Outcome Measures In Cancer Patients Research Articles

Quality of life outcomes in patients undergoing surgery for locally recurrent rectal cancer

BackgroundSurvival has been considered the key outcome measure for cancer patients, however quality of life (QoL) is increasingly being considered as an important outcome measure. MethodThe Cochrane Central Register of Controlled Trials, MEDLINE, Embase and CINAHL were searched using medical subject headings. Reference lists of identified studies, clinicaltrials.gov and the WHO International Clinical Trials Registry were also searched. All clinical trials which included recurrent rectal cancer and QoL were identified, with restrictions to human, since 2000 and English language. Results16 publications were identified. The studies were quite heterogeneous with regard to the patients included, tools used to assess QoL, times when QoL is assessed and comparator groups; they were further limited by small sample size. Many studies reported combined data with local advanced rectal cancer. ConclusionPatients with recurrent rectal cancer have impaired QoL. Surgery further impairs their QoL, for between 6 and 9 months. The dimensions affected include urinary, and sexual function, feceal incontinence, pelvic pain, muscular skeletal function, and employment. Predictors of poor post operative QoL are poor preoperative Qol, female, and need for a boney resection. Patients who receive an R0 resection have better QoL than those after a R1 or R2 resection.

Psychological and spiritual well-being aspects of the quality of life in colostomy patients

Background/Aim. Colorectal cancer and its treatment can have a negative impact on the quality of life which has become an important outcome measure for cancer patients. The aim of this work was assessment of psychological and spiritual dimension of the quality of life in colostomy patients, regarding the gender and age. Methods. This is a cross-sectional study conducted at the Abdominal Surgery Polyclinic in the Clinical Canter of Vojvodina among colostomy patients operated between January 2010 and June 2011. The instrument used in this study was Quality of Life Questionnaire for a Patient with an Ostomy (QOL-O). Results. Majority of respondents were male (M:F = 50.7% : 49.3%). The age ranged between 36?86 years. Respondents did not report difficulties in adjustment to stoma, but their great difficulty was to look at it and the sense of depression and anxiety. The care of stoma was worse perceived by younger respondents (p = 0.014). Respondents were mostly satisfied with their memorizing ability and having the sense of control. The lowest score was found in sensing satisfaction or enjoyment in life. The age had a significant impact on positive aspects of psychological well-being (p < 0.05). Higher scores were found among younger age groups. The mean score of spiritual well-being (6.47 ? 3.01) was lower than the mean score of psychological well-being (7.76 ? 2.35). There were no statistically significant differences regarding gender (t = -0.738, df = 65, p = 0.463) or age (F = 1.307, p = 0.280). Conclusion. Psychological and spiritual well-being in colostomy patients appeared to be at satisfactory level, but it is necessary to provide tailor made support in order to prevent and resolve negative responses to stoma.

Music interventions for psychological and physical outcomes in cancer: a systematic review and meta-analysis

A systematic review and meta-analysis to examine the effect of music interventions on psychological and physical outcome measures in cancer patients. We searched six English-language databases and three major Chinese-language databases in March 2011. Nine databases were reviewed from 1966 or the start of the database to March 2011. All randomized controlled trials comparing music intervention with standard care, other interventions, or placebo for psychological and physical outcomes in cancer were included. Study quality was evaluated by the Grading of Recommendations Assessment, Development, and Evaluation Working Group. We then performed a meta-analysis of music interventions for psychological and physical outcomes in cancer. Of 322 total studies found, 32 randomized trials (3181 participants) met the inclusion criteria. Seven high-quality studies indicated music had positive effects on coping anxiety assessed by the Self-Rating Anxiety Scale. Two moderate-quality studies suggested music reduced anxiety assessed by the Hamilton Anxiety Scale. Eight moderate-quality studies revealed music lowered anxiety assessed by the Spielberger State-Trait Anxiety Inventory. Seven moderate-quality studies demonstrated that music improved depression. Seven moderate-quality studies observed that music had positive effects on pain management. Two moderate-quality studies suggested music worsened fatigue. Four moderate-quality studies indicated music lowered heart rate. Three low-quality studies suggested music could reduce respiratory rate. Two moderate-quality studies indicated that music improved quality of life. Individual randomized trials suggest that music intervention is accepted by patients and associated with improved psychological outcomes. The effects of music on vital signs especially blood pressure are small. High-quality trials are needed to further determine the effects of music intervention.