School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia.
Cancer Council Victoria, Melbourne, VIC, Australia.
Support Care Cancer. 2022 Jun;30(6):5299-5309. doi: 10.1007/s00520-022-06914-w. Epub 2022 Mar 12.
To examine how socio-demographic, comorbidities and information needs influence quality of life (QoL) outcomes of survivors of breast, colorectal, or prostate cancer, non-Hodgkin lymphoma or melanoma.
Cross-sectional postal survey with eligible participants identified through a population-based cancer registry. QoL outcomes were assessed by EQ-5D-5L, social difficulties index (SDI) and, for those employed at diagnosis, current employment. Regression analyses explored associations between outcome variables and cancer type, age, time since diagnosis, residential location, socio-economic disadvantage, comorbidities and unmet information needs. Mediation analyses examined whether comorbidities and information needs explained relationships between outcome variables and socio-economic disadvantage.
2115 survivors participated. Mean EQ-5D-5L scores (mean = 0.84) were similar to population averages and SDI scores were low for the entire sample (mean = 3.80). In multivariate analyses, being aged over 80, greater socio-economic disadvantage, comorbidities and unmet information needs decreased EQ-5D-5L scores. Higher SDI scores were associated with socio-economic disadvantage, comorbidities and unmet information needs. Not being employed was associated with being aged over 50, more comorbidities and socio-economic disadvantage. Comorbidities but not information needs partially mediated the impact of socio-economic disadvantage on EQ-5D-5L and SDI accounting for 17% and 14% of the total effect of socio-economic disadvantage respectively. Neither comorbidities nor information needs mediated the association between socio-economic disadvantage and employment outcomes.
To improve quality of life, survivorship care should be better tailored to address the needs of individuals given their overall health and impact of comorbidities, their age and type of cancer and not simply time since diagnosis.
研究社会人口统计学因素、合并症和信息需求如何影响乳腺癌、结直肠癌、前列腺癌、非霍奇金淋巴瘤或黑色素瘤幸存者的生活质量（QoL）结局。
通过基于人群的癌症登记处确定合格参与者，进行横断面邮寄调查。使用 EQ-5D-5L、社会困难指数（SDI）评估 QoL 结局，并为那些在诊断时就业的人评估当前就业情况。回归分析探讨了结局变量与癌症类型、年龄、诊断后时间、居住地点、社会经济劣势、合并症和未满足的信息需求之间的关系。中介分析检验了合并症和信息需求是否解释了结局变量与社会经济劣势之间的关系。
共有 2115 名幸存者参与了研究。平均 EQ-5D-5L 评分（均值=0.84）与人群平均值相似，整个样本的 SDI 评分较低（均值=3.80）。在多变量分析中，年龄超过 80 岁、社会经济劣势程度较大、合并症和未满足的信息需求会降低 EQ-5D-5L 评分。较高的 SDI 评分与社会经济劣势、合并症和未满足的信息需求相关。未就业与年龄超过 50 岁、更多的合并症和社会经济劣势相关。合并症但不是信息需求部分中介了社会经济劣势对 EQ-5D-5L 和 SDI 的影响，分别占社会经济劣势总效应的 17%和 14%。合并症和信息需求都没有中介社会经济劣势与就业结局之间的关系。
为了提高生活质量，生存护理应该更好地针对个体的整体健康状况和合并症的影响、年龄和癌症类型进行调整，而不仅仅是根据诊断后的时间进行调整。
