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Lim: Health-related Needs and Quality of Life in Childhood Cancer Survivors
Original Article

Asian Oncology Nursing 2015; 15(4): 246-255.

Published online: 31 December 2015

DOI: https://doi.org/10.5388/aon.2015.15.4.246

Health-related Needs and Quality of Life in Childhood Cancer Survivors

Su-Jin Lim

College of Nursing, Incheon Catholic University, Incheon, Korea.

Address reprint requests to: Lim, Su-Jin. College of Nursing, Incheon Catholic University, 12 Haesong-ro, Yeonsu-gu, Incheon 22000, Korea. Tel: +82-32-830-7054, Fax: +82-32-830-7059, susanna@iccu.ac.kr

Received 17 August 2015       Revised 28 October 2015       Accepted 10 November 2015

© 2015 Korean Oncology Nursing Society

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of this study was to identify the health-related needs and quality of life in childhood cancer survivors and to identify the relationship between health-related needs and quality of life.

Methods

Data were collected from April 11 to May 30, 2014. The participants aged 18~35 years diagnosed with a childhood cancer had completed actual treatment (surgery, chemotherapy, or radiation therapy) at least two years earlier. They were randomly selected from among childhood cancer survivors under follow-up management after cancer treatment at three general hospitals in Korea. Descriptive statistics, t-tests, one-way ANOVA, the post-hoc Scheffé test, and Pearson's correlation coefficients were used to analyze the data.

Results

Among the 371 participants, 214 (57.7%) were male and the mean age was 22.5 years. The mean score for health-related needs was 2.72 out of 5. Positive self-motivation need had the highest mean score of domain. The mean score for quality of life was 5.92 out of 10. Health-related needs and quality of life were negatively correlated (r= - .70, p<.001).

Conclusion

Health-related needs of childhood cancer survivors should be regularly assessed to meet their needs and improve the quality of life of childhood cancer survivors.

Keywords: Childhood, Neoplasms, Survivors, Needs, Quality of Life

Figures and Tables

Table 1

Health-related Needs (N=371)

aon-15-246-i001
Domain Item M±SD
Total (41 items) 2.72 ± 0.78
Physical Total (5 items) 2.34 ± 0.94
01. Difficulty in concentrating 2.11 ± 1.24
02. Memory decline 2.40 ± 1.36
03. Difficulty in performing work 2.18 ± 1.23
04. Physical limitation 2.76 ± 1.37
05. Lack of energy & Fatigue 2.24 ± 1.07
Informational & health care system Total (11 items) 3.22 ± 1.02
06. Information about follow-up care 3.13 ± 1.36
07. Information about cancer recurrence 3.26 ± 1.39
08. Information about potential late-effects 3.22 ± 1.39
09. Various type of given information 3.16 ± 1.34
10. Information about what causes cancer 3.48 ± 1.39
11. Information about infertility 3.48 ± 1.33
12. Advice about nutrition and diet 3.37 ± 1.32
13. Comfortable mind 3.01 ± 1.48
14. Comprehensive health system 3.08 ± 1.31
15. Having health Professional who care me exclusively 2.96 ± 1.32
16. Health Professionals who have time to discuss issues 3.29 ± 1.24
Psychological Total (5 items) 2.27 ± 0.98
17. Difficulty in interacting with friends 1.83 ± 1.12
18. Feeling down or depressed 2.26 ± 1.29
19. Feeling loss of control over life 1.93 ± 1.25
20. Coping with changes to lifestyle 2.85 ± 1.35
21. Uncertainty about the future 2.49 ± 1.42
Social Total (4 items) 2.22 ± 0.92
22. Changes in the way others see me 2.16 ± 1.22
23. Talking to other people about cancer history 2.09 ± 1.30
24. Alcohol, tobacco, coffee etc 1.93 ± 1.25
25. Accepting changes in my appearance 2.69 ± 1.51
Cancer related psychosocial support Total (6 items) 2.18 ± 0.90
26 Physical disability concerns 2.77 ± 1.37
27 Recurrence concerns 2.47 ± 1.34
28 Fears about pain 2.07 ± 1.28
29 Counseling with health professionals 2.40 ± 1.28
30 Change of role within family 1.81 ± 1.12
31 Sexual dysfunction 1.53 ± 1.07
Financial support Total (4 items) 2.92 ± 1.02
32 Financial concern 3.13 ± 1.36
33 Extra expenses concern 3.25 ± 1.47
34 Difficulty in getting job 2.38 ± 1.40
35 Difficulty in insurance 3.64 ± 1.39
Positive selfmotivation need Total (6 items) 3.23 ± 1.00
36 Communication with survivors 3.12 ± 1.38
37 Opportunity to meet mentor 3.07 ± 1.44
38 Finding meaning in cancer experience 3.28 ± 1.42
39. Maintaining a positive outlook 3.14 ± 1.39
40. Opportunity to help other childhood cancer patients 3.64 ± 1.23
41 Transition to adult healthcare 3.13 ± 1.36
Table 2

Quality of Life (N=371)

aon-15-246-i002
Domain Item M ± SD
Total (41items) 5.92 ± 1.36
Physical Total (8 items) 7.38 ± 1.70
1. Fatigue 5.10 ± 2.81
2. Appetite changes 7.48 ± 2.87
3. Aches or pain 7.97 ± 2.52
4. Sleep changes 7.24 ± 3.01
5. Constipation 8.23 ± 2.70
6. Nausea 9.20 ± 1.71
7. Menstrual changes or fertility 7.86 ± 3.30
8. Rate your overall physical health 5.96 ± 2.15
Psychological Total (15 items) 5.68 ± 1.66
9. How difficult is it for you to cope today as a result of your disease and treatment? 7.24 ± 2.69
10. How good is your quality of life? 6.59 ± 2.11
11. How much happiness do you feel? 6.66 ± 2.29
12. To what degree do you feel like you are in control of things in your life? 6.20 ± 2.22
13. How satisfying is your life? 6.44 ± 2.27
14. How is your present ability to concentrate or to remember things? 5.77 ± 2.44
15. How useful do you feel? 7.13 ± 2.49
16. Has your illness or treatment caused changes in your appearance? 4.70 ± 3.53
17. Has your illness or treatment caused changes in your self concept (the way you see yourself)? 3.57 ± 2.82
How distressing were the following aspects of your illness and treatment?
18. Initial diagnosis 3.93 ± 3.57
19. Cancer treatment (chemotherapy,radiation surgery) 2.01 ± 2.35
20. Completion of treatment 5.65 ± 3.08
21. How much anxiety do you have? 6.24 ± 2.94
22. How much depression do you have? 6.70 ± 2.79
To what extent are you fearful of
23. Future diagnostic tests 6.14 ± 3.18
24. A second cancer 5.64 ± 3.54
25. Recurrence of your cancer 5.36 ± 3.59
26. Spreading (metastasis) of your cancer 6.23 ± 3.65
Social Total (8 items) 5.92 ± 1.90
27. How distressing has your illness been for your family? 3.09 ± 2.88
28. Is the amount of support you receive from others sufficient to meet your needs? 5.32 ± 2.89
29. Is your continuing health care interfering with your personal relationships? 7.60 ± 2.96
30. Is your sexuality impacted by your illness? 8.51 ± 2.71
31. To what degree has your illness and treatment interfered with your employment? 6.19 ± 3.33
32. To what degree has your illness and treatment interfered with your activities at home? 6.09 ± 3.17
33. How much isolation do you feel is caused by your illness? 6.25 ± 3.27
34. How much financial burden have you incurred as a result of your illness and treatment? 4.34 ± 3.31
Spiritual Total (6 items) 5.92 ± 1.36
35. How important to you is your participation in religious activities such as praying, going to church or temple? 3.22 ± 3.59
36. How important to you are other spiritual activities such as meditation and praying? 2.82 ± 3.32
37. How much has your spiritual life changed as a result of cancer diagnosis? 4.42 ± 3.38
38. How much uncertainty do you feel about your future? 5.21 ± 3.01
39. To what extent has your illness made positive changes in your life? 5.71 ± 2.83
40. Do you sense a purpose/mission for your life or a reason for being alive? 5.96 ± 2.89
Table 3

Difference in Health-related Needs and Quality of Life by Characteristics of Participants (N=371)

aon-15-246-i003
Variables Categories n (%) Health-related needs Quality of life
M ± SD t or F (p) Scheffé M ± SD t or F (p) Scheffé
Gender Male 214 (57.7) 2.68 ± 0.77 - 1.03 (.304) 6.09 ± 1.30 2.71 (.007)
Female 157 (42.3) 2.77 ± 0.78 6.00 ± 1.41
Age (year) 18~25 307 (82.8) 2.70 ± 0.79 0.57 (.634) 5.96 ± 1.37 0.20 (.896)
26~30 47 (12.7) 2.83 ± 0.69 5.80 ± 1.30
31~35 12 (3.2) 2.85 ± 0.78 5.95 ± 1.42
36~40 5 (1.3) 2.58 ± 0.89 5.73 ± 1.55
M ± SD 22.50 ± 4.20
Marital status Married (living with partner) 13 (3.5) 2.71 ± 0.76 - 0.04 (.966) 5.96 ± 1.51 0.90 (.931)
Unmarried 358 (96.5) 2.72 ± 0.78 5.92 ± 1.36
Residence Metropolitan (capital) area 245 (66.0) 2.73 ± 0.77 0.30 (.739) 5.90 ± 1.35 1.25 (.287)
Province 123 (33.2) 2.71 ± 0.80 6.00 ± 1.36
Abroad 3 (0.8) 2.39 ± 1.02 4.79 ± 2.30
Religion Yes 204 (55.0) 2.77 ± 0.79 1.30 (.196) 6.02 ± 1.36 1.47 (.143)
No 167 (45.0) 2.66 ± 0.75 5.81 ± 1.36
Highest education ≤ Middle school graduate 37 (10.0) 2.81 ± 0.92 2.62 (.074) 5.95 ± 1.67 0.97 (.379)
High school graduate 202 (54.4) 2.63 ± 0.76 6.01 ± 1.38
≥ College/university graduate 132 (35.6) 2.82 ± 0.74 5.79 ± 1.24
Employment status Employed 322 (86.8) 2.67 ± 0.76 2.99 (.004) 6.03 ± 1.34 - 3.78 ( < .001)
Unemployed 49 (13.2) 3.03 ± 0.79 5.26 ± 1.32
Sexual activity Yes 95 (25.6) 2.81 ± 0.75 - 1.34 (.182) 5.86 ± 1.31 0.53 (.599)
No 276 (74.4) 2.69 ± 0.78 5.95 ± 1.38
Smoking Yes 33 (8.9) 3.05 ± 0.74 2.66 (.011) 5.45 ± 1.51 - 1.93 (.061)
No 338 (91.1) 2.69 ± 0.77 5.97 ± 1.34
Drinking Yes 219 (59.9) 2.67 ± 0.70 - 1.41 (.159) 5.95 ± 1.23 0.44 (.662)
No 152 (40.1) 2.79 ± 0.87 5.89 ± 1.54
Exercise Yes 292 (78.7) 2.70 ± 0.77 - 0.95 (.343) 5.98 ± 1.35 1.52 (.132)
No 79 (21.3) 2.79 ± 0.78 5.71 ± 1.40
Diagnosis Leukemiaa 145 (39.1) 2.56 ± 0.77 3.03 (.004)
a<b		 6.12 ± 1.36 2.17 (.036)
a > b
Central nerve system tumorb 56 (15.1) 3.01 ± 0.84 5.51 ± 1.53
Lymphomac 68 (18.3) 2.82 ± 0.71 5.95 ± 1.21
Bone tumord 18 (4.9) 2.92 ± 0.68 5.35 ± 1.33
Ovary cancere 4 (1.1) 3.04 ± 0.60 6.86 ± 0.99
Neuroblastomaf 8 (2.2) 2.91 ± 0.89 5.39 ± 1.42
Soft tissue sarcomag 16 (4.3) 2.65 ± 0.83 5.93 ± 1.36
Othersh 56 (15.0) 2.51 ± 0.64 6.06 ± 1.28
Treatment types received Surgery only 8 (2.2) 2.25 ± 0.55 0.74 (.640) 6.87 ± 1.32 1.73 (.100)
Chemotherapy only 91 (24.5) 2.65 ± 0.74 6.17 ± 1.34
Surgery + Radiation 2 (0.5) 2.51 ± 0.41 6.26 ± 1.74
Surgery + Chemotherapy 57 (15.4) 2.69 ± 0.75 5.96 ± 1.40
Radiation + Chemotherapy 62 (16.7) 2.76 ± 0.82 5.82 ± 1.19
Surgery + Radiation + Chemotherapy 61 (16.4) 2.74 ± 0.80 5.90 ± 1.40
(Allo) Bone marrow transplant 86 (23.2) 2.81 ± 0.82 5.62 ± 1.43
Other 4 (1.1) 2.77 ± 0.37 6.24 ± 0.49
Late-effect Yes 202 (54.4) 2.94 ± 0.77 6.35 ( < .001) 5.43 ± 1.33 - 8.54 ( < .001)
No 169 (45.6) 2.45 ± 0.70 6.52 ± 1.14
Table 4

Correlation between Health-related Needs and Quality of Life

aon-15-246-i004
Variables Needs QOL Physical Psychological Social Spiritual
r (p) r (p) r (p) r (p) r (p) r (p)
Needs 1.00
QOL - .70 ( < .001) 1.00
 Physical - .50 ( < .001) .71 ( < .001) 1.00
 Psychological - .74 ( < .001) .92 ( < .001) .54 ( < .001) 1.00
 Social - .60 ( < .001) .78 ( < .001) .49 ( < .001) .67 ( < .001) 1.00
 Spiritual - .08 (.142) .49 ( < .001) .20 ( < .001) .28 ( < .001) .13 ( < .001) 1.00

QOL=Quality of life.

Notes

This work was supported by the Incheon Catholic University Research Grant of 2015.

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