Comprehensive Assessment of the Elderly Cancer Patient: The Feasibility of Self-Report Methodology

2002 ◽  
Vol 20 (3) ◽  
pp. 770-775 ◽  
Author(s):  
Sally S. Ingram ◽  
Pearl H. Seo ◽  
Robert E. Martell ◽  
Elizabeth C. Clipp ◽  
Martha E. Doyle ◽  
...  

PURPOSE: Comprehensive geriatric assessment (CGA) has aided the medical community greatly in understanding the quality-of-life issues and functional needs of older patients. With its professional team assessment approach, however, CGA may be time consuming and costly. The goal of the present study was to assess the ability of cancer patients to complete a self-administered CGA and then to characterize cancer patients across multiple domains and age groups. PATIENTS AND METHODS: Two hundred sixty-six male outpatient oncology patients at the Durham Veterans Affairs Medical Center were asked to fill out a survey assessing 10 domains (demographics, comorbid conditions, activities of daily living, functional status, pain, financial well being, social support, emotional state, spiritual well-being, and quality of life). RESULTS: Seventy-six percent of the patients who received their surveys and kept their appointments returned the assessment tool. Older oncology patients had significantly less education (P < .0001), income (P = .05), frequent exercise (P = .01), and chance of being disease free (P = .003) than younger patients. Other findings in older patients were a higher rate of marriage (P = .02), more difficulty in taking medications (P = .05), and less cigarette (P = .03) and alcohol (P = .03) use. Members of all age cohorts reported a sense of social support, with younger patients deriving this more from family and friends than older patients, and older patients deriving social support more from membership in religious communities than younger patients. No differences were found across age groups for number and impact of comorbid illnesses, number of medications, basic and instrumental activities of daily living, pain, overall health rating, financial adequacy, anxiety, depression, and quality of life. CONCLUSION: CGA can be conducted in an outpatient cancer community using a self-report format. Despite the fact that this population varied demographically across age groups and is limited to veterans, this study demonstrated remarkable similarities between younger and older cancer patients in terms of functional status, health states, and quality of life.

2018 ◽  
Vol 2018 ◽  
pp. 1-8
Author(s):  
Max J. Weiling ◽  
Wencke Losensky ◽  
Katharina Wächter ◽  
Teresa Schilling ◽  
Fabian Frank ◽  
...  

Purpose. The general assumption is that cancer therapy impairs the quality of life in elderly patients more than in younger ones. We were interested in the effects of radiochemotherapeutic treatment on the quality of life of elderly patients compared to younger patients and compared to normative data of a general German population. Methods and Materials. A total of 465 patients completed the EORTC QLQ-C30 questionnaire. Repetitive completion of the questionnaire over time led to 1407 datasets. Our patient cohort contained 197 (42.4%) patients with colorectal cancer followed by 109 (23.4%) patients with head and neck cancer, 43 (9.2%) patients with lung cancer, and 116 (25%) with other types of cancer. Patients were categorized into five age groups, the respective cut-offs being 40, 50, 60, and 70 years. Normative data were drawn from a population study of a general German population. Results. Functional scores and symptom scores were approximately stable between the different age groups. Our data does not suggest a significant difference between the investigated age groups. Advancing age evened out the differences between the normative data of the general German population and the cancer patients in 11 of 15 scores. Conclusions. The general belief about younger patients having fewer physical and psychological problems related to radiochemotherapy needs to be reconsidered. Overall resilience of older patients is apparently underestimated.


2021 ◽  
Vol 12 ◽  
Author(s):  
Svenja Heyne ◽  
Peter Esser ◽  
Kristina Geue ◽  
Michael Friedrich ◽  
Anja Mehnert-Theuerkauf

BackgroundMultimodal cancer treatments are often associated with sexual problems. Identifying patients with sexual problems could help further elucidate serious issues with their sexuality and thus promote or maintain patients’ sexual health. We aimed to assess the occurrence of sexual problems in patients across different tumor locations and to explore associated sociodemographic, medical and psychosocial factors.MethodsWe included 3,677 cancer patients (mean age 58 years, age range 18–75 years, 51.4% women) from a large epidemiological multicenter study in Germany on average 13.5 months after cancer diagnosis. The occurrence and frequency of sexual problems were assessed via a binary item on the problem checklist of the Distress Thermometer (DT). Controlled associations of these problems with sociodemographic, medical and psychosocial factors including distress (DT), anxiety (GAD-7), depression (PHQ-9), quality of life (EORTC-QLQ-C30), and social support (SSUK-8) are analyzed using logistic regression analysis.ResultsWe found that 31.8% of patients reported sexual problems, with a significant higher proportion in men (40.5%) compared to women (23.7%), OR 2.35, 95% CI [1.80–3.07] and a higher proportion in patients with a partner (35.6%) compared to those without a partner (3.5%), OR 2.83, 95% CI [2.17–3.70]. Tumor location was associated with occurrence of sexual problems: patients with cancer, affecting the male genital organs had the highest chance for sexual problems, OR 2.65, 95% CI [1.18–3.95]. There was no significant difference in the occurrence of sexual problems between age groups OR 0.99, 95% CI [2.13–3.53] and type of therapy (e.g., operation OR 0.91, 95% CI [0.72–1.15]). Sexual problems were further associated with elevated levels of anxiety, OR 1.05, 95% CI [1.02–1.10], less social support, OR 0.93, 95% CI [0.90–0.97] and lower quality of life in terms of impaired functioning (e.g., social function, OR 0.99, 95% CI [0.99–1.00]).ConclusionsSexual problems are commonly reported by patients. Male patients and those living with a partner are more likely to report sexual problems. Sexual problems are associated with different aspects of well-being. The findings imply the practical relevance to screen for sexual problems among patients and identified groups that should be particularly monitored.


2017 ◽  
Vol 3 (2) ◽  
pp. 54-64 ◽  
Author(s):  
Ayse Berivan BAKAN ◽  
Asuman GURAKSIN

Background: When people face health problems, their life satisfaction levels and social relations could be ruined. When it comes to an eerie, deadly and chronic disease like cancer, the individual is much more likely to be affected by it.Objective: This descriptive study aims to identify quality of life and level of social support and the affecting factors in cancer patients.Methods: The sample included 170 patients who applied to Internal Diseases, Radiation Oncology, Thorax diseases clinics and Chemotherapy polyclinic in a university hospital in Turkey between March and August, 2005, who met the research criteria, and who volunteered to participate in the study. The sample represented 20 % of the target population. Data were collected through SF-36 Quality of Life Scale and Multidimensional Scale of Perceived Social Support.Results: The patients’ Global Quality of Life mean score was found 38.67 ± 13.64, and mean score for the Perceived Social Support was found 59.19 ± 17.5. Global Quality of Life score was higher in those who underwent an operation and who received ambulatory health care. Although Global Quality of Life was not influenced by the gender variable, male patients’ level of well-being was found to be higher. Perceived Social Support total score was found to be higher in those who knew about their disease. Family support was found to be higher in those who were married and who lived in town; it was found to be low in those who had low socio-economic level and who received inpatient treatment. Friend support was found to be high in those who knew about their disease.Conclusion: There was a linear relationship between Perceived Social Support and Quality of Life. It is recommended that more studies with wider groups of participants would shed more light to the issue of identifying quality of life, social support level and the relationships between them in cancer patients.


Author(s):  
Jeffrey J. Martin

While people with disabilities have much in common with able-bodied people, on a population level, researchers have demonstrated a number of important differences between people considered able-bodied and those labeled as disabled. The purpose of this chapter is to provide an overview of those differences. First, individuals with acquired disabilities face significant challenges when adjusting to a life with an impairment. While having a disability is not synonymous with poor health, people with disabilities often experience secondary conditions such as diabetes, chronic pain, and obesity. People with disabilities tend to experience more loneliness and depression and have less social support compared to able-bodied people. Lower levels of education and socioeconomic status also create challenges to enjoying a strong quality of life. Significant social and environmental barriers make performing activities of daily living and engaging in sport and exercise more difficult than for able-bodied individuals. People with disabilities often face far more daily challenges to their well-being compared to able-bodied individuals.


2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 456-456
Author(s):  
Kathryn Gessner ◽  
Sean McCabe ◽  
Pauline Filippou ◽  
Hannah McCloskey ◽  
Judy Hamad ◽  
...  

456 Background: Bladder cancer patients’ care is often managed by caregivers, yet caregiving can create a physiologic and emotional burden that compromises the caregivers’ own quality of life (QOL). Our objective was to determine the impact of disease stage on caregiver QOL among a large national cohort of bladder cancer patients. Methods: We performed a cross-sectional survey of bladder cancer caregivers using the Bladder Cancer Advocacy Network Patient Survey Network and Inspire platforms to determine caregiver QOL using the CareGiver QOL questionnaire (CarGOQoL). Caregivers were also queried regarding demographic, socioeconomic and clinical characteristics of their loved one. We present descriptive statistics and a multiple linear regression model to identify factors independently associated with QOL domain score. Results: 132 respondents self-identified as caregivers of patients with bladder cancer. Among respondents, 85% were a spouse, 86% were female, and 97% were white. The mean age was 63 years (range 34 to 72 years) and 73% of respondents completed college. The highest cancer stage for patients was non-invasive in 42%, muscle-invasive in 33%, and metastatic in 24%. On bivariable analysis, stage was associated with leisure and social support but was not associated with global QOL, psychologic or physical well-being, burden, relationship with healthcare, administration and finances, coping, self-esteem or private life. However, on multivariable analysis controlling for age, race, years since diagnosis, and comorbidity, stage was significantly associated with Caregiver QOL (p=0.04). Conclusions: Disease stage significantly impacts QOL among bladder cancer caregivers. As the caregiver is increasingly considered as a stakeholder in survivorship efforts, future interventions should consider targeting social support among caregivers of patients with advanced bladder cancer.


Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 5296-5296
Author(s):  
Mirsa B. Hussain ◽  
Gangadharan P. Sarita ◽  
Nandakumar Devi ◽  
Bejoy C. Thomas ◽  
Krishnan Rita ◽  
...  

Abstract Introduction: The deteriorating effects of chemotherapy on cancer patients are well documented, as is the need and impact of psychosocial interventions in improving quality of life (QOL). In India, cancer centres have a very high patient load and providing quality treatment and achieving good survival is still the first priority. Published studies from India on QOL in cancer patients are far and few, current ongoing studies are even fewer. The present study is on effect of chemotherapy on QOL, and prevalence of psychological morbidity in the Indian context. Patients and Methods: The study sample consisted of 117 cancer patients undergoing chemotherapy with curative intent as single modality or as part of the multi modality regimen. Nearly 30% of the sample had lymphoproliferative disease, 17% had haematological malignancies, 45% had solid tumours, and the rest had multiple myeloma. The assessments were carried out using the Distress Inventory for cancer version 2 (DIC V2), Functional Assessment of Cancer Therapy-General (FACT-G), and the Hospital Anxiety and Depression scales (HADS). Results: Older patients (&gt;=47 years) had significantly greater spiritual distress, and difficulties in activities of daily living, but had better emotional well being compared to younger patients (&lt;47 years). Patients from lower income strata had significantly greater distress levels and poorer QOL than those in the upper income category. Those with advanced disease had significantly poorer scores on most of the QOL subscales. More than 20% of the patients were found to have significant psychological morbidity ranging from mood disturbances (12%), to anxiety (3%) and depression (5%). Though chemotherapy did not significantly influence anxiety and depression, it was noted that male patients had significantly higher depression rates than females. Conclusions: The study was intended to measure the existence of psychological morbidity within the cancer patients. Older patients, those from lower incomes groups, and those with advanced disease had significantly greater levels of distress and significantly poorer QOL scores. Depression rates were significantly higher in male patients than in female patients. This shows the need to have psychiatric assessment and intervention among patients undergoing cancer chemotherapy.


2000 ◽  
Vol 18 (16) ◽  
pp. 3052-3060 ◽  
Author(s):  
L.M.L. Ong ◽  
M.R.M. Visser ◽  
F.B. Lammes ◽  
J. van der Velden ◽  
B.C. Kuenen ◽  
...  

PURPOSE: By means of a randomized double-blind study, the effect of providing taped initial consultations on cancer patients’ satisfaction, recall, and quality of life was investigated. PATIENTS AND METHODS: Consecutive cancer patients referred to either the gynecology or medical oncology outpatient clinic were eligible. Initial consultations were audiotaped. Patients were either provided with the tape (experimental group) or not (control group). Baseline variables included sociodemographics, preferences for information, coping styles, and clinical characteristics. Follow-up (after 1 week and 3 months) variables included attitudes toward the intervention, satisfaction, recall, and quality of life. Assessments took place through mailed questionnaires and telephone interviews. RESULTS: Two hundred one patients were included (response, 71%), 105 in the experimental group and 96 in the control group. Most patients (75%) listened to the tape, the majority of which (73%) listened with others. Almost all patients, both in the experimental group (96%) and control group (98%) were positive about the intervention. Expectations were confirmed; patients provided with the tape were more satisfied (P < .05) and recalled more information (P < .01) than patients without the tape. The intervention did not have an effect on quality of life. An interaction effect was found between the intervention and patients’ age on satisfaction with the taped consultation (P < .01) and recall of diagnostic information (P < .01); access to tapes seems more helpful in enhancing satisfaction in younger patients and recall of diagnostic information in older patients. CONCLUSION: Cancer patients and their families value the taped initial consultation. This intervention enhances their satisfaction and improves their recall of information. Tapes seem more helpful in enhancing satisfaction in younger patients and recall of diagnostic information in older patients.


2021 ◽  
Vol 20 ◽  
pp. 153473542199490
Author(s):  
Iván Ruiz-Rodríguez ◽  
Isabel Hombrados-Mendieta ◽  
Anabel Melguizo-Garín ◽  
Mª José Martos-Méndez

Introduction: The aim of the present study is to carry out a multidimensional analysis of the relationship of social support with quality of life and the stress perceived by cancer patients. Methods: The participants were 200 patients with cancer. Data was gathered on sociodemographic characteristics, health, quality of life, social support and perceived stress. Results: Frequency of and satisfaction with different sources and types of support are related positively with improvement of quality of life and negatively with perceived stress. The emotional support from the partner and the emotional and informational support from the family are significant predictors of quality of life. Emotional support from the family reduces patients’ perceived stress. Satisfaction with emotional support from the partner and with the informational support from friends and family increases quality of life. Satisfaction with emotional support from the family and with informational support from friends decreases patients’ perceived stress. Instrumental support and support provided by health professionals are not good predictors of quality of life and perceived stress. Satisfaction with the support received is more significantly related with quality of life and stress than the frequency with which the sources provide support. Conclusions: These results have important practical implications to improve cancer patients’ quality of life and reduce their perceived stress through social support. Designing intervention strategies to improve satisfaction with the support provided to patients by their closest networks results in a global benefit for the patient’s quality of life.


2021 ◽  
Vol 28 (2) ◽  
pp. 1495-1506
Author(s):  
Brent Burbridge ◽  
Hyun Lim ◽  
Lynn Dwernychuk ◽  
Ha Le ◽  
Tehmina Asif ◽  
...  

Introduction: Venous access is a crucial element in chemotherapy delivery. It remains unclear whether cancer patients prefer a port to a peripherally inserted central catheter (PICC). Our study aimed to assess cancer patients’ satisfaction with their venous access device and to compare the quality of life (QoL) of subjects with a PICC to those with a port. Methods: In this prospective cohort study, EORTC QLQ-C30, and a locally developed quality of life survey (QLAVD), designed to assess satisfaction with venous access devices, were administered to breast or colorectal cancer patients over a one-year period following the device insertion. Mixed effects models were used to assess changes on mean scores at different time points. Results: A total of 101 patients were recruited over a three-year period, (PICC group, n = 50; port group, n = 51). Survey response rates for months one and three were 72% and 48%, respectively. Overall, no significant differences were noted between the two groups in relation to EORTC QOL. At three months, the mean pain scores were 3.5 ± 2.3 for the port and 1.3 ± 0.75 for PICC (<0.001). The mean score for a negative effect of the venous access device on psychosocial well-being was 6.0 ± 4.1 for PICC and 3.0 ± 2.7 for the port (p = 0.005). Complications related to PICCs occurred in 38% patients versus 41% with a port (p > 0.24). Conclusions: Although subjects with a port experienced more pain during the device insertion or access for chemotherapy, it had a smaller negative impact on psychosocial scores than the PICC. No significant differences in complications rates were observed between the two devices.


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