Background
Methods
Procedure
Sample
Measures
− − − − − − − | Global quality of life (gQoL) Physical functioning (PF) Emotional functioning (EF) Cognitive functioning (CF) Role functioning (RF) Social functioning (SF) Fatigue |
Statistical analyses
Results
Quality of life in patients and healthy controls
Score | M ± SD Study population | M ± SD Healthy population a
| Difference |
---|---|---|---|
gQoL | 49.2 ± 22.0 | 70.8 ± 22.1 | 21.6 |
PF | 66.7 ± 20.9 | 90.1 ± 16.7 | 23.4 |
EF | 50.4 ± 28.6 | 78.7 ± 21.0 | 28.3 |
CF | 65.5 ± 29.4 | 91.2 ± 17.0 | 25.7 |
RF | 51.5 ± 30.9 | 88.0 ± 22.9 | 36.6 |
SF | 58.4 ± 32.0 | 91.0 ± 19.4 | 32.6 |
F | 56.4 ± 27.6 | 17.0 ± 22.0 | 39.4 |
Quality of life in different patient groups
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Age:A comparison of scale values from participants of different age groups was done. We are only reporting those results that are statistically and clinically significant [17]. Participants younger than 39 years had a slightly higher physical functioning than those older than 60. Emotional functioning was most impaired in the 40–59 year olds, while no difference between the two other groups was found. Social functioning was most impaired in the youngest group, followed by the middle and then by the oldest group. Fatigue symptoms were more pronounced in the middle than in the youngest group (see Table 3). For each of the age groups scale values differed significantly from values of similar age groups in the healthy population. However, the differences were more pronounced in the youngest group (≤39) and lowest in the oldest (≥60) for most scales. These results are shown in Table 4.Table 3Contains all clinically meaningful differences in scale values between participants in different age groupsScoreAge aNM ± SDp-valueDifferencePF≤3912971.7 ± 20.8.0007.3≥6067164.5 ± 20.5EF≤3912654.47 ± 25.7.0077.540–59101446.9 ± 28.940–59101446.9 ± 28.9.0008.2≥6065255.0 ± 28.0SF≤3912952.8 ± 30.1.0019.9≥6067762.8 ± 30.840–59102956.2 ± 32.8.0006.6≥6067762.8 ± 30.8F≤3912851.1 ± 66.7.0476.040–59103957.1 ± 77.8Table 4Shows mean scale values from the study population compared to the healthy population sample [16] in different age groupsScoreAge aM ± SD study populationM healthy population bDifferencegQoL≤3953.78 ± 20.3481.7027.9240–5947.25 ± 22.2772.8525.60≥6051.33 ± 21.6763.5512.22PF≤3971.68 ± 20.8098.1026.4240–5967.52 ± 21.2094.3026.78≥6064,50 ± 20,4982,4317.93EF≤3954.37 ± 25.7184.8030.4340–5946.87 ± 28.8580.1533.28≥6055.02 ± 28.0281.0025.98CF≤3968.72 ± 26.9896.9528.2340–5962.42 ± 30.5494.3031.88≥6069.72 ± 27.4486.3016.58SF≤3952.84 ± 30.1397.3044.4640–5956.19 ± 32.7592.8536.66≥6062.75 ± 30.8386.0023.25RF≤3954.97 ± 29.8396.7041.7340-5950.75 ± 31.1590.8040.05≥6051.88 ± 30.7681.4029.52F≤3951.13 ± 27.237.6043.5340–5957.12 ± 27.6712.1544.97≥6056.51 ± 20.3423.2033.31
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Gender:Between men and women in the study population, clinically meaningful differences were found for physical, emotional, cognitive and role functioning as well as for fatigue. Women reported stronger impairments than men. All found differences were classified as minor according to Osoba [17] (see Table 5).Table 5Contains all clinically meaningful score differences for men and womenScoreSexNM ± SDP valueDifferencePFMale53370.26 ± 21.61.0005.01Female129965.25 ± 20.57EFMale52856.63 ± 28.38.0008.88Female126447.75 ± 28.30CFMale53470.23 ± 27.33.0006.60Female130763.63 ± 29.99RFMale52456.04 ± 31.90.0006.52Female128949.52 ± 30.31FMale53151.04 ± 28.65.0007.68Female129058.72 ± 26.85
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Diagnosis:Between patients with different diagnoses, statistically and clinically meaningful differences concerning physical, emotional, cognitive, social, and role functioning as well as fatigue were found. Patients with prostate carcinoma reported less impairment than other patient groups in different domains of QoL: physical and role functioning were moderately increased compared to patients with breast cancer and malignancies of the female genital organs; emotional functioning was much higher than for patients with malignancies of thyroid and other endocrine glands; social functioning was moderately increased compared to patients with malignancies of the female genital organs; and fatigue symptoms were less distinct than in patients with breast cancer, malignancies of the female genital organs, with leukemia/lymphomas, and with gastrointestinal carcinoma. Patients with malignancies of thyroid and other endocrine glands reported decreased emotional functioning compared to patients with leukemia/lymphomas, with colorectal cancer, and with gastrointestinal carcinoma. Patients with breast cancer reported slightly decreased emotional and cognitive functioning compared to patients with colorectal carcinoma. Table 6 provides details of these results.Table 6Depicts statistically and clinically significant differences in scale values between groups of patients with different malignanciesScoreDiagnosisNM ± SDP valueDifferencePFBreast cancer82466.95 ± 19.58.0355.35Malignancies of female genital organs17461.30 ± 20.26PFBreast cancer82466.95 ± 19.58.0337.87Prostate carcinoma8574.82 ± 20.12PFMalignancies of female genital organs17461.30 ± 20.26.00013.52Prostate carcinoma8574.82 ± 20.12EFColorectal carcinoma21155.92 ± 28.83.0327.09Breast carcinoma80148.28 ± 28.37EFColorectal carcinoma21155.92 ± 28.83.00218.34Malignancies of thyroid and other endocrine glands5537.58 ± 26.88EFProstate carcinoma8458.73 ± 29.71.00221.15Malignancies of thyroid and other endocrine glands5537.58 ± 26.88EFHemoblastoses23452.03 ± 29.91.01514.45Malignancies of thyroid and other endocrine glands5537.58 ± 26.88EFgastrointestinal carcinoma9354.39 ± 29.09.01916.81Malignancies of thyroid and other endocrine glands5537.58 ± 26.88CFColorectal carcinoma21671.45 ± 27.28.0068.96Breast cancer82662.49 ± 30.19SFMalignancies of female genital organs17051.57 ± 33.00.03914.14Prostate carcinoma8765.71 ± 29.24RFBreast cancer82051.10 ± 29.56.04411.35Prostate carcinoma8762.45 ± 31.15RFMalignancies of female genital organs16848.12 ± 31.61.02514.33Prostate carcinoma8762.45 ± 31.15FBreast cancer82257.88 ± 26.77.00513.31Prostate carcinoma8744.57 ± 28.73FMalignancies of female genital organs16959.17 ± 25.96.00714.60Prostate carcinoma8744.57 ± 28.73FProstate carcinoma8744.57 ± 28.73.00814.19Hämoblastosen23958.76 ± 27.83FProstate carcinoma23944.57 ± 28.73.01715.50gastrointestinal carcinoma9160.07 ± 27.67
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Previous treatment:Patients who had undergone radiotherapy and chemotherapy showed moderately decreased physical functioning compared to patients with other treatment methods (radiotherapy only, chemotherapy only, or other). Other differences were not clinically meaningful (see Table 7).Table 7Shows the difference in physical functioning between patients with radio- and chemotherapy compared to patients with other treatmentsScoreChemo- and radiotherapy aNM ± SDMedianQ25Q75p- valueDifferencePFno126367.75 ± 20.9066.6753.3386.67.00119.36yes56348.39 ± 21.0866.6746.6780.00
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Tumor stage and time interval since diagnosis:Comparing different tumor stages, lymph node manifestations, and metastatic spread did not show any significant differences concerning the QoL of patients. Furthermore, there was no correlation with QoL regarding the time interval between diagnosis and rehabilitation.
Improvement of quality of life after rehabilitation
Rehabillitation |
N
| M ± SD | Median | Q25 | Q75 |
P- value | Δ |
---|---|---|---|---|---|---|---|
pre gQoL post gQoL | 1850 | 49,22 ± 22,05 | 50,00 | 33,33 | 66,67 | 0000 | 11,84 |
1578 | 61,06 ± 20,16 | 66,67 | 50,00 | 75,00 | |||
pre PF post PF | 1832 | 66,71 ± 20,99 | 66,67 | 53,33 | 80,00 | 0000 | 6,70 |
1561 | 73,41 ± 18,97 | 73,33 | 60,00 | 86,67 | |||
prae EF post EF | 1792 | 50,37 ± 28,61 | 50,00 | 25,00 | 75,00 | 0000 | 16,29 |
1531 | 66,66 ± 26,70 | 66,67 | 50,00 | 91,67 | |||
prae SF post SF | 1835 | 58,37 ± 32,05 | 66,67 | 33,33 | 83,33 | 0000 | 9,07 |
1559 | 67,44 ± 29,54 | 66,67 | 50,00 | 100,00 | |||
prae KF post KF | 1841 | 65,54 ± 29,39 | 66,67 | 50,00 | 83,33 | 0000 | 5,35 |
1573 | 70,89 ± 27,66 | 83,33 | 50,00 | 100,00 | |||
prae RF post RF | 1813 | 51,46 ± 30,93 | 50,00 | 33,33 | 66,67 | 0000 | 13,69 |
1535 | 65,15 ± 28,59 | 66,67 | 50,00 | 100,00 | |||
prae F post F | 1821 | 56,47 ± 27,61 | 55,56 | 33,33 | 77,78 | 0,000 | 8,68 |
1553 | 65,15 ± 26,51 | 33,33 | 22,22 | 66,67 |