title: Quality of life and its associated factors in patients with hepatocellular carcinoma receiving one course of transarterial chemoembolization treatment: a longitudinal study.
abstract: OBJECTIVE
  To (a) explore changes in physical and psychological distress and quality of life (QOL) and (b) identify the significant pre- and postdischarge factors related to changes in physical and mental domains of QOL over a period of 2 months in patients with hepatocellular carcinoma receiving one course of transarterial chemoembolization (TACE) treatment.
  
  
  METHODS
  A longitudinal prospective design was used, with participants recruited from a teaching hospital in Northern Taiwan. Data were collected three times: within 3 days prior to discharge (T0) and at the fourth (T1) and eighth (T2) weeks after discharge. A set of structured questionnaires was used to assess participants' QOL, symptom distress, anxiety, and depression. Changes in QOL and associated factors were examined using generalized estimating equations.
  
  
  RESULTS
  Eighty-nine patients were included in this study. Fatigue was reported to be the most distressful symptom after treatment. Overall QOL improved monthly after discharge. Change in physical QOL 2 months after TACE treatment was associated with age, diagnosis status, level of symptom distress, and depression after discharge. Change in mental QOL was significantly associated with gender, diagnosis status, and anxiety and depression after discharge.
  
  
  CONCLUSIONS
  Health care providers should pay special attention to patients of older age, those who are male, and those who have higher levels of depression and anxiety after discharge. Designing personalized education programs before discharge for patients with newly diagnosed cancer versus those who have recurrent disease is suggested to help patients maintain a better QOL after discharge.
authors.affiliation: Department of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan.
authors.forename: Shiow-Ching
authors.initials: SC
authors.lastname: Shun
authors.forename: Chien-Hung
authors.initials: CH
authors.lastname: Chen
authors.forename: Jin-Chuan
authors.initials: JC
authors.lastname: Sheu
authors.forename: Ja-Der
authors.initials: JD
authors.lastname: Liang
authors.forename: Jyh-Chin
authors.initials: JC
authors.lastname: Yang
authors.forename: Yeur-Hur
authors.initials: YH
authors.lastname: Lai
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires