A Latent Profile Analysis of Health-related Quality of Life Domains in Cancer Survivors

PurposeThe aim of this research was to examine heterogeneity of Health-related Quality of Life (HrQOL) in Cancer Survivors (both undergoing and completed treatment) using latent profile analysis and to determine whether these groups differed by demographic and health characteristics.MethodsParticipants(n=229) recruited through an oncology day ward and outpatient department in a local hospital, completed height, weight and handgrip measures as well as the validated patient generated subjective global assessment and EORTC-QLQ-C30 questionnaires. A latent profile analysis was performed to identify subgroups based on HrQOL domain scores. Multinominal Logistic Regression was conducted to determine the relationship between these subgroups and demographic and health characteristics. ResultsThree latent subtypes were identified: (1)high quality of life(n=122, 52.8%); (2)compromised quality of life(n=79, 34.2%) and (3)low quality of life(n=30, 12.99%). All subtypes scored lower for functioning scales (with the exception of the higher quality of life group for physical, role and emotional functioning) and higher for symptom scales then the reference norm population. There were large clinically meaningful differences between the high quality of life group and the low quality of life group for all HrQOL scales. Those in the low quality of life group were slightly younger than those in the high quality of life group(OR = 0.956, p &lt; .05, CI = 0.917– 0.998). Workers were &gt;7 times more likely to be in low quality of life than the high quality of life group. Compared to the high quality of life group, the odds of belonging to the compromised quality of life group decreased significantly by having higher handgrip strength (OR = .955, p &lt; .05, CI = .924 - .988). The odds of belonging to the low quality of life group increased significantly for those with higher number of nutrition impact symptoms (NIS) (OR = 1.375, p &lt; .05, CI = 1.004 – 1.883).ConclusionsThis is the first study to examine heterogeneity of HrQOL using latent profile analysis in Irish Cancer Survivors. In clinical practice understanding how aspects of HrQOL group together may allow clinicians to better understand and treat cancer survivors, informing more individualised nutrition care.<br/

Applying the thresholds for clinical importance for fourteen key domains of the EORTC QLQ-C30: A Latent Class Analysis of Cancer Survivors.

A person’s quality of life is impacted from the beginning of their oncology experience. One of the most common tools to measure quality of life is the EORTC QLQ-C30. The absolute scores it produces can be difficult to interpret in the clinical setting, and thresholds to help identify those who require intervention have recently been introduced. The aim of this research was to identify heterogeneity of these thresholds for clinical importance using latent class analysis in cancer survivors (those undergoing and those who have completed treatment) attending a hospital in the northwest of Ireland. We identified 3 distinct classes of cancer survivors, using Mplus 6.11: high clinical impact (13.9%), compromised physical function (40.3%) and low clinical impact (45.9%). The compromised physical function group were slightly more likely to be older (OR = 1.042, p < .05, CI = 1.000–1.086), not employed (OR = 8.347, p < .01, CI = 2.092–33.305), have lower PG-SGA scores (OR = .826, p < .001, CI = .755–.904), and not have been diagnosed in the last 2 years (OR = .325, p < .05, CI = .114–.923) compared to the high clinical impact group. The low clinical impact group were more likely to be female (OR = 3.288, p < .05, CI = 1.281–1.073), not employed (OR = 10.129, p < .01, CI = 2.572–39.882), have a lower BMI (OR = .921, p < .05, CI = .853–.994), and lower PG-SGA scores (OR = .656, p < .001, CI = .573–.750) than the high clinical impact group. Functional and symptom issues impact on quality of life, and therefore, identifying those of clinical importance is crucial for developing supportive care strategies

Nutrition Practices among Adult Cancer Survivors Living on the Island of Ireland: A Cross-Sectional Study

The purpose of this research was to explore the nutrition practices among post-treatment cancer survivors across Ireland. Cancer survivors aged 18+ years living across Ireland, who were not palliative and had completed active cancer treatment at least six months previous, were recruited to complete an online survey assessing dietary quality, food choice and satisfaction with food-related life as well as clinical and nutrition status. It was circulated by cancer support networks and on social media. Descriptive statistics are presented. The cohort (n = 170) was predominantly female (85.9%) and had breast cancer (64.7%). Mean age was 51.5 ± 10.9 years and 42.7% of the cohort were >five years post-treatment. Only 20% and 12% of the cohort had been assessed by a dietitian during and post-treatment, respectively. The mean dietary quality score was 10.3 ± 1.7, which was measured by the Leeds short-form food frequency questionnaire (SFFFQ). Using a 5-point Likert scale, the median satisfaction with food-related life score was 19 (3.3), which evaluates cognitive judgements on the person’s food-related life. The food choice questionnaire (FCQ) assesses the relative importance of a range of factors related to dietary choice to individuals. The primary determinant of food choice in this cohort was the natural content (31.7%) followed by health (24.7%). Vitamin and mineral supplement use was reported by 69.8% of the cohort; the most consumed was Vitamin D. Four themes emerged from an optional open-ended question: awareness of nutritional importance; desire for specific nutritional advice and dietetic referral; cancer and treatment nutrition impacts were highlighted; as well as struggles with weight gain. This research provides useful insight into the nutrition practices of Irish cancer survivors. A desire and need for individualised and specific advice are evident

The Relationship Between Diet and Lifestyle Behaviours in a Sample of Higher Education Students; A Cross-Sectional Study

Transitioning into higher education (HE) impacts health behaviours. Poor dietary and lifestyle behaviours may correlate and increase risk of co-morbidities. The introduction of the Okanagan Charter detailed the important role of health promotion within a HE setting. The aim of this study was to assess the relationship between dietary quality and lifestyle behaviours of students attending HE

The Prevalence of Weak Handgrip Strength in Ambulatory Oncology Patients and its Relationship with Quality of Life

Muscle strength as a proxy for muscle function has emerged as a predictor of nutritional status in both clinical as well as epidemiological studies. Hand grip strength (HGS) is a reliable non-invasive test of muscle strength. Dynapenia (weak strength) is independently associated with loss of physical functionality, quality of life (QoL) characteristics and reduced survival. The first aim of this study was to investigate the prevalence of dynapenia using handgrip strength (HGS) in ambulatory oncology patients and if this had an impact on quality of life (QoL). This prospective cross-sectional study was conducted in the oncology day ward and outpatient clinic in Sligo University Hospital (SUH). To assess QoL, participants completed the European Organisation for Research and Treatment of Cancer Quality-of-life Questionnaire Core 30 (EORTC QLQ-C30). Isometric handgrip dynamometry was used to determine muscle strength of the dominant forearm. Three measures were performed, and the highest value was analysed. Weak handgrip strength was defined as(n=160) was predominantly female (58.1%), breast cancer was the most prevalent cancer type (29.4%) and the mean age was 63.2 ± 11.3 years. Over half of the cohort was overweight (53.5%) and 70% had not received nutritional advice from a dietician, with 77.5% reporting weight changes since diagnosis. Weak handgrip strength was present in 26.9% of the cohort. Weaker HGS was significantly associated with poorer QoL, physical, role and cognitive functioning (p \u3c 0.05). Additionally, weaker HGS was associated with increased symptom scale scores for fatigue, pain and appetite loss (p \u3c 0.05). Results display how poor muscular strength impacts QoL in an ambulatory oncology setting in the North-West of Ireland. If routine screening of muscle strength was conducted in oncology patients, it could aid timely referral to nutrition support and combat the negative impacts on their future