Health-related quality of life in breast cancer: A cross-cultural survey of German, Japanese, and South Korean patients
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The aim of this study was to evaluate health-related quality of life (HRQOL) in breast cancer patients across countries, and to cross-culturally examine the impact of psychosocial factors on HRQOL.
Patients and methods
A total of 413 women with breast cancer from Germany (n=195), Japan (n=112), and Korea (n=106) completed a survey assessing HRQOL and HRQOL-related factors. HRQOL was measured using the Short-Form Health Survey (SF-8). Measures of psychological distress (Hospital Anxiety and Depression Scale and Impact of Event Scale-Revised), coping (Dealing with Illness Inventory-German Revised), and social support (Illness-Specific Social Support Scale-German Revised) were included.
The effect of the factor country on physical QOL was seen to be significant, but small (P=0.049, ES=0.018). The scales of General Health (P=0.023), Vitality (P=0.004), and Role Emotional (P=0.003) differed across countries, with the South Korean patients having lower scores compared to the German and Japanese patients. The nature of the impact of psychosocial factors on HRQOL did not differ greatly across countries except with regard to avoidance, however, the degree to which these factors influence HRQOL did differ greatly. Overall, depression, depressive coping, and problematic support showed a strong detrimental effect on the HRQOL of breast cancer patients.
Results from this study suggest that strategies which target an improvement of HRQOL in cancer patients should also consider the patients’ cultural and healthcare system contexts. Interventions are needed to improve detrimental psychosocial factors.
KeywordsHealth-related quality of life Breast cancer Culture Coping Social support Psychological distress
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The German part of this research was supported by the Cora Lobscheid Foundation and the Astrid-Haugstrup-Sörensen-Gedächtnisstiftung within the Donors’ Association for the Promotion of Sciences and Humanities in Essen, Germany (grant numbers T 129 – 12.171 and T 100 – 13.496). The authors thank Dr. Stefan Hentschel and his team from the Hamburg Cancer Registry.
- 16.Ware JE, Kosinski M, Dewey JE, Gandek B (1999) How to score and interpret single-item health status measures: a manual for users of the SF-8 TM Health Survey. QualityMetric Inc., Lincoln, RIGoogle Scholar
- 21.Weiss DS, Marmar CR (1997) The impact of event scale – revised. In: Wilson JP, Keane TM (eds) Assessing psychological trauma and PTSD. Guilford Press, New York, pp 399–411Google Scholar
- 23.Zaun S (2002) Psychometrische ÜberprÜfung und Weiterentwicklung des dealing with illness inventory – revised an einer Stichprobe aus einer onkologischen Rehabilitationsklinik. Dissertation, Universitätsklinikum Hamburg-Eppendorf, HamburgGoogle Scholar
- 25.Ramm GC, Hasenbring M (2003) Die deutsche Adaptation der Illness-Specific Social Support Scale und ihre teststatistische ÜberprÜfung beim Einsatz an Patienten vor und nach -Knochenmarktranplantation. Z Med Psychol 12:29–38Google Scholar
- 31.Skarstein J, Aass N, Fossa SD, Skovlund E, Dahl AA (2000) Anxiety and depression in cancer patients: relation between the Hospital Anxiety and Depression Scale and the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire. J Psychosom Res 49:27–34PubMedCrossRefGoogle Scholar
- 41.Organisation for Economic Co-operation and Development (OECD) (2005) OECD health data 2005. Available from URL: http://www.oecd.org/dataoecd/16/6/34970073.pdf [accessed July 28, 2005]Google Scholar