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 ◽  
...  

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.

Author(s):  
Iraktânia Vitorino Diniz ◽  
Isabelle Katherinne Fernandes Costa ◽  
João Agnaldo Nascimento ◽  
Isabelle Pereira da Silva ◽  
Ana Elza Oliveira de Mendonça ◽  
...  

ABSTRACT Objective: To assess the quality of life of people with intestinal stoma and its association with sociodemographic and clinical characteristics. Method: Cross-sectional and analytical study conducted with people with intestinal stoma. An instrument was used for sociodemographic and clinical characterization: COH-QOL-OQ, validated in Brazil. Results: The sample included 152 people with stomas. There were significant differences among all dimensions (p-value < 0.01) of quality of life. The dimension spiritual well-being had the highest mean, with 6.69 (±1.56), followed by the psychological well-being dimension, 5.00 (±1.94), social well-being, 4.63 (±1.83), and physical well-being, 4.54 (±1.77). Marital status, religion, type of stoma, and permanence had statistically significant associations with dimensions of quality of life (p-value < 0.05). Conclusion: The assessment of quality of life in people with intestinal stoma presented lower scores in the physical, social, and psychological dimensions. There was an association between better quality of life scores and people with definitive ileostomy, in a domestic partnership and practicing other religions.


Author(s):  
Rhanderson N Cardoso ◽  
Daniel Garcia ◽  
Alexandre Benjo ◽  
Francisco Macedo ◽  
Cesar Benjo ◽  
...  

Background: Permanent pacemakers (PPM) have improved cardiovascular outcomes and quality of life (QoL) in patients with a wide variety of cardiac rhythm disturbances. Nevertheless, misperceptions about the safety of daily activities (SODA) and associated factors can compromise patients’ absolute well-being. We aimed to study factors associated with worst QoL in PPM patients. Methods: PPM patients from a tertiary hospital answered an 18-question questionnaire about their perception on the SODA, which was scored based on misperception rate. Patients also answered SF-36, a validated QoL questionnaire which is scored from 0 to 100 on each of its 8 scales. Baseline characteristics were compared to average on SF-36 scales in a cross-sectional model by t-test for categorical variables and by univariable regression for continuous variables. Statistical analysis was done with Stata software 10.0 (Texas). Results: A total of 75 PPM patients aged 65.3±12 years were included, of which 31 (41%) were males. Most common reason for PPM was 3rd degree atrioventricular block (44%). Body mass index (p=0.019) and misperception rate on SODA (p=0.003) presented a significant negative regression coefficient with SF-36 average. Age, gender, average income, Chagas disease etiology, diabetes, hypertension, ejection fraction, NYHA classification, previous myocardial infarction (MI), smoking history and peripheral vascular disease were not significantly associated with SF-36 QoL results. Conclusions: In a cross-sectional study, body mass index and misperceptions about the safety of daily-life activities were associated with worst quality of life in patients with permanent pacemaker. These results suggest that optimal physician education of patients and their families about the SODA for PPM patients may ultimately improve patients’ well-being.


2012 ◽  
Vol 30 (12) ◽  
pp. 1304-1309 ◽  
Author(s):  
William Breitbart ◽  
Shannon Poppito ◽  
Barry Rosenfeld ◽  
Andrew J. Vickers ◽  
Yuelin Li ◽  
...  

Purpose Spiritual well-being and sense of meaning are important concerns for clinicians who care for patients with cancer. We developed Individual Meaning-Centered Psychotherapy (IMCP) to address the need for brief interventions targeting spiritual well-being and meaning for patients with advanced cancer. Patients and Methods Patients with stage III or IV cancer (N = 120) were randomly assigned to seven sessions of either IMCP or therapeutic massage (TM). Patients were assessed before and after completing the intervention and 2 months postintervention. Primary outcome measures assessed spiritual well-being and quality of life; secondary outcomes included anxiety, depression, hopelessness, symptom burden, and symptom-related distress. Results Of the 120 participants randomly assigned, 78 (65%) completed the post-treatment assessment and 67 (56%) completed the 2-month follow-up. At the post-treatment assessment, IMCP participants demonstrated significantly greater improvement than the control condition for the primary outcomes of spiritual well-being (b = 0.39; P <.001, including both components of spiritual well-being (sense of meaning: b = 0.34; P = .003 and faith: b = 0.42; P = .03), and quality of life (b = 0.76; P = .013). Significantly greater improvements for IMCP patients were also observed for the secondary outcomes of symptom burden (b = −6.56; P < .001) and symptom-related distress (b = −0.47; P < .001) but not for anxiety, depression, or hopelessness. At the 2-month follow-up assessment, the improvements observed for the IMCP group were no longer significantly greater than those observed for the TM group. Conclusion IMCP has clear short-term benefits for spiritual suffering and quality of life in patients with advanced cancer. Clinicians working with patients who have advanced cancer should consider IMCP as an approach to enhance quality of life and spiritual well-being.


2018 ◽  
Vol 75 (6) ◽  
pp. 611-617
Author(s):  
Gordana Repic ◽  
Suncica Ivanovic ◽  
Cedomirka Stanojevic ◽  
Sanja Trgovcevic

Background/Aim. Colorectal cancer and its treatment can have a negative impact on the quality of life which has become an important outcome measure for cancer patients. The aim of this work was assessment of psychological and spiritual dimension of the quality of life in colostomy patients, regarding the gender and age. Methods. This is a cross-sectional study conducted at the Abdominal Surgery Polyclinic in the Clinical Canter of Vojvodina among colostomy patients operated between January 2010 and June 2011. The instrument used in this study was Quality of Life Questionnaire for a Patient with an Ostomy (QOL-O). Results. Majority of respondents were male (M:F = 50.7% : 49.3%). The age ranged between 36?86 years. Respondents did not report difficulties in adjustment to stoma, but their great difficulty was to look at it and the sense of depression and anxiety. The care of stoma was worse perceived by younger respondents (p = 0.014). Respondents were mostly satisfied with their memorizing ability and having the sense of control. The lowest score was found in sensing satisfaction or enjoyment in life. The age had a significant impact on positive aspects of psychological well-being (p < 0.05). Higher scores were found among younger age groups. The mean score of spiritual well-being (6.47 ? 3.01) was lower than the mean score of psychological well-being (7.76 ? 2.35). There were no statistically significant differences regarding gender (t = -0.738, df = 65, p = 0.463) or age (F = 1.307, p = 0.280). Conclusion. Psychological and spiritual well-being in colostomy patients appeared to be at satisfactory level, but it is necessary to provide tailor made support in order to prevent and resolve negative responses to stoma.


2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 115s-115s
Author(s):  
M. Lazenby ◽  
Z. Alward ◽  
R. Gatarny ◽  
C. Ayash ◽  
F. Gany

Background: Little is known about the psychosocial care experience of Muslims who are in treatment of advanced cancer in non-Muslim majority settings. Aim: To describe the experience of Muslims who are in treatment of advanced cancer in a non-Muslim majority setting and to identify beliefs and practices for culturally congruent psychosocial care. Methods: This cross-sectional study, which is in progress, uses a semistructured interview guide and self-report questionnaires with Muslim patients ≥ 21 years who are in treatment of stage III or IV cancer at an academic cancer center in the northeast of the United States. Analysis of interviews is by grounded theory and of questionnaires by frequencies, percentages, and measures of central tendency and dispersion for quality of life: Functional Assessment of Cancer Therapy-General (FACT-G; range 0-108) with subscales: Physical Well-Being (PWB [range 0-28]), Social Well-Being (SWB [range 0-28]), Emotional Well-Being (EWB [range 0-24]), and Functional Well-Being (FWB [range 0-28]; higher scores reflect better quality of life Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-Sp [range 0-48]), with subscales: peace (range 0-16), meaning (range 0-16), and faith (range 0-16); higher scores reflect better spiritual well-being. Distress Thermometer (DT; 0 = no distress, 10 = worst distress). Hospital Anxiety and Depression Scale (HADS), with subscale: anxiety (0-21) and depression (0-21); higher scores reflect worse condition. Results: Eleven (female, n=5 [45.5%]) Muslim patients from 10 countries of origin with a mean age of 55.2 (±10.9) years who were in treatment of breast, colorectal, gastric, lung, ovarian, prostate, melanoma and lymphoma cancers (Stage 4, n=8 [72.7%]) have been interviewed to date. Mean scores were: FACT-G 85.6 (±17.9) (PWB 22.3 [±5.1], SWB 23.8 [±3.8], EWB 18.6 [±4.5], FWB 20.7 [±6.7]; FACIT-Sp 123.8 (±24.6) (peace 11.6 [±4.5], meaning 13.7 [±3.1], faith 12.9 [±3.8]), DT 2.13 (SD 2.58); HADS anxiety 3.9 (±3.2) and depression 3.8 (±3.7). Four universal themes emerged: (1) Faithful Muslims must seek and submit to treatment. (2) Spiritual practices (prayer and other traditional healing practices) are sources of meaning. (3) Psychosocial care in a non-Muslim majority setting is often presented in ways incongruent with Muslims' beliefs and practices. (4) Psychosocial care would be acceptable if congruent with Muslims' beliefs and practices. Conclusion: Presenting psychosocial care as part of routine cancer treatment and, in non-Muslim majority settings, delivering psychosocial care that is culturally congruent with Islamic beliefs and practices, may increase the acceptability of psychosocial care among Muslims who are in treatment of advanced cancer.


2020 ◽  
Vol 66 (12) ◽  
pp. 23-28
Author(s):  
Emel Gülnar ◽  
Hüsna Özveren ◽  
Ercan Yuvanç

Urinary incontinence (UI) increases the risk of medical complications and psychosocial, physical, and emotional problems. PURPOSE: This cross-sectional descriptive study investigated the correlation between spiritual well-being (SWB) and quality of life (QOL) in patients with UI. METHODS: Patients with UI visiting an outpatient urology clinic of a university hospital in Turkey were invited to participate. Data were collected using the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being 12 Item Scale (FACIT-Sp-12) (range 0–48 with higher scores indicating better SWB) and the Incontinence Quality of Life Questionnaire (I-QOL) (range 0–100 with higher scores indicating better QOL). RESULTS: The sample consisted of 383 patients. Most were female (235; 61%), had completed high school (169; 44%), had experienced UI for an average of 3.54 years (SD 3.44), and were between 21 and 92 years of age (mean 52.7; SD 14). The mean I-QOL score was 65.31 ± 19.71 with subscores ranging from a low of 59.69 for social embarrassment to a high of 71.44 for psychosocial impact. The average FACIT-Sp-12 score was 28.00 ± 6.08. Overall I-QOL and FACIT-Sp-12 scores were weakly positively correlated (r = .235). CONCLUSION: In this study both QOL and SWB scores were good; higher UI-specific QOL scores and some subscores were associated with higher SWB scores and subscores. Incontinence QOL should be determined together with SWB in patients with UI.


2019 ◽  
Vol 11 (02) ◽  
pp. 77-83
Author(s):  
Tophan Heri Wibowo

ABSTRACT Patients with previous myocardial infarction and stroke are the highest risk group for further coronary and cerebral events. myocardial infarction alters physical, psychosocial, spiritual well-being and adversely affects overall quality of life This study aimed to determine the effect of age and the quality of life among myocardial infarction patients. This study utilized descriptive correlational research with cross sectional approach. The study utilized set of instruments, an adapted instrument of MacNew Quality of Life After Myocardial Infarction (MacNew QLMI) questionnaire to measure the quality of life myocardial infarction. The results of this study were obtained middle age group were 66,7 %. Quality of life for physical domain has an average weighted mean of 4.51. the results of the data analysis using the Mann Whitney test were obtained emotional domain p=0,995 (p<0,05), physical domain p=0,624 (p<0,05), social domain p=0,191 (p<0,05). It means that the age does not influence the quality of life of patients with Myocardial Infarction. Keywords: Age, Quality of Life, Myocardial infarction


Author(s):  
Bianca Cristine Soares Ferreira ◽  
Shirley Santos Martins ◽  
Tamires Barradas Cavalcante ◽  
João Ferreira Silva Junior ◽  
Sueli Coelho da Silva Carneiro

Objectives: To analyze the relationships between the quality of life (QOL) of people with stoma with sociodemographic, clinical, lifestyle, sanitation, and housing indicators. Method: Cross-sectional study with a sample of 106 individuals with stoma interviewed from May to December 2019. A sociodemographic and clinical questionnaire and the City of Hope Quality of Life Ostomy Questionnaire were used. Results: Spiritual well-being (7.71 +/-1.09) was the best performing domain. Quality of life did not differ between men and women (p = 0.372), but was associated with education (< 0.001) and family income (p = 0.025), diabetes (p = 0.008) and alcoholism (p = 0.044), drinking water conditions (p < 0.001), garbage disposal (p = 0.021), having electricity (p = 0.034), housing type (p = 0.026), number of rooms (p = 0.023), and housing coverage (p = 0.021). Conclusion: worse socioeconomic, sanitation, and housing indicators appear to negatively impact the QOL of people with stomata.


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