An exploratory study to descrive the QUALITY OF LIFE OF VETERANS WITH LUNG AND DISSEMINATED COLON CANCERS FROM DIAGNOSIS TO DEATH
Lucille Specht Ryan (1987)
This prospective exploratory study describes the quality of life of veterans with lung and disseminated colon cancers from the time of diagnosis to death. Participants included 268 patients with lung cancer and 70 with colon cancer from eleven Veterans Administration Medical Centers who completed self-assessment forms on a monthly basis. Quality of life was defined as a subjective response to the symptoms and life style changes associated with the diagnosis and treatment of cancer. Data was obtained using a modified version of the Quality of Life Index (QLI) including 40 visual analogue scales (100 mm). Factor analysis revealed four factors which are labeled Vitality, Freedom from Psychological Distress, Freedom from Acute Physical Side Effects and Freedom from Breathing Problems. The Vitality factor, which includes items related to psychological and physical well-being, was most highly correlated with quality of life (r =.93). Serial plots and the results of t tests and RMANOVA reveal that, although both groups had similar quality of life at the time of diagnosis, patients with lung cancer experienced significantly lower quality of life on all four factors and overall quality of life throughout most of their illness. The most striking finding was that, during the final six months of life for the colon cancer patients, quality of life declined precipitously. One month before death, quality of life for both groups was again equal and at very low levels (Overall quality of life M = 24 mm). Additional findings indicate that both groups experienced an increase in acute physical symptoms during the first three months but no further change. The colon cancer patients experienced some relief from psychological distress during the first three months, but lung cancer patients did not. Rather, the lung cancer patients experienced progressive declines in Vitality and Overall Quality of Life. While Freedom from Breathing Problems scores were consistently lower for the lung cancer patients, both groups experienced marked declines as death approached. Based on these findings several suggestions for clinical interventions are made.