title: Factors Affecting Health-Related Quality of Life in Patients With Cholangiocarcinoma in the Northeastern Region of Thailand.
abstract: BACKGROUND
  Cholangiocarcinoma (CCA) remains a major health problem and causes high mortality in Northeastern Thailand. Patients with CCA have a poor prognosis, and little is known about their health-related quality of life (HRQOL) and its determinants.
  
  
  OBJECTIVE
  The objective of this study was to investigate factors affecting HRQOL and its changes over time among CCA patients.
  
  
  METHODS
  Two hundred thirty-seven patients with CCA were recruited during a 6-month period in 2011 in 5 tertiary hospitals in 4 provinces of northeastern Thailand. Health-related quality of life after diagnosis of CCA was measured by the Functional Assessment of Cancer Therapy-Hepatobiliary questionnaire (Thai version 4). The HRQOL score of CCA patients at different times after diagnosis was compared by repeated-measures analysis of variance. Generalized estimating equation was used to identify factors affecting HRQOL among CCA patients.
  
  
  RESULTS
  Of 237 eligible patients registered, 99 confirmed cases completed follow-up at 2 months. Overall HRQOL varied over time, with the score at baseline being significantly lower than 1 and 2 months later. An adjusted analysis showed that patients who were 60 to 69 years old had higher HRQOL scores than did younger patients. Patients using alternative medicine had lower HRQOL scores than did those who did not.
  
  
  CONCLUSIONS
  Health-related quality-of-life scores among CCA patients changed over time and were related to age at recruitment and use of alternative medicine.
  
  
  CONCLUSIONS
  Healthcare providers should carefully communicate about the diagnosis and its implications. Patients with CCA, especially younger patients and those who have used traditional medicine, may benefit from counseling and help with mobilizing family and social support.
authors.affiliation: Author Affiliations: Department of Epidemiology, Faculty of Public Health, Khon Kaen University (Drs Woradet and Promthet); Department of Public Health, Faculty of Health and Sports Science, Thaksin University, Phatthalung (Dr Woradet); and Department of Community Health, Faculty of Public Health, Ubon Ratchathani Rajabhat University, Thailand (Dr Songserm); and Clinical Trial Service Unit & Epidemiological Studies Unit, University of Oxford, United Kingdom (Dr Parkin).
authors.forename: Somkiattiyos
authors.initials: S
authors.lastname: Woradet
authors.forename: Supannee
authors.initials: S
authors.lastname: Promthet
authors.forename: Nopparat
authors.initials: N
authors.lastname: Songserm
authors.forename: Donald M
authors.initials: DM
authors.lastname: Parkin
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D018281:Cholangiocarcinoma / Q000628:therapy*; D000529:Complementary Therapies / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013785:Thailand