Life after cervical cancer: Quality of life among Chinese women (original) (raw)
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Health and Quality of Life Outcomes, 2010
Background: Women with cervical cancer now have relatively good 5-year survival rates. Better survival rates have driven the paradigm in cancer care from a medical illness model to a wellness model, which is concerned with the quality of women's lives as well as the length of survival. Thus, the assessment of quality of life among cervical cancer survivors is increasingly paramount for healthcare professionals. The purposes of this review were to describe existing validated quality of life instruments used in cervical cancer survivors, and to reveal the implications of quality of life measurement for Chinese cervical cancer survivors. Methods: A literature search of five electronic databases was conducted using the terms cervical/cervix cancer, quality of life, survivors, survivorship, measurement, and instruments. Articles published in either English or Chinese from January 2000 to June 2009 were searched. Only those adopting an established quality of life instrument for use in cervical cancer survivors were included. Results: A total of 11 validated multidimensional quality of life instruments were identified from 41 articles. These instruments could be classified into four categories: generic, cancer-specific, cancer site-specific and cancer survivor-specific instruments. With internal consistency varying from 0.68-0.99, the test-retest reliability ranged from 0.60-0.95 based on the test of the Pearson coefficient. One or more types of validity supported the construct validity. Although all these instruments met the minimum requirements of reliability and validity, the original versions of these instruments were mainly in English. Conclusion: Selection of an instrument should consider the purpose of investigation, take its psychometric properties into account, and consider the instrument's origin and comprehensiveness. As quality of life can be affected by culture, studies assessing the quality of life of cervical cancer survivors in China or other non-English speaking countries should choose or develop instruments relevant to their own cultural context. There is a need to develop a comprehensive quality of life instrument for Chinese cervical cancer survivors across the whole survivorship, including immediately after diagnosis and for short-(less than 5 years) and long-term (more than 5 years) survivorship.
Impact of cervical cancer on quality of life of women in Hubei, China
Scientific Reports
We aimed to assess the quality of life (QOL) of the patients with cervical cancer after initial treatment, the factors affecting QOL and their clinical relevance. A total of 256 patients with cervical cancer who visited Zhongnan Hospital of Wuhan University from January 2017 to December 2017 were enrolled in this study. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 item (EORTC QLQ-C30) and cervical cancer module (EORTC QLQ-CX24) was used to assess the QOL of patients. More than half of the patients with cervical cancer reported an excellent QOL. Symptoms mostly experienced were insomnia, constipation, financial difficulties, and menopausal symptoms. Global QOL and social functioning were statistically associated with education level, occupation, the area of living, family income and treatment modality. Similarly, role functioning showed significant association with the stage of cancer, treatment modality and time since diagnosis. The rural area of living and poor economic status of the patients with cervical cancer has a negative impact on overall quality of life. Younger and educated patients are more worried about sexuality. Patients treated with multiple therapies had more problems with their QOL scales than patients treated with surgery only. Cervical Cancer (CC) is the fourth most common female cancer with estimated incidence and mortality of 528,000 and 266,000 respectively in the world 1. China alone has around 18.7% (98,900 cases) of the total CC and 11.5% (30,500 deaths) of the total mortality in the world 2. Although the overall incidence of CC in China is lower than African or South Asian countries, there are specific regions such as Hubei province, the central part of China, with one of the highest prevalence of CC 3. Moreover, Wufeng county in Hubei province has the second highest incidence of CC and the highest mortality rate in China 4. Effective therapy for CC including surgery and concurrent chemoradiation can have a cure rate of 80% of women with early-stage disease [International Federation of Gynecology and Obstetrics (FIGO) stages I-II] and 60% of women with stage III disease 5. The survival rate of CC in China is also increasing probably due to the free screening program that began in 2009. However, the quality of life after treatment has been primarily neglected 6. The majority of patients with CC are diagnosed at a relatively younger age, and most of them have a long additional life expectancy with sequelae of the disease and its treatment. Therefore, the quality of life in CC survivors has become a more significant issue with the increased numbers of survivors 7. The Quality of Life (QOL) of patients with CC is an essential assessment for personalizing treatment and providing better care. CC survivors had clinically significant problems with social functioning, constipation, diarrhea, severe lymphedema, menopausal symptoms, reduced body image, sexual or vaginal functioning, as well as difficulties with their finances compared with the general female population. Studies have identified that health-related QOL can also help to predict survival in patients with cancer 8-10. There is a dearth of studies focused on the holistic care of the patients with CC primarily on post-treatment long-term QOL in China. It is essential to conduct such studies to identify and address the problem to improve their QOL. The objective of this study was to assess the QOL of the patients with CC after the initial treatment and identify factors that affect the QOL to provide a basis for improved comprehensive clinical care.
Purpose: The physical and emotional impact of cancer and its treatment may be detrimental to the sexual well-being of patients. We aimed to gain an in-depth insight on the impact of cancer on the sexual wellbeing of cancer patients living in a middle-income setting with limited supportive care services. Methods: Twenty focus group discussions, stratified by gender, were conducted among 102 patients with breast, cervical, colorectal, or prostate cancer. Participants were recruited from five hospitals in Klang Valley, Malaysia. Discussions were audio recorded and transcribed verbatim. Thematic analysis was performed using NVivo. Results: Three major themes emerged: loss, adjustments, and unmet supportive care needs. Under the main theme of loss, changes in physical appearances and childbearing abilities negatively impacted participants’ self-confidence and body image, particularly in the females. Changes in quality of sexual activity were commonly raised, which often brought about con...
Cancer, 2007
BACKGROUND. The purpose of this study was to identify problems related to long-term quality of life (QOL) and sexual function in cervical cancer survivors. METHODS. The authors enrolled 860 women (median time since diagnosis, 5.86 years) with a history of cervical cancer (stage I to IVa) who had been treated at any of 6 hospitals from 1983 through 2004 and 494 control subjects selected randomly from a representative sample of Korean women. Subjects filled out a questionnaire that included the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30, its Cervical Cancer Module, and additional sexual function items. RESULTS. Cervical cancer survivors had clinically significant worse problems with social functioning, constipation, diarrhea, and difficulties with their finances than controls (P < .01). Survivors also reported more severe lymphedema and menopausal symptoms and worse body image, sexual and/or vaginal functioning, and sexual worry (P < .01). Anxiety about sexual performance was more problematic in survivors than in controls (P < .01), as was dyspareunia for women who received radiotherapy (P < .01). CONCLUSIONS. These findings can increase the awareness of healthcare providers to the potential need for counseling and other interventions among women who have been successfully treated for cervical cancer and could help them improve their impaired QOL.
Quality of Life in Cervical Cancer Survivors and Healthy Women: Thai Urban Population Study
Asian Pacific journal of cancer prevention : APJCP, 2017
Background : To determine a baseline quality of life (QoL) in cervical cancer survivors compared to that of healthy subjects in the tertiary Thammasat University Hospital, Thailand. Materials and Methods: The investigation was conducted at the outpatient gynecological department of Thammasat University Hospital between January and June 2016. A total of 192 women were entered into the study (97 cervical cancer survivors; 37 after radical hysterectomy (RH), 43 with concurrent chemoradiation (CRT), and 17 featuring both RH and CRT; and 95 control subjects from the same outpatient department with no history of malignancy). Participant QoL was assessed using a Thai version of the EORTC-QLQ-C30 (European Organization for Research Treatment of Cancer Quality-of-Life) and a general survey for the assessment of sociodemographic data was also conducted. Results: There were significant differences in physical, role, emotional and social functions between cervical cancer survivor and control gr...
Chinese Women’s Sexuality Concerns After Gynecologic Cancer
Cancer Nursing, 2012
Background: Sexuality has been recognized as an integral aspect of quality of life. Issues surrounding sexuality have also been acknowledged to have a great impact on the quality of life of gynecologic cancer patients. Objectives: The objectives of this study were to describe sexual function and sexual activity among Chinese women after gynecologic cancer and to identify significant predicting factors of women's sexuality outcome changes. Methods: This is a descriptive correlational study that was performed in mainland China. A sexuality scale was used to assess women's sexuality outcomes. Results: A total of 156 Chinese women who had gynecologic cancer were included in this study. Study results revealed that sexual dysfunction was an important concern among these women (62.2%). The rate of sexual inactivity (70.5%) was relatively high. Reasons for sexual inactivity were related to worry about possibly weakening the potency of treatment (46.5%), fear of cancer recurrence (41.1%), and lack of sexual interest (31%). When looking at predictors of negative changes of women's sexuality after cancer, this study found that older age (950 years old) was associated with the decrease of sexual desire/interest (odds ratio, 3.64; confidence interval, 1.19Y11.16). Women who received radiation therapy had more severe vaginal dryness (odds ratio, 2.27; confidence interval, 1.10Y4.72) and were less sexually active than those who did not have radiation therapy. Conclusion: Chinese women after gynecologic cancer suffered from various sexuality concerns. Implications for Practice: Considering the high rates of sexual dysfunction and sexual inactivity, there is a need to integrate sexuality into routine nursing care.
Sexual Quality of Life in Gynecological Cancer Survivors in Iran
Asian Pacific journal of cancer prevention : APJCP, 2021
OBJECTIVE Patients with gynecological cancer might suffer from suboptimal sexual quality of life. This cross sectional study aimed to assess the sexual quality of life in the survivors of gynecological cancers and was recruited in a teaching hospital affiliated to Tehran University of Medical Sciences between 2018 and 2020. MATERIAL AND METHODS The data was collected by a web-based platform with validated self-administered questionnaires including demographic information, and the Sexual Quality of Life-Female (SQOL-F) questionnaire. The data were analyzed using appropriate tests. RESULTS Totally, 42% (106) of the participants had a sexual relationship in the last 6 months. The mean (SD) of sexual quality of life score was 46.84 (11.86) with the range of 0-90. The patients with cervical cancer had a worse sexual quality of life in Psychosexual Feelings (P=0.048) and Self-Worthlessness (p=0.036) compared with other gynecological cancers. Sexual quality of life did not improve or worse...
Changes in sexual life experienced by women in Taiwan after receiving treatment for breast cancer
International Journal of Qualitative Studies on Health and Well-being
As the number of breast cancer survivors increases, these patients with sexual problems also increase. For breast cancer survivors, sexual problems are a common and painful experience. Although breast cancer survivors often encounter sexual problems, Taiwanese women are culturally conservative and patients rarely discuss sex problems with clinicians. In this study, we used qualitative methods to better understand the changes in sexual life and related care strategies for breast cancer survivors. Twenty interviews were conducted on clinical patients enrolled in hospitals that received breast cancer treatment. The data were analysed by performing a constant comparative analysis. Three themes emerged: the causes of changes in sexual life, internal response strategies and external response strategies. Ten subthemes were identified. Changes in sexual life in patients with breast cancer in this study included changes related to body image, influence of friends and family, age, genital problems, and illegal love of a partner. Breast cancer survivors can tolerate and regulate sexual life changes by adopting internal and external response strategies. Medical staff must be sensitive and must understand strategies for dealing with sexual life changes that may occur during cancer adjustment and how these strategies can help women's well-being in the rest of their lives.