Quality of Life in Postoperative Colorectal Cancer Survivors: A Structural Equation Model

Abstract

Objective: The present study has been aimed at constructing a causal model to determine factors affecting healthrelatedquality of life (HRQoL) in postoperative patients with colorectal cancer (CRC) following discharge.Materials and Methods: A cross-sectional study was conducted with 396 postoperative CRC cancer patients fromten tertiary hospitals representing each of the four Regions of Thailand. Data was collected through a standardquestionnaire. Structure equation modeling (SEM) was applied to analyze data.Results: The findings revealed that the majority of patients with CRC surgery had a moderate HRQoL. One hundredand twenty-three patients (31.1%) had complications. SEM showed a good fit with ƛ2=40.347, df=28, p=0.062,GFI=0.980, CFI=0.959 and RMSEA=0.033. The final model showed that age, stage of cancer and healthcare servicebeing received following CRC surgery had direct effects on HRQoL. Nutritional status and follow-up outpatientclinic had indirect effects on HRQoL during postoperative complications. Moreover, social support and primaryfamily caregiver support had indirect effects on HRQoL through self-management capacity.Conclusion: The findings of this study emphasized the importance of implementing effective strategies to improvequality of life among postoperative patients with CRC after discharge and indicated these strategies should focuson quality of healthcare service following CRC surgery, self-management capacity and prevention of postoperativecomplications. Postoperative complications can be reduced by providing effective follow-up in outpatient clinicsand nutritional status management, consequently improving quality of life among this population.

Factors contributing to the quality of life among Thai patients diagnosed with colorectal cancer with a stoma: An integrative review

“…These results are consistent with the prior studies in other countries, which found that marital status, sexual activity and healthcare provider support were significantly associated with QOL in CRC ostomates (Alenezi et al, 2021;Andrade et al, 2016). However, the family care levels were prominently reported with a strong relation to QOL in Thai CRC ostomates and differed from those in other countries (Atthaphinan & Lueboonthavatchai, 2017;Decha & Navicharern, 2016;Janthathai et al, 2018;Suttipong et al, 2021;Teerathongdee, 2014). It reflects that QOL in Thai CRC ostomates was influenced by the levels of care from the family where they lived as an extended family.…”

“…Themes were drawn from the abstraction and synthesis procedure, The relationships between QOL and sociodemographic and clinical variables, such as personal characteristics and illness history, had been studied to understand the influence of these variables on QOL in Thai CRC ostomates. Six quantitative studies tested the associations between sociodemographic and clinical variables and QOL (Atthaphinan & Lueboonthavatchai, 2017;Chutikamo et al, 2017;Decha & Navicharern, 2016;Janthathai et al, 2018;Maneesin et al, 2012;Suttipong et al, 2021).…”

“…Eight quantitative studies evaluated the correlations between physiological variables and QOL (Atthaphinan & Lueboonthavatchai, 2017;Chinuntuya & Chutitorn, 2020;Chutikamo et al, 2017;Decha & Navicharern, 2016;Janthathai et al, 2018;Maneesin et al, 2012;Suttipong et al, 2021;Teerathongdee, 2014).…”

“…The result demonstrated that unmet needs had a significantly negative relationship with QOL, whereas higher levels of self-esteem had a significantly positive relationship with QOL (Chutikamo et al, 2017;Janthathai et al, 2018). ostomates (Atthaphinan & Lueboonthavatchai, 2017;Chutikamo et al, 2017;Decha & Navicharern, 2016;Janthathai et al, 2018;Maneesin et al, 2012;Suttipong et al, 2021;Teerathongdee, 2014).…”

“…In the Thai population, previous research studies have demonstrated that the majority of the CRC ostomates had a moderate to high QOL (Atthaphinan & Lueboonthavatchai, 2017;Chinuntuya & Chutitorn, 2020;Chutikamo et al, 2017;Decha & Navicharern, 2016;Janthathai et al, 2018;Maneesin et al, 2012;Suttipong et al, 2021;Teerathongdee, 2014). It is noticeable that Thai ostomate's QOL is different from those in other countries with a mild to moderate QOL (Ahmed et al, 2019;Chinh et al, 2018;Goldstine et al, 2019;Liao & Qin, 2014;Pierzak et al, 2016).…”