Quality of life trajectories after diagnosis of gynecologic cancer: A theoretically based approach

Brian D. Gonzalez, Sharon L. Manne, Jerod Stapleton, Shannon Myers-Virtue, Melissa Ozga, David Kissane, Carolyn Heckman, Mark Morgan

Research output: Contribution to journalArticleResearchpeer-review

Abstract

PurposeThe course of quality of life after diagnosis of gynecologic cancer is not well understood. We aimed to identify subgroups of gynecologic cancer patients with distinct trajectories of quality of life outcomes in the 18-month period after diagnosis. We also aimed to determine whether these subgroups could be distinguished by predictors derived from Social-Cognitive Processing Theory.MethodsGynecologic cancer patients randomized to usual care as part of a psychological intervention trial (NCT01951807) reported on depressed mood, quality of life, and physical impairment soon after diagnosis and at five additional assessments ending 18 months after baseline. Clinical, demographic, and psychosocial predictors were assessed at baseline, and additional clinical factors were assessed between 6 and 18 months after baseline.ResultsA two-group growth mixture model provided the best and most interpretable fit to the data for all three outcomes. One class revealed subclinical and improving scores for mood, quality of life, and physical function across 18 months. A second class represented approximately 12 % of patients with persisting depression, diminished quality of life, and greater physical disability. Membership of this high-risk subgroup was associated with holding back concerns, more intrusive thoughts, and use of pain medications at the baseline assessment (ps < .05).ConclusionsTrajectories of quality of life outcomes were identified in the 18-month period after diagnosis of gynecologic cancer. Potentially modifiable psychosocial risk factors were identified that can have implications for preventing quality of life disruptions and treating impaired quality of life in future research.
Original languageEnglish
Pages (from-to)589-598
Number of pages10
JournalSupportive Care in Cancer
Volume25
Issue number2
DOIs
Publication statusPublished - Feb 2017

Keywords

  • Gynecologic neoplasms
  • Quality of life
  • Depression
  • Physical impairment
  • Growth mixture modeling

Cite this

Gonzalez, Brian D. ; Manne, Sharon L. ; Stapleton, Jerod ; Myers-Virtue, Shannon ; Ozga, Melissa ; Kissane, David ; Heckman, Carolyn ; Morgan, Mark. / Quality of life trajectories after diagnosis of gynecologic cancer : A theoretically based approach. In: Supportive Care in Cancer. 2017 ; Vol. 25, No. 2. pp. 589-598.
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abstract = "PurposeThe course of quality of life after diagnosis of gynecologic cancer is not well understood. We aimed to identify subgroups of gynecologic cancer patients with distinct trajectories of quality of life outcomes in the 18-month period after diagnosis. We also aimed to determine whether these subgroups could be distinguished by predictors derived from Social-Cognitive Processing Theory.MethodsGynecologic cancer patients randomized to usual care as part of a psychological intervention trial (NCT01951807) reported on depressed mood, quality of life, and physical impairment soon after diagnosis and at five additional assessments ending 18 months after baseline. Clinical, demographic, and psychosocial predictors were assessed at baseline, and additional clinical factors were assessed between 6 and 18 months after baseline.ResultsA two-group growth mixture model provided the best and most interpretable fit to the data for all three outcomes. One class revealed subclinical and improving scores for mood, quality of life, and physical function across 18 months. A second class represented approximately 12 {\%} of patients with persisting depression, diminished quality of life, and greater physical disability. Membership of this high-risk subgroup was associated with holding back concerns, more intrusive thoughts, and use of pain medications at the baseline assessment (ps < .05).ConclusionsTrajectories of quality of life outcomes were identified in the 18-month period after diagnosis of gynecologic cancer. Potentially modifiable psychosocial risk factors were identified that can have implications for preventing quality of life disruptions and treating impaired quality of life in future research.",
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Gonzalez, BD, Manne, SL, Stapleton, J, Myers-Virtue, S, Ozga, M, Kissane, D, Heckman, C & Morgan, M 2017, 'Quality of life trajectories after diagnosis of gynecologic cancer: A theoretically based approach' Supportive Care in Cancer, vol. 25, no. 2, pp. 589-598. https://doi.org/10.1007/s00520-016-3443-4

Quality of life trajectories after diagnosis of gynecologic cancer : A theoretically based approach. / Gonzalez, Brian D.; Manne, Sharon L.; Stapleton, Jerod; Myers-Virtue, Shannon; Ozga, Melissa; Kissane, David; Heckman, Carolyn; Morgan, Mark.

In: Supportive Care in Cancer, Vol. 25, No. 2, 02.2017, p. 589-598.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Quality of life trajectories after diagnosis of gynecologic cancer

T2 - A theoretically based approach

AU - Gonzalez, Brian D.

AU - Manne, Sharon L.

AU - Stapleton, Jerod

AU - Myers-Virtue, Shannon

AU - Ozga, Melissa

AU - Kissane, David

AU - Heckman, Carolyn

AU - Morgan, Mark

PY - 2017/2

Y1 - 2017/2

N2 - PurposeThe course of quality of life after diagnosis of gynecologic cancer is not well understood. We aimed to identify subgroups of gynecologic cancer patients with distinct trajectories of quality of life outcomes in the 18-month period after diagnosis. We also aimed to determine whether these subgroups could be distinguished by predictors derived from Social-Cognitive Processing Theory.MethodsGynecologic cancer patients randomized to usual care as part of a psychological intervention trial (NCT01951807) reported on depressed mood, quality of life, and physical impairment soon after diagnosis and at five additional assessments ending 18 months after baseline. Clinical, demographic, and psychosocial predictors were assessed at baseline, and additional clinical factors were assessed between 6 and 18 months after baseline.ResultsA two-group growth mixture model provided the best and most interpretable fit to the data for all three outcomes. One class revealed subclinical and improving scores for mood, quality of life, and physical function across 18 months. A second class represented approximately 12 % of patients with persisting depression, diminished quality of life, and greater physical disability. Membership of this high-risk subgroup was associated with holding back concerns, more intrusive thoughts, and use of pain medications at the baseline assessment (ps < .05).ConclusionsTrajectories of quality of life outcomes were identified in the 18-month period after diagnosis of gynecologic cancer. Potentially modifiable psychosocial risk factors were identified that can have implications for preventing quality of life disruptions and treating impaired quality of life in future research.

AB - PurposeThe course of quality of life after diagnosis of gynecologic cancer is not well understood. We aimed to identify subgroups of gynecologic cancer patients with distinct trajectories of quality of life outcomes in the 18-month period after diagnosis. We also aimed to determine whether these subgroups could be distinguished by predictors derived from Social-Cognitive Processing Theory.MethodsGynecologic cancer patients randomized to usual care as part of a psychological intervention trial (NCT01951807) reported on depressed mood, quality of life, and physical impairment soon after diagnosis and at five additional assessments ending 18 months after baseline. Clinical, demographic, and psychosocial predictors were assessed at baseline, and additional clinical factors were assessed between 6 and 18 months after baseline.ResultsA two-group growth mixture model provided the best and most interpretable fit to the data for all three outcomes. One class revealed subclinical and improving scores for mood, quality of life, and physical function across 18 months. A second class represented approximately 12 % of patients with persisting depression, diminished quality of life, and greater physical disability. Membership of this high-risk subgroup was associated with holding back concerns, more intrusive thoughts, and use of pain medications at the baseline assessment (ps < .05).ConclusionsTrajectories of quality of life outcomes were identified in the 18-month period after diagnosis of gynecologic cancer. Potentially modifiable psychosocial risk factors were identified that can have implications for preventing quality of life disruptions and treating impaired quality of life in future research.

KW - Gynecologic neoplasms

KW - Quality of life

KW - Depression

KW - Physical impairment

KW - Growth mixture modeling

UR - https://www.ncbi.nlm.nih.gov/pubmed/27757706

U2 - 10.1007/s00520-016-3443-4

DO - 10.1007/s00520-016-3443-4

M3 - Article

VL - 25

SP - 589

EP - 598

JO - Supportive Care in Cancer

JF - Supportive Care in Cancer

SN - 0941-4355

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ER -