Objective:
To investigate predictors of general QoL and health status of advanced cancer patients in the outpatient setting considering disease severity and disability related variables including mobility and to find the association between subjective symptoms and mobility.
Method:
A cross-sectional study involved 494 patients with advanced cancer with five types of cancers (colon, breast, uterus, liver and lung) using stratified sampling. Data collection was carried out through one-on-one interviews by trained nurses. Global Disability (GD) including mobility was evaluated using the 36-item version of WHODAS 2.0 questionnaire while symptom and performance were assessed using Memorial Symptom Assessment Scale-Short Form and Karnofsky performance Status Scale. Hierachial block regression analyses were conducted to identify predictors of general quality of life, measured with vas score.
Results:
About 30% of advanced cancer patients had moderate/severe GD and general health status decreased with increase especially in the domains of mobility (β coefficient = 0.78, p<0.001). Advanced cancer patients with three factors of anxiety, pain and fatigue explained 23% of the variance of mobility. In the subgroup divided according to the cancer type, fatigue significantly predicted disability in all cancer types, however, pain significantly related only in colon, uterus and breast cancer patients after adjustment of other symptoms. With a unit increase in the domains of mobility, there was 66% increase in GD after adjustment of three symptom factors.
Conclusion
The general health status of the advanced cancer patients are influenced by the disability level especially of mobility and participation limitation. Some symptoms such as anxiety, pain and fatigue may affect the functional level in different patterns according the cancer types. Intervention for improving the mobility level could be effective management for patients with advanced cancer.
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