Self-perceived burden predicts lower quality of life in advanced cancer patients: the mediating role of existential distress and anxiety

Lin, Xiaodan; Guiru, Xu; Chen, Guojuan; Xiao, Huimin

doi:10.1186/s12877-022-03494-6

Cited by 9 publications

(7 citation statements)

References 37 publications

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“…While other scholars attributed psychological and emotional consequences of cancer disease and treatment to unrelieved pain, their treatment decisions and prognosis, and ageing process [ 34 , 35 ] our findings suggested that uncertainty, poor treatment outcomes or recovery, fear of death, side effects from therapeutic procedures, cost of care, care-related expenses and inability to finance treatments including hospital stays, and transportation were crucial factors. This aligns with a previous study [ 36 ] that found the significance of high existential distress on poor quality of life of persons living with cancer. Compared to developed countries, this resource-deprived rural setting in Ghana lacks well-structured health facilities that provide treatment options and reduce outcome uncertainties as well as economic or welfare systems to offer financial support throughout diagnosis and treatment, particularly for the aged.…”

Section: Discussionsupporting

confidence: 93%

Impact of cancer diagnosis and treatment: a qualitative analysis of strains, resources and coping strategies among elderly patients in a rural setting in Ghana

Mensah,

Mikare,

Mensah

et al. 2023

BMC Geriatr

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Background Rurality is fraught with numerous difficulties including a lack of advanced health facilities to provide health services, and an absence of specialist cancer services, and qualified personnel, among others. These factors exacerbate the challenges of elderly patients diagnosed with cancer and further pose limitations to activities/instrumental activities of daily living. Yet, there is limited scholarship on the strains that affect elderly patients diagnosed with cancer and the resources that helps them to overcome them. This study explores the strains, resources, and coping strategies of elderly patients diagnosed with cancer and undergoing treatment in rural Ghana. Methods An exploratory, descriptive qualitative design was adopted. Purposive sampling was used to recruit 20 individuals to participate in in-depth interviews. The collected data was analysed inductively using Collaizi’s framework. QSR NVivo-12 was used in managing the data. Results The results were grouped into two main categories, namely: strains and resources. Within the category of strains, three main themes with their corresponding sub-themes emerged: cancer-related strains (systemic side effects from treatment, altered physical appearance and body image, and experience of pain), elderly strains (altered functional ability, limited social interactions and participation, psycho-emotional reactions, limited/restricted economic participation, and financial strains), and health system strains (negative attitude and insensitive communication, delay in diagnosis, lack of geriatric oncology care, lack of community-based specialist cancer centre and long travel distance to access care, and limited availability of essential cancer medicines and other radiations services). Four types of resources were available to cancer patients: personal resources, family resources, community resources, and healthcare systems resources. Conclusion In conclusion, elderly patients diagnosed with cancer experience physical, economic, psychological, and emotional strains that threaten their health and well-being. However, they are able to leverage family, community, and health system-related resources to navigate through the strains. There is, therefore, a need to expand advanced health facilities with geriatric oncology units and specialists to improve access to cancer care in rural areas. The government needs to assist elderly persons with costs associated with their diagnosis and treatment through the expansion of the National Health Insurance Scheme to include this as part of the benefits package.

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Section: Discussionsupporting

confidence: 93%

Impact of cancer diagnosis and treatment: a qualitative analysis of strains, resources and coping strategies among elderly patients in a rural setting in Ghana

Mensah,

Mikare,

Mensah

et al. 2023

BMC Geriatr

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“…Modified by Lin et al, 14 the Perceived Social Support Scale (PSSS) included 12 items in 3 dimensions: family support (4 items), friend support (4 items) and social support (4 items). Each item was scored on a scale of 1-7, with a total score of 12-84 points.…”

Section: Tilburg Frailty Indicatormentioning

confidence: 99%

Mediating the Role of Perceived Social Support Between Frailty and Self-Perceived Burden in Elderly Patients with Diabetes

Chen,

et al. 2024

PPA

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To explore the mediating effects of perceived social support between frailty and self-perceived burden (SPB) in elderly patients with diabetes and to provide a theoretical basis for reducing that burden. Methods: A total of 169 elderly patients with diabetes who were hospitalised in the endocrinology department of a third-class hospital in Wuxi between May 2020 and July 2022 were included in this study using the convenience sampling method. Patients were assessed by the general information questionnaire, the Chinese version of the Tilburg frailty inventory (TFI), the Self-Perceived Burden Scale (SPBS) and the Perceived Social Support Scale (PSSS). The SPSS 22.0 software was used for Pearson's correlation analysis and multiple linear regression analysis. Model four of the SPSS PROCESS was used for mediating the effect analysis. Results: The SPBS of elderly patients with diabetes was positively correlated with the TFI (P < 0.01) and negatively correlated with the PSSS (P < 0.01). The results of the Bootstrap test showed that the mediating effect of the PSSS on the relationship between the TFI and the SPBS in elderly patients with diabetes was 0.296 (95% CI: 0.007, 0.066), and the mesomeric effect accounted for 17.3% of the total effect. Conclusion:The debilitation of elderly patients with diabetes can be reduced by decreasing their SPB through perceived social support. This can be achieved through comprehensive interventions by nurses.

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“…And each item was given on a Likert-type format with 5 options (1 = none of the time, 5 = all of the time). The total score ranges from 10 to 50, with the following stages: none (10)(11)(12)(13)(14)(15)(16)(17)(18)(19), mild (20)(21)(22)(23)(24)(25)(26)(27)(28)(29), moderate (30)(31)(32)(33)(34)(35)(36)(37)(38)(39), and severe (40)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50). Wu and Jiang translated it into Chinese with satisfactory internal consistency coe cient (Cronbach's α = 0.91) [38].…”

Section: Self-perceived Burden Scale (Spbs)mentioning

confidence: 99%

“…Self-perceived burden (SPB) was another fundamental factor associated with QOL [23,24]. SPB is a multidimensional concept characterized as "individual's empathic concern engendered from the impact of his/her disease and care needs on family members, leading to psychological distress, self-blame, and a diminished sense of self-worth" [25], which includes psychological burden, economic burden, treatment burden and family burden.…”

Section: Introductionmentioning

confidence: 99%

Influence of financial toxicity on quality of life in lung cancer patients undergoing immunotherapy: the mediating effect of self-perceived burden

Zhang,

Xu,

Yang

et al. 2024

Preprint

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Background Although immunotherapy has the potential to prolong the median survival time and overall survival of patients with lung cancer, it is also a driver of immune related adverse events, which may directly affect the therapeutic effect and reduce quality of life (QOL). Attention to measure QOL in lung cancer patients undergoing immunotherapy is under-explored because of the therapy’s relative novelty. And a great deal of empirical researches has indicated the important influence of financial toxicity (FT) and self-perceived burden (SPB) on QOL. However, yet no research has ever clarified the relationship among FT, SPB, and QOL simultaneously. Hence, the purpose of this study is to understand the level of QOL of lung cancer patients undergoing immunotherapy, and attempt to clarify the potential mediating roles of SPB on the relationship between FT and QOL. Methods A convenience sample of 342 lung cancer patients undergoing immunotherapy was recruited from a cancer hospital from October 2022 to April 2023 in this cross-sectional study. Participants were requested to complete the structured questionnaires: sociodemographic and clinical questionnaire, Functional Assessment of Cancer Therapy–Lung (FACT-L), Self -Perceived Burden Scale (SPBS) and COmprehensive Score for financial Toxicity (COST). Data were subjected to Pearson correlation analysis and bootstrapping analysis in the structural equation modelling. Results The total score of FACT-L was (79.90 ± 15.84) points in 322 lung cancer patients administrated with immunotherapy. FT (β = 0.37, P < 0.01) and SPB (β = -0.27, P < 0.01) had a direct effect on QOL. In addition, SPB partly mediated the association between FT and QOL, and the standardized indirect effect was 0.19, accounting for 33.9% of the total effect. Conclusions The present study revealed that lung cancer patients undergoing immunotherapy experienced a lower QOL. And higher financial burden resulted in greater self-perceived burden, thus associated with inferior QOL. It is imperative for healthcare providers to routinely assessed QOL, financial toxicity or risk and self- perceived burden for lung cancer patients undergoing immunotherapy, and assist those patients in understanding the potential financial risk of each choice and help them take more active roles in their routine clinical care.

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Self-perceived burden predicts lower quality of life in advanced cancer patients: the mediating role of existential distress and anxiety

Cited by 9 publications

References 37 publications

Impact of cancer diagnosis and treatment: a qualitative analysis of strains, resources and coping strategies among elderly patients in a rural setting in Ghana

Impact of cancer diagnosis and treatment: a qualitative analysis of strains, resources and coping strategies among elderly patients in a rural setting in Ghana

Mediating the Role of Perceived Social Support Between Frailty and Self-Perceived Burden in Elderly Patients with Diabetes

Influence of financial toxicity on quality of life in lung cancer patients undergoing immunotherapy: the mediating effect of self-perceived burden

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