Quality of life of older adults diagnosed with cancer in Palestine: A cross sectional study

Inad Nawajah; Carol  El Jabari; Hussein  Jabareen; Wafa Kammoun-Rebai; Kamel Jebreen; Hasan Almanasreh; Eqbal  Radwan

doi:10.31893/multiscience.2024097

Keywords:

Abstract

The majority of new cancer diagnoses and cancer deaths occur in the elderly making cancer primarily a disease of older adults. Due to the heterogeneous ageing process and complications resulting from therapy and toxicity, the treatment of older patients with cancer remains challenging. The current study aims to evaluate the quality of life (QOL) of cancer patients over the age of 60 and identify the factors associated with QOL in Palestine. A cross-sectional and descriptive design was employed for this study. The sample included 136 older patients with cancer attending hospitals in East Jerusalem and the West Bank. Data were collected between June and July 2022 using self-reported questionnaires, including socio-demographic data and the Functional Assessment of Cancer Therapy - General (FACT-G). Binary logistic regression was used to identify factors associated with QOL. The age of patients ranged from 60 to 90 years (mean 66.62 years, SD ± 5.46) of which 64.7% (n=88) were females, and 35.3% (n=48) were males. More than half of the participants (64.7%, n=88) had good QOL whereas 35.3% (n=48) had poor QOL. The overall QOL of participants was reported as 2.34 (SD = 0.47), which indicates a good QOL. The highest mean score was found in the social and family well-being domain (2.93 ± 0.76) followed by the physical well-being (2.31 ± 0.82). The difference was significant for functional well-being (t= -2.86, P=.005). Gender was significantly associated with the QOL. Males were about 0.40 times more likely to have lower QOL than females (OR: 0.40; 95 CI%: 0.20-0.98; P = 0.04). In contrast, no significant associations were found for the other factors. A deeper understanding of older patients' QOL and its predictors is essential for comprehending the issues facing the ageing population, and being aware of these variables may be useful for establishing programs to promote QOL.
References
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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

How to cite

Nawajah, I., El Jabari , C., Jabareen , H., Kammoun-Rebai , W., Jebreen, K., Almanasreh, H., & Radwan, E. (2024). Quality of life of older adults diagnosed with cancer in Palestine: A cross sectional study. Multidisciplinary Science Journal, 6(7), 2024097. https://doi.org/10.31893/multiscience.2024097

[1] Abu Farha, N. H., Khatib, M. T., Salameh, H., & Zyoud, S. E. H. (2017). Cancer-related post-treatment pain and its impact on health-related quality of life in breast cancer patients: a cross-sectional study in Palestine. Asia Pacific Family Medicine, 16(1), 1–9. https://doi.org/10.1186/s12930-017-0037-3

[2] Alfano, C. M., Ganz, P. A., Rowland, J. H., & Hahn, E. E. (2012). Cancer survivorship and cancer rehabilitation: revitalizing the link. Journal of Clinical Oncology, 30(9), 904–906

[3] Azaiza F., Cohen M., Awa M., & Daoud F. (2010). Factors associated with low screening for breast cancer in the Palestinian Authority: relations of availability, environmental barriers, and cancer-related fatalism. Cancer, 116(19), 4646–4655. https://doi.org/10.1002/cncr.25378

[4] Braithwaite, D., Satariano, W. A., Sternfeld, B., Hiatt, R. A., Ganz, P. A., Kerlikowske, K., & Caan, B. J. (2010). Long-term prognostic role of functional limitations among women with breast cancer. Journal of the National Cancer Institute, 102(19), 1468–1477. https://doi.org/10.1093/jnci/djq344

[5] Bseiso, R. A., & Thabet, A. A. M. (2017). The relationship between siege stressors, anxiety, and depression among patients with cancer in the Gaza Strip. Health Science Journal, 11(2), 499. DOI: 10.21767/1791-809X.1000499

[6] Busolo, D., & Woodgate, R. (2015). Palliative care experiences of adult cancer patients from ethnocultural groups: a qualitative systematic review protocol. JBI Evidence Synthesis, 13(1), 99–111. DOI: 10.11124/jbisrir-2015-1809

[7] Conrad, R., Mücke, M., Marinova, M., Burghardt, A., Stieber, C., Cuhls, H., & Radbruch, L. (2017). Measurement of quality of life in palliative care: evidence for criterion-oriented validity of a single-item approach. Journal of Palliative Medicine, 20(6), 604-610. https://doi.org/10.1089/jpm.2016.0218

[8] Craig, B. M., Reeve, B. B., Brown, P. M., Cella, D., Hays, R. D., Lipscomb, J., Pickard, S., & Revicki, D. A. (2014). US valuation of health outcomes measured using the PROMIS-29 Value in Health, 17(8), 846–853. https://doi.org/10.1016/j.jval.2014.09.005

[9] Dreidi, M. T. M., & Hamdan-Mansour, A. M. (2016). Pain, sleep disturbance, and quality of life among Palestinian patients diagnosed with cancer Journal of Cancer Education, 31, 796–803. https://doi.org/10.1007/s13187-015-0946-5

[10] Dreidi, M. T., Asmar, I., & Al-Rjoub, B. (2016). The association of depression and fatigue with quality of life among Palestinian patients with cancer. Health Science Journal, 10(6), 474. DOI: 10.21767/1791-809X.1000474

[11] El Jabari, C., Nawajah, I., & Jabareen, H. (2022). FACT-G Assessment of the Quality of Life for Palestinian Patients with Cancer. Qatar Medical Journal, 2022(3), 43. DOI: https://doi.org/10.5339/qmj.2022.43

[12] El Sharif, N., & Imam, A. (2021). Current Status of Diabetes in Palestine: Epidemiology, Management, and Healthcare System. In: Laher, I. (eds) Handbook of Healthcare in the Arab World. Springer, Cham. https://doi.org/10.1007/978-3-030-36811-1_43

[13] ElMokhallalati, Y., Alaloul, E., Shatat, M., Shneewra, T., El Massri, S., Shaer, O., Relton, S., Abu-Odah, H., & Allsop, M. J. (2022). The symptom burden and quality of life in cancer patients in the Gaza Strip, Palestine: a cross-sectional study. PLOS One, 17(1):e0262512. https://doi.org/10.1371/journal.pone.0262512

[14] Esbensen, B. A., Østerlind, K., & Hallberg, I. R. (2007). Quality of life of elderly persons with cancer: A 6-month follow-up. Scandinavian Journal of Caring Sciences, 21(2), 178–190. https://doi.org/10.1111/j.1471-6712.2007.00454.x

[15] Fischer, M., Visser, A., Voerman, B., Garssen, B., Van Andel, G., & Bensing, J. (2006). Treatment decision-making in prostate cancer: patients’ participation in complex decisions. Patient education and counselling, 63(3), 308–313 https://doi.org/10.1016/j.pec.2006.07.009

[16] Fried, T. R., Byers, A. L., Gallo, W. T., Van Ness P. H., Towle, V. R., O'Leary, J. R., & Dubin, J. A. (2006). Prospective study of health status preferences and changes in preferences over time in older adults. Archives of Internal Medicine, 166(8), 890–895. https://doi:10.1001/architect.166.8.890

[17] Gayatri, D., Efremov, L., Kantelhardt, E. J., Mikolajczyk, R. (2021). Quality of life of cancer patients at palliative care units in developing countries: systematic review of the published literature. Quality of Life Research, 30, 315–343. https://doi.org/10.1007/s11136-020-02633-z

[18] Gosain, R., Gupta, M., Roy, A. M., Strosberg, J., Glaser, K. M., & Iyer, R. (2022). Health-related quality of life (HRQoL) in neuroendocrine tumours: a systematic review. Cancers, 14(6), 1428. https://doi.org/10.3390/cancers14061428

[19] Hack, T. F., Degner, L. F., Watson, P., & Sinha, L. (2006). Do patients benefit from participating in medical decision-making? Longitudinal follow-up of women with breast cancer Psycho-Oncology: Journal of the Psychological, Social, and Behavioral Dimensions of Cancer, 15(1), 9–19. https://doi.org/10.1002/pon.907

[20] Jolly, T. A., Deal, A. M., Nyrop, K. A., Williams, G. R., Pergolotti, M., Wood, W. A., & Muss, H. B. (2015). Geriatric assessment identified deficits in older cancer patients with normal performance status. The Oncologist, 20(4), 379–385. https://doi.org/10.1634/theoncologist.2014-0247

[21] Kent, E. E., Ambs, A., Mitchell, S. A., Clauser, S. B., Smith, A. W., & Hays, R. D. (2015). Health-related quality of life in older adult survivors of selected cancers: data from the SEER-MHOS linkage. Cancer 121(5), 758–765. https://doi.org/10.1002/cncr.29119

[22] Khleif, M. H., Imam, A. M. (2013). Quality of life for Palestinian patients with cancer in the absence of a palliative-care service: a triangulated study. The Lancet, 382, S23 DOI: https://doi.org/10.1016/S0140-6736(13)62595-7

[23] Maraqa, B. N., Ahmed, M. (2021). Quality of life and post-traumatic stress disorder among adult females with cancer in Palestine: a cross-sectional study. European Journal of Psychotraumatology, 12(1), 190–4699. https://doi.org/10.1080/20008198.2021.1904699

[24] MOH (2023). https://site.moh.ps/index/ArticleView/ArticleId/6091/Language/ar

[25] Muss, H. B., Berry, D. A., Cirrincione, C., Budman, D. R., Henderson, I. C., Citron, M. L., & Hudis, C. A. (2007). Toxicity of older and younger patients treated with adjuvant chemotherapy for node-positive breast cancer: the Cancer and Leukemia Group B Experience. Journal of Clinical Oncology, 25(24), 3699–3704.

[26] Nayak, M. G., George, A., Vidyasagar, M. S., Mathew, S., Nayak, S., Nayak, B. S., Shashidhara, Y. N. & Kamath, A. (2017). Quality of life among cancer patients. Indian journal of palliative care, 23(4), 445. doi: 10.4103/IJPC.IJPC_82_17

[27] Noh, J. W., Kim, J., Park, J., Kim, H. J., & Kwon, Y. D. (2015). Gender difference in the relationship between health-related quality of life and work status. PLoS One, 10(12), e0143579. https://doi.org/10.1371/journal.pone.0143579

[28] Pérez, B. E., Martínez, A. O. R. (2016). Salud mental y funcionamiento familiar en adultos mayores de Melchor Ocampo, Estado de México. Psicología Iberoamericana, 24(1), 38–46.

[29] Pergolotti, M., Deal, A. M., Lavery, J., Reeve, B. B., & Muss, H. B. (2015). The prevalence of potentially modifiable functional deficits and the subsequent use of occupational and physical therapy by older adults with cancer. Journal of Geriatric Oncology, 6(3), 194–201. https://doi.org/10.1016/j.jgo.2015.01.004

[30] Puts, M. T. E., Monette, J., Girre, V., Wolfson, C., Monette, M., Batist, G., & Bergman, H. (2011). Quality of life during cancer treatment in older newly diagnosed patients. Results of a prospective pilot study Annals of Oncology, 22(4), 916–923. https://doi.org/10.1093/annonc/mdq446

[31] Quick, H. E., & Moen, P. (1998). Gender, employment, and retirement quality: A life course approach to the differential experiences of men and women. Journal of Occupational Health Psychology, 3(1), 44. https://psycnet.apa.org/doi/10.1037/1076-8998.3.1.44

[32] Ramasubbu, S. K., Pasricha, R. K., Nath, U. K., Rawat, V. S., & Das, B. (2021). Quality of life and factors affecting it in adult cancer patients undergoing cancer chemotherapy in a tertiary care hospital. Cancer Reports, 4(2), e1312. https://doi.org/10.1002/cnr2.1312

[33] Rockoff, Y., El Jabari, C., Avgar, A., Ziv, M., & Barnea, T. (2004). Coping with breast cancer among Palestinian and Israeli women (Project COPE) Available from: http://brookdale-en1.pionet.com/files/Project-COPE-Breast-Cancer.pdf.

[34] Roy, S., Vallepu, S., Barrios, C., & Hunter, K. (2018). Comparison of comorbid conditions between cancer survivors and age-matched patients without cancer. Journal of Clinical Medicine Research, 10(12), 911. doi 10.14740/jocmr3617w

[35] Shamallakh, A. N., & Imam, A. M. (2017). Quality of life in patients with cancer in the Gaza Strip: a cross-sectional study. The Lancet, 390, S21 DOI: https://doi.org/10.1016/S0140-6736(17)32072-X

[36] Silbermann, M., & Hassan, E. A. (2011). Cultural perspectives in cancer care: impact of Islamic traditions and practices in Middle Eastern countries. Journal of Pediatric Hematology and Oncology, 33, S81–S86 DOI: 10.1097/MPH.0b013e318230dab6

[37] Smith, A. W., Reeve, B. B., Bellizzi, K. M., Harlan, L. C., Klabunde, C. N., Amsellem, M, Bierman, A. S., & Hays, R. D. (2008). Cancer, comorbidities, and health-related quality of life of older adults. Health care financing review, 29(4), 41–56.

[38] Sun, S., Chen, J., Johannesson, M., Kind, P., Xu, L., Zhang, Y., & Burström, K. (2011). Population health status in China: EQ-5D results, by age, sex, and socio-economic status, from the National Health Services Survey 2008. Quality of life research, 20, 309–320. https://doi.org/10.1007/s11136-010-9762-x

[39] Thweib, N. (2011). Quality of life of Palestinian cancer patients. Journal of Pediatric Hematology and Oncology, 33, S68–S69. DOI: 10.1097/MPH.0b013e3182122438

[40] UN (United Nations). (2017). World Population Ageing 2017: Highlights Book Series: Statistical Papers - United Nations (Ser. A), Population and Vital Statistics Report. ISBN (PDF): 9789213627457. https://doi.org/10.18356/10e32e81-en

[41] WHO (World Health Organization). (2022). Available online: https://www.who.int/news-room/fact-sheets/detail/ageing-and-health (accessed on December 9, 2022).

Abstract

References

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