Shim EJ, Mehnert A, Koyama A, Cho SJ, Inui H, Paik NS, Koch UHealth-related quality of life in breast cancer: a cross-cultural survey of German, Japanese, and South Korean patients. Breast Cancer Res Treat 99: 341-350

Institute of Medical Psychology, University Medical Center Hemburg-Eppendorf, Martinistr,52-S35, 20246, Hamburg, Germany.
Breast Cancer Research and Treatment (Impact Factor: 3.94). 11/2006; 99(3):341-50. DOI: 10.1007/s10549-006-9216-x
Source: PubMed


The aim of this study was to evaluate health-related quality of life (HRQOL) in breast cancer patients across countries, and to cross-culturally examine the impact of psychosocial factors on HRQOL.
A total of 413 women with breast cancer from Germany (n = 195), Japan (n = 112), and Korea (n = 106) completed a survey assessing HRQOL and HRQOL-related factors. HRQOL was measured using the Short-Form Health Survey (SF-8). Measures of psychological distress (Hospital Anxiety and Depression Scale and Impact of Event Scale-Revised), coping (Dealing with Illness Inventory-German Revised), and social support (Illness-Specific Social Support Scale-German Revised) were included.
The effect of the factor country on physical QOL was seen to be significant, but small (P = 0.049, ES = 0.018). The scales of General Health (P = 0.023), Vitality (P = 0.004), and Role Emotional (P = 0.003) differed across countries, with the South Korean patients having lower scores compared to the German and Japanese patients. The nature of the impact of psychosocial factors on HRQOL did not differ greatly across countries except with regard to avoidance, however, the degree to which these factors influence HRQOL did differ greatly. Overall, depression, depressive coping, and problematic support showed a strong detrimental effect on the HRQOL of breast cancer patients.
Results from this study suggest that strategies which target an improvement of HRQOL in cancer patients should also consider the patients' cultural and healthcare system contexts. Interventions are needed to improve detrimental psychosocial factors.

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Available from: Anja Mehnert, Oct 13, 2014
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    • "In the Southern European Psycho- Oncology Study (SEPOS), for example, Portuguese cancer patients showed higher levels of fatalism and lower levels of anxiety and depression with respect to Italian cancer patients, as well as higher levels of spirituality (Grassi et al., 2004b; Travado et al., 2010). In another cross-cultural study, differences were found on health, vitality and emotional symptoms , with South Korean cancer patients reporting lower scores compared to German and Japanese patients (Shim et al., 2006). Also differences were found between German and Chinese cancer patients in a further cross-cultural study analyzing anxiety, depression , and unmet psychosocial needs (Lam et al., 2011). "

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    • "A few factors have been identified as predictors of overall quality of life among women with recurrent breast cancer, including age, time since recurrence, recurrence pattern (local-regional or distant recurrence), sites of metastasis, current physical symptoms, and treatment status [16-18]. Unmet needs were reported to be associated with QOL in breast cancer patients [13,15,19,20]. However, to our knowledge, no study has investigated the predictive value of unmet needs on QOL among recurrent breast cancer patients. "
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    ABSTRACT: This study aimed to evaluate the prevalence and the effects of unmet needs on quality of life (QOL) among recurrent breast cancer survivors. Completed questionnaires were collected from 52 women with recurrent breast cancer. Clinical and socio-demographic characteristics were reviewed, and the Supportive Care Needs Survey, Functional Assessment of Cancer Therapy-Breast Cancer Instrument, and Beck Depression Inventory (BDI) were administered. The frequency of unmet needs and the mean differences by patient characteristics and BDI scores were analyzed. The predictive value of unmet needs on QOL, controlling for socio-demographic variables and then for clinical variables, was analyzed in hierarchical regression models. The most common unmet needs belonged to the health system and information domain. The depressive group had greater unmet needs in the psychological domain (p<0.001), physical and daily living domain (p=0.001), and health and information domain (p=0.002). Patients with lower education attainment and those with lower performance status had greater unmet needs in the psychological needs (p=0.002) and in the physical and daily living needs domain (p=0.002), respectively. Unmet needs in the psychological domain (p=0.008), physical and daily living domain (p=0.022), and sexuality domain (p=0.040) strongly predicted QOL of women with recurrent breast cancer. Unmet needs were strong predictors for QOL among recurrent breast cancer patients. This suggests that QOL of women with recurrent breast cancer is possibly more affected by unmet needs than by patient's socio-demographic or clinical characteristics. Intervention strategies could be developed based on the identified needs of women with recurrent breast cancer in order to improve their QOL. Further longitudinal and prospective studies will be necessary to confirm the independent impact of unmet needs on QOL.
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    • "In supporting the results of the present study, the study of Ozon et al., titled as quality of life in breast cancer patients in Turkey showed that statistically there was no significant correlation between age, marital status, monthly income level with QoL; however, there was a direct correlation between education and QoL. In a study by Shim et al., there was also a significant correlation between education and QoL; while there was no correlation between age and marital status with QoL.[34] The reasons of these differences can be due to probable differences in some inclusion criteria and/or other above mentioned causes. "
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