Higher Overall Quality Of Life Research Articles

Quality of life evaluation and decision-making after mastectomy for breast reconstruction of breast cancer patients.

Abstract Abstract #4098 Background:
 What is the level of information and the information needs of Breast Cancer patients after mastectomy regarding secondary breast reconstruction. Evaluation of the impact of a mastectomy regarding Quality of Life, satisfaction with the surgical result and personal job situation as well as the influence of a partnership according to the Quality of Life parameters.
 Material and Methods:
 From January 2000 until May 2003 a number of 282 women suffering from Breast Cancer underwent a mastectomy for various indications. During the routinely Breast Cancer follow-up Quality of Life was assessed using the EORTC QLQ-C30 questionnaire and the breast cancer specific module BR23 in patients at least one year after the mastectomy. 149 (52.8%) patients were excluded for the following reasons: Local recurrence (5%), pT4 stage cancer (3.5%), performed secondary breast reconstruction (22%) and an age of over 75 years (22.3%). 3.5% of the remaining 133 (47.2%) patients died, 3.5% moved with unknown address and 7.1% refused the questionnaire. All together 86 (30.5%) questionnaires could be evaluated.
 Results:
 93% of the patients were aware of the possibility to have a breast reconstruction.
 Patients satisfied with the results of the surgical procedure comprised a higher level of content with their body image and reported higher overall Quality of Life compare to less satisfied patients.
 Patients with a good body image had significantly less problems showing themselves nude to their partner (p < .0001) and accepted physical touch by them in the breast region significantly more frequently (p < .004) compared to those with a poor body image.
 16% of the patients underwent secondary breast reconstruction between the last follow-up and the start of the questionnaire. 8% of the patients made the decision for breast reconstruction after filling in the questionnaire due to more information.
 Discussion:
 Although the majority of patients were well informed about the modalities of breast reconstruction, an additional 8% of the patients made a decision for breast reconstruction. In conclusion, due to our observation, additional information to patients about the possibility of secondary breast reconstruction even after one or more years, can lead to an unexpected high number of secondary breast reconstruction. We believe that this further information should be integrated into routine clinical practice. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 4098.

Do patients benefit from participating in medical decision making? Longitudinal follow-up of women with breast cancer

This study sought to examine the relationships between decisional role (preferred and assumed) at time of surgical treatment (baseline), congruence between assumed role at baseline and preferred role 3 years later (follow-up), and quality of life at follow-up. Two hundred and five women diagnosed with breast cancer completed the decisional role preference scale at baseline and follow-up, and the EORTC QLQ-C30 at follow-up. A statistically significant number of women had decisional role regret, with most of these women preferring greater involvement in treatment planning than was afforded them. Women who indicated at baseline that they were actively involved in choosing their surgical treatment had significantly higher overall quality of life at follow-up than women who indicated passive involvement. These actively involved women had significantly higher physical and social functioning and significantly less fatigue than women who assumed a passive role. Quality of life was significantly related to reports of experienced involvement in treatment decision making, but not to reports of preferred involvement, or congruence between preferred and experienced involvement.

Effect of Employment on Quality of Life and Psychological Functioning in Patients With HIV/AIDS

The need to address the role of employment in the psychosocial adjustment of persons with HIV/ AIDS has been consistently recognized in the clinical care and research literature. In this study, 200 volunteer HIV/AIDS patients completed questionnaires assessing medical and vocational histories, quality of life, and psychological functioning. Employed and unemployed participants did not significantly differ in terms of gender, education level, ethnicity, prevalence of diagnosed psychiatric and substance use disorders, or overall level of psychological functioning. However, with HIV illness severity statistically controlled, employed participants reported significantly higher overall quality of life.

SEX DIFFERENCES IN THE RELATIONSHIP BETWEEN PHYSICAL ACTIVITY AND QUALITY OF LIFE AMONG COLLEGE SENIORS

549 Considerable research has demonstrated inverse relationships between negative psychological states, such as depression and anxiety, and physical activity. In addition, some research has indicated that higher levels of physical activity are generally associated with a higher overall quality of life. Yet differences in this relationship between genders, various modes of physical activity, and various dimensions of quality of life are less clear. As part of a larger controlled trial (Project GRAD) baseline data were used to calculate correlation coefficients between quality of life and physical activity, separately for men (N=256) and women (N=320). Quality of Life was assessed using the Quality of Life Survey (Woodruff & Conway, 1990). Minutes spent in moderate, vigorous and strength activities were measured using the 7-day Physical Activity Recall (PAR). For men, a positive relationship was found between overall quality of life and minutes spent in both strength (r=.15, p<.01) and vigorous activities (r=.17, p<.005). Men who reported significantly more satisfaction on the self subscale of the quality of life measure also reported engaging in more minutes of both vigorous (r=.22, p<.001) and strength activity (r=.21, p<.001), but no relationships were evident between any of the activity variables and the personal life, whole-life, or work/school subscales of the quality of life measure. Women who reported more minutes of moderate activity reported higher overall quality of life (r=.12, p<.05) and higher satisfaction on the personal life subscale (r=.14, p<.01). Women who reported more minutes spent in vigorous activity reported higher satisfaction of the“self” subscale (r=.14, p<.01). No other significant relationships were found for women. Quality of life was related to vigorous and strength activity in men, but primarily to moderate activity in women. Findings suggest different modes of physical activity are related to different aspects of quality of life for women and men.

Effects of illness attribution and depression on the quality of life among persons with serious mental illness

Attributing one's problems to a mental illness is associated with reduced subjective quality of life (QOL) among persons with schizophrenia, controlling for a broad range of socio-demographic, social, clinical, and psychosocial variables. Persons who attributed their problems to a ‘physical, medical, or biological’ problem in contrast to a ‘mental illness’ reported more positive social relations and higher overall quality of life. Much of the negative effect of mental illness attributions is explained by perceived stigma, lower self-esteem, and a higher level of depressive symptomatology. Depressive symptoms have an independent negative effect on QOL net of all other variables. These findings have important implications for the appropriate rehabilitation of persons with mental illness and require further scrutiny with prospective data.

Stage of Religious Faith and Reactions to Terminal Cancer

This study focused on the impact of terminal cancer on the lives of patients and their spouses as a function of the stage of religious faith of the subjects. Patients at more complex stages of faith reported higher overall quality of life; higher quality of socioeconomic life, family life, and psychological and spiritual life; and greater marital intimacy than patients at simpler stages of faith. Patients, regardless of stage of faith, reported the most important factor in their quality of life was their personal relationships, and this importance increased after the diagnosis of cancer. The spouses’ quality of life seemed mostly related to the state of the patients’ health.