Health-related quality of life and the predictive role of sense of coherence, spirituality and religious coping in a sample of Iranian women with breast cancer: a prospective study with comparative design

Abstract

BackgroundThere is disagreement among studies of health-related quality of life (HRQoL) changes in breast cancer patients over time. Reportedly, assessment of HRQoL prior to diagnosis may be crucial to provide a clear point of comparison for later measurements. The aims of this study were (1) to investigate changes in HRQoL, sense of coherence (SOC), spirituality and religious coping in a group of women with breast cancer from the pre-diagnosis phase to 6 months later in comparison with a control group, and (2) to explore the predictor role of SOC, spirituality, and religious coping within the breast cancer group at the 6-month follow-up.MethodsA sample of women with breast cancer (n = 162) and a matched control group (n = 210) responded to the following instruments on both occasions: the European Organization for Research and Treatment of Cancer QLQ-C30, the SOC Scale, the Spiritual Perspective Scale and the Brief Religious Coping Scale. A series of General Linear Model (GLM) Repeated Measures was used to determine changes between the groups over time. Also, Multiple Linear Regression analyses were applied to each of the HRQoL dimensions, as dependent variable at the 6 months follow-up.ResultsPhysical and role function, fatigue, and financial difficulties were rated worse by the women with breast cancer during the first 6 months in comparison to the controls, which was both a statistically (p < 0.001) and clinically significant difference. Women had better scores for global quality of life (p < 0.001), and emotional functioning (p < 0.01) during the same period of time. The degree of SOC (p < 0.01) and baseline ratings of several dimensions of HRQoL (p < 0.05) were the most important predictors of HRQoL changes.ConclusionsCollecting HRQoL data before a final diagnosis of breast cancer is important to identify women at risk of deterioration in HRQoL during and after treatment. Special attention should be paid to physical and role functioning impairment, fatigue, and financial difficulties experienced by these women. These results underscore that the degree of SOC may be more important as a predictor for HRQoL changes in this sample than spirituality and religious coping.

Psychological adjustment after breast cancer: a systematic review of longitudinal studies

“…Regarding education level, 3 studies found that higher education level predicted better quality of life and fewer depressive symptoms . Nine studies found no association .…”

“…Three studies found that advanced cancer stage predicted poorer quality of life, but 2 studies found no associations . Two studies examined the association between the number of lymph nodes affected and psychological adjustment.…”

Anxiety and Depression in Cancer Patients: The Association with Religiosity and Religious Coping

“…The growing literature showed mixed results on the association between religious coping and cancer distress (Trevino et al 2014;Rohani et al 2015;Zamanian et al 2015). In a systematic review of 17 studies examining religious/spiritual coping strategies in cancer adjustment, Thuné-Boyle et al (2006) found seven of the studies showed some evidence for the beneficial effect of religious coping, with one study showing religious coping to be detrimental in a subgroup of their population.…”

Self-reported health-related quality of life (HRQoL) and factors affecting HRQoL among individuals with health insurance in Iran

“…Meanwhile, approximately six million people have SSIO insurance in Tehran city [12,13]. Evidence has been published regarding the HRQoL of patients with many diseases and chronic conditions in Iran [14,15]. Nonetheless, insufficient evidence-based information regarding HRQoL and its determinants within the essential health and health-related insurance system in Tehran and throughout Iran has been published.…”