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Chun and Noh: Influence of Urinary Dysfunction on Quality of Life in Women with Cervical Cancer after Radical Hysterectomy
Original Article

Asian Oncol Nurs 2019;19(3):150-158.

Published online: 12 September 2019

DOI: https://doi.org/10.5388/aon.2019.19.3.150

Influence of Urinary Dysfunction on Quality of Life in Women with Cervical Cancer after Radical Hysterectomy

Nami Chun1, Gie-Ok Noh2

1College of Nursing, Sungshin Women's University, Seoul

2College of Nursing, Konyang University, Daejeon, Korea

Address reprint requests to: Noh, Gie-Ok College of Nursing, Konyang University, 158 Gwanjeodong-ro, Seo-gu, Daejeon 35365, Korea Tel: +82-42-600-8575 Fax: +82-42-600-8555 E-mail: nkorn91@konyang.ac.kr

Received 4 July 2019       Revised 19 August 2019       Accepted 9 September 2019

Copyright © 2019 Korean Oncology Nursing Society

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

This study was conducted to identify the quality of life (QOL) and the influence of urinary dysfunction on QOL in women with cervical cancer after radical hysterectomy.

Methods

A secondary analysis was conducted using data collected for a previous study of Chun et al. and the same subjects of a group of 157 cervical cancer patients. Novel data from the EORTC QLQ-C30 and QLQ-CX24 were used in addition to the results of urinary dysfunction from the previous study. Descriptive analysis of EORTC QLQ-C30 and QLQ-CX24 results and a multiple regression analysis were conducted to explore the influence of urinary dysfunction on global QOL.

Results

Subjects showed low QOL especially for social, physical and role function in the EORTC QLQ-C30 as well as the QLQ-CX24. Intensity of urinary dysfunction (p<.001) as well as daily life distress due to urinary dysfunction (p<.001) were the most significant factors affecting QOL in women with cervical cancer after radical hysterectomy.

Conclusion

Results suggest that oncology nurses should pay attention to the relatively low QOL of post-hysterectomy patients. They should also consider the influence of urinary dysfunction on QOL when developing nursing intervention programs to increase the QOL for women with cervical cancer after radical hysterectomy.

Keywords: Hysterectomy, Uterine cervical neoplasms, Urination disorders, Quality of life

References

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Table 1.
Differences of Quality of Life to Characteristics in Women with Cervical Cancer (N= 157)
Variables Categories n (%) or M ± SD Quality of Life t/F p
M ± SD
Age (year) 30∼39 13 (8.3) 59.62 ± 15.16 .34 .852
40∼49 30 (19.1) 61.39 ± 15.39    
50∼59 64 (40.8) 59.64 ± 22.13    
60∼69 38 (24.2) 57.24 ± 18.50    
70∼79 12 (7.6) 54.86 ± 23.42    
Religion status Yes 110 (70.1) 60.30 ± 18.58 1.31 .192
No 47 (29.9) 55.85 ± 21.49    
Presence of spouse Yes 117 (74.5) 61.04 ± 19.35 2.30 .023
No 40 (25.5) 52.92 ± 19.02    
Occupation Yes 64 (40.8) 62.89 ± 19.13 2.04 .043
No 93 (59.2) 56.45 ± 19.63    
Education Middle school or below 41 (26.1) 56.30 ± 21.55 .54 .585
High school 75 (47.8) 60.11 ± 19.34    
College or above 41 (26.1) 59.76 ± 18.06    
Monthly income (10,000 won) ＜100≥ 27 (17.2) 51.85 ± 18.82 1.73 .163
≥ 100∼＜300≥ 63 (40.1) 59.39 ± 22.02    
≥ 300∼＜500 43 (27.4) 60.27 ± 16.75    
≥ 500 24 (15.3) 63.54 ± 16.81    
Number of family member 1 21 (13.4) 49.21 ± 22.35 3.73 .026
2≥ 3 46 (29.3)90 (57.3) 57.97 ± 16.1061.76 ± 19.87 c c＞ a, b*
≥ 3 90 (57.3) 61.76 ± 19.87    
FIGO stage Stage I Stage II 132 (84.1) 25 (15.9) 60.42 ± 19.1151.67 20.69 2.07 .040
Stage II 25 (15.9) 51.67 ± 20.69    
Treatment type Surgery only 73 (46.5) 58.11 ± 19.59 –.55 .585
Surgery + additional treatment 84 (53.5) 59.82 ± 19.63    
Surgery type RAH 102 (65.0) 57.84 ± 21.04 .53 .590
LRH 45 (28.7) 61.30 ± 15.40    
LARVH 10 (6.4) 60.83 ± 21.53    
Nerve sparing in surgery Yes 11 (7.0) 57.50 ± 20.20 –.25 .800
No 146 (93.0) 59.13 ± 19.59    
Ovaries removed Yes 106 (67.5) 58.09 ± 20.00 –.85 .394
No 51 (32.5) 60.95 ± 18.67    
Time since surgery (month) 1∼12 26 (16.6) 58.33 ± 19.00 .13 .940
13∼36 25 (15.9) 58.33 ± 19.54    
37∼60 37 (23.6) 60.81 ± 19.03    
＞60 69 (43.9) 58.57 ± 20.41    
Current voiding type Self-voiding 149 (94.9) 59.62 ± 19.87 4.43 ＜.001
CIC 8 (5.1) 47.92 ± 5.89    
Lower extremities lymphedema Yes 43 (27.4) 55.43 ± 23.07 1.25 .215
No 114 (72.6) 60.31 ± 17.96)    

* Scheffé post hoc; FIGO= International Federation of Gynecology and Obstetrics; RAH= Radical abdominal hysterectomy; LRH= Laparoscopic radical hysterectomy; LARVH= Laparoscopy assisted radical vaginal hysterectomy; CIC= Clean intermittent catheterization

Table 2.
Urinary Dysfunction and Quality of Life in Women with Cervical Cancer (N= 157)
Variables Subcategories Items M ± SD Min Max
Urinary dysfunction Intensity   1.19 ± 0.82 0 3.40
Daily Life Distress   1.09 ± 0.93 0 3.90
Quality of life: EORTC QLQ-C30 Global quality of life   59.02 ± 19.57 0 100
Functional scales Physical functioning 79.02 ± 16.94 26.67 100
Role functioning 79.51 ± 24.23 0 100
Emotional functioning 73.62 ± 25.21 0 100
Cognitive functioning 74.42 ± 19.84 0 100
Social functioning 77.07 ± 26.38 0 100
Symptom scales/items Fatigue 38.57 ± 23.72 0 100
Nausea and vomiting 9.24 ± 18.81 0 100
Pain 11.68 ± 18.44 0 100
Dyspnea 11.89 ± 20.33 0 100
Sleep disturbance 32.70 ± 33.64 0 100
Appetite loss 16.14 ± 25.77 0 100
Constipation 34.18 ± 34.37 0 100
Diarrhea 12.10 ± 21.73 0 100
Financial problem 25.90 ± 30.80 0 100
Quality of life: EORTC QLQ-CX24 Symptom scale Symptom experience 15.50 ± 12.13 0 63.64
    Body Image 32.13 ± 29.65 0 100
    Sexual/vaginal functioning 38.46 ± 29.49 g (N= 65) 0 100
  Symptom items Lymphoedema 14.44 ± 27.29 0 100
    Peripheral neuropathy 19.53 ± 26.97 0 100
    Menopausal symptoms 21.87 ± 26.88 0 100
    Sexual worry 27.81 ± 35.97 0 100
  Functional items Sexual activity 87.26 ± 21.86 0 100
    Sexual enjoyment (N= 65 71.79 ± 24.465) 0 100

EORTC QLQ= European Organization for Research and Treatment of Cancer Quality of Life Questionnaire.

Table 3.
Correlation between Intensity of Urinary Dysfunction / Daily Life Distress and Global Quality of Life in Women with Cervical Cancer (N= 157)
Variables Intensity Daily life distress
r (p) r (p)
Global QOL –.51 (＜.001) –.53 (＜.001)

QOL= Quality of life.

Table 4.
Influence of Intensity of Urinary Dysfunction on Quality of Life in Women with Cervical Cancer (N= 157)
Variables B SE β t p
(Constant) 75.44 5.72 　 13.19 ＜.001
Urinary dysfunction: intensity –11.89 1.64 –.50 –7.27 ＜.001
Presence of spouse* –5.20 3.66 –.12 –1.42 .157
Occupation* –7.29 2.73 –.18 –2.67 .008
FIGO stage* –3.78 3.68 –.07 –1.03 .306
Number of family members=2* 5.33 5.02 .12 1.06 .290
Number of family members=3* 4.18 4.78 .11 0.87 .383
    Adjusted R2=.30, F=12.22, p＜.001  

* Dummy variable; Presence of spouse (0= yes), Occupation (0= yes), FIGO stage (0= stage I), Number of family members (0= 1).

Table 5.
Influence of Daily Life distress on Quality of Life in Women with Cervical Cancer (N= 157)
Variables B SE β t p
(Constant) 72.57 5.52 　 13.14 ＜.001
Urinary dysfunction: daily life distress –10.71 1.44 –.51 –7.43 ＜.001
Presence of spouse* –4.49 3.64 –.10 –1.24 .219
Occupation* –6.53 2.71 –.17 –2.42 .017
FIGO stage* –3.27 3.67 –.06 –0.89 .374
Number of family members= 2* 4.44 4.99 .10 0.89 .375
Number of family members= 3* 4.10 4.75 .10 0.86 .389
    Adjusted R2=.31, F=12.66, p＜.001  

* Dummy variable; Presence of spouse (0= yes), Occupation (0= yes), FIGO stage (0= stage I), Number of family members (0= 1).

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