What Defines Quality of Life for Older Patients Diagnosed with Cancer? A Qualitative Study

Abstract

The treatment of cancer can have a significant impact on quality of life in older patients and this needs to be taken into account in decision making. However, quality of life can consist of many different components with varying importance between individuals. We set out to assess how older patients with cancer define quality of life and the components that are most significant to them. This was a single-centre, qualitative interview study. Patients aged 70 years or older with cancer were asked to answer open-ended questions: What makes life worthwhile? What does quality of life mean to you? What could affect your quality of life? Subsequently, they were asked to choose the five most important determinants of quality of life from a predefined list: cognition, contact with family or with community, independence, staying in your own home, helping others, having enough energy, emotional well-being, life satisfaction, religion and leisure activities. Afterwards, answers to the open-ended questions were independently categorized by two authors. The proportion of patients mentioning each category in the open-ended questions were compared to the predefined questions. Overall, 63 patients (median age 76 years) were included. When asked, “What makes life worthwhile?”, patients identified social functioning (86%) most frequently. Moreover, to define quality of life, patients most frequently mentioned categories in the domains of physical functioning (70%) and physical health (48%). Maintaining cognition was mentioned in 17% of the open-ended questions and it was the most commonly chosen option from the list of determinants (72% of respondents). In conclusion, physical functioning, social functioning, physical health and cognition are important components in quality of life. When discussing treatment options, the impact of treatment on these aspects should be taken into consideration.

Reliability and validity of the cancer-related dysfunctional beliefs and attitudes about sleep scale in cancer patients

“…Cancer is a source of stress, which, together with the effects of anti-tumor therapy, causes a series of physiological and psychological imbalances in patients, with changes in sleep, cognition, and behavior. Sleep disorders, such as insomnia, run through the entire process of diagnosis [ 3 – 5 ], treatment and regression of cancer patients, seriously affecting their quality of life [ 6 , 7 ]. Several surveys have shown that insomnia is the most common sleep disorder in cancer patients [ 8 – 10 ].…”

Care quality and satisfaction at the cancer hospital – a questionnaire study of older patients with cancer and their family members

“…The main need of older patients with cancer is the maintenance of their independence and freedom. Physical mobility is important for performing the activities that give them joy and satisfaction in life [ 8 ]. In addition, needs based on the individual’s personal circumstances, preconceptions, and knowledge about cancer affect their experience regarding the quality of care [ 6 ].…”

Interventions to improve nutritional status for older patients with cancer – a holistic approach is needed

“…QoL, physical function, patient preferences) has been previously described, though, these endpoints are often neither a priority nor appropriately investigated in randomized controlled trials (RCTs) [10,11 ▪▪ ]. However, these endpoints are often more important for the patients than survival benefit in itself [12,13].…”