title: Change in quality of life in Chinese women with breast cancer: changes in psychological distress as a predictor.
abstract: BACKGROUND
  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).
  
  
  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 beta = -0.266, p < 0.005; FU1/FU2: standardized beta = -0.243, p < 0.005). Changes in depression scores consistently predicted subsequent changes in overall (standardized beta = 4.96; 95% CI, 3.749, 6.171, p < 0.001), physical (standardized beta = 1.752; 95% CI, 1.209, 2.294, p < 0.001), and functional (standardized beta = 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.
authors.affiliation: 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.
authors.forename: Wing S
authors.initials: WS
authors.lastname: Wong
authors.affiliation: 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. Fielding@hkusua.hku.hk.|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. Fielding@hkusua.hku.hk.|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. Fielding@hkusua.hku.hk.
authors.forename: Richard
authors.initials: R
authors.lastname: Fielding
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000523:psychology*; D002681:China / Q000453:epidemiology; D005260:Female; D006723:Hong Kong; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged; D011788:Quality of Life; D013315:Stress, Psychological