Shaila M Strayhorn1, Leslie R Carnahan2, Kristine Zimmermann2, Theresa A Hastert3, Karriem S Watson4, Carol Estwing Ferrans5, Yamilé Molina6,7,8. 1. University of Illinois at Chicago Institute for Health Research and Policy, 1747 W. Roosevelt Rd., Chicago, IL, 60608, USA. 2. University of Illinois at Chicago Center for Research on Women and Gender, 1640 W. Roosevelt Rd., Chicago, IL, 60608, USA. 3. Karmanos Cancer Institute of Wayne State University, 4100 John R St, Detroit, MI, 48201, USA. 4. University of Illinois Cancer Center, 914 S. Wood St., Chicago, IL, 60612, USA. 5. University of Illinois at Chicago College of Nursing, 845 S. Damen Ave., Chicago, IL, 60612, USA. 6. University of Illinois at Chicago Center for Research on Women and Gender, 1640 W. Roosevelt Rd., Chicago, IL, 60608, USA. ymolin2@uic.edu. 7. Karmanos Cancer Institute of Wayne State University, 4100 John R St, Detroit, MI, 48201, USA. ymolin2@uic.edu. 8. Division of Community Health Sciences, School of Public Health, 1603 W. Taylor St., MC 923, Chicago, USA. ymolin2@uic.edu.
Abstract
PURPOSE: We explored how lifetime comorbidities and treatment-related cancer symptoms were associated with quality of life (QOL) in rural cancer survivors. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
PURPOSE: We explored how lifetime comorbidities and treatment-related cancer symptoms were associated with quality of life (QOL) in rural cancer survivors. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
Authors: Mari Lashbrook; Christina M Bernardes; Marilynne N Kirshbaum; Patricia C Valery Journal: Aust J Rural Health Date: 2018-05-25 Impact factor: 1.662
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Authors: Shaila M Strayhorn; Marquita W Lewis-Thames; Leslie R Carnahan; Vida A Henderson; Karriem S Watson; Carol E Ferrans; Yamilé Molina Journal: Support Care Cancer Date: 2020-08-15 Impact factor: 3.603