Psychological well-being outcomes in disease-free survivors of mid-low rectal cancer following curative surgery
Department of Oncological and Surgical Sciences, Clinica Chirurgica II, University of Padova, Padova, Italy. Psycho-Oncology
(Impact Factor: 2.44).
07/2011; 20(7):706-14. DOI: 10.1002/pon.1763
The aim of this cross-sectional study was to evaluate psychological well-being outcomes in disease-free survivors who previously underwent radical surgery for rectal adenocarcinoma.
All patients with rectal adenocarcinoma who underwent primary surgery at a single institution from 1990 to 2002 were considered for inclusion in the study. We identified and sent questionnaires to 145 patients after excluding those who had died or had recurrent disease. One hundred and seventeen patients (men/women: 74/43; median age: 65 years) returned the questionnaires. Patients' well being was evaluated using the Psychological General Well-Being Index (PGWBI) questionnaire. The mean PGWBI score was compared with normative data of the general population. The impact of patient-, tumor- and treatment-related factors on patients' long-term psychological well-being status was also evaluated.
Compared with the general population, study patients had significantly better anxiety, depressed mood, positive well being, general health, vitality scales and global index scores. On multivariate analysis, positive well being was independently affected by time from diagnosis (36 months; p=0.025) and occurrence of early major complications (p=0.024). Variables that were independently associated with worse self-control included primary education (p=0.04) and the presence of fecal urgency (p=0.049). General health was negatively affected by time from diagnosis (36 months; p=0.047) and fecal urgency (p=0.009).
Patients who have survived cancer are likely to re-evaluate the importance of everyday events and this may explain why they had better PGWBI scores. This study also identified that a short time from diagnosis, early adverse events and bowel dysfunction had a negative impact on patients' well being.
Available from: Giuseppe Insalaco
- "Higher scores indicate better health. The six scales can be further summed to provide a global index score representing one comprehensive subjective well-being ranging from 0 to 110 . A global score <60 suggests a severe distress; from 60 to 72 suggests a moderate distress; and >72 suggests a positive well-being. "
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ABSTRACT: Sleep-disordered breathing adversely affects daytime alertness and cognition. Obstructive sleep apnea (OSA) patients have several typical symptoms including habitual snoring, excessive daytime sleepiness, fatigue, lack of concentration, memory impairment, and at times psychological disturbances. We evaluated different aspects in the health related quality of life (HRQoL) in subjects referred to our sleep laboratory for their first examination for suspicion of OSA.
One hundred ninety-eight consecutive outpatients (152 M) (mean age 52.7 +/- 12.8 years, range 18-82 years; mean BMI 31.0 +/- 6.5 kg/m2, range 17.3-57.8 kg/m2) were evaluated with two self-reported questionnaires for HRQoL assessment: Psychological General Well-Being Index (PGWBI), that asses anxiety, depressed mood, positive well-being, self-control, general health, vitality, and 12-Item Short-Form Health Survey (SF-12), consisting in Physical and Mental Component Summaries (PCS and MCS). Epworth Sleepiness Scale (ESS) was used to assess daytime sleepiness before nocturnal diagnostic examination.
Subjects showed variable HRQoL scores. HRQoL was worse in women than men and it decreased with age. No relation was found with AHI severity (range 0-129 n/h). BMI and TSat90 (range 0-87.9%) affected physical health perception (SF-12 PCS). Furthermore TSat90 influenced PGWBI Vitality subscale. Subjects with ESS > 10 showed a worse HRQoL profile (p < 0.001) in SF-12 and in PGWBI. Multiple regression analysis showed that age, BMI and ESS were significant predictors of SF-12 PCS (p < 0.001; r2 = 0.23).
A worse HRQoL perception among subjects referred for OSA suspicion was not related to disease severity. BMI and hypoxemia influenced only some HRQoL dimensions, while excessive daytime sleepiness worsens all HRQoL components considered.
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ABSTRACT: This book presents eleven contributions from scholars shedding light on different aspects of well-being during the life course, covering diverse parts of the world, and employing research methods ranging from reviews, secondary data analysis, and qualitative approaches to pilot studies and quantitative investigations. The book provides a broad overview regarding the topic of well-being as well as insights into very specific matters. The determinants of well-being range from physiological, social, psychological, spiritual, and economic factors which can be examined individually or concerning their interplay. They can be studied on the micro, meso and macro levels, from an individual, group-related, organizational or societal perspective. This book takes on the challenge of doing justice to this diversity to create a holistic picture.
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ABSTRACT: Patients' health-related quality of life (HRQoL) is now considered a relevant clinical outcome. This study systematically reviewed articles published in the last 5 years, focusing on the impact of rectal cancer treatment on patients' HRQoL. Of the 477 articles retrieved, 56 met the inclusion criteria. The most frequently reported comparisons were between surgical procedures (21 articles), especially between sphincter-preserving and non-sphincter preserving surgery or between stoma and stoma-free patients (13 articles), and between multimodality therapies (11 articles). Additionally, twelve articles compared patients' and healthy controls' HRQoL as primary or secondary aim. The majority of the studies were observational (84 %), controlled (66 %), cross-sectional (54 %), prospective (100 %), with a sample of more than 100 patients (59 %), and with more than 60 % of patients treated with neoadjuvant therapy (50 %). The most frequently used instruments were the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (QLQ-C30), its colorectal cancer specific module QLQ-CR38, and the Medical Outcomes Study Short-Form 36 items questionnaire. Findings from the included articles are summarised and commented, with a special focus on the comparison between surgical treatments, between irradiated and not-irradiated patients, and between patients and the general population.
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