Department of Medical Oncology, Leiden University Medical Center, 2300 RC Leiden, P.O. Box 9600, Leiden, The Netherlands.
Division of Breast Oncology, Saitama Cancer Center, Saitama, Japan.
Breast Cancer Res Treat. 2017 Nov;166(2):459-471. doi: 10.1007/s10549-017-4417-z. Epub 2017 Jul 31.
Cultural differences are hypothesized to influence patients' Quality of Life (QoL) reports. However, there is a lack of empirical cross-cultural studies comparing QoL of patients with cancer. This study aims to compare QoL of women with breast cancer in the Netherlands and Japan, and to investigate the association of QoL with sociodemographic, clinical, and psychological variables (illness perceptions).
Dutch (n = 116) and Japanese (n = 148) women with early breast cancer undergoing chemotherapy completed the EORTC QLQ-C30 and Brief Illness Perception Questionnaire immediately before their second cycle of chemotherapy.
Dutch women reported poorer Physical, Role, Emotional, and Cognitive functioning than Japanese women. Additionally, illness perceptions were significantly different in Japan and the Netherlands, but these did not vary across treatment type. In Japan, QoL of women receiving AC-chemotherapy was better than that of women receiving FEC-chemotherapy, whereas in the Netherlands, QoL did not vary as a function of chemotherapy. Illness perceptions about symptom severity, adverse consequences, and emotional representations were negatively related to most domains of patients' QoL in both countries. Adding illness perceptions as covariates to the ANOVA analyses rendered the effects of country and treatment type on QoL non-significant.
Comparing Dutch and Japanese women with early breast cancer revealed important differences in treatment modalities and illness perceptions which both appear to influence QoL. Perceptions about cancer have been found to vary across cultures, and our study suggests that these perceptions should be considered when performing cross-cultural studies focusing on patient-reported outcomes.
文化差异被假设会影响患者的生活质量（QoL）报告。然而，目前缺乏比较癌症患者 QoL 的跨文化实证研究。本研究旨在比较荷兰和日本的乳腺癌女性患者的 QoL，并调查 QoL 与社会人口统计学、临床和心理变量（疾病认知）的关联。
正在接受化疗的荷兰（n=116）和日本（n=148）早期乳腺癌女性在第二次化疗前立即完成了 EORTC QLQ-C30 和简短疾病认知问卷。
荷兰女性报告的身体、角色、情绪和认知功能比日本女性差。此外，日本和荷兰的疾病认知存在显著差异，但这些差异不因治疗类型而异。在日本，接受 AC 化疗的女性的 QoL 优于接受 FEC 化疗的女性，而在荷兰，化疗对 QoL 没有影响。在两国，对症状严重程度、不良后果和情绪表现的疾病认知与患者 QoL 的大多数领域呈负相关。将疾病认知作为协变量添加到方差分析中，使得国家和治疗类型对 QoL 的影响不再显著。
比较荷兰和日本的早期乳腺癌女性患者，发现治疗方式和疾病认知存在重要差异，这些差异似乎都影响了 QoL。已经发现对癌症的认知在不同文化中存在差异，我们的研究表明，在进行关注患者报告结果的跨文化研究时，应该考虑这些认知。
