University of Illinois at Chicago Institute for Health Research and Policy, 1747 W. Roosevelt Rd., Chicago, IL, 60608, USA.
University of Illinois at Chicago Center for Research on Women and Gender, 1640 W. Roosevelt Rd., Chicago, IL, 60608, USA.
Support Care Cancer. 2020 Apr;28(4):1839-1848. doi: 10.1007/s00520-019-05005-7. Epub 2019 Jul 24.
We explored how lifetime comorbidities and treatment-related cancer symptoms were associated with quality of life (QOL) in rural cancer survivors.
Survivors (n = 125) who were rural Illinois residents aged 18+ years old were recruited from January 2017 to September 2018. We conducted 4 multivariable regressions with QOL domains as outcomes (social well-being, functional well-being, mental health-MHQOL, physical health-PHQOL); the number of physical and psychological comorbidities (e.g., arthritis, high blood pressure, stroke) and treatment-related cancer symptoms (e.g., worrying, feeling sad, lack of appetite, lack of energy) as predictors; and, cancer-related and demographic factors related to these variables as covariates.
The number of comorbidities and number of treatment-related symptoms were inversely associated with functional well-being (Std β = - 0.36, p < 0.0001 and - 0.18, p = 0.03), and MHQOL (Std β = - 0.30, p = 0.001 and Std β = - 0.25, p = 0.004). Comorbidities were associated inversely with social well-being (Std β = - 0.27, p = .003). Comorbidities and treatment-related symptoms were not associated with PHQOL (p = 0.20-0.24). Sensitivity analyses suggested that psychological comorbidities, treatment-related psychological symptoms, and physical comorbidities were associated with social well-being, functional well-being, and MHQOL.
Our study highlights the utility of risk-based survivorship care plans to address the negative, additive impact of comorbidities and the treatment-related symptoms to improve the health-related QOL among rural survivors. Future research should assess how contextual factors (e.g., geographic distance to oncologists and other providers) should be incorporated in survivorship care planning and implementation for rural survivors.
本研究旨在探讨终生合并症和与治疗相关的癌症症状如何影响农村癌症幸存者的生活质量（QOL）。
本研究于 2017 年 1 月至 2018 年 9 月期间招募了 125 名居住在伊利诺伊州农村地区、年龄在 18 岁及以上的癌症幸存者。我们进行了 4 项多变量回归分析，将生活质量（社会幸福感、功能幸福感、心理健康-MHQOL、身体健康-PHQOL）作为结果变量，身体和心理合并症的数量（如关节炎、高血压、中风）和与治疗相关的癌症症状（如担忧、悲伤、食欲不振、缺乏精力）作为预测因子，并将与这些变量相关的癌症相关和人口统计学因素作为协变量。
合并症的数量和与治疗相关的症状数量与功能幸福感（标准β=−0.36，p<0.0001 和−0.18，p=0.03）和 MHQOL（标准β=−0.30，p=0.001 和标准β=−0.25，p=0.004）呈负相关。合并症与社会幸福感呈负相关（标准β=−0.27，p=0.003）。合并症和与治疗相关的症状与 PHQOL 无关（p=0.20-0.24）。敏感性分析表明，心理合并症、与治疗相关的心理症状和身体合并症与社会幸福感、功能幸福感和 MHQOL 相关。
本研究强调了基于风险的生存护理计划的实用性，以解决合并症和与治疗相关的症状的负面影响，从而改善农村幸存者的健康相关生活质量。未来的研究应该评估如何将情境因素（例如，距离肿瘤学家和其他提供者的地理距离）纳入农村幸存者的生存护理计划和实施中。
