Assessment of Health-Related Quality of Life and Distress in an Asian Community-Based Cancer Rehabilitation Program
Abstract
:1. Introduction
2. Materials and Methods
2.1. Participants
2.2. Patient Evaluation
2.3. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Weaver, K.E.; Forsythe, L.P.; Reeve, B.B.; Alfano, C.M.; Rodriguez, J.L.; Sabatino, S.A.; Hawkins, N.A.; Rowland, J.H. Mental and physical health-related quality of life among U.S. cancer survivors: Population estimates from the 2010 National Health Interview Survey. Cancer Epidemiol. Biomark. Prev. 2012, 21, 2108–2117. [Google Scholar] [CrossRef] [PubMed]
- Silver, J.K.; Baima, J.; Mayer, R.S. Impairment-driven cancer rehabilitation: An essential component of quality care and survivorship. CA Cancer J. Clin. 2013, 63, 295–317. [Google Scholar] [CrossRef]
- Samant, R.; Balchin, K.; Cisa-Paré, E.; Renaud, J.; Bunch, L.; McNeil, A.; Murray, S.; Meng, J. The importance of humour in oncology: A survey of patients undergoing radiotherapy. Curr. Oncol. 2020, 27, e350–e353. [Google Scholar] [CrossRef] [PubMed]
- Lei, Y.Y.; Ho, S.C.; Lau, T.; Kwok, C.; Cheng, A.; Cheung, K.L.; Lee, R.; Yeo, W. Longitudinal change of quality of life in the first five years of survival among disease-free Chinese breast cancer survivors. Qual. Life Res. 2021, 30, 1583–1594. [Google Scholar] [PubMed]
- Silver, J.K.; Gilchrist, L.S. Cancer rehabilitation with a focus on evidence-based outpatient physical and occupational therapy interventions. Am. J. Phys. Med. Rehabil. 2011, 90, S5–S15. [Google Scholar] [CrossRef]
- Loh, K.W.; Ng, T.; Choo, S.P.; Saw, H.M.; Mahendran, R.; Tan, C.; Chang, G.; Ong, Y.J.; Yee, A.; Chan, A.; et al. Cancer Supportive and Survivorship Care in Singapore: Current Challenges and Future Outlook. J. Glob. Oncol. 2018, 4, 1–8. [Google Scholar] [CrossRef]
- la Cour, K.; Cutchin, M.P. Developing community based rehabilitation for cancer survivors: Organizing for coordination and coherence in practice. BMC Health Serv. Res. 2013, 13, 339. [Google Scholar] [CrossRef]
- Riba, M.B.; Donovan, K.A.; Andersen, B.; Braun, I.; Breitbart, W.S.; Brewer, B.W.; Buchmann, L.O.; Clark, M.M.; Collins, M.; Corbett, C.; et al. Distress Management, Version 3.2019, NCCN Clinical Practice Guidelines in Oncology. J. Natl. Compr. Cancer Netw. 2019, 17, 1229–1249. [Google Scholar]
- Zabora, J.; BrintzenhofeSzoc, K.; Curbow, B.; Hooker, C.; Piantadosi, S. The prevalence of psychological distress by cancer site. Psychooncology 2001, 10, 19–28. [Google Scholar] [CrossRef]
- Carlson, L.E.; Angen, M.; Cullum, J.; Goodey, E.; Koopmans, J.; Lamont, L.; MacRae, J.H.; Martin, M.; Pelletier, G.; Robinson, J.; et al. High levels of untreated distress and fatigue in cancer patients. Br. J. Cancer 2004, 90, 2297–2304. [Google Scholar] [CrossRef]
- Gascon, B.; Panjwani, A.A.; Mazzurco, O.; Li, M. Screening for Distress and Health Outcomes in Head and Neck Cancer. Curr. Oncol. 2022, 29, 3793–3806. [Google Scholar] [CrossRef] [PubMed]
- Ozalp, E.; Cankurtaran, E.S.; Soygür, H.; Geyik, P.O.; Jacobsen, P.B. Screening for psychological distress in Turkish cancer patients. Psychooncology 2007, 16, 304–311. [Google Scholar] [CrossRef] [PubMed]
- van Beek, F.E.; Jansen, F.; Baatenburg de Jong, R.J.; Langendijk, J.A.; Leemans, C.R.; Smit, J.H.; Takes, R.P.; Terhaard, C.H.J.; Custers, J.A.E.; Prins, J.B.; et al. Psychological Problems among Head and Neck Cancer Patients in Relation to Utilization of Healthcare and Informal Care and Costs in the First Two Years after Diagnosis. Curr. Oncol. 2022, 29, 3200–3214. [Google Scholar] [CrossRef]
- Donovan, K.A.; Deshields, T.L.; Corbett, C.; Riba, M.B. Update on the Implementation of NCCN Guidelines for Distress Management by NCCN Member Institutions. J. Natl. Compr. Cancer Netw. 2019, 17, 1251–1256. [Google Scholar] [CrossRef]
- Donovan, K.A.; Grassi, L.; McGinty, H.L.; Jacobsen, P.B. Validation of the distress thermometer worldwide: State of the science. Psychooncology 2014, 23, 241–250. [Google Scholar] [CrossRef]
- Chidobem, I.; Tian, F.; Mgbodile, C.; Mgbodile, F.; Jokar, T.O.; Ogbuokiri, E.; Khan, N. Assessing the Relationship between Socioeconomic Status, Race, and Psychological Distress in Cancer Survivors: A Population Based Study. Curr. Oncol. 2022, 29, 2575–2582. [Google Scholar] [CrossRef]
- Rao, W.W.; Yang, M.J.; Cao, B.N.; You, Y.Y.; Zhang, Y.Y.; Liu, Y.Y.; Kou, C.; Yu, Y.; Cassidy, R.M.; Yu, Q.; et al. Psychological distress in cancer patients in a large Chinese cross-sectional study. J. Affect Disord. 2019, 245, 950–956. [Google Scholar] [CrossRef]
- Kim, S.J.; Rha, S.Y.; Song, S.K.; Namkoong, K.; Chung, H.C.; Yoon, S.H.; Kim, G.M.; Kim, K.R. Prevalence and associated factors of psychological distress among Korean cancer patients. Gen. Hosp. Psychiatry 2011, 33, 246–252. [Google Scholar] [CrossRef]
- ACTION Study Group. Health-related quality of life and psychological distress among cancer survivors in Southeast Asia: Results from a longitudinal study in eight low- and middle-income countries. BMC Med. 2017, 15, 10. [Google Scholar]
- Kuo, A. Distress among cancer patients attending rehabilitation in the community. Support Care Cancer 2022, 30, 279–287. [Google Scholar] [CrossRef]
- Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health. Office of Cancer Survivorship—Definitions. Available online: http://cancercontrol.cancer.gov/ocs/statistics/definitions.html (accessed on 7 September 2022).
- Yanez, B.; Pearman, T.; Lis, C.G.; Beaumont, J.L.; Cella, D. The FACT-G7: A rapid version of the functional assessment of cancer therapy-general (FACT-G) for monitoring symptoms and concerns in oncology practice and research. Ann. Oncol. 2013, 24, 1073–1078. [Google Scholar] [CrossRef] [PubMed]
- Cella, D.F.; Tulsky, D.S.; Gray, G.; Sarafian, B.; Linn, E.; Bonomi, A.; Silberman, M.; Yellen, S.B.; Winicour, P.; Brannon, J. The functional assessment of cancer therapy scale: Development and validation of the general measure. J. Clin. Oncol. 1993, 11, 570–579. [Google Scholar] [CrossRef] [PubMed]
- Mah, K.; Swami, N.; Le, L.W.; Chow, R.; Hannon, B.L.; Rodin, G.; Zimmermann, C. Validation of the 7-item Functional Assessment of Cancer Therapy-General (FACT-G7) as a short measure of quality of life in patients with advanced cancer. Cancer 2020, 126, 3750–3757. [Google Scholar] [CrossRef]
- Pearman, T.; Yanez, B.; Peipert, J.; Wortman, K.; Beaumont, J.; Cella, D. Ambulatory cancer and US general population reference values and cutoff scores for the functional assessment of cancer therapy. Cancer 2014, 120, 2902–2909. [Google Scholar] [CrossRef] [PubMed]
- Tuinman, M.A.; Gazendam-Donofrio, S.M.; Hoekstra-Weebers, J.E. Screening and referral for psychosocial distress in oncologic practice: Use of the Distress Thermometer. Cancer 2008, 113, 870–878. [Google Scholar] [CrossRef]
- Lim, H.A.; Mahendran, R.; Chua, J.; Peh, C.X.; Lim, S.E.; Kua, E.H. The Distress Thermometer as an ultra-short screening tool: A first validation study for mixed-cancer outpatients in Singapore. Compr. Psychiatry 2014, 55, 1055–1062. [Google Scholar] [CrossRef]
- Pachman, D.R.; Barton, D.L.; Swetz, K.M.; Loprinzi, C.L. Troublesome symptoms in cancer survivors: Fatigue, insomnia, neuropathy, and pain. J. Clin. Oncol. 2012, 30, 3687–3696. [Google Scholar] [CrossRef]
- Cheng, K.K.F.; Wong, W.H.; Koh, C. Unmet needs mediate the relationship between symptoms and quality of life in breast cancer survivors. Support Care Cancer 2016, 24, 2025–2033. [Google Scholar] [CrossRef]
- Chui, P.L.; Abdullah, K.L.; Wong, L.P.; Taib, N.A. Quality of Life in CAM and Non-CAM Users among Breast Cancer Patients during Chemotherapy in Malaysia. PLoS ONE 2015, 10, e0139952. [Google Scholar] [CrossRef]
- Edib, Z.; Kumarasamy, V.; Binti Abdullah, N.; Rizal, A.M.; Al-Dubai, S.A. Most prevalent unmet supportive care needs and quality of life of breast cancer patients in a tertiary hospital in Malaysia. Health Qual. Life Outcomes 2016, 14, 26. [Google Scholar] [CrossRef]
- Chow, W.L.; Tan, S.M.; Aung, K.C.Y.; Chua, S.Y.N.; Sim, H.C. Factors influencing quality of life of Asian breast cancer patients and their caregivers at diagnosis: Perceived medical and psychosocial needs. Singap. Med. J. 2020, 61, 532–539. [Google Scholar]
- Leow, M.K.; Griva, K.; Choo, R.; Wee, H.L.; Thumboo, J.; Tai, E.S.; Newman, S. Determinants of Health-Related Quality of Life (HRQoL) in the Multiethnic Singapore Population—A National Cohort Study. PLoS ONE 2013, 8, e67138. [Google Scholar] [CrossRef]
- Thumboo, J.; Fong, K.Y.; Machin, D.; Chan, S.P.; Soh, C.H.; Leong, K.H.; Feng, P.H.; Thio, S.T.; Boey, M.L. Quality of life in an urban Asian population: The impact of ethnicity and socio-economic status. Soc. Sci. Med. 2003, 56, 1761–1772. [Google Scholar] [CrossRef]
- Lu, Q.; You, J.; Kavanagh, A.; Warmoth, K.; Meng, Z.; Chen, Z.; Chandwani, K.D.; Perkins, G.H.; McQuade, J.L.; Raghuram, N.V.; et al. Differences in quality of life between American and Chinese breast cancer survivors. Supportive Care Cancer 2016, 24, 3775–3782. [Google Scholar] [CrossRef] [PubMed]
- Lam, W.W.; Au, A.H.; Wong, J.H.; Lehmann, C.; Koch, U.; Fielding, R.; Mehnert, A. Unmet supportive care needs: A cross-cultural comparison between Hong Kong Chinese and German Caucasian women with breast cancer. Breast Cancer Res. Treat. 2011, 130, 531–541. [Google Scholar] [CrossRef] [PubMed]
- Pearce, M.J.; Coan, A.D.; Herndon, J.E., II; Koenig, H.G.; Abernethy, A.P. Unmet spiritual care needs impact emotional and spiritual well-being in advanced cancer patients. Support Care Cancer 2012, 20, 2269–2276. [Google Scholar] [CrossRef] [PubMed]
- Siddiqi, A.; Given, C.W.; Given, B.; Sikorskii, A. Quality of life among patients with primary, metastatic and recurrent cancer. Eur. J. Cancer Care 2009, 18, 84–96. [Google Scholar] [CrossRef]
- Sloan, J.A.; Zhao, X.; Novotny, P.J.; Wampfler, J.; Garces, Y.; Clark, M.M.; Yang, P. Relationship between deficits in overall quality of life and non-small-cell lung cancer survival. J. Clin. Oncol. 2012, 30, 1498–1504. [Google Scholar] [CrossRef]
- Hamer, J.; McDonald, R.; Zhang, L.; Verma, S.; Leahey, A.; Ecclestone, C.; Bedard, G.; Pulenzas, N.; Bhatia, A.; Chow, R.; et al. Quality of life and symptom burden in patients with metastatic breast cancer. Support Care Cancer 2016, 24, 4035–4043. [Google Scholar]
- Park, J.E.; Jang, H.J.; Seo, K.S. Quality of life, upper extremity function and the effect of lymphedema treatment in breast cancer related lymphedema patients. Ann. Rehabil. Med. 2012, 36, 240–247. [Google Scholar]
- Maltser, S.; Cristian, A.; Silver, J.K.; Morris, G.S.; Stout, N.L. A Focused Review of Safety Considerations in Cancer Rehabilitation. PM R 2017, 9, S415–S428. [Google Scholar] [CrossRef] [PubMed]
- Pirl, W.F.; Fann, J.R.; Greer, J.A.; Braun, I.; Deshields, T.; Fulcher, C.; Harvey, E.; Holland, J.; Kennedy, V.; Lazenby, M.; et al. Recommendations for the implementation of distress screening programs in cancer centers: Report from the American Psychosocial Oncology Society (APOS), Association of Oncology Social Work (AOSW), and Oncology Nursing Society (ONS) joint task force. Cancer 2014, 120, 2946–2954. [Google Scholar] [CrossRef] [PubMed]
- Mehnert, A.; Hartung, T.J.; Friedrich, M.; Vehling, S.; Brähler, E.; Härter, M.; Keller, M.; Schulz, H.; Wegscheider, K.; Weis, J.; et al. One in two cancer patients is significantly distressed: Prevalence and indicators of distress. Psychooncology 2018, 27, 75–82. [Google Scholar] [CrossRef]
- Ng, C.G.; Mohamed, S.; Kaur, K.; Sulaiman, A.H.; Zainal, N.Z.; Taib, N.A.; MyBCC Study Group. Perceived distress and its association with depression and anxiety in breast cancer patients. PLoS ONE 2017, 12, e0172975. [Google Scholar] [CrossRef] [PubMed]
- Yi, J.C.; Syrjala, K.L. Anxiety and Depression in Cancer Survivors. Med. Clin. N. Am. 2017, 101, 1099–1113. [Google Scholar] [CrossRef] [PubMed]
- Speck, R.M.; Courneya, K.S.; Mâsse, L.C.; Duval, S.; Schmitz, K.H. An update of controlled physical activity trials in cancer survivors: A systematic review and meta-analysis. J. Cancer Surviv. 2010, 4, 87–100, Published Correction Appears in J. Cancer Surviv. 2011, 5, 112. [Google Scholar] [CrossRef]
- Jacobsen, P.B.; Donovan, K.A.; Vadaparampil, S.T.; Small, B.J. Systematic review and meta-analysis of psychological and activity-based interventions for cancer-related fatigue. Health Psychol. 2007, 26, 660–667. [Google Scholar] [CrossRef]
- Riedl, D.; Giesinger, J.M.; Wintner, L.M.; Loth, F.L.; Rumpold, G.; Greil, R.; Nickels, A.; Licht, T.; Holzner, B. Improvement of quality of life and psychological distress after inpatient cancer rehabilitation: Results of a longitudinal observational study. Wien Klin. Wochenschr. 2017, 129, 692–701. [Google Scholar] [CrossRef]
- Silver, J.K.; Baima, J.; Newman, R.; Galantino, M.L.; Shockney, L.D. Cancer rehabilitation may improve function in survivors and decrease the economic burden of cancer to individuals and society. Work 2013, 46, 455–472. [Google Scholar] [CrossRef]
- Chiu, L.; Chiu, N.; Chow, E.; Cella, D.; Beaumont, J.L.; Lam, H.; Popovic, M.; Bedard, G.; Poon, M.; Wong, E.; et al. Comparison of three shortened questionnaires for assessment of quality of life in advanced cancer. J. Palliat. Med. 2014, 17, 918–923. [Google Scholar] [CrossRef]
- Ho, P.J.; Gernaat, S.A.M.; Hartman, M.; Verkooijen, H.M. Health-related quality of life in Asian patients with breast cancer: A systematic review. BMJ Open 2018, 8, e020512. [Google Scholar] [CrossRef] [PubMed]
Characteristics | |
---|---|
Age, mean (SD) | |
- 31–40 | 12 (3.9) |
- 41–50 | 23 (7.6) |
- 51–60 | 88 (28.9) |
- 61–70 | 112 (36.8) |
- 71–80 | 69 (22.7) |
Gender, n (%) | |
- Male | 59 (19.4) |
- Female | 245 (80.6) |
Ethnicity, n (%) | |
- Chinese | 280 (92.1) |
- Malay | 18 (5.9) |
- Indian | 6 (2.0) |
Cancer type, n (%) | |
- Breast | 181 (59.5) |
- Brain | 4 (1.3) |
- Bladder | 4 (1.3) |
- Colorectal | 19 (6.3) |
- Head and neck | 9 (3.0) |
- Hepatopancreatobiliary | 3 (1.0) |
- Kidney | 4 (1.3) |
- Lung | 12 (3.9) |
- Hematological | 14 (4.6) |
- Ovarian | 13 (4.3) |
- Prostate | 30 (9.9) |
- Uterine | 11 (3.6) |
Stage, n (%) | |
- No recurrence | 144 (47.3) |
- Localized/ regional | 52 (17.1) |
- Metastatic | 108 (35.5) |
Scores | |
---|---|
FACT-G7 total scores, mean (SD) | 11.68 (4.17) |
FACT-G7, n (%) | |
- Low (≤16) | 267 (87.8) |
- Not low (>17) | 37 (12.2) |
FACT-G7 mean item ratings, mean (SD) | |
- I have a lack of energy (fatigue) | 1.49 (1.11) |
- I have nausea | 1.43 (1.24) |
- I have pain | 0.34 (1.28) |
- I worry that my condition will get worse | 1.56 (1.28) |
- I am able to enjoy life | 2.26 (1.30) |
- I am sleeping well | 2.31 (1.15) |
- I am content with the quality of my life right now | 2.30 (1.15) |
Distress thermometer, mean (SD) | 3.51 (2.45) |
Distress thermometer ≥ 5, n (%) | 188 (61.8) |
Univariate Analysis | Multivariate Analysis | |||
---|---|---|---|---|
Variables | p Value | Odds Ratio | 95% CI | p Value |
Age | 0.441 | |||
Gender | ||||
- Male | Reference | |||
- Female | 0.601 | |||
Ethnicity | ||||
- Chinese | Reference | Reference | - | - |
- Malay | <0.001 | 0.157 | 0.056–9.439 | <0.001 |
- Indian | 0.598 | 0.488 | 0.052–4.55 | 0.529 |
Tumor type | 0.873 | |||
Cancer stage | ||||
- No recurrence | Reference | Reference | - | - |
- Localized/ regional | 0.921 | 1.11 | 0.446–2.78 | 0.818 |
- Metastatic | 0.014 | 2.98 | 1.15–7.72 | 0.025 |
Problems, n (%) | |
---|---|
Worry | 146 (48.0) |
Fatigue | 144 (47.4) |
Memory/concentration | 142 (46.7) |
Tingling in hands/feet | 141 (46.4) |
Sleep | 130 (42.8) |
Pain | 129 (42.4) |
Skin dry/itchy | 117 (38.4) |
Fears | 91 (29.9) |
Insurance | 69 (22.7) |
Sadness | 68 (22.4) |
Variables | Odds Ratio | 95% CI | p Value |
---|---|---|---|
Practical problems | |||
Family health issues | 4.27 | 1.41–10.71 | 0.003 |
Emotional problems | |||
Depression | 8.38 | 2.51–28.04 | 0.001 |
Worry | 3.08 | 1.41–6.75 | 0.005 |
Physical problems | |||
Breathing | 4.59 | 1.52–13.86 | 0.007 |
Getting around | 4.03 | 1.36–11.95 | 0.012 |
Indigestion | 3.31 | 1.06–10.32 | 0.039 |
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Tay, M.R.J.; Wong, C.J.; Aw, H.Z. Assessment of Health-Related Quality of Life and Distress in an Asian Community-Based Cancer Rehabilitation Program. Curr. Oncol. 2022, 29, 7012-7020. https://doi.org/10.3390/curroncol29100551
Tay MRJ, Wong CJ, Aw HZ. Assessment of Health-Related Quality of Life and Distress in an Asian Community-Based Cancer Rehabilitation Program. Current Oncology. 2022; 29(10):7012-7020. https://doi.org/10.3390/curroncol29100551
Chicago/Turabian StyleTay, Matthew Rong Jie, Chin Jung Wong, and Hui Zhen Aw. 2022. "Assessment of Health-Related Quality of Life and Distress in an Asian Community-Based Cancer Rehabilitation Program" Current Oncology 29, no. 10: 7012-7020. https://doi.org/10.3390/curroncol29100551
APA StyleTay, M. R. J., Wong, C. J., & Aw, H. Z. (2022). Assessment of Health-Related Quality of Life and Distress in an Asian Community-Based Cancer Rehabilitation Program. Current Oncology, 29(10), 7012-7020. https://doi.org/10.3390/curroncol29100551