Physical Well-being Scores Research Articles

Relationship between Sedentary Time, Physical Activity, and Health-Related Quality of Life in Spanish Children.

Higher sedentary time and lower physical activity (PA) are associated with a poor health-related quality of life (HRQoL) in children. The aims of this study were: (1) to analyze the sedentary time, objectively measured PA levels (light, moderate, vigorous, and moderate-to-vigorous physical activity (MVPA)), and HRQoL dimensions (physical well-being, emotional well-being, self-esteem, family, friends, school, and total score) in children; and (2) to examine the association between sedentary time, PA levels, and HRQoL in children separately by sex. A total of 459 children (8.4 ± 0.4 years old, 50.54% males) from 15 schools in Granada (Spain) participated in the study. A tri-axial accelerometer was used to measure PA levels in the children for 7 consecutive days. The Revidierter KINDer Lebensqualitätsfragebogen (KINDL-R) questionnaire was used to determine the children’s HRQoL dimensions. The results showed that males presented more minutes engaged in MVPA than females. Both sedentary time and PA levels were associated with self-esteem and total score (all p < 0.05). In males, moderate and vigorous PA levels were associated with higher HRQoL, whereas light PA was associated with higher HRQoL in females. Future studies should take into account the use of activities with difference intensities in order to increase HRQoL in males and females.

Patients and family caregivers report high treatment expectations during palliative chemotherapy: a longitudinal prospective study

BackgroundWhen discussing treatment options and future care, it is important to understand the expectations of patients and family caregivers related to palliative chemotherapy and to identify patterns in patients’ quality of life. The study aims were to evaluate differences in treatment expectations and quality of life between patients with thoracic cancer (non-small-cell lung cancer, small-cell lung cancer and mesothelioma) who were < 70 and ≥ 70 years of age and receiving palliative chemotherapy and to assess family caregivers’ treatment expectations.MethodsA prospective longitudinal study included patients with thoracic cancer receiving outpatient palliative chemotherapy at a university hospital in Denmark and their family caregivers. Patients’ treatment expectations and quality of life were assessed three times during treatment with a survey of treatment expectations and the Functional Assessment of Cancer Therapy – General questionnaire. Family caregivers’ treatment expectations were assessed once.ResultsA total of 48 patients and 36 family caregivers participated between 2018 and 2019. No statistically significant age-related differences in treatment expectations and quality of life were identified. 28% of patients aged < 70 years and 7% of those aged ≥70 years expected a cure. Among family caregivers, 36% expected a cure. Across both age groups, mean total quality of life scores significantly decreased from 73.2 at first palliative chemotherapy cycle to 70.5 at third cycle (p = 0.02). No meaningful changes were found in quality of life within either age group. A subgroup analysis found no significant between-group differences in quality of life. Mean physical well-being score for all patients decreased from 20.3 at first cycle to 18.4 at third cycle (p = 0.03) and mean emotional well-being score decreased from 15.4 at first cycle to 14.6 at third cycle (p = 0.04).ConclusionThis study emphasizes the importance of initiating conversations about treatment expectations and paying attention to expectations that may differ by the age of the patient and between patients and family caregivers. Addressing treatment expectations among patients and family caregivers and monitoring quality of life among patients is important in clinical practice.

BREAST-Q Outcomes before and after Bilateral Reduction Mammaplasty.

The BREAST-Q is the only questionnaire specific to bilateral breast reduction that was developed according to federal and international standards. Many payors mandate minimum resection weights for preapproval, despite lacking supportive evidence for this practice. This study aimed to assess changes in BREAST-Q scores after bilateral breast reduction, and determine whether compliance with Schnur requirements impacts improvement in patient-reported outcomes. Patients presenting for bilateral breast reduction from 2011 to 2017 were asked to complete the BREAST-Q preoperatively and postoperatively. Multivariate regression analysis was performed to isolate factors associated with favorable outcomes. Complete data were available for 238 patients. Mean time to postoperative BREAST-Q was 213 days. Complications occurred in 31 patients (13.0 percent). Mean preoperative BREAST-Q scores were below normative values (p < 0.001), and mean postoperative scores were above normative values (p < 0.001 for Satisfaction with Breasts, Psychosocial Well-being, and Sexual Well-being; and p = 0.05 for Physical Well-being). Postoperative Physical Well-being scores were similar to normative values for resections less than Schnur (p = 0.32), but below norms for resections greater than Schnur (p < 0.0001). On multivariate regression (n = 230), complication and surgeon experience were the only independent predictors of lesser improvement on the Satisfaction with Breasts subscale. This study is the largest to include both preoperative and postoperative bilateral breast reduction BREAST-Q scores, and to compare multiple subscales to normative data. Scores overwhelmingly increased, regardless of age or Schnur compliance. Complications negatively impacted degree of BREAST-Q improvement. Interestingly, postoperative Physical Well-being was slightly higher in women with non-Schnur-compliant resections. Bilateral breast reduction substantially improves patient welfare, and our data question the validity of insurer-mandated minimum resections. Therapeutic, III.

Impact of treatment and frailty on elder-relevant physical function outcomes in older adults with metastatic castration-resistant prostate cancer (mCRPC).

76 Background: Maintenance of physical function is a key consideration in treatment decision-making for older adults with metastatic cancer, many of whom are frail. However, physical function outcomes with treatment, and effects of frailty, have not been adequately explored in the mCRPC setting. We evaluated the effects of frailty status and treatment with docetaxel (CHEMO), abiraterone (ABI), enzalutamide (ENZA), and radium 223 (RAD) on elder-relevant physical function outcomes in older men with mCRPC. Methods: Men aged 65+ were enrolled in this multicenter prospective observational cohort study. Daily function was evaluated with the OARS instrumental activities of daily living (IADL). Objective physical function was assessed by grip strength and the Short Physical Performance Battery (SPPB). Falls were documented during interviews. We also collected FACT-G physical well-being (PWB) and functional well-being (FWB) subscales. Assessments were performed at baseline, 3 months, and 6 months. We identified frailty status with a validated frailty index. Mixed effects regression models were used to examine the difference in primary outcomes over time by treatment group or frailty status adjusted for baseline characteristics. Factors associated with falls within 6 months of treatment initiation were determined with logistic regression. Results: A total of 70, 38, 67, and 23 men starting CHEMO, ABI, ENZA, and RAD were included. Mean age, education, race, number of medications, and BMI were similar at baseline between treatment groups. In treatment-stratified analyses without considering frailty, no significant changes over time were reported for any physical function outcome. Frailty was significantly associated with lower IADL function (p &lt; 0.0001), worse grip strength (p &lt; 0.0001), worse SPPB score (p &lt; 0.0001), worse PWB (p &lt; 0.0001), and worse FWB (p &lt; 0.0001) at baseline. In frailty-stratified analyses, grip strength (p = 0.0345) worsened, but SPPB (p = 0.0147) improved significantly over time. Also, changes in SPPB (p = 0.0394) and PWB scores (p = 0.0269) over time differed by frailty status, where frail cohorts had greater improvement over time in both scores. Frailty and treatment type were not predictors of falls whereas prior falls history (OR: 3.52, 95% CI: 1.40-8.86) and age (OR: 1.07, 95% CI: 1.01-1.14) were significant predictors. Conclusions: Frail older men receiving treatment for mCRPC have worse IADL function, grip strength, SPPB scores, PWB, and FWB at baseline. Although grip strength worsened over time, they had greater improvement in SPPB scores and PWB over time than fit patients. Contrary to our hypothesis, most older adults do not experience significant worsening in elder-relevant physical function outcomes over time regardless of treatment. The impact of frailty requires further study.

Health-related quality-of-life (HRQoL) analysis from a randomized phase II trial of androgen signaling inhibitors with or without androgen deprivation therapy (ADT) for castration-sensitive prostate cancer: LACOG 0415.

64 Background: LACOG0415 is a 3-arm randomized trial evaluating ADT with abiraterone acetate plus prednisone (ADT+AAP), apalutamide alone (APA) or apalutamide with AAP (APA+AAP) for patients with locally-advanced, high-risk biochemical recurrence or metastatic castration-sensitive prostate cancer (ASCO 2020). In this trial, ADT+AAP and APA+AAP achieved the primary endpoint of percentage of patients with PSA ≤ 0.2 ng/mL at week 25. Apalutamide alone showed a high PSA decline &gt; 50% rate, but did not achieve the pre-specified PSA threshold. Here we report patient-reported outcome data using Functional Assessment of Cancer Therapy-Prostate (FACT-P). Methods: HRQoL was measured in the overall population using the FACT-P questionnaire, comprising 5 subscales: physical wellbeing (PWB), functional wellbeing (FWB), emotional wellbeing (EWB), social/family wellbeing (SFWB), and prostate cancer subscale (PCS). Scores for each patient were measured at baseline and every four weeks until week 25. Questionnaire completion was defined as ≥ 1 question answered at an assessment time point. Analysis of HRQoL change from baseline and deterioration included only patients with baseline and ≥ 1 postbaseline score. Differences greater than 10-points in FACT-P total score and differences greater than 3-points in PWB, FWB, EWB, SFWB, and PCS scores were considered clinically significant. The time-to-event endpoint was estimated by Kaplan-Meier method and compared by stratified log-rank test. Results: 128 patients were included in LACOG0415 trial and 122 of them completed the HRQoL assessments (ranging from 95.3% at baseline to 79.7% at week 25). FACT-P and all subscales scores were similar for all three arms at baseline. There were no meaningful differences in FACT-P scores at baseline and at week 25 between the 3 arms. The subscales scores also showed no statistically differences at baseline and at week 25. Time to FACT-P deterioration did not show any statistically difference between three arms ( P=0.3371). Conclusions: ADT free alternatives with APA alone or APA+AAP did not show meaningful differences in HRQoL in patients with advanced castration-sensitive prostate cancer compared to ADT+AAP. The short follow-up period limited the ability to explore differences in HRQoL after 25 weeks. Larger studies with longer follow-up are needed to further evaluate HRQoL with ADT-free strategies. Clinical trial information: NCT02867020. [Table: see text]

Quality of life of Japanese elderly oral cancer patients during the perioperative period

Japan’s aging society has an increasing incidence of oral cancer. This study investigated perioperative changes in quality of life (QoL) among 172 oral cancer patients (elderly ≥75 years vs non-elderly <75 years), pre-treatment, at treatment completion, and at 1, 3, and 6 months post-treatment, using the following Functional Assessment of Cancer Therapy – Head and Neck (FACT-H&N) subscales: physical well-being (PWB), social/family well-being (SWB), emotional well-being (EWB), functional well-being (FWB), additional head- and neck-specific concerns (H&N). SWB (P=0.026), H&N (P=0.024), and total FACT-H&N (P=0.009) scores were significantly lower in the elderly group than in the non-elderly group at 6 months post-treatment, especially for mastication items (H&N1, P=0.047; H&N11, P=0.004), but not for swallowing items (H&N5 and H&N7, both P> 0.05). PWB (P= 0.004), EWB (P< 0.001), and FWB (P= 0.022) scores in the non-elderly group were significantly higher at 6 months post-treatment than before treatment. In the elderly group, no subscale showed a better score at 6 months post-treatment. Post-treatment QoL in elderly oral cancer patients did not improve, unlike in non-elderly patients.

Acute toxicity and health-related quality of life after accelerated whole breast irradiation in 5 fractions with simultaneous integrated boost

IntroductionAcceleration of radiotherapy in 5 fractions for breast cancer can reduce the burden of treatment. We report on acute toxicity after whole-breast irradiation with a simultaneous integrated boost in 5 fractions over 10–12 days. Material and methodsAcute toxicity and health-related quality of life (HRQoL) of 200 patients, randomized between a 15- or 5-fractions schedule, were collected, using the CTCAE toxicity scoring system, the Multidimensional Fatigue Inventory, EORTC QLQ-C30 and BR23 and the BREAST-Q questionnaire. The prescribed dose to the breast was either 15∗2.67 Gy (40.05 Gy) or 5∗5.7 Gy (28.5 Gy). 90% of patients received a SIB to a cumulative dose of 46.8 Gy (15∗3.12 Gy) or 31 Gy (5∗6.2 Gy). ResultsPhysician-assessed toxicity was lower for the 5-fractions group. A significant difference was observed for breast pain (p = 0.002), fatigue (p < 0.0001), breast edema (p = 0.001) and dermatitis (p = 0.003). Patients treated in 5 fractions reported better mean HRQoL scores for breast symptoms (p = 0.001) and physical well-being (p = 0.001). A clinically important deterioration in HRQoL of 10 points or more was also less frequently observed in the latter group for physical functioning (p = 0.0005), social functioning (p = 0.0007), fatigue (p = 0.003), breast symptoms (p = 0.0002) and physical well-being (p = 0.002). ConclusionIn this single institute study, acute toxicity of accelerated breast radiotherapy in 5 fractions over 10–12 days seems to compare favourably to hypofractionated breast radiotherapy in 15 fractions. Less breast edema, dermatitis, desquamation, breast pain and fatigue are seen. Social and physical functioning are also less disturbed and patients have a better future perspective.

Assessment of Health-Related Quality of Life and Medication Adherence In Tuberculosis Patients

Tuberculosis (TB) is an infectious disease caused by bacteria called Mycobacterium tuberculosis. The disease mainly affects lungs and causes pulmonary tuberculosis. It can also affect intestine, meninges, skin, bones and other tissues of the body. Although the drugs alone can cure TB, it still remains a major public health problem worldwide. The aim of the study was to assess the quality of life and medication adherence in TB patients. The Quality of life was assessed using SF-36 in patients receiving DOTS treatment in initial or continuous phase while the medication adherence was analyzed using Morisky Green Levine Scale. Subjects were also counselled about their disease during their first visit and a follow up was done after a month. A total of 152 subjects were enrolled in the study of which majority of the subjects had Pulmonary TB (55.26%). Diabetes was found to be the most common comorbidity followed by HTN. The average Physical Component Summary (PCS) and Mental component summary (MCS) were found to be 44.34 and 39.60 respectively. Females had a better quality of life scores compared to males. High adherence was seen in 32.24% of patients while 28.29% had low adherence. Follow up was done for 135 subjects. 15 subjects defaulted and 2 of them died. There was a significant increase in the QoL scores and medication adherence after one month. A significant association was found between the Physical functioning (p=0.001) and emotional wellbeing (p=0.01) with Duration of treatment indicating that subjects who had completed more than one month of their treatment had marked improvement in Physical functioning and emotional well-being scores.

Effect of Cardiac Surgery on One-Year Patient-Reported Outcomes: A Prospective Cohort Study

Current cardiac surgery risk algorithms and quality measures focus on perioperative outcomes. However, delivering high-value, patient-centered cardiac care will require a better understanding of long-term patient-reported quality of life after surgery. Our objective was to prospectively assess the effect of cardiac surgery on long-term patient-reported outcomes. Patients undergoing cardiac surgery at an academic medical center (2016 to 2017) were eligible for enrollment. Patient-reported outcomes were measured using the National Institutes of Health Patient-Reported Outcomes Measurement Information System preoperatively and 1 year postoperatively across five domains: mental health, physical health, physical functioning, social satisfaction, and applied cognition. Baseline data and perioperative outcomes were obtained from The Society of Thoracic Surgeons Database. The effect of cardiac surgery on long-term patient-reported quality of life was assessed. Ninety-eight patients were enrolled and underwent cardiac surgery, with 92.9% (91 of 98) successful follow-up. The most common operation was coronary artery bypass graft surgery at 63.3% (62 of 98), with 60.2% (59 of 98) undergoing an elective operation. One-year all-cause mortality was 5.1% (5 of 98). Rate of major morbidity was 11.2% (11 of 98). Cardiac surgery significantly improved patient-reported outcomes at 1 year across four domains: mental health (preoperative 47.3 ± 7.7 vs postoperative 51.1 ± 8.9, P< .001), physical health (41.2 ± 8.2 vs 46.3 ± 9.3, P< .001), physical functioning (39.8 ± 8.6 vs 44.8 ± 8.5, P < .001), and social satisfaction (46.8 ± 10.9 vs 50.7 ± 10.8, P= .023). Hospital discharge to a facility did not affect 1-year patient-reported outcomes. Cardiac surgery improves long-term patient-reported quality of life. Mental, physical, and social well-being scores were significantly higher 1 year postoperatively. Data collection with the National Institutes of Health Patient-Reported Outcomes Measurement Information System provides meaningful, quantifiable results that may improve delivery of patient-centered care.

The effect of the coronavirus (COVID-19) pandemic on health-related quality of life in children.

The study was conducted to examine the effect of the COVID-19 pandemic on health-related quality of life in children. The study was conducted with 597 children aged 7-13 and their parents using the online data collection tool via social media. Socio-demographic form and Generic Health-related Quality of Life Questionnaire for Children (Kid-KINDL) were used to collect the data. SPSS 23.0 program, descriptive statistics, Mann-Whitney U test and Kruskal-Wallis variance analysis were used to evaluate the data. During the pandemic, 41.5% of the parents stated that their child gained weight, tendency to sleep of 34.2% and tendency to use the Internet of 69.3% increased. The average self-reported quality of life score of the children was found to be 73.91±8.44. The self-esteem sub-dimension score of the children whose tendency to sleep increased during the pandemic (p<0.05); and the physical well-being (p<0.001), emotional well-being (p<0.001), self-esteem (p<0.001), family (p<0.01), school (p<0.05) sub-dimensions and total (p<0.05) score averages of the children whose tendency to use the Internet were found to be lower. The emotional well-being, family and friends sub-dimensions as well as total average scores of the children of the parents who feel fear/anxiety about coronavirus becoming a pandemic and who stated that lockdown negatively affected their mental health were found to be lower (p<0.05). Although self-reported quality of life scores of children were generally good, parents reported that their children gained weight, tendency to sleep and internet use increased during the pandemic.

Association between gross motor competence and health-related quality of life in (pre)schoolchildren: the mediating role of cardiorespiratory fitness

ABSTRACT Background: Motor competence, defined as a person’s ability to execute different motor skills, is directly associated with children’s physical, mental, and social development and may be essential in encouraging an active lifestyle in childhood. Although health-related quality of life (HRQoL) in children has been described as an individual’s subjective perception of the impact of health status on physical, psychological and social functioning, in very young children, a HRQoL parent-proxy report is needed since (pre)schoolchildren have problems expressing their feelings and understanding items on HRQoL instruments. In addition, the influence of motor competence on fitness levels has strong empirical support, so it seems reasonable to hypothesize that cardiorespiratory fitness might play a crucial role in the association between motor competence and HRQoL in children. Objectives: This study examined the association between gross motor competence (G-MC) and HRQoL in typically developing children, and whether this association between G-MC and HRQoL was mediated by cardiorespiratory fitness. Methods: An observational cross-sectional study with 1088 (pre)schoolchildren (51.84% boys, 48.16% girls) aged between 4 and 7 years (5.32 ± 0.60) belonging to 21 schools in the Spanish provinces of Cuenca and Ciudad Real were included. G-MC was evaluated using the MABC-2 battery, HRQoL was assessed using the KINDL-R questionnaire and cardiorespiratory fitness using the 20m-shuttle-run-test. Partial correlations, covariance models and mediation analyses were conducted. Results: The mean scores of HRQoL (physical well-being, self-esteem, friends, school and global score index) were significantly higher (p < 0.05) in children with higher G-MC. When cardiorespiratory fitness was added as a covariate, all the results remained unchanged (p < 0.05), except for physical well-being for the total sample as well as emotional well-being and the global score index for girls. Simple mediation analyses showed that cardiorespiratory fitness acted as a mediator between G-MC and physical well-being (Indirect Effect = 0.04 [95% CI = 0.01; 0.07]) for the total sample. For boys, it acted as a mediator between G-MC and physical well-being (Indirect Effect = 0.04 [95% CI = 0.00; 0.08]) and school (Indirect Effect = 0.05 [95% CI = 0.01; 0.09]), and, for girls, between G-MC and emotional well-being (Indirect Effect = 0.04 [95% CI = 0.01; 0.08]) and the global score index (Indirect Effect = 0.02 [95% CI = 0.00; 0.05]). Conclusions: The results of this study suggest that good G-MC levels are associated with better HRQoL, mainly in global score index of HRQoL and self-esteem, friends, and school dimensions in typically developing children. Further, cardiorespiratory fitness mediates the association between G-MC and the physical dimension of HRQoL in (pre)schoolchildren. Additionally, physical and academic dimensions are mediated by cardiorespiratory fitness for boys and the emotional and global score indices of HRQoL are mediated by cardiorespiratory fitness for girls. These findings provide scientific evidence that improving motor competence and cardiorespiratory fitness might be a practical strategy to increase HRQoL in children. Thus, families and the educational community should promote effective interventions and incorporate opportunities inside and outside school that aim to jointly improve motor competence and cardiorespiratory fitness.

A Longitudinal Analysis of First Professional Year Pharmacy Student Well-being

Objective. To assess and characterize Doctor of Pharmacy (PharmD) students' well-being across the first professional year (P1) and determine the relationship between the number of examinations taken, student grade point average, and well-being scores. Methods. All P1 students (N=76) enrolled at one college of pharmacy self-reported their career, community, financial, physical, social, and overall well-being on a weekly basis during the fall and spring semesters. Parametric statistical tests were used to examine the extent to which students' well-being scores varied throughout the academic year, the extent to which their domain-specific well-being scores predicted overall well-being scores, and the association between their well-being scores and the number of examinations they had taken in a week and their grade point average. Results. Overall and domain-specific well-being scores significantly decreased from the beginning to the end of fall semester. Students' overall well-being across the academic year was most frequently predicted by their career well-being, physical well-being, and social well-being scores. Career, community, physical, and overall well-being scores were significantly negatively associated with the number of examinations the students completed during the week. Students' self-reported overall well-being during the fall semester was positively associated with their fall semester GPA. Conclusion. Significant variation was found in students' domain-specific and overall well-being across the P1 year. These findings can guide both the development and timing of school interventions to promote student well-being.

Meme küçültme ameliyatı olan hastaların memnuniyetinin Breast-Q anketi ile değerlendirilmesi

Purpose: The aim of this study is to evaluate the influence of patient demographics, operative techniques and post-operative care on patient satisfaction after breast reduction operations were evaluated in this study. Materials and Methods: Patients who undergo breast reduction surgery were offered to fulfil Breast-Q reduction module survey in pre-operative and post-operative sixth month period. Patient data such as age, height, weight, smoking, marital status and parenting have been recorded. Operative variances such as drain use and cutaneous stitches and complications, post-operative discharge days, staying in a private room were recorded with post-operative survey module. Results: Seventy-six patients were included in this study. The average age was 45.8 and mean body mass index (BMI) was 29.2. Post-operative satisfaction with breasts, psychosocial, sexual and physical wellbeing scores were significantly higher than pre-operative scores. Older women had higher pre-operative scores from satisfaction with breasts and psychosocial wellbeing. Younger patients and normal weight patients had higher scores from post-operative physical wellbeing. Satisfaction with breasts, sexual and physical wellbeing, satisfaction with information, surgeon and medical stuff scores were significantly lower in patients who had a post-operative complication.Conclusion: Surgery without complications is the most powerful factor that increases patient satisfaction. Patient demographics such as age and BMI can be used for patient selection for higher patient satisfaction.

Health-related quality of life (HRQoL) for olaparib versus enzalutamide or abiraterone in metastatic castration-resistant prostate cancer (mCRPC) with homologous recombination repair (HRR) gene alterations: PROfound.

5539 Background: In the randomized Phase III PROfound trial (NCT02987543), olaparib significantly prolonged radiographic progression-free survival compared with physician’s choice of new hormonal agent (pcNHA, enzalutamide or abiraterone) in men with mCRPC and HRR gene alterations, whose disease had progressed on prior NHA. Olaparib significantly improved time to pain progression in Cohort A. We report additional patient reported outcome measures of HRQoL in the overall study population (Cohorts A+B). Methods: HRQoL was assessed in the overall study population using the Functional Assessment of Cancer Therapy-Prostate (FACT-P) questionnaire, comprising 5 subscales: physical wellbeing (PWB), functional wellbeing (FWB), emotional wellbeing, social wellbeing, and prostate cancer subscale (PCS). The Trial Outcome Index (TOI; PWB+FWB+PCS) and FACT Advanced Prostate Symptom Index (FAPSI-6: derived from 6 FACT-P items) were also calculated. Adjusted mean change and time to deterioration in scores were statistically analyzed. Results: Baseline FACT-P total score was similar for both treatment arms. FACT-P total and subscale scores during treatment were all higher for olaparib vs pcNHA, with clinically meaningful differences between treatment arms in the adjusted least square (LS) mean changes from baseline in all but FWB and FAPSI-6 (Table). The time to deterioration in FACT-P total and TOI, FAPSI-6, PWB and PCS scores favored olaparib but were not statistically significant, with hazard ratios ranging from 0.68 to 0.94. Further HRQoL results for cohort A will also be presented. Conclusions: Olaparib delayed deterioration in HRQoL scores vs pcNHA and was associated with better HRQoL functioning over time compared with pcNHA in men with mCRPC and HRR gene alterations. Clinical trial information: NCT02987543 . [Table: see text]

Self-Evaluation Differences Among Swedish Children and Adolescents Over a 30-Year Period.

International research has found changes in how today’s young people evaluate themselves. The present Swedish research contributes with new findings by distinguishing different patterns of change in self-evaluation in two age groups. The study investigates generational and gender differences in five self-evaluation dimensions in two samples, one from 1983 (N = 3052 10–16-year-old students) and one from 2013 (N = 1303 10–18-year-old students). Three age groups were analyzed. The generational comparison for primary school (ages 10–12) showed higher scores in 2013 than in 1983 for all five self-evaluation dimensions. Interactions between generation and gender were found for psychological well-being, relations to others, school competence evaluations, and the total score, demonstrating, in contrast to international research, a greater increase for girls than for boys. Noteworthy is that girls in primary school had higher scores in 2013. The generational comparison for lower secondary school (ages 13–15) demonstrated higher scores for school competence, relational self-evaluations, and a total higher score in 2013. Interactions between generation and gender were found for total, physical, and psychological well-being evaluation scores, indicating an increase for boys and a decrease for girls in 2013 compared to 1983. The gender comparison for secondary school (ages 16–18, 2013), showed gender differences for physical, psychological well-being, school competence evaluations, and for the total score to the advantage of boys. The study discusses changes in self-evaluation in relation to phenomena such as permissive child-rearing, decreased demands in school, increased self-enhancement behavior through social media, and narrow body ideals in today’s society. The study recommends that interventions directed toward groups with low self-evaluation scores should be considered.

Evaluation of the Preoperative Perception of Quality of Life and Satisfaction of Women With Breast Cancer Using the BREAST-Q™ Questionnaire

IntroductionAlmost 40% of women who undergo breast surgery are dissatisfied with the decision-making process as well as cosmetic results. Our objective was to demonstrate the usefulness of the BREAST-Q™ preoperative questionnaire to evaluate the satisfaction and health-related quality of life in women with diagnosis of breast cancer prior to surgery, as well as identifying satisfaction profiles. MethodsProspective cohort observational study in women with breast cancer, evaluating preoperative quality of life using the BREAST-Q™ questionnaire. Percentile measures for each domain and baseline physical characteristics were assessed for posterior analysis. ResultsThe average score in the breast satisfaction domain was 58.9±16.9. The average score in the preoperative psychosocial well-being domain was 70.5±16.1. Patients who were offered conservative surgery had a mean physical well-being score of 80.7±18.5, and those who were offered mastectomy had an average score of 79.9±17.7. The sexual well-being average score was 63.2±20.7. No statistically significant differences were found between low-score and high-score groups regarding epidemiological and clinical characteristics. ConclusionsPreoperative evaluation in breast cancer patients provides correct assessment of the effect of surgical treatment on patient satisfaction and quality of life. This information is useful for communicating with patients about their expectations and postoperative results.

Variance in symptom assessment between patient and caregiver: A prospective study of patients staged as metastatic prostate cancer—An interim analysis.

56 Background: Closely monitored and managed patient reported outcomes (PROs) can impact survival of cancer patients. However, the reliability and validity of patients’ self-reported symptoms are somewhat open to question, as past studies have shown that patients may underreport health information to their physicians. Identifying where the discrepancy between PROs and actual symptomology lies may be important in improving providers’ grasp of a patients’ disease state. The purpose of this study is to compare prostate cancer patients’ reports of their symptoms and functioning with the patients’ caregivers’ perception of the same factors. Methods: 50 patients with metastatic prostate cancer on Androgen Deprivation Therapy (ADT) and their caregivers were asked to independently complete the Functional Assessment of Cancer Therapy- Prostate (FACT-P), Brief Pain Inventory- Short Form (BPI-SF), and EQ-5D-3L questionnaires in relation to the patient’s condition. Patient and caregiver dyad responses to these instruments were then compared by t-tests for continuous measures and Chi-Square for discrete measures. Results: Not all patient and caregiver dyads completed all of the data collection instruments. Patients are more likely than caregivers to rate themselves as having fewer limitations on mobility (n=47, p≤0.001), less pain and/or discomfort (n=46, p≤0.001), and less limitations with self-care (n=46, p≤0.001). Furthermore, caregivers were more likely to rate patients as having more anxiety (n=47, p≤0.001), more severe pain (n=20, p&lt;0.05), and lower overall physical wellbeing scores (n=40, p&lt;0.005). Ratings for emotional and social functioning were not significantly different between the patient and their caregiver. Conclusions: Overall a high degree of agreement was reported between patient and caregiver ratings of the patient’s symptoms and functioning; however, when differences were present the caregivers consistently rated the patients’ conditions as more severe, particularly in relation to physical symptoms. This may indicate that patients are minimizing their symptoms when reporting to their physicians.

Abstract PD6-1: BREAST-Q satisfaction and quality of life outcomes in young women undergoing mastectomy and reconstruction for breast cancer

Abstract Background: Young women with breast cancer (BC) often receive aggressive local therapy and are more likely to undergo (bilateral) mastectomy and receive postmastectomy radiation (RT) than older women. Our previous work suggested better quality of life (QOL) outcomes among women undergoing breast conserving therapy (BCT) vs. mastectomy, even with reconstruction (recon), although limited data was available regarding recon. In the current analysis, we sought to understand the impact of recon, accounting for RT, on long-term satisfaction and QOL. Methods: Between 10/2016-11/2017, we administered the BREAST-Q, a validated patient-reported outcomes measure designed to evaluate satisfaction and QOL after breast cancer surgery and recon, to 743 women in the Young Women’s Breast Cancer Study, a multi-site prospective cohort that enrolled women diagnosed (dx’d) at age &amp;lt; 40 from 2006-2016. Demographic and treatment information was obtained by surveys and chart review. Recon was defined as autologous, implant or complex (combination of autologous and implant). Mean BREAST-Q scores for each domain (breast satisfaction, physical, psychosocial, and sexual) were compared by recon types and stratified by receipt of RT; higher BREAST-Q scores (range: 0-100) indicate better QOL. Linear regression was used to identify predictors of BREAST-Q scores. Results: 584 women with Stage 0-3 BC completed the Breast-Q at a median of 5.7 [range 2-10] years from dx), 357 (61%) had mastectomy and recon and were included in the analytic sample. Median age at dx was 36 years; 85% had stage 0, 1 or 2 disease; 41% received RT and 76% underwent bilateral mastectomy. 90.5% underwent immediate recon; of which 65.5% were tissue expander placement. Definitive recon included autologous tissue in 16%; implants in 81% and complex recon in 3%. Mean BREAST-Q breast satisfaction, psychosocial, and physical well-being scores differed based on recon type accounting for RT (Table 1). Significantly lower scores for breast satisfaction were seen in women having implant +RT. Scores were not impacted by bilateral procedure, timing of recon, use of tissue expander, extent of axillary surgery, cancer stage or other treatment factors. In multivariate analyses, receipt of RT, lymphedema and implant-based recon were associated with lower breast satisfaction scores. Physical well-being scores were lower for those with complex recon, for non-White women, for women who reported being financially uncomfortable, for those with lymphedema, and for those &amp;lt;5 years from surgery. Psychosocial well-being scores were lower for women who received RT, had BMI &amp;gt;25, and for those who reported being financially uncomfortable. Sexual well-being scores were lower for women with a BMI &amp;gt;25 and for those who reported being financially uncomfortable. Conclusion Type of recon and receipt of radiation among young survivors who undergo mastectomy and recon for early breast cancer appears to have a differential impact on satisfaction and QOL. Our finding of lower breast satisfaction among young women who received RT, particularly after implant recon, underscores the importance of counseling regarding surgical options, especially for women who may receive RT after mastectomy and who are candidates for BCT. Table 1. Unadjusted BREAST-Q scores stratified by RTBREAST-Q DomainAutologous -RT N=29Autologous +RT N=27Implant -RT N=174Implant +RT N=113Complex N=13Global p-valueSatisfaction with Breasts, mean (sd)67 (19)63 (18)64 (18)53 (18)58 (22)&amp;lt;0.01Physical well-being, mean (sd)81 (13)80 (14)80 (15)77 (14)67 (18)0.01Psychosocial well-being, mean (sd)71 (18)64 (18)72 (20)66 (23)62 (20)0.03Sexual well-being, mean (sd)54 (21)50 (24)52 (20)47 (22)48 (27)0.26RT= radiation Citation Format: Laura Dominici, Jiani Hu, Hee Jeong Kim, Tari King, Kathryn Ruddy, Rulla Tamimi, Jeffrey Peppercorn, Lidia Schapira, Virginia Borges, Stephen Come, Ellen Warner, Julia Wong, Ann Partridge, Shoshana Rosenberg. BREAST-Q satisfaction and quality of life outcomes in young women undergoing mastectomy and reconstruction for breast cancer [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr PD6-1.

Abstract P4-13-10: An evaluation of patient reported outcomes following oncoplastic breast conserving surgery with a crescent modification of the chest wall perforated flap utilizing Breast Q

Abstract Background: An increasing acceptance of chest wall perforator flaps has provided additional options for enhancing the cosmetic appearance of the conserved breast after breast cancer surgery. Traditional lateral intercostal anterior perforator (LICAP) flap involves a lateral chest wall scar. To enhance the cosmetic results of LICAP flap, we propose the crescent modification of the LICAP flap to conceal the scar in the inframammary crease. Aim: The aim of our study was to investigate patient satisfaction and cosmetic outcome by using the BREAST-Q after undergoing crescent-modification of LICAP flap partial breast reconstruction. Methods: All eighteen consecutive patients with who underwent crescent modification of LICAP flap reconstruction for partial breast reconstruction after wide local excision of breast cancer between June 2017 and July 2019 were invited to complete the BREAST-Q questionnaire. All patients were prospectively evaluated and their demographic, clinical and pathological details were recorded on a database. Results: The median psychological, physical and sexual well-being scores were 93 (IQR 63-100), 82 (IQR 69-95) and 70 (IQR 46-96) respectively. The median satisfaction score with breast was 88 (IQR 66-100) Conclusions: In a carefully selected group of women with breast cancer, our study demonstrates that the crescent-modification of the LICAP flap for partial breast reconstruction provides a safe and effective technique with preservation of satisfaction with breast, physical, psychological and sexual well-being. Citation Format: Amtul R Carmichael, Amtul Shafee Sami, Kefah Mokbel. An evaluation of patient reported outcomes following oncoplastic breast conserving surgery with a crescent modification of the chest wall perforated flap utilizing Breast Q [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P4-13-10.

Abstract P2-13-18: Catalyzing navigation for breast cancer survivors (CaNBCS)

Abstract Background; Survivorship care plans (SCPs) are personalized documents, provided at the end of the treatment by patients’ oncology clinicians that summarize the diagnosis and treatment, late and long-term adverse effects, ongoing surveillance for recurrence, screening for new cancers, and health maintenance of cancer survivors. Considered as a tool for cancer survivors, experts in cancer survivorship and accrediting organizations such as Commission on Cancer (CoC) have endorsed the use of SCPs even in the absence of firm evidence of their efficacy. Safety net hospitals are at the forefront of providing care for vulnerable low-income cancer survivors who may also have low educational attainment, low health literacy, and limited English proficiency. Cancer survivors who are racial and ethnic minorities and low income may experience higher symptom burden and limitation of function. Prior work has shown that patients who in safety net health setting, do not benefit from SCPs and only 25% share them with their primary care providers. Methods This study is a pilot randomized clinical trial to assess the role of patient navigation in cancer survivors. Breast cancer survivors were randomized to SCPs with or without patient navigation. In the intervention, arm navigators discussed the survivorship care planning and issues with patients at the time of delivery, 6 weeks by phone, at 3 months and then at 6 months. The primary outcome was breast cancer-related quality of life (QOL) was assessed by FACT B questionnaire. The secondary outcome was self-efficacy. In addition, we conducted focus groups for cancer survivors, patient navigators, and oncology providers to understand their perspective. Cancer survivors who had completed the treatment for breast cancer within 1-5 years were eligible to participate in the study. Participants spoke English(N=20), Chinese (n =10) or Spanish (n=10). Results: There were 20 participants in each arm, 10 English speaking and 5 each Spanish and Chinese speaking. At 6 months and final follow up, 32 patients were available for analysis. One patient developed metastatic cancer, two patients had changes in their insurance status and five were not available for final analysis. We performed Wilcoxon non-parametric analysis to assess changes in all five domains of FACT B. There were trends towards improvement in the change in emotional well-being score, functional well-being score and overall QOL in the intervention arm, but it was not statistically significant. Physical well-being score change was similar. There was no difference in the mean self-efficacy scores for both arms. At baseline, 57.7% breast cancer survivors reported being not all/a little bit satisfied with their sex life and 53.9% reported not all/a little bit feeling sexually attractive. 87.5 % of survivors reported having accepted their illness quite a bit/ very much. Conclusions Our study successfully recruited patient from a diverse patient population in safety net settings. Patient navigation combined with survivorship care showed encouraging trends in improvement in emotional well-being, physical well-being, and QOL, although it was not statistically significant. There was no difference in mean self-efficacy score. We are currently analyzing the qualitative data to assess the implementation of the intervention. Citation Format: Niharika Dixit, Barbara Cicerelli, Roy Cherian, Nancy Burke. Catalyzing navigation for breast cancer survivors (CaNBCS) [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P2-13-18.