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      Quality of life of women with locally advanced or metastatic breast cancer Translated title: Calidad de vida de mujeres con cáncer de mama localmente avanzado o metastásico Translated title: Qualidade de vida de mulheres acometidas por câncer de mama localmente avançado ou metastático

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          Abstract

          ABSTRACT Objectives: To identify the main affected domains of quality of life of hospitalized women with locally advanced or metastatic breast cancer; and to analyze the association between the level of quality of life and stage of cancer. Method: This was a cross-sectional quantitative, study conducted in Rio de Janeiro, Brazil, between March and July 2017. Interviews were performed with 199 women. The researchers administered the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30, with analysis using the Statistical Package for the Social Sciences software and the Kruskal-Wallis test. Results: Mean global health status was 32.04. On the functional scales, cognitive functioning scored the highest (60.47), while role functioning scored the lowest (12.48). Fatigue presented the highest mean (69.57). The scores for global health status and the functional scales (with the exception of the social functioning) decreased as staging progressed. Conclusion: The stage of cancer affects the quality of life of the studied sample of women.

          Translated abstract

          RESUMEN Objetivos: Identificar los dominios de calidad de vida afectados en mujeres hospitalizadas con cáncer de mama localmente avanzado o metastásico; analizar la asociación entre el nivel de calidad de vida y la estadificación del cáncer. Método: Estudio cuantitativo transversal realizado en Río de Janeiro, entre marzo y julio de 2017. 199 mujeres fueron entrevistadas. Se aplicó el European Organization for Research and Treatment of Cancer Quality of Life Questionnarie Core 30, para análisis el Statistical Package for the Social Sciences y la prueba Kruskal-Wallis. Resultados: El estado de salud global promedio fue 32.04. El funcionamiento cognitivo tuvo el promedio más alto (60.47) y el desempeño personal más bajo (12.48). Fatiga presentó el promedio más alto (69.57). El estado de salud global y la escala funcional (excepto social) redujeron sus puntajes a medida que avanzaba la estadificación. Conclusión: La estadificación del cáncer interfirió con la calidad de vida de estas mujeres.

          Translated abstract

          RESUMO Objetivos: Identificar os principais domínios de qualidade de vida afetados em mulheres com câncer de mama localmente avançado ou metastático hospitalizadas; e analisar a associação entre o nível de qualidade de vida e o estadiamento do câncer. Método: Estudo transversal, quantitativo, realizado no Rio de Janeiro, Brasil, entre março e julho de 2017. Entrevistaram-se 199 mulheres. Aplicou-se o European Organization for Research and Treatment of Cancer Quality of Life Questionnarie Core 30, com análise no Statistical Package for the Social Sciences e teste Kruskal-Wallis. Resultados: A média do status de saúde global foi 32,04. Na escala funcional, o funcionamento cognitivo teve maior média (60,47) e o desempenho pessoal a menor média (12,48). A fadiga apresentou maior média (69,57). O status de saúde global e a escala funcional (exceto social) reduziram seus escores à medida que o estadiamento avançava. Conclusão: O estadiamento do câncer interferiu na qualidade de vida dessas mulheres.

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          Most prevalent unmet supportive care needs and quality of life of breast cancer patients in a tertiary hospital in Malaysia

          Background Addressing breast cancer patients’ unmet supportive care needs in the early stage of their survivorship have become a prime concern because of its significant association with poor quality of life (QOL), which in turn increases healthcare utilization and costs. There is no study about unmet supportive care needs of breast cancer patients in Malaysia. This study aims to assess the most prevalent unmet supportive care needs of Malaysian breast cancer patients and the association between QOL and patients’ characteristics, and their unmet supportive care needs. Methods A cross-sectional study was conducted at the Surgery and Oncology Clinic between May 2014 and June 2014 in a tertiary hospital in Malaysia. A total of 117 patients out of 133 breast cancer patients recruited by universal sampling were interviewed using a structured questionnaire consisted of three parts: participants’ socio-demographic and disease characteristics, Supportive Care Needs Survey-Short Form Questionnaire (SCNS-SF34) and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30). Results The highest unmet supportive care needs were observed in the psychological domain (Mean 53.31; SD ± 21.79), followed by physical domain (Mean 38.16; SD ± 27.15). Most prevalent unmet supportive care needs were uncertainty about the future (78.6 %), fears about the cancer spreading (76.1 %), feelings of sadness (69.2 %), feelings about death and dying (68.4 %), concerns about those close to the patient (65.0 %) and feeling down or depressed (65.0 %). Multivariate linear analysis showed that early breast cancer survivors diagnosed at an advanced stage and with greater physical and psychological needs were significantly (p < 0.05) associated with poorer QOL. Conclusion Most prevalent unmet needs among Malaysian breast cancer patients were found in the psychological domain. Early breast cancer survivors with late stage diagnosis who had more unmet needs in psychological and physical domains were more likely to have a poor QOL.
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            Validity, reliability and understanding of the EORTC-C30 and EORTC-BR23, quality of life questionnaires specific for breast cancer

            Objective: To validate and assess reliability and understanding of the EORTC–C30 quality of life questionnaire and its breast cancer specific module, the EORTC-BR23. Methods: This study was conducted at the AC Camargo Cancer Hospital, São Paulo, Brazil. A total of 100 women diagnosed with breast cancer were interviewed. Internal consistency, confirmatory factorial analysis, convergent validity, construct validity and degree of understanding were examined. Reliability was assessed by comparison of means at times 1 and 2, inter-class coefficient and Bland-Altman graphics. Results: Cronbach’s alpha ranged from 0.72 to 0.86 for the EORTC-C30 and from 0.78 to 0.83 for the EORTC-BR23 questionnaire. Most questions were confirmed in the confirmatory factorial analysis. In the construct validity analysis, the questionnaires were capable of differentiating patients with or without lymphedema, apart from the symptom scales of both questionnaires. Both questionnaires presented a significant correlation in most domains of the SF-36, in the convergent validity analysis. Only a few criticisms were reported concerning questions, and the mean grade of understanding was high (C30 = 4.91 and BR23 = 4.89). The questionnaires presented good rates of reliability, with the exception of the functional scale of the C30 and the symptom scale of the BR23. Conclusions: The EORTC-C30 and EORTC-BR23 quality of life questionnaires were validated, presented good rates of reliability and are easily understood, allowing them to be used in Brazil to assess quality of life among women with breast cancer.
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              The course of cancer related fatigue up to ten years in early breast cancer patients: What impact in clinical practice?

              Little is known about the cancer related fatigue (CRF) along cancer course and risk factors that could predict CRF development and persistence in breast cancer (BC) survivors. This prospective study detected incidence, timing of onset, duration of CRF, impact on QoL and psychological distress. Seventy-eight early BC patients, undergoing chemotherapy (CT) followed or not by hormonal therapy were assessed for QoL and psychological distress by EORTC QLQC30 and HADs questionnaires. Fatigue was investigated with mix methods, structured interview and psychometric measures. A qualitative analysis was added to assess the behavioral pattern of CRF. Low fatigue levels were identified after surgery (9%), increasing during (49%) and at the end of CT (47%), maintaining after 1 year (31%) and declining up to ten years of follow-up. Prevalence of CRF was higher at the end of CT and lower at follow-up. At the end and after 1 and 2 years from CT, persistence of CRF was associated to anxiety in 20%, 11% and 5% and to depression in 15%, 10% and 5% respectively. A relationship between CRF and psychological distress was observed; patients presenting depression and anxiety before CT were at higher risk for fatigue onset at a later period. A relationship between fatigue and QoL was noted at the end of CT. Our study shows the fatigue timely trend in early BC patients from surgery, CT and follow-up. Identification of biological, psychological, social predictor factors related to fatigue could be helpful for early interventions in patients at higher risk of developing fatigue.
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                Author and article information

                Journal
                rgenf
                Revista Gaúcha de Enfermagem
                Rev. Gaúcha Enferm.
                Universidade Federal do Rio Grande do Sul. Escola de Enfermagem (Porto Alegre, RS, Brazil )
                0102-6933
                1983-1447
                2020
                : 41
                : e20190292
                Affiliations
                [1] Rio de Janeiro Rio de Janeiro orgnameUniversidade Federal do Rio de Janeiro orgdiv1Escola de Enfermagem Anna Nery Brazil
                [2] Rio de Janeiro Rio de Janeiro orgnameInstituto Nacional de Câncer José Alencar Gomes da Silva orgdiv1Hospital do Câncer III Brazil
                Article
                S1983-14472020000100423 S1983-1447(20)04100000423
                10.1590/1983-1447.2020.20190292
                32555955
                d760cb40-b021-4bf5-affc-d3cd5f5e1e3c

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 02 September 2019
                : 06 January 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 16, Pages: 0
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                SciELO Revista de Enfermagem

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                Original Articles

                Breast neoplasms,Perfil de saúde,Cuidados paliativos,Qualidade de vida,Neoplasias da mama,Perfil de salud,Calidad de vida,Neoplasias de la mama,Health profile,Palliative care,Quality of life

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