Julia Mo1, Cynthia A Thomson2, Virginia Sun3, Christopher S Wendel4, Mark C Hornbrook5, Ronald S Weinstein6, Elizabeth Ercolano7, Marcia Grant3, Zuleyha Cidav8, Ruth C McCorkle7, Robert S Krouse9. 1. Department of Surgery, University of Pennsylvania, 3400 Spruce St., 4 Silverstein, Philadelphia, PA, 19104, USA. 2. Mel & Enid Zuckerman College of Public Health and University of Arizona Cancer Center, Tucson, AZ, USA. 3. Division of Nursing Research and Education, City of Hope, Duarte, CA, USA. 4. College of Medicine, University of Arizona, Tucson, AZ, USA. 5. Center for Health Research, Kaiser Permanente, Portland, OR, USA. 6. Arizona Telemedicine Program, University of Arizona, Tucson, AZ, USA. 7. School of Nursing, Yale University, West Haven, CT, USA. 8. Center for Mental Health, University of Pennsylvania, Philadelphia, PA, USA. 9. Department of Surgery, University of Pennsylvania, 3400 Spruce St., 4 Silverstein, Philadelphia, PA, 19104, USA. robert.krouse@pennmedicine.upenn.edu.
Abstract
BACKGROUND: Cancer survivors (CS) with ostomies may face challenges in sustaining physical activity (PA) levels and maintaining healthy diets. This analysis describes lifestyle behaviors and their relationships with health-related quality of life (HRQOL) in CS with ostomies. METHODS: This is a cross-sectional, secondary analysis of a multisite randomized self-management education trial for CS with ostomies. The baseline self-reported measures were queried on aerobic PA and diet using the City of Hope Quality of Life Ostomy measure, and the Self-Efficacy to Perform Self-Management Behaviors questionnaire (SE). PA was compared against the American Cancer Society PA guidelines for CS. Relationships between PA and HRQOL were evaluated using multiple linear regression, stratified by BMI. RESULTS: Among 200 responders, fewer than 20% met or exceeded the PA guideline for cancer survivors; overall, confidence in the ability to perform gentle or aerobic PA was moderate (6/10 on the SE). Overall HRQOL (p = 0.038), psychological well-being (p = 0.017), and physical strength (p = 0.025) were associated with increased PA. Almost half (48.7%) of CS reported a special diet. CS with urostomies were less likely to report diet adjustments after their ostomy surgeries (OR: 0.16, 95% CI [0.08-0.38]) than CS with fecal ostomies. CONCLUSIONS: Better HRQOL is associated with PA guideline achievement among CS with ostomies. Additionally, diet adjustments were reported more frequently in CS with fecal ostomies. Our findings bear clinical relevance for designing ostomy self-management and lifestyle recommendations for CS with ostomies. IMPLICATIONS FOR CANCER SURVIVORS: The evaluation of lifestyle behaviors may be an especially important focus for CS with ostomies.
BACKGROUND: Cancer survivors (CS) with ostomies may face challenges in sustaining physical activity (PA) levels and maintaining healthy diets. This analysis describes lifestyle behaviors and their relationships with health-related quality of life (HRQOL) in CS with ostomies. METHODS: This is a cross-sectional, secondary analysis of a multisite randomized self-management education trial for CS with ostomies. The baseline self-reported measures were queried on aerobic PA and diet using the City of Hope Quality of Life Ostomy measure, and the Self-Efficacy to Perform Self-Management Behaviors questionnaire (SE). PA was compared against the American Cancer Society PA guidelines for CS. Relationships between PA and HRQOL were evaluated using multiple linear regression, stratified by BMI. RESULTS: Among 200 responders, fewer than 20% met or exceeded the PA guideline for cancer survivors; overall, confidence in the ability to perform gentle or aerobic PA was moderate (6/10 on the SE). Overall HRQOL (p = 0.038), psychological well-being (p = 0.017), and physical strength (p = 0.025) were associated with increased PA. Almost half (48.7%) of CS reported a special diet. CS with urostomies were less likely to report diet adjustments after their ostomy surgeries (OR: 0.16, 95% CI [0.08-0.38]) than CS with fecal ostomies. CONCLUSIONS: Better HRQOL is associated with PA guideline achievement among CS with ostomies. Additionally, diet adjustments were reported more frequently in CS with fecal ostomies. Our findings bear clinical relevance for designing ostomy self-management and lifestyle recommendations for CS with ostomies. IMPLICATIONS FOR CANCER SURVIVORS: The evaluation of lifestyle behaviors may be an especially important focus for CS with ostomies.
Authors: Cheryl L Rock; Colleen Doyle; Wendy Demark-Wahnefried; Jeffrey Meyerhardt; Kerry S Courneya; Anna L Schwartz; Elisa V Bandera; Kathryn K Hamilton; Barbara Grant; Marji McCullough; Tim Byers; Ted Gansler Journal: CA Cancer J Clin Date: 2012-04-26 Impact factor: 508.702
Authors: John L Gore; Mark S Litwin; Julie Lai; Elizabeth M Yano; Rodger Madison; Claude Setodji; John L Adams; Christopher S Saigal Journal: J Natl Cancer Inst Date: 2010-04-16 Impact factor: 13.506