Cancer Patients In Turkey Research Articles

The validity and reliability of the Turkish version of the Quality of Life Index [QLI] (Cancer version)

Purpose Quality of life always has become an important concern in the health care of cancer patients. This descriptive study was planned to assess the validity and reliability of the Turkish version of Quality of Life Index – Cancer version in the assessment of the quality of life of lung cancer patients. Method The validity and reliability of the scale was performed in two phases. Phase I focused on construction of the Turkish version of the instrument and pilot testing. The scale was translated using the back-translation technique. Five nursing experts reviewed the translation for inconsistencies with the original English form. The comprehensiveness and clarity of the scale was assessed with 20 patients. Phase II included factor analysis and psychometric assessment of the scale. The final version of the scale was pretested with 154 cancer patients. Results According to the recommendations of the expert panel, some items were revised and modified, and the Turkish version of the scale was created. The content validity index (CVI) was 97%. Patients cited that this questionnaire was easy to read and understood. Differently from the original QLI scale, factor analysis was changed the domain of some items. Test–retest coefficients for items were between 0.63 and 0.95 ( p < 0.05). The scale showed high internal reliability, Cronbach’s alpha values for domain varied between 0.63 and 0.85 and was 0.89 for the tool. Conclusion The Turkish version of the QLI was sufficient and suitable tool in evaluating the quality of life of lung cancer patients in Turkey.

P114 Opinions of nurses and doctors related to pain control of cancer patients in Turkey

P114 Opinions of nurses and doctors related to pain control of cancer patients in Turkey

P64 Coping of family caregivers of cancer patients in Turkey

P64 Coping of family caregivers of cancer patients in Turkey

Development and validation of the Nightingale Symptom Assessment Scale (N-SAS) and predictors of the quality of life of the cancer patients in Turkey

Purpose Treatment-related side effects have an adverse impact on the health-related quality of life (HRQoL) of cancer patients undergoing chemotherapy. This study is a description of the validity and responsiveness demonstrated by a new cancer and cancer treatment-specific symptom scale – the Nightingale Symptom Assessment Scale (N-SAS) - which was developed and validated to address the QoL of Turkish cancer patients. Method The comprehensiveness and clarity of the scale was assessed using 10 patients and pilot testing was carried out with 179 patients. A sample of 374 cancer patients who had received chemotherapy participated in the main study. Descriptive statistics were calculated and comparative tests and factor analysis were performed. Results The internal reliability of N-SAS was examined and the validity of this scale was determined by correlation with FACT-G. The scale showed high internal reliability, Cronbach's α for the subscales varied between 0.81 and 0.87 and was 0.93 for the tool. Longitudinal analyses showed that changes in N-SAS scores were strongly correlated with changes in FACT-G. Multivariate analysis revealed that having a metastatic cancer diagnosis, having a low level of income, receiving taxane-based therapy and being a woman were the most important predictive factors for the well-being of the cancer patients in this study. Conclusions The high correlation with the FACT-G suggests that the new scale is a valid instrument that can be used to evaluate the effect of antineoplastic therapies on a cancer patient's QoL and can help guide nursing care as well as track the improvement of patients' HRQoL.

Effect of acupressure on chemotherapy-induced nausea and vomiting in gynecologic cancer patients in Turkey

Purpose The aim of the current study was to assess the effect of acupressure applied to the pericardium 6 (P6 or Neiguan) acupuncture point with a wristband (Sea-Band™) on nausea–vomiting in addition to the standard antiemetic medications used to prevent nausea–vomiting due to chemotherapy in gynecologic cancer patients. Method In this prospective research we used pre- and posttests. The study consisted of 34 patients with gynecologic cancer. Results We found a significant decrease in the patients' mean scores of nausea and the use of antiemetic medications following acupressure applied to the patients with a wristband, when compared with their mean scores of nausea and the use of antiemetic medications prior to the application ( p < 0.05), and we also observed a decline in their mean scores of vomiting and retching episodes; however, this decline was not found to be statistically significant ( p > 0.05). Conclusions The findings from this study suggest that the acupressure applied to P6 acupuncture point with wristbands may be effective in reducing chemotherapy-related nausea and may decrease the antiemetic use after chemotherapy. Further research with more subjects is needed.

Frequency of co-morbid illnesses in cancer patients in Turkey

e20717 Background: Co-morbidities in cancer patients can adversely affect the management of their primary illnesses at multiple levels from diagnosis to therapy. We saught to examine co-morbid conditions in cancer patients treated at 3 university hospitals in Turkey representing three different geographic locations. Methods: A total of 622 consecutive cancer patients presenting to outpatient clinics were recruited to the study from November 2007 to May 2008. Each patient answered a questionnaire consisting of questions on co-morbidities and drugs taken. Based on the questionnaire, Charlson Comorbidity Index (CCI) was calculated. Results: Their median age was 55 years (minimum-maximum: 21–87) and 376 (62%) were female. Breast cancer (39%), colon and rectum (19%) and lung cancer (14%) were the 3 most frequent cancers. Of the patients, 60% had at least 1 co-morbid disease and 49% were using at least one medication daily. The most frequent comorbid diseases were hypertension (25%), other cardiovascular disorders (15%) and diabetes mellitus (13%). Incidence of comorbid diseases were increasing by age; 65% in patients between 60–69 years and 76% in patients older than 70 (r=0.25, p&lt;0.001). Similarly, of those over 70 years, 65% was on at least 1 medication (r=0.29, p&lt;0,001). CCI scores were calculated as 0 in (71%), 1 (23%) and 2 (5%) and it also worsened by increasing age (r=0.15, p&lt;0.001). Conclusions: It is crucial to remember that co-morbid illnesses are not infrequent and many patients take medications for conditions unrelated to their cancer, which potentially may affect multiple stages of clinical management. No significant financial relationships to disclose.

Quality of life and complementary and alternative medicine use among cancer patients in Turkey

Aim The purpose of this study was to assess the relationships between quality of life and use of complementary and alternative medicine (CAM) among Turkish cancer patients. Methods This cross-sectional study was conducted in Istanbul University Institute of Oncology, Turkey. Two-hundred patients were invited and informed consent was obtained, however 179 cancer patients completed the study. The Patient Characteristics form, The Nightingale Symptom Assessment Scale and The Functional Assessment of Cancer Therapy Scale were used in the evaluation of the patients’ characteristics and quality of life. Results Some form of CAM had been used by 71.5% of the sample. Frequently used CAM methods appeared to be religious practices (68.2%) and only 37.4% of the patients used herbs. However, female patients, single patients, and individuals with metastatic disease and worse quality of life showed a tendency to use CAM more often. More than one-third of our patients began to use CAM immediately after being diagnosed with cancer and factors associated with CAM use varied according to the type of CAM. Although CAM use did not affect the patients’ quality of life, logistic regression analysis revealed that gender, type of cancer diagnosis and education level were important factors to be considered in different CAM therapies. Conclusion CAM use is common in cancer patients in Turkey. More discussion about CAM use should take place between patients and health professionals to inform the patients’ decisions.

Depression-anxiety and quality of life and the use of complementary and alternative medicine among breast cancer patients in Turkey.

Abstract Abstract #3130 Purpose: Breast cancer is the most common cancer type among women. The aim of this study was to examine the association between the use of complementary and alternative medicine (CAM) and quality of life, and anxiety and depression, and demographic characteristics of Anatolian women with breast cancer.&amp;#x2028; Methods: Quality of life was measured with European Organization for Treatment and Research of Cancer (EORTC) quality of life core questionnaire (QLQ-C30, version 3.0) and anxiety and depression was measured with Hospital Anxiety and Depression Scale (HADS). The demographic characteristics of patients were filled by patient to a standard form.&amp;#x2028; Results: Totally 122 patients with breast cancer were enrolled, and 50% (n=61) of patients reported that they were using CAM. The most commonly used CAM methods were stinging nettle (57%) and prayer and spiritual healing (49%). The statistical analysis showed that, there was a meaningful correlation between CAM usage and education level (p=0.031) and radiotherapy (p=0.002). There was no relationship between use of CAM and patients age, time since diagnosis, stage of cancer, chemotherapy using, smoking and residence. Analysis of patients showed a positive correlation between CAM and RF2 (Role Functioning) (p=0.014) and FI (Financial Difficulties) (p=0.011) and negative correlation between CAM and EF (Emotional Functioning) (p=0.033). There was no correlation between use of CAM and anxiety and depression scale. The RF2 (p=0.02), EF (p=0.047), FA (Fatigue) (p=0.038), PA (Pain) (p=0.043) and depression results (p=0.008) were better at patients with high education level. We analysed CAM using in patients living in rural or urban area, and the EF (p=0.006), CF (Cognitive Functioning) (p=0.027), PA (p=0.025), DY (Dyspnoea) (p=0.045) and DI (Diarrhoea) (p=0.000) results were better in urban area.&amp;#x2028; Conclusions: According to the various studies in the literature, 20-83.3% of breast cancer patients were using CAM and the CAM methods are different in different countries and cultures. Our results suggest that the use of CAM among Anatolian women with breast cancer is popular. This study findings showed no correlation between anxiety and depression and CAM usage. There is a tendency to CAM usage in patients with financial problems. Emotional functioning was also worse in those patients. The study results showed that the use of CAM is more common among breast patients with bad emotional status and poor financial status. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 3130.

The association between individual attachment patterns, the perceived social support, and the psychological well‐being of Turkish informal caregivers

This study aimed to investigate the relations among the psychological well-being (i.e. depression and state/trait anxiety levels), attachment patterns (i.e. secure, ambivalent, avoidant), and the perceived social support from family/friends/significant others of caregivers of cancer patients in Turkey. Fifty-one caregivers of adult cancer patients were recruited from the oncology outpatient clinic of the Marmara Medical School Hospital in Istanbul. Caregivers were assessed with the Adult Attachment Scale, the Beck Depression Inventory, State-trait Anxiety Inventories, and the Multidimensional Scale of Perceived Social Support. Stepwise multiple regression analysis indicated that depression was predicted by ambivalent attachment and the perceived social support from family. The support from significant others was the significant predictor of trait anxiety and the caregivers' ambivalent attachment score was the significant predictor of state anxiety. We assert that ambivalent attachment pattern could confer a vulnerability to psychological distress in cancer caregivers. Assessing the psychological experiences and needs of caregivers and being aware of possible risk factors (such as attachment patterns) and protective factors (social support network) for depression and anxiety might be helpful for successful programmes and interventions that support the caregivers of cancer patients.

Effect of the First Chemotherapy Course on the Quality of Life of Cancer Patients in Turkey

Multiple studies have examined the quality of life of cancer patients before or after treatment, but few have evaluated the impact of a specific course of treatment on cancer patients' quality of life. Using a longitudinal design, we examined the quality of life of 24 women and 8 men before receiving their initial course of chemotherapy and again at 21 days after the first course of chemotherapy. The study was carried out at the outpatient chemotherapy unit of a university hospital located in the city of Izmir, West Turkey. Research data were collected using a patient demographic form and the Rolls Royce Model Quality of Life Scale. All of the postchemotherapy mean scores from the quality-of-life instrument were statistically significantly lower at day 21, except for the cognitive functioning subscale. Overall, initial chemotherapy was found to have a significantly negative effect on the quality of life of cancer patients. Nurses can help patients prepare for an initial decrease in their quality of life early in treatment.

Reliability and Validity of the Functional Living Index-Cancer in Turkish Cancer Patients

The objective of this study was to test the reliability and validity of the Turkish version of the Functional Living Index-Cancer in Turkey. The English version of the Functional Living Index-Cancer was translated into Turkish following the standard translation methodology. The questionnaire was administered to 110 cancer patients who had been receiving chemotherapy. Internal consistency reliability was in the acceptable range for this instrument. Among cancer patients, the Cronbach alpha reliability for the total scale was .88, and subscale alpha coefficients ranged from .60 to .83, which is similar to the alpha of .79 observed in the Functional Living Index-Cancer, English version. The results of the principle components analysis and varimax rotation resulted in 5-factor structure: physical functioning, psychological functioning, current well-being, social functioning, and gastrointestinal symptoms. The results of this study suggest that the Turkish version of the Functional Living Index-Cancer is a reliable and valid supplementary measure of the quality of life in cancer patients in Turkey, and it can be used in clinical trials and studies of outcome research in oncology.

Understanding the reliability and validity of the EORTC QLQ-C30 in Turkish cancer patients

Quality of life (QOL) has become an important area to address. The most commonly used QOL tool in oncology is the European Organization for Research and Treatment of Cancer QOL measure (EORTC QLQ-C30). The aim of this study is to examine the reliability and validity of this widely used questionnaire in Turkish language. A total of 114 cancer patients were recruited in this study. The internal consistency of the subscales, concurrent validity between EORTC QLQ-C30 version 3.0 and Short Form-36 (SF-36), the correlations between the subscales of EORTC QLQ-C30 and Hospital Anxiety and Depression scale-Anxiety (HADS-A), and Hospital Anxiety and Depression scale-Depression (HADS-D) were also evaluated. Cronbach's alpha-coefficient for multi-item scales ranged from 0.56 to 0.85, with emotional functioning having the highest Cronbach's alpha-coefficient. General health/QOL subscale was correlated significantly with all other subscales. Modest correlations were found between relevant subscales of SF-36 and EORTC QLQ-C30 scales indicating good convergent validity. Although score of emotional functioning subscale was significantly correlated with HADS-A, no correlation was found with HADS-D. The correlations between general health/QOL and HADS-A and HADS-D were significant though Pearson's coefficients were below 0.4. The EORTC QLQ-C30 version 3.0 is a reliable and valid instrument and suitable for measuring the QOL in cancer patients in Turkey.

1331 PUBLICATION Factors affecting the disclosure practice of physicians treating cancer patients in Turkey

1331 PUBLICATION Factors affecting the disclosure practice of physicians treating cancer patients in Turkey

The Status of Alternative Treatment in Cancer Patients in Turkey

This study was designed to measure the frequency at which Turkish patients with cancer resort to complementary and alternative medicine (CAM). A total of 704 patients referred to the Gülhane Military Medical Academy and Ankara Numune Training Hospital between September 2002 and January 2003 were asked about the CAM therapies they used. Of these, 276 patients (39.2%) had used CAM. Gender, marital status, educational status, age, financial status, severity of pain, history of cancer in the family, and their own ideas concerning CAM therapies were found to be correlated with the frequency of resorting to CAM. Resorting to CAM may lead to delayed diagnosis and treatment, adverse drug interactions, treatment withdrawal, and disease progression. Therefore, it is very important to inform patients about these potential dangers. Further studies are needed to clarify the reasons that lead patients to resort to CAM.

The use of complementary and alternative (non-conventional) medicine in cancer patients in Turkey

The purpose of this study was to define various methods of complementary and alternative medicine (CAM) used by cancer patients and their characteristics in Turkey. The sample consisted of 100 cancer patients who were monitored in the oncology outpatient and inpatient departments of two hospitals. Almost all participating patients were receiving conventional treatment, 36% of which were also using CAM methods. Female patients and individuals with lower educational background showed a tendency to use CAM methods more often. The most frequently used CAM method appeared to be herbal therapy, and the most commonly used herb was the stinging nettle. Most patients obtained information about CAM methods from their friends, the media and from CAM vendors. Patients' responses indicate that "the desire to do everything possible to fight the disease" and "the idea that it may be helpful, at least it's not harmful" were the two most common reasons for using CAM. Of the patients, 79.3% acknowledged a varying degree of benefit from the methods they use. The most frequently indicated benefit was "feeling better both physically and emotionally". Most findings in this study are similar to the results of other research conducted on the subject in Turkey.

Does awareness of diagnosis make any difference to quality of life?

The object of this study was to investigate how the information status with regard to diagnosis, in addition to social and clinical factors, influenced emotional functioning and quality of life in a group of cancer patients in Turkey. A consecutive sample of 100 cancer patients being treated for different diagnoses in a tertiary care centre were prospectively evaluated. Data on patient disease and social characteristics, clinical factors, and scores on the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) were analysed by logistic regression models. A significant proportion (44%) of the patients did not know of their diagnosis of cancer. The scores on functional and symptom scales and global health status/quality of life according to QLQ-C30 did not differ according to the information given or not given on diagnosis. However, the independently significant determinants of good emotional functioning were male gender (P=0.002), low serum alanine transferase levels (P=0.025), good social functioning (P=0.002), and the absence of constipation (P=0.005). In Turkey, it is still common for cancer patients not to be informed of their diagnosis, and there is a great need to improve this situation. Honest disclosure of the truth does not worsen any dimension of quality of life in general or emotional functioning in particular. On the contrary, those with hepatic dysfunction, female gender, poor social functioning and constipation are the ones at increased risk of poor emotional functioning, and these patients may benefit from psychological screening.

Prevalence of hepatitis G virus (HGV) in cancer patients in Turkey

Prevalence of hepatitis G virus (HGV) in cancer patients in Turkey