均较高.由此得出QLQ-C30各项心理测量学特性均达到要求,临床效度和实用性也比较好,在中国大陆的癌症病人中是可行的、可信的、有效的和敏感的.     

Quality of life in transplant patients, compared to other stressful health situations in pulmonary patients

Transplantation may imply severe biopsychosocial impairments. In order to know the quality of life of patients one year after transplantation, 58 subjects were compared to three different groups of patients (stabilized and acute COPD patients, and lung cancer patients in a surgery unit). Patients filled in two questionnaires: EORTC QLQ-C30 (quality of life) and HAD (anxiety and depression). The quality of life dimensions with inter-group differences were physical, role, emotional and cognitive functioning, global health status, and a number of symptoms (fatigue, dyspnea, insomnia and appetite loss). There were differences in depression, and but not in anxiety. Transplant and surgical patients showed better quality of life and affective status than chronic pulmonary patients. Discriminant analysis showed that the transplant group was the best described group. We conclude that patients, one year after transplantation, show similar quality of life as asymptomatic hospitalised patients, somewhat better than chronic patients in a stabilized stage of the disease, and much better than severe chronic patients.     

Positive factors associated with quality of life among Chinese patients with renal carcinoma: a cross-sectional study

Quality of life and positive psychological variables has become a focus of concern in patients with renal carcinoma. However, the integrative effects of positive psychological variables on the illness have seldom been reported. The aims of this study were to evaluate the quality of life and the integrative effects of hope, resilience and optimism on the quality of life among Chinese renal carcinoma patients. A cross-sectional study was conducted at the First Hospital of China Medical University. 284 participants completed questionnaires consisting of demographic and clinical characteristics, EORTC QLQ-C30, Adult Hope Scale, Resilience Scale-14 and Life Orientation Scale-Revised from July 2013 to July 2014. Pearson’s correlation and hierarchical regression analyses were performed to explore the effects of related factors. Hope, resilience and optimism were significantly associated with quality of life. Hierarchical regression analyses indicated that hope, resilience and optimism as a whole accounted for 9.8, 24.4 and 21.9% of the variance in the global health status, functioning status and symptom status, respectively. The low level of quality of life for Chinese renal carcinoma patients should receive more attention from Chinese medical institutions. Psychological interventions to increase hope, resilience and optimism may be essential to enhancing the quality of life of Chinese cancer patients.     

EORTC QLQ—C30及其在胸部肿瘤患者生命质量研究中的应用

生命质量研究是近年来肿瘤研究的热点之一,其主要作用评价治疗效果,选择治疗方案;应用于抗肿瘤新药筛选;用于预测患者预后和远期生存状态。EORTC QLQ-C30及其子量表在世界范围内被应用于胸部肿瘤治疗和研究当中并取得了较好效果,为评价食管癌和肺癌的各种治疗方法提供了一个较好的参考标准,同时对提高食管癌和肺癌的治疗水平和改善病人生命质量起到了一定的推动作用。     

4O例皮肤恶性黑色素瘤患者生存质量的临床分期评价

皮肤恶性黑色素瘤是一种高度恶性的皮肤肿瘤,且转移早、易复发、治疗效果不理想,如何提高患者的生存质量成为医学领域一个重要的课题。本文用EORTCQLQ-C30V3．0中文版量表对40例皮肤恶性黑色素瘤患者的生命质量进行临床分期测评,采用t检验与因子分析法进行比较分析,结果发现I期、Ⅱ期患者积分公因子在疲乏、情绪低落、食欲...     

Pain Intensity,Psychological Inflexibility,and Acceptance of Pain as Predictors of Functioning in Adolescents with Juvenile Idiopathic Arthritis: A Preliminary Investigation

Juvenile Idiopathic Arthritis (JIA) is a chronic rheumatic disease associated with pain and maladjustment. This study investigated whether pain, acceptance of pain, and psychological inflexibility uniquely predicted functional disability, anxiety, general quality of life (QOL), and health-related quality of life (HQOL) among adolescents with JIA. Twenty-three adolescents with JIA and pain were recruited from a pediatric rheumatology clinic. Participants completed self-report measures pertaining to the key study variables. A series of multiple regression analyses demonstrated that higher pain uniquely predicted higher functional disability. Greater psychological inflexibility uniquely predicted higher anxiety, lower general QOL, and lower HQOL. Increases in acceptance of pain were found to be uniquely related to increases in general QOL. These data confirm prior findings that pain impacts functioning, and provide preliminary findings that psychological inflexibility and acceptance may be important targets of psychological intervention for youth with JIA and pain to improve functioning and QOL.     

Pilot Testing and Preliminary Psychometric Validation of the Polish Translation of the EORTC INFO25 Questionnaire

The quality of information that oncological patients receive from health care professionals is an underestimated issue in Poland and Eastern European countries. There is lack of sufficient data on this subject. The European Organization for Research and Treatment of Cancer (EORTC) supplies a new tool for measuring the quality of information provided to cancer patients. The purpose of the study is the translation into Polish, pilot testing and preliminary validation of the EORTC information module (INFO25). Following the EORTC translation procedures, forward and back translations of the questionnaire were performed (English?→?Polish, Polish?→?English). The intermediate version of the INFO25 was pilot-tested together with the general questionnaire of quality of life (EORTC QLQ-C30). Reliability, validity and known-group comparison tests were performed. A total of 21 patients with different cancer diagnoses were recruited into the study (7 women and 14 men; mean age of 60,2 years, age range 25–73 years). Apart from filling out the INFO25, patients were interviewed about the difficulties with answering every questionnaire item. Patients' comments were analyzed and minor language changes were made to the initial translation. The internal consistency of the INFO25 showed a reliability of 0,78. The final version of the Polish translation of the INFO25 module was obtained and approved by the EORTC Quality of Life Department. It can now be used in clinical setting and for scientific purposes.     

Associations of Quality of Life,Physical Activity and Mood States in Women with Breast Cancer Treated with Curative Intent

This study aims to investigate the associations between quality of life, physical activity and mood states in women with breast cancer. A total of 354 women (mean age, 51.74?±?8.63 years; body mass index (BMI), 28?±?5.67 kg/m²) completed the Baecke Physical Activity Questionnaire, Profile of Mood States (POMS), European Organisation for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30) and European Organisation for Research and Treatment of Cancer Breast Cancer-Specific Quality of Life Questionnaire (EORTC QLQ-BR23). Pearson’s correlation and multiple linear regressions were used to verify the relations between outcomes and independent variables. Correlations between scores on POMS, Baecke Physical Activity Questionnaire and global health status/quality of life subscale of EORTC QLQ-C30 found associations (p?<?0.01) between physical activity (r?=?0.191), vigour (r?=?0.333) and fatigue (r?=??0.433). Multiple linear regression analysis of the global health status/quality of life subscale of the EORTC QLQ-C30 showed significant differences for vigour (p?<?0.001), social function (p?=?0.003), side effects of systemic therapy (p?=?0.019), arm and breast symptoms (p?<?0.001) and Baecke physical activity score (p?=?0.006). Physical activity is an independent factor related to the quality of life in women with breast cancer. Understanding these variables may influence clinical decisions during treatment and allow positive interventions regarding symptoms, functions and lifestyle.     

Quality of Life Before and After Cataract Surgery: Research in a Sample of Polish Patients

The goal of this paper is to present possible change in quality of life (QoL) in older sample of people with vision disturbances. The patients were investigated twice: before (N = 193) and 4 month after the cataract surgery (N = 69), by means of the scale for vision functioning, and the Life Quality Questionnaire (Schalock & Keith, 1993) extend with the items measuring health related quality of life (HRQoL). Two problems were formulated: To what extent are visual defects associated with the decreased subjective QoL? What changes are observed in perceived QoL during the period of treatment of visual defects? The patients reported significant increase of HRQoL, however they did not report similar increase of a general QoL. Few reasons are considered: overlapping of the content of visual function scales and HRQoL and different indices of a general QoL and HRQoL, lack of a proper postoperative care, low socio-economic status of the participants, and too high expectation concerning better functioning after the surgery.     

Influence of Religiosity on the Quality of Life and on Pain Intensity in Chronic Pancreatitis Patients After Neurolytic Celiac Plexus Block: Case-Controlled Study

The quality of life in patients with chronic pancreatitis (CP) is reduced due to their suffering of high levels of pain. It has been presented that quality of life can also be linked to religiosity and/or spirituality. The aim of this study is to assess the influence of religious practices on the quality of life and on the subjective level of pain in CP patients. Ninety-two patients (37 women and 55 men) with chronic pancreatitis were treated invasively for pain with neurolytic celiac plexus block (NCPB). The religiosity of the patients was recorded and served as a dichotomizer. Group 1 was for patients who claimed to have no contact with the church or to have very sporadic contact (N = 35 patients). Group 2 was for patients who claimed to have deep faith and were regular participants at church activities (N = 57 patients). Visual analogue scale was used to assess pain, while the quality of life was measured by using QLQ C-30 questionnaire adapted for chronic pancreatitis patients in Polish population. The patients were assessed prior to the pain-relieving intervention and subsequently 2 and 8 weeks after it. The intensity of pain was reduced in both groups significantly after performing the NCPB. Patients who declared a deep faith reported higher level of pain on the VAS scale prior to intervention than non-religious patients. Quality of life in both groups of patients significantly improved after NCPB. Following NCPB, global quality of life in patients who declared higher religiosity/church attendance was significantly higher (79.88) than for those patients who have no contact or sporadic contact with the church (44.21, P < 0.05). NCPB resulted in significant reduction of pain and increase in quality of life in both groups of patients with CP. Nevertheless, in the group declaring higher religiosity/church attendance, reported pain was higher, but, despite that, quality of life better. It may be concluded that religious practices might serve as an additional factor improving quality of life and coping in patients suffering from chronic pancreatitis.     

Quality of Life and Multiple Sclerosis: Comparison Between People with Multiple Sclerosis and People from the General Population

This paper evaluated the quality of life (QOL) of people with multiple sclerosis (MS) and people from the general population. Gender differences between the 2 groups of respondents and the influence of coping style on adjustment were also evaluated. The participants were 381 (144 males, 237 females) people with MS, and 291 (101 males, 190 females) people from the general population. The results demonstrated that people with MS experienced lower levels of QOL than people from the general population for both the objective and subjective dimensions of all domains (physical health, psychological adjustment, social relationships, environmental adjustment). All coping strategies (problem-focused, focusing on the positive, detachment, wishful thinking, seeking social support) were important predictors of QOL for both males and females with MS, with wishful thinking being the strongest predictor of poor QOL. These results are discussed in terms of the various factors that impact on QOL among people with MS, and the types of coping strategies that are most adaptive in improving the QOL of people with this illness.     

The feasibility,reliability and validity of the EORTC QLQ-C30 in assessing the quality of life of patients with a symptomatic HIV infection or AIDS (CDC IV)

Abstract

The objective of this study was to evaluate the feasibility, reliability and validity of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (the QLQ-C30) in a longitudinal study of the quality of life (QoL) of patients with a symptomatic HIV infection or AIDS. The OLQ-C30 is a 30-item questionnaire composed of five functional subscales. 3 symptom subscales, an overall QoL subscale, and a number of additional single item symptom measures. The questionnaire was administered serially to a sample of 156 Dutch patients. The average time to complete the questionnaire was less than 11 minutes, with most patients requiring no assistance. With one exception (role functioning subscale), the data supported the hypothesized scale structure of the questionnaire. Eight of the 9 subscales met or approached the minimal criterion for reliability (Cronbach's alpha ≤ .70) at baseline and/or follow-up. The validity of the QLQ-C30 was supported by 3 findings: (1) the correlations observed among the subscales. while statistically significant, were of only a moderate magnitude, indicating that distinct components of QoL are being assessed; (2) a number of the subscales could discriminate clearly between patients differing in stage of disease and in Karnofsky Performance Status; and (3) significant changes in QLQ-C30 scores in the expected direction, were observed over time. These results lend support to the QLQ-C30 as a reasonably reliable and valid instrument for assessing the QoL of patients with HIV infection. Additional research is needed to improve the role functioning subscale. to evaluate the QLQ-C30's concurrent validity by comparing it with other available QoL instruments, and to examine more thoroughly its responsiveness to clinically important changes in patients' health status over the entire disease and treatment trajectory.     

Quality of Well-Being Scale and Chronic Low Back Pain

Outcome measures that assess quality of life for use in health policy decisions need to be investigated in chronic pain patients. In the present study, the validity of the Quality of Well-Being Scale (QWB) was evaluated on 67 adult chronic low back pain (CLBP) patients who were enrolled in a 12-week multidisciplinary pain treatment program. Participants completed the QWB, a battery of pain measures, a behavioral observation task, and a medical exam. The findings indicated that CLBP patients have a low level of functioning or quality of life (M = .567, SD = .08) compared with persons with life-threatening diseases. The QWB score was significantly correlated with observational measures of pain behavior and pain-related coping strategies. Multivariate analysis indicated that interference in daily activities, distorted ambulation, affective distress, pain duration, and guarding were the most significant predictors of quality of well-being (multiple R = .84, p < .0001). Patients with medically incongruent physical signs had significantly lower QWB scores than patients with congruent signs. Overall, the data supported the validity of the QWB in a sample of CLBP patients.     

Obesity-Related Quality of Life and Distorted Self-Body Image in Adults

Quality of life (QOL) is associated with body mass index (BMI). Self-awareness of false body image may influence the behavior of weight control and QOL. This study was conducted to identify the relationships between BMI and QOL, and distortion of self-estimated body image and its impact on QOL and the general health of Korean adults. A total of 229 adults who visited two university hospitals in Seoul and Chungju cities for regular health check-up responded to a questionnaire. To assess QOL, a Korean version of the obesity-related Quality of Life Scale (KOQOL) was used. The results showed that obesity-related quality of life decreased as BMI increased and as alcohol consumption became heavier. In the low weight and normal body weight groups, a portion of the groups had a more obese self-estimated body image than their actual BMI. In the overweight and obese groups, some had a leaner self-estimated body image than their actual BMI. Persons who had a self-body image of being fat had a low QOL. For Korean adults over 20 and under 65, a higher BMI is associated with a lower obesity-related quality of life. Persons who thought themselves fat had a lower QOL, regardless of their real body type.     

临床心理干预对白血病患者生存质量影响研究

本研究按随机和匹配的原则,将64名白血病患者分入干预组和对照组。对于干预组进行了为期1 5天的临床心理干预,对照组仅接受相应的医学治疗和护理。以欧洲癌症研究与治疗组织编制的肿瘤患者生存质量量表(EORTCQLQ -C30 )为指标,观察临床心理干预对白血病患者生存质量的影响。结果发现,与对照组相比,干预组患者生存质量显著改善     

Quality of Life in Women Following Various Surgeries of Body Manipulation: Organ Transplantation, Mastectomy, and Breast Reconstruction

This study aimed to determine biopsychosocial differences (anxious-depressive symptomatology and quality of life) among three groups of patients who underwent surgical interventions related to body manipulation, as well as to assess the clinical significance of these results versus reference values. Four groups were compared: women who underwent organ transplant (n = 26), mastectomy for breast cancer (n = 36), breast reconstruction (n = 36), and general population (n = 608). The Hospital Anxiety and Depression Scale and the EORTC QLQ-C30 were used. Women who underwent mastectomy showed the highest anxious-depressive symptomatology and quality-of-life impairment in comparison to the remaining groups, and they also displayed the most clinically significant deterioration in the majority of dimensions (large effect sizes). In contrast, the group with implantation of a healthy organ (transplantation) only showed higher biopsychosocial impairment than the group with reconstruction of an organ (breast reconstruction) in gastrointestinal dysfunctions and in the global self-perception of health.