Quality of Life of Patients with Advanced Cancer in Treatment: Review and Qualitative Synthesis

Hansen, Cristiano de Assis Pereira; Nunes, Carlos Roberto de Oliveira; Fernandes, Tatiane Aparecida Simas

doi:10.32635/2176-9745.RBC.2024v70n4.4835

home Sumário navigate_before Anterior Atual Seguinte navigate_next

home Sumário

Literature Review • Rev. Bras. Cancerol. 70 (4) • 2024 • https://doi.org/10.32635/2176-9745.RBC.2024v70n4.4835 linkcopy

Quality of Life of Patients with Advanced Cancer in Treatment: Review and Qualitative Synthesis

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Introduction: Global cancer incidence has increased and many patients live for a long time with a metastatic disease when it is important to discuss the quality of life during treatment.

Objective: To conduct a qualitative literature review to describe what are the main factors affecting the quality of life of patients with advanced cancer in oncological treatment highlighting the most relevant findings in the perspective of the patients.

Method: Nine articles that form the corpus of analysis have been selected. The methodological approach was Bardin´s content analysis through code frequency, co-occurrence and contingent analysis, eventually leading to a final thematic synthesis.

Results: Eleven themes and fifteen sub-themes addressing the main theme were found: possibility of becoming a family burden. The theme least related to the others, possibly indicating a complementary dimension, was keeping hope.

Conclusion: Qualitative synthesis concluded that concerns regarding family support network appear to significantly influence the quality of life of patients with advanced cancer under treatment.

Key words:
Quality of Life; Neoplasm Metastasis; Qualitative Research; Indicators of Quality of Life

Author	Country	Participants	Research objective	Method	Results	MMAT score
Luoma M; Hakamies-Blomqvist, 2004²¹	Finland	Twenty-five women with advanced breast cancer, under chemotherapy treatment, aged between 18 and 70 years old	Investigate factors that affect QL and are not perceived by a quantitative assessment instrument (EORTC QLQ C30)	Purposive sampling until theoretical saturation is achieved (reached with 18 participants) within a clinical trial. Semi-structured interviews were subjected to phenomenological analysis. The AtlasTi software was used.	The treatment is capable of negatively influencing QL (due to side effects) and sometimes positively (with oncological pain relief or regained capacity to do good things). Being able to work helped the QL of some patients, as well as support from friends and family. Learning to live day-to-day had a positive effect.	5
Janssens et al., 2021²²	Belgium and Italy	Twenty-four patients in treatment for lung cancer, average age of 62 years-old	Investigate how patients with advanced lung cancer perceive their QL and what they consider most important in its determination	Purposive sampling of patients submitted to focus groups with transcribed interviews for thematic analysis. The NVivo software was used	Three themes were found: physical aspects, psychological aspects and social aspects. Changes in physical appearance, nausea, fatigue, sensory changes and risk of infections affected QL. Loss of autonomy, freedom and independence affected QL. Social interaction is capable to keep QL and communication with health professionals can be negative	5
Lee Mortensen et al., 2018²³	Denmark	Eighteen women with metastatic breast cancer aged between 41 and 72 years old	Exploring QL of Danish women with metastatic breast cancer and a possible relationship with their support needs.	Purposive sampling in multiple oncological centers of the country was explored through focus groups, with transcription of sessions and thematic analysis through constructive approach. The NVivo software was used	Two themes were explored: impact of metastatic cancer on QL and treatment and need for support. Symptoms or effects on the physical sphere compromised QL, highlighting fatigue. Continuing working or establishing goals helped QL. Emotional issues like depression and anxiety had an impact on QL. On the subject of need for support, exams cause anxiety and reduce the time available in the day-to-day. Social assistance and timely psychological support were other needs	4
Berterö et al., 2008²⁰	Sweden	Twenty-three patients with advanced lung cancer under treatment, 12 men, average age of 63 years-old	Describe how people with advanced cancer diagnosis experienced the impact of the disease on their life situation and QL	Purposive sampling and qualitative interviews guided by the phenomenology approach	Six themes were found and one great general theme that aimed at capturing the general essence of the study object (QL): live with the usual	5
Ginter A.C, 2020²⁴	USA	Nine young women (up to 40 years old) with metastatic breast cancer	Understand the life experience of young women with metastatic breast cancer, particularly the essence of their QL	Purposive sampling and recruitment in cascade motion with semistructured interviews guided by phenomenological approach and life course theory that guided the thematic analysis	Five themes were found: "this should not be happening right now", "how do I tell the others", "benefits of keeping the mind busy", "contemplating the future" and "living instead of surviving"	5
Lee et al., 2016²⁵	Singapore	Forty-six patients with advanced cancer, similar proportion of men and women, average age 59 years-old and breast cancer (19), colorectal (7) and lung (6), mainly	Identify QL domains exploring the subjective experience of what constitutes a good QL to the participants	Purposive sampling in two reference locations in Singapore Interviews and focus groups were conducted, subjected to thematic analysis The NVivo software was used	Twenty-two themes were found, grouped in six domains: "pain and suffering", "social health", "mental health", "spiritual health", "financial well-being" and "physical health"	5
CharalambousA; Kouta C, 2016²⁶	Cyprus	Fifteen men with advanced prostate cancer under chemotherapy treatment	Explore cancer-related fatigue and its impact on the overall QL of patients	Purposive sampling in two outpatient oncology services of public hospitals in Cyprus, up to theoretical saturation. Open question interviews were conducted, object of the thematic analysis	Three themes were found: "dependency on others", "loss of decision-making power" and "disruption of daily life"	5
Rowland et al., 2014²⁷	United Kingdom	Nine patients with advanced lung cancer, mostly men (6), average age of 66 years-old	Explore the perception of patients on their QL, considering their view on smoking	Purposive sampling with maximum variation strategy, in which semistructured interviews were conducted until theoretical saturation. A thematic analysis was conducted from an interpretive and phenomenological approach	Five themes were found: "effects of the disease on QL", "family support", "coping strategies", "medical support" and "smoking". Helped QL: adaptation, family support, open communication between the couple, hobbies or interests, in addition to focusing on the future. Affected QL: physical limitations, cancer stigma causing feeling of isolation and family concern	5
Parra-Morales et al., 2021²⁸	Colombia	Seven men with advanced prostate cancer under treatment, average age of 60 years-old	Describe the perception of patients regarding changes in their QL since the diagnosis and during treatment	Purposive sampling, maximum variation of types with patients from the public or private systems, with a history of 1.5 to 4.5 years since the diagnosis, submitted to different treatments. Semistructured phone interviews were conducted and submitted to thematic analysis according to Braun & Clarke	Nine categories were found (five at first, reported in the literature review, and four new). Affected QL: urinary symptoms (mostly urinary obstruction), sexual dysfunction, hormonal changes (mostly hot flashes), pain/fatigue/nausea, changes in disposition and mental health (mostly negative emotions about the diagnosis), functional limitations (preventing the practice of sports, for example), health system issues (access limitations). Helped QL: incorporating personal practices (new lifestyle, spirituality/religiosity and positive attitude) and social support (from family and, mostly, medical assistance)	5

vertical_align_top show_chart

more_horiz close
- image
- translate
- link
- article
- vertical_align_top
- file_download
- show_chart
- image
- translate
- link
- article

location_on

Instituto Nacional de Câncer Rua Marquês de Pombal, 125 - 2º andar, Centro , CEP 20230-240, Tel.: +55 21 3207-6132 - Rio de Janeiro - RJ - Brazil
E-mail: rbc@inca.gov.br

rss_feed Acompanhe os números deste periódico no seu leitor de RSS

1. Compromised functionality	8. Keeping away bad thoughts	15. Social isolation	22. Health services interaction helps	29. Thinking of a meaning for life
2. Negative effects of the treatment	9. Support from work colleagues	16. Loss of autonomy	23. Adaptation	30. Spirituality
3. Positive effects of the treatment	10. Enjoy life	17. Preserved functionality	24. Not having financial concerns	31. Expressing the experience of cancer
4. Oncological pain	11. Family	18. Doubts about the future	25. Having financial concerns	32. Lack of a normal life
5. Fatigue	12. Keeping normality	19. Keeping hopes up	26. Learning or experimenting new things	33. Smoking
6. Cancer stigma	13. Lack of hope	20. Feeling of being a burden on the family	27. Keeping the mind busy	34. Taking care of their health
7. Accomplishing small things	14. Support from friends	21. Health services interaction impairs	28. Having a goal