Health-related quality of life in Chinese inpatients with lung cancer treated in large general hospitals: across-sectional study

Abstract

ObjectiveIn China, psychosocial problems of patients with cancer are under-recognised and undertreated in medical oncology practice. This study examined the health-related quality of life (QOL) in inpatients with lung cancer treated in large general hospitals and explored the demographic, clinical and psychosocial factors associated with QOL.DesignCross-sectional study.Participants and settingAltogether, 148 inpatients with lung cancer were consecutively recruited from two large general hospitals in Tianjin, China.Main outcome measuredQOL, pain intensity, depressive and anxiety symptoms, and social support were assessed with WHO QOL Scale Brief Version, four-point Verbal Rating Scale, Hospital Anxiety and Depression Scale and Social Support Rating Scale, respectively.ResultsCompared with the normative data for the Chinese general population, patients had significantly lower scores in physical (t=−25.860, p<0.001) and psychological (t=−18.225, p<0.001) QOL. Being unmarried (β=−2.471, 95% CI −4.908 to –0.034), poor economic status (β=−1.764, 95% CI −2.964 to –0.564), cancer metastasis (β=−1.328, 95% CI −2.632 to –0.024), poor performance status (β=−0.959, 95% CI −1.542 to –0.376), depression (β=−0.465, 95% CI −0.631 to –0.299), anxiety (β=−0.208, 95% CI −0.354 to –0.062) and low utilisation of social support (β=−0.344, 95% CI −0.577 to –0.111) were independently associated with poor physical QOL, while female gender (β=−1.494, 95% CI −0.649 to –2.339), less education years (β=−0.209, 95% CI −0.294 to –0.123), currently receiving chemotherapy (β=−1.536, 95% CI −3.051 to –0.021), small-cell cancer (β=−1.157, 95% CI −2.223 to –0.091), more intense pain (β=−0.535, 95% CI −0.919 to –0.151), poor performance status (β=−0.930, 95% CI −1.383 to –0.477), anxiety (β=−0.178, 95% CI −0.248 to –0.108) and inadequate subjective social support (β=−0.137, 95% CI −0.153 to –0.121) were independently associated with poor psychological QOL.ConclusionsInpatients with lung cancer treated in Chinese large general hospitals have poorer QOL than the general population. Effective prevention and management of psychosocial problems are potentially effective to improve their QOL.

Peer Review #1 of "Quality of life of older Chinese adults receiving primary care in Wuhan, China: a multi-center study (v0.2)"

“…Given the many deleterious effects of depression on both physical and mental health (Zhong et al 2015), it is reasonable to find the significant association of depression with poor QOL. Overall, our findings on these physical and psychosocial correlates of poor QOL are consistent with previous studies (Cao et al 2016;Chen et al 2013;Gu et al 2018;Zhu et al 2018).…”

“…Considering the negative effects of major medical conditions on physical QOL, and hearing problem on daily functioning, the significant associations of diminished QOL with more major medical conditions and hearing problem in our study are expected (Gopinath et al 2012). The theory of QOL satisfaction model argues that unmet social needs are an important cause of reduced QOL (Gu et al 2018). Consistent with this theory, loneliness was found to be significantly associated with poor QOL in this study.…”

“…In traditional Chinese culture, adult children are a major source of social support for older adults (Zhong et al 2016b). Since social support plays an important role in buffering against the negative effects of stress, and protecting against physical and mental morbidities (Gu et al 2018), the relationship between no living adult children and poor QOL in our study might be explained by insufficient social support to older adults without adult children.…”

“…Quality of life (QOL) is an important outcome measure of health-care practice, which is broader than the definition of health and defined as a sense of well-being that encompasses physical health, role functioning, social functioning, and psychological health (Gu et al 2018;Post 2014;Yu et al 2016). To overcome the limitation of current disease-centered treatment in Chinese primary care, it is necessary to include QOL as an important therapeutic target of primary health-care.…”

Smartphone Use and Sleep Quality in Chinese College Students: A Preliminary Study

“…Developed by Shuiyuan Xiao in 1986, the SSRS has good reliability and validity (36). A higher total score in each subscale represents a higher level of social support (37).…”