Influencing Factors of Health-Related Quality of Life in Thai Children with Cancer

Main Article Content

Pranee Khamchan
Busakorn Punthmatharith
Wongchan Petpichetchian
Thirachit Chotsampancharoen

Abstract

Identification of factors predicting health-related quality of life (HRQOL) is essential to develop effective interventions for nurse in order to improve HRQOL in children with cancer in Thailand. The descriptive study aimed to examine the influences of family functioning, coping, symptom distress, trait anxiety, state anxiety, functional status, and self-care behavior on HRQOL of children with cancer. Purposive sampling was used to recruit 199 children with cancer and 199 caregivers from eight tertiary hospitals in three parts of Thailand. Children were 9-18 years old, received chemotherapy at least one cycle, had good consciousness, and had no serious conditions. The eight self-report questionnaires were used to collect the data: 1) Demographic data questionnaire, 2) Chulalongkorn Family Inventory, 3) The Play-Performance Scale for Children, 4) The Thai Pediatric Quality of Life Inventory version 4.0, 5) The Thai version of Coping of Disease Inventory, 6) The revised Thai versions of State and Trait Anxiety Inventory for Children, 7) Self-care Behavior Questionnaire, and 8) The Memorial Symptom Assessment Scale 10–18. Caregivers self-reported the first three questionnaires and children self-reported the Questionnaires 4-8. Questionnaires 2, 4-5, and 7-8 were tested for reliability using Cronbach’s alpha coefficient; yielding values of .89, .93, .88, .82, and .91 respectively. The reliability of the Questionnaire 6, yielding the Cronbach’s alpha coefficient of .89 for A-State scale and .88 for A-Trait scale. The test-retest intraclass correlation coefficient for Questionnaire 3 was .93. Descriptive statistics and multiple stepwise regression were used for data analysis.


The results revealed that 33.3 percent of the variance (R2 = .333, p < .001) of the HRQOL of Thai children with cancer was explained by trait anxiety (β = -.391, p < .001) and functional status (β = .347, p < .001). This provides useful information for nurses to promote functional status of children, thereby in enhancing optimal HRQOL in Thai children with cancer.

Article Details

How to Cite
Khamchan, P., Punthmatharith, B., Petpichetchian, W., & Chotsampancharoen, T. (2019). Influencing Factors of Health-Related Quality of Life in Thai Children with Cancer. Journal of Research in Nursing-Midwifery and Health Sciences, 39(3), 1–16. Retrieved from https://he02.tci-thaijo.org/index.php/nur-psu/article/view/218938
Section
Research Articles

References

Ministry of Public Health. Public health statistics [Internet]. 2016 [cited 2018 Jul 2]. Available from: http://bps.ops.moph.go.th/index.php?mod=bps&doc=5

Imsamran W, Chaiwarawattana A, Wiangnon S, et al. Cancer in Thailand. (Vol VIII, 2010-2012) [Internet]. National Cancer Institute, Thailand; 2015 [cited 2018 Jul 2]. Available from: http://www.nci.go.th/th/File_download/Nci%20Cancer%20Registry/Cancer%20in%20Thailand8.pdf

National Cancer Institute. Hospital-based cancer registry 2015. Bangkok: Rumthaiplace; 2017. Available from: http://www.nci.go.th/th/cancer_record/cancer_rec1.html

Li HCW, Lopez V, Chung JOK, et al. The impact of cancer on the physical, psychological and social well-being of childhood cancer survivors. Eur J Oncol Nurs. (2013); 17(2): 214-219.

Momani TG, Mandrell BN, Gattuso JS, et al. Children's perspective on health-related quality of life during active treatment for acute lymphoblastic leukemia: an advanced content analysis approach. Cancer Nurs. 2015; 38(1): 49-58.

Ruland CM, Hamilton GA, Schjødt-Osmo B. The complexity of symptoms and problems experienced in children with cancer: a review of the literature. J Pain Symptom Manage. 2009; 37(3): 403-418. doi:10.1016/j.jpainsymman.2008.03.009.

Ferreira KA, Kimura M, Teixeira MJ, et al. Impact of cancer-related symptom synergisms on health-related quality of life and performance status. J Pain Symptom Manage. 2008; 35(6): 604-16. doi:10.1016/j.jpain symman.2007.07.010

Sodergren SC, Husson O, Robinson J, et al. Systematic review of the health-related quality of life issues facing adolescents and young adults with cancer. Qual Life Res. 2017; 26(7): 1659-72.

World Health Organization. The World Health Organization quality of life assessment (WHOQOL): position paper. Soc Sci Med. 1995; 41(10): 1403-9.

Ferrans CE, Zerwic JJ, Wilbur JE, et al. Conceptual model of health-related quality of life. J Nurs Scholarsh. 2005; 37(4): 336-42.

Taylor RM, Gibson F, Franck LS. A concept analysis of health-related quality of life in young people with chronic illness. J Clin Nurs. 2008; 17(14): 1823-33. doi:10.1111/j. 1365-2702.2008.02379.x

Landolt MA, Vollrath M, Niggli FK, et al. Health-related quality of life in children with newly diagnosed cancer: a one year follow-up study. Health Qual Life Outcomes. 2006; 4(64): 1-8.

Fakhry H, Goldenberg M, Sayer G, et al. Health-related quality of life in childhood cancer. J Dev Behav Pediatr. 2013; 34: 419-40.

Yagci-Kupeli B, Akyuz C, Kupeli S, et al. Health-related quality of life in pediatric cancer survivors. J Pediatr Hematol Oncol. 2012; 34(3): 194-9.

Eiser C, Eiser JR, Stride CB. Quality of life in children newly diagnosed with cancer and their mothers. Health Qual Life Outcomes. 2005; 3(29): 1-5. doi:10.1186/1477-7525-3-29

Eilertsen BM, Jozefiak T, Rannestad T, et al. Quality of life in children and adolescents surviving cancer. Eur J Oncol Nurs. 2012; 16: 185-93.

Punthmatharith B, Buddharat U, Wattanasit P. Predictive factors for quality of life of among children with cancer in Thailand. Thai Cancer Journal. 2013; 34(1): 3-17. Thai

Jitnumsub, P. (2009). Quality of life in acute leukemia patients in Siriraj hospital [Master’s independent study]. [Bangkok]: Silpakorn University; 2009. 92 p. Thai.

Punthmatharith B, Buddharat U, Wattanasit P. Quality of life and factors influencing quality of life of cancer children in southern Thailand. Songkla Med J. 2008; 26(5): 501-11. Thai.

Stokke J, Sung L, Gupta A, et al. Systematic review and meta-analysis of objective and subjective quality of life among pediatric, adolescent, and young adult bone tumor survivors. Pediatr Blood Cancer. 2015; 62: 1616-29.

Pek JH, Chan YH, Yeoh AE, et al. Health-related quality of life in children with cancer undergoing treatment: a first look at the Singapore experience. Ann Acad Med Singapore. 2010; 39(1): 43-8.

Klassen A, Anthony S, Khan A, et al. Identifying determinants of quality of life of children with cancer and childhood cancer survivors: a systematic review. Supportive Care Cancer. 2011; 19(9): 1275-87. doi:10.1007/s00520-011-1193-x

Maurice-Stam H, Oort F, Last B, Brons P, et al. School-aged children after the end of successful treatment of non-central nervous system cancer: longitudinal assessment of health-related quality of life, anxiety and coping. Eur J Cancer Care. 2009; 18(4): 401-10. doi:10.1111/j.1365-2354.2008.01041.x

Baggott C, Dodd M, Kennedy C, et al. An evaluation of the factors that affect the health-related quality of life of children following myelosuppressive chemotherapy. Support Care Cancer. 2011; 19(3): 353-61.

Sato I, Higuchi A, Yanagisawa T, et al. Factors influencing self- and parent-reporting health-related quality of life in children with brain tumors. Qual Life Res. 2013; 22(1): 185-201. doi:10.1007/s11136-012-0137-3

Fortier MA, Batista ML, Wahi A, et al. Illness uncertainty and quality of life in children with cancer. J Pediatr Hematol Oncol. 2013; 35(5): 366-70.

Barakat LP, Marmer PL, Schwartz LA. Quality of life of adolescents with cancer: family risk and resource. Health Qual Life Outcomes. 2010; 8(63): 1-8.

Wilson IB, Cleary PD. Linking clinical variables with health-related quality of life: a conceptual model of patient outcomes. JAMA. 1995; 273(1): 59-65. doi:10.1001/jama. 1995.03520250075037

Vlachioti E, Matziou V, Perdikaris P, et al. Assessment of quality of life of children and adolescents with cancer during their treatment. Jpn J Clin Oncol. 2016; 46(5): 453-61.

Stam H, Grootenhuis MA, Caron HN, et al. Quality of life and current coping in young adult survivors of childhood cancer: positive expectations about the further course of the disease were correlated with better quality of life. Psycho-oncology. 2006; 15(1): 31-43.

Khamchan P. A causal model health-related quality of life in Thai children with cancer [dissertation]. [Songkhla]: Prince of Songkla University; 2018. 228 p.

Vorapongsathon T. Considerations in using multiple regression for research. Thai J Hlth Res. 1989; 3(1): 55-62. Thai.

Varni JW. The PedsQLTM measurement model for the pediatric quality of life inventoryTM[Internet]. 1998 [cited 2014 Dec 22]. Available from http://www.pedsql.org

Varni JW, Seid M, Kurtin PS. PedsQL 4.0: Reliability and validity of the Pediatric Quality of Life Inventory version 4.0 generic core scales in healthy and patient populations. Med Care. 2001; 39(8): 800-812.

Sritipsukho P, Wisai M, Thavorncharoensap M. Reliability and validity of the Thai version of the Pediatric Quality of Life Inventory 4.0. Qual Life Res. 2013; 22(3): 551-7. doi:10.1007/s11136-012-0190-y

Suwannaosod S. A structural equation model of spiritual well-being, depression, and health-related quality of life among Thai adolescents with cancer [dissertation]. [Ohio]: Kent State University; 2017. 155 p.

Trangkasombat U. Family functioning in the families of psychiatric patients: a comparison with nonclinical families. J Med Assoc Thai. 2006; 89(11): 1946-53. Thai.

Oupraman W. Family functioning in the families of depressed and nondepressed children [master’s thesis]. [Bangkok]: Chulalongkorn University; 1994. 134 p. Thai.

Epstein NB, Baldwin LM, Bishop DS. The Mcmaster Family Assessment Device. J Marital Fam Ther. 1983; 9(2): 171-80.

Collins JJ, Byrnes ME, Dunkel IJ, et al. The measurement of symptoms in children with cancer. J Pain Symptom Manage. 2000; 19(5): 363-77.

Hilton A, Skrutkowski M. Translating instruments into other languages: development and testing processes. Cancer Nurs. 2002; 25(1): 1-7.

Chaiyawat W. Psychometric properties of the Thai version of the state-trait anxiety inventory for children-revised (STAIC-R) and the child medical fear scale-revised (CMFS-R) in Thai school age children [dissertation]. [New York]: University at Buffalo; 2000. 193 p.

Lansky SB, List MA, Lansky LL, et al. The measurement of performance in childhood cancer patients. Cancer. 1987; 60(7): 1651-6.

Silapavitayatorn B. Uncertainty in illness and coping strategies among children with cancer [master’s thesis]. [Chiang Mai]: Chiang Mai University; 2008. 85 p. Thai.

Spielberger CD, Reheiser EC. Assessment of emotions: anxiety, anger, depression, and curiosity. Appl Psychol Health Well Being. 2009; 1(3): 271–302.

Goldstein J. Play in children’s development, health and well-being [Internet]. 2012 [cited 2018 Jul 2]. Available from: http://www.jouercestlavie.fr/IMG/pdf/play_in_children_s_development_health_and_well-being_-_final.pdf

Aldridge AA, Roesch SC. Coping and adjustment in children with cancer: a meta-analytic study. J Behav Med. 2007; 30(2): 115-29. doi:10.1007/s10865-006-90

Hampel P, Petermann F. Age and gender effects on coping in children and adolescents. J Youth Adolesc. 2005; 34(2): 73-83.

Zimmer-Gembeck MJ, Skinner EA. Review: The development of coping across childhood and adolescence: an integrative review and critique of research. Int J Behav Dev. 2011; 35(1): 1-17.

Ruccione K, Lu Y, Meeske K. Adolescents' psychosocial health-related quality of life within 6 months after cancer treatment completion. Cancer Nurs. 2013; 36(5): E61-72. doi:10.1097/NCC.0b013e3182902119

Kanellopoulos A, Hamre HM, Dahl AA, et al. Factors associated with poor quality of life in survivors of childhood acute lymphoblastic leukemia and lymphoma. Pediatr Blood Cancer. 2013; 60(5): 849-55. doi:10.1002/pbc.24375

Spielberger CD, Reheiser EC. Measuring anxiety, anger, depression, and curiosity as emotional states and personality traits with the STAI, STAXI, and STPI. In: Hersen M, Hilsenroth MJ, Segal DL, editors. Comprehensive handbook of psychological assessment: personality assessment. Vol 2. New Jersey: Wiley; 2004. p. 70-86.

Vaezzadeh N, Douki ZE, Hadipour A, et al. The effect of performing preoperative preparation program on school age children's anxiety. Iran J Pediatr. 2011; 21(4): 461-6.

Pao M, Bosk A. Anxiety in medically ill children/adolescents. Depress Anxiety. 2011; 28(1): 40-9. doi:10.1002/da.20727

Lu C, Yuan L, Lin W, et al. Depression and resilience mediates the effect of family function on quality of life of the elderly. Arch Gerontol Geriatr. 2017; 71: 34-42.

Boylu AA, Copur Z, Oztop H. Investigation of the factors influencing family functions style. IJRBS. 2013; 2(3): 26-40.

Phuong Minh N. Factors associated with self-care behavior among school-age children with thalassemia in Thai Nguyen, Vietnam [master’s thesis]. [Chonburi]: Burapha University; 2014. 91 p.

Hinds PS, Billups CA, Cao, X, et al. Health-related quality of life in adolescents at the time of diagnosis with osteosarcoma or acute myeloid leukemia. Eur J Oncol Nurs. 2009; 13(3): 156-63.