The association between chronic disease burden and quality of life among breast cancer survivors in Missouri
The association between chronic disease burden and quality of life among breast cancer survivors in Missouri
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DOI：
10.1007/s10549-011-1525-z
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发表时间：
2011-10-01
影响因子：
3.8
通讯作者：
Schootman, Mario
中科院分区：
文献类型：
--
作者：
Deshpande, Anjali D.;Sefko, Julianne A.;Schootman, Mario
更大的慢性病负担可能会降低乳腺癌幸存者的生活质量(QOL)。我们的目标是调查乳腺癌患者确诊后1年的慢性疾病负担与生活质量之间的关系。我们分析了从密苏里州癌症登记确诊的女性乳腺癌幸存者样本中收集的诊断后1年的横断面数据。我们使用了8个RAND-36子量表来评估生理、情感和社会功能的生活质量领域。使用Katz的共病测量方法，我们计算了慢性病负担(0、1和2+)。在控制了潜在的协变量：社会人口学、临床、心理社会、行为危险因素和获得医疗服务后，每个生活质量子量表的多变量一般线性模型被用来检验慢性病负担和生活质量之间的关系。参与者(n=1089)平均年龄58岁(范围27-96岁)，大多数是白人(92%)，已婚(68%)，至少受过高中教育(95%)，并有医疗保险(97%)。66%的幸存者慢性病负担评分为0，17%的患者慢性病负担评分为1，17%的患者慢性病负担评分为2+。在粗略模型中，慢性病负担与每个生活质量分量表显著相关(P<；0.001)。在完全调整的模型中，慢性病负担仍然与六个子量表显著相关，但与情绪问题子量表的情绪幸福感和角色限制无关。确诊一年后，有较高慢性病负担的乳腺癌幸存者的身体和社会功能低于没有额外健康状况的幸存者。这些差异不能用相关的协变量完全解释。确定可修改的干预目标对于改善有其他慢性健康状况的幸存者的生活质量结果至关重要。
Greater chronic disease burden may decrease quality of life (QOL) of breast cancer survivors. Our objective was to investigate the association between chronic disease burden and QOL in breast cancer survivors at 1 year post-diagnosis. We analyzed cross-sectional data collected 1 year post-diagnosis from a sample of female breast cancer survivors identified from the Missouri cancer registry. We used eight RAND-36 subscales to assess physical, emotional, and social functioning QOL domains. Using Katz's measure of comorbidity, we computed chronic disease burden (0, 1, and 2+). Multivariable general linear models for each QOL subscale were used to examine associations between chronic disease burden and QOL after controlling for potential covariates: socio-demographic, clinical, psychosocial, behavioral risk factors, and access to medical care. Participants (n = 1089) were 58-year old on average (range 27-96) and mostly White (92%), married (68%), had at least a high school education (95%), and had health insurance (97%). Sixty-six percent of survivors had a chronic disease burden score of 0, 17% had 1, and 17% had 2+. Chronic disease burden was significantly associated with each QOL subscale in crude models (P < 0.001). In fully adjusted models, chronic disease burden was still significantly correlated with six subscales, but not with the emotional well-being and role limitations due to emotional problems subscales. One year post-diagnosis, breast cancer survivors with higher chronic disease burden had lower physical and social functioning than survivors without additional health conditions. These differences were not fully explained by relevant covariates. Identifying modifiable targets for intervention will be critical for improving QOL outcomes among survivors who have other chronic health conditions.