Quality of working life can protect against cognitive and emotional vulnerability in women living with metastatic breast cancer: a cross-sectional study

Quality of life of patients treated for stage IV breast cancer. Multidimensional assessment and examination of determining factors

Introduction

Metastatic breast cancer (MBC) can profoundly impact patients' lives. The health-related quality of life (HRQOL) of MBC metavivors remains a paramount concern. This study exa-mined the multifaceted aspects of HRQOL in MBC metavivors.

Material and methods

Ninety-eight participants with over 4 years of meta-static disease were evaluated using the European Organisation for Research and Treatment of Cancer (EORTC) questionnaires QLQ-C30, QLQ-BR42 and QLQ-BM22 alongside the Assessment of Survivor Concerns (ASC) questionnaire.

Results

HRQOL scores were high (> 80/100 points) in some HRQOL areas, including role, cognitive and social functioning and breast symptoms. Moderate limitations (> 30 points) occurred in global QOL and financial impact (QLQ-C30); sexual functioning, sexual enjoyment, future perspective, breast satisfaction, upset by hair loss, skeletal symptoms, and weight gain (QLQ-BR42); and psychosocial aspects of QLQ-BM22. Worries were moderate in the two ASC factors (6.8 and 5.3) and the global scale (11.7). The multivariate model that best explains high risk of low global QOL included limiting comorbidity, financial impact, cancer worry and role functioning (R 2 = 0.692). Patients with only bone metastases showed higher cancer and health worries (ASC scale) than patients with soft tissues and visceral sites.

Conclusions

This study shows that MBC metavivors adapted well to their situation and underscores the persistent HRQOL challenges they face. In-depth analysis of the QLQ-C30 glo-bal score highlights the need to address not only medical aspects but also integrated psychosocial and economi-cal support in MBC metavivor care. HRQOL variations across metastatic sites underscore the need to tailor interventions to address site-specific challenges.

Characterizing cancer-related cognitive impairments and impact on quality of life in women with metastatic breast cancer

PURPOSE

Little is known about cancer-related cognitive impairments (CRCI) in women with metastatic breast cancer (MBC). The purpose of this study is to (1) comprehensively describe CRCI and any associated psychosocial and behavioral symptoms, (2) determine observable sociodemographic and clinical risk factors for CRCI, and (3) explore cognitive and psychosocial predictors of quality of life and social functioning in women living with MBC.

METHODS

Using a cross-sectional design, women with MBC completed assessments (objective and subjective measures of CRCI including 3 open-ended questions, measures of psychosocial and behavioral factors, and assessments of quality of life and social function), and data were analyzed using descriptive statistics, qualitative content analysis, correlation analyses, t tests, analysis of variance, and linear regression models.

RESULTS

Data from 52 women were analyzed. 69.2% of the sample reported clinically significant CRCI and 46% of the sample scored < 1 standard deviation below the standardized mean on one or more cognitive tests. Those with triple-negative MBC (compared to HER2+), recurrent MBC (compared to de novo), and no history of chemotherapy had worse subjective CRCI, and those without history of surgery and older age had worse objective CRCI. Subjective CRCI, but not objective CRCI, was significantly associated with quality of life and social functioning.

CONCLUSION

Subjective and objective CRCI are likely a common problem for those with MBC. Subjective CRCI is associated with poorer quality of life and lower social functioning. Healthcare providers should acknowledge cognitive symptoms, continually assess cognitive function, and address associated unmet needs across the MBC trajectory.

Factors associated with distress among female cancer survivors at the workplace: A cross-sectional study

OBJECTIVES

This study aimed to investigate the levels of fatigue, social support, spiritual well-being, and distress of female cancer survivors at the workplace, and identify factors associated with distress.

METHODS

One hundred and eighty-two working female cancer survivors participated from the outpatient ward in two medical institutions in South Korea and they completed questionnaires assessing their general characteristics, fatigue, social support (colleagues and superiors), and spiritual well-being distress (existential and religious well-being). The data were analyzed using descriptive statistics, T-test, one-way ANOVA, correlation, and multiple linear regression with SPSS /WIN18 version.

RESULTS

Most of the participants were breast and thyroid cancer (78.5%), married (46.2%), working periods below 10 years (62.7%) and the average age was 49.7 years. Distress positively correlated with fatigue and significant predictors of distress were "type of work" and "main source of household income" among general characteristics, fatigue, religious well-being, and existential well-being.

CONCLUSIONS

Our findings suggest that integrated program including educational and practical factors to reduce fatigue and increase spiritual well-being (i.e., peace, faith, meaning, et al.) can decrease distress. Whereas, the "ambivalence" of God accompanied by high religious well-being (i.e., punishment, abandon, blame, and so on) can rather increase distress. The development of an integrated management system of distress at work can be applied as a practical factor to improve job satisfaction, organizational performance, and quality of life.