title: Understanding the impact of the treatment pathway upon the health-related quality of life of women with newly diagnosed endometrial cancer - a qualitative study.
abstract: OBJECTIVE
  (1) To determine the impact of treatment and recovery on the health-related quality of life (HRQoL) of endometrial cancer (EC) patients. (2) To explore how treatment types and delivery affect HRQoL and invite suggestions for improvement.
  
  
  METHODS
  Qualitative study. In-depth, semi-structured interviews at 3, 6, 9 or 12 months post-treatment were carried out with 22 women with stage IA to IVB EC who had undergone treatment at a tertiary referral centre for gynaecological cancers in Sheffield, UK. 21 were treated surgically and 4 received adjuvant treatment. Data were analysed using an inductive thematic approach.
  
  
  RESULTS
  Four dominant themes emerged regarding the treatment pathway: pre-treatment concerns, experience during treatment, post-treatment and survivorship issues. Expectations and understandings of EC and its treatment were often inaccurate. Proper explanations eased anxiety but were uncommon. Laparoscopic surgery was welcomed where offered but did not necessarily influence coping ability. Instead, women evaluated treatment impacts against their expectations. Treatments affected women's physical abilities, self-perception and relationships resulting in re-evaluation of lifestyle.
  
  
  CONCLUSIONS
  The impact of treatment upon HRQoL for women with EC differs from other gynaecological cancers. Better information provision would enhance coping ability. Coping methods and expectations appear to influence HRQoL more than treatment modality.
authors.affiliation: University of Sheffield Medical School, Beech Hill Road, Sheffield S10 2RX, UK.
authors.forename: Helen
authors.initials: H
authors.lastname: Bowes
authors.affiliation: Health Economics & Decision Science, School of Health & Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield S1 4DA, UK. Electronic address: g.l.jones@sheffield.ac.uk.
authors.forename: Georgina
authors.initials: G
authors.lastname: Jones
authors.affiliation: Academic Unit of Primary Medical Care, University of Sheffield, Northern General Hospital, Herries Road, Sheffield S5 7AU, UK.
authors.forename: Joanne
authors.initials: J
authors.lastname: Thompson
authors.affiliation: UPMC Beacon Hospital, Dublin 18, Ireland.
authors.forename: Mo'iad
authors.initials: M
authors.lastname: Alazzam
authors.affiliation: Health Economics & Decision Science, School of Health & Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield S1 4DA, UK.
authors.forename: Hilary
authors.initials: H
authors.lastname: Wood
authors.affiliation: School of Nursing and Midwifery, University of Sheffield, S5 7AU, UK.
authors.forename: Sharron
authors.initials: S
authors.lastname: Hinchliff
authors.affiliation: Department of Obstetrics and Gynaecology, University of New South Wales, Sydney NSW 2031, Australia.
authors.forename: William
authors.initials: W
authors.lastname: Ledger
authors.affiliation: UPMC Beacon Hospital, Dublin 18, Ireland.
authors.forename: John
authors.initials: J
authors.lastname: Tidy
mesh_terms: D000222:Adaptation, Physiological; D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D019091:Critical Pathways; D016889:Endometrial Neoplasms / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D007407:Interviews as Topic; D008137:Longitudinal Studies; D008875:Middle Aged; D036301:Qualitative Research; D011788:Quality of Life; D018714:Radiotherapy, Adjuvant; D018570:Risk Assessment; D012649:Self Concept; D018434:Sickness Impact Profile; D017741:Survivors / Q000523:psychology; D013997:Time Factors; D016896:Treatment Outcome; D006113:United Kingdom
keywords: Endometrial cancer; Health-related quality of life; Qualitative methods; Treatment