Quality of life and understanding of disease status among cancer patients of different ethnic origin

Abstract

Patients managed in European or North American cancer centres have a variety of ethnic backgrounds and primary languages. To gain insight into the impact of ethnic origin, we have investigated understanding of disease status and quality of life (QoL) for 202 patients. Patients completed questionnaires in their first language (52 English, 50 Chinese, 50 Italian, 50 Spanish or Portuguese), including the Functional Assessment of Cancer Therapy -General (FACT-G) QoL instrument, questions about disease status, expectations of cure and the language and/or type of interpretation used at initial consultation. Physicians also evaluated their status of disease and expectation of cure, and performance status was estimated by a trained health professional. The initial consultation was usually provided in English (except for 32% of Chinese-speaking patients); interpretation was provided by a family member for 34% of patients with limited English proficiency (LEP) and by a bilingual member of staff for 21%. Patients underestimated their extent of disease and overestimated their probability of cure (P ¼ 0.001 and o0.0001, respectively). Estimates of probability of cure by the English speakers were closer to those of their physicians than the other groups (P ¼ 0.02). English-speaking patients reported better and Italian-speaking patients poorer overall QoL (Po0.001 for Italian vs other groups). Performance status was correlated with QoL and most closely related with the extent of disease. Understanding of cultural differences is important for optimal management of patients with cancer.

Quality of Life of Patients Operated on for Low Rectal Cancer: Impact of the Type of Surgery and Patients' Characteristics

“…In other studies, stoma and nonstoma patients were compared, but a great proportion of these patients had undergone high anterior resection, which is associated with better function and quality of life than low anterior resection. 1,2,4,19 Second, to avoid cultural differences, 12 only patients living on the French territory were eligible for our study. Finally, instead of relying only on the global impact of the surgery or stoma status on QoL variables, we also considered individual patient characteristics by conducting differential statistical analyses.…”

“…QoL results are not easy to generalize, because the impact of a diagnosis or treatment can differ solely because of cultural difference. 3,4,7,12 Third, the impact of rectal surgery on QoL may also depend on patient-related factors, such as age, gender, education, or marital status. 13 Previous studies performed on patients sustaining various malignancies have shown associations between QoL scores and age, 14,15 education level, 13 marital status, 13,16 and social support.…”

Response and Non-response to a Quality-of-Life Question on Sexual Life: A Case Study of the Simple mean Imputation Method

“…The researchers, Fayers et al, proposed several checks to apply to the observed data before using the simple mean imputation [1] Despite a widely recognised need to assess perception of HRQoL in relation to cultural, ethnic and religious characteristics, not much is known about this in non-Caucasian populations [9,10]. A few studies investigated HRQoL and patterns of responses to HRQoL questions in African-American and Hispanic patients [2,8,11].…”

The Singaporean English and Chinese versions of the EQ-5D achieved measurement equivalence in cancer patients

“…Patients in many cancer centers in North America and Europe have a variety of ethnic and language backgrounds [2]. Quantitative confirmation of equivalence between different language versions of the same instrument is an important issue in the development and application of health-related quality-of-life (HRQoL) measures, both for use within multiethnic societies and for multi-country studies and cross-cultural comparison [3].…”