ASPO Abstracts
Quality of Life, Patient Satisfaction, and Psychological Distress in Women with Hormone Receptor Positive (HR) Breast Cancer
Category: Survivorship & Health Outcomes/Comparative Effectiveness Research
Conference Year: 2019
Abstract Body:
Study Purpose: This study examined the impact of patient satisfaction on quality of life in women with hormone receptor positive breast cancer. Furthermore, psychological distress was examined as a mediator of the relationship between patient satisfaction and quality of life. Methods: Three hundred eighty three women with HR+ breast cancer receiving adjuvant hormonal therapy completed baseline measures, including the Functional Assessment of Cancer Therapy-Breast (FACT-B), National Comprehensive Cancer Network (NCCN) Distress Thermometer, Patient Satisfaction Questionnaire — 18 (PSQ-18) and background measures of socio-demographic, lifestyle and medical characteristics. Subjects were recruited from Georgetown University, Kaiser Permanente -Atlanta, and Henry Ford Health System - Detroit, MI. Eligible participants were women with hormone receptor positive invasive breast, > 18 years of age, non-metastatic cancer, were fluent in English, and initiated adjuvant hormonal therapy within 12 months of their diagnosis. Results: Patient satisfaction was positively correlated with total Quality of Life and all FACT-B subscales (physical well-being, social well-being, emotional well-being, functional well-being, and an additional Breast Cancer Subscale) (r=1.8-4.1, p<.05). A regression-based approach to mediation analysis was conducted using PROCESS to determine if distress mediates the predictive effect of patient satisfaction on quality of life. The standardized regression coefficient between patient satisfaction and distress was statistically significant, as was the standardized regression coefficient between patient satisfaction and QoL. The indirect effect was (-.0543)(-1.823) = .099. The significance of this indirect effect was tested using bootstrapping procedures. The bootstrapped unstandardized indirect effect was .099, and the 95% confidence interval ranged from .043, .169. Thus, the indirect effect was statistically significant. Conclusions: Results support the positive relationship between patient satisfaction and psychosocial outcomes (QoL), as well as how distress can mediate this relationship. This highlights the need for physician-based interventions that improve the manner in which treatment is delivered to breast cancer patients.
Keywords: Breast Cancer, Quality of Life, Patient Satisfaction