Health-related Quality of Life among Breast Cancer Patients from Palestine: an Assessment with EuroQoL-5 Dimensions Scale

Supervisor :

Dr. Samah Al-Jabi

Abstract:

Background:Increasing incidence rates of breast cancer among Palestinian women, and the cancer impact on survivors lives necessitates the importance of increased knowledge about patients health related quality of life (HRQoL). 

Purpose:The purposes of this study were to assess the HRQoL among breast cancer patients, to examine the effects of many socio-demographic aspects, and to identify the impact of breast cancer clinical characteristics and treatment options on quality of life using EuroQoL EQ-5D scale.

Design:A cross-sectional descriptive and hospital-based study.

Methods:A convenient sample was collected over 6 months from four oncology centers in West-Bank, Palestine in 2014. The EuroQol-5 Dimension scale was used to assess patients' HRQoL. Non-parametric tests (Kruskal Wallis and Mann Whitney tests) of association where appropriately performed to investigate significant effects on QOL. Descriptive statistics were used to describe socio-demographic and disease related clinical characteristics of the patients. All analysis were performed using SPSS version 16.0.

Results :A total of 244 breast cancer women were interviewed. The mean age (± SD) of all respondents was (52.7 ± 12.2) years. The majority of participants were obese 110 (45.1%), illiterate and primary educated 122 (50.0%), had moderate and high family monthly income 184 (75.4%), married 167 (68.4%), living in the city 135 (55.3%), unemployed 198(81.1%), non-smoker 224 (91.8%), with as many as ( 62.7%) of them without family history of Breast cancer. In regard of breast cancer characteristics, IDC was the highest frequent type 205 (88.4%), stage 2  was viewed to be the highest among responders 136 (56.4%) and the majority of patients (72.8%) underwent  mastectomy (MRM). HRQoL was good,  The median of EQ-5D index was 0.72 (IQR:0.51-0.84), the median of EQ-VAS was 70 (IQR: 55-80) and there was a significantly strong positive correlation (R = 0.51; p < 0.001) between the EQ-5D-5L index values and the reported EQ-VAS scores. A significant association were found between education, income, employment, spirituality, exercise, DM, HTN, BCT and TNM staging with HRQoL.

Conclusion:Palestinian breast cancer survivors reported favorable overall quality of life.  higher educational attainments, higher family monthly income, highly spiritual thoughts and believes, high physical activity and exercising have been highly significantly associated with better overall HRQoL. Furthermore, breast conservational therapy (BCT) was also significantly improving QOL among Palestinian women. Thus, improve overall QOL should be considered a very important goal in treatment of breast cancer.