Significant determinants in predicting health-related quality of life among Chinese cancer patient and caregiver dyads in Hong Kong

Abstract

BACKGROUND: Cancer is a major disorder that physically and psychologically exerts a considerable impact on health-related quality of life (HRQOL) not only for cancer patients, but also for caregivers. It has been reported that cancer patients and caregivers experience high stress level, sleep disturbance, anxiety, depression, and had impaired HRQOL. However, few studies has investigated HRQOL and determined the impacts of physical, psychological factors, physical activity and social support on HRQOL for cancer patients-caregiver dyads. METHODS: This study aims to investigate HRQOL and determine significant factors in HRQOL for both cancer patients and their caregivers. 231 mixed type cancer patient-caregiver dyads completed an online questionnaire consisting of short form-12 health survey (SF-12), perceived stress scale (PSS), Pittsburg sleep quality index (PSQI), hospital anxiety and depression scale (HADS), international physical activity questionnaire (IPAQ) and multidimensional scale of perceived social support (MSPSS). Multiple linear regressions using HRQOL as dependent variables and PSS, PSQI, HADS anxiety and depression scores, natural log (IPAQ), and MSPSS as the independent variables were conducted for cancer patients and caregivers separately. RESULTS: Mean age was 57.4 (SD=10.4) and 53.7 (SD=12.5) for patients and caregivers, respectively. For patients, HADS-depression [standardized coefficient beta=-0.305, (p <.001)], natural log (IPAQ) (0.268, p<.001) and MSPSS-friend (0.154, p=.017) were significant predictors in SF-12 physical composite score (PCS). HADS-depression (-0.366, p<.001), HADS-anxiety (-0.435, p<.001) and caregiver’s MSPSS-family (0.098, p=0.021) were significant predictors in SF-12 mental composite score (MCS). For caregivers, PSQI (-0.324, p<.001), age (-0.294, p<.001), HADS-depression (-0.193, p<.001), gender of female (-0.141, p=.013) and patients’ MSPSS-total (0.115, p=.047) were found to be significant in predicting SF-12 PCS. While HADS-depression (-0.320, p<.001), PSS (-0.302, p<.001), HADS-anxiety (-0.236, p=.004) and age (0.118, p=.009) were significant predictors in SF-12 MCS. CONCLUSION: For cancer patients, depression score was a risk factor, physical activity, friends support were protective factors for cancer patients’ physical wellbeing; while depression and anxiety scores were risk factors and caregivers’ perceived family support was a protective factor in cancer patients’ mental wellbeing. For caregivers, except for patients’ perceived social support-total score as a protective factor, sleep disturbance, depression and anxiety scores, older age and female were risk factors for caregivers’ physical wellbeing. However, for caregivers’ mental wellbeing, except for older age as a protective factor, depression and anxiety scores, and high stress were risk factors.