Clinical Significance of Symptom Burden and Quality of Life Decrement in Cancer Patients with Mild Anemia.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 5305-5305
Author(s):  
Lee S. Schwartzberg ◽  
Barry V. Fortner ◽  
Arthur C. Houts
Keyword(s):  
Quality Of Life ◽  
Clinical Significance ◽  
Effect Size ◽  
Cancer Care ◽  
Symptom Burden ◽  
Effect Sizes ◽  
Mild Anemia ◽  
Cohen’S D ◽  
Health Related

Abstract Background. Cancer related anemia (CRA) is associated with increased symptom burden and reduced quality of life (QoL) compared to non-anemic subjects. Standard treatment guidelines for CRA recomend treatment when hemoglobin (Hb) declines to ≤ 10 g/dl. We compared patients with mild anemia to those with normal Hb level to assess clinical significance of mild anemia. Methods. 3416 patients from a large community oncology database sorted by gender and Hb were retrospectively reviewed. Patients receiving chemotherapy (<30 days) and/or growth factor (< 60 days) were excluded. Each case provided one Hb determination and same day self reported scores on the Cancer Care Monitor (CCM), a validated measure of symptom burden, functioning, and health related QoL comprising 6 scales. All CCM items are rated for symptom severity on a 0–10 scale. Effect sizes for male groups are calculated relative to normal males (Hb > 14), and effect sizes for females are calculated relative to normal females (Hb > 12). Positive effect size (Cohen’s exact d) values indicate greater symptom burden, and negative effect size values indicate lower quality of life. Results. Group differences on CCM measures were not accounted for by demographic, cancer diagnosis, and chemotherapy history differences. Table 1 shows a pattern of greater symptom burden, lower functioning, and worse QOL for males and females with mild anemia (p < .05). As compared to standards for minimal clinically important differences such as found with SF-36 (0.09 < Cohen’s d < 0.28). patients with mild anemia showed clinically significant differences in terms of effect size (0.11 < Cohen’s d < 0.61). Conclusions. The QoL impact of mild CRA is significant and failure to treat mild anemia may result in unnecessary symptom burden and noteworthy decrements in health related quality of life. Differences in QoL for Patients with Mild Anemia M Hb12<14 M Hb >14 Effect Size F Hb 10<12 F Hb >12 Effect Size Cancer Care Monitor Measure* (n = 327) (n = 471) Males (n = 449) (n = 2169) Females Note. *Mean (SE) for each item or scale. Adjusted means with different subscripts across rows are significantly different (p < .05) by Bryant Paulson comparisons. Fatigue Item 3.10 (0.16) b 2.27 (0.13) c 0.30 3.47 (0.13) b 2.65 (0.06) d 0.30 Physical Symptoms 49.54 (0.58) b 45.49 (0.48) c 0.38 49.32 (0.49) b 46.97 (0.22) d 0.22 General Distress 49.51 (0.57) b 47.07 (0.47) d 0.19 51.23 (0.49) c 49.85 (0.22) b 0.11 Despair 50.74 (0.52) b 48.58 (0.43) c 0.25 50.37 (0.44) b 49.13 (0.19) c 0.14 Impaired Performance 55.55 (0.87) b 49.78 (0.70) c 0.61 55.02 (0.73) b 49.90 (0.32) c 0.48 Quality of Life 49.41 (0.79) b 53.46 (0.64) c −0.45 48.95 (0.67) b 52.39 (0.29) c −0.35

scholarly journals Health-related quality-of-life among patients with premature ovarian insufficiency: a systematic review and meta-analysis

2019 ◽  
Vol 29 (1) ◽  
pp. 19-36 ◽  
Author(s):  
X. T. Li ◽  
P. Y. Li ◽  
Y. Liu ◽  
H. S. Yang ◽  
L. Y. He ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Effect Size ◽  
Meta Analysis ◽  
Effect Sizes ◽  
Medium Effect ◽  
Health Related Quality ◽  
Ovarian Insufficiency ◽  
Related Quality ◽  
Health Related

Abstract Purpose To systematically review studies investigating health-related quality-of-life (HrQoL) in patients with premature ovarian insufficiency (POI), to examine questionnaires used and to conduct a meta-analysis of control studies with normal ovarian function. Methods Data sources: PubMed, Embase, Web of science, CNKI, and CQVIP, searched from inception until June 2018. The search strategy was a combination of medical (e.g. POI), subjective (e.g. well-being) and methodological (e.g. questionnaires) keywords. PRISMA guidelines were used to assess outcome data quality/validity by one reviewer, verified by a second reviewer. Risk of bias within studies was evaluated. A meta-analysis compared HrQoL in patients and non-patients. Due to measurement differences in the studies, the effect size was calculated as standard mean difference. Results We identified 6869 HrQoL studies. Nineteen geographically diverse studies met inclusion criteria, dated from 2006, using 23 questionnaires. The meta-analysis included six studies with 645 POI participants (age 33.3 ± 5.47) and 492 normal-ovarian control subjects (age 32.87 ± 5.61). Medium effect sizes were found for lower overall HrQoL (pooled SMD = − 0.73, 95% CI − 0.94, − 0.51; I2 = 54%) and physical function (pooled SMD = − 0.54, 95% CI − 0.69, − 0.39; I2 = 55%). Heterogeneity was investigated. Effect sizes varied for sexual function depending on the measure (SMD = − 0.27 to − 0.74), overall HrQoL (SF-36) had the largest effect size (− 0.93) in one study. The effect sizes for psychological and social HrQoL were small. Conclusion POI is associated with low-to-medium effect size on HrQoL compared to normal ovarian controls. The greatest effects are found in general HrQoL and most sexual function areas. Condition-specific questionnaires and RCTs are recommended for further investigation.

scholarly journals Symptom burden, psychological distress, and health-related quality of life in cancer survivors with pelvic late radiation tissue injuries

2021 ◽  
Author(s):  
Grete K. Velure ◽  
Bernd Müller ◽  
May Aa. Hauken
Keyword(s):  
Quality Of Life ◽  
Psychological Distress ◽  
Cancer Survivors ◽  
Symptom Burden ◽  
Life Questionnaire ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
Tissue Injuries

Abstract Purpose Curative radiotherapy for cancer may lead to severe late radiation tissue injuries (LRTIs). However, limited knowledge exists about pelvic cancer survivors’ LRTI symptoms, distress, and health-related quality of life (HRQOL). We sought to assess the symptom burden, distress, and HRQOL in survivors with established pelvic LRTIs compared to norm populations and to investigate the relation between these factors. Methods Cancer survivors referred for treatment of established pelvic LRTIs were recruited nationwide. LTRIs were assessed with the Expanded Prostate Cancer Index Composite (EPIC), psychological distress was assessed with the General Health Questionnaire (GHQ-12), and HRQOL was assessed with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORCT-QLQ-C30). Results A total of 107 participants (mean age 64, 53% men) were included. Compared to norms, participants reported more urinary (mean 68.7 vs. 89.5; p = 0.00; d = 1.4) and bowel symptoms (mean 62.5 vs. 92.4; p = 0.00; d = 2.7), increased psychological distress (mean 13.4 vs. 10.3; p = 0.00; d = 0.6), and overall poorer HRQOL (mean 54.9 vs. 71.2; p = 0.00; d = 0.7). Higher symptom burden and higher levels of psychological distress were associated with lower HRQOL (r2 = 46%), but psychological distress did not moderate the influence of symptoms on HRQOL. Conclusion Cancer survivors with established pelvic LRTIs are highly burdened compared to norms. The association of the LRTI-related symptom burden with HRQOL is independent of the level of psychological distress. Both coping and treatment interventions are crucial to promoting long-term health and HRQOL. Trial registration NCT03570229.

Sex Differences in Patients Who Have Cancer with Mild Anemia: Symptom Burden and Quality of Life

2005 ◽  
Vol 2 (4) ◽  
pp. 241-246
Author(s):  
Lee S. Schwartzberg ◽  
Barry V. Fortner ◽  
Arthur C. Houts
Keyword(s):  
Quality Of Life ◽  
Sex Differences ◽  
Symptom Burden ◽  
Mild Anemia

An Integrative Review of Factors Associated With Symptom Burden at the End of Life in Children With Cancer

2020 ◽  
Vol 37 (4) ◽  
pp. 284-295 ◽  
Author(s):  
Ijeoma Julie Eche ◽  
Ifeoma Mary Eche ◽  
Teri Aronowitz
Keyword(s):  
Quality Of Life ◽  
End Of Life ◽  
Symptom Burden ◽  
Health Related Quality ◽  
Inclusion Criteria ◽  
Children With Cancer ◽  
Symptom Experiences ◽  
Related Quality ◽  
Health Related

Children with cancer experience multiple symptoms at end of life (EOL) that impair their health-related quality of life. Using the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, this integrative literature review comprehensively summarized symptom experiences of children with cancer at EOL. The Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, and Academic Premier were searched between January 2007 to September 2019 for articles published in English using the MeSH terms: symptom burden or distress AND children with cancer or pediatric cancer or cancer children or oncology and pediatrics AND EOL care or palliative care or death or dying or terminally ill. The inclusion criteria were the following: (a) study designs [randomized controlled trials, nonexperimental, secondary analysis (if aims were distinct from primary studies) and qualitative]; (b) participants <18 years old (died of cancer, had no realistic chance of cure, or had advanced cancer); and (c) focused on symptom experiences/burden at EOL. Exclusion criteria were nonresearch articles, systematic reviews, case studies, reports, and studies that focused on cancer survivors and/or those receiving curative therapies. Twenty-seven articles met inclusion criteria. The most prevalent symptoms—pain, fatigue, dyspnea, and loss of appetitewere associated with impairments in health-related quality of life. Children with brain tumors experienced higher symptom burden compared to those with hematologic/solid malignancies. Children who received cancer-directed therapies experienced disproportionate symptoms and were more likely to die in the intensive care unit compared with those who did not receive cancer-directed therapies. Most common location of death was home. This integrative review indicated that children with cancer were polysymptomatic at EOL. Strategies facilitating effective symptom management at EOL are needed.

Breast cancer nursing interventions and clinical effectiveness: a systematic review

2020 ◽  
Vol 10 (3) ◽  
pp. 276-286
Author(s):  
Raymond Javan Chan ◽  
Laisa Teleni ◽  
Suzanne McDonald ◽  
Jaimon Kelly ◽  
Jane Mahony ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Symptom Burden ◽  
Risk Of Bias ◽  
Self Report ◽  
Self Management ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

ObjectivesTo examine the effects of nurse-led interventions on the health-related quality of life, symptom burden and self-management/behavioural outcomes in women with breast cancer.MethodsCochrane Controlled Register of Trials (CENTRAL), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline and Embase databases were searched (January 1999 to May 2019) to identify randomised controlled trials (RCTs) and controlled before-and-after studies of interventions delivered by nurses with oncology experience for women with breast cancer. Risk of bias was evaluated using the revised Cochrane risk-of-bias tool for randomised trials. Intervention effects were synthesised by cancer trajectory using The Omaha System Intervention Classification Scheme.ResultsThirty-one RCTs (4651 participants) were included. All studies were at risk of bias mainly due to inherent limitations such as lack of blinding and self-report data. Most studies (71%; n=22) reported at least one superior intervention effect. There were no differences in all outcomes between those who receive nurse-led surveillance care versus those who received physical led or usual discharge care. Compared with control interventions, there were superior teaching, guidance and counselling (63%) and case management (100%) intervention effects on symptom burden during treatment and survivorship. Effects of these interventions on health-related quality of life and symptom self-management/behavioural outcomes were inconsistent.DiscussionThere is consistent evidence from RCTs that nurse-led surveillance interventions are as safe and effective as physician-led care and strong evidence that nurse-led teaching, guidance and counselling and case management interventions are effective for symptom management. Future studies should ensure the incorporation of health-related quality of life and self-management/behavioural outcomes and consider well-designed attentional placebo controls to blind participants for self-report outcomes.Protocol registrationThe International Prospective Register of Systematic Reviews (PROSPERO): CRD42020134914).

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