Contribution of Sociodemographic, Clinical, and Psychological Variables to Quality of Life in Women with Cervical Cancer
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Contribution of Sociodemographic, Clinical, and Psychological Variables to Quality of Life in Women with Cervical Cancer in the Follow‑Up Phase Ana Clara Lopes1 · Rosário Bacalhau1 · Martim Santos1 · Marta Pereira1 · M. Graça Pereira1
© Springer Science+Business Media, LLC, part of Springer Nature 2019
Abstract This study evaluates the contribution of sociodemographic, clinical, and psychological variables to quality of life (QoL) of women with cervical cancer in the follow-up phase. This cross-sectional study, conducted at the Portuguese Oncology Institute of Lisbon, included 200 women with cervical cancer during follow-up. Patients were assessed on QoL (EORTC QLQ-C30), body image and specific symptoms (EORTC QLQ-CX24), psychological morbidity (HADS), social support (SSSS), emotional expression (CECS), and spirituality (SpREUK). Education and social support contributed positively to QoL, whereas body image and symptoms contributed negatively. Body image played a moderating role in the relationship between depression and QoL, but not between anxiety and QoL. Spirituality and emotional expression did not moderate the relationship between anxiety/depression and QoL. Health professionals should reference and monitor women with cervical cancer, providing support at the diagnosis and follow-up phase since physical and psychological symptoms, resulting from the disease, remain after the end of treatment and contribute negatively to their QoL. Interventions should focus on these particular outcomes to promote patients’ QoL. Keywords Cervical cancer · Follow-up · Spirituality · Emotional expression · Quality of life
Introduction Cervical cancer (CC) is the seventh most frequent in the world and the second most common in women after breast cancer, with a high incidence in women between 35 and 50 years (Castro et al., 2014). According to the World Health Organization [WHO] (2014) in 2012, 528 000 new cases of CC were reported worldwide, with a majority (85%) occurring in less developed regions, with 266 000 deaths occurring in the same year. CC is therefore considered a major public health problem (Basu, Mittal, Vale, & Kharaji, 2018). About 90% of CC(s) are squamous cell cancers and the other 10% correspond to adenocarcinoma (WHO, 2014). The diagnosis of CC is most often done through the HPV test or cervical/pap smear (Sasaki et al., 2017). The therapeutic modality depends on the diagnosis, disease stage, and * M. Graça Pereira [email protected] 1
School of Psychology, University of Minho, Campus de Gualtar, 4710‑057 Braga, Portugal
patient preference (Sociedade Portuguesa de Ginecologia [SPG], 2016). According to Basu et al. (2018), systematic preventing of woman through population-based programs may significantly decrease the CC mortality. Age and education influence quality of life (QoL). Younger patients seem to present more psychological alterations (Sekse, Hufthammer, & Vika, 2014) and concerns about body image (Teo et al., 2017). However, the literature is not consensual, and some authors report a positiv
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