The time taken to complete quality of life questionnaires in an advanced cancer trial

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 8592-8592
Author(s):  
M. R. Stockler ◽  
S. Heritier ◽  
A. K. Nowak ◽  
D. Goldstein ◽  
J. Turner ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Advanced Cancer ◽  
Karnofsky Performance Status ◽  
Performance Status ◽  
Depression Scale ◽  
Well Being ◽  
Cancer Trial ◽  
Respondent Burden ◽  
Quality Of Life Questionnaires

8592 Background: Respondent burden is important when designing trials in advanced cancer. We determined the time taken to complete a set of quality of life questionnaires (TTTCQ) in a randomized trial of sertraline in advanced cancer. Methods: Participants recorded the times they started and finished an 11 page questionnaire of 187 items including the Centre for Epidemiologic Studies Depression Scale, Hospital Anxiety and Depression Scale, Functional Assessment of Cancer Therapy General and Fatigue scales, and 4 other validated instruments. Determinants of the TTTCQ were sought amongst the self-ratings of anxiety, depression, fatigue, trouble concentrating, other aspects of quality of life, and other characteristics including age, Karnofsky Performance Status (KPS) and treatment. Distributions are summarised by their median, interquartile range (25th to 75th percentiles, IQR) and interdecile range (10th to 90th percentiles, IDR). Associations were assessed with Spearman’s rank correlation coefficient (r), and differences with the Mann-Whitney test. All p-values are two-sided. Results: The TTTCQ was available for 128 of 150 subjects (85%). Median age was 66 (IQR 59 to 73), median KPS was 80 (IQR 70 to 90), and 63% were male. The median TTTCQ was 30 mins (IQR 23 to 40, IDR 15 to 50), equating to a median of 10 secs per item (IQR 7 to 13, IDR 5 to 16). The TTTCQ was modestly correlated with age and KPS (r = 0.19, p = 0.04 for both). Age and KPS were not correlated (r = 0.03, p = 0.8). Subjects aged 60 or older had a median TTTCQ 10 mins longer than those 59 or younger (35 v 25 mins, p = 0.002). Subjects with a KPS of 100, 90, 80, and 70 or less had a median TTTCQ of 20, 25, 31, and 35 mins respectively. TTTCQ was modestly correlated with self-ratings of: problems coping with treatment, dry mouth, feeling dizzy or lightheaded (r = 0.22 to 0.25, p = 0.01). Correlations were weak or non-existent with all measures of depression, anxiety, trouble concentrating, emotional well-being, and overall well-being (r = 0.10 to 0.18, p = 0.04 to 0.25). TTTCQ was unaffected by gender, opioids, steroids and number of previous cytotoxic regimens. Conclusions: Respondent burden was less of a problem than anticipated and little affected by treatments or self-rated psychological problems. No significant financial relationships to disclose.

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.

A placebo-controlled trial of Sertraline's effects on symptoms, well-being and survival in advanced cancer: The ZEST Trial

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 9002-9002 ◽  
Author(s):  
N. R. Wilcken ◽  
D. Goldstein ◽  
A. K. Nowak ◽  
P. J. Beale ◽  
M. Jefford ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Advanced Cancer ◽  
Cox Model ◽  
Controlled Trial ◽  
Depression Scale ◽  
Final Analysis ◽  
Well Being ◽  
Hazard Ratio ◽  
Sensitivity Analyses

9002 Background: Depression, anxiety, fatigue and impaired well-being are common, important and closely related in advanced cancer. We sought to determine the effects of sertraline (a well-tolerated, SSRI antidepressant) on these symptoms and survival in a broad cross-section of people with advanced cancer but without major depression. Methods: 189 participants (pts) were randomly allocated to sertraline 50 mg daily or placebo. Assessments were at baseline; months 1, 2, 4, 6, 9, 12; and, then 3-monthly. Outcome measures rated by pts included the: Centre for Epidemiologic Studies Depression scale (CES-D); Hospital Anxiety and Depression Scale (HADS-A, HADS-D); and the Functional Assessment of Cancer Therapy General and Fatigue scales (FACT-G and FACT-F). Clinicians completed Spitzer's Quality of Life Index (SQLI). Outcomes on all scales are expressed from 0 (worst) to 100 (best). The primary analyses of sertraline's effects on quality of life were based on scores at 4 and 8 weeks adjusted for baseline scores using generalised estimating equations. Efficacy analyses are by intention to treat; toxicity analyses by treatment received. P-values and 95% confidence intervals (CI) are 2-sided. Results: Recruitment was stopped after the first planned interim analysis of 150 pts showed a trend in overall survival favouring placebo (univariable logrank p=0.04; multivariable Cox model hazard ratio 1.61, CI 1.1 to 2.5, p=0.02). This trend was weaker at the final analysis including all 189 patients and longer follow-up (univariable logrank p=0.09); and, after accounting for baseline factors (multivariable Cox model hazard ratio 1.27, CI 0.87 to 1.8, p=0.2). Sertraline had no significant effects (scale: benefit over placebo, 95% CI) on depression (CES-D: 0.4, −2.6 to 3.4), anxiety (HADS-A: 2.0, −1.5 to 5.5), fatigue (FACT-F: 0.3, −4.3 to 4.9), overall quality of life (FACT-G: 1.7, −1.3 to 4.7) or clinicians’ ratings (SQLI: 2.0, −2.5 to 6.5). Subgroup and sensitivity analyses also excluded significant benefits. Sertraline was discontinued more often and earlier than placebo (logrank p = 0.03). The trial was closed for lack of benefit. Conclusions: Sertraline did not improve symptoms, well-being or survival and should be reserved for those with a proven indication. No significant financial relationships to disclose.

scholarly journals Quality of Life of Cancer Patients Treated with Chemotherapy

2020 ◽  
Vol 17 (19) ◽  
pp. 6938
Author(s):  
Anna Lewandowska ◽  
Grzegorz Rudzki ◽  
Tomasz Lewandowski ◽  
Michał Próchnicki ◽  
Sławomir Rudzki ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Negative Impact ◽  
Karnofsky Performance Status ◽  
Performance Status ◽  
Life Quality ◽  
Disease Process ◽  
Well Being ◽  
Life Questionnaire ◽  
Cross Sectional

Background: Life-quality tests are the basis for assessing the condition of oncological patients. They allow for obtaining valuable information from the patients regarding not only the symptoms of disease and adverse effects of the treatment but also assessment of the psychological, social and spiritual aspects. Taking into account assessment of the quality of life made by the patient in the course of disease has a positive effect on the well-being of patients, their families and their caregivers as well as on satisfaction with the interdisciplinary and holistic oncological care. Methods: A population-based, multi-area cross-sectional study was conducted among patients with cancer in the study in order to assess their life quality. The method used in the study was a clinical interview. Quality of life was measured using the EQ-5D-5L Quality of Life Questionnaire, the Karnofsky Performance Status, our own symptom checklist, Edmonton Symptom Assessment and Visual Analogue Scale. Results: In the subjective assessment of fitness, after using the Karnofsky fitness index, it was shown that 28% (95% CI (confidence interval): 27–30) of patients declared the ability to perform normal physical activity. In the assessment the profile, quality of life and psychometric properties of EQ-5D-5L, it was shown that patients had the most severe problems in terms of self-care (81%, 95% CI: 76–89) and feeling anxious and depressed (63%, 95% CI: 60–68). Conclusions: Cancer undoubtedly has a negative impact on the quality of life of patients, which is related to the disease process itself, the treatment used and the duration of the disease.

scholarly journals Quality of life support in advanced cancer—web and technological interventions: systematic review and narrative synthesis

2021 ◽  
pp. bmjspcare-2020-002820
Author(s):  
Kathleen Kane ◽  
Fiona Kennedy ◽  
Kate L Absolom ◽  
Clare Harley ◽  
Galina Velikova
Keyword(s):  
Quality Of Life ◽  
Advanced Cancer ◽  
Life Support ◽  
Well Being ◽  
Narrative Synthesis ◽  
Monitoring Tools ◽  
Technological Interventions ◽  
Cancer Trajectory ◽  
Interactive Health Communication

BackgroundAs treatments continue to progress, patients with advanced cancer are living longer. However, ongoing physical side-effects and psychosocial concerns can compromise quality of life (QoL). Patients and physicians increasingly look to the internet and other technologies to address diverse supportive needs encountered across this evolving cancer trajectory.Objectives1. To examine the features and delivery of web and technological interventions supporting patients with advanced cancer. 2. To explore their efficacy relating to QoL and psychosocial well-being.MethodsRelevant studies were identified through electronic database searches (MEDLINE, PsychINFO, Embase, CINAHL, CENTRAL, Web of Science and ProQuest) and handsearching. Findings were collated and explored through narrative synthesis.ResultsOf 5274 identified records, 37 articles were included. Interventions were evaluated within studies targeting advanced cancer (13) or encompassing all stages (24). Five subtypes emerged: Interactive Health Communication Applications (n=12), virtual programmes of support (n=11), symptom monitoring tools (n=8), communication conduits (n=3) and information websites (n=3). Modes of delivery ranged from self-management to clinically integrated. Support largely targeted psychosocial well-being, alongside symptom management and healthy living. Most studies (78%) evidenced varying degrees of efficacy through QoL and psychosocial measures. Intervention complexity made it challenging to distinguish the most effective components. Incomplete reporting limited risk of bias assessment.ConclusionWhile complex and varied in their content, features and delivery, most interventions led to improvements in QoL or psychosocial well-being across the cancer trajectory. Ongoing development and evaluation of such innovations should specifically target patients requiring longer-term support for later-stage cancer.PROSPERO registration numberCRD42018089153.

P–478 Quality of life assessment in women undergoing assisted reproduction. A study of FertiQol and HADS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
N Figueras-Puigderrajols ◽  
A Ballesteros ◽  
D Guerra
Keyword(s):  
Quality Of Life ◽  
Depression Scale ◽  
Well Being ◽  
Self Esteem ◽  
Mobile App ◽  
Life Assessment ◽  
Fertility Treatment ◽  
Anxiety And Depression ◽  
Gamete Donation

Abstract Study question The present study aims to explore infertility-related psychosocial outcomes, including fertility quality of life (QoL), as well as anxiety and depression levels, in women diagnosed with infertility. Summary answer Differences on fertility-related QoL appeared when comparing treatment types (gamete donation vs own gamete). Furthermore, statistically significant associations were found between QoL and anxious-depressive symptomatology. What is known already Those who wish to have children and do not achieve their objective just like other peers can see their goals and expectations with pessimism, generating concern and a series of negative emotions. Several psychological implications of infertility have been described, such as increased levels of stress, anxiety, depression, decreased self-esteem, mood and hope, or poor relationship adjustment. The emotional impact of infertility in people’s life cycle can be so strong that reducing it only to biological aspects would lead to a dangerous situation of neglect. For this reason, QoL assessment in ART becomes an important need. Study design, size, duration FertiQol stands as the most widely used tool to assess infertility-related QoL, overcoming the limitations of other instruments that only target specific medical conditions. The present is a multi-site cross-sectional study over patients with infertility (n = 104), aiming to explore their fertility-QoL, as well as their anxiety and depression levels, which are symptoms that have been previously associated.Questionnaire administration, and sociodemographic and medical data gathering took place between January 2019 and December 2020. Participants/materials, setting, methods Participants were 104 female patients (M.age= 39.8) undergoing or expecting a fertility treatment. The FertiQol Spanish version was administered through mobile app, and its paper version distributed at medical/psychological appointments. QoL was self-reported through FertiQol, assessing the influence of infertility problems in various areas (e.g. impact on self-esteem, emotions, general health, family, partners, social relationships, work, life projects...). Additionally, HADS (Hospital Anxiety and Depression Scale) was provided as a measurement of anxiety and depression levels. Main results and the role of chance Regarding treatments, 50.6% of participants were currently undergoing gamete donation while 44.3% were undergoing treatments that involved using their own gametes. After comparing QoL between these treatment types, results showed that patients who underwent egg donation, compared to those who used their own eggs, reported statistically significantly lower scores of QoL in the Social Subscale (p = .03), but not in the other psychological outcomes. Also, statistically significant negative correlations were found between HADS and all core FertiQol subscales (p&lt; .05). Results are consistent with previous studies showing similar associations between fertility QoL and anxiety and depression, as well as with increased psychological negative implications of gamete donation. The majority of participants reported non-pathological scores of anxiety and depression when considering the cut off value of 8 for HADS, thus suggesting the presence of a relatively healthy sample. The number of treatments that patients had previously taken and the years of infertility were not associated with any of the psychological variables. Limitations, reasons for caution Some limitations to consider are presence of co-morbid diagnosis, differences in medication, or patient’s cultural backgrounds.Also, conclusions should be interpreted cautiously since the design doesn’t allow causal inferences. Further investigations should consider a continuous assessment to explore changes in psychological well-being at different points of intervention, specially with gamete donation. Wider implications of the findings: The great advantage we’ve seen so far when using FertiQol is the possibility to identify more accurately the true impact on other aspects of patient’s well-being besides the emotional area.ART professionals, including psychologists and counselors,will have more information within a small amount of time about QoL when using this tool. Trial registration number 1503-BCN–019-DG

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.

scholarly journals Psychological well-being, marital adjustment and quality of life after hysterectomy: a comparative study

2018 ◽  
Vol 7 (12) ◽  
pp. 4960
Author(s):  
Kusum Lata Mathur ◽  
Manu Sharma ◽  
Mohua Mazumdar ◽  
Shikha Talati ◽  
Siddharth Srivastav
Keyword(s):  
Quality Of Life ◽  
Marital Adjustment ◽  
Comparison Group ◽  
Psychiatric Morbidity ◽  
Depression Scale ◽  
Well Being ◽  
Study Groups ◽  
Life Questionnaire ◽  
Gynecological Surgery

Background: Hysterectomy is the most common major gynecological surgery often performed for benign lesions. Many studies have reported adverse psychosocial outcomes post-hysterectomy. There is a paucity of studies from India addressing psychiatric morbidity after hysterectomy. To evaluate psychological wellbeing, marital adjustment and quality of life in patients undergoing hysterectomy for non-malignant conditions, in comparison with patients undergoing surgery other than hysterectomy.Methods: A cross-sectional study was conducted on 100 consecutive out-patients who underwent hysterectomy for non-malignant indications at least 6 months ago. The comparison group comprised of 50 consecutive out-patients who underwent gynecological surgery other than hysterectomy at least 6 months ago formed the comparison group. The study participants were evaluated on Hospital Anxiety and Depression Scale (HADS), Psychological General Well-being Index (PGWBI), Marital Adjustment Test (MAT) and Women’s Quality of Life Questionnaire (WOMQOL).Results: The indications for hysterectomy were: uterine leiomyoma (69%), uterovaginal prolapse (18%), dysfunctional uterine bleeding (12%), and endometriosis (1%). Abdominal hysterectomy was performed in 92 patients while 8 patients underwent vaginal hysterectomy. There were no significant differences in the study groups on scores of HADS, PGWBI, MAT and WOMQOL (p>0.05). Both the study groups had good marital adjustment and majority reported no depression and anxiety.Conclusions: There is no major psychiatric morbidity, decline in marital adjustment and quality of life after hysterectomy for benign conditions among Indian women. Future research on the ethno-cultural implications and effect of hysterectomy on mental health will be a significant addition to the available evidence in India.

scholarly journals Patient-reported outcomes at discontinuation of anti-angiogenesis therapy in the randomized trial of chemotherapy with bevacizumab for advanced cervical cancer: an NRG Oncology Group study

2020 ◽  
Vol 30 (5) ◽  
pp. 596-601
Author(s):  
Dana Chase ◽  
Helen Q Huang ◽  
Bradley J Monk ◽  
Lois Michelle Ramondetta ◽  
Richard T Penson ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cervical Cancer ◽  
Patient Reported Outcomes ◽  
Performance Status ◽  
Well Being ◽  
Treatment Discontinuation ◽  
Life Assessment ◽  
Recurrent Cervical Cancer ◽  
Patient Reported

IntroductionTo describe patient-reported outcomes and toxicities at time of treatment discontinuation secondary to progression or toxicities in advanced/recurrent cervical cancer patients receiving chemotherapy with bevacizumab.MethodsSummarize toxicity, grade, and health-related quality of life within 1 month of treatment discontinuation for women receiving chemotherapy with bevacizumab in GOG240.ResultsOf the 227 patients who received chemotherapy with bevacizumab, 148 discontinued study protocol treatment (90 for disease progression and 58 for toxicity). The median survival time from treatment discontinuation to death was 7.9 months (95% CI 5.0 to 9.0) for those who progressed versus 12.1 months (95% CI 8.9 to 23.2) for those who discontinued therapy due to toxicities. The most common grade 3 or higher toxicities included hematologic, gastrointestinal, and pain. Some 57% (84/148) of patients completed quality of life assessment within 1 month of treatment discontinuation. Those patients who discontinued treatment due to progression had a mean decline in the FACT-Cx TOI of 3.2 points versus 2.2 in patients who discontinued therapy due to toxicity. This was a 9.9 point greater decline in the FACT-Cx TOI scores than those who discontinued treatment due to progression (95% CI 2.8 to 17.0, p=0.007). The decline in quality of life was due to worsening physical and functional well-being. Those who discontinued treatment due to toxicities had worse neurotoxicity and pain.DiscussionPatients who discontinued chemotherapy with bevacizumab for toxicity experienced longer post-protocol survival but significantly greater declination in quality of life than those with progression. Future trial design should include supportive care interventions that optimize physiologic function and performance status for salvage therapies.

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