Weight Loss in Advanced Cancer: Sex Differences in Health-Related Quality of Life and Body Image

Weight maintenance is a priority in cancer care, but weight loss is common and a serious concern. This study explores if there are sex differences in the perception of weight loss and its association to health-related quality of life (HRQoL) and body image. Cancer patients admitted to Advanced Medical Home Care were recruited to answer a questionnaire, including characteristics, the HRQoL-questionnaire RAND-36, and a short form of the Body Image Scale. Linear regression analyses stratified by sex and adjusted for age were performed to examine associations between percent weight loss and separate domains of HRQoL and body image score in men and women separately. In total, 99 participants were enrolled, of which 80 had lost weight since diagnosis. In men, an inverse association between weight loss and the HRQoL-domain physical functioning, β = −1.34 (95%CI: −2.44, −0.24), and a positive association with body image distress, β = 0.22 (95%CI: 0.07, 0.37), were found. In women, weight loss was associated with improvement in the HRQoL-domain role limitations due to physical health, β = 2.02 (95%CI: 0.63, 3.41). Following a cancer diagnosis, men appear to experience weight loss more negatively than women do. Recognizing different perceptions of weight loss may be of importance in clinical practice.

Health-related quality of life of patients 12 months following surgical intensive care discharge

Health related quality of life (HRQoL) and the effect of selected socio-demographic and clinical intensive care variables on HRQoL of patients 12 months following adult surgical intensive care unit discharge in the Western Cape was evaluated. A prospective observational study was conducted. The sample comprised 46 patients who had survived 12 months following discharge. Structured telephonic interviews were conducted using a self-developed and SF-36v2 HRQoL questionnaire. Data was analyzed using Stastica 7 and values were accepted as significant at the 5% level. Low mean HRQoL domain scores (43% - 53%) were found implying a poor HRQoL outcome. Physical functioning [43.5%], Role Play [44.5%] and Role Emotion [43.1%] scores were specifically lower than the other HRQoL domain scores. Age and severity of illness scores (APACHE II) were significantly associated with the social functioning (p=0.01) and physical functioning (p=0.02) scores respectively. APACHE II may be a useful contributor in predicting long-term physical functioning outcomes in patients following surgical ICU discharge. The HRQoL outcomes are slightly lower than that found for inter-national ICU populations however responses in the domains affected are comparable. Low physical functioning, role play and role emotion scores indicate a need for further physical and emotional rehabilitation following surgical ICU discharge.