Fatiregun Olamijulo Adedeji, Olagunju Andrew Toyin, Erinfolami Adebayo Rasheed, Arogunmati Olubunmi Ayodele, Fatiregun Omolara Amina, Adeyemi Joseph Dada
Federal Neuropsychiatric Hospital, PMB 2008, Yaba, Lagos, Nigeria; Department of Psychiatry, Lagos University Teaching Hospital, PMB 12003, Lagos, Nigeria.
Department of Psychiatry, College of Medicine, University of Lagos, PMB 12003, Lagos, Nigeria; Department of Psychiatry, Lagos University Teaching Hospital, PMB 12003, Lagos, Nigeria.
Breast. 2017 Feb;31:150-156. doi: 10.1016/j.breast.2016.11.010. Epub 2016 Nov 17.
Health Related Quality of life (HRQoL) is increasingly recognised as an important indicator of outcome and well-being in oncology care. We set out in this study to evaluate whether significant association exists between anxiety disorders (ADs) and HRQoL in breast cancer, such that any intervention addressing ADs would potentially improve HRQoL.
A cross sectional evaluation of 200 attendees of an oncology clinic was done using designed questionnaire to gather socio-demographic and clinical data. Subsequently, the Schedule for clinical Assessment in Neuropsychiatry was used to ascertain ADs and the European Organization for Research and Treatment of Cancer QOL Questionnaire (THE EORTC QLQ-C30) Version 3 with its breast specific supplement (QLQ-BR-23) was used to profile HRQoL in participants.
The mean age of participants was 49.6(±11.2) years, and 54% of participants had stage III and IV breast cancer. Findings on EORTC QLQ-C30 following univariate analyses showed association between ADs and poorer mean scores on global health status, functional domains including physical, emotional, social, and cognitive functions (p < 0.05). On the symptom scale, those with ADs had higher symptom load including fatigue, pain, insomnia, appetite loss, diarrhoea and financial difficulties (p < 0.05). Similarly, the QLQ-BR-23 showed correlation between ADs and poorer mean scores on breast cancer specific issues like body image, future perspectives, sexual functioning, sexual enjoyment, systemic therapy side-effects, upset by hair loss and breast symptoms (p < 0.05). Findings after controlling for age, treatment, cancer duration, recurrence and stage showed the same pattern of relationship between ADs and HRQoL; however, the global health status, cognition, sexual functioning, and higher symptom load with respect to appetite loss and financial difficulties were not independently related with ADs.
Scaling up of oncological services, supportive care and targeted psychosocial interventions are indicated for optimal outcome of breast cancer. Longitudinal research with focus on the complex relationship between HRQoL and ADs along with their modifiable determinants across the trajectories of breast cancer is warranted.
健康相关生活质量（HRQoL）日益被视为肿瘤护理中结果和幸福感的重要指标。在本研究中，我们旨在评估焦虑症（ADs）与乳腺癌患者的HRQoL之间是否存在显著关联，以便任何针对ADs的干预措施都有可能改善HRQoL。
使用设计好的问卷对200名肿瘤门诊患者进行横断面评估，以收集社会人口统计学和临床数据。随后，使用神经精神病学临床评估量表确定ADs，并使用欧洲癌症研究与治疗组织生活质量问卷（EORTC QLQ-C30）第3版及其乳腺癌特异性补充问卷（QLQ-BR-23）来描绘参与者的HRQoL。
参与者的平均年龄为49.6（±11.2）岁，54%的参与者患有III期和IV期乳腺癌。单因素分析后EORTC QLQ-C30的结果显示，ADs与总体健康状况、包括身体、情感、社会和认知功能在内的功能领域的较差平均得分之间存在关联（p < 0.05）。在症状量表上，患有ADs的患者症状负担更高，包括疲劳、疼痛、失眠、食欲减退、腹泻和经济困难（p < 0.05）。同样，QLQ-BR-23显示ADs与乳腺癌特定问题（如身体形象、未来展望、性功能、性享受、全身治疗副作用、脱发困扰和乳腺症状）的较差平均得分之间存在相关性（p < 0.05）。在控制年龄、治疗、癌症病程、复发和分期后的结果显示，ADs与HRQoL之间的关系模式相同；然而，总体健康状况、认知、性功能以及食欲减退和经济困难方面较高的症状负担与ADs并无独立关联。
为了实现乳腺癌的最佳治疗效果，需要扩大肿瘤服务、支持性护理和有针对性的心理社会干预。有必要开展纵向研究，重点关注HRQoL与ADs之间的复杂关系及其在乳腺癌病程中的可改变决定因素。
