Health-related quality of life in breast cancer patients: A bibliographic review of the literature from 1974 to 2007

<p>Abstract</p> <p>Background</p> <p>Quality of life in patients with breast cancer is an important outcome. This paper presents an extensive overview on the topic ranging from descriptive findings to clinical trials.</p> <p>Methods</p> <p>This was a bibliographic review of the literature covering all full publications that appeared in English language biomedical journals between 1974 and 2007. The search strategy included a combination of key words 'quality of life' and 'breast cancer' or 'breast carcinoma' in titles. A total of 971 citations were identified and after exclusion of duplicates, the abstracts of 606 citations were reviewed. Of these, meetings abstracts, editorials, brief commentaries, letters, errata and dissertation abstracts and papers that appeared online and were indexed ahead of publication were also excluded. The remaining 477 papers were examined. The major findings are summarized and presented under several headings: instruments used, validation studies, measurement issues, surgical treatment, systemic therapies, quality of life as predictor of survival, psychological distress, supportive care, symptoms and sexual functioning.</p> <p>Results</p> <p><it>Instruments</it>-Several valid instruments were used to measure quality of life in breast cancer patients. The European Organization for Research and Treatment of Cancer Core Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and its breast cancer specific complementary measure (EORTC QLQ-BR23) and the Functional Assessment Chronic Illness Therapy General questionnaire (FACIT-G) and its breast cancer module (FACIT-B) were found to be the most common and well developed instruments to measure quality of life in breast cancer patients. <it>Surgery</it>-different surgical procedures led to relatively similar results in terms of quality of life assessments, although mastectomy patients compared to conserving surgery patients usually reported a lower body image and sexual functioning. <it>Systemic therapies</it>-almost all studies indicated that breast cancer patients receiving chemotherapy might experience several side-effects and symptoms that negatively affect their quality of life. Adjuvant hormonal therapies also were found to have similar negative impact on quality of life, although in general they were associated with improved survival. <it>Quality of life as predictor of survival</it>-similar to known medical factors, quality of life data in metastatic breast cancer patients was found to be prognostic and predictive of survival time. <it>Psychological distress</it>-anxiety and depression were found to be common among breast cancer patients even years after the disease diagnosis and treatment. Psychological factors also were found to predict subsequent quality of life or even overall survival in breast cancer patients. <it>Supportive care</it>-clinical treatments to control emesis, or interventions such as counseling, providing social support and exercise could improve quality of life. <it>Symptoms</it>-Pain, fatigue, arm morbidity and postmenopausal symptoms were among the most common symptoms reported by breast cancer patients. As recommended, recognition and management of these symptoms is an important issue since such symptoms impair health-related quality of life. <it>Sexual functioning</it>-breast cancer patients especially younger patients suffer from poor sexual functioning that negatively affect quality of life.</p> <p>Conclusion</p> <p>There was quite an extensive body of the literature on quality of life in breast cancer patients. These papers have made a considerable contribution to improving breast cancer care, although their exact benefit was hard to define. However, quality of life data provided scientific evidence for clinical decision-making and conveyed helpful information concerning breast cancer patients' experiences during the course of the disease diagnosis, treatment, disease-free survival time, and recurrences; otherwise finding patient-centered solutions for evidence-based selection of optimal treatments, psychosocial interventions, patient-physician communications, allocation of resources, and indicating research priorities were impossible. It seems that more qualitative research is needed for a better understanding of the topic. In addition, issues related to the disease, its treatment side effects and symptoms, and sexual functioning should receive more attention when studying quality of life in breast cancer patients.</p

Quality of life in patients with lung cancer: an epidemiological study

A population-based study of quality of life in patients with lung cancer cases and chronic respiratory disease controls was carried out at Stobhill Hospital in Glasgow between January 1995 and April 1996. The main results may be summarised as follows: There were no significant differences between quality of life in cases and controls except for pain and loss of appetite. Patients with different socio-economic status had different quality of life. The poorer reported a lower level of quality of life. Social support systems, social networks, and socio-demographic status of the patients were found to predict baseline quality of life prior to diagnosis. Non-medical factors (Deprivation Category and marital status) were found to be significant predictors of patients' global quality of life at follow-up, whereas medical factors (cell type and treatment modalities) were not. Global quality of life prior to diagnosis was a clear predictor of survival. Treatment regimens were found to be ineffective regardless of cell types and stage of disease when comparing baseline and follow-up assessments of quality of life in patients with lung cancer. Patients' reactions to the study indicated that they did not find the study intrusive. Patients' perceptions of quality of life were found to differ from those of health professionals. In the light of study findings it is concluded that conducting a robust epidemiological study of quality of life in patients with lung cancer is feasible. It is essential that such an assessment be carried out in the context of their socio-economic status. The results suggest that quality of life is a real and useful prognostic factor. It predicts survival and it is important to include quality of life measures in future studies of outcomes in lung cancer care. The above forms the basis of recommendations to improve lung cancer care and to provide guidelines for further work

Development and psychometric testing of a new instrument to measure factors influencing women's breast cancer prevention behaviors (ASSISTS)

Background: Breast cancer preventive behaviors have an extreme effect on women's health. Despite the benefits of preventive behaviors regarding breast cancer, they have not been implemented as routine care for healthy women. To assess this health issue, a reliable and valid scale is needed. The aim of the present study is to develop and examine the psychometric properties of a new scale, called the ASSISTS, in order to identify factors that affect women's breast cancer prevention behaviors. Methods: A multi-phase instrument development method was performed to develop the questionnaire from February 2012 to September 2014. The item pool was generated based on secondary analyses of previous qualitative data. Then, content and face validity were applied to provide a pre-final version of the scale. The scale validation was conducted with a sample of women recruited from health centers affiliated with Tehran University of Medical Sciences. The construct validity (both exploratory and confirmatory), convergent validity, discriminate validity, internal consistency reliability and test-retest analysis of the questionnaire were tested. Results: Fifty-eight items were initially extracted from the secondary analysis of previous qualitative data. After content validity, this was reduced to 49 items. The exploratory factor analysis revealed seven factors (Attitude, supportive systems, self-efficacy, information seeking, stress management, stimulant and self-care) containing 33 items that jointly accounted for 60.62 % of the observed variance. The confirmatory factor analysis showed a model with appropriate fitness for the data. The Cronbach's alpha coefficient for the subscales ranged from 0.68 to 0.85, and the Intraclass Correlation Coefficient (ICC) ranged from 0.71 to 0.98; which is well above the acceptable thresholds. Conclusion: The findings showed that the designed questionnaire was a valid and reliable instrument for assessing factors affecting women's breast cancer prevention behaviors that can be used both in practice and in future studies

Abdominopelvic Pain in Patient with Uterus Didelphys and Unilateral Obstructed Hemivagina and Ipsilateral Renal Agenesis (OHVIRA Syndrome)

Introduction: Uterus didelphys with obstructed hemivagina associated with ipsilateral renal agenesis (OHVIRA syndrome) is a rare female urogenital malformation and delay in its diagnosis could lead to several complications.&nbsp;Case presentation: A 21-year-old virgin woman was admitted to the emergency department (ED) with severe abdominal pain, without fever and vaginal discharge. She reported a history of cyclic abdominopelvic pain and dysmenorrhea for 5 years. The primary diagnosis (OHVIRA syndrome) was made using ultrasonography, spiral computed tomography (CT) and magnetic resonance imaging (MRI). In addition, laparoscopy was performed to confirm diagnosis and drain hematosalpinx. Then, hysteroscopy was carried out&nbsp;for septum resection and catheter insertion. At one-month follow-up the ultrasonography showed normal left hemicavity of uterus associated with significant decrease in dysmenorrhea.&nbsp;Conclusion: Being aware of OHVIRA syndrome and clinical suspicion of this rare anomaly are essential for making a timely diagnosis, preventing complications, relieving symptoms, and preserving future fertility

A survey of the relationship between EQ and organizational entrepreneurship of the employees of Bank Maskan in Kerman province (Iran)

In recent decades, organizational entrepreneurship is taken into attention by researchers. The concept of organizational entrepreneurship is of great importance for the organizations in a new era, as well as the factors affecting the entrepreneurial orientation are. EQ as a variable related to the management of our own feelings and establishing the effective communication with others took our attention. One of the psychological variables in relation with organizational entrepreneurship is EQ. EQ is an array of non-cognitive capabilities, competencies, and skills that influence one’s ability to succeed in coping with environmental demands and pressures. Based on the importance of organizational entrepreneurship and the effect of personality characteristics including EQ on organizational entrepreneurship, the present study attempted to evaluate the relation between EQ and organizational entrepreneurship in Bank Maskan of Kerman province. The present study is applied in terms of aim and it is descriptive-correlation in terms of method. The study population was the employees of Bank Maskan in Kerman province as 357 people. The sample size was selected randomly based on Cochran’s formula, 185 employees of Bank Maskan in Kerman province. For data collection of EQ data, Shrink test was applied and to evaluate the organizational entrepreneurship, Dr. Moqimi questionnaire was used and their reliability by Cronbach’s alpha were 0.89, 0.87, respectively. For data analysis, one-sample t-test and Pearson correlation analysis were applied and the results showed a positive and strong relation between EQ and organizational entrepreneurshi

A survey of the relationship between EQ and organizational entrepreneurship of the employees of Bank Maskan in Kerman province (Iran)

In recent decades, organizational entrepreneurship is taken into attention by researchers. The concept of organizational entrepreneurship is of great importance for the organizations in a new era, as well as the factors affecting the entrepreneurial orientation are. EQ as a variable related to the management of our own feelings and establishing the effective communication with others took our attention. One of the psychological variables in relation with organizational entrepreneurship is EQ. EQ is an array of non-cognitive capabilities, competencies, and skills that influence one’s ability to succeed in coping with environmental demands and pressures. Based on the importance of organizational entrepreneurship and the effect of personality characteristics including EQ on organizational entrepreneurship, the present study attempted to evaluate the relation between EQ and organizational entrepreneurship in Bank Maskan of Kerman province. The present study is applied in terms of aim and it is descriptive-correlation in terms of method. The study population was the employees of Bank Maskan in Kerman province as 357 people. The sample size was selected randomly based on Cochran’s formula, 185 employees of Bank Maskan in Kerman province. For data collection of EQ data, Shrink test was applied and to evaluate the organizational entrepreneurship, Dr. Moqimi questionnaire was used and their reliability by Cronbach’s alpha were 0.89, 0.87, respectively. For data analysis, one-sample t-test and Pearson correlation analysis were applied and the results showed a positive and strong relation between EQ and organizational entrepreneurshi

A survey of the relationship between EQ and organizational entrepreneurship of the employees of Bank Maskan in Kerman province (Iran)

In recent decades, organizational entrepreneurship is taken into attention by researchers. The concept of organizational entrepreneurship is of great importance for the organizations in a new era, as well as the factors affecting the entrepreneurial orientation are. EQ as a variable related to the management of our own feelings and establishing the effective communication with others took our attention. One of the psychological variables in relation with organizational entrepreneurship is EQ. EQ is an array of non-cognitive capabilities, competencies, and skills that influence one’s ability to succeed in coping with environmental demands and pressures. Based on the importance of organizational entrepreneurship and the effect of personality characteristics including EQ on organizational entrepreneurship, the present study attempted to evaluate the relation between EQ and organizational entrepreneurship in Bank Maskan of Kerman province. The present study is applied in terms of aim and it is descriptive-correlation in terms of method. The study population was the employees of Bank Maskan in Kerman province as 357 people. The sample size was selected randomly based on Cochran’s formula, 185 employees of Bank Maskan in Kerman province. For data collection of EQ data, Shrink test was applied and to evaluate the organizational entrepreneurship, Dr. Moqimi questionnaire was used and their reliability by Cronbach’s alpha were 0.89, 0.87, respectively. For data analysis, one-sample t-test and Pearson correlation analysis were applied and the results showed a positive and strong relation between EQ and organizational entrepreneurshi

Evaluation of the relation between poverty and health-related quality of life in the people over 60 years-old in the district 4 of Tehran municipality in 2009-2010

Please cite this article as: Heidarnia MA, Ghaemian T, Montazeri A, Abadi AR. Evaluation of the relation between poverty and health-related quality of life in the people over 60 years-old in the district 4 of Tehran municipality in 2009-2010. Novel Biomed 2013;1:23-28.As the articles in recent years well indicate, more than all other factors, social determinants of health are involved in people's health status and quality of life (QOL). Among these social factors, the economic one is introduced as the main factor determining health status. This study was designed to evaluate the impact of poverty on QOL. The health-related QOL of poor people under coverage of a public charity institution (group 1) was compared with the QOL of ordinary people (group2) using the SF-36 questionnaire. The QOL scores in the groups 1 and 2 were analyzed by Mann-Whitney, Kruskal -Wallis tests and logistic regression using the SPSS 16.00 software. A total of 400 individuals were studied. The results showed significant differences between the two groups in the QOL measures of SF-36, except for physical and mental health measures (P&lt;0.001). With regard to the adverse consequence of the Physical Component Scale (PCS), employing logistic regression analysis, statistically significant relationships between the two groups in the demographic characteristics, except age and marital status, were found. For the adverse consequence of Mental Component Scale (MCS), logistic regression showed statistically significant differences between the two groups in the demographic characteristics, except for age. The findings indicate that poverty diminishes the QOL in most aspects; however, considering all aspects of QOL is necessary to promote the individuals' health

Educational inequalities in self-reported health in a general Iranian population

<p>Abstract</p> <p>Background</p> <p>The aim of this study was to investigate the relationship between educational level and self-reported health in an Iranian population, in order to provide evidence on social inequalities in health from a country in which such data need to be collected.</p> <p>Methods</p> <p>This population-based study was carried out in Tehran, Iran. Individuals aged 15 years and over were interviewed. Self-reported health was measured by asking each individual to respond to the question: "In general how would you describe your health at present?" We used years of formal education as a measure of socioeconomic status and categorized the answers in five levels. Logistic regression analysis was used to estimate odds ratios and 95% confidence intervals indicating the contribution of educational level to self-reported health, adjusting for age, gender, marital status, and chronic diseases.</p> <p>Results</p> <p>In all, 4163 individuals were interviewed. The mean age of the respondents was 35.1 years (SD = 16.0); 52% were female; the mean duration of formal education was 10.0 years (SD = 4.5); and 31% rated their health 'less than good'. Overall, women rated their health more poorly than men (P < 0.0001), and the findings showed that those with higher education rated their health significantly better than those with lower educational levels after adjusting for the age, gender, marital status and chronic diseases. The odds ratio for having 'less than good' self-rated health in those at the lowest educational level compared with those at the highest was 2.65 (95% CI = 1.88–3.73).</p> <p>Conclusion</p> <p>The findings indicated an inverse relationship between educational level and self-rated health, and that age, gender, and chronic conditions had independent effects on self-reported health status. The findings of this first study from Iran suggest that health inequalities in developing countries such as Iran need to be addressed and policies for tackling the problem should be considered. In this respect, less well-educated people and women should be seen as the first target populations. It seems that although expanding the educational system might help the state to provide people with more educational options, it is also necessary to ensure that equal opportunities and access to quality education are provided for those from lower socioeconomic backgrounds; otherwise the current situation might cost the government more in the long term because of poor health among disadvantaged groups.</p