Rohani Camelia, Abedi Heidar-Ali, Omranipour Ramesh, Langius-Eklöf Ann
Department of Health, Shahid Beheshti University of Medical Sciences School of Nursing and Midwifery, Valiasr st., Niayesh Crossroad, Tehran, 1985717443, Iran.
Department of Nursing, Islamic Azad University Nursing and Midwifery School, Isfahan (Khorasgan) Branch, Isfahan, 8153653791, Iran.
Health Qual Life Outcomes. 2015 Mar 28;13:40. doi: 10.1186/s12955-015-0229-1.
There is disagreement among studies of health-related quality of life (HRQoL) changes in breast cancer patients over time. Reportedly, assessment of HRQoL prior to diagnosis may be crucial to provide a clear point of comparison for later measurements. The aims of this study were (1) to investigate changes in HRQoL, sense of coherence (SOC), spirituality and religious coping in a group of women with breast cancer from the pre-diagnosis phase to 6 months later in comparison with a control group, and (2) to explore the predictor role of SOC, spirituality, and religious coping within the breast cancer group at the 6-month follow-up.
A sample of women with breast cancer (n = 162) and a matched control group (n = 210) responded to the following instruments on both occasions: the European Organization for Research and Treatment of Cancer QLQ-C30, the SOC Scale, the Spiritual Perspective Scale and the Brief Religious Coping Scale. A series of General Linear Model (GLM) Repeated Measures was used to determine changes between the groups over time. Also, Multiple Linear Regression analyses were applied to each of the HRQoL dimensions, as dependent variable at the 6 months follow-up.
Physical and role function, fatigue, and financial difficulties were rated worse by the women with breast cancer during the first 6 months in comparison to the controls, which was both a statistically (p < 0.001) and clinically significant difference. Women had better scores for global quality of life (p < 0.001), and emotional functioning (p < 0.01) during the same period of time. The degree of SOC (p < 0.01) and baseline ratings of several dimensions of HRQoL (p < 0.05) were the most important predictors of HRQoL changes.
Collecting HRQoL data before a final diagnosis of breast cancer is important to identify women at risk of deterioration in HRQoL during and after treatment. Special attention should be paid to physical and role functioning impairment, fatigue, and financial difficulties experienced by these women. These results underscore that the degree of SOC may be more important as a predictor for HRQoL changes in this sample than spirituality and religious coping.
关于乳腺癌患者健康相关生活质量（HRQoL）随时间变化的研究存在分歧。据报道，诊断前对HRQoL的评估对于为后续测量提供明确的比较点可能至关重要。本研究的目的是：（1）调查一组乳腺癌女性从诊断前阶段到6个月后的HRQoL、连贯感（SOC）、精神性和宗教应对方式的变化，并与对照组进行比较；（2）在6个月随访时，探讨SOC、精神性和宗教应对方式在乳腺癌组中的预测作用。
一组乳腺癌女性样本（n = 162）和一个匹配的对照组（n = 210）在两个时间点都对以下工具进行了回答：欧洲癌症研究与治疗组织QLQ-C30、SOC量表、精神视角量表和简短宗教应对量表。使用一系列广义线性模型（GLM）重复测量来确定两组随时间的变化。此外，在6个月随访时，将每个HRQoL维度作为因变量进行多元线性回归分析。
与对照组相比，乳腺癌女性在最初6个月内对身体和角色功能、疲劳和经济困难的评分更差，这在统计学上（p < 0.001）和临床上均有显著差异。同期女性的总体生活质量（p < 0.001）和情感功能（p < 0.01）得分更高。SOC程度（p < 0.01）和HRQoL几个维度的基线评分（p < 0.05）是HRQoL变化的最重要预测因素。
在乳腺癌最终诊断前收集HRQoL数据对于识别治疗期间和治疗后HRQoL有恶化风险的女性很重要。应特别关注这些女性所经历的身体和角色功能损害、疲劳和经济困难。这些结果强调，在该样本中，作为HRQoL变化的预测因素，SOC程度可能比精神性和宗教应对方式更重要。
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