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Aminisani et al. Quality of life among rectal cancer patients

Table 4: Association between HRQOL and its dimensions and sociodemographic and clinical factors
Regression coefficient, R 95% CI
Dependent variable Covariates
B (SE) Beta P Lower bound Upper bound
QOL total Income -11.44 (5.14) -0.22 0.029 -21.66 -1.23
2
R = 9% Treatment 8.73 (3.47) 0.25 0.014 1.83 15.63
EF Stage of disease -14.99 (7.1) -0.21 0.03 -29.14 -0.83
R = 18% Treatment 8-81 (4.09) 0.23 0.035 0.65 16.96
2
PF Sex (male\female) 14.55 (5.84) 0.23 0.015 2.94 26.16
2
R = 23% Treatment 9.07 (3.91) 0.21 0.023 1.29 16.85
Physicalactivity 26.07 (7.67) 0.31 0.001 10.82 41.32
SF Stage of disease -22.42 (7.90) -0.29 0.006 -38.15 -6.68
2
R = 11% Treatment 9.42 (4.32) 0.22 0.032 0.80 18.03
RF Physicalactivity 32.66 (9.32) 0.33 0.001 14.15 51.18
2
R = 17%
Symptom total Treatment -9.14 (2.94) -0.32 0.003 -15.00 -3.27
2
R = 22% Physicalactivity -15.51 (5.98) -0.26 0.011 -27.44 -3.59
Pain Treatment -8.83 (4.63) -0.18 0.06 -18.05 0.39
2
R = 25% Physicalactivity -31.18 (9.41) -0.31 0.001 -49.93 -12.43
Stage of disease 21.146 (8.33) 0.24 0.013 4.55 37.74
Fatigue Treatment -14.94 (4.56) -0.33 0.002 -24.03 -5.85
2
R = 27% Physicalactivity -22.68 (9.29) -0.25 0.017 -41.19 -4.17
Stage of disease 23.66 (8.23) 0.29 0.005 7.26 40.06
Comorbidities -14.49 (6.73) -0.21 0.035 -27.90 -1.07
HRQOL: health-related quality of life; CI: confidence interval; PF: physical functioning; RF: role functioning; EF: emotional functioning; SF:
social functioning
was higher than that in the general population [20] . The performance and lower pain and fatigue. There is
difference between our results and other studies might evidence that type of surgery affects the QOL after
be explained by the time of recruitment of the study surgery among patients with cancer of the rectum.
population. In our study, all patients were diagnosed Evidence showed that cancer-free patients with rectal
less than one year and some were receiving active cancer who had no terminal abdominal stoma showed
treatment, and some patients with advanced stages a better score in all categories of the QOL 30 after five
were also included. Our results showed that younger years . In addition, it has been shown that sphincter
[23]
and older patients had almost the same score of the sparing operations are higher among patients who
overall QOL and its dimensions except emotional undergone neoadjuvant chemo-radiotherapy and they
dimension which was lower in younger patients. It in show better scores in QOL . However, in this study
[24]
line with the results of other studies which showed we combined neoadjuvant and adjuvant therapies,
the poorer emotional performance of younger therefore the reason for such results cannot be clearly
patients [9,21] . We found that females generally had concluded. In this study, patients with comorbidities
poorer QOL than men, the same reported by Li et al. had poorer scores on total QOL and its dimensions
[9]
but some studies reported the lower social wellbeing and showed higher pain and fatigue, however, in the
score among men, that might be because they used final model it was predictive of only fatigue. Studies
different instrument for assessment of the QOL [21] . also showed a poorer performance of QOL among
those with comorbidities .
[25]
In the current study income and treatment options
were predictors of the total score of QOL. Income was Another finding of this study was the association
negatively predictive of QOL score, surgery plus CRT between physical activity and the score of PF and
was positively related to the higher score of the QOL RF dimensions, those with sufficient physical activity
total score. The QOL of the long-term survival group had better scores in these dimensions, and it was
was associated with lifestyle factors, symptoms and also negatively predictive of symptom total, pain and
usual activity, and the presence of a stoma was not fatigue. Those with sufficient physical activity had
the matter. However, QOL one year after surgery was lower scores in symptom total, had lower pain and
associated with adjuvant therapy [22] . fatigue. Studies demonstrated the positive effect of
physical activity on quality of life among patients
In this study, stage of disease was negatively with CRC [26] .
predictive of EF and SF, but positively predictive of
pain and fatigue. Treatment option was predictive of This study has some limitations, we included patients
all QOL dimensions (except CF) and pain and fatigue. from teaching hospitals, those who were admitted to
Those who received surgery plus CRT had better private hospitals might be from higher socioeconomic
214 Journal of Cancer Metastasis and Treatment ¦ Volume 3 ¦ September 29, 2017