Abstract
The purpose of this study was to analyze the psychological well-being, quality of life, and cognitive strategies activated by patients with high-grade glioma. We hypothesized that the self-perceived quality of life is modulated by physical and psychological factors and that in order to understand this modulation more psychometric approaches are necessary. Data were collected from a sample of 73 consecutive patients with a histological diagnosis of primary malignant brain cancer (grade IV glioblastoma and grade III anaplastic astrocytoma) hospitalized in a specialized Italian center. The Functional Assessment of Cancer Therapy (FACT) scale and the Schedule of Evaluation of Individual Quality of Life–Direct Weighting (SEIQoL-DW) scale were used to assess quality of life. The mean FACT-Brain (Br) score was 122.37. Similarly, the median SEIQoL-DW score was 72.9 out of a maximum value of 100. No gender effect was found in relation to overall quality of life. Patients with high depression and/or anxiety scores reported lower quality of life (QoL) scores in all the instruments considered. We did not find any gender effect concerning depression and anxiety levels. However, we found that men and women, though having similar physical and functional well-being, reported different QoL determinants, since men seem to rely more on physical adjustment, while women activate more introspective strategies. Positive actions, family issues, negative thoughts, health, and positive thoughts were found to be the most reported themes. In conclusion, the present study strongly suggests that a positive psychological adjustment is possible also in the event of a severe diagnosis and during aggressive treatments, but QoL determinants might be considered too in order to help health professionals to understand patients’ experience and to meet their needs.
Similar content being viewed by others
References
Louis DN, Ohgaki H, Wiestler OD, Cavenee WK, Burger PC, Jouvet A, Kleihues P (2007) The 2007 WHO classification of tumours of the central nervous system. Acta Neuropathol 114:97–109. doi:10.1007/s00401-007-0243-4
Ostrom QT, Bauchet L, Davis FG, Deltour I, Fisher JL, Langer CE, Barnholtz-Sloan JS (2014) The epidemiology of glioma in adults: a “state of the science” review. Neuro Oncol 16(7):896–913
Stupp R, Mason WP, Van Den Bent MJ, Weller M, Fisher B, Taphoorn MJ et al (2005) Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med 352(10):987–996
Taphoorn MJ, Sizoo EM, Bottomley A (2010) Review on quality of life issues in patients with primary brain tumors. Oncologist 15(6):618–626
Bottomley A (2002) The cancer patient and quality of life. Oncologist 7:120–125. doi:10.1634/theoncologist.7-2-120
Carr AJ, Gibson B, Robinson PG (2001) Measuring quality of life: Is quality of life determined by expectations or experience? BMJ 322:1240–1243. doi:10.1136/bmj.322.7296.1240
Keir ST, Calhoun Eagan RD, Swartz JJ, Saleh OA, Friedman HS (2008) Screening for distress in patients with brain cancer using the NCCN's rapid screening measure. PsychoOncology 17:621–625
Pelletier G, Verhoef MJ, Khatri N, Hagen N (2002) Quality of life in brain tumor patients: the relative contributions of depression, fatigue, emotional distress, and existential issues. J Neurooncol 57:41–49. doi:10.1023/A:1015728825642
Cheng JX, Zhang X, Liu BL (2009) Health-related quality of life in patients with high-grade glioma. NeuroOncol 11:41–50. doi:10.1215/15228517-2008-050
Wasner M, Paal P, Borasio GD (2013) Psychosocial care for the caregivers of primary malignant brain tumor patients. J Soc Work End-Life Palliat Care 9(1):74–95
Bosma I, Reijneveld JC, Douw L, Vos MJ, Postma TJ, Aaronson NK, Klein M (2009) Health-related quality of life of long-term high-grade glioma survivors. Neuro Oncol 11(1):51–58
Strang S, Strang P (2001) Spiritual thoughts, coping and ‘sense of coherence’ in brain tumour patients and their spouses. Palliat Med 15(2):127–134
Holzner B, Kemmler G, Sperner-Unterweger B, Kopp M, Dunser M, Margreiter R, Greil R (2001) Quality of life measurement in oncology – a matter of the assessment instrument? Eur J Cancer 37:2349–2356. doi:10.1016/S0959-8049(01)00307-0
Lucchiari C, Botturi A, Pravettoni G (2010) The impact of decision models on self-perceived quality of life: a study on brain cancer patients. ecancer 4:187–196. doi:10.3332/ecancer.2010.187
Waldron D, O'Boyle AC, Kearney M, Moriarty M, Carney D (1999) Quality-of-life measurement in advanced cancer: Assessing the individual. J Clin Oncol 17:3603–3611
Matud MP (2004) Gender differences in stress and coping styles. Personal Individ Differ 37:1401–1415
Folstein MF, Folstein SE, McHugh PR (1975) Mini-mental state. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12:189–198
Costantini M, Musso M, Viterbori P, Bonci F, Del Mastro L, Garrone O et al (1999) Detecting psychological distress in cancer patients: validity of the Italian version of the Hospital Anxiety and Depression Scale. Support Care Cancer 7:121–127. doi:10.1007/s005209900026
Zigmond AS, Snaith RP (1983) The hospital anxiety and depression scale. Acta Psychiat Scand 67:361–370. doi:10.1111/j.1600-0447.1983.tb09716.x
Cella DF, Bonomi AE, Lloyd SR, Tulsky DS, Kaplan E, Bonomi P (1995) Reliability and validity of the Functional Assessment of Cancer Therapy–Lung (FACT-L) quality of life instrument. Lung Cancer 12(3):199–220
Hickey AM, Bury G, O’Boyle CA, Bradley F, O’Kelly FD, Shannon W (1996) A new short form individual quality of life measure (SEIQoL-DW): Application in a cohort of individuals with HIV/AIDS. Br Med J (Clin Res Ed) 313:29–33
Felgoise SH, Stewart JL, Bremer BA, Walsh SM, Bromberg MB, Simmons Z (2009) The SEIQoL-DW for assessing quality of life in ALS: strengths and limitations. Amyotroph Lateral Scler 10(5–6):456–462
Wettergren L, Kettis-Lindblad Å, Sprangers M, Ring L (2009) The use, feasibility and psychometric properties of an individualised quality-of-life instrument: a systematic review of the SEIQoL-DW. Qual Life Res 18(6):737–746
Farquhar M, Ewing G, Higginson IJ, Booth S (2010) The experience of using the SEIQoL-DW with patients with advanced chronic obstructive pulmonary disease (COPD): issues of process and outcome. Qual Life Res 19(5):619–629
Moons P, Marquet K, Budts W, De Geest S (2004) Validity, reliability and responsiveness of the “Schedule for the Evaluation of Individual Quality of Life - Direct Weighting” (SEIQoL-DW) in congenital heart disease. Health Qual Life Outcomes 2:27
Ritchie J, Spencer L (1994) Qualitative data analysis applied policy research. In: Bryman A, Burgess T (eds) Analysing qualitative data. Routledge, London, pp 173–194
Kvale EA, Murthy R, Taylor R, Lee JY, Nabors LB (2009) Distress and quality of life in primary high-grade brain tumor patients. Support Care Cancer 17:793–799. doi:10.1007/s00520-008-0551-9
Brown PD, Ballman KV, Rummans TA, Maurer MJ, Sloan JA, Boeve BF et al (2006) Prospective study of quality of life in adults with newly diagnosed high-grade glioma. J Neurooncol 76:283–291. doi:10.1007/s11060-005-7020-9
Giovagnoli AR, Tamburini M, Boiardi A (1996) Quality of life in brain tumor patients. J Neurooncol 30(1):71–80. doi:10.1007/BF00177445
Pringle AM, Taylor R, Whittle IR (1999) Anxiety and depression in patients with an intracranial neoplasm before and after tumour surgery. Br J Neurosurg 13:46–51. doi:10.1080/02688699944177
Litofsky NS, Farace E, Anderson F, Meyers CA, Huang W, Laws ER Jr (2004) Depression in patients with high-grade glioma: results of the Glioma Outcomes Project. Neurosurgery 54:358–366. doi:10.1227/01.NEU.0000103450.94724.A2
Catt S, Chalmers A, Fallowfield L (2008) Psychosocial and supportive-care needs in high-grade glioma. Lancet Oncol 9:884–891. doi:10.1016/S1470-2045(08)70230-4
Zeidner M, Saklofske D (1996) Adaptive and maladaptive coping. In: Zeidner M, Endler NS (eds) Handbook of coping: theory, research, applications. John Wiley & Sons, Oxford, pp 505–531, xxi
Role of funding source
The study was not funded
Conflict of interest
Authors declared no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Lucchiari, C., Botturi, A., Silvani, A. et al. Cognitive strategies and quality of life of patients with high-grade glioma. Support Care Cancer 23, 3427–3435 (2015). https://doi.org/10.1007/s00520-015-2691-z
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00520-015-2691-z