|Year : 2017 | Volume
| Issue : 6 | Page : 1643-1648
|Comparative study of life quality of relatives of cancer and noncancer patients
Fatemeh Najafi1, Mansooreh Tajvidi2, Mohammad Zare3
1 Master in medical-surgical Nursing, Islamic Azad University of Medical Science, Tehran, Iran
2 Department of Nursing, School of Nursing and Midwifery, Karaj Branch, Islamic Azad University; Clinical Cares and Health Promotion Research Center, Karaj Branch, Islamic Azad University, Karaj, Iran
3 Phd of Epidemiology, Faculty of Nursing and Midwifery, Islamic Azad University of Medical Science, Tehran, Iran
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|Date of Web Publication||11-Jan-2018|
| Abstract|| |
Introduction: Cancer is a chronic and incurable disease that can have a significant impact on patients and their families. If the family members of the patient in nuclear family as the main caregivers of the patient do not receive required supports from health caregivers and do not have enough information on disease, caring, and complications of the treatments, not only the patient's health but also their own health will be endangered. The main objective of this article is to compare the life quality of relatives of cancer and noncancer patients. Method: This study is a correlational type of cross-sectional descriptive study. In this study, 245 relatives of cancer patients and 245 relatives of noncancer patients were selected using available sampling method and according to inclusion criteria. Data were collected using life quality questionnaire (SF-36). To analyze the data, SPSS 19 software and descriptive and inferential statistical tests, Pearson correlation coefficient, and t-test were used. Result: The results show that there is a significant difference between life quality of relatives of cancer patients and noncancer patients (t = 3.33) at the level of (P < 0.01). Conclusion: After obtaining necessary permissions form the administrators of the hospital, we referred to the clinic, got familiar with its administrators, and started to recruit family to the study. relatives of cancer and noncancer patients with the following took part in the study: having a certain year-old patint with a confirmed diagnosis of desease for at least many months, being able to read and write Persian, and suffering from no mental disorder.
Keywords: Cancer patients, life quality, nonpatients, Qazvin, relatives
|How to cite this article:|
Najafi F, Tajvidi M, Zare M. Comparative study of life quality of relatives of cancer and noncancer patients. Ann Trop Med Public Health 2017;10:1643-8
|How to cite this URL:|
Najafi F, Tajvidi M, Zare M. Comparative study of life quality of relatives of cancer and noncancer patients. Ann Trop Med Public Health [serial online] 2017 [cited 2018 Nov 17];10:1643-8. Available from: http://www.atmph.org/text.asp?2017/10/6/1643/222689
| Introduction|| |
Family is the first institution in the lives of individuals, and it plays key role in feeling healthy and in one's ability to comply with various conditions. Tension and stress factors such as acute disease affecting the members of the family are threats to the stability of the family, which might result in the development of problems for that person and the family. In addition, family is the most basic social unit which plays an important and sensitive role in society and is the main tool for integration and cohesion in the society. when one of the family members becomes a patient, all family members are indirectly affected by the disease and are faced with tensions during their caring period, leading to undesired physical and mental reactions in different raeson. Due to the increasing need for relatives of the patient, quality of life and efficiency should be used as variables in the studies related to relatives as caregivers of people with chronic disease (Masoudi et al., 2011). In general, quality of life is one of the most fundamental and multidimensional concepts that the World Health Organization considers as understanding of each person's life situation, goals, values, standards, and individual interests. This definition has a broad meaning that is influenced by physical and psychological health, level of independence, social relationships, and one's personal beliefs. Today, true meaning and value is the quality of life rather than its quantity. Quality of life includes a broad meaning which includes social, economic, environmental aspects, and health satisfaction. Quality of life is a subjective concept of well-being and satisfaction with life experiences which includes positive and negative aspects of one's life. Quality of life is the subjective and personal perception of happiness or satisfaction of the factors affecting the physical, emotional, and social function and well-being and it affects the family relations. Thus, many researchers have stressed on the need to enhance the quality of life of the patient's family. Quality of life is a comprehensive and general concept that includes all aspects of a person's life. With regard to the physical dimension, the most important is the function status of the person. Understanding quality of life is affected by the person's ability at various ages to continue the function or perform daily activities such as self-care and going to school and work. Psychological dimension is an important part of the quality of life and a positive attitude is effective in improving the quality of life. With regard to social and cultural dimensions, roles of each person in the family and the community and his social relations are among the factors influencing the quality of life. Quality of life is considered as a sign of quality health care and part of treatment program of the disease, and its measurement in chronic diseases can provide more information on health status of the patient for us. In addition, it can provide good guidelines to enhance care quality. The primary goal of treatment especially in chronic diseases is to enhance the quality of life by reducing the effects of disease and patients with chronic diseases. This is not found among families where quality of life is low. Health personnel can affect the quality of life of patients through examining the health status of individuals and families so that with improved health status, their quality of life will also improve. While identifying or measuring the adverse effects of a diseases on a patient's quality of life is not the means to determine the level of incidence of a disease but rather very important in terms of issues related to human health. It can also determine the negative impact of disease or effects of treatment on quality of life of the patient. As a concept, quality of life is a comprehensive concept and it covers all aspects of life. It includes varying degrees of life satisfaction related to health. Considering the statistics on the prevalence of cancer in Iran, the role of the family is the best source of care for patients with cancer, the possibility of potential care pressure, changes in the quality of life of families of patient with cancers, and the experience of the researcher in dealing with problems related to issues that affect the familes of the cancer patient. Due to the importance of this subject and the lack of domestic research in this field, this study investigates and compares the quality of life of relatives of cancer and noncancer patients, referred to hospitals affiliated to Qazvin University of medical sciences And in case of significant changes in the quality of life of these relatives, studies are needed to increase their quality of life.
| Materials and Methods|| |
This study is a correlational type of cross-sectional descriptive study. The study population included all relatives of cancer and noncancer patients who were referred to Qazvin Velayat Hospital Clinic. Research environment included outpatient chemotherapy unit and emergency unit of Velayat Hospital in Qazvin province. Sampling was performed from relatives of cancer and noncancer outpatient patients referred to clinic of the Velayat Hospital in Qazvin province, which met the following inclusion criteria:
Inclusion criteria for the relatives of cancer patients
- Relatives of cancer patients referred to the outpatient chemotherapy unit in the hospital of Qazvin province
- Relatives who referred to the clinic with patients and just care from one person
- The age of relatives was 18–65 years and patients were older than 18 years
- Relatives could read and write
- Relatives of the patient who does not need emergency hospitalization after chemotherapy.
Inclusion criteria for relatives of noncancer patients
- Relatives of cancer patients referred to centers of Qazvin Velayat Hospital and underwent treatment
- Relatives who referred to the clinic with patients and they do not care for another person
- The age of relatives was 18–65 years and patients was older than 18 years
- Relatives could read and write
- Relatives of the patient who do not need emergency hospitalization after examination and drug prescription.
To calculate the number of relatives of patients with cancer, the formula n = z2pq/d2 was used and sampling was performed on the same number of relatives of patients without cancer who were referred to clinics. Greater number of samples were considered but after dropping some because of failing to meet inclusion criteria, 245 people were included in the study. Questionnaires on their demographic characteristics and quality of life were completed. Then the obtained data were analyzed using descriptive statistics (frequency, mean, and standard deviation) and inferential statistics such as Pearson correlation, regression, t test, and SPSS 19 software (IBM).
To collect data on the life quality of people, many questionnaires were developed in which most were on quality of life. 36-item quality of life questionnaire (SF-36) has 36 questions composed of eight subscales and each subscale consists of 2–10 items. Eight subscales of the questionnaire were physical functioning, role impairment due to physical health problems, role impairment due to emotional health problems, energy/fatigue, emotional well-being, social functioning, pain, and general health. In addition, by integrating subscales, two general subscales of physical health and mental health were obtained. In this questionnaire, lower scores mean lower quality of life and vice versa. The reliability of quality of life questionnaire was tested using statistical analysis and internal consistency, and its validity was tested by comparing the known groups and convergent validity. Internal consistency analysis showed that except for the subscale of vitality, other scales of Persian version of this questionnaire have the minimum standard of reliability coefficients in the range of 0.77–0.9.
In this study, 245 cancer patients and 245 relatives of noncancer patients referred to medical and educational Center of Velayat were studied. However, a number of questions related to the demographic characteristics of patients were answered by their relatives. The highest percentage (52.7) of cancer patients was male and the lowest percentage (47.3) was female, and in noncancer patients, the highest percentage (62.2) was females and the lowest percentage (38.8) was male. The highest percentage (39.6) of cancer patients was in the age group over 51 years and the lowest percentage (9.4) was in the age group under 30 years, and in noncancer patients, the highest percentage (26.5) was in the age group of 31–40 years and the lowest of them (94.4) was in the age group of under 30 years. The highest percentage (32.7) of cancer patients was illiterate and the lowest percentage (1.4) had master degree, and in noncancer patients, the highest percentage (35.1) was illiterate while the lowest percentage of (3.3) had master degree. The highest percentage (78) of cancer patients in terms of marital status was married and the lowest percentage of them (22) was single and in noncancer patients, the highest percentage (82) of them was married and the lowest percentage (18) was single. The highest percentages of (42.2) of cancer patients in terms of employment situation were housekeepers and the lowest percentages (0.4) were employers, and in noncancer patients, the highest percentages (46.9) were housekeepers while the lowest percentage (1.6) were employers. The highest percentage (43.7) of cancer patients in terms of income level was without income and the lowest percentage (18.4) of them had the income between 20 and 30 Million Rials and in non-cancer patients, the highest percentage (46.9) was without income and the lowest percentage had income between 20 and 30 Million Rials. The highest percentage (51.1) of cancer patients in terms of hospitalization was in the status of nonhospitalization and the lowest percentage (48.9) was hospitalized and in patients without cancer, the highest percentage (88) was in the status of nonhospitalization and the lowest percentage (20) was hospitalized. The highest percentage of cancer patients in terms of insurance type was covered by social security insurance and the lowest percentage (3.7) was covered by Armed Forces Insurance, and in the noncancer patients, the highest percentage (62.9) was covered by social security insurance and the lowest percentage (1.6) was covered by health-care insurance. Regarding financing, the highest percentage of the cancer patients (32.7) was self-financed and the lowest percentage (17.1) was financed by parents and in noncancer patients, the highest percentage (60.8) was self-financed while the lowest percentage (4.9) was financed by their parents. In terms of the type of diseases, the highest percentage of cancer patients (15.5) had breast cancer and the lowest percentage (1.2) had skin cancer and in noncancer patients, the highest percentage (19.6) had kidney stones while the lowest percentage (0.8) suffered from hemorrhoids [Table 1].
|Table 1: Life quality status according to scores for the relatives of cancer and noncancer patients in a study that examined the relationship between quality of life of relatives of cancer and noncancer patients|
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Here are the findings from the research hypothesis test. This research has a previous quality of life variable and spiritual health criterion variable. To investigate the relationship between these variables, Pearson correlation coefficient and dependent test were used. It can be seen that the assumption of normalization with a significant level greater than 0.05 is confirmed for the variables under study [Table 2].
|Table 2: Kolmogorov-Smirnov test to examine the normal distribution of data in a study investigating the life quality of relatives of cancer and noncancer patients|
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To examine the normal distribution of data, Kolmogorov–Smirnov test was used. As shown in [Table 1], the normal distribution assumption with significance level was >0.05 which confirmed the variables studied, so the data of study follow normal distribution. Therefore, parametric tests were used to analyze the data. To examine the relationship between these variables, Pearson correlation coefficient and t-test were used. The results are presented in [Table 3].
|Table 3: The results of t-test to compare the quality of life of relatives of cancer patients and noncancer patients in a study investigating the life quality of relatives of cancer and noncancer patients|
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The results in [Table 4] show that the mean quality of life of relatives of noncancer patients is more than that in relatives of cancer patients.
|Table 4: Comparing the mean quality of life of relatives of cancer and noncancer patients|
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| Discussion|| |
The results showed the effect of cancer on all dimensions of quality of life, and the findings show that in relatives of cancer patients, the highest mean belonged to physical function (27) and lowest mean belonged to pain (3.94), while in noncancer patients, the highest mean belonged to physical function (26.75) and the lowest mean belonged to pain (4.17). With regard to the physical dimension, the quality of life of relatives of cancer patients (49.95) is lower than that of relatives of noncancer patients (50.66). With regard to the mental function dimension, the quality of life of relatives of cancer patients (37.89) was more than that of relatives of noncancer patients (37.86). However, the mean quality of life of relatives of noncancer patients (44.26) was more than of relatives of cancer patients (43.92) which was at the moderate level. A study conducted by Asarudi et al. also showed that the quality of life of nurses is at the moderate range (64.38) and the mean quality of life in the physical dimension was 66.9 and the quality of life in the mental dimension was 56.3, which is in line with this research. Based on the findings of this study, there is a significant relationship (P < 0.05) between the age and the quality of life in the two groups, but those aged over 51 years had better quality of life. However, in a study conducted with the aim of investigating the quality of life and demographic variables affecting elderly people covered by Health Center in South of Tehran, it was reported that there is an inverse and significant relationship between age and the quality of life. In the study conducted, a significant relationship was found between gender and quality of life (P < 0.05). In relatives of cancer patients, males had a better quality of life, but in relatives of noncancer patients, females had a better quality of life. In a study conducted by Arash et al., a significant correlation was found between gender and the quality of life. In addition, a significant relationship was found between marital status and quality of life (P < 0.05). In the relatives of cancer patients, married people had a higher quality of life while in relatives of cancer patients, single people had a higher quality of life. In a study, it was shown that married people had a better quality of life when compared to single people. In this study, significant relationship was found between job, education, income, relativity with the patient, insurance, and quality of life in relatives of cancer and noncancer patients (P < 0.05). Alvim et al. also reported that supportive sources in times of illness are effective in adaptability and improved quality of life and patients who live alone have a poor quality of life. Results of the study conducted to explore the quality of life related to health and factors affecting it in women with breast cancer showed that quality of life was lower in the mental health dimension compared to other dimensions. In addition, factors related to the life quality of patients with breast cancer including marital status, job, and type of breast surgery had a significant correlation with health-related quality of life. In addition, in the research conducted by Shahmirzadi et al. on elderly people, it was shown that quality of life reduced under the influence of increased number of chronic diseases. These results are consistent with the results of the research conducted with the aim of reviewing the impact of life review treatment with a spiritual approach on the quality of life in cancer patients. In the mentioned study, results suggest that treatment with spiritual approach was effective on quality of life in cancer patients and it can be used as an effective method to improve the quality of life of these patients.
| Conclusion and Implication of Study|| |
Chronic disease is a change in health status that cannot be treated through simple surgical procedure or a medical treatment for a short period and the patient has many chronic problems. Patients' problems have an impact on their family. According to the results of this study, the nurses' emphasis on paying attention to the concept of care, comprehensive view, and paying attention to care client can help all nurses and clinical specialists. The main motivation of conducting this research was to use its results to improve the quality of life of the relatives of cancer patients who have special health needs in different dimensions. As nurses are the closest members of the patient care team, the findings of this research help them have a holistic view in the treatment of patients. In addition, the results of this study would help managers at various levels of nursing to identify novel strategies to improve the quality of nursing cares. Nowadays, developments in nursing field as in other fields are due to studies conducted in this area. By conducting any research, a way is paved for further studies, and the results of this study can be a starting point to conduct future studies to provide care based on acceptable standards to improve the quality of life of relatives of patients, especially relatives of patients who have chronic diseases. In this regard, paying attention to the different variables such as quality of life of relatives of patients with chronic diseases is essential.
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Conflicts of interest
There are no conflicts of interest.
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School of Nursing and Midwifery, Islamic Azad University of Karaj, Karaj, Alborz; Research Center of Health Promotion and Clinical Care, School of Nursing and Midwifery, Islamic Azad University of Karaj, Karaj, Alborz
Source of Support: None, Conflict of Interest: None
[Table 1], [Table 2], [Table 3], [Table 4]
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