title: Factors associated with quality of life of outpatients with breast cancer and gynecologic cancers and their family caregivers: a controlled study.
abstract: BACKGROUND
  Quality of life (QOL) issues are of interest in cancer because effective methods of treatment and detection have led to an increase in the number of long-term survivors. The objectives of the study were: to assess the subjective QOL of stable Sudanese women cancer outpatients and their family caregivers, using the WHO 26-item QOL Instrument; compare with matched general population groups, as well as diabetic and psychiatric patient groups; examine patient-caregiver concordance in ratings; and assess the variables associated with their QOL, with a view to identifying factors that can enhance quality of care.
  
  
  METHODS
  Responses of oncology outpatients with breast cancer (117), cervical cancer (46) and ovarian cancer (18) (aged 44.6, SD 11.5) were compared with those of their family caregivers and matched general population groups. Data were analyzed by univariate and multivariate statistics.
  
  
  RESULTS
  The cancer groups had similar QOL domain scores, which were significantly lower than those of their caregivers, but higher than the control group as well as those of psychiatric and diabetic patients studied previously. Patients who were married, with higher education, better employment, and with longer duration of illness had higher QOL. Patients on radiotherapy and their caregivers had higher QOL scores. Correlations between patient's ratings and caregiver impression of patient's QOL were high. Caregiver impression was a significant predictor of patient's and caregiver's QOL. Other predictors for the patient were: currently feeling sick and duration of illness; for the caregiver: feeling sick, relationship to patient, and age.
  
  
  CONCLUSIONS
  Cancer patients in stable condition and with psychosocial support can hope to enjoy good QOL with treatment. The findings constitute an evidence base for the country's cancer care program, to boost national health education about prognosis in cancer. Families living with women cancer patients are vulnerable and need support if the patient is recently diagnosed, less educated, single, not formally employed; and the caregiver is female, parent, younger, less educated, unemployed and feels sick. Clinicians need to invest in the education and support of family caregivers. The patient-caregiver dyad should be regarded as a unit for treatment in cancer care.
authors.affiliation: Department of Psychiatry, Faculty of Medicine, Kuwait University, Kuwait. awadal@yahoo.com <awadal@yahoo.com>
authors.forename: Abdel W
authors.initials: AW
authors.lastname: Awadalla
authors.forename: Jude U
authors.initials: JU
authors.lastname: Ohaeri
authors.forename: Abdullah
authors.initials: A
authors.lastname: Gholoum
authors.forename: Ahmed O A
authors.initials: AO
authors.lastname: Khalid
authors.forename: Hussein M A
authors.initials: HM
authors.lastname: Hamad
authors.forename: Anila
authors.initials: A
authors.lastname: Jacob
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000553:Ambulatory Care / Q000379:methods / Q000523:psychology*; D000704:Analysis of Variance; D001943:Breast Neoplasms / Q000523:psychology* / Q000628:therapy; D017028:Caregivers / Q000523:psychology*; D016022:Case-Control Studies; D005195:Family Relations; D005260:Female; D005833:Genital Neoplasms, Female / Q000523:psychology* / Q000628:therapy; D006701:Home Nursing / Q000379:methods / Q000523:psychology; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D010051:Ovarian Neoplasms / Q000523:psychology / Q000628:therapy; D011379:Prognosis; D011788:Quality of Life; D012307:Risk Factors; D012959:Socioeconomic Factors; D013397:Sudan; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000523:psychology / Q000628:therapy