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The OVIS study is a population-based study that aims at evaluating medical care in Schleswig-Holstein (Germany). In this paper, the health related quality of life (QoL, EORTC QLQ-C30 and -BR23) of 1,927 women with breast cancer is reported. The global health status/QoL score was comparable to reference data of the age-adjusted German general population, but clinical meaningful differences (> or = 10 points) were found for all functioning scales (with the exception of physical functioning) and for three of the symptom scales/items (fatigue, dyspnoe, insomnia) with OVIS patients showing more deficits. Furthermore, OVIS patients scored higher on the item financial difficulties. Logistic regression analyses revealed that coming from an urban surrounding, having a higher social status and attendance to a regular aftercare predicted a good overall QoL, while factors that were related to perceived complications in the course of the therapy raised the risk for a low QoL rating. It is of interest, that attendance to a rehabilitation and interest in self-help groups independently predicted an increased risk for a low quality of life. Overall, we assume the global QoL is rating slightly too optimistic since major deficits were reported on the specific physical and functional scales/items.
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PMID:The OVIS study: health related quality of life measured by the EORTC QLQ-C30 and -BR23 in German female patients with breast cancer from Schleswig-Holstein. 1728 96

The aim of this study was to document changes from baseline to 6 and 12 months after treatment in health-related quality of life (HRQOL) in relation to sociodemographic and clinical parameters among advanced oral/oropharyngeal cancer patients treated with reconstructive surgery and adjuvant radiotherapy. The HRQOL of 80 consecutive patients was assessed by the EORTC QLQ-C30 and QLQ-H&N35 questionnaires, pretreatment and 6 and 12 months posttreatment. Several patterns of HRQOL changes were distinguished: most general HRQOL issues do not change after treatment or improve compared to baseline scores (emotional functioning, pain, insomnia, constipation) and most head and neck specific issues deteriorate after treatment but return to pretreatment levels at 12 months, except for senses, opening mouth, sticky saliva, and coughing which remain deteriorated in the long term. Although improvement to baseline levels was noted, it should be kept in mind that baseline levels of patients are often deviant from "normal" scores from the general population. Tumour site and stage, comorbidity, and extensive resections were significantly associated with HRQOL outcomes, as were marital status and age. These results, obtained in a homogenous group of patients, may serve as HRQOL benchmarks for future studies investigating surgical and other treatment modalities.
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PMID:Quality of life after surgical treatment for oral and oropharyngeal cancer: a prospective longitudinal assessment of patients reconstructed by a microvascular flap. 1730 19

The aim of this study was to assess disability, psychological distress and quality of life in Polish breast cancer survivors with arm lymphedema. One thousand sets of questionnaires consisting of WHO-DAS II, GHQ-30, EORTC QLQ-C30 and QLQ-BR23 were sent to members of the Polish Federation of Breast Cancer Survivors Clubs "Amazonki." The response rate was 28.3% of whom 31.70% reported arm lymphedema. The WHO-DAS II survey showed that patients with arm lymphedema had a higher overall disability score (45.04 versus 38.80 in group without arm lymphedema; p=0.01) and higher mean values in the scales of understanding and communicating, getting around, life activities at home, getting along with people, participating in society. The EORTC QLQ-C30 survey showed that patients with lymphedema had lower mean values in physical (0.55 versus 0.65; p=0.001), emotional (0.47 versus 0.57; p=0.01), social (0.59 versus 0. 73; p=0.002), cognitive and role functioning, increased fatigue, pain, insomnia, dyspnea, nausealvomiting and financial problems. The EORTC QLQ-BR23 data demonstrated worse future perspectives and an increase in breast and arm symptoms, and the GHQ-30 survey produced higher psychological distress (scores 15.18 versus 11.24; p=0.004). In conclusion, breast cancer survivors with arm lymphedema were more disabled, experienced a poorer quality of life and had increased psychological distress in comparison to survivors without this condition.
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PMID:Disability, psychological distress and quality of life in breast cancer survivors with arm lymphedema. 1731 31

Little is known of how the quality of life (QOL) of patients with colorectal cancer changes with time following an operation, and whether or not there are predictors of QOL after one year in this population. The European Organization for Research and Treatment of Cancer QLQ-C30 QOL questionnaire was administered to patients before their operation for colorectal cancer, and monthly following the operation for up to one year. Multivariate regression analysis was performed to examine the predictors of QOL one year after the operation. One hundred patients with a mean age of 64 years participated. The scores of five QOL dimensions (physical function, role function, fatigue, pain, and dyspnoea) dropped significantly below the preoperative values at one month following the operation. The scores returned to the preoperative values within three months following the operation. The scores of seven QOL dimensions (global QOL, emotional function, social function, insomnia, appetite loss, diarrhea, and financial difficulties) had improved within three months after the operation. Other scores, including cognitive function, nausea and vomiting, and constipation remained unchanged. Stepwise regression analyses showed that preoperative performance status predicted various QOL scales one year following the operation. The overall QOL of colorectal cancer patients became stabilized about three months after the operation.
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PMID:Prospective analysis of quality of life in the first year after colorectal cancer surgery. 1743 8

In a prospective, randomized study, an individual psychosocial support intervention performed by specially trained oncology nurses, or psychologists, were compared with standard care. Consecutive primary breast cancer patients about to start adjuvant therapy (n = 179) were included. Data were supplied by the questionnaires European Organisation for Research and Treatment of Cancer Quality of Life Study Group Core Quality of life questionnaire with 30 questions (EORTC QLQ-C30) and Breast Cancer Module with 23 questions (BR23), the Hospital Anxiety and Depression Scale, Spielberger's State-Trait Anxiety Inventory, and the Impact of Event Scale before randomization and 1, 3, and 6 months later. Patient files provided data on utilization of psychosocial support offered in routine care. Global quality of life/health status, nausea and vomiting, and systemic therapy side effects were the subscales showing significant Group by Time interactions, favoring the interventions. Intervention groups improved statistically significantly more than the standard care group regarding insomnia, dyspnea, and financial difficulties. Nurse patients experienced less intrusion compared with the standard care group. All groups showed statistically and clinically significant improvements with time on several subscales. The intervention groups, however, improved to a greater extent. Fewer patients in the intervention groups used psychosocial hospital support compared with the standard care group. In conclusion, psychosocial support by specially trained nurses using techniques derived from cognitive behavioral therapy is beneficial for breast cancer patients and may be a realistic alternative in routine cancer care.
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PMID:Individual psychosocial support for breast cancer patients: a randomized study of nurse versus psychologist interventions and standard care. 1751 May 77

We performed this study to examine the prevalence and correlates of fatigue and depression, and their relevance to health-related quality of life in disease-free breast cancer survivors. A total of 1,933 breast cancer survivors recruited from five large hospitals in Korea completed a mailed survey, which included the Brief Fatigue Inventory, Beck Depression Inventory, European Organization for Research and Treatment of Cancer QLQ-C30, and QLQ-BR23. With a framework that included sociodemographic, clinical, and symptom characteristics, multivariate logistic regression models were used to identify factors associated with fatigue and depression. Among breast cancer survivors, 66.1% reported moderate to severe fatigue and 24.9% reported moderate to severe depression. Risk factors common to both fatigue and depression were lower income, dyspnea, insomnia, appetite loss, constipation, and arm symptoms. Risk factors for fatigue only included younger age, employment, presence of gastrointestinal disease, and pain. Having a musculoskeletal disease was identified as a risk factor for depression only. Both fatigue and depression were influenced by sociodemographic factors, comorbidity and symptom characteristics rather than cancer or treatment-related factors. Both fatigue and depression were negatively associated with survivors' health-related quality of life. However, the patterns of differences in health-related quality of life according to severity of fatigue or depression were similar. This concurrent examination of risk factors for fatigue and depression may be helpful in the development of clinical management strategies in disease-free breast cancer survivors.
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PMID:Fatigue and depression in disease-free breast cancer survivors: prevalence, correlates, and association with quality of life. 1835 87

To identify the impact of multiple symptoms and their co-occurrence on health-related quality of life (HRQOL) dimensions and performance status (PS), 115 outpatients with cancer, who were not receiving active cancer treatment and were recruited from a university hospital in Sao Paulo, Brazil completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30, the Beck Depression Inventory, and the Brief Pain Inventory. Karnofsky Performance Status scores also were completed. Application of TwoStep Cluster analysis resulted in two distinct patient subgroups based on 113 patient experiences with pain, depression, fatigue, insomnia, constipation, lack of appetite, dyspnea, nausea, vomiting, and diarrhea. One group had multiple and severe symptom subgroup and another had less symptoms and with lower severity. Multiple and severe symptoms had worse PS, role functioning, and physical, emotional, cognitive, social, and overall HRQOL. Multiple and severe symptom subgroup was also six times as likely as lower severity to have poor role functioning; five times more likely to have poor emotional; four times more likely to have poor PS, physical, and overall HRQOL; and three times as likely to have poor cognitive and social HRQOL, independent of gender, age, level of education, and economic condition. Classification and Regression Tree analyses were undertaken to identify which co-occurring symptoms would best determine reduction in HRQOL and PS. Pain and fatigue were identified as indicators of reduction on physical HRQOL and PS. Fatigue and insomnia were associated with reduction in cognitive; depression and pain in social; and fatigue and constipation in role functioning. Only depression was associated with reduction in overall HRQOL. These data demonstrate that there is a synergic effect among distinct cancer symptoms that result in reduction in HRQOL dimensions and PS.
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PMID:Impact of cancer-related symptom synergisms on health-related quality of life and performance status. 1836 59

Breast cancer, the commonest malignancy in women, is now the most common cancer in Nigeria, but little is known about the quality of life (QOL) of Nigerian women breast cancer survivors and the predictive factors that may influence their QOL. Health-related QOL (HRQOL) was evaluated in 35 Nigerian women receiving radiotherapy for breast cancer at the University College Hospital, Ibadan by using the European Organization for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ - C30 version 3). Linear regression procedures were used to evaluate the association of HRQOL outcomes with medical and socio-demographic factors. Physical functioning (PF), Emotional functioning (EF) and Cognitive functioning (CF) scores were above average (76.9 +/- 20.6, 61.9 +/- 30.3 and 60.0 +/- 32.1 respectively) while Role functioning (RF) and Social functioning (SF) scores were below average (46.2 +/- 36.6 and 40.9 +/- 42.8 respectively). High symptom scale scores were recorded for fatigue, pain and financial difficulties (52.7 +/- 32.8, 59.1 +/- 34.4 and 71.4 +/- 38.8 respectively). Age had no significant influence on any of the functional and symptom scale scores as well as the overall QOL. The overall QOL was significantly related to PF, CF and SF. It was also significantly and inversely related to the scores of fatigue, nausea and vomitng, pain, insomnia and financial difficulty. The findings of this study provide important information on QOL and their correlates among Nigerian women undergoing radiotherapy for breast cancer and are helpful in developing treatment strategies accordingly.
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PMID:Health related quality of life and its determinants in Nigerian breast cancer patients. 1839 66

Transplantation may imply severe biopsychosocial impairments. In order to know the quality of life of patients one year after transplantation, 58 subjects were compared to three different groups of patients (stabilized and acute COPD patients, and lung cancer patients in a surgery unit). Patients filled in two questionnaires: EORTC QLQ-C30 (quality of life) and HAD (anxiety and depression). The quality of life dimensions with inter-group differences were physical, role, emotional and cognitive functioning, global health status, and a number of symptoms (fatigue, dyspnea, insomnia and appetite loss). There were differences in depression, and but not in anxiety. Transplant and surgical patients showed better quality of life and affective status than chronic pulmonary patients. Discriminant analysis showed that the transplant group was the best described group. We conclude that patients, one year after transplantation, show similar quality of life as asymptomatic hospitalised patients, somewhat better than chronic patients in a stabilized stage of the disease, and much better than severe chronic patients.
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PMID:[Quality of life in transplant patients, compared to other stressful health situations in pulmonary patients]. 1841 89

The aim was to evaluate the correlates of existential well-being (EWB) and investigate the relationship between EWB and health-related quality of life (HRQOL) according to the McGill Quality of Life Questionnaire (MQOL) in breast cancer survivors (BCS) and in the general population. BCS (N = 1,933) recruited from five large hospitals completed a mailed survey, which included the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (QLQ-C30), Quality of Life Questionnaire Breast Cancer Module (QLQ-BR23) and the MQOL. Reference data were derived from a representative sample of the Korean adult population composed of 500 women selected by a nationwide random route technique. Multiple logistic regression analysis showed that members of the general population with a lower educational status were more likely to report poor EWB. However, among BCS, correlates that were associated with poor EWB included lower monthly income, lower educational status, unemployment and comorbidities. Almost all factors listed on the HRQOL questionnaire were correlated with EWB in BCS as well as in the general population (P < 0.001). Factors listed on the QLQ-C30 that were correlated to a clinically meaningful extent with EWB in the general population included physical functioning, nausea and vomiting, and appetite loss, whereas among BCS, insomnia and distress over hair loss were meaningfully correlated with EWB. Compared with general population, BCS showed different EWB correlates and distinct associations with HRQOL findings. Our data suggest that socio-economic status and comorbidities influence on their EWB.
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PMID:Correlates of existential well-being and their association with health-related quality of life in breast cancer survivors compared with the general population. 1919 Oct 21


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