A comparison of the clinical determinants of health-related quality of life and subjective well-being in long-term breast cancer survivors

Abstract

Research concerning long-term breast cancer survivors (BCS) has primarily analysed their health-related quality of life (HRQoL). However, other dimensions of life considered important by patients might be affected by cancer treatments as well. The aim of this paper is thus to compare the clinical determinants of HRQoL and of overall quality of life as described by measures of subjective well-being (SWB) in long-term BCS. SWB represents a person's own evaluation of their overall situation. A total of 321 French BCS diagnosed 5 to 15 years ago participated in a cross-sectional mailed survey. Outcome measures were the physical and mental health scores of the 36-item Short-Form survey and measures of SWB (happiness, life satisfaction and the positive and negative affect scales). Multivariate regression analyses suggest that HRQoL and SWB measures provide different pictures of the experience of breast cancer. Treatment type has no impact on HRQoL but is correlated with all our SWB measures while time since diagnosis positively affects physical health but not SWB. We conclude that it could be fruitful to analyse SWB, alongside the traditional study of HRQoL, in order to enhance our understanding of the various long-lasting consequences of breast cancer.

Gender, race, BMI, and social support in relation to the health-related quality of life of cancer survivors: a report from the American Cancer Society’s Study of Cancer Survivors II (SCS-II)

“…Consistent with prior research [17,18,56], higher education was significantly correlated with higher mental HRQoL. Gender differences emerged with being married or in a married-like relationship being associated with higher mental HRQoL among only males and older age being only significantly associated with higher mental HRQoL among females.…”

“…For example, in terms of physical HRQoL, this study's findings support previous research that younger age [18,22], being employed [17,18], and females married or in a marriedlike relationship [15] are associated with higher physical HRQoL. Additionally, those with a higher number of experienced comorbidities and females with cancer recurrence, metastasis, or multiple cancer diagnoses were found to have poorer physical HRQoL [15,[20][21][22]].…”

“…Additionally, those with a higher number of experienced comorbidities and females with cancer recurrence, metastasis, or multiple cancer diagnoses were found to have poorer physical HRQoL [15,[20][21][22]]. Yet, a higher cancer stage and closer time to diagnosis were not significantly associated with lower physical HRQoL within this sample despite significant results in prior studies [18,19]. These insignificant findings may be due to variations in significance for cancer stage and time since diagnosis across different cancer types.…”

“…Correlates of poorer physical and mental HRQoL among survivors include lack of a partner [15], low socioeconomic status (SES) [15][16][17][18], advanced cancer stage [19,20], invasive or systemic treatments [20,21], shorter time since diagnosis [18], and increased frequency of comorbidities and symptoms [15,[20][21][22]. Age affects each domain of HRQoL differently, with older age negatively correlating with physical HRQoL [18] and younger age negatively correlating with mental HRQoL [15]. Differences in HRQoL according to race have been largely understudied with mixed results due to limited minority representation within cancer survivorship studies [23][24][25].…”

Happiness and health in psychiatry: what are their implications?

“…However, identify what makes life happy can be useful in various types of health prevention (primary, secondary and tertiary) 84 . This particularly applies to promoting mental health as specified in the WHO parameters: a state of well-being in which people can understand and use their own skills, deal with the stresses of life, work and love, and may contribute to their communities 8,9 .…”