Significant Improvement In Overall Quality Of Life Research Articles

Assessing Long-Term Quality of Life Concerns Through Survivorship Clinic in Head and Neck Cancer Patients.

To characterize the concerns of head and neck cancer (HNC) patients and discern changes in quality-of-life (QoL) during long-term follow-up. Retrospective review. Survivorship clinic at a tertiary academic center. A retrospective review was conducted on HNC patients seen in our survivorship clinic between 1/2020 and 1/2024 using the University of Washington Quality of Life (UW-QOL) Questionnaire. Three hundred and forty-two patients were seen for 914 encounters. Patients were divided into 4 groups: pretreatment (n = 326), 0 to 12 months posttreatment (n = 247), 1 to 3 years posttreatment (n = 248), and more than 3 years posttreatment (n = 64). The average follow-up after treatment was 459 days (range: 0-5.2 years). Multivariable analysis revealed significant improvements in overall QoL, health-related QoL, social-emotional composite scores, activity, anxiety, appearance, chewing, mood, pain, speech, and recreation at more than 1-year posttreatment compared to less than 1-year posttreatment. However, declines were noted in saliva and taste scores. No differences in scores were observed between patients 1 to 3 years posttreatment and those >3 years posttreatment. At all timepoints before and after treatment, top concerns were pain, activity, and swallowing. Patients with oral cancer followed for more than 1-year posttreatment had worse scores in appearance, chewing, pain, and speech compared to those with oropharyngeal cancer. Understanding the evolving concerns of HNC patients is imperative for enhancing care. Most QoL domains improve at 1-year posttreatment except for saliva, taste, swallowing, and shoulder function. QoL scores stabilize after 1-year post-treatment. Pain, activity, and swallowing remain the top concerns at all time points.

Abstract PO3-11-03: A Randomized Controlled Trial to Assess the Benefit of Art & Music Therapy on Quality of Life in Patient with Breast Cancer

Abstract Introduction: Quality of life (QoL) in oncology captures the well-being of a patient and is considered a significant outcome criterion. Breast cancer (BC) is the most diagnosed cancer in women, however, standardizing integrative therapies to alleviate the burden of cancer and improve QoL is still an unmet need. Art and music therapy might mitigate psychological and emotional distress. We sought to evaluate their efficacy compared to control among patients with BC during or after active therapy. Methods: Seventy-six treated patients with Stages I-III BC were randomly assigned to art, music therapy, or routine oncology care standard of care arm (SOC) for 3 months and received two sessions per month by a licensed therapist (including in-person/virtual and group sessions). The primary outcome was an improvement in QoL measured by the Functional Assessment of Cancer Therapy–Breast (FACT-B) questionnaire and secondary outcomes included: cognitive function measured by Functional Assessment of Cancer Therapy–Cognition (FACT-Cog), response to a 4-component Cleveland Clinic Visual Analog Scale (CCVAS), indicators of anxiety and depression assessed by the Generalized Anxiety Disorder-7 item (GAD-7) and Patient Health Questionnaire-9 item (PHQ-9). All questionnaires were assessed at baseline, 30, 90, and 180 days. Statistical considerations included stratified randomization, and a mean difference in 15 points between either of the interventions. SOC arm was considered relevant at the 3-month mark. Mean improvement within groups was performed using paired t-tests whereas independent t-tests were used to evaluate mean improvement between interventions (1 or 2 vs. SOC arm). All analyses were performed using SPSS version 26 (IBM, Armonk, NY). Results: Forty-five participants completed the study to date and were included in the interim analysis. Median age was 58 (57-59), white race (51.1%), patients on active treatment (45%), art therapy group (n=16), music therapy (n=15) and standard of care (n=14). Significant improvement was noted in the art therapy arm at 3 months in FACT-B physical well-being (p=0.04), functional well-being (p=0.008) domains as well as GAD-7 (p=0.003), PHQ-9 (p=0.04) and FACT-Cog section “impact on quality of life” (p=0.03). At 6 months, the art therapy arm demonstrated lower scores in the CCVAS questionnaire total score, emotional distress (p=0.01) and anxiety (p=0.004) scales. Music therapy participants reported a significant improvement only in GAD-7 index(p=0.04) at 3 and 6 months compared to SOC. No significant difference was found between art and music therapy arms. Conclusion: Art therapy patients exhibited significant improvement in overall QoL (including anxiety, depression, improvement in cognitive function) and 4-scale CCVAS (emotional distress, anxiety, depression, and pain). Music therapy improved anxiety scores (GAD-7). Art and music therapy should be considered in the care of patients to manage cancer associated distress and improve their quality of life. Table 1. Comparison of test changes from 3 months to baseline within groups Table 2. Comparison of test changes from 6 months to baseline within groups Citation Format: Maria Herran, Mohamed Mohanna, Saad Sabbagh, Barbara Dominguez, Kaylee Sarna, Rachel Upton-Rice, Angie Burdine, Zeina Nahleh. A Randomized Controlled Trial to Assess the Benefit of Art & Music Therapy on Quality of Life in Patient with Breast Cancer [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO3-11-03.

Yoga vs. behavioral placebo for fatigue and quality of life among older cancer survivors.

12023 Background: Older cancer survivors consistently express the need for interventions to reduce fatigue and maintain quality of life (QOL). We previously showed that yoga, compared to standard care, effectively improved fatigue and QOL among older survivors. Whether yoga is superior to a rigorous behavioral placebo for improving fatigue and QOL in older survivors is unknown. To examine the efficacy of yoga vs a behavioral placebo for improving fatigue and QOL in older survivors. Methods: Older cancer survivors (age 60+) 2-60 months post-treatment were randomized to receive Yoga for Cancer Survivors (YOCAS; 75-minute sessions 2x/week for 4 weeks) or a behavioral placebo (Survivorship Health Education – SHE; 75-minute sessions 2x/week for 4 weeks). The YOCAS intervention includes breathing exercises, yoga poses, and mindfulness activities. The SHE placebo includes education based on ASCO cancer survivorship recommendations. Fatigue and QOL (i.e., overall, physical, emotional, and functional) were assessed pre- and post-intervention with the Functional Assessment for Chronic Illness Therapy-Fatigue (FACIT-F). The within-group and between-group intervention effects on fatigue were examined by 2-tailed t tests and ANCOVAs. Results: 173 older survivors were enrolled (91% women, mean age 67 [range=60-85], 90% White, 10% racial minority, 2.3% Hispanic, 71% breast cancer). On average, participants completed 6 in-person yoga sessions and 1 additional weekly, home-based yoga practice, for an average of 183 minutes of yoga/week with no intervention-related adverse events. There were significant between group differences on fatigue, where yoga participants reported significantly more improvement in fatigue than controls (1.6±0.9, p<0.05). There were also significant between group differences on the emotional component of QOL, where yoga participants reported significant improvement in the emotional component of QOL but controls did not (0.8±0.4, p<0.045). Moreover, there were statistical trends for between group differences on the physical and functional component of QOL, where yoga participants reported improvements in the physical (0.8±0.4, p<0.063) and functional components of QOL (0.9±0.5, p<0.089) but controls did not. There were significant between group differences on overall QOL, where yoga participants reported significant improvement in overall QOL but controls did not (3.8±1.4, p<0.007). 94% of participants reported the intervention useful for symptom management and would recommend it to others. Conclusions: Results suggest that older survivors: 1) can safely utilize yoga for treating side effects, 2) experience improvements in fatigue and QOL via yoga therapy, and 3) find yoga a useful treatment for side effects and recommend it to others. Future research is needed to confirm these results and increase uptake by older, and ethnically and racially diverse survivors. Clinical trial information: NCT02613364 .

Effectiveness of lifestyle modification on quality of life among uncontrolled diabetics and hypertensives in India - Community based intervention study.

Background:Diabetes and hypertension contribute to more than half of morbidity, mortality and years lived with disability in developing countries like India. It impacts the quality of life (QoL) of patients and their family. Management of these diseases is in infancy and emphasis is laid on pharmacological interventions. Though nonpharmacological measures are crucial for management, their implementation is questionable. Hence, this study was conducted to measure the effectiveness of lifestyle modifications on QoL among uncontrolled hypertensives and diabetics in rural India.Methods:An interventional study was done in 3 villages with 100 participants each, where village one received lifestyle modification as intervention and village two physical activity and village three control receiving standard care. The baseline data included socio-demographic characteristics such as awareness of hypertension, diabetes, lifestyle pattern and physical activity, and WHO QoL. The participants were trained, followed up, and assessed after 12 months following intervention. QoL scores between groups and pre- and post-intervention in the group were compared using Mann–Whitney U and Wilcoxon signed-rank test, respectively.Results:In this study, there was a significant improvement in overall QoL and in all the four domains, namely physical, psychological, social relationship, and environmental domains in both the intervention villages. QoL was significantly better in both the intervention groups following intervention than compared to the control group.Conclusions:QoL improves with intervention on uncontrolled diabetics and hypertensives. It is time to emphasize on the collaboration among physicians and on the holistic integrative health services delivery for non-communicable diseases.

Syndromic Craniosynostosis: Objective and Parent-Reported Outcome Measurements after Cranio-Facial Remodelling Surgeries

Introduction: Syndromic craniosynostosis (SC) is a rare entity compared to the non-syndromic variant. Treatment involves a multidisciplinary approach towards a multitude of problems. Early intervention is known to be better for optimum results. We reviewed outcomes of children with SC who underwent reconstructive cranio-facial surgery. Materials and Methods: A retrospective study was conducted using data from hospital case files and the picture archival communication system. Objective data like the cephalic index (CI), both preoperatively and post-operatively, were compared. Subjective data for the cosmesis outcome – “Sloan and Whitaker outcome class” – following surgery were assessed. Also, parent-reported outcome measurement (PROM) was performed with various parameters to assess quality of life (QOL). Results: We had 21 operated cases of SC, with 19 needing cranio-facial remodelling. The male to female ratio was 11:10. Crouzon’s syndrome was the most common syndromic association followed by Apert’s syndrome. Nineteen patients underwent cranio-facial remodelling surgeries and 2 underwent the ventriculo-peritoneal shunt only – for raised intracranial pressure (ICP). Nine patients underwent cranial remodelling with fronto-orbital advancements, and 3 of these patients also received le-fort’s type 3 osteotomy and advancement later. Ten patients underwent fronto-orbital advancement with parieto-occipital barrel-stave osteotomies. Outcomes: Improvement in the CI was maximum at the 6-month follow-up. Six (37.5%) cases had Sloan class 1 outcome, 9 (56.25%) had class 2 outcomes, and 1 patient had a class 6 outcome. Whitaker cosmesis outcomes – 14 out of 16 cases (87.5%) had Category 1 outcomes. PROM was assessed. All parents reported at least a moderate improvement in cosmesis following surgery. Out of 15 cases, 10 (66%) reported significant improvement, while 4 (26.6%) cases reported moderate improvement with respect to eye and visual problems. Four parents reported snoring as a significant problem even after surgery. Most parents felt that the children were doing well, attending regular school, and social well-being was normal and had an overall good QOL. Conclusions: SC cases may have a multitude of other problems like raised ICP, ophthalmological problems, poor intelligence, and cognition apart from cosmetic concerns. PROMs revealed good outcomes in terms of cosmesis, cognition, and ophthalmological and oral cavity-related problems. Significant improvement in overall QOL was seen in most patients following cranio-facial remodelling surgery.

POS-604 MIDDLE MOLECULE CLEARANCE & EXPANDED DIALYSIS: WHAT IS THE IMPACT ON PATIENT-REPORTED SYMPTOM BURDE, THROUGH THE LENS OF THE LONDON EVALUATION OF ILLNESS (LEVIL)

Traditionally used high flux (HF) dialyzers are incapable of clearing toxins of larger middle molecular weight, which are mainly responsible for chronic systemic inflammation, cardiovascular adversity, and poor clinical outcomes in the hemodialysis (HD) population. The recent advent of medium cut-off dialyzers (MCO)–termed expanded dialysis (HDx), have been proven to clear these hard-to-reach toxins while selectively retaining valuable proteins–a step in the right direction as we strive to improve patient care. However, there is no literature focusing on the direct impact of HDx on patient-reported symptoms and quality of life (QoL); a mortality risk in itself. Historically used cross-sectional QoL and symptom measurement tools are unable to properly assess and track the variabilities of symptom burden and are not responsive to short-term changes. The London Evaluation of Illness (LEVIL) is a patient-reported symptoms measurement tool meant for iterative use, and captures fluctuations in real-time. Symptom domains measured by LEVIL include general well-being, energy, sleep quality, bodily pain, appetite, and breathing; domains relevant to the chronic kidney disease population. We report on the impact of 12 weeks of HDx therapy on symptom burden and QoL in patients undergoing conventional HD, measured by LEVIL. A single-centred interventional pilot study in the prevalent chronic HD population-London Health Sciences Centre where 22 participants completed the study. The study was 14 weeks in length; the first 2 weeks patients completed the LEVIL questionnaire with each dialysis session using their HF dialyzer to establish baseline symptom scores. Patients were then changed to Theranova (Baxter–MCO dialyzer) for 12-weeks, continuing the complete LEVIL with each HD session. Bloodwork for CBC, lytes, urea, Cr, Ca, Phos, Alb, CRP, B2M, Free-Light-Chains (FLC) were drawn at the beginning and end of the study. Baseline results were stratified into two groups. Those with an average baseline LEVIL score (scale of 0=poor, 100=excellent) of 70 or above were grouped as “HIGH baseline,” while those with a LEVIL score of <70 were labeled “LOW baseline.” When all six symptom domains were combined, resulting in an “overall” QoL score, 73% of patients had a LOW baseline score (mean 51.5±10.2). There was a significant improvement in overall QoL in this group after 8 (mean 64.6±16.2, p=0.0013) and 12 weeks of HDx therapy (mean 67.2±16.6, p=0.0001). There was no impact on overall QoL in those with a HIGH baseline score. There were no significant differences in lab values other than a reduction of FLC in both groups, most significantly in Kappa-FLC in those with LOW baseline scores (p=0.0182). Domain-specific results also showed that patients with LOW baseline scores benefited after 8 weeks of therapy in the domains of general well-being (p=0.0008) and energy (p=0.0011). Sleep quality improved after just 4 weeks of therapy (p=0.0098). HDx improves QoL and symptom burden in those with LOW baseline LEVIL scores, significantly impacting general well-being, energy, and sleep quality. LEVIL can identify patients who may benefit from HDx and proves to capture the response to treatment after 8 weeks in the domains that most significantly impact HD patients’ QoL. Could this be the ‘magic wand’ to improve patient care?

Quality of life in heart failure patients undergoing hybrid comprehensive telerehabilitation versus usual care results of TELEREH-HF randomized clinical trial

Abstract Background Heart failure (HF) is a clinical syndrome associated with physical capacity impairment and poor quality of life (QoL). The hybrid comprehensive telerehabilitation (HCTR) consisting of telecare, telerehabilitation and homemonitoring of implantable devices might be an option to improve QoL. Purpose to investigate the influence of HCTR on various facets of QoL in HF pts in comparison to usual care (UC). Methods The present analysis formed part of TELEREH-HF multicenter, randomized trial that enrolled 850 HF pts (NYHA I-III, LVEF≤40%). Patients were randomized 1:1 to HCTR plus UC or UC. Patients underwent either an HCTR (1 week in hospital and 8 weeks at home) or UC with observation. The psychology telecare had a form of supportive psychotherapy via phone. The Short Form 36 Questionnaire was used to assess QoL. Measurements were made before and after intervention/observation. Results HCTR group showed significant improvement in overall QoL, physical domain, and 4 areas of QoL (physical functioning [PF], role functioning related to physical state, general health, vitality). A significant positive change in QoL in UC group was observed in vitality and social functioning. There were significant differences in QoL after intervention/observation between groups. Results showed higher improvement in HCTR for overall QoL, physical domain and 3 areas of QoL (PF, role functioning related to physical state and bodily pain [BP]), Table 1. Conclusion In comparison to UC, HCTR resulted in significant improvement in overall QoL, physical domain and 3 specific areas of QoL: PF, role functioning related to physical state and BP. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): National Centre for Research and Development, Warsaw, Poland

Quality of life in heart failure patients undergoing hybrid comprehensive telerehabilitation versus usual care - results of the Telerehabilitation in Heart Failure Patients (TELEREH-HF) Randomized Clinical Trial.

IntroductionHybrid comprehensive telerehabilitation (HCTR) consisting of telecare (with psychological telesupport), telerehabilitation and remote monitoring of implantable devices might be an innovative option improving heart failure (HF) patients’ quality of life (QoL) and emotional health. The aim of the study was to investigate the influence of HCTR on various facets of QoL in HF patients in comparison with usual care (UC) alone.Material and methodsThe present analysis formed part of a multicenter, randomized trial that enrolled 850 HF patients (NYHA I–III, LVEF ≤ 40%). Patients were randomized 1 : 1 to HCTR plus UC or UC only. Patients underwent either an HCTR program or UC with observation. The psychological intervention in the HCTR group included supportive psychological counseling via mobile phone. The Medical Outcome Survey Short Form 36 Questionnaire was used to assess QoL. Measurements were made before and after a 9-week intervention (HCTR group)/observation (UC group).ResultsAfter the intervention, the HCTR group showed significant improvement in overall QoL, physical domain (PD) of QoL, and 4 areas of QoL (physical functioning (PhF), role functioning related to physical state (RF), general health (GH), vitality (VI)). A significant positive change in QoL in the UC group was observed only in VI and social functioning. There were also significant differences in QoL after 9-week intervention/observation between the two groups. The results showed greater improvement in HCTR for overall QoL (p = 0.009), PD of QoL (p = 0.0003) and three specific areas of QoL: PhF (p = 0.001), RF (p = 0.003), bodily pain (BP) (p = 0.015).ConclusionsIn comparison to UC, HCTR resulted in improvement in overall QoL, PD of QoL and 3 specific areas of QoL: PhF, RF and BP.

The Effects of Diet and Dietary Interventions on the Quality of Life among Breast Cancer Survivors: A Cross-Sectional Analysis and a Systematic Review of Experimental Studies.

There is an ongoing need for solid evidence about the effects of healthy behaviors, and particularly diet, on the quality of life (QoL) among breast cancer survivors. We first conducted a cross-sectional study on 68 Italian stage I-III breast cancer survivors, to investigate the association of adherence to the Mediterranean diet (MD), physical activity and weight status with QoL. Adherence to MD and physical activity was assessed using structured questionnaires. QoL was assessed using the European Organization for the Research and Treatment of Cancer Quality-of-Life tools. We showed that low consumption of red meat and carbonated beverages, daily consumption of wine and high consumption of dishes seasoned with sofrito had beneficial effects on several QoL subscales. By contrast, using olive oil as the main culinary fat, low consumption of commercial sweets and high consumption of nuts were associated with negative effects. Overall, these findings resulted in a null effect of adherence to MD on QoL. Furthermore, we observed better QoL sub-scores among women who performed moderate physical activity (i.e., diarrhea) and those who were underweight/normal weight (i.e., physical functioning and dyspnea) if compared with their counterparts (p-values ≤ 0.003 after correction for multiple comparison). Next, we performed a systematic review of nine experimental studies to summarize whether dietary interventions might improve QoL among breast cancer patients. All the studies demonstrated significant improvements in overall QoL and/or its subscales after the interventions. However, differences in study design, interventions and tools used for QoL assessment did not allow us to provide an overall estimate. Moreover, only a single-arm trial evaluated the effect of an exclusive dietary-based intervention, while others combined dietary recommendations with physical activity and weight loss programs. For these reasons, our study encourages more efforts to improve the robustness of current evidence, through more homogenous tools, larger population-based studies and further randomized controlled trials.

Salute to the sun: a new dawn in yoga therapy for breast cancer.

IntroductionInterest in the application of yoga for health benefits in western medicine is growing rapidly, with a significant rise in publications. The purpose of this systematic review is to determine whether the inclusion of yoga therapy to the treatment of breast cancer can improve the patient's physical and psychosocial quality of life (QoL).MethodsA search of peer reviewed journal articles published between January 2009 and July 2014 was conducted. Studies were included if they had more than 15 study participants, included interventions such as mindfulness‐based stress reduction (MBSR) or yoga therapy with or without comparison groups and had stated physical or psychological outcomes.ResultsScreening identified 38 appropriate articles. The most reported psychosocial benefits of yoga therapy were anxiety, emotional and social functioning, stress, depression and global QoL. The most reported physical benefits of yoga therapy were improved salivary cortisol readings, sleep quality and lymphocyte apoptosis. Benefits in these areas were linked strongly with the yoga interventions, in addition to significant improvement in overall QoL.ConclusionThe evidence supports the use of yoga therapy to improve the physical and psychosocial QoL for breast cancer patients with a range of benefits relevant to radiation therapy. Future studies are recommended to confirm these benefits. Evidence‐based recommendations for implementation of a yoga therapy programme have been derived and included within this review. Long‐term follow‐up is necessary with these programmes to assess the efficacy of the yoga intervention in terms of sustainability and patient outcomes.

Effects of an 8-week resistant training programme on quality of life and physical activity

Quality of Life (QoL) following a Coronary Artery Bypass Graft (CABG), have been found to predict subsequent morbidity and mortality, independent of known prognostic factors, whereas other studies reported that a substantial proportion of post-CABG patients who did not receive a proper recovery experienced either no improvement or less improvement in QoL after hospital discharge. The aim of this study was to assess the effects of 2-month Cardiac Rehabilitation (CR) programme on post-CABG patients’ health-related QoL, physical activity and hemodynamics profile. Forty patients who underwent cardiac surgery have been divided to either a CR group (n = 20) who followed a phase VI a supervised resistant training programme twice a week for 2 months at hospital or a control group (n = 20) who followed a usual standard hospital care. The outcome measures were a 6-min Walking Test (6-MWT), 36-Item Short Form Survey (36-SF), resting HR, SBP and DBP. At the end of the study period, there was no significant difference in resting SBP (p = 0.119) between both groups. However, the CR groups showed significant differences in the 6-MWT distance (p = 0.000), resting HR (p = 0.034) and DBP (p = 0.005) compared to the standard hospital care group. In addition, patient satisfaction in the CR groups, as measured in the survey, held a significant improvement in overall QoL (p = 0.000) compared to the standard hospital care group. This study observed a complete disappearance of symptoms and sign of improvements in the heart beats, SBP and DBP after resistance training. This type of CR using a moderate intensity exercise programme proved to improve QoL, physical activities and worth implementing in selected categories of patients.

Effects of progressive muscular relaxation training on anxiety, depression and quality of life of endometriosis patients under gonadotrophin-releasing hormone agonist therapy

To explore the effects of progressive muscle relaxation (PMR) training on anxiety, depression and quality of life (QOL) of endometriosis patients under gonadotrophin-releasing hormone (GnRH) agonist therapy. This was a controlled, randomized, open-label study. One hundred consecutive Han Chinese endometriosis patients, aged 18-48 years, were randomly assigned to a PMR group (n=50) and a control group (n=50). In a study of 12 weeks' duration, both groups received one dose of depot leuprolide, 11.25mg IM. In addition to the GnRH agonist therapy, the PMR group received 12 weeks of PMR training. Anxiety level was measured using the state-trait anxiety inventory (STAI). Depression was assessed using subscale D of the hospital anxiety and depression scale (HADS-D). Health-related QOL was measured with SF-36 instrument. The patients were evaluated with STAI, HADS-D and SF-36 before and after the PMR intervention. The control group and the PMR group were comparable at baseline. After 12 weeks of intervention, both groups showed significant improvement in overall QOL (P<0.05). The PMR group, but not the control group, showed significant improvement in state anxiety, trait anxiety and depression after intervention (P<0.05). Moreover, the PMR group showed significant improvement in all QOL domains after intervention; by contrast, the control group showed significant improvement in all physical health domains and only two mental health domains after intervention. Between-group comparisons of the improvement in scores after intervention showed that the PMR group had significantly better improvement in the scores of anxiety, depression and overall/domain QOL than the control group (P<0.05). Repeated measures ANOVA revealed that both PMR intervention and time had significant individual as well as interactive effects on state anxiety, trait anxiety depression and overall QOL (P<0.05). This study suggests that PMR training is effective in improving anxiety, depression and QOL of endometriosis patients under GnRH agonist therapy. This is the first study to explore the effects of psychosomatic therapy on emotional status and QOL of endometriosis patients, and may serve as an important reference for future psychosomatic interventions on endometriosis.

Long‐term effect of the self‐management comprehensive coping strategy program on quality of life in patients with breast cancer treated with high‐dose chemotherapy

This study aims to examine the effectiveness of a self-management multimodal comprehensive coping strategy program (CCSP) on quality of life (QOL) among breast cancer patients 1 year after treatment. Patients (n = 110) with stage II, III, or IV breast cancer scheduled to receive high dose chemotherapy and autologous hematopoietic stem cell transplantation were randomized to either CCSP treatment or control group. The CCSP intervention was taught 2 week before hospital admission with reinforcement at specified times during treatment and 3 months after discharge. The CCSP components included educational information, cognitive restructuring, coping skills enhancement, and relaxation with guided imagery. Instruments administered at baseline included the following: Quality of Life Index-Cancer Version (QOLI-CV), State-Trait Anxiety Inventory, Beck Depression Inventory, and Coping Strategies Questionnaire. At 1-year follow-up, patients (n = 73) completed and returned the follow-up QOLI-CV. Patients were mainly ≥ 40 years of age, married, Caucasian, and diagnosed with advanced breast cancer. A model measuring effectiveness of CCSP on QOL (total and subscale) at 1-year follow-up showed that the CCSP group (n = 38) had significant improvement in overall QOL (p < 0.01), health and functioning (p < 0.05), and socioeconomic (p < 0.05) and psychological/spiritual well-being (p < 0.01) compared with the control group (n = 35). The CCSP patients frequently used the CCSP to manage psychological (51%) and sleep problems (60%). The CCSP improved QOL for patients at 1-year follow-up. Patients overwhelmingly reported that CCSP was beneficial. The CCSP as an effective coping intervention has potential as a self-management program for breast cancer survivors.

PC-FACS

PC-FACS

Virologic Suppression, Treatment Adherence, and Improved Quality of Life on a Once-Daily Efavirenz-Based Regimen in Treatment-Naïve HIV-1–Infected Patients Over 96 Weeks

Purpose: This study evaluated the long-term efficacy, safety, adherence, and quality of life (QoL) of a once-daily efavirenz-based antiretroviral regimen in two 96-week prospective open-label single-arm studies of treatment-naïve HIV-1–infected patients. Methods: Patients received once-daily efavirenz 600 mg and lamivudine 300 mg with either enteric-coated didanosine 400 mg (Daily Antiretroviral Therapy trial [DART] I) or extended-release stavudine 100 mg (DART II). The primary efficacy outcome measure was HIV RNA <400 copies/mL at Week 48. Results: In an intent-to-treat (ITT) analysis, HIV RNA level <400 (<50) copies/mL was reached by 82%(80%) and 74% (72%) of patients at Week 48 in DART I and II. At Week 96, the corresponding values were 74% (68%) and 55% (54%), respectively. Both regimens were well tolerated. There were no discontinuations for virologic failure. Medication adherence assessed by pill counts was above 80% in 90% of the patients in DART I and more than 80% of patients in DART II. Treatment produced a significant improvement in overall QoL. Conclusion: Once-daily efavirenz-based antiretroviral therapy was effective, durable, and well tolerated. In this study, a high level of adherence was achieved with improvement in overall QoL.

Exercise Dose Required to Enhance Quality of Life in Cancer Survivors

0705 The treatment of certain cancers is often accompanied by serious psychological and physiological side effects that can greatly reduce the quality of life (QOL) in cancer survivors. These include: decreased aerobic capacity, muscular atrophy, decreased strength and flexibility, adverse body composition changes, depression, anxiety and fatigue. Previous studies have shown exercise to be effective in reducing or alleviating many of these side effects, leading to an improvement in overall QOL. However, most studies have utilized a pretest-posttest design that is sufficiently insensitive to recognize the exercise dose needed to generate significant change in QOL. PURPOSE: The purpose of this study was to investigate the exercise dose required to significantly improve QOL in cancer survivors. METHODS: Twenty cancer survivors (15 female, 5 male, 43–79 years of age) served as subjects. Subjects participated in a ten-week low to moderate intensity (25–40% heart rate reserve) exercise program for 14–20 minutes, three times a week. QOL was assessed weekly with the Quality of Life Index for Patients with Cancer. This scale is composed of 14 items evaluating physical condition, normal activities, and personal attitudes on general quality of life. RESULTS: ANOVA results revealed a significant increase in QOL over the ten weeks (p = .0001). Followup analysis (Scheffe post-hoc test) revealed a significant improvement in overall QOL by week 6 (p < .05). Of the 14 sub-scale components that compose the overall QOL score, the subjects improved most on their perceived strength, ability to sleep and their ability to perform daily tasks. CONCLUSIONS: These results indicate that low to moderate intensity aerobic exercise is beneficial in improving QOL and at least six weeks of aerobic activity are needed to see a significant improvement in QOL. This relatively low dose-response relationship should be beneficial in optimizing cancer survivor adherence to an exercise program.

Exercise Dose Required to Enhance Quality of Life in Cancer Survivors

0705 The treatment of certain cancers is often accompanied by serious psychological and physiological side effects that can greatly reduce the quality of life (QOL) in cancer survivors. These include: decreased aerobic capacity, muscular atrophy, decreased strength and flexibility, adverse body composition changes, depression, anxiety and fatigue. Previous studies have shown exercise to be effective in reducing or alleviating many of these side effects, leading to an improvement in overall QOL. However, most studies have utilized a pretest-posttest design that is sufficiently insensitive to recognize the exercise dose needed to generate significant change in QOL. PURPOSE: The purpose of this study was to investigate the exercise dose required to significantly improve QOL in cancer survivors. METHODS: Twenty cancer survivors (15 female, 5 male, 43–79 years of age) served as subjects. Subjects participated in a ten-week low to moderate intensity (25–40% heart rate reserve) exercise program for 14–20 minutes, three times a week. QOL was assessed weekly with the Quality of Life Index for Patients with Cancer. This scale is composed of 14 items evaluating physical condition, normal activities, and personal attitudes on general quality of life. RESULTS: ANOVA results revealed a significant increase in QOL over the ten weeks (p = .0001). Followup analysis (Scheffe post-hoc test) revealed a significant improvement in overall QOL by week 6 (p < .05). Of the 14 sub-scale components that compose the overall QOL score, the subjects improved most on their perceived strength, ability to sleep and their ability to perform daily tasks. CONCLUSIONS: These results indicate that low to moderate intensity aerobic exercise is beneficial in improving QOL and at least six weeks of aerobic activity are needed to see a significant improvement in QOL. This relatively low dose-response relationship should be beneficial in optimizing cancer survivor adherence to an exercise program.