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Momennasab M, Ghorbani F, Yektatalab S, Magharei M, Tehranineshat B. The Effect of Spiritual Group Therapy on the Quality of Life and Empowerment of Women with Breast Cancer: A Randomized Clinical Trial in Iran. JOURNAL OF RELIGION AND HEALTH 2024; 63:1504-1522. [PMID: 38489131 DOI: 10.1007/s10943-024-02009-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/29/2024] [Indexed: 03/17/2024]
Abstract
This randomized clinical trial was carried out on 74 women with breast cancer between May 2015 and April 2016 in the south of Iran. The patients were selected using a simple sampling method and randomly divided into an intervention (n = 30) and a control (n = 37) group. Five spiritual therapy sessions were conducted for the intervention group. Each session lasted one hour. The quality of life and empowerment of the patients were measured before and one month after the intervention. To collect data, four instruments were used, including a demographic information form, the European Organization for Research and Treatment of Cancer QOL questionnaire Cancer-30 (EORTC QLQ C-30), EORTC QLQ Breast-23 (EORTC QLQ-BR23), and the Cancer Empowerment Questionnaire (CEQ). After the intervention, a difference was observed between the groups concerning the mean score of general health (P = 0.016) and emotional function (P = 0.029), but there was no significant difference between the groups concerning the mean score of empowerment (P = 0.62). Thus, it appears that spiritual group therapy can improve the quality of life of this group of patients.IRCT registration number: IRCT 2014050417546N2.
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Affiliation(s)
- Marzieh Momennasab
- Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh Ghorbani
- Student Research Committee, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shahrzad Yektatalab
- Community Based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahboobeh Magharei
- Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Banafsheh Tehranineshat
- Community Based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
- Department of Nursing, Faculty of Nursing and Midwifery, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
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Roustaee S, Roudi Rashtabadi O, Tirgari B, Jahani Y, Tahmasebi S. Mirror therapy effect on shoulder pain and disability and quality of life of mastectomy women: a randomized clinical trial. Disabil Rehabil 2023; 45:4227-4235. [PMID: 36428274 DOI: 10.1080/09638288.2022.2148296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 11/13/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE To investigate mirror therapy (MT) influence on shoulder pain/disability and quality of life in mastectomy women. MATERIALS AND METHODS Sixty unilateral mastectomy women were recruited and randomly assigned to an MT group (N = 30) or a sham therapy (ST) (N = 30). Women in the MT and ST group attended a nurse-led, unsupervised, 30 min a day, five days a week, and at home training program for three weeks with and without a mirror, respectively. Shoulder pain and disability scale and QOL outcomes were assessed at baseline and 3 months after intervention. RESULTS Shoulder pain and disability were significantly improved in the MT group but there was not meaningful difference between groups in the EORTC-QOL scales except for some functional scores of QLQ-BR23 scale in the MT group after 3 months follow-up. CONCLUSIONS Nurses should instruct MT as a rehabilitation program to mastectomy patients during or after hospitalization to reduce their post-op shoulder pain and disability. This intervention may have also positive impact on their self-care outcomes. It is recommended that further studies should be performed with nurse-supervised exercises, a validated tool for measuring QOL for a long period after surgery, and a longer follow-up period at least for 6 months.Implication for rehabilitationThis study aimed to investigate whether an unsupervised, nurse-led mirror therapy (MT) can alleviate shoulder pain and disability of mastectomy patients and improve their quality of life.Our findings indicated that nurse-led MT as a novel rehabilitation option for mastectomy patients, may reduce shoulder pain and disability even after long period after the surgery.Rehabilitation centers can equip rooms for MT so breast cancer women can use it immediately after mastectomy.Mirror therapy can be used as a rehabilitation method for mastectomy patients because it is easy-to-use, inexpensive, and without the need to attend a rehabilitation center.Rehabilitation centers can provide mirrors along with nursing instructions to women who want to use this method at home.
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Affiliation(s)
- Sanaz Roustaee
- Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Omsalimeh Roudi Rashtabadi
- Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran
- Department of Medical Surgical Nursing, Faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | - Batool Tirgari
- Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | - Yunes Jahani
- Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Sedigheh Tahmasebi
- Breast Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Farajivafa V, Khosravi N, Rezaee N, Koosha M, Haghighat S. Effectiveness of home-based exercise in breast cancer survivors: a randomized clinical trial. BMC Sports Sci Med Rehabil 2023; 15:96. [PMID: 37550769 PMCID: PMC10405487 DOI: 10.1186/s13102-023-00710-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 08/02/2023] [Indexed: 08/09/2023]
Abstract
BACKGROUND Breast cancer patients are recommended to engage in regular exercise. In developing countries, where there is a lack of facilities to offer specialized, supervised exercise for this population, regularly exercising might be a challenge. We aimed to evaluate the effectiveness of a home-based intervention in this population. METHODS Breast cancer survivors were randomly assigned to either the home-based exercise program or the usual care group. Exercise intervention included walking, balance, and stretch exercises, along with weekly follow-up telephone calls. Quality of life (QOL) was evaluated using EORTC QLQ-C30 and EORTC QLQ-BR23 questionnaires and the predicted VO2 peak was measured using the Ebbeling submaximal treadmill test. RESULTS Eighty-nine patients were enrolled in the study. Reported minutes of exercise gradually increased from 40.7 min per week in week 1 to 116.9 min per week in week 12. This intervention improved global QOL (P = 0.001), social functioning (P = 0.04), and the predicted VO2 peak (P = 0.01). CONCLUSION This home-based exercise regime effectively increased quality of life and physical activity levels. TRIAL REGISTRY Iranian Registry of Clinical Trials identifier: IRCT20140810018746N1, prospectively registered 08/01/2018, https://en.irct.ir/trial/27959 .
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Affiliation(s)
- Vahid Farajivafa
- Department of Physical Education and Sport Sciences, Faculty of Humanities, Tarbiat Modares University, Tehran, Iran
| | - Nasim Khosravi
- Department of Physical Education and Sport Sciences, Faculty of Humanities, Tarbiat Modares University, Tehran, Iran
| | - Nilofar Rezaee
- Department of Exercise Physiology, Faculty of Sport Sciences, University of Guilan, Rasht, Iran
| | - Maryam Koosha
- Department of Social Welfare, Institute for Humanities and Cultural Studies, Tabatabaei University, Tehran, Iran
| | - Shahpar Haghighat
- Department of Cancer Quality of Life, Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran.
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Bagheri A, Babaei M, Rezaei S, Motallebnejad ZA, Ganjalikhani M, Malekahmadi M, Esmaillzadeh A. The effect of Mediterranean diet on nutritional status, muscle mass and strength, and inflammatory factors in patients with colorectal cancer-induced cachexia: study protocol for a randomized clinical trial. Trials 2022; 23:1015. [DOI: 10.1186/s13063-022-06985-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 12/06/2022] [Indexed: 12/15/2022] Open
Abstract
Abstract
Background
Current dietary strategies to manage cancer cachexia and the relevant outcomes did not provide a comprehensive solution. This study will evaluate the effect of a Mediterranean diet on inflammatory markers, nutritional status, muscle mass, and strength among patients with cancer cachexia (CC).
Methods
This will be a randomized clinical trial involving men and women diagnosed with localized or advanced colorectal cancer-induced cachexia. In total, 40 patients with CC will be recruited based on inclusion criteria and then these patients will be randomly allocated to receive either a Mediterranean diet (n = 20) or only routine nutritional advice (n = 20) for 8 weeks. The primary outcome will be nutritional status, muscle mass and strength, and serum concentrations of inflammatory markers including interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and high-sensitive C-reactive protein (hs-CRP). Moreover, we will consider serum albumin and total protein levels, complete blood count (CBC), and quality of life as the secondary outcomes. All outcomes will be measured at the beginning and end (the eighth week) of the study. We will assess participants’ adherence to the prescribed diets by using a 1-day food record in the second, fourth, sixth, and eighth weeks of the study.
Discussion
Along with adequate calorie and protein intake in cancer cachexia, reducing inflammatory cytokines might be a useful strategy for maintaining nutritional status and body composition. Mediterranean diet has been shown to have anti-inflammatory properties, and by its components, it might help patients with cachexia to have a better nutritional status and quality of life.
Trial registration
Iranian Registry of Clinical Trials (www.irct.ir) RCT20211027052884N1. Prospectively registered on November 09, 2021.
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Marzban S, Shokravi S, Abaei S, Fattahi P, Karami M, Tajari F. Patient-Reported Outcome Measures of Breast Cancer Surgery: Evidence Review and Tool Adaptation. Cureus 2022; 14:e27800. [PMID: 36134055 PMCID: PMC9481225 DOI: 10.7759/cureus.27800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2022] [Indexed: 11/25/2022] Open
Abstract
The objective of this scoping review was to review survey instruments for Patient-Reported Outcome Measures (PROMs) and provide recommendations to construct a tool for PROMs specifically for breast cancer patients who have undergone surgery, to overcome the limitations of existing validated tools. A total of 924 articles were screened. Nine articles were selected based on the eligibility criteria. We found that PROMs' data collection along with advancements in the treatment of breast cancer and the resultant improved clinical outcomes, there is a growing appreciation and focus on improving patients' quality of life (QoL). Previous studies have shown that the assessment of PROMs is linked to a positive effect on patients' symptoms of distress, quality of life, acceptance, and satisfaction. Several PROMs tools have been validated for use in cancer survivors. However, it is unclear whether existing tools are appropriate for use in breast cancer patients who have undergone surgical treatment. Hence, we conducted a scoping review. Following a review of the current PROM related to breast cancer and the necessity to build specialized PROMs related to the outcomes of breast cancer surgery, we provide recommendations for the development of a comprehensive tool to overcome the limitations of existing PROMs tools.
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Effectiveness of logotherapy and nutrition counseling on psychological status, quality of life, and dietary intake among breast cancer survivors with depressive disorder: a randomized clinical trial. Support Care Cancer 2022; 30:7997-8009. [PMID: 35759049 DOI: 10.1007/s00520-022-07237-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 06/17/2022] [Indexed: 11/12/2022]
Abstract
Breast cancer (BC) can negatively influence multiple facets of survivors' lives including mental health, quality of life (QoL), and dietary behavior. Logotherapy as a psycho-education program may help breast cancer survivors (BCSs) discover their meaning of life throughout distressful events. The present study aimed to determine the effects of logotherapy along with nutrition counseling on psychological status, QoL, and dietary intake among BCSs who were diagnosed with depression.This randomized clinical trial was conducted on 90 BCSs who scored ≥ 14 on Beck's depression test. Participants were randomly assigned into two groups to receive nutrition counseling plus logotherapy (n = 46) or nutrition counseling alone (n = 44) for 8 weeks. Primary outcomes (depression, anxiety, and QoL) and secondary outcomes (anthropometric indices, dietary intake, and eating disorder status) were measured at baseline and after 8 weeks.All dimensions of QoL, anthropometric measurements, and the compulsive eating scale improved significantly in both groups after 8 weeks. A combination of nutrition counseling and logotherapy resulted in a significant reduction in anxiety (P < 0.001) and depression (P < 0.001) scores compared with the nutrition counseling alone. In addition, participants who received logotherapy plus nutrition counseling significantly consumed less energy, carbohydrate, and fat intake after 8 weeks compared with the control group (P < 0.001).It can be concluded that logotherapy along with nutrition education would be an important step in improving anxiety, depression, and QoL of patients with BC who had depressive symptoms.Trial registration number: (IR.ACECR.IBCRC.REC.1396.17).
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Cultural Adaptation and Validation of the EORTC QLQ-BR45 to Assess Health-Related Quality of Life of Breast Cancer Patients. EUROPEAN PHARMACEUTICAL JOURNAL 2022. [DOI: 10.2478/afpuc-2021-0018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Abstract
Background
The European Organization for Research and Treatment of Cancer (EORTC) QLQ-BR23 is considered a premier module for breast cancer patients that is utilised synchronously with the core questionnaire. However, new and scalable treatments on breast cancer patients’ quality of life (QoL) need a more accurate and comprehensive tool to be assessed. Therefore, the EORTC introduced the newly updated module EORTC QLQ-BR45. Hence, the current study aims to perform cultural adaptation, pilot testing and assessment of the psychometric properties of the Egyptian Arabic translation of the EORTC QLQ-BR45 module on Egyptian breast cancer patients.
Patients and Methods
First, a review of the existing Arabic translation and the modified preliminary translation was sent to a professional proofreader. Then, comprehensibility of the Egyptian Arabic translation was pilot tested on a sample of 13 breast cancer patients. Afterwards, 74 patients with proven locally advanced breast cancer receiving neoadjuvant chemotherapy at Beni-Suef University Hospital, Beni-Suef, Egypt were interviewed. A second interview was conducted post-surgery for patients receiving target therapy, endocrine therapy or radiotherapy. The psychometric properties of the EORTC QLQ-BR45 were assessed in terms of reliability, convergent and divergent validity.
Results
Adequate internal consistency reliability (Cronbach’s α coefficients >0.7) was demonstrated for the questionnaire, except for body image scale (α = 0.51) and systemic therapy side effects scale (α = 0.63). Multi-trait scaling analysis exhibited acceptable convergent and divergent validity, and scaling success was observed for all questionnaire items.
Conclusion
The Egyptian Arabic version of the EORTC QLQ-BR45 module is valid and adequately reliable. These results support using the EORTC QLQ-BR45 in future breast cancer clinical trials.
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Mohammadi F, Oshvandi K, Kamallan SR, Khazaei S, Ranjbar H, Ahmadi‐Motamayel F, Gillespie M, Jenabi E, Vafaei SY. Effectiveness of sodium bicarbonate and zinc chloride mouthwashes in the treatment of oral mucositis and quality of life in patients with cancer under chemotherapy. Nurs Open 2022; 9:1602-1611. [PMID: 35170247 PMCID: PMC8994952 DOI: 10.1002/nop2.1168] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 11/09/2021] [Accepted: 12/15/2021] [Indexed: 11/29/2022] Open
Abstract
Aim The purpose of the study is to evaluate the effectiveness of sodium bicarbonate and zinc chloride mouthwashes on oral mucositis and quality of life in patients undergoing chemotherapy. Design The present study was a randomized controlled trial study. Methods One hundred forty‐four patients with a cancer diagnosis were randomly assigned into three groups: sodium bicarbonate mouthwash (n = 48), zinc chloride mouthwash (n = 48) and placebo group (n = 48). The severity of mucositis and quality of life were examined blindly at the baseline and 3‐week follow‐up. Results The grade of oral mucositis decreased at the end of the third weeks in the sodium bicarbonate and zinc chloride groups rather than the placebo group (p < .001). The severity of oral mucositis in the sodium bicarbonate and zinc chloride groups decreased from end of the first week until third week (p < .001). In addition, there was significant difference in the severity of oral mucositis among the groups at the end of the second (p = .014) and the third weeks (p < .001). Also, there was a statistically significant difference in quality of life scores between the sodium bicarbonate and zinc chloride mouthwash with the placebo group (p < .001). Conclusion Zinc chloride and sodium bicarbonate mouthwashes were effective in treating and reducing the severity of oral mucositis, and subsequently improving quality of life in patients with cancer under chemotherapy. Therefore, we can recommend zinc chloride and sodium bicarbonate at the beginning of chemotherapy to improve oral health and promoting quality of life in these patients.
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Affiliation(s)
- Fateme Mohammadi
- Department of Pediatric Nursing, Chronic Diseases (Home Care) Research Center and Autism Spectrum Disorders Research CenterDepartment of NursingHamadan University of Medical SciencesHamadanIran
| | - Khodayar Oshvandi
- Department of Medical Surgical NursingSchool of Nursing and Midwifery, Mother and Child Care Research CenterHamadan University of Medical SciencesHamadanIran
| | - Seyed Ramesh Kamallan
- Department of Medical‐Surgical NursingStudent Research CenterHamadan University of Medical SciencesHamadanIran
| | - Salman Khazaei
- Department of EpidemiologyHealth Sciences Research CenterHealth Sciences & Technology Research InstituteHamadan University of Medical SciencesHamadanIran
| | - Hossein Ranjbar
- Department of Hematology and OncologyDepartment of Internal MedicineSchool of MedicineHamadan University of Medical SciencesHamadanIran
| | - Fatemeh Ahmadi‐Motamayel
- Department of Oral and Maxillofacial MedicineSchool of DentistryDental Research CenterHamadan University of Medical SciencesHamadanIran
| | - Mark Gillespie
- School of Health Nursing and MidwiferyUniversity of the West of ScotlandPaisleyScotland
| | - Ensiyeh Jenabi
- Research Assistant Professor of Reproductive Health (By Research)Autism Spectrum disorders Research CenterHamadan University of Medical SciencesHamadanIran
| | - Seyed Yaser Vafaei
- Department of PharmaceuticsDepartment of Pharmaceutics and Pharmaceutical BiotechnologySchool of PharmacyHamadan University of Medical SciencesHamadanIran
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Seth I, Seth N, Bulloch G, Rozen WM, Hunter-Smith DJ. Systematic Review of Breast-Q: A Tool to Evaluate Post-Mastectomy Breast Reconstruction. BREAST CANCER (DOVE MEDICAL PRESS) 2021; 13:711-724. [PMID: 34938118 PMCID: PMC8687446 DOI: 10.2147/bctt.s256393] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 11/29/2021] [Indexed: 12/12/2022]
Abstract
Purpose The aim of this systematic review is to update and synthesize new evidence on BREAST-Q questionnaire’s ability to reflect patient-reported outcomes in women who have undergone breast reconstruction surgery (BRS) following mastectomy. Methods PubMed, Science Direct, Google Scholar, Cochrane CENTRAL, and Clincaltrial.gov were searched for relevant studies from January 2009 to September 2021. Any interventional or observational studies that used BREAST-Q to assess patient-reported outcomes in the assessment of BRS following mastectomy were included. Results A total of 42 studies were eligible for inclusion in the review. Three were randomized controlled trials and 39 were observational studies. Compared with pre-operative scores, there was an improvement in all BREAST-Q outcome domains following BRS including ‘satisfaction with breasts’, “satisfaction with outcome” “psychosocial”, “physical”, and “sexual wellbeing”. Sexual well-being had the lowest BREAST-Q score both pre-and post-operatively (37.8–80.0 and 39.0–78.0, respectively). Autologous BRS reports higher satisfaction and overall wellbeing compared to implant-based BRS. BREAST-Q has a higher and narrow internal consistency of 0.81 to 0.96 compared with other patient-reported outcome measures (PROMs; EORTC-QLQ, FACT-B, BR-23, BCTOS). The BREAST-Q questionnaire is the only PROM which allows patients to reflect on their care, surgical outcomes, and satisfaction collectively. Conclusion This review highlights the fact that BREAST-Q can effectively and reliably measure satisfaction and wellbeing of breast cancer patients after BRS. Comparatively, sexual wellbeing shows poorer outcomes following BRS and more longitudinal studies are necessary to understand the basis for these findings. Compared to other PROMs, BREAST-Q is reliable and specific to breast cancer surgery. Overall, BREAST-Q can help clinicians improve their quality of service, understand patient experiences, and may be used as an auditing tool for surgical outcomes.
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Affiliation(s)
- Ishith Seth
- Department of Surgery, Bendigo Health, Bendigo, Victoria, 3550, Australia
| | - Nimish Seth
- Department of Surgery, The Alfred Hospital, Melbourne, Victoria, 3004, Australia
| | - Gabriella Bulloch
- Faculty of Science, Medicine and Health, University of Melbourne, Melbourne, Victoria, 3010, Australia
| | - Warren M Rozen
- Peninsula Clinical School, Central Clinical School at Monash University, The Alfred Centre, Melbourne, Victoria, 3004, Australia
| | - David J Hunter-Smith
- Peninsula Clinical School, Central Clinical School at Monash University, The Alfred Centre, Melbourne, Victoria, 3004, Australia
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Firouzbakht M, Hajian-Tilaki K, Moslemi D. Analysis of quality of life in breast cancer survivors using structural equation modelling: the role of spirituality, social support and psychological well-being. Int Health 2021; 12:354-363. [PMID: 31927594 PMCID: PMC7322199 DOI: 10.1093/inthealth/ihz108] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 07/29/2019] [Accepted: 10/29/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND To explore and characterize the inter-relationship between psychological well-being, spirituality, social support, comorbidity, demographic and lifestyle factors and quality of life (QoL). METHODS This cross-sectional study was conducted with 305 breast cancer survivors in northern Iran in 2017. The demographic and socio-economic data and physical activity were measured with a standard questionnaire. The standard European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 QoL scale, a system-of-belief inventory questionnaire, the social support scale, the short form of the Hospital Anxiety and Depression Scale and the fatigue severity scale (FSS) were used in data collection. In structural equation modelling analysis, we used the maximum likelihood procedure to estimate the direct and indirect effects of relevant factors on QoL. RESULTS The median age (quartile 1 [Q1], quartile 3 [Q3]) of patients was 50 y (43, 55). The psychological factors designated by anxiety, depression and FSS had a negative significant direct effect on QoL (β=-0.62). Spirituality has a positive direct effect (β=0.089) but a negligible indirect effect (β=0.020) on QoL, while the direct association of social support was almost negligible. CONCLUSIONS The findings emphasized the unifying structure of the determinants of QoL and the mediating negative association of psychological factors with QoL. Thus the supportive education efforts should focus on improving psychological well-being along with standard treatment in breast cancer survivors.
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Affiliation(s)
- Mojgan Firouzbakht
- Social Determinants of Health Research Center, Health Research Institute, Ghang-Afrouz St. Babol University of Medical Sciences, Babol, Iran
| | - Karimollah Hajian-Tilaki
- Department of Biostatistics and Epidemiology, Ghang-Afrouz St. Babol University of Medical Sciences, Babol, Iran
| | - Dariush Moslemi
- Department of Radiotherapy, School of Paramedical Sciences, Ghang-Afrouz St. Babol University of Medical Sciences, Babol, Iran
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Char S, Bloom JA, Erlichman Z, Jonczyk MM, Chatterjee A. A comprehensive literature review of patient-reported outcome measures (PROMs) among common breast reconstruction options: What types of breast reconstruction score well? Breast J 2021; 27:322-329. [PMID: 33565192 DOI: 10.1111/tbj.14186] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 01/16/2021] [Accepted: 01/20/2021] [Indexed: 01/21/2023]
Abstract
PURPOSE Breast cancer continues to be the most prevalent cancer affecting women. Many reconstructive options exist after oncologic resection. Breast reconstruction can have a lasting impact on many areas of the patient's life, and therefore, a high consideration for patient satisfaction is crucial. Patient-reported outcome measures (PROMs) provide an important tool in the evaluation of different surgical methodologies. The aim of this comprehensive systematic review is to look at various surgical modalities in breast reconstruction as they relate to patient satisfaction. METHODS A PubMed PRISMA search was performed. Criteria for inclusion included nipple-sparing or skin-sparing mastectomy with autologous or implant-based reconstruction, level 2 volume displacement or volume replacement oncoplastic surgery, and measurement of patient-reported outcomes using the BREAST-Q or other validated PROMs. From the data set, weighted proportions were generated and analyzed using the Kruskal-Wallis rank sum test and a post hoc Dunn's test. RESULTS After obtaining 254 full text copies, 43 articles met inclusion criteria and were included. Analysis of BREAST-Q data showed oncoplastic breast surgery was significantly preferred over mastectomy regardless of the type of reconstruction. Nipple-sparing was significantly preferred over skin-sparing mastectomy, autologous reconstruction was significantly preferred over implant-based reconstruction, and prepectoral implant placement was preferred over subpectoral implant placement. Validated PROMs other than BREAST-Q showed similar trends in all but type of mastectomy. CONCLUSIONS In this comprehensive systematic review, oncoplastic surgery showed the most favorable PROMs when compared to other reconstructive modalities. Autologous was preferred over implant-based reconstruction, and prepectoral was preferred over subpectoral implant placement.
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Affiliation(s)
- Sydney Char
- Tufts University School of Medicine, Boston, Massachusetts, USA
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Khodabakhshi A, Seyfried TN, Kalamian M, Beheshti M, Davoodi SH. Does a ketogenic diet have beneficial effects on quality of life, physical activity or biomarkers in patients with breast cancer: a randomized controlled clinical trial. Nutr J 2020; 19:87. [PMID: 32828130 PMCID: PMC7443288 DOI: 10.1186/s12937-020-00596-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 07/27/2020] [Indexed: 12/22/2022] Open
Abstract
Introduction Despite recent interest in the use of ketogenic diets (KDs) for cancer, evidence of beneficial effects is lacking. This study examined the impact of a randomly assigned KD on quality of life, physical activity and biomarkers in patients with breast cancer. Method A total of 80 patients with locally advanced or metastatic breast cancer and without a history of renal disease or diabetes were randomly assigned to either a KD or a control group for this 12-week trial. Concurrent with the first, third, and fifth chemotherapy sessions, quality of life, physical activity, and biomarkers (thyroid function tests, electrolytes, albumin, ammonia, ALP, lactate and serum ketones) were assessed. Dietary intake was also recorded on admission and the end of the treatment. Results No significant differences were seen in quality of life or physical activity scores between the two groups after 12 weeks; however, the KD group showed higher global quality of life and physical activity scores compared to the control group at 6 weeks (P = 0.02 P = 0.01). Also, serum lactate and ALP levels decreased significantly in the KD group compared to the control group at the end of the intervention (10.7 ± 3 vs 13.3 ± 4, 149 ± 71 vs 240 ± 164, P = 0.02 and P = 0.007, respectively). A significant inverse association was observed between total carbohydrate intake and serum beta-hydroxybutyrate at 12 weeks (r = − 0.77 P < 0.001). No significant differences between groups were observed in thyroid hormones, electrolytes, albumin, LDH or ammonia. Compliance among KD subjects ranged from 66.7 to 79.2% as assessed by dietary intake and serum ketones levels of > 0.5. Conclusion According to our results, besides a higher global quality of life and physical activity scores compared to the control group at 6 weeks, KD diet combined to chemotherapy in patients with breast cancer does not bring additional benefit about quality of life and physical activity at 12 weeks. However, decreases seen in levels of lactate and ALP in the KD group suggest that a KD may benefit patients with breast cancer. Trial registration This trial has been registered on Iranian Registry of Clinical Trials (IRCT) under the identification code: IRCT20171105037259N2 https://www.irct.ir/trial/30755
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Affiliation(s)
- Adeleh Khodabakhshi
- Department of Nutrition, School of Public Health, Kerman University of Medical Sciences, Kerman, Iran.,Physiology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | | | | | - Maryam Beheshti
- Department of Nutrition and Dietetics, Mofid children's hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sayed Hossein Davoodi
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. .,Department of Cellular and Molecular Nutrition, Faculty of Nutrition Science and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Hajian-Tilaki K, Hajian-Tilaki E. Factor structure and reliability of Persian version of hospital anxiety and depression scale in patients with breast cancer survivors. Health Qual Life Outcomes 2020; 18:176. [PMID: 32522209 PMCID: PMC7288677 DOI: 10.1186/s12955-020-01429-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Accepted: 06/02/2020] [Indexed: 11/12/2022] Open
Abstract
Introduction Anxiety and depression are significant concerns in breast cancer patients, and it may remain for a long term after primary treatments. The hospital anxiety and depression scale (HADS) is widely used to measure depressive and anxiety symptoms in clinical practices. The purpose of this study was to assess the psychometric properties of the Persian version of this scale in Iranian breast cancer survivors. Methods A total of 305 patients with breast cancer, refered to Cancer Hospital in northen Iran and completed the primary treatments were enrolled in. All patients responded to a 14-item HADS. We performed confirmatory factor analysis (CFA) to examine the factor structure of HADS and the item-scale analysis in order to estimate the item reliability and consider the Cronbach’s alpha as a measure of internal consistency. Results With a threshold of ≥8, the prevalence of anxiety and depression symptoms (moderate/severe) was 78.9 and 66.9%, respectively. The Cronbach’s alpha coefficients for anxiety and depression were 0.81 and 0.78, respectively. The CFA confirmed the two-factor structure model for HADS, indicating a good fitting summary indexes (χ2/df = 2.83, NFI = 0.88, RFI = 0.82, IFI = 0.92, CFI = 0.92, and RMSEA = 0.078). Conclusion The CFA and item reliability analysis have indicated an excellent psychometric property of the Persian version of HADS to measure depressive and anxiety symptoms in breast cancer survivors. Thus, HADS is a useful screening tool to identify post-breast cancer anxiety and depressive disorders.
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Affiliation(s)
- Karimollah Hajian-Tilaki
- Department of Biostatistics and Epidemiology, Babol University of Medical Sciences, Babol, Iran. .,Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
| | - Erfaneh Hajian-Tilaki
- Student Research Committee, Rasoul Psychiatric Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Hosseini SA, Zahrooni N, Ahmadzadeh A, Ahmadiangali K, Assarehzadegan MA. The Effect of CoQ 10 Supplementation on Quality of Life in Women with Breast Cancer Undergoing Tamoxifen Therapy: A Double-Blind, Placebo-Controlled, Randomized Clinical Trial. Psychol Res Behav Manag 2020; 13:151-159. [PMID: 32110123 PMCID: PMC7039424 DOI: 10.2147/prbm.s241431] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Accepted: 02/01/2020] [Indexed: 01/05/2023] Open
Abstract
Background Survival rates among breast cancer patients and the number of patients living with treatment side effects have improved, leading to increased focus on quality of life (QOL). The objective of this study was to determine the efficacy of CoQ10 on QOL scores among breast cancer patients in Iranian undergoing tamoxifen therapy. Methods Thirty breast cancer patients were randomized into two groups. The first group received 100 mg CoQ10, and the second group took fplacebo once a day for 8 weeks. QOL was evaluated by a standard QOL questionnaire and a specific questionnaire on QOL of breast cancer patients at baseline and the end of the study. Also, physical activity of patients was assessed with the IPAQ questionnaire and dietary intake determined by a 3-day dietary record. Results The data of 30 subjects were analyzed. According to QOL C30 data, CoQ10 led to a significant increase in physical functioning (P=0.029), emotional functioning (P=0.031), and cognitive functioning (P=0.023) compared to placebo. Symptom scales revealed a notable reduction in appetite loss in the first group (P=0.01). Global health status showed no significant changes in either study arm. On the QOL BR23, progress in functions and decline in symptoms were not statistically significant. Arm symptoms showed significant reduction (P=0.022) in patients that received placebo. Conclusion This trial indicates that CoQ10 supplementation has effects in ameliorating some dimensions of QOL in breast cancer patients. To generalize the results, larger and longer intervention studies are needed. Clinical Trial Registration IRCT2015042021874N1.
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Affiliation(s)
- Seyed Ahmad Hosseini
- Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Nazanin Zahrooni
- Department of Nutrition, Faculty of Paramedicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ahmad Ahmadzadeh
- Thalassemia and Hemoglobinopathy Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Kambiz Ahmadiangali
- Biostatistics Division, Health School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohammad-Ali Assarehzadegan
- Immunology Research Center, Institute of Immunology and Infectious Diseases, Iran University of Medical Science, Tehran, Iran
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Quality of Life and Hope Assessment in Women with Breast Cancer After Poetry Therapy as a Psychotherapy Method: A 6-Month Follow-Up Study. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT 2019. [DOI: 10.5812/ijcm.96069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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16
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Gadisa DA, Gebremariam ET, Ali GY. Reliability and validity of Amharic version of EORTC QLQ-C30 and QLQ-BR23 modules for assessing health-related quality of life among breast cancer patients in Ethiopia. Health Qual Life Outcomes 2019; 17:182. [PMID: 31830992 PMCID: PMC6909579 DOI: 10.1186/s12955-019-1257-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 12/04/2019] [Indexed: 12/24/2022] Open
Abstract
Background Breast cancer is the most common cancer among women and it affects quality of life of those women. So far, the two most frequently used tools for assessing health related quality of life in breast cancer patients, EORTC QLQ-C30 and EORTC QLQ-BR23 modules, were not validated in Ethiopia. Hence, the present study aimed to assess the psychometric properties of the tools among Ethiopian breast cancer patients. Methods Institutional based longitudinal study was conducted from January 1 to May 1, 2017 GC at only nationwide oncology center, Tikur Anbessa Specialized Hospital (TASH), Addis Ababa, Ethiopia. A total of 146 patients who visited the facility during that period, with no missing quality of life data, were selected for analysis. The psychometric properties of the EORTC QLQ-C30 and EORTC QLQ-BR23 were evaluated in terms of reliability, convergent, divergent, construct and clinical validity using SPSS version 22. Results Satisfactory internal consistency reliability (Cronbach’s α coefficients > 0.7) was confirmed, except for cognitive function (α = 0.516) of EORTC QLQ-C30 and body image (α = 0.510) of EORTC QLQ-BR23. Multiple-trait scaling analysis demonstrated a good convergent and divergent validity. No scaling errors were observed. Most items in EORTC QLQ-BR23 possessed a weak or no correlation with its own dimension in EORTC QLQ-C30 (r < 0.4) except with some of symptom scales. A statistically significant chemotherapy induced quality of life scores changes (P ≤ 0.05) were observed in all dimensions of both instruments between baseline and the end of first cycle chemotherapy, except for body image (P = 0.985) and sexual enjoyment (P = 0.817) of EORTC QLQ-BR23, indicating clinical validity. Conclusion Amharic version of the EORTC QLQ-C30 and EORTC QLQ-BR23 modules are valid and adequately reliable tool and can be used for clinical and epidemiological cancer researches to study the health related quality of life (HRQoL) of women with breast cancer in Ethiopia.
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Affiliation(s)
- Diriba Alemayehu Gadisa
- Lecturer of pharmacology at Pharmacy department, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia.
| | - Esayas Tadesse Gebremariam
- Lecturer of pharmacoepidemiology and social pharmacy at Pharmacy department, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
| | - Getnet Yimer Ali
- Global One Health initiative, Office of International Affairs, The Ohio State University, Columbus, Ohio, USA
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Cordova LZ, Hunter-Smith DJ, Rozen WM. Patient reported outcome measures (PROMs) following mastectomy with breast reconstruction or without reconstruction: a systematic review. Gland Surg 2019; 8:441-451. [PMID: 31538070 DOI: 10.21037/gs.2019.07.02] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The cornerstone of reconstructive surgery following mastectomy is to restore cosmesis and improve physical and psychological health. Consequently, it has become essential for instruments that measure surgical outcomes to include the direct perspective of patients. Many reviews have failed to show significant improvements in quality of life domains following breast reconstruction compared to mastectomy alone. However, with advances in surgical techniques and patient reported outcome measure (PROM) assessment tools designed precisely for breast reconstruction patients, a modern systematic review is warranted. An electronic literature review was performed using CINAHL, Cochrane Library and Medline (using PubMed) comparing patient reported outcome measures of patients undergoing mastectomy alone versus patients undergoing mastectomy with breast reconstruction. Studies in the English and Portuguese languages since the year 2000 were included. The review was undertaken adhering to PRISMA guidelines with last entry on the 31/5/2018. Full text review yield 42 articles of relevance to the inclusion criteria. The most widely used PROM instruments such as Breast-Q, EORTC-Q30/Q23, Short Form 36, FACT-B and others are explored. The specific difficulties conducting such studies and biases identified are investigated further. Studies comparing mastectomy alone against mastectomy with reconstruction show difficulties forming groups with similar clinical and epidemiological characteristics. There are inherent limitations to performing a randomised controlled trial on this topic, including matching patient groups in terms of age, socioeconomical background and cancer staging, and this affects the results of the PROM instruments. Within these limitations, the literature suggests that PROM support the use of breast reconstruction following mastectomy but care must be made selecting patients. The finding is supported by the National Institute for Health and Clinical Excellence (NICE) guidelines which state that breast reconstruction should be offered to all women undergoing breast cancer surgery.
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Affiliation(s)
- Leonardo Z Cordova
- Department of Plastic, Reconstructive and Hand Surgery, Peninsula Health, Frankston, Australia.,Peninsula Clinical School, Central Clinical School at Monash University, The Alfred Centre, Melbourne, Australia
| | - David J Hunter-Smith
- Department of Plastic, Reconstructive and Hand Surgery, Peninsula Health, Frankston, Australia.,Peninsula Clinical School, Central Clinical School at Monash University, The Alfred Centre, Melbourne, Australia
| | - Warren M Rozen
- Department of Plastic, Reconstructive and Hand Surgery, Peninsula Health, Frankston, Australia.,Peninsula Clinical School, Central Clinical School at Monash University, The Alfred Centre, Melbourne, Australia
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18
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Şahin S, Uyanık M. The impact of occupation-based problem-solving strategies training in women with breast cancer. Health Qual Life Outcomes 2019; 17:104. [PMID: 31208425 PMCID: PMC6580619 DOI: 10.1186/s12955-019-1170-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 06/02/2019] [Indexed: 11/29/2022] Open
Abstract
Background By identifying the occupations of women with breast cancer who have performance problems, to examine the impact of the application of occupation-based problem-solving strategies (OB-PSS) training on cancer-related fatigue, depression, and quality of life. Methods The study comprises 22 women outpatients in the clinic. Socio- demographic and Clinical Features Information Collection Form, Canadian Occupational Performance Measure (COPM), Cancer Fatigue Scale (CFS), Beck Depression Inventory (BDI), The European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire C-30 and BR23 (EORTC QOL-C30 - EORT QOL-BR23) tests have been applied to survivors. OB-PSS training was conducted on a face-to-face basis once a week for 6 weeks. Results When activity distribution results in accordance with the performance areas are studied, women with breast cancer were seen to suffer problems mostly in their most productive areas (housework management). As a means of solving these performance problems, they developed adaptive strategies like including additional new steps to these activities. Statistically meaningful results have been obtained between measurements before and after the treatment process through all tests (p < 0.01). Conclusions OB-PSS provides positive gains in women with breast cancer in terms of a reduction in the degree of cancer-related fatigue and depression, and a progress in performance and satisfaction levels particularly in activities where performance problems are experienced and an improvement in quality of life. OB-PSS training could be used as an appropriate rehabilitation approach for coping with problems in women’ life with breast cancer.
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Affiliation(s)
- Sedef Şahin
- Faculty of Health Sciences, Department of Occupational Therapy, Hacettepe University, Samanpazarı, 06100, Ankara, Turkey.
| | - Mine Uyanık
- Faculty of Health Sciences, Department of Occupational Therapy, Hacettepe University, Samanpazarı, 06100, Ankara, Turkey
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19
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Dehghan H, Keshtkaran A, Ahmadloo N, Bagheri Z, Hatam N. Patient Involvement in Care and Breast Cancer Patients’ Quality of Life- a Structural Equation Modeling (SEM)
Approach. Asian Pac J Cancer Prev 2018; 19:2511-2517. [PMID: 30256045 PMCID: PMC6249441 DOI: 10.22034/apjcp.2018.19.9.2511] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 06/18/2018] [Indexed: 11/27/2022] Open
Abstract
In cancer patients, improving the quality of life is a basic goal of treatment, with the patient – physician relationship as a major factor. Therefore the aim of this structural equation modeling study was to analyze the influence of patient involvement in care on quality of life in 411 breast cancer patients undergoing outpatient chemotherapy and radiotherapy. Two questionnaires were used: 1-patient-physician questionnaire, 2-EORTC QLQC-30 (to measure QOL). The structural equation model exhibited an excellent data fit (Chi-Square= 31.04 / RMSEA= 0.042), T-values for all paths with the exception of that between patient satisfaction and emotional- cognitive function, were significant. According to the findings, various aspects of the physician-patient relationship are significantly and positively associated with quality of life and increasing patient involvement in care by increasing trust and satisfaction, was associated with marked improvement. The findings of this study emphasized the importance of an effective relationship between doctor and patient as a contributing factor for improving the quality of life. Therefore it is suggested that policymakers and decision-makers active in strategic planning for the health system and physicians responsible for treatment pay more attention to developing and improving relationships with patients as an approach to improving patient outcomes, particularly with reference to quality of life.
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Affiliation(s)
- Hajar Dehghan
- Students Research Committee, School of Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Keshtkaran
- Department of Health Service Administration, School of Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Niloofar Ahmadloo
- Department of Radiotherapy and Oncology, school of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Bagheri
- Department of Biostatistics, school of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nahid Hatam
- Department of Health Service Administration, School of Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
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20
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Relationship Between Defense Mechanisms and the Quality of Life in Women With Breast Cancer. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT 2018. [DOI: 10.5812/ijcm.11116] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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21
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22
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Shin WK, Song S, Jung SY, Lee E, Kim Z, Moon HG, Noh DY, Lee JE. The association between physical activity and health-related quality of life among breast cancer survivors. Health Qual Life Outcomes 2017; 15:132. [PMID: 28666465 PMCID: PMC5493872 DOI: 10.1186/s12955-017-0706-9] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 06/20/2017] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND The quality of life for breast cancer survivors has become increasingly important because of their high survival rate and prolonged life expectancy. The purpose of this study was to examine the association of physical activity following diagnosis and health-related quality of life (HRQOL) in breast cancer survivors. METHODS We conducted a cross-sectional study of breast cancer survivors. A total of 231 women aged 21-78 years who had been diagnosed with stages I to III breast cancer and had breast cancer surgery at least 6 months prior were recruited from three hospitals between September 2012 and April 2015 and were included in this study. We asked participants about their HRQOL and engagement in physical activity using structured questionnaires. We examined the association between HRQOL levels and physical activity using a generalized linear model. RESULTS Breast cancer survivors in the high physical activity group (3rd tertile) were more likely to have lower scores for fatigue (p for trend = 0.001) and pain (p for trend = 0.02) and higher scores for sexual function (p for trend = 0.007) than those in the low physical activity group (1st tertile). When we stratified participants by stage, we found increasing scores for physical functioning (p for trend =0.01) and decreasing scores for fatigue (p for trend = 0.02) with increasing levels of physical activity in breast cancer survivors with stage I breast cancer. In survivors with stages II and III, we found statistically significant associations with fatigue (p for trend = 0.02) and sexual functioning (p for trend = 0.001). CONCLUSIONS In conclusion, engagement in physical activity was related to better health-related quality of life among breast cancer survivors. Our findings may warrant further prospective and intervention studies to support the benefit of physical activity in improving the quality of life and survival of Korean breast cancer survivors.
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Affiliation(s)
- Woo-Kyoung Shin
- Research Institute of Human Ecology, Seoul National University, Seoul, 08826, South Korea
| | - Sihan Song
- Department of Food and Nutrition, Sookmyung Women's University, Seoul, 04310, South Korea
| | - So-Youn Jung
- Breast Cancer Center, National Cancer Center, Goyang, 10408, South Korea
| | - Eunsook Lee
- Breast Cancer Center, National Cancer Center, Goyang, 10408, South Korea
| | - Zisun Kim
- Department of Surgery, Soonchunhyang University Bucheon Hospital, Bucheon, 14584, South Korea
| | - Hyeong-Gon Moon
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, 03080, South Korea
| | - Dong-Young Noh
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, 03080, South Korea
| | - Jung Eun Lee
- Research Institute of Human Ecology, Seoul National University, Seoul, 08826, South Korea. .,Department of Food and Nutrition, Seoul National University, Seoul, 08826, South Korea.
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Fabi A, Falcicchio C, Giannarelli D, Maggi G, Cognetti F, Pugliese P. The course of cancer related fatigue up to ten years in early breast cancer patients: What impact in clinical practice? Breast 2017; 34:44-52. [PMID: 28500901 DOI: 10.1016/j.breast.2017.04.012] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 04/24/2017] [Accepted: 04/25/2017] [Indexed: 11/29/2022] Open
Abstract
Little is known about the cancer related fatigue (CRF) along cancer course and risk factors that could predict CRF development and persistence in breast cancer (BC) survivors. This prospective study detected incidence, timing of onset, duration of CRF, impact on QoL and psychological distress. Seventy-eight early BC patients, undergoing chemotherapy (CT) followed or not by hormonal therapy were assessed for QoL and psychological distress by EORTC QLQC30 and HADs questionnaires. Fatigue was investigated with mix methods, structured interview and psychometric measures. A qualitative analysis was added to assess the behavioral pattern of CRF. Low fatigue levels were identified after surgery (9%), increasing during (49%) and at the end of CT (47%), maintaining after 1 year (31%) and declining up to ten years of follow-up. Prevalence of CRF was higher at the end of CT and lower at follow-up. At the end and after 1 and 2 years from CT, persistence of CRF was associated to anxiety in 20%, 11% and 5% and to depression in 15%, 10% and 5% respectively. A relationship between CRF and psychological distress was observed; patients presenting depression and anxiety before CT were at higher risk for fatigue onset at a later period. A relationship between fatigue and QoL was noted at the end of CT. Our study shows the fatigue timely trend in early BC patients from surgery, CT and follow-up. Identification of biological, psychological, social predictor factors related to fatigue could be helpful for early interventions in patients at higher risk of developing fatigue.
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Affiliation(s)
- Alessandra Fabi
- Regina Elena National Cancer Institute, Division of Medical Oncology 1, via Elio Chianesi 53, 00124, Rome, Italy.
| | - Chiara Falcicchio
- Regina Elena National Cancer Institute, Service of Psiconcology, via Elio Chianesi 53, 00124, Rome, Italy
| | - Diana Giannarelli
- Regina Elena National Cancer Institute, Biostatistic Unit, via Elio Chianesi 53, 00124, Rome, Italy
| | - Gabriella Maggi
- Regina Elena National Cancer Institute, Service of Psiconcology, via Elio Chianesi 53, 00124, Rome, Italy
| | - Francesco Cognetti
- Regina Elena National Cancer Institute, Division of Medical Oncology 1, via Elio Chianesi 53, 00124, Rome, Italy
| | - Patrizia Pugliese
- Regina Elena National Cancer Institute, Service of Psiconcology, via Elio Chianesi 53, 00124, Rome, Italy
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Questionnaire to assess quality of life in patients with breast cancer – Validation of the Chinese version of the EORTC QLQ-BR 53. Breast 2017; 32:87-92. [DOI: 10.1016/j.breast.2016.12.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 12/18/2016] [Accepted: 12/26/2016] [Indexed: 11/24/2022] Open
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25
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Tabrizi FM, Radfar M, Taei Z. Effects of supportive-expressive discussion groups on loneliness, hope and quality of life in breast cancer survivors: a randomized control trial. Psychooncology 2016; 25:1057-63. [DOI: 10.1002/pon.4169] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 04/24/2016] [Accepted: 05/02/2016] [Indexed: 01/22/2023]
Affiliation(s)
| | - Moloud Radfar
- Nursing and Midwifery Department; Urmia University of Medical Sciences; Urmia Iran
| | - Zeynab Taei
- Student Research Center; Urmia University of Medical Sciences; Urmia Iran
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26
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Melam GR, Buragadda S, Alhusaini AA, Arora N. Effect of complete decongestive therapy and home program on health- related quality of life in post mastectomy lymphedema patients. BMC Womens Health 2016; 16:23. [PMID: 27145867 PMCID: PMC4855407 DOI: 10.1186/s12905-016-0303-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Accepted: 04/26/2016] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Secondary lymphedema is common in women treated for breast cancer. It may be a result of surgery or radiotherapy. Edema commonly affects the arm, leading to discomfort, reduced arm movements, pain and diminished quality of life. Therefore, the relationship between post mastectomy lymphedema and quality of life has evolved as an important criteria in treatment of breast cancer survivors. METHODS Sixty breast cancer survivors who developed post mastectomy lymphedema were recruited. Patients were divided into 2 groups (n = 30) according to the treatment they received; Conventional therapy (CT) and Complete Decongestive Therapy (CDT) groups. Measurements were taken at baseline, 4 and 6 weeks. Health related Quality of Life was evaluated with the EORTC QLQ C30 and EORTC QLQ-BR23 questionnaires. Pain was measured using the Visual Analogue Scale. Descriptive statistics were used to analyze participant demographics and repeated measures of ANOVA was used for within and between group comparisons. RESULTS Both groups showed improved quality of life and diminished pain after 6 weeks of treatment. However, greater improvement was observed in CDT group compared to the CT group. CONCLUSION In this study, remedial exercises and home program in addition to manual lymphatic drainage and compression bandaging resulted in improved quality of life. Early identification of lymphedema and incorporation of remedial exercises and a home program improve the quality of life for breast cancer survivors. TRIAL REGISTRATION Trial registry ID: ISRCTN13242080 , Date of registration: 7 April 2016.
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Affiliation(s)
- Ganeswara Rao Melam
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, PO Box 10219, Riyadh, 11433, Saudi Arabia
| | - Syamala Buragadda
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, PO Box 10219, Riyadh, 11433, Saudi Arabia.
| | - Adel A Alhusaini
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, PO Box 10219, Riyadh, 11433, Saudi Arabia
| | - Nisha Arora
- Maharishi Markendeshwar Institute of Physiotherapy and Rehabilitation, M.M University, Mullana, India
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Hadi N, Shabaninezhad E, Shabgard Shahraki Z, Montazeri A, Tahmasebi S, Zakeri Z, Talei A. The Reduction in Upper Extremity Volume and Improved Quality of Life in Women With Post-Mastectomy Lymphedema by Complex Decongestive Therapy. WOMEN’S HEALTH BULLETIN 2016. [DOI: 10.17795/whb-29324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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28
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Nguyen J, Popovic M, Chow E, Cella D, Beaumont JL, Chu D, DiGiovanni J, Lam H, Pulenzas N, Bottomley A. EORTC QLQ-BR23 and FACT-B for the assessment of quality of life in patients with breast cancer: a literature review. J Comp Eff Res 2015; 4:157-66. [DOI: 10.2217/cer.14.76] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background: This study aims to compare the development, characteristics and validity of two widely used tools in the breast cancer population, the EORTC QLQ-BR23 and the FACT-B. Methods: A literature search was conducted using Ovid MEDLINE, OLDMEDLINE, Embase, Embase Classic and the Cochrane Central Register of Controlled Trials to identify relevant studies. Results: Both tools were found to be reliable and valid. The QLQ-BR23 focuses on physical function, whereas the FACT-B emphasizes emotional well-being. Scoring, item format, organization and response options differ between questionnaires. Conclusion: Overall, both questionnaires are effective in assessing breast cancer-specific quality of life. Clear similarities and differences between the two tools exist. Decision-making between the questionnaires should be based on the purpose and design of the study.
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Affiliation(s)
- Jasmine Nguyen
- Rapid Response Radiotherapy Program, Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada
| | - Marko Popovic
- Rapid Response Radiotherapy Program, Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada
| | - Edward Chow
- Rapid Response Radiotherapy Program, Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada
| | - David Cella
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Jennifer L Beaumont
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Dominic Chu
- Rapid Response Radiotherapy Program, Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada
| | - Julia DiGiovanni
- Rapid Response Radiotherapy Program, Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada
| | - Henry Lam
- Rapid Response Radiotherapy Program, Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada
| | - Natalie Pulenzas
- Rapid Response Radiotherapy Program, Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada
| | - Andrew Bottomley
- European Organisation for Research & Treatment of Cancer Headquarters, Brussels, Belgium
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Niu HY, Niu CY, Wang JH, Zhang Y, He P. Health-related quality of life in women with breast cancer: a literature-based review of psychometric properties of breast cancer-specific measures. Asian Pac J Cancer Prev 2015; 15:3533-6. [PMID: 24870752 DOI: 10.7314/apjcp.2014.15.8.3533] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Breast cancer is one of the most common cancers in women in the world. Health-related quality of life (HRQL) at treatment endpoint in cancer clinical trials is widely considered to be increasingly important. The aim of this review was to provide a literature-based assessment of the validity, reliability and responsiveness of breast cancer-specific HRQL instruments in women breast cancer patients. MATERIALS AND METHODS The databases consulted were Medline, PubMed, and Embase. The inclusion criteria required studies to: (1) involve use of HRQL measures; (2) cover women with breast cancer under standard treatment (surgery, radiation therapy, chemotherapy, hormone therapy, and targeted therapy); (3) involve the validity, reliability, or responsiveness of HRQL; (4) deal with validation of breast cancer-specific HRQL instruments. RESULTS A total of 16 studies were identified through the literature search that met the 4 inclusion criteria. Some seven instruments were assessed among these 16 studies: EORTC QLQ-BR23, FACT-B, FACT-ES, HFRDIS, LSQ- 32, QLICP-BR, and SLDS-BC. EORTC QLQ-BR23, FACT-B, LSQ-32, QLICP-BR, and SLDS-BC are more general breast cancer-specific HRQL instruments. FACT-EB is the endocrine subscale combined with FACT-B in order to measure the side effects and putative benefits of hormonal treatment administered in breast cancer patients. HFRDIS is the HRQL measure focusing on hot flash concerns. CONCLUSIONS This paper provides an overall understanding on the currently available breast cancer-specific HRQL instruments in women breast cancer patients.
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Affiliation(s)
- Hui-Yan Niu
- Department of Geriatrics, Shengjing Hospital, China Medical University, Shenyang, China E-mail :
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Evaluation of cross-cultural adaptation and measurement properties of breast cancer-specific quality-of-life questionnaires: a systematic review. Qual Life Res 2014; 24:1179-95. [PMID: 25391488 DOI: 10.1007/s11136-014-0840-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE To assess the procedures of translation, cross-cultural adaptation, and measurement properties of breast cancer-specific quality-of-life questionnaires. METHODS Searches were conducted in the databases MEDLINE, EMBASE, CINAHL, and SciELO using the keywords: "Questionnaires," "Quality of life," and "Breast cancer." The studies were analyzed in terms of methodological quality according to the guidelines for the procedure of cross-cultural adaptation and the quality criteria for measurement properties of questionnaires. RESULTS We found 24 eligible studies. Most of the articles assessed the translation and measurement properties of the instrument EORTC QLQ-BR23. Description about translation and cross-cultural adaptation was incomplete in 11 studies. Translation and back translation were the most tested phases, and synthesis of the translation was the most omitted phase in the articles. Information on assessing measurement properties was provided incompletely in 23 articles. Internal consistency was the most tested property in all of the eligible articles, but none of them provided information on agreement. Construct validity was adequately tested in only three studies that used the FACT-B and QLQ-BR23. Eight articles provided information on reliability; however, only four found positive classification. Responsiveness was tested in four articles, and ceiling and floor effects were tested in only three articles. None of the instruments showed fully adequate quality. CONCLUSION There is limited evidence on cross-cultural adaptations and measurement properties; therefore, it is recommended that caution be exercised when using breast cancer-specific quality-of-life questionnaires that have been translated, adapted, and tested.
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Law KS, Azman N, Omar EA, Musa MY, Yusoff NM, Sulaiman SA, Hussain NHN. The effects of virgin coconut oil (VCO) as supplementation on quality of life (QOL) among breast cancer patients. Lipids Health Dis 2014; 13:139. [PMID: 25163649 PMCID: PMC4176590 DOI: 10.1186/1476-511x-13-139] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Accepted: 08/23/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Breast cancer is the most common cancer amongst Malaysian women. Both the disease and its treatment can disrupt the lives of the woman and adversely affect all aspects of life and thus can alter a woman's quality of life. The aim of this study was to examine the effect of virgin coconut oil (VCO) on the quality of life (QOL) of patients diagnosed with breast cancer. METHODS This was a prospective study of breast cancer patients admitted into the Oncology Unit of Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia. The sample consisted of 60 patients with stage III and IV breast cancer allocated to either an intervention group (n = 30) or a control group (n = 30) using a simple random table. QOL was evaluated from the first cycle of chemotherapy to the sixth cycle, and data were collected using a validated Bahasa Malaysia version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Breast Cancer Module (EORTC QLQ-C30) and its breast-specific module (QLQ-BR 23). RESULTS The mean age of breast cancer patients was 50.2 (SD = 13.5) years. There were significant mean score differences for functioning and global QOL between groups (α < 0.01). The intervention group also had better scores for symptoms including fatigue, dyspnea, sleep difficulties, and loss of appetite compared to the control group. Although there are deteriorations for sexual enjoyment, the intervention group exhibited improvement in breast functioning and symptom scores for body image, sexual function, future perspective, breast symptoms, and systemic therapy side effects. CONCLUSION VCO consumption during chemotherapy helped improve the functional status and global QOL of breast cancer patients. In addition, it reduced the symptoms related to side effects of chemotherapy.
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Affiliation(s)
- Kim Sooi Law
- Institut Perubatan dan Pergigian Termaju, Universiti Sains Malaysia, Bertam, 13200 Kepala Batas, Pulau Pinang, Malaysia.
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El Fakir S, Abda N, Bendahhou K, Zidouh A, Bennani M, Errihani H, Benider A, Bekkali R, Nejjari C. The European Organization for Research and Treatment of Cancer quality of life questionnaire-BR23 Breast Cancer-Specific Quality of Life Questionnaire: psychometric properties in a Moroccan sample of breast cancer patients. BMC Res Notes 2014; 7:53. [PMID: 24447401 PMCID: PMC3906893 DOI: 10.1186/1756-0500-7-53] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Accepted: 01/07/2014] [Indexed: 11/20/2022] Open
Abstract
Background Quality of life (QOL) and its measurement in cancer patients is becoming increasingly important. Breast cancer diagnosis and treatment are often associated with psychological distress and reduced QoL. In Arabic-speaking countries, QoL of patients with cancer is inadequately studied. The aim of this study was to test the reliability and validity of the Moroccan Arabic version of the European Organization for Research and Treatment of Cancer (EORTC) Breast Cancer-Specific Quality of Life Questionnaire (QLQ-BR23). Methods After translation and cross-cultural adaptation, the questionnaire was tested on breast cancer patients. The participants’ number for the test and the retest were 105 and 37 respectively. Internal consistency was tested using Cronbach’s alpha coefficient (α), the test-retest reliability using intraclass correlation coefficients (ICC). Construct validity was assessed by examining item-convergent and divergent validity. Results The questionnaire was administered to 105 patients. The mean age of patients was 48 years (SD: 16), 62.9% were married. 68.6% of all participants lived in urban area. The average time to complete the QLQ- BR23 was 15 min. Cronbach’s alpha coefficient, were all >0.7, with the exception of breast symptoms and arm symptoms. All items exceeded the 0.4 criterion for convergent validity except item 20 and 23 related to pain and skin problems in the affected breast respectively. Conclusion In general, the findings of this study indicated that the Moroccan Arabic version of the EORTC QLQ-BR23 is a reliable and valid supplementary measure of the QOL in breast cancer patients and can be used in clinical trials and studies of outcome research in oncology.
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Affiliation(s)
- Samira El Fakir
- Department of epidemiology and public health, Faculty of Medicine, University Sidi Mohammed Ben Abdellah, Fez, Morocco.
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Jafari N, Farajzadegan Z, Zamani A, Bahrami F, Emami H, Loghmani A, Jafari N. Spiritual therapy to improve the spiritual well-being of Iranian women with breast cancer: a randomized controlled trial. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2013; 2013:353262. [PMID: 24023572 PMCID: PMC3759260 DOI: 10.1155/2013/353262] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/27/2013] [Revised: 06/26/2013] [Accepted: 07/18/2013] [Indexed: 02/03/2023]
Abstract
Purpose. The aim of this study was to investigate the role of spiritual therapy intervention in improving the spiritual well-being and quality of life (QOL) of Iranian women with breast cancer. Methods. This randomized controlled clinical trial (RCT) recruited 65 women with breast cancer, randomly assigned to a 6-week spirituality-based intervention (n = 34) or control group (n = 31). Before and after six-week spiritual therapy intervention, spiritual well-being and quality of life (QOL) were assessed using Functional Assessment of Chronic Illness Therapy Spiritual Well-being scale (FACIT-Sp12) and cancer quality-of-life questionnaire (QLQ-C30), respectively. t-test, Paired t-test, pearson's correlation, and hierarchical regression analyses were used for analysis using Predictive Analytic software (PASW, version 18) for Windows. Results. After six spiritual therapy sessions, the mean spiritual well-being score from 29.76 (SD = 6.63) to 37.24 (SD = 3.52) in the intervention group (P < 0.001). There was a significant difference between arms of study (F = 22.91, P < 0.001). A significant positive correlation was detected between meaning and peace with all subscales of functional subscales on European Organization for Research and Treatment of Cancer quality of Life (EORTC QLQ-C30) (P < 0.05). Hierarchical regression analyses of participants indicated that the study arm, pain, and financial impact were significant predictors of spiritual well-being and overall QOL. Social functioning was another significant predictor of spiritual well-being. Conclusion. The results of this randomized controlled trial study suggest that participation in spiritual therapy program is associated with improvements in spiritual well-being and QOL. Targeted interventions to acknowledge and incorporate spiritual needs into conventional treatment should be considered in caring of Iranian patients with breast cancer.
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Affiliation(s)
- Najmeh Jafari
- Community Medicine Department, School of Medicine, Isfahan University of Medical Sciences, Hezar Jerib Street, Isfahan, Iran
| | - Ziba Farajzadegan
- Community Medicine Department, School of Medicine, Isfahan University of Medical Sciences, Hezar Jerib Street, Isfahan, Iran
| | - Ahmadreza Zamani
- Community Medicine Department, School of Medicine, Isfahan University of Medical Sciences, Hezar Jerib Street, Isfahan, Iran
| | - Fatemeh Bahrami
- Consultation Department, Psychology school, Isfahan University, Hezar Jerib Street, Isfahan, Iran
| | - Hamid Emami
- Radiotherapy Department, School of Medicine, Isfahan University of Medical Sciences, Hezar Jerib Street, Isfahan, Iran
| | - Amir Loghmani
- Community Medicine Department, School of Medicine, Isfahan University of Medical Sciences, Hezar Jerib Street, Isfahan, Iran
| | - Nooshin Jafari
- Anesthesiology Department, School of Medicine, Isfahan University of Medical Sciences, Hezar Jerib Street, Isfahan, Iran
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Jafari N, Farajzadegan Z, Zamani A, Bahrami F, Emami H, Loghmani A. Spiritual well-being and quality of life in Iranian women with breast cancer undergoing radiation therapy. Support Care Cancer 2012; 21:1219-25. [PMID: 23138932 DOI: 10.1007/s00520-012-1650-1] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2012] [Accepted: 10/30/2012] [Indexed: 12/12/2022]
Abstract
PURPOSE Psychological distress and morbidity are common consequences of diagnosis and treatment of breast cancer and associated with poor quality of life (QOL). Spiritual well-being is an important aspect of QOL, but little is known about the spiritual well-being and its relationship with QOL in patients of different cultures such as Iranian Muslim patients. The aim of this study was to investigate the association of QOL and spirituality among patients with breast cancer undergoing radiation therapy. METHODS This was a cross-sectional study which was conducted in the Breast Cancer Research Center of St. S. Al-Shohada Hospital, Isfahan, Iran. Spiritual well-being was measured using the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale (FACIT-Sp12). The European Organisation for Research and Treatment of Cancer Quality of Life (EORTC QLQ-C30) and its supplementary breast cancer questionnaire (QLQ-BR23) were used to assess the quality of life of patients. Descriptive analysis, Pearson's correlation, and multiple regression analysis were performed for statistical assessment. RESULTS In all, 68 patients fulfilled the study's inclusion criteria and were interviewed. The mean global QOL was 41.42 (SD = 18.02), and the mean spiritual well-being was 28.41 (SD = 6.95). There was a significant positive correlation between general QOL and total spiritual well-being scores. Also, spiritual well-being, social functioning, pain, and arm symptoms were significant predictors of global QOL. DISCUSSION The results of this study provide evidence that breast cancer survivors in Iran experience a poor quality of life across a broad spectrum of health domains, particularly social, emotional, and spiritual, indicating that psychosocial-spiritual support should be considered in caring for patients with breast cancer.
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Affiliation(s)
- Najmeh Jafari
- Community Medicine Department, School of Medicine, Isfahan University of Medical Sciences, Hezar Jerib St., Isfahan, Iran
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Abstract
The renin-angiotensin system (RAS) is a hormonal cascade that acts together to regulate blood pressure. Angiotensin II (Ang II) is the major octapeptide of RAS and mediates its cellular and physiological actions by acting on AT1 and AT2 receptor. Most of the cellular and physiological actions of Ang II such as cellular growth and proliferation, vasoconstriction, antinatriuresis and increase in blood pressure are mediated via AT1 receptor. The functions associated with the AT2 receptors are less studied, in part, due to its lower expression in adult tissues. However, AT2 receptor has been suggested as functional antagonist of AT1 receptors and thereby opposes the actions of Ang II mediated via AT1 receptor. Thus, the activation of AT2 receptors has been shown to cause vasodilatation, natriuresis and decrease in blood pressure. After the discovery of the AT2 receptor in various parts of the kidney, including in proximal tubules, there has been an interest in establishing a link between the renal AT2 receptor, renal Na-excretion and blood pressure regulation. Earlier, we have reported that activation of renal AT2 receptors increases urinary Na excretion in obese Zucker rats, in part via inhibiting Na+/K+- ATPase (NKA) activity and stimulating nitric oxide/cGMP pathway in the proximal tubules. An impaired pressure natriuresis and increased AT1 receptor function is believed to be the cause of hypertension in obese Zucker rats and other animal models of obesity. In this review, we are focussing on the role of renin angiotensin system especially AT2 receptors in obesity associated hypertension.
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Affiliation(s)
- Quaisar Ali
- Heart and Kidney Institute, Department of Pharmacological and Pharmaceutical Sciences, University of Houston, Houston, TX 77204, USA; Department of Pharmacal Sciences, Harrison School of Pharmacy, Auburn University, Auburn AL 36849, USA
| | - Tahir Hussain
- Heart and Kidney Institute, Department of Pharmacological and Pharmaceutical Sciences, University of Houston, Houston, TX 77204, USA; Department of Pharmacal Sciences, Harrison School of Pharmacy, Auburn University, Auburn AL 36849, USA
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Kontodimopoulos N, Samartzis A, Papadopoulos AA, Niakas D. Reliability and validity of the Greek QLQ-C30 and QLQ-MY20 for measuring quality of life in patients with multiple myeloma. ScientificWorldJournal 2012; 2012:842867. [PMID: 22919356 PMCID: PMC3419404 DOI: 10.1100/2012/842867] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2012] [Accepted: 06/10/2012] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES The aim of this study was to assess the psychometric properties of the Greek EORTC QLQ-C30 and QLQ-MY20 instruments. METHOD A sample of myeloma patients (N = 89) from two tertiary hospitals were surveyed with the QLQ-C30, QLQ-MY20 and various demographic and disease related questions. The previously validated Greek SF-36 instrument was used as a "gold standard" for health-related quality of life (HRQoL) comparisons. Hypothesized scale structure, internal consistency reliability (Cronbach's alpha) and various forms of construct validity (convergent, discriminative, concurrent and known-groups) were assessed. RESULTS Multitrait scaling confirmed scale structure of the QLQ-C30 and QLQ-MY20, with good item convergence (96% and 72%) and discrimination (78% and 58%) rates. Cronbach's α was >0.70 for all but one scale (cognitive functioning). Spearman's correlations between similar QLQ-C30 and SF-36 scales ranged between 0.35-0.80 (P < 0.001). Expected interscale correlations and known-groups comparisons supported construct validity. QLQ-MY20 scales showed comparatively lower correlations with QLQ-C30 functional scales, and higher correlations with conceptually related symptom scales. CONCLUSIONS The observed psychometric properties of the two instruments imply suitability for assessing myeloma HRQoL in Greece. Future studies should focus on generalizability of the results, as well as on specific issues such as longitudinal validity and responsiveness.
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Affiliation(s)
- Nick Kontodimopoulos
- School of Social Sciences, Hellenic Open University, Bouboulinas 57-59, 26222 Patras, Greece.
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Jafari N, Zamani A, Farajzadegan Z, Bahrami F, Emami H, Loghmani A. The effect of spiritual therapy for improving the quality of life of women with breast cancer: a randomized controlled trial. PSYCHOL HEALTH MED 2012; 18:56-69. [PMID: 22533516 DOI: 10.1080/13548506.2012.679738] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Diagnosis of breast cancer is a devastating psychological experience for a woman. Also, treatments such as radiation therapy may cause psychosocial distress in these patients and threaten their quality of life (QOL). Among several approaches, spirituality has been shown to be significantly associated with improving the QOL. The aim of this study was to assess the role of spiritual therapy intervention in improving the QOL of patients with breast cancer undergoing radiation therapy. This was a randomized controlled trial study undertaken in a radiotherapy clinic, Isfahan, Iran. Between October 2010 and February 2011, 68 patients under radiation therapy were randomized to either spiritual therapy intervention group or control group who received routine management and educational programs. Before and after six weeks of spiritual therapy sessions, the QOL was evaluated using Cancer quality-of-life questionnaire (QLQ)-C30 and breast cancer-specific questionnaire (BR-23). Multivariate, repeated-measures ANOVA, t-test, and Paired t-test were used for analysis using Predictive Analytic Soft Ware (PASW, version 18) for windows. In all, 65 patients actually completed the six-week intervention and were evaluated for the outcome. The mean Global health status score/QOL reached from 44.37 (SD = 13.03) to 68.63 (SD = 10.86), (p = 0.00). There was a statistically significant difference in all functional scales of QLQ-C30 after intervention (p < 0.05). The results of this trial showed that the spiritual therapy program can improve the overall QOL of women with breast cancer; therefore, it could be adopted in comprehensive care programs for women with breast cancer.
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Affiliation(s)
- Najmeh Jafari
- Community Medicine Department, Isfahan University of Medical Sciences, Isfahan, Iran
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Poorkiani M, Abbaszadeh A, Hazrati M, Jafari P, Sadeghi M, Mohammadianpanah M. The effect of rehabilitation on quality of life in female breast cancer survivors in Iran. Indian J Med Paediatr Oncol 2011; 31:105-9. [PMID: 21584214 PMCID: PMC3089917 DOI: 10.4103/0971-5851.76190] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background: The purpose of this study was to compare the quality of life (Qol) of female breast cancer survivors who received rehabilitation intervention beside medical care and survivors who received medical care alone. Materials and Methods: Fifty-seven female breast cancer survivors were assigned to usual medical care (control group) or to usual medical care plus rehabilitation intervention (experimental group). Qol of all patients was assessed before, 1 week and 3 months after intervention. The intervention consisted of physiotherapy, education and individual counseling. The authors used the European Organization for Research and Treatment of Cancer core questionnaire and breast module (EORTC QLQ-C30/BR23) for the assessment of Qol. Results: Patients who received rehabilitation had significantly better Qol. Overall, mean of Qol scores improved gradually in experimental group from before to 1 week and 3 months after intervention. In contrast, minimal change was observed between pre/post and follow-up measures for control group. Conclusion: Rehabilitation after breast cancer treatment has the potential for physical, psychological and overall Qol benefits.
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Affiliation(s)
- M Poorkiani
- Department of Nursing, College of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
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Shi HY, Uen YH, Yen LC, Culbertson R, Juan CH, Hou MF. Two-year quality of life after breast cancer surgery: a comparison of three surgical procedures. Eur J Surg Oncol 2011; 37:695-702. [PMID: 21664099 DOI: 10.1016/j.ejso.2011.05.008] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2011] [Revised: 04/22/2011] [Accepted: 05/16/2011] [Indexed: 10/18/2022] Open
Abstract
PURPOSE To analyze longitudinal changes in each subscale of a quality of life (QOL) measure and to explore their relationships to effective QOL predictors in breast cancer surgery patients. PATIENTS AND METHODS This prospective study analyzed 172 patients at two tertiary academic hospitals. All patients completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and its supplementary breast cancer measure (QLQ-BR23) at baseline and at 1 and 2 years postoperatively. The 95% confidence intervals for differences in responsiveness estimates were derived by bootstrap estimation. Scores derived by these instruments were interpreted by generalized estimating equation (GEE) before and after surgery. RESULTS A 2-year follow-up survey of the examined population revealed significant (P < 0.05) improvement in each QOL subscale. In both postoperative surveys, effect size was largest in the QLQ subscales for patients who had received mastectomy with reconstruction and lowest in those who had received modified radical mastectomy. After adjusting for time effects and baseline predictors, GEE approaches revealed the following explanatory variables for QOL: time, type of surgical procedure, age, chemotherapy, radiotherapy, hormone therapy, and preoperative functional status. CONCLUSIONS When evaluating QOL after breast cancer surgery, several factors other than the surgery itself should be considered. Patients should also be advised that their postoperative QOL might depend not only on the success of their operations, but also on their preoperative functional status.
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Affiliation(s)
- H Y Shi
- Graduate Institute of Healthcare Administration, Kaohsiung Medical University, 807 Kaohsiung, Taiwan, ROC
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Kontodimopoulos N, Ntinoulis K, Niakas D. Validity of the Greek EORTC QLQ-C30 and QLQ-BR23 for measuring health-related quality of life in breast cancer patients. Eur J Cancer Care (Engl) 2011; 20:354-61. [PMID: 20345453 DOI: 10.1111/j.1365-2354.2009.01170.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The aim of this study was to assess construct validity and internal consistency reliability of the Greek EORTC QLQ-C30 and QLQ-BR23 instruments. A sample of female breast cancer patients (n= 105) were self-administered the QLQ-C30, QLQ-BR23 and SF-36 and questions on treatment and socio-demographic status. Hypothesised scale structure, reliability (Cronbach's α) and construct validity (convergent, discriminative, concurrent and known-groups) were assessed. Multitrait scaling confirmed scale structure of the QLQ-C30 and QLQ-BR23 with good item convergence (92% and 85%), and discrimination (87% and 84%) rates. Cronbach's α was >0.70 for all but one scale (cognitive functioning). Strength of Spearman's correlations between the QLQ-C30 and SF-36 scales assessing similar health-related quality of life dimensions ranged from 0.25 to 0.64 (P < 0.01). Construct validity was confirmed with satisfactory results for interscale correlations and known-groups comparisons. QLQ-BR23 scales showed comparatively low (<0.40) correlations with QLQ-C30 functional scales, and higher correlations with conceptually related symptom scales. Most QLQ-C30 and QLQ-BR23 scales discriminated between pre-treatment and current treatment patients. The overall psychometric results for the Greek version of the QLQ-C30 and QLQ-BR23 confirmed it as a reliable and valid questionnaire for assessing breast cancer-specific HRQoL in Greece.
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Affiliation(s)
- N Kontodimopoulos
- Faculty Of Social Sciences, Hellenic Open University, Bouboulinas 57-59, Patras, Greece.
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Trait anxiety predicts disease-specific health status in early-stage breast cancer patients. Qual Life Res 2011; 20:865-73. [PMID: 21203853 PMCID: PMC3148437 DOI: 10.1007/s11136-010-9830-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2010] [Indexed: 12/24/2022]
Abstract
Purpose The objectives of this study were to examine the differences in health status (HS) of women with breast cancer (BC) at different moments in time, and between women scoring high and not high on trait anxiety, and to identify possible predictors of HS 6 and 12 months after surgery. Methods Patients (N = 223) completed a trait anxiety questionnaire before diagnosis. Women who received a diagnosis of BC completed a BC-specific HS questionnaire 1, 3, 6 and 12 months after surgery. ANCOVA for repeated measures and multiple regression analysis were used in the analyses. Results Women scoring high on trait anxiety had significant (P < .005) lower Body image, worse Future perspective and Sexual functioning, and more Side-effects than women who did not score high on trait anxiety. At 6 and 12 months after surgery, the same aspects of HS were predicted by higher trait anxiety scores. Conclusions Higher scores on trait anxiety resulted in worse scores on four HS domains, indicating that there should be more attention for this group of patients, even before treatment starts.
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Health-related quality of life after chemotherapy cycle in breast cancer in Iran. Med Oncol 2010; 28 Suppl 1:S70-4. [DOI: 10.1007/s12032-010-9714-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2010] [Accepted: 10/04/2010] [Indexed: 10/18/2022]
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Alawadhi SA, Ohaeri JU. Validity and reliability of the European Organization for Research and Treatment in Cancer Quality of Life Questionnaire (EORTC QLQ): experience from Kuwait using a sample of women with breast cancer. Ann Saudi Med 2010; 30:390-6. [PMID: 20697165 PMCID: PMC2941253 DOI: 10.4103/0256-4947.67083] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Although the EORTC QLQ-C30 and its breast-specific module (BR-23) are widely used instruments, the few reports on their psychometric characteristics from Arab and neighboring countries involved limited analyses. Our objective was to assess the psychometric characteristics of both questionnaires using the responses of a larger sample of Arab women. METHODS Participants were consecutive clinic attendees at the Kuwait Cancer Control Center. The indices assessed were alpha coefficients, item-internal consistency (IIC), item-discriminant validity (IDV), and known-groups validity. RESULTS The 348 women were aged 48.3 (10.3) years. The intra-class correlation for the test-retest statistic and the internal consistency values for the multi-item scales were >0.7 alpha. With the exception of the pain subscale, all items met the IIC criterion of >0.4 correlation with the corresponding scale. For IDV, the BR-23 performed better than the QLQ-C30. The scale scores discriminated between patients at different disease stages, and between sick and well populations. CONCLUSION With the exception of the pain subscale, the Arabic version of the questionnaires is psychometrically sound.
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Affiliation(s)
| | - Jude U. Ohaeri
- Department of Psychiatry, Psychological Medicine Hospital, Safat, Kuwait
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Hatam N, Ahmadloo N, Ahmad Kia Daliri A, Bastani P, Askarian M. Quality of life and toxicity in breast cancer patients using adjuvant TAC (docetaxel, doxorubicin, cyclophosphamide), in comparison with FAC (doxorubicin, cyclophosphamide, 5-fluorouracil). Arch Gynecol Obstet 2010; 284:215-20. [PMID: 20740365 DOI: 10.1007/s00404-010-1609-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2010] [Accepted: 07/14/2010] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The aim of this study was to compare two regimens of chemotherapy in patients with breast cancer, including FAC (doxorubicin, cyclophosphamide, and 5-fluorouracil) and TAC (docetaxel, doxorubicin and cyclophosphamide); and analyze the toxicity of these treatments and observe patient's health-related quality of life. METHODS Health-related quality of life was assessed for up to 4 months (from the beginning to the end of chemotherapy cycles), using European organization and cancer treatment quality of life questionnaire (EORTC) QLQ-C30. A group of 100 patients, with node-positive breast cancer were studied in order to compare the toxicity of adjuvant therapy TAC with FAC and the subsequent effects on the patient's quality of life. RESULTS After a 4-month follow-up of patients, our findings showed that despite having the same mean score of QOL at the start of adjuvant chemotherapy, the QOL in TAC arm was decreased more as a result of the higher range of toxicity in TAC regimen. CONCLUSION In spite of increase in disease-free patients who received TAC regimen and increase their survival rate, there is significant toxicity and decrease in QOL in TAC protocol compare to FAC protocol. Using prophylactic granulocyte colony stimulating factor (G-CSF) along with increased education aimed at improving patient's knowledge and also the provision of a supportive group involving psychiatrics and patients that have successfully experienced the same treatment may be helpful.
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Affiliation(s)
- N Hatam
- School of Management and Medical Information Sciences, Shiraz University of Medical Science, Shiraz, Iran.
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Multimodal exercise improves quality of life of women being treated for breast cancer, but at what cost? Randomized trial with economic evaluation. Breast Cancer Res Treat 2010; 124:163-75. [DOI: 10.1007/s10549-010-1126-2] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2010] [Accepted: 08/11/2010] [Indexed: 11/25/2022]
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Sharif F, Abshorshori N, Tahmasebi S, Hazrati M, Zare N, Masoumi S. The effect of peer-led education on the life quality of mastectomy patients referred to breast cancer-clinics in Shiraz, Iran 2009. Health Qual Life Outcomes 2010; 8:74. [PMID: 20653966 PMCID: PMC2919455 DOI: 10.1186/1477-7525-8-74] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2010] [Accepted: 07/23/2010] [Indexed: 11/22/2022] Open
Abstract
Background Breast cancer among women is a relatively common with a more favorable expected survival rates than other forms of cancers. This study aimed to determine the improved quality of life for post-mastectomy women through peer education. Methods Using pre and post test follow up and control design approach, 99 women with stage I and II of breast cancer diagnosis were followed one year after modified radical mastectomy. To measure the quality of life an instrument designed by the European organization for research and treatment of cancer, known as the Quality of Life Question (QLQ-30) and it's breast cancer supplementary measure (QLQ-BR23) at three points in time (before, immediately and two months after intervention) for both groups were used. The participant selection was a convenient sampling method and women were randomly assigned into two experimental and control groups. The experimental group was randomly assigned to five groups and peer educators conducted weekly educational programs for one month. Tabulated data were analyzed using chi square, t test, and repeated measurement multivariate to compare the quality of life differences over time. Results For the experimental group, the results showed statistically significant improvement in all performance aspects of life quality and symptom reduction (P < 0.001), while the control group had no significant differences in all aspects of life quality. Conclusion The findings of this study suggest that peer led education is a useful intervention for post-mastectomy women to improves their quality of life.
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Affiliation(s)
- Farkhondeh Sharif
- Mental Health Nursing Department, Fatemeh, Faculty of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
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Min SY, Kim HY, Jung SY, Kwon Y, Shin KH, Lee S, Kim SW, Kang HS, Yun YH, Lee ES. Oncological safety and quality of life associated with mastectomy and immediate breast reconstruction with a latissimus dorsi myocutaneous flap. Breast J 2010; 16:356-61. [PMID: 20545939 DOI: 10.1111/j.1524-4741.2010.00941.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
To determine the quality of life (QoL) of breast cancer patients who underwent mastectomy and immediate breast reconstruction with a latissimus dorsi myocutaneous flap (LD), and the oncological safety of the procedure. Between May 2001 and March 2007, 2,566 patients had breast cancer surgery at the National Cancer Center, Korea. Of the 2,566 patients, 1,699 had breast-conserving surgery (BCS) and 120 had a mastectomy with an immediate LD. We retrospectively compared the oncologic safety of the two techniques. We also assessed the QoL using the EORTC QLQ BR-23 and Zung's self-rating depression scale in 52 LD patients, 104 age- and stage-matched patients who underwent BCS, and 104 age-matched healthy women. The LD group had earlier stage disease than the BCS group at baseline, but following surgery, the groups did not differ in the rates of local recurrence or systemic metastases. Compared with the healthy group, the patient groups had poorer functioning and more depression (p < 0.001). Among the patient groups, the LD group reported lower scores for body image (p = 0.007) and future perspective (p = 0.023) than the BCS group. In the LD group, patients who received neoadjuvant chemotherapy reported lower scores for future perspective and higher scores for depression than those who did not receive neoadjuvant chemotherapy (p < 0.001). The BCS and LD groups did not differ in oncological outcome, and the QoL of patients in the LD group was not always good. Mastectomy with immediate reconstruction should be considered carefully and tailored to the patient's needs and characteristics.
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Affiliation(s)
- Sun Young Min
- Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea
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Den Oudsten BL, Van Heck GL, Van der Steeg AFW, Roukema JA, De Vries J. Clinical factors are not the best predictors of quality of sexual life and sexual functioning in women with early stage breast cancer. Psychooncology 2009; 19:646-56. [DOI: 10.1002/pon.1610] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Alawadi SA, Ohaeri JU. Health - related quality of life of Kuwaiti women with breast cancer: a comparative study using the EORTC Quality of Life Questionnaire. BMC Cancer 2009; 9:222. [PMID: 19586536 PMCID: PMC2714557 DOI: 10.1186/1471-2407-9-222] [Citation(s) in RCA: 89] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2009] [Accepted: 07/08/2009] [Indexed: 01/26/2023] Open
Abstract
Background The Kuwaiti perspective on quality of life (QOL) in breast cancer is important because it adds the contribution from a country where the disease affects women at a relatively younger age and seems to be more aggressive. We used the EORTC QLQ – C30 and its breast-specific module (BR-23) to highlight the health-related QOL of Kuwaiti women with breast cancer, in comparison with the international data, and assessed the socio-demographic and clinical variables that predict the five functional scales and global QOL (GQOL) scale of the QLQ – C30. Methods Participants were consecutive clinic attendees for chemotherapy, in stable condition, at the Kuwait Cancer Control Center. Results The 348 participants were aged 20–81 years (mean 48.3, SD 10.3); 58.7% had stages III and IV disease. Although the mean scores for QLQ – C30 (GQOL, 45.3; and five functional scales, 52.6%–61.2%) indicated that the patients had poor to average functioning, only 5.8% to 11.2% had scores that met the </= 33% criterion for problematic functioning, while 12.0% to 40.0% met the >66% criterion for more severe symptoms. Most (47.8%–70.1%) met the >66% criterion for "good functioning" on the BR-23 functional scales. The mean scores of the QLQ – C30 indicated that, despite institutional supports, Kuwaiti women had clinically significantly poorer global QOL and functional scale scores, and more intense symptom experience, in comparison with the international data (i.e., </= 10% difference between groups). For the BR-23, Kuwaiti women seemed to have clinically significantly better functional scale scores, but more severe symptoms, especially systemic side effects and breast symptoms. Younger women had poorer HRQOL scores. In regression analysis, social functioning accounted for the highest proportion of variance for GQOL. Conclusion The relatively high number that met the criterion for good functioning on the functional scales is an evidence base to boost national health education about psychosocial prognosis in cancer. In view of the poor performance on the symptom scales, clinicians treating Kuwaiti women with breast cancer should prepare them for the acute toxicities of treatment and address fatigue. The findings call for the institution of a psycho-oncology service to address psycho-social issues.
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Affiliation(s)
- Shafika A Alawadi
- Department of Medicine, Faculty of Medicine, Kuwait University, Kuwait.
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Montazeri A, Vahdaninia M, Harirchi I, Ebrahimi M, Khaleghi F, Jarvandi S. Quality of life in patients with breast cancer before and after diagnosis: an eighteen months follow-up study. BMC Cancer 2008; 8:330. [PMID: 19014435 PMCID: PMC2588619 DOI: 10.1186/1471-2407-8-330] [Citation(s) in RCA: 153] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2008] [Accepted: 11/11/2008] [Indexed: 12/24/2022] Open
Abstract
Background Measuring quality of life in breast cancer patients is of importance in assessing treatment outcomes. This study examined the impact of breast cancer diagnosis and its treatment on quality of life of women with breast cancer. Methods This was a prospective study of quality of life in breast cancer patients. Quality of life was measured using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and its breast cancer supplementary measure (QLQ-BR23) at three points in time: baseline (pre diagnosis), three months after initial treatment and one year after completion of treatment (in all 18 months follow-up). At baseline the questionnaires were administered to all suspected identified patients while both patients and the interviewer were blind to the final diagnosis. Socio-demographic and clinical data included: age, education, marital status, disease stage and initial treatment. Repeated measure analysis was performed to compare quality of life differences over the time. Results In all, 167 patients diagnosed with breast cancer. The mean age of breast cancer patients was 47.2 (SD = 13.5) years and the vast majority (82.6%) underwent mastectomy. At eighteen months follow-up data for 99 patients were available for analysis. The results showed there were significant differences in patients' functioning and global quality of life at three points in time (P < 0.001). Although there were deteriorations in patients' scores for body image and sexual functioning, there were significant improvements for breast symptoms, systematic therapy side effects and patients' future perspective (P < 0.05). Conclusion The findings suggest that overall breast cancer patients perceived benefit from their cancer treatment in long-term. However, patients reported problems with global quality of life, pain, arm symptoms and body image even after 18 months following their treatments. In addition, most of the functional scores did not improve.
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Affiliation(s)
- Ali Montazeri
- Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran.
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