The Impact of Non-pharmacologic Traditional Chinese Medicine on Health-Related Quality of Life and Symptom Management in Breast Cancer Patients: A Systematic Review and Meta-Analysis

Objective:This study aimed to investigate how nutrition indicators and physical function may influence Health-related Quality of Life (HRQoL) of breast cancer patients undergoing treatment. Methods:This was a cross sectional study among a total of 163 breast cancer patients. Series of measurements including anthropometry, biochemical, and dietary were employed to assess patients’ nutritional status while physical function was assessed by handgrip strength. HRQoL of patients was determined using European Organization for Research and Treatment of Cancer quality of life questionnaire Core 30 (EORTC-QLQ-C30) version 3.0. Multiple linear regression was used to identify factors associated with HRQoL. Results:Breast cancer patients perceived moderately their overall quality of life (QoL), with the mean global health status (GHS) score of 69.12. Emotional functioning was the poorest functional scale while fatigue was the most distressing symptom presented by the patients. Approximately 20% of patients had low corrected arm muscle area while more than half had low hemoglobin level. More than 90% of patients did not meet the overall dietary recommendation and had poor handgrip strength. Mid-upper arm circumference (MUAC) was associated with GHS (β: 0.906; 95% CI: 0.22, 1.56) and cognitive functioning (β: -1.543; 95% CI: -3.07, -0.01). Handgrip strength was positively associated with most of HRQoL outcomes. Conclusions:Breast cancer patients reported overall good nutritional status and moderate QoL during treatment. Being well-nourished improved HRQoL and handgrip strength could be a potential proxy for functional outcomes as well as overall QoL.

Allergy: a global problem. Quality of life.

Quality of Life and Self-Esteem for Children With Urinary Urge Incontinence and Voiding Postponement

The objective of the study was to examine the association between overall and health-related quality of life and smoking in men and women of discrete smoking groups in Finland. The design was a Health 2000 Survey, conducted in Finland 2000--2001. The setting and participants were a two-stage, stratified, nationally representative cluster sample that comprised 8,028 persons aged 30 or over living in mainland Finland. Health-related quality of life was measured by the 15D questionnaire; and overall quality of life was assessed by a single question measure capturing the respondent's own perception and estimation of his/her quality of life. The present study showed that daily smokers had both lower health-related and overall quality of life than never-smokers among the Finnish adult population. Health-related quality of life profiles showed that daily smokers did worse than never-smokers in a considerable number of the health dimensions. The effects of smoking were observed not only through health: the daily smokers registered significantly lower ratings of overall quality of life compared with never-smokers, too. Both the health-related and overall quality of life of ex-smokers approached those of never-smokers. The results of the present study suggest that improved health is not the only benefit of smoking cessation; better quality of life and more fulfilling everyday living can also be expected. As the major health consequences of smoking usually manifest themselves only after several years of smoking, both health-related and overall quality of life measurements could be used as an intervention tool for motivating people to quit.

Background: Complementary and Alternative Medicine (CAM) is widely adopted by female breast cancer patients seeking to improve their health-related quality of life. However, research related to the quality of life of breast cancer patients who use CAM is still ambiguous and has never been done in Indonesia. Objective: This study aims to compare the quality of life between breast cancer patients who use conventional therapy (chemotherapy) with a combination of conventional therapy and CAM. Methods: This cross-sectional study was conducted on 80 women who underwent chemotherapy at least one cycle at RSUD Sanjiwani, Gianyar. Participants were divided into two groups: those treated with conventional therapy only, and those who also incorporated CAM therapies such as massage, herbal medicine, and spiritual healing practices. Assessment of quality of life in patients was conducted using the standardized EORTC QLQ-C30 questionnaire developed by the European Organisation for Research and Treatment of Cancer. Quality-of-life scores between groups were compared using an independent t-test. Results: The results showed that there were significant differences in breast cancer patients who used conventional therapy (chemotherapy) with a combination of conventional therapy and CAM in the domain of global health status (61, 67 vs 71.67, p=0.000), cognitive functioning (54.33 vs 27.67, p=0.000), role functioning (53.33 vs 29.33, p=0.009), fatigue (35.22 vs 24.44, p=0.000), nausea and vomiting (74 vs 45.67, p=0.000) and pain (85.67 vs 52.33, p=0.000). Conclusion: The combination of conventional therapy and CAM significantly improved global health status and symptom management in breast cancer patients, suggesting its potential to enhance quality of life alongside standard treatment. Keywords: Breast Cancer; Complementary and Alternative Medication (CAM); Conventional; EORTC QLQ-C30; Quality of Life.

Hepatitis C treatment and quality of life – You can’t always get what you want, but you might get what you need

Quality of life in prostate cancer patients.

Timing of quality of life assessment in cancer clinical trials: fine tuning remains a challenge

Health Related Quality of Life (HRQoL) is an important health outcome in the holistic management of patients especially those suffering from life limiting conditions such as cervical cancer. In Kenya, Cervical cancer is the most frequent cancer among women. However, little is known and documented on HRQoL of cervical cancer patients. This study assessed HRQoL of cervical cancer patients in western Kenya. A cross-sectional study involving 334 cervical cancer patients was conducted in Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH) in Kisumu from September 2014 to February 2015. FACT-Cx (The Functional Assessment of Chronic Illness Therapy –for measuring Quality of Life in cervical cancer patients) Version 4 and a structured questionnaire were used to collect data. Quantitative data was analyzed using Statistical Package for Social Scientists (SPSS) Version 20 and Statistical Application Software (SAS) version 9.2 at a statistical significance of P ≤ 0.05, descriptive and inferential statistics were performed. The mean HRQoL was 35.35 (SD=13.21). More than half of the respondents experienced poor functional and physical wellbeing, 221 (66%) and 201 (60%) respectively and no patient experienced good functional and physical wellbeing. While 189 (57%) experienced fair overall quality of life. Multiple cumulative logistic regression analysis between cancer stage and treatment had statistically significant association with overall quality of life (X2 = 105.34 and 70.72; with df=3 and 6; p-values = 0.0001 and 0.0001, respectively); also between age, marital status, level of education and religion showed positive influence on overall quality of life except for religion (X2 = 21, 11, 113 and 4 with df=3 for all and p-values = 0.0001, 0.0121, 0.0001, 0.2563 respectively). Cervical cancer patients do fairly better with emotional and social wellbeing, while they experience poor functional and physical wellbeing due to large proportion of patients presenting at stage IV and III of the disease. There is a need to include HRQoL assessment in routine management of cervical cancer patients to enhance their quality of life.

A BSTRACT Patients with liver cirrhosis experience a significantly reduced health-related quality of life (HRQoL) due to a multifaceted interaction of physiological, psychological, and social factors. Identifying these key determinants is crucial for enhancing care strategies and treatment outcomes. This study systematically explored the factors influencing both negative and positive aspects of HRQoL in patients with liver cirrhosis. A comprehensive literature search was performed across PubMed, Scopus, Embase, and Google Scholar, focusing on original research published since January 1, 2021. Studies involving sarcopenia in cirrhosis and its impact on HRQoL, including various subgroups and influencing factors, were included to ensure a wide-ranging analysis. The review identified multiple significant risk factors associated with poor HRQoL in cirrhotic patients. These included advanced age, female gender, lower socioeconomic status, low body mass index, and the presence of comorbid conditions such as anxiety and depression. Additionally, complications like ascites, hepatic encephalopathy, abnormal endoscopic findings, higher disease severity scores, sarcopenia, disturbed sleep, impaired sexual function, muscle cramps, and elevated levels of bilirubin, prothrombin time, and albumin-bilirubin ratio were linked to diminished HRQoL. On the other hand, interventions such as increased physical activity, liver transplantation, stem cell therapy, mindfulness practices, and the use of probiotics, rifaximin, and lactulose showed positive effects on HRQoL. These insights underscore the importance of adopting a comprehensive management approach for liver cirrhosis that addresses not only physical health but also psychological and social well-being. Future research should aim at developing targeted interventions to reduce the burden of these risk factors and promote overall quality of life in this patient population.

The current study evaluated the efficacy of incorporating standardized health-related quality of life (HRQL) assessments as a routine part of the outpatient chemotherapy treatment of cancer patients in a community hospital in terms of: 1) facilitating nurse-patient communication, 2) increasing nurses' awareness of patients' HRQL, 3) patient management, 4) patients' satisfaction, and 5) patients' HRQL. The study employed a sequential cohort design with repeated measures. Ten nurses and 219 patients participated in this community hospital-based study. The intervention involved patients completing standardized HRQL questionnaires via a touch-screen computer, the results of which were provided to nurses and patients in a graphic summary. Questionnaire and medical record data were used to assess outcomes. HRQL-related topics were discussed significantly more frequently in the intervention group than in the control group (mean = 4.8 topics vs 3.8 topics, respectively; P = .02). Nurses' awareness of patients' levels of daily activity, pain, and overall quality of life was significantly better in the intervention than the control group. The mean number of HRQL-related notations in the medical records was significantly higher in the intervention group (24 vs 20; P< .05). Only modest effects were observed in patient management (counseling behavior), and no significant effects were found in patient satisfaction or changes in HRQL over time. Incorporating standardized HRQL assessments in daily clinical oncology nursing practice primarily facilitates the discussion of HRQL issues and increases nurses' awareness. Additional efforts are needed to enhance the effect of routine HRQL assessments on patient management and HRQL.

Background: A growing body of research has demonstrated that impaired central pain modulation or central sensitization (CS) is a crucial mechanism for the development of persistent pain in chronic whiplash-associated disorders (WAD) and fibromyalgia (FM) patients. Furthermore, there is increasing evidence for cognitive dysfunctions among these patients. In addition, chronic WAD and FM patients often report problems with health-related quality of life (QoL). Yet, there is limited research concerning the interrelations between cognitive performance, indices of CS, and health-related QoL in these patients. Objectives: (1) Examining the presence of cognitive impairment, CS, and limitations on healthrelated QoL in patients with chronic WAD and FM compared to healthy controls. (2) Examining interrelations between performance-based cognitive functioning, CS, and self-reported healthrelated QoL in these 3 study groups. Study Design: A case-control study was conducted. Setting: The present study took place at the University Hospital Brussels, the University of Brussels, and the University of Antwerp. Methods: Fifty-nine patients (16 chronic WAD patients, 21 FM patients, and 22 pain-free volunteers) filled out the Short Form 36 item Health Survey (SF-36), a self-reported psychosocial questionnaire, to assess health-related QoL. Next, they were subjected to various pain measurements (pressure hyperalgesia, deep-tissue hyperalgesia, temporal summation [TS], and conditioned pain modulation [CPM]). Finally, participants completed a battery of performance-based cognitive tests (Stroop task, psychomotor vigilance task [PVT], and operation span task [OSPAN]). Results: Significant cognitive impairment, bottom-up sensitization, and decreased health-related QoL were demonstrated in patients with chronic WAD and FM compared to healthy controls (P &lt; 0.017). CPM was comparable between the 3 groups. Cognitive performance was significantly related to central pain modulation (deep-tissue hyperalgesia, TS, CPM) as well as to self-reported health-related QoL (P &lt; 0.05). Decreased cognitive performance was related to deficient central pain modulation in healthy controls. Further, significant correlations between decreased cognitive performance and reduced health-related QoL were revealed among all study groups. Additionally, FM patients showed correlations between cognitive impairment and increased health-related QoL. Remarkably, impaired selective attention and working memory were related to less TS, whereas impaired sustained attention was correlated with dysfunctional CPM in FM patients. Limitations: Based on the current cross-sectional study no firm conclusions can be drawn on the causality of the relations. Conclusion: In conclusion, this paper has demonstrated significant cognitive deficits, signs of CS, and reduced health-related QoL in chronic WAD and FM patients compared to healthy individuals. Significant relations between cognitive performance and CS as well as health-related QoL were demonstrated. These results provide preliminary evidence for the clinical importance of objectively measured cognitive deficits in patients with chronic WAD and FM. Key words: Chronic pain, fibromyalgia, whiplash, central sensitization, conditioned pain modulation, temporal summation, cognition, quality of life

Patient-reported outcomes (PROs) as a routine measure for cancer inpatients: the final missing piece of the puzzle?

Quality of Life for Patients Diagnosed with Diabetic Foot

55BC patients with disease stage I-III were randomized into a training group and control group. The training group performed maximal strength training twice a week for 3months, whereas the control group followed prescribed treatment without strength training. Overall quality of life was measured by The European Organization for Research and Treatment of Cancer Core Quality of life Questionnaire-C30 and additional BC module BR23before and after the intervention. The results obtained from pre-tests and those obtained after 3months of intervention revealed that patients in the training group significantly increased one repetion maximum, by 20.4kg (20%) (p=0.001, d=0.9). Simultaneously, statistically significant alterations were observed in this variable for the control group, one repetition maximum decreased by 8.9kg (9%) (p = 0.001, d = 0.5). The overall quality of life improved significantly by 13% for the training group with large effect (p = 0.002, d = 0.6), but no relevant changes were observed in the control group (p = 0.44, d=0.2). Results revealed remarkable changes in overall quality of life after 3-month post-test period between the two groups with large effect (p = 0.002, d = 0.9). The training sessions had helped in diminishing the sense of fatigue by 24% (p = 0.03, d = 0.6), while it had got worse by 25% (p = 0.02, d = 0.4) for the control group. Again, the data on large effect were noticed to differ between the groups (p = 0.01, d = 0.6). Maximal strength training for BC patients was well tolerated, safe and feasible and showed strength improvements that led to improved muscle strength and improved overall quality of life. These data certainly support the therapeutic role for maximal strength training in the treatment of BC.