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Change in quality of life in Chinese women with breast cancer: changes in psychological distress as a predictor

  • Supportive Care International
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Abstract

Introduction

The effect of fluctuating psychological distress on quality of life (QoL) scores is not well delineated. We examined how changes in psychological distress affected change in QoL over time in 259 Chinese women recovering from breast cancer (BC).

Patients and methods

Women were interviewed during their first postoperative outpatient visit for chemotherapy (Baseline), at 3 months (FU1), and at 6 months after Baseline (FU2). Respondents completed the Chinese version of the FACT-G version-3 scale [FACT-G (Ch)]. Psychological distress was assessed using three categorical measures of depression, mood, and boredom. Linear mixed effects (LME) models examined whether changes in psychological distress predicted subsequent changes in QoL.

Results

Respondents’ mood improved significantly over time from baseline to FU2 (Baseline/FU2: standardized β = −0.266, p < 0.005; FU1/FU2: standardized β = −0.243, p < 0.005). Changes in depression scores consistently predicted subsequent changes in overall (standardized β = 4.96; 95% CI, 3.749, 6.171, p < 0.001), physical (standardized β = 1.752; 95% CI, 1.209, 2.294, p < 0.001), and functional (standardized β = 0.872; 95% CI, 0.308, 1.436, p < 0.001) QoL scores.

Conclusions

The magnitude of change in psychological distress significantly impacted physical and functional, but not social QoL in Chinese BC patients. These data highlight the need to address psychological and physical distress as part of the drive to improve physical and functional QoL for women with BC.

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Notes

  1. There were four possible interaction terms: ΔDepression×ΔMood, ΔDepression×ΔBoredom, ΔMood×ΔBoredom, and ΔDepression×ΔMood×ΔBoredom.

  2. Interaction terms added in follow-up LME analyses: Model 1, ΔDepression × ΔMood × ΔBoredom; Model 2, ΔDepression × ΔMood; Model 3, ΔDepression × ΔBoredom.

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Acknowledgements

This project was supported by grants from the Hong Kong Government Health Services Research Committee (HSRC # 821005) and a donation from Mr. CS Suen. The following people contributed to the study in different ways and at different times, and their help is acknowledged: PHK Choi FRCR, DTK Choy FRCR, WYC Foo, WH Lau FRCR, AWM Lee, SF Leung, SKO FRCR, Dr. JST Sham FRCR, VKC Tse, FRCR, KH Wong, Professor CLW Chan for suggestions regarding the questionnaire, and Dr. CLM Yu whose efforts in coordinating the project are deeply appreciated. Finally, we thank all patients and their families who gave their time to this project at a most difficult point in their lives.

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Authors and Affiliations

  1. Health Behavioral Research Group, Department of Community Medicine & Unit for Behavioral Sciences, School of Public Health, The University of Hong Kong, 5/F William M. W. Mong Block, Faculty of Medicine Building, 21 Sassoon Road, Pokfulam, Hong Kong

    Wing S. Wong & Richard Fielding

  2. Centre for Psycho-Oncology Research & Training, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 5/F William M. W. Mong Block, Faculty of Medicine Building, 21 Sassoon Road, Pokfulam, Hong Kong

    Richard Fielding

  3. Department of Community Medicine & Unit for Behavioral Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 5/F William M. W. Mong Block, Faculty of Medicine Building, 21 Sassoon Road, Pokfulam, Hong Kong

    Richard Fielding

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  1. Wing S. Wong
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Correspondence to Richard Fielding.

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Wong, W.S., Fielding, R. Change in quality of life in Chinese women with breast cancer: changes in psychological distress as a predictor. Support Care Cancer 15, 1223–1230 (2007). https://doi.org/10.1007/s00520-006-0190-y

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