Methodologic issues in assessing the quality of life of cancer patients

Article Abstract:

In the past, the survival of a cancer patient was often an elusive goal, and it has only been within recent years that the success rate for some cancers has become sufficiently good that questions about the quality of life have been raised. These questions have also become important in diseases for which two or more different treatments of roughly equal effectiveness exist. It is obvious that other things being equal, the treatment that offers the best quality of life is preferable. However, surprisingly few studies of cancer treatment have included measures of the quality of life. Perhaps this is due to the unfamiliarity of many clinical researchers with the methods of the social sciences. Furthermore, in many cases where measures of the quality of life are included, the results confirm the importance of acquiring data. For example, quality of life data has been acquired for breast cancer treatments, and patients with conserved breasts were found to enjoy a higher quality of life than patients who underwent mastectomy. This is not always the case, however; quality of life measurements have also demonstrated that some of the concerns anticipated for breast-conserving surgery patients, such as recurrence of cancer, failed to materialize. Much remains to be accomplished, however, in the methodology of quality of life research. Often, quality of life is measured by recording subjective impressions. The net result is invariably tautological: I have a good quality of life because I'm happy. Why am I happy? Well, I have a good quality of life, of course. Objective measures must be developed, but the solution is not straightforward. How many mutually independent measures of quality of life are there? Do measures of life quality even need to be completely independent? Should measures of life quality be weighted equally in statistical analysis or are some more important than others? Indeed, are some more important for one patient than for another? Clearly, the problems facing researchers who wish to study quality of life are enormous. Regardless of how these problems are solved, the data resulting from future quality of life studies will enhance cancer care. (Consumer Summary produced by Reliance Medical Information, Inc.)

---

Psychosocial issues: psychological and social issues for older people with cancer

Article Abstract:

A short discussion of the role of social and psychological factors affecting older people with cancer is presented. The author first cautions against placing too much emphasis on generalizations, since older people differ among themselves as much as younger people. There are, however, some generalizations to consider. Older people are more likely to experience a variety of losses. Not only loss of health, but loss of vigor and sensory losses often develop with increasing age. Older people are more likely to experience the deaths of loved ones, including spouses, family members, and close friends. Older people may also lose their social roles, a problem that is more common in the so-called ''developed'' countries. It should not be assumed, however, that how older people perceive themselves is intimately tied up with feelings of age. Older people may have rich lives and aspirations. It should be remembered that although 65 years is a standard for ''old age'', as reflected by the customary retirement age, many 65-year-old men and women have several decades of life ahead of them. When older people develop cancer, it should not be assumed that they are too psychologically frail to be told the full details of their condition. Their responses to disease are likely to be quite similar to those of younger patients. For example, a woman of 70 may suffer the same psychological trauma resulting from mastectomy as a woman of 30 or 40. Physicians should realize that the majority of elderly people do not want to enter a nursing home, even for a short stay. While a nursing home might seem to be a practical and sensible option, care must be taken not to ignore the feelings of the older patient. The author points out the possibility for the devastating psychological effects of ''learned helplessness'' among the elderly. According to this notion, as patients learn that they can not control some aspects of their lives, they may become depressed and fail to try to exert any control, even over events that are within their power to change. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Social aspects, Aging, Aged, Elderly

---

Social support and the cancer patient: implications for future research and clinical care

Article Abstract:

While many would agree that the social support of a patient with cancer, or any serious disease, is important, it is difficult to state how important it is and how to measure its effects. Some theoretical models of social support have been elaborated, however. Such models may make a distinction between main effects and stress reduction. Main effects, as their name implies, involve a direct effect of the support, for example pressure to quit smoking or encouragement to see a physician and take medication regularly. Stress reduction effects, as their name implies, reduce the stress associated with cancer, and may therefore improve not only coping with the disease, but also provide a better internal environment with better immune system function and reduction of the neuroendocrine responses normally associated with stress. The authors argue that cancer research should not limit itself to outcome measures such as mortality, tumor recurrence or psychosocial adaptation. They advocate including measures of the quality of life of the patient in cancer studies as well. Of course, many cancer studies do include the quality of life in their research, but to the authors quality of life includes philosophical and religious aspects as well as coping with the tasks of day-to-day living. They suggest that cancer research should incorporate questions involving how the social support of the patient deals with philosophical and religious issues. (Consumer Summary produced by Reliance Medical Information, Inc.)

Patient advocacy

Similar abstracts:

• Abstracts: Energy supplementation and the nutritional status of hemodialysis patients. Vitamin and trace element status of women with disordered eating
• Abstracts: Differences in the quality of semen in outdoor workers during summer and winter. Fewer sperm in the summer: it's not the heat, it's...
• Abstracts: Positive Lyme serology in subacute bacterial endocarditis: a study of four patients. Invasion of the central nervous system by Borrelia burgdorferi in acute disseminated infection
• Abstracts: Arteriographic findings in EDTA chelation therapy on peripheral arteriosclerosis. Effects and limitations of pentoxifylline therapy in various stages of peripheral vascular disease of the lower extremity
• Abstracts: Linguistic performance in schizophrenia: a comparison of acute and chronic patients. Re-examination of the language of psychotic subjects

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.