Development and validation of the Comprehensive Quality of Life Outcome (CoQoLo) inventory for patients with advanced cancer

2015 ◽  
Vol 9 (1) ◽  
pp. 75-83 ◽  
Author(s):  
Mitsunori Miyashita ◽  
Makoto Wada ◽  
Tatsuya Morita ◽  
Mayumi Ishida ◽  
Hideki Onishi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Advanced Cancer ◽  
Group Performance ◽  
Medical Center ◽  
Performance Status ◽  
Intraclass Correlation ◽  
Eastern Cooperative Oncology Group ◽  
Reliability And Validity ◽  
Cross Sectional

BackgroundThe purpose of this study was to develop a scale capable of measuring comprehensive quality of life (QOL) outcomes based on the concept of a good death for patients with advanced cancer.MethodsWe conducted an anonymous cross-sectional questionnaire survey on inpatients being treated at the Oncology Clinic in Saitama Medical University International Medical Center and seven palliative units throughout Japan.ResultsA total of 405 patients with cancer participated in this study. Factor analysis of scores on the Comprehensive Quality of Life Outcome (CoQoLo) inventory revealed 28 items and the following 10 subscales: physical and psychological comfort; staying in a favourite place; maintaining hope and pleasure; good relationships with medical staff; not being a burden to others; good relationships with family; independence; environmental comfort; being respected as an individual; and having a fulfilling life. The total CoQoLo score was moderately correlated with satisfaction (r=0.34) and overall QOL (r=0.34), and moderately correlated with feelings of support and security regarding cancer care (r=0.44). Cronbach's α and the intraclass correlation coefficient of the total score were 0.90 and 0.79, respectively. No significant correlation was found between the total CoQoLo score and self-reported Eastern Cooperative Oncology Group performance status (r=−0.01).ConclusionsThese results suggest that the CoQoLo has sufficient reliability and validity and therefore provides an accurate measure of QOL outcomes independent of the general physical condition of the patient.

Assessment of Quality of Life in Outpatients With Advanced Cancer: The Accuracy of Clinician Estimations and the Relevance of Spiritual Well-Being—A Hoosier Oncology Group Study

2003 ◽  
Vol 21 (14) ◽  
pp. 2754-2759 ◽  
Author(s):  
Michael J. Fisch ◽  
Michael L. Titzer ◽  
Jean L. Kristeller ◽  
Jianzhao Shen ◽  
Patrick J. Loehrer ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Advanced Cancer ◽  
Performance Status ◽  
Well Being ◽  
Categorical Variables ◽  
Therapeutic Trial ◽  
Slight Variation ◽  
Cross Sectional ◽  
Spiritual Well Being

Purpose: To evaluate the association between quality-of-life (QOL) impairment as reported by patients and QOL impairment as judged by nurses or physicians, with and without consideration of spiritual well-being (SWB). Patients and Methods: A total of 163 patients with advanced cancer were enrolled onto a therapeutic trial, and cross-sectional data were derived from clinical and demographic questionnaires obtained at baseline, including assessment of patient QOL and SWB. Clinicians rated the QOL impairment of their patients as mild, moderate, or severe. Clinician-estimated QOL impairment and patient-derived QOL categories were compared. Correlation coefficients were estimated to associate QOL scores using different instruments. The analysis of variance method was used to compare Functional Assessment of Cancer Therapy–General scores on categorical variables. Results: There was no significant association between self-assessment scores and marital status, education level, performance status, or predicted life expectancy. However, a strong relationship between SWB and QOL was noted (P < .0001). Clinician-estimated QOL impairment matched the level of patient-derived QOL correctly in approximately 60% of cases, with only slight variation depending on the method of categorizing patient-derived QOL scores. The accuracy of clinician estimates was not associated with the level of SWB. Interestingly, a subset analysis of the inaccurate estimates revealed an association between lower SWB and clinician underestimation of QOL impairment (P = .0025). Conclusion: Clinician estimates of QOL impairment were accurate in more than 60% of patients. SWB is strongly associated with QOL, but it is not associated with the overall accuracy of clinicians’ judgments about QOL impairment.

Percutaneous cervical cordotomy for cancer-related pain: prospective multimodal outcomes evaluation

2020 ◽  
pp. bmjspcare-2019-002084
Author(s):  
Aimee Doyle ◽  
Manohar Lal Sharma ◽  
Manish Gupta ◽  
Andreas Goebel ◽  
Kate Marley
Keyword(s):  
Quality Of Life ◽  
Group Performance ◽  
Breakthrough Pain ◽  
Performance Status ◽  
Eastern Cooperative Oncology Group ◽  
Oral Morphine ◽  
Opioid Dose ◽  
Oral Morphine Equivalent ◽  
Global Impression Of Change

BackgroundPercutaneous cervical cordotomy (PCC) offers pain relief to patients with unilateral treatment-refractory cancer-related pain. There is insufficient evidence about any effects of this intervention on patients’ quality of life.MethodComprehensive multimodal assessment to determine how PCC affects pain, analgesic intake and quality of life of patients with medically refractory, unilateral cancer-related pain.This study was set in a multidisciplinary, tertiary cancer pain service. Patient outcomes immediately following PCC were prospectively recorded. Patients were also followed up at 4 weeks.ResultsOutcome variables collected included: background and breakthrough pain numerical rating scores before PCC, at discharge and 4 weeks postprocedure; oral morphine equivalent opioid dose changes, Patient’s Global Impression of Change, Eastern Cooperative oncology group performance status and health related quality of life score, that is, EuroQol-5 dimension-5 level (EQ-5D).ConclusionsDespite significant improvement in pain and other standard outcomes sustained at 4 weeks, there was little evidence of improvement in EQ-5D scores. In patients with terminal cancer, improved pain levels following cordotomy for cancer-related pain does not appear to translate into improvements in overall quality of life as assessed with the generic EQ-5D measure.

scholarly journals Quality of life analyses in patients with multiple myeloma: results from the Selinexor (KPT-330) Treatment of Refractory Myeloma (STORM) phase 2b study

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Gabriel Tremblay ◽  
Patrick Daniele ◽  
Janis Breeze ◽  
Lingling Li ◽  
Jatin Shah ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Multiple Myeloma ◽  
Nuclear Export ◽  
Group Performance ◽  
Performance Status ◽  
Eastern Cooperative Oncology Group ◽  
Difference Threshold ◽  
Open Label ◽  
Ecog Ps

Abstract Background Selinexor is an oral, selective nuclear export inhibitor. STORM was a phase 2b, single-arm, open-label, multicenter trial of selinexor with low dose dexamethasone in patients with penta-exposed relapsed/refractory multiple myeloma (RRMM) that met its primary endpoint, with overall response of 26% (95% confidence interval [CI], 19 to 35%). Health-related quality of life (HRQoL) was a secondary endpoint measured using the Functional Assessment of Cancer Therapy – Multiple Myeloma (FACT-MM). This study examines impact of selinexor treatment on HRQoL of patients treated in STORM and reports two approaches to calculate minimal clinically important differences for the FACT-MM. Methods FACT-MM data were collected at baseline, on day 1 of each 4-week treatment cycle, and at end of treatment (EOT). Changes from baseline were analyzed for the FACT-MM total score, FACT-trial outcome index (TOI), FACT-General (FACT-G), and the MM-specific domain using mixed-effects regression models. Two approaches for evaluating minimal clinically important differences were explored: the first defined as 10% of the instrument range, and the second based on estimated mean baseline differences between Eastern Cooperative Oncology Group performance status (ECOG PS) scores. Post-hoc difference analysis compared change in scores from baseline to EOT for treatment responders and non-responders. Results Eighty patients were included in the analysis; the mean number of prior therapies was 7.9 (standard deviation [SD] 3.1), and mean duration of myeloma was 7.6 years (SD 3.4). Each exploratory minimal clinically important difference threshold yielded consistent results whereby most patients did not experience HRQoL decline during the first six cycles of treatment (range: 53.9 to 75.7% for the first approach; range: 52.6 to 72.9% for the second). Treatment responders experienced less decline in HRQoL from baseline to EOT than non-responders, which was significant for the FACT-G, but not for other scores. Conclusion The majority of patients did not experience decline in HRQoL based on minimal clinically important differences during early cycles of treatment with selinexor and dexamethasone in the STORM trial. An anchor-based approach utilizing patient-level data (ECOG PS score) to define minimal clinically important differences for the FACT-MM gave consistent results with a distribution-based approach. Trial registration This trial was registered on ClinicalTrials.gov under the trial-ID NCT02336815 on January 8, 2015.

scholarly journals Prospective cohort study of surgical outcome for spinal metastases in patients aged 70 years or older

2020 ◽  
Vol 102-B (12) ◽  
pp. 1709-1716
Author(s):  
Yutaro Kanda ◽  
Kenichiro Kakutani ◽  
Yoshitada Sakai ◽  
Takashi Yurube ◽  
Shingo Miyazaki ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Performance Status ◽  
Eastern Cooperative Oncology Group ◽  
Spinal Metastases ◽  
Palliative Surgery ◽  
Advanced Age ◽  
Health State ◽  
Survival Times ◽  
The Mean

Aims With recent progress in cancer treatment, the number of advanced-age patients with spinal metastases has been increasing. It is important to clarify the influence of advanced age on outcomes following surgery for spinal metastases, especially with a focus on subjective health state values. Methods We prospectively analyzed 101 patients with spinal metastases who underwent palliative surgery from 2013 to 2016. These patients were divided into two groups based on age (< 70 years and ≥ 70 years). The Eastern Cooperative Oncology Group (ECOG) performance status (PS), Barthel index (BI), and EuroQol-5 dimension (EQ-5D) score were assessed at study enrolment and at one, three, and six months after surgery. The survival times and complications were also collected. Results In total, 65 patients were aged < 70 years (mean 59.6 years; 32 to 69) and 36 patients were aged ≥ 70 years (mean 75.9 years; 70 to 90). In both groups, the PS improved from PS3 to PS1 by spine surgery, the mean BI improved from < 60 to > 80 points, and the mean EQ-5D score improved from 0.0 to > 0.7 points. However, no significant differences were found in the improvement rates and values of the PS, BI, and EQ-5D score at any time points between the two groups. The PS, BI, and EQ-5D score improved throughout the follow-up period in approximately 90% of patients in each group. However, the improved PS, BI, and EQ-5D scores subsequently deteriorated in some patients, and the redeterioration rate of the EQ-5D was significantly higher in patients aged ≥ 70 than < 70 years (p = 0.027). Conclusion Palliative surgery for spinal metastases improved the PS, activities of daily living, and quality of life, regardless of age. However, clinicians should be aware of the higher risk of redeterioration of the quality of life in advanced-age patients. Cite this article: Bone Joint J 2020;102-B(12):1709–1716.

Patients’ Awareness of Advanced Disease Status, Psychological Distress and Quality of Life Among Patients With Advanced Cancer: Results From the APPROACH Study, India

2021 ◽  
pp. 104990912110428
Author(s):  
Aanchal Satija ◽  
Sushma Bhatnagar ◽  
Semra Ozdemir ◽  
Eric Finkelstein ◽  
Chetna Maholtra ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Psychological Distress ◽  
Advanced Cancer ◽  
Cancer Diagnosis ◽  
Advanced Disease ◽  
Disease Status ◽  
Educational Background ◽  
Solid Cancer ◽  
Cross Sectional

Background: Prognostic disclosure to patients with advanced cancer facilitates treatment decisions and goals of care discussions. However, the perspectives of patients, families and physicians differ in this regard across different cultures. Non-disclosure of cancer diagnosis or prognosis is commonly observed in family-centric cultures such as India. Aim: To assess the prevalence of and factors associated with cancer patients’ awareness of advanced disease status; and its with quality of life and psychological distress. Methods: Patients for this cross-sectional questionnaire-based survey were recruited from oncology and palliative medicine clinics at a tertiary cancer hospital in India from January 2017 to June 2018. Patients aged ≥ 21 years, aware of cancer diagnosis and receiving oncology treatment for Stage IV solid cancer were included in the study after obtaining written informed consent. Results: Two hundred patients were enrolled, of which 146 (73%) were not aware of the stage of their malignancy and 9 (4.5%) believed that their disease was at stage I, II or III. Those who were aware of their advanced cancer stage had more years of education (9.9 years vs 8.1 years, p = .05) and had poorer spiritual wellbeing in the faith domain (adjusted difference −1.6, 95% confidence interval −3.1 to −0.1, p = .03) compared to those who were unaware. Conclusion: It is recommended that future studies may explore prognostic understanding in Indian patients according to their socio-cultural, spiritual and educational background.

scholarly journals Impact of Sleep Disturbances on the Quality of Life Among Schizophrenic Out-patients of Jimma University Medical Center, Southwest Ethiopia: Hospital Based Cross-sectional Study

2020 ◽  
Vol 13 (1) ◽  
pp. 684-691
Author(s):  
Aman Dule ◽  
Mustefa Mohammedhussein ◽  
Mohammedamin Hajure
Keyword(s):  
Quality Of Life ◽  
Sleep Disturbances ◽  
Medical Center ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Southwest Ethiopia ◽  
Schizophrenic Patients ◽  
Jimma University

Aim: Current study was aimed to assess the impacts of sleep disturbances on patient’s quality of life. Background: Schizophrenia is a syndrome, which affects sleep. Up to 80% of schizophrenic patients complain of sleep disturbances which affect the quality of life Objectives: To assess the association of sleep disturbances and quality of life and other contributing factors among schizophrenic patients on follow-up treatment at Jimma University Southwest Ethiopia. Methods: A cross-sectional study with a consecutive sampling of 411 out-patients at Jimma University medical center was employed from April 21-June 20, 2019. Sleep disturbances and the quality of life were assessed by Pittsburgh sleep quality index and WHOQOL-BREF, respectively. Epi data version 3.1 and SPSS version 23.0 software was used. Chi-square and independent samples t-test were used for association and P-value < 0.05 was considered for statistical significance. Results: Most participants had sleep disturbances and the mean score of positive scale on PANSS was higher for patients with sleep disturbances. About one-fourth of the patients had very good subjective sleep quality and > 85% of sleep efficiency was reported by 139 participants. More than half (51.1%) of the subjects had used sleep medication and the majority (64.7%) of them were reported daytime dysfunctions in the past month. The social domain (M±SD=3.92±2.51, t=8.46, p= <0.001, eta2=0.15) and overall WHOQOL (M±SD=57.60±16.87, t=9.24, p= < 0.001, eta2= 0.17) score had a large difference of means and about 15% and 17% of the variance in sleep disturbance have been explained. Conclusion: Generally, the finding of the current study was in agreement with most of the previous studies and sleep disturbances respectively moderate to significant effects on the patient’s quality of life.

Exploring factors associated with quality of life in women undergoing mammography

2020 ◽  
Author(s):  
Chih Jung Wu ◽  
Ya-Jung Wang ◽  
Liang-Chih Liu
Keyword(s):  
Quality Of Life ◽  
Emotional Distress ◽  
Medical Center ◽  
Depression Scale ◽  
Emotional Problems ◽  
Well Being ◽  
Cross Sectional ◽  
Factors Associated ◽  
Central Taiwan

Abstract Purpose: Mammography is broadly used in early detection of breast cancer. However, women undergoing mammography had experienced physical, psychological, and social disturbance; this could affect their Quality of Life (QoL). Only few studies in QoL have been done on cancer screening populations. The purpose of this study was to explore factors associated with QoL among women undergoing mammography. Methods: This research used a cross-sectional questionnaire survey and conducted with 158 women who were undergoing mammography. Data were collected from an outpatient department in a medical center located in central Taiwan from December 2014 to October 2015. The Functional Assessment of Cancer Therapy Scale –General, Chinese version was used to assess the QoL. Emotional distress was measured by using the Hospital Anxiety and Depression Scale and Mishel’s Uncertainty in Illness Scale. Descriptive statistic and multiple liner regression were used to analyze the data. Results: The multiple liner regression results revealed that women with benign breast tumors had better functional well-being (β = 1.276, p = 0.021). Women who had higher uncertainty (β=-0.216, p < 0.01) and emotional distress (β = -1.229, p < 0.01) experienced lower QoL. Conclusion: In this study, the uncertainty, emotional distress significantly predicted the QoL in women undergoing mammography screening. Clinical staff should pay attention to the emotional problems of women undergoing mammography. When women receive the mammography, this is an opportune time to educate them regarding the examination process and inform them of how reductions in uncertainty and emotional problems may help improve their QoL.

The most troublesome aspects of quality of life for people with advanced cancer in a supportive care trial

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 18527-18527
Author(s):  
A. K. Nowak
Keyword(s):  
Quality Of Life ◽  
Advanced Cancer ◽  
Intraclass Correlation ◽  
Well Being ◽  
Dry Mouth ◽  
Single Item ◽  
Retest Reliability ◽  
Data Form ◽  
Test Retest Reliability

18527 Background: ZEST is a placebo-controlled trial of sertraline for people with advanced cancer who feel depressed, anxious or tired but do not have a clear indication for antidepressants. We describe here the aspects of quality of life (QL) rated most troublesome at baseline by the first 150 subjects. Methods: Subjects completed a battery of QL questionnaires including the CES-D, HADS, FACT-G, FACT-Fatigue, and the Patient Disease and Treatment Assessment Form (Pt DATA Form). The Pt DATA Form assesses pertinent symptoms and concerns using 40 single items with a uniform response scale from 0 (no trouble at all) to 10 (worst I can imagine). Test-retest reliability was assessed with the intraclass correlation coefficient (ICC). Convergent validity was assessed by testing correlations between single items from the PT DATA Form and the corresponding, validated, multi-item scales. Results: The median age was 66 (IQR 59 to 73); median Karnofsky Perfomance Status was 80 (IQR 70 to 90); 63% were male; commonest primaries were colorectal (17%), lung (16%), prostate, (14%), breast (13%), and gynaecologic (10%). The aspects rated worst (mean score, proportion scoring >3) were: Fatigue (5.5, 90%), Problems with sex (4.1, 51%), Trouble sleeping (3.6, 49%), Drowsiness (3.5, 54%), Not feeling myself (3.5, 51%), Pain (3.4, 45%), Shortness of breath (3.4, 47%), Problems doing what I wanted (3.1, 45%), Anxiety (3.0, 40%), Depression (2.7, 36%), Dry mouth (2.7, 38%), Trouble concentrating (2.7, 30%), Irritability (2.6, 32%), Altered sense of taste (2.5, 34%), Difficulty walking (2.4, 32%), and Constipation (2.1, 24%). Mean scores were higher in men than women for Problems with sex (5.0 v 2.4, p < 0.001); and, in subjects aged 65 or younger for Hair loss (2.4 v 1.1, p = .01). There were no other significant differences by gender or age. Correlations supported the validity of the single item scales for depression, anxiety, fatigue; and for physical, emotional and overall well-being. The test-retest reliability of the Pt DATA Form was good (ICC >0.5 for 34 of 40 items). Conclusions: Pertinent aspects of QL were validly measured with single item scales. Insomnia, dry mouth, altered sense of taste and irritability were more troublesome than many other, better studied symptoms. No significant financial relationships to disclose.

QTc interval in advanced cancer patients

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e20658-e20658
Author(s):  
D. Trivanovic ◽  
R. Dobrila-Dintinjana ◽  
Z. Mavric ◽  
D. Stimac ◽  
M. Petkovic
Keyword(s):  
Prognostic Factors ◽  
Advanced Cancer ◽  
Median Survival ◽  
Cardiac Disease ◽  
Group Performance ◽  
Performance Status ◽  
Eastern Cooperative Oncology Group ◽  
Solid Cancer ◽  
Qtc Interval ◽  
One Year

e20658 Background: The purpose is to identify prognostic factors that may have impact on survival in patients with advanced cancer. Methods: We retrospectively reviewed the data of patients who had biopsy proven advanced solid cancer disease in stage IV and no history or evidence of any prior cardiac disease. Univariate and multivariate stepwise Cox proportional hazard regression analysis were performed to identify independent predictors of one year survival. Results: Between 1/01 and 9/05, 143 patients (83 male and 60 female) with advanced cancers were evaluated in our institution. The primary site of disease was lung (28%), pancreas (19%), colon (15%), rectum (13%), breast (12%), and other (13%). The median follow-up was 12,5 months, median overall survival (OS) was 8.1 months, and 1-year OS rate was 62%. Median age was 65 years. OS was significantly related to the following pre-treatment prognostic factors: Age ≥65 (years), anaemia (hemoglobin level <13.2 g/dl), Eastern Cooperative Oncology Group performance status (ECOG PS) 0–1, and prolonged QTc interval in electrocardiogram (ECG). However, multivariate analysis revealed only prolonged QTc as independent prognostic parameter with 1-y survival status. Using 440 ms as the cut off value, the QTc interval was prolonged in 32 patients (22%) with median survival of 45 days and normal in 111 patients (78%) with median survival of 280 days. During the one-year 25 patients (78%) died in group with prolonged QTc interval while in group with normal QTc interval died 63 patients (57%). Conclusions: The results of our study indicate that a prolonged QTc interval (> 440 ms) is an adverse prognostic sign in patients with advanced cancer and without cardiac disease which correlates with increased mortality rates within one year after the diagnosis. Our findings suggest that QTc prolongation may be a good adjunct in risk stratification of patients with advanced cancer who are being considered for aggressive treatment regimens. [Table: see text] No significant financial relationships to disclose.

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