title: What determines the health-related quality of life among regional and rural breast cancer survivors?
abstract: OBJECTIVE
  To assess the health-related quality of life (HRQoL) of regional and rural breast cancer survivors at 12 months post-diagnosis and to identify correlates of HRQoL.
  
  
  METHODS
  In 2006/07, 323 (202 regional and 121 rural) Queensland women diagnosed with unilateral breast cancer participated in a population-based, cross-sectional study. HRQoL was measured using the Functional Assessment of Cancer Therapy, Breast plus arm morbidity (FACT-B+4) self-administered questionnaire.
  
  
  RESULTS
  In age-adjusted analyses, mean HRQoL scores of regional breast cancer survivors were comparable to their rural counterparts 12 months post-diagnosis (122.9, 95% CI: 119.8, 126.0 vs. 123.7, 95% CI: 119.7, 127.8; p>0.05). Irrespective of residence, younger (<50 years) women reported lower HRQoL than older (50+ years) women (113.5, 95% CI: 109.3, 117.8 vs. 128.2, 95%CI: 125.1, 131.2; p<0.05). Those women who received chemotherapy, reported two complications post-surgery, had poorer upper-body function than most, reported more stress, reduced coping, who were socially isolated, had no confidante for social-emotional support, had unmet health care needs, and low health self-efficacy reported lower HRQoL scores.
  
  
  CONCLUSIONS
  The results underscore the importance of supporting and promoting regional and rural breast cancer programs that are designed to improve physical functioning, reduce stress and provide psychosocial support following diagnosis. Further, the information can be used by general practitioners and other allied health professionals for identifying women at risk of poorer HRQoL.
authors.affiliation: School of Public Health, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Queensland 4059. t.disipio@qut.edu.au
authors.forename: Tracey
authors.initials: T
authors.lastname: DiSipio
authors.forename: Sandi
authors.initials: S
authors.lastname: Hayes
authors.forename: Beth
authors.initials: B
authors.lastname: Newman
authors.forename: Monika
authors.initials: M
authors.lastname: Janda
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000503:physiopathology* / Q000523:psychology; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006801:Humans; D008875:Middle Aged; D011788:Quality of Life; D011793:Queensland; D012424:Rural Population; D017741:Survivors