177 research outputs found
Sexual functioning in male survivors of lymphoma: a systematic review
No full textIntroduction: the lymphomas [Hodgkin’s Lymphoma (HL) and Non-Hodgkin’s Lymphoma (NHL)] are among the most common cancers affecting men under 45 years. Survival rates are now excellent, but treatment is associated with a number of side effects including sexual dysfunction with potential implications for compromised QoL (quality of life). Aims: to address the: (i) prevalence of sexual dysfunction among lymphoma survivors relative to the general population, survivors of other cancers, and in survivors of HL and NHL; and (ii) relationships between sexual functioning and disease and treatment, demographic, and psychological variables. Methods: inclusion criteria were quantitative studies that focused on adult male survivors of lymphoma, included a comparison group and presented results separately for HL and NHL. Standardized systematic searches were used. Information about design, sample size, age, time since diagnosis, type of treatment, comparison group, measures and findings were extracted from eligible studies.Results: ten articles met the inclusion criteria, of which nine included patients with HL only, and one included patients with HL or NHL. Sexual function was compromised relative to the general population, better than testicular cancer survivors, and worse than leukaemia survivors. Depression was consistently associated with sexual dysfunction. There was evidence that chemotherapy, relapse, reduced testosterone levels, older age at survey and worse physical QoL were associated with worse sexual function. Conclusions: conclusions are limited by methodological issues including lack of utilization of standardized measures of sexual function and longitudinal research. Even so, there is evidence of sexual dysfunction among lymphoma survivors. Clinicians need to be sensitive to these issues. Future longitudinal work is necessary to determine the likelihood of recovery.<br/
Health related quality of life (HRQoL) in survivors of lymphoma: a systematic review and methodological critique
No full textSurvival rates for Hodgkin’s Disease and Non-Hodgkin’s Lymphoma have improved in recent years. However, these improvements are associated with various late effects, which can compromise health-related quality of life (HRQoL). Assessment is essential to identify patients at most risk for compromised HRQoL , but is dependent on availability of reliable and sensitive measures. This review therefore aimed to: (i) identify and evaluate commonly used measures; (ii) compare HRQoL in lymphoma patients with the general population; (iii) assess the impact of different treatments on HRQoL; and (iv) identify associations between HRQoL and demographic, medical and psychological variables. Standardized systematic searches identified 18 eligible studies which reported quantitative results by histologic diagnosis and included adult survivors of lymphoma. Information about design, sample, measures and findings was extracted from each study. The SF-36 and the EORTC QLQ-C30 were the most commonly used measures. Survivors of lymphoma experienced worse physical but comparable mental HRQoL to the general population. No conclusions could be drawn about the effects of different treatments on HRQoL. Correlates of better HRQoL included younger age (physical), educational level, being employed, male gender, earlier stage disease, not having co-morbid illnesses, and meeting public health exercise guidelines. Limitations of current research relating to research design, sample demographics and reporting of descriptive statistics were identified. Given the increasing numbers of patients living with lymphoma, controlled studies using cancer-specific instruments are required to determine the extent of physical and psychological consequences associated with the conditio
Developmental and family factors
No full textThis chapter will provide an overview of two major topics. The first section will focus on children’s perceptions and experience of illness in themselves and their families. This section will review evidence from studies examining the psychological impact of illness as well as those which have evaluated interventions to improve outcome.The second section focuses on the role of the family in illness. This covers ways in which couples cope with illness, and the impact of support provided. The final section examines the impact on the family of a child’s illness and the role of interventions in facilitating coping and outcomes<br/
Implications of sperm banking for health-related quality of life up to 1 year after cancer diagnosis
No full textBackground: Sperm banking is recommended for all men diagnosed with cancer where treatment is associated with risk of longterm gonadatoxicity, to offer the opportunity of fatherhood and improved quality of life. However, uptake of sperm banking is lower than expected and little is known about why men refuse. Our aims were to determine: (i) demographic and medical variables associated with decisions about banking and (ii) differences in quality of life between bankers and non-bankers at diagnosis (Time 1 (T1)) and 1 year later (Time 2 (T2)).Methods: Questionnaires were completed by 91 men (response rate¼86.67%) at T1 and 78 (85.71% response rate) at T2.Results: In all, 44 (56.41%) banked sperm. They were younger and less likely to have children than non-bankers. In a subset of men who were not sure if they wanted children in the future (n¼36), 24 banked sperm. Among this group, those who banked were younger, more satisfied with clinic appointments and less worried about the health of future children. At T2, there were no differences in quality of life between bankers and non-bankers.Conclusion: For those who are uncertain about future reproductive plans, decisions depend on their health on diagnosis and satisfaction with clinic care. We conclude that extra care should be taken in counselling younger men who may have given little consideration to future parenting. Results support previous findings that the role of the doctor is vital in facilitating decisions, especially for those who are undecided about whether they wanted children in the future or not
Quality of life implications as a consequence of surgery: limb salvage, primary and secondary amputation
No full textPurpose. We investigated self-reported quality of life (QoL), body image and daily competence of patients as a consequence of limb salvage surgery (LSS), primary or secondary amputation, and the views of patients following secondary amputation.Patients. Patients (n=37) had all been treated for osteosarcoma or Ewing's sarcoma in the lower limb.Methods. QoL was measured by questionnaire. A separate interview to determine satisfaction with decision-making was conducted with those treated for secondary amputation.Results. For the total group, QoL was below that expected from population norms. There were no differences in QoL between those undergoing LSS surgery compared with amputation. However, LSS reported better daily competence and were less likely to use a walking aid. For the total group, body image and daily competence were associated with better QoL.Discussion. All these patients are at risk of compromised QoL following surgery. Our data are in line with previous work suggesting outcomes may be better for LSS compared with amputation. Following secondary amputation, most patients (80%) did not regret initial LSS treatment, but felt that the time gained allowed them to come to terms with subsequent surger
Health-Related Quality of Life in Patients with Hepatocellular Carcinoma: A Systematic Review
No full textBACKGROUND & AIMS: This systematic review was conducted to identify the following: (1) generic and disease-specific measures used to assess health -related quality of life ( HRQOL) in patients with hepatocellular carcinoma (HCC); (2) HRQOL in patients with HCC compared with those with chronic liver disease and the general population; (3) effects of treatment (liver surgery, hepatic artery transcatheter treatment, and radiotherapy) on HRQOL; (4) relationships between physical variables, symptoms, and HRQOL; (5) relationships between demographic characteristics, psychological variables, and HRQOL; and (6) effects of psychological interventions on HRQOL. METHODS: Computerized databases including British Nursing Index, Cumulative Index to Nursing and Allied Health Literature, Cochrane library, PsychoINFO, and Pubmed were searched. RESULTS: Thirty- six articles were identified. The results suggested the following. Four original articles described the development of standardized measures to assess liver cancer-specific HRQOL. Patients with HCC reported worse physical, emotional, and functional HRQOL, but better social/family HRQOL compared with the general population. HRQOL improved after liver surgery, hepatic artery transcatherer treatment, and radiotherapy. Better liver function, early stage of disease, and no recurrence were correlated positively with better HRQOL; and pain, fatigue, nausea, and performance status were associated with worse HRQOL. HRQOL was correlated negatively with depression, uncertainty, chance health locus of control, and positively with satisfaction with medical services. Psychosocial interventions may reduce negative feelings and enhance HRQOL. CONCLUSIONS: Future work should explore the effects of psychological variables on HRQOL and the interaction between physical and psychological variables in relation to HRQOL
Gender differences in self-reported late effects, quality of life and satisfaction with clinic in survivors of lymphoma
No full textObjectives: gender differences in perceived vulnerability to late effects and views about follow-up among cancer survivors have received little attention. As lymphoma affects both genders similarly, we compared the consequences of cancer (late effects, perceived vulnerability and quality of life (health-related quality of life (HRQoL)), and satisfaction with clinic visits between genders.Methods: a cohort of 115 younger adults (18–45 years, >5 years disease-free survival), who had been treated for lymphoma participated. Questionnaires (n = 91) were completed before and after (n = 62) routine consultant-led appointments. Survivors (n = 24) without appointments were recruited by post. Questionnaires included HRQoL, late effects, perceived vulnerability, issues survivors wanted to discuss and reported discussing in clinic, time waiting in clinic and consultation satisfaction.Results: there were no gender differences in number of self-reported late effects or perceived vulnerability. Men with more late effects reported worse psychological HRQoL (r = 0.50, p<0.001). While men wanted to discuss more topics than they did, women were able to discuss the topics they wanted (ANOVA, p = 0.01). Multiple regression analyses showed a shorter wait in clinic (r = ?0.46, p = 0.009) and discussing more topics (r = 0.34, p = 0.06) explained 30.6% of the variance in consultation satisfaction for men.Conclusions: issues surrounding follow-up provision are increasingly important given the length of survival in young adults following treatment for lymphoma. Men may experience poor psychological well-being due to distress about unanswered concerns. Consideration of their concerns should be prioritised, given that satisfaction and ultimately continued attendance at clinic and HRQoL may be dependent on the extent to which follow-up meets survivors' expectation
Health-related quality of life in patients with hepatocellular carcinoma: the mediation effects of illness perceptions and coping
No full textBackground The aims of this study were to explore health-related quality of life (HRQOL) in patients with hepatocellular carcinoma (HCC). We report the following: (1) differences in HRQOL between patients with HCC and the general population; (2) significant physical and psychological predictors of HRQOL; and (3) mediation effects of illness perceptions and coping on HRQOL. Methods Patients with HCC (n=286) from Taiwan completed standardized measures of HRQOL, illness perception (cognitive representations, emotional representations and illness comprehensibility) and coping (emotion-oriented and problem-orientation coping). Demographic and physical variables were also collected. Results Patients with HCC had worse global HRQOL, physical, role, cognitive and social functioning, but better emotional functioning than the general population. Physical variables and cognitive representation were significant predictors of global HRQOL, physical functioning and emotional functioning. Cognitive representation mediated the relationships between physical variables and global HRQOL, physical functioning and emotional functioning, but coping only mediated the relationship between cognitive representation and global HRQOL. Conclusions The results suggest that physical variables have direct effects on global HRQOL and physical functioning, but there were also partial mediations through cognitive representation. The effect of physical variables on emotional functioning was mediated through cognitive and emotional representations. Patients with better performance status and positive illness perceptions tended to report better HRQOL, but those with negative illness perceptions and who used more emotion-oriented coping had worse HRQOL. Limitations of the work associated with use of theory and measures developed in Europe and the US are discussed, as are the clinical implications for patients with HCC. Copyright (c) 2012 John Wiley & Sons, Ltd
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