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Modifiable and fixed factors predicting quality of life in people with colorectal cancer.

Gray NM, Hall SJ, Browne S, Macleod U, Mitchell E, Lee AJ, Johnston M, Wyke S, Samuel L, Weller D, Campbell NC - Br. J. Cancer (2011)

Bottom Line: Adding modifiable factors, poorer role (P<0.001) and social functioning (P=0.003), fatigue (P=0.001), dyspnoea (P=0.001), anorexia (P<0.001), depression (P<0.001) and worse perceived consequences (P=0.013) improved the model fit considerably (R(2)=0.574).Omitting functioning subscales resulted in recent diagnosis (P=0.002), lower perceived personal control (P=0.020) and travel difficulties (P<0.001) becoming significant predictors.Unmodifiable factors, including metastatic (or unstaged) disease at diagnosis, have less impact.

View Article: PubMed Central - PubMed

Affiliation: Centre of Academic Primary Care, University of Aberdeen, Foresterhill Health Centre, Westburn Road, Aberdeen AB25 2AY, UK. n.gray@abdn.ac.uk

ABSTRACT

Background: People with colorectal cancer have impaired quality of life (QoL). We investigated what factors were most highly associated with it.

Methods: Four hundred and ninety-six people with colorectal cancer completed questionnaires about QoL, functioning, symptoms, co-morbidity, cognitions and personal and social factors. Disease, treatment and co-morbidity data were abstracted from case notes. Multiple linear regression identified modifiable and unmodifiable factors independently predictive of global quality of life (EORTC-QLQ-C30).

Results: Of unmodifiable factors, female sex (P<0.001), more self-reported co-morbidities (P=0.006) and metastases at diagnosis (P=0.036) significantly predicted poorer QoL, but explained little of the variability in the model (R(2)=0.064). Adding modifiable factors, poorer role (P<0.001) and social functioning (P=0.003), fatigue (P=0.001), dyspnoea (P=0.001), anorexia (P<0.001), depression (P<0.001) and worse perceived consequences (P=0.013) improved the model fit considerably (R(2)=0.574). Omitting functioning subscales resulted in recent diagnosis (P=0.002), lower perceived personal control (P=0.020) and travel difficulties (P<0.001) becoming significant predictors.

Conclusion: Most factors affecting QoL are modifiable, especially symptoms (fatigue, anorexia, dyspnoea) and depression. Beliefs about illness are also important. Unmodifiable factors, including metastatic (or unstaged) disease at diagnosis, have less impact. There appears to be potential for interventions to improve QoL in patients with colorectal cancer.

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Related in: MedlinePlus

Flowchart of numbers of participants approached, consented and recruited to the study in North East Scotland.
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fig1: Flowchart of numbers of participants approached, consented and recruited to the study in North East Scotland.

Mentions: In Glasgow, participants were identified by five clinical staff members in three hospitals; clinical staff did not retain details of who had been approached; thus, it was not possible to calculate recruitment or consenting rates. In Grampian, recruitment was from four hospitals; eligible participants were identified by researchers and then approached by a member of the clinical team. Of 436 eligible patients, 310 (71%) were recruited (Figure 1). The mean QoL score was 65.791 (s.d., 21.81).


Modifiable and fixed factors predicting quality of life in people with colorectal cancer.

Gray NM, Hall SJ, Browne S, Macleod U, Mitchell E, Lee AJ, Johnston M, Wyke S, Samuel L, Weller D, Campbell NC - Br. J. Cancer (2011)

Flowchart of numbers of participants approached, consented and recruited to the study in North East Scotland.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3111166&req=5

fig1: Flowchart of numbers of participants approached, consented and recruited to the study in North East Scotland.
Mentions: In Glasgow, participants were identified by five clinical staff members in three hospitals; clinical staff did not retain details of who had been approached; thus, it was not possible to calculate recruitment or consenting rates. In Grampian, recruitment was from four hospitals; eligible participants were identified by researchers and then approached by a member of the clinical team. Of 436 eligible patients, 310 (71%) were recruited (Figure 1). The mean QoL score was 65.791 (s.d., 21.81).

Bottom Line: Adding modifiable factors, poorer role (P<0.001) and social functioning (P=0.003), fatigue (P=0.001), dyspnoea (P=0.001), anorexia (P<0.001), depression (P<0.001) and worse perceived consequences (P=0.013) improved the model fit considerably (R(2)=0.574).Omitting functioning subscales resulted in recent diagnosis (P=0.002), lower perceived personal control (P=0.020) and travel difficulties (P<0.001) becoming significant predictors.Unmodifiable factors, including metastatic (or unstaged) disease at diagnosis, have less impact.

View Article: PubMed Central - PubMed

Affiliation: Centre of Academic Primary Care, University of Aberdeen, Foresterhill Health Centre, Westburn Road, Aberdeen AB25 2AY, UK. n.gray@abdn.ac.uk

ABSTRACT

Background: People with colorectal cancer have impaired quality of life (QoL). We investigated what factors were most highly associated with it.

Methods: Four hundred and ninety-six people with colorectal cancer completed questionnaires about QoL, functioning, symptoms, co-morbidity, cognitions and personal and social factors. Disease, treatment and co-morbidity data were abstracted from case notes. Multiple linear regression identified modifiable and unmodifiable factors independently predictive of global quality of life (EORTC-QLQ-C30).

Results: Of unmodifiable factors, female sex (P<0.001), more self-reported co-morbidities (P=0.006) and metastases at diagnosis (P=0.036) significantly predicted poorer QoL, but explained little of the variability in the model (R(2)=0.064). Adding modifiable factors, poorer role (P<0.001) and social functioning (P=0.003), fatigue (P=0.001), dyspnoea (P=0.001), anorexia (P<0.001), depression (P<0.001) and worse perceived consequences (P=0.013) improved the model fit considerably (R(2)=0.574). Omitting functioning subscales resulted in recent diagnosis (P=0.002), lower perceived personal control (P=0.020) and travel difficulties (P<0.001) becoming significant predictors.

Conclusion: Most factors affecting QoL are modifiable, especially symptoms (fatigue, anorexia, dyspnoea) and depression. Beliefs about illness are also important. Unmodifiable factors, including metastatic (or unstaged) disease at diagnosis, have less impact. There appears to be potential for interventions to improve QoL in patients with colorectal cancer.

Show MeSH
Related in: MedlinePlus