Abstract
BackgroundCancer and its treatment have a major impact on the lives of patients and their intimate partners, such as on their health-related quality of life (HRQOL). The aims of this study are to: (i) assess the HRQOL of advanced cancer patients and spousal caregivers, and explore the relationship between the HRQOL of cancer patients and that of their spousal caregivers; (ii) detect factors influencing the HRQOL of cancer patients and spousal caregivers; and (iii) explore the impact of anxiety and depression on the HRQOL of couples.MethodsA total of 131 couples where one of the partners was hospitalized for advanced cancer were invited to complete a survey to assess their demographic and background information, HRQOL, and anxiety and depression. HRQOL was measured using the SF-12, while anxiety and depression were measured using the Hospital Anxiety and Depression Scale. Data were analyzed using a T-test, Pearson correlations, multiple linear regressions, and structural equation modeling.ResultsIn general, the spousal caregivers had higher levels of HRQOL (seven out of eight SF-12 domains and two SF-12 dimensions) p = 0.038–0.000, anxiety (p = 0.002), and depression (p = 0.011) than patients. Correlations of HRQOL between patients and spouses were small to moderate (r = 0.193–0.398). Multiple independent factors influencing the physical component summary (PCS), mental component summary (MCS), vitality (VT), and role emotional (RE) sections of the SF-12 were identified, including: gender, time since diagnosis, levels of education, working status, the extent to which spousal caregivers were informed about the disease, improved marital relationship after the diagnosis of cancer, and anxiety and depression. For both patients and spousal caregivers, the strongest independent factor influencing HRQOL (SF-12 PCS, MCS, VT, and RE) was anxiety and depression. Anxiety and depression may have both actor and partner effects on the HRQOL of couples to various degrees.ConclusionsThe findings of this study call attention to the HRQOL of couples and its influencing factors. Individual characteristics of cancer patients and spouses, marital relationship, and anxiety and depression are highlighted as areas in which couples coping with cancer could benefit from interventions to improve their HRQOL.Electronic supplementary materialThe online version of this article (doi:10.1186/s12904-016-0142-3) contains supplementary material, which is available to authorized users.
Highlights
Cancer and its treatment have a major impact on the lives of patients and their intimate partners, such as on their health-related quality of life (HRQOL)
Excluded from the study were couples with the following characteristics: (i) cancer patients who had other major health problems, such as dementia; (ii) spousal caregivers who were unable to care for patients due to chronic illness or who were suffering from a serious physical or mental illness, including cancer; and (iii) those who were unable to communicate in Mandarin
Over half of the couples (51.5 %) had been diagnosed for less than 6 months, all of the patients were in the advanced stage of cancer, namely, stage III (n = 56, 42.7 %) and stage IV (n = 75, 57.3 %)
Summary
Cancer and its treatment have a major impact on the lives of patients and their intimate partners, such as on their health-related quality of life (HRQOL). It is unfortunate that in developing countries, where treatment options are both limited and expensive, most new cases of cancer are frequently diagnosed at the advanced stage [2] This late diagnosis of cancer and the limited treatment options available in developing countries, e.g., in China, may lead to poor prognoses for cancer, which in turn may affect the health-related quality of life (HRQOL) of cancer patients. This further supports the argument that more attention should be paid to the problem of the HRQOL of cancer patients. The challenges posed by cancer and its treatment are felt by patients and by the members of their family [3], by spouses, who are typically the primary caregivers of cancer patients [4]
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