The Predicting Factors of Quality of Life in Women With Invasive Ovarian Cancer

Summary: †¢ †¢ Disease status is not a significant predictor of QoL. †¢ Drug of chemotherapy, fatigue and appetite/GI symptom has negatively affected on QoL after chemotherapy. †¢ To provide nursing instruction for daily life to increase self-care ability and QoL for survivors. Content Outline: Introduction: Ovarian cancer is the seventh most common cancer in women worldwide, and more than 75% newly diagnosed patients are already in the late stage due to the lack of symptoms. This situation thus profoundly impacts their quality of life. Moreover, consequent surgery, chemotherapy, and/or recurring negative effects of physical and psychological symptoms has also been associated with their quality of life (QOL). However, studies exploring the predicting factors of quality of life for women with invasive ovarian cancer are sparse. Objectives: To (1) compare the differences in clinical characteristics (newly diagnosed, and long-term survivor with progression-free or recurrence) and quality of life in women with ovarian cancer, and (2) explore predicting factors for quality of life in women with invasive ovarian cancer. Methods: Patients were recruited from a teaching hospital in northern Taiwan. A cohort study was performed on patients with ovarian cancer at the bedside for those undergoing surgery or at the outpatient settings for those completing active treatment. Medical records (disease status, clinical and demographic characteristics), self-reported patients' daily activities, sleep, and quality of life by EORTC QLQ-C30 and OV28 were collected. Moreover, we used global health in EORTC QLQ-C30 as a dependent variable for multivariate analysis, and correlated with age by fitting multiple linear regression models and using the stepwise variable selection procedure to identify the predictor. Results: There was a total of 258 patients, where fifty-eight (22.66%) patients were in the elderly group (age≧60 years). Compared to the younger ovarian cancer patients, the elderly patients had more late stage (stages III and IV according to FIGO) ovarian cancer, and had a higher number of pregnancies and births. We found that BMI (at the time of diagnosis), chemotherapy protocol, the time since their primary chemotherapy, and recurrence rate upon completion of all treatment were not predictors. Fatigue, appetite/GI side effect, and education level (education below elementary) were negative predictors for QoL. The drug of chemotherapy only negatively impacted on QoL when interacting with age. The women self-reported good sleep quality and more years of survival after surgery were positive predictors for QoL. Conclusion: The risk factor for the elderly group's lowered quality of life were being treated with Lipodox and less educational years. Therefore, we suggest providing the patient more individualized nursing intervention for managing side-effect symptom (fatigue and appetite/ GI problems), and providing nursing instruction for daily life to increase self-care ability and sleep quality during treatment and progressionfree follow-up period in order to maintain their QOL. First Primary Presenting Author Primary Presenting Author Ya-Ling Yang, PhD, RN National Taiwan University School of Nursing Assistant Professor Taipei Taiwan Professional Experience: 2015-present-Assistant professor, School of Nursing, College of Medicine, National Taiwan University, Taiwan. 1990-2015 -Senior Instructor, School of Nursing, College of Medicine, National Taiwan University, Taiwan. 1996-present -Adjunct Supervisor, Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan. 2009-present -the board chairman of Lambda Beta Chapter-At-Large R.O.C., Sigma Theta Tau International Honor Society Nursing. Numerous presentations at scientific meetings. Author Summary: Ya-Ling Yang is a senior faculty in school of Nursing, National Taiwan University. She also is an expertise in maternity newborn/ women's health care and research. She is still working on developing the bereavement care model for perinatal loss family and providing related nursing education protocol for nursing students. She also works together with gynecologist to study "Gratitude" in spiritual care and its effect on quality of life in ovarian cancer women.