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Title: Health-related quality of life and its socio-economic and cultural predictors among advanced cancer patients: Evidence from the APPROACH cross-sectional survey in Hyderabad-India
Authors: Jacob, J.
Palat, G.
Verghese, N.
Chandran, P.
Rapelli, V.
Kumari, S.
Malhotra, C.
Teo, I.
Finkelstein, E. 
Ozdemir, S. 
Keywords: Advanced cancer
End-of-life care
Palliative care
Palliative oncology
Quality of life
Socio-demographic predictors
Issue Date: 2019
Publisher: BioMed Central Ltd.
Citation: Jacob, J., Palat, G., Verghese, N., Chandran, P., Rapelli, V., Kumari, S., Malhotra, C., Teo, I., Finkelstein, E., Ozdemir, S. (2019). Health-related quality of life and its socio-economic and cultural predictors among advanced cancer patients: Evidence from the APPROACH cross-sectional survey in Hyderabad-India. BMC Palliative Care 18 (1) : 94. ScholarBank@NUS Repository.
Rights: Attribution 4.0 International
Abstract: Background: Patients with advanced cancer often experience poor health-related quality-of-life (HRQoL) due to cancer and treatment-related side-effects. With India's palliative care landscape in its infancy, there is a concern that advanced cancer patients, especially individuals who are from disadvantaged populations experience poor HRQoL outcomes. We aim to assess HRQoL of advanced cancer patients in terms of general well-being (physical, functional, emotional, and social/family well-being), pain experiences, psychological state, and spiritual well-being, and determine the relationship between belonging to a disadvantaged group and HRQoL outcomes. We hypothesize that patients from disadvantaged or minority backgrounds, identified in this paper as financially distressed, female, lower years of education, lower social/family support, minority religions, and Non-General Castes, would be associated with worse HRQoL outcomes compared to those who are not from a disadvantaged group. Methods: We administered a cross-sectional survey to 210 advanced cancer patients in a regional cancer center in India. The questionnaire included standardized instruments for general well-being (FACT-G), pain experiences (BPI), psychological state (HADS), spiritual well-being (FACT-SP); socio-economic and demographic characteristics. Results: Participants reported significantly lower general well-being (mean ± SD) (FACT-G = 62.4 ± 10.0) and spiritual well-being (FACT-SP = 32.7 ± 5.5) compared to a reference population of cancer patients in the U.S. Patients reported mild to moderate pain severity (3.2 ± 1.8) and interference (4.0 ± 1.6), normal anxiety (5.6 ± 3.1) and borderline depressive symptoms (9.7 ± 3.3). Higher financial difficulty scores predicted most of the HRQoL domains (p ? 0.01), and being from a minority religion predicted lower physical well-being (p ? 0.05) and higher pain severity (p ? 0.05). Married women reported lower social/family well-being (p ? 0.05). Pain severity and interference were significant predictors of most HRQoL domains. Conclusions: Advanced cancer patients, especially those with lower financial well-being and belonging to minority religions, reported low physical, functional, emotional, social/family, and spiritual well-being, and borderline depressive symptoms. Future studies should be directed at developing effective interventions supporting vulnerable groups such as those with financial distress, and those belonging to minority religions. © 2019 The Author(s).
Source Title: BMC Palliative Care
ISSN: 1472-684X
DOI: 10.1186/s12904-019-0465-y
Rights: Attribution 4.0 International
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