Quality of Life Assessment and Pain Severity in Breast Cancer Patients Prior to Palliative Oncology Treatment in Indonesia: A Cross-Sectional Study.

ABSTRACT

PURPOSE: Studies assessing quality of life (QOL) in palliative care settings are still scarce. We assessed the QOL score and pain severity in advanced breast cancer patients at the National Cancer Hospital in Indonesia and associations between QOL domains with QOL and pain scores. MATERIALS AND METHODS: A total of 160 patients who met the study inclusion criteria (female, >18 years old, diagnosed with stage III or IV breast cancer) answered the European Organization for Research and Treatment of Cancer QOL questionnaire (EORTC QLQ-C15-PAL) and the visual analogue scale (VAS) tool for pain severity, prior to palliative oncology treatment. Additionally, several sociodemographic and clinical characteristics were collected. Linear regression models, adjusted for age, the Karnofsky Performance Status (KPS) score, and specific QOL domains were used to explore the associations between the global QOL and VAS scores with the different QOL domains. RESULTS: The patients had a mean age of 50 years (range 29-76). The overall score for QOL and score for VAS was (mean ± SD) 78.02 ± 15.34 and 2.1 ± 2.4, respectively. The analysis demonstrated that the domains of emotional functioning (effect estimate 0.25; 95% CI 0.14 to 0.37), fatigue (-0.21; -0.33 to -0.09), pain (-0.13; -0.25 to -0.01), insomnia (-0.25; -0.37 to -0.13), and appetite loss (-0.13; -0.25 to -0.008) were associated with the QOL score. Only the KPS score (-0.28; -0.46 to -0.11) was associated with the VAS score. CONCLUSION: Our study showed high QOL and low VAS scores in advanced breast cancer patients prior to palliative oncology treatment. Several QOL domains (emotional functioning, fatigue, pain, insomnia, and appetite loss) were associated with QOL and the KPS was associated with the pain score. Therefore, these specific QOL domains should be given priority in improving QOL in this patient group.