Quality of Life, a study

Research in Nursing and Health 1999

Viewing themselves as survivors and maintaining family relationships can help African-American women remain optimistic and maintain a high quality of life years after they are diagnosed with breast cancer, results of a recent study suggest.

The study of 98 African-American women who survived breast cancer for about 4 years sought to understand factors that affect their quality of life. Researchers looked at demographic variables, such as income and marital status; current concerns; social resources, such as family functioning; and medical factors, such as pain and disease recurrence.

Most women reported a high quality of life and said they felt generally optimistic. The authors note that scores were similar to those from a sample of primarily white breast cancer patients.

Those who felt supported by their families reported a higher quality of life, a finding that ``underscores the importance of including family members in programs of care,'' write Prof. Laurel L. Northouse, with the University of Michigan in Ann Arbor, and the team of researchers from Michigan.

Their study, in the December issue of Research in Nursing and Health, found that certain medical factors such as recurrence of cancer and the presence of cancer cells in the lymph nodes, indicating cancer spread, had a negative effect on the women's quality of life.

However, age, education, marital status, and income did not significantly relate to quality of life.

Women's concerns included wanting their children to be more settled and wanting to feel closer to God. Many women were single parents who had young children, adult children, or both living at home, the investigators found. Those who reported more concerns in their lives appraised their illness as more stressful, which affected the quality of their life.

``It appears that as these other concerns in women's lives increased, they were more likely to view their illness as stressful, which then indirectly affected their quality of life,'' Northouse and colleagues suggest.

Many women reported low energy, sleep disturbances, sensory problems, mental distress and pain. These factors did not necessarily interfere with quality of life.

``The high quality of life reported by many of these women may be attributed to the fact that they were 'cancer survivors' who were, on the average, 4 years postdiagnosis,'' the researchers conclude.

Northouse's team adds that the findings have implications for clinical practice. Health professionals need to help women foster a positive appraisal of their illness, manage current concerns, find support among family members and reduce distressful symptoms, they write.

SOURCE: Research in Nursing and Health 1999;22:449-460.

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