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S Kaasa

Publications and source records attributed to S Kaasa.

At least 91 records · Page 5Linked to original sources
PubMed1998

Health-related quality of life in the general Norwegian population assessed by the European Organization for Research and Treatment of Cancer Core Quality-of-Life Questionnaire: the QLQ=C30 (+ 3).

PURPOSE: To obtain reference data on health-related quality of life (HRQOL) for the functional and symptom scales and single items of the European Organization for Research and Treatment of Cancer Core Quality-of-Life Questionnaire (EORTC QLQ-C30 [+ 3]) in a representative sample of the Norwegian general population. PATIENTS AND METHODS: A randomly selected sample of 3,000 people from the Norwegian population, aged 18 to 93 years, who represent geographic diversity, took part in this postal survey. The EORTC QLQ-C30 (+ 3) and a questionnaire about demographic data and health were sent by mail. A new questionnaire package was sent as a reminder after 3 weeks. RESULTS: The survey yielded a high response rate with 1,965 of 2,892 eligible persons responding (68%). There was a low amount of missing data (1.8%). Internal consistency was highly satisfactory and yielded Cronbach's alpha coefficients greater than 0.70 for all but two functional scales and one symptom scale. The sensitivity of the questionnaire was shown by the excellent discrimination between age and sex groups. Clinical validity was shown by the distinct differences according to age and sociodemographic characteristics. Women reported lower functional status and global quality of life (mean scale scores from 71.7 to 91.0) than men (mean scale scores from 75.4 to 94.4), and also more symptoms and problems. This was remarkably consistent across age groups, as was a decline in functional status with an increase in age. CONCLUSION: This is the first study that presented reference data from the EORTC QLQ-C30 (+ 3) in a sample from a general population and seems to provide valid measures of HRQOL within different age groups. The results may serve as a guideline for clinicians when interpreting HRQOL in their own groups of patients, and contributes to a better understanding of the significance of mean scores and their clinical relevance.

Adult↗
PubMed1998

Short form 36 (SF-36) health survey: normative data from the general Norwegian population.

Anchoring health-related quality of life (HRQOL) measures in population norms makes clinical interpretations more meaningful and is in accordance with practice in other fields of medicine. In this paper norms for the Short Form 36 (SF-36) are presented in a random sample, representative of the general Norwegian population. In addition, sociodemographic variables affecting the scale scores are explored and discussed. The response rate was 67%, being lowest among subjects aged 70 years or over. Data-completeness strongly declined with increasing age. Physical health scales were also strongly affected by age. In all scales, with the exception of general health perceptions, women reported having poorer health than men. Marital status affected the four mental health scales. Educational status affected all the scales, but the effect was smallest in the mental scales. These norms can be employed for comparison in case-control studies, or to interpret HRQOL changes in prospective studies. Differences in social status should be given special attention. Caution should be exercised when assessing subjective health or employing the norms among subjects aged 70 years or over.

Activities of Daily Living↗
PubMed1998

Hodgkin's disease: quality of life in future trials.

It is of great importance to collect data of objective as well as subjective morbidity in patients cured for Hodgkin's disease. Such information may be used when new treatment strategies are discussed, in patients information and communication, to establish rehabilitation programs and to identify individuals who may benefit from rehabilitation. Measurement of health related quality of life (HRQOL) may give important information on how the cancer and/or the treatment has influenced the patients. There is no gold standard instrument for measurement of HRQOL in cancer. However, it is a consensus to use multidimensional patients rated measures with a standard format and scoring procedure. SF-36, EORTC QLQ-C30 and FACT are widely used in Europe and North America. Domain specific instruments includes a more comprehensive evaluation of a specific domain, for example anxiety or fatigue. Fatigue seems to be a prevalent symptom in Hodgkin's disease survivors and might affect patients' ability to perform normal activities and will often reduce their quality of life. Fatigue is defined as a subjective feeling of tiredness and might be measured by standardised and validated instruments such as the Fatigue Questionnaire (FQ) and the Multi-Dimensional Fatigue Inventory (MFI-20). Clinical significance might be defined as a meaningful difference based on consensus by the patient, the doctor and the society. In oncology there is no agreement of how long a meaningful difference in survival should be. For HRQOL a difference between 7 to 10 on a scale ranking from 0 to 100 has been regarded as clinical significant by some researchers. Another strategy to approach the issue of clinical significance is to use norms-estimates from the normal population- and/or reference estimates as guidelines. The long-term complication of the successful treatment of Hodgkin's disease reinforced the need for continued surveillance of treatment and related morbidities. Fatigue is a prevalent symptom and detailed diagnostic work-up is essential to identify patients with this problem. More knowledge about possible biological causes is required in order to understand fatigue and the impact on quality of life among Hodgkin's disease survivors.

Clinical Trials as Topic↗
PubMed1997

[Use of alternative medicine among Norwegian hospitalized cancer patients].

A national multi-centre study was performed to investigate the prevalent use of alternative medicine, or non-proven therapies, among Norwegian cancer patients. Of 911 patients invited to take part in the study 642 were included in the final analysis. Among the 630 assessable patients, 20% had been or were current users of non-proven therapies. In the northern most and western parts of Norway the most preferred alternative methods are healing by hand and faith healing, while herbs, vitamins, diets and Iscador are popular in the central and southern parts. Use of nonproven therapies is common in the northern part of the country. Prevalent users are middle-aged patients with long-standing symptomatic disease and former users of non-proven therapies for nonmalignant disease. About 40% of the patients would like non-proven therapies to be an option in hospital. Most of the users of non-proven therapies (80%) had consulted practitioners of scientific medicine first; 15% had started treatment with non-proven therapies simultaneously. The users of non-proven therapies report having received less hope of cure (30%) from their physicians than the non-users (50%) had. Most of the users had learned about non-proven therapies from friends or relatives. Most users believe that non-proven therapies might make them stronger and relieve their symptoms. Very few patients believe in a cure (10%). Nearly 40% felt that non-proven therapies had no definite effect on them. Four patients reported adverse effects. 15 patients had been treated abroad, usually in Denmark.

Adult↗
PubMed1997

Prospective, longitudinal quality-of-life study of patients with head and neck cancer: a feasibility study including the EORTC QLQ-C30.

Despite modern advances in the treatment of head and neck cancer, the survival rate fails to improve. Considering the different treatment modalities involved, quality of life has been thought of as an additional end point criterion for use in clinical trials. A Nordic protocol to measure the quality of life of head and neck cancer patients before, during, and after treatment was established. Before the study, a pilot study was done with this protocol. The main purpose of this pilot study was to find out whether this cancer population would answer quality-of-life questionnaires repeatedly (six times) over a 1-year period and whether the chosen questionnaires-a core questionnaire (European Organisation for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30)), a tumor-specific questionnaire, and a psychological distress measure (Hospital Anxiety and Depression scale (HAD))-were sensitive for changes to functions and symptoms during the study year. The results presented in this article all refer to the pilot study. Forty-eight consecutive patients agreed to participate in the study. The most common tumor locations were the oral cavity (17) and the larynx (12). Almost all patients received combined treatment: 45 of 48 radiation therapy, 18 of 48 chemotherapy, and 17 of 48 surgery. After the primary treatment, 40 patients had complete tumor remission. Four of the 48 patients did not answer any questionnaires and were therefore excluded from the study. Of the remaining 44 patients, 3 died during the study year, and another 6 withdrew for various reasons. Thirty-five (85%) of the 41 patients alive at the 1-year follow-up answered all six questionnaires and thus completed the study. Mailed questionnaires were used throughout the study. All questionnaires were well accepted and found to be sensitive to changes during the study year. The greatest variability was found for symptoms and functions related specifically to head and neck cancer. The symptoms were swallowing difficulties, hoarse voice, sore mouth, dry mouth, and problems with taste. They all showed the same pattern, with an increase of symptoms during and just after finishing the treatment. The HAD scale revealed a high level of psychological distress, with 21% probable cases of psychiatric morbidity at diagnosis. In conclusion, it was shown that the study design and questionnaires were feasible for the forthcoming prospective quality-of-life assessment of Swedish and Norwegian head and neck cancer patients.

Adult↗
PubMed1997

Why are cancer patients using non-proven complementary therapies? A cross-sectional multicentre study in Norway.

This study addressed the use of alternative medicine, here called non-proven therapies (NPTs), among hospitalized Norwegian cancer patients. A total of 126 (20%) of the assessable 630 patients were users of NPTs. Approximately 43% of all patients and more than 60% of the users of NPTs stated that they would like NPTs to be an option in hospitals belonging to the National Health Service. Most users of NPTs (82%) consulted traditional medicine first, while 15% started treatment with NPTs simultaneously. Users of NPTs reported to have received less hope of a cure (30%) from their physicians than non-users (50%). Users mostly learned about NPTs from friends and relatives. Most users believed that NPTs might give them strength and relieve their symptoms. Very few patients believed in a cure (10%). Nearly 40% were uncertain of any effect of the NPTs or felt there had been no effect. 4 patients reported adverse effects. 15 patients had been treated abroad, most of them in Denmark. Expenses incurred through use of NPTs were mostly moderate, but some patients used large sums of money. Patients' opinions on whether or not the treatment had been expensive were closely linked to their anticipation of the effect of the treatment.

Adolescent↗
PubMed1997

Disclosing the cancer diagnosis: the patients' experiences.

497 Norwegian cancer patients (346 females, 151 males, mean age = 56 years (S.D. = 12)), admitted to a cancer rehabilitation centre, were surveyed on how they were told their diagnosis. Predictors of general satisfaction with the information were assessed. 43% of the subjects were informed by phone, letter or in the corridor/on the round and estimated that the information was presented in less than 5 minutes. Satisfaction with the information was predicted by perceiving the physicians as personally interested (B = 0.528, P < 0.001), comprehending the information (B = 0.245, P < 0.001), being informed in the physicians' offices (B = 0.338, P < 0.001), being informed by physicians at oncological departments (B = 0.278, P = 0.01) and increasing time spent on the disclosure (B = 0.140, P = 0.01). Other aspects of physician-patient communication than the pure presentation of valid information is highly valued by the patients. However, a substantial proportion of physicians present the cancer diagnosis in such a manner that the possibility of engaging in conversation about the diagnosis and the effect upon the patient is very limited. The findings call for remedial attention to the subject and improvement in performance.

Adaptation, Psychological↗
PubMed1997

Communicating with and treating cancer patients: how does the use of non-proven therapies and patients' feeling of mental distress influence the interaction between the patient and the hospital staff.

A questionnaire-based study was carried out at the Department of Oncology, University Hospital of Tromsø, during the period July 1990-October 1991. The 252 participating patients received a questionnaire at arrival at the oncology unit and the surviving patients a follow-up questionnaire at home 4 months later. The aim of the study was to assess whether patients' attitudes to information about their malignant disease and satisfaction with the given treatment correlated to their use of non-proven therapies (NPTs) and reported mental distress. Patients under 45 years of age significantly more often preferred comprehensive medical information than older patients (83% versus 52%, P = 0.001). Better educated patients were more satisfied with the information given by their general practitioner (GP) (P = 0.05) and at their local hospital (P = 0.02) than other patients. Of all responders, 81% of the patients treated in the department were completely satisfied with the opportunities to ask questions while 87% reported being given comprehensive information. Only 2% of the patients reported to have received unwanted information. Better educated patients expressed less satisfaction with the information given and the possibility of influencing their own treatment at the Department of Oncology (P = 0.02). Patients expressing mental distress wanted less information (P = 0.05) and expressed less satisfaction with the quality of the perceived information in the oncology unit (P = 0.004). They were also less satisfied with the treatment given (P = 0.05) and their own influence on the treatment decision (P = 0.02). Users of NPT did not feel the received treatment to be the best possible (P = 0.04).

Adolescent↗
PubMed1997

Psychological distress after cancer cure: a survey of 459 Hodgkin's disease survivors.

To assess the levels of psychological distress and identify predictors of anxiety/depression caseness after cancer cure, a national population of 557 Hodgkin's disease (HD) survivors was surveyed. The respondents [204 women, 255 men, mean age 44 years (SD = 12)] returned a mailed questionnaire including The Hospital Anxiety and Depression Scale (HADS). Disease and treatment variables were based on the hospital records. A total of 27% had caseness scores (anxiety, 14.5%; depression, 4%; anxiety and depression, 8.5%). In a multiple logistic regression analysis, anxiety caseness was predicted by low educational status [OR (odds ratio) = 2.07, 95% CI = 1.02-4.22], observational period 7 years or longer (7-10 years: OR = 3.07, 95% CI = 1.26-7.47), combined irradiation and chemotherapy treatment (OR = 2.77, 95% CI = 1.17-6.54) and psychiatric symptoms before HD (OR = 2.55, 95% CI = 1.40-4.65) or during treatment (OR = 3.51, 95% CI = 2.08-5.90). Depression caseness was predicted by age (OR = 1.03, 95% CI = 1.00-1.06) and psychiatric symptoms before HD (OR = 5.1, 95% CI = 2.55-10.31) Anxiety cases are more prevalent than in the general Norwegian population, and were found to be most common 7-10 years after treatment. The most intensive treatment was associated with increased risk for anxiety caseness. The subjects experienced distress during treatment precedes difficulties in long-term adjustment. Focusing on these predictors during treatment and follow-up controls may improve long-term outcome.

Adult↗
PubMed1996

[Patients with cancer-related pain and other chronic pain. Priorities and assessment].

In a survey completed at our hospital, 519 doctors and nurses were asked how pain treatment was estimated whether it received priority, and to what degree patients' pain syndromes were assessed. A total of 473 responded to the questionnaire. In the study cancer-related pain and pain from causes other than cancer were assessed in separate population groups. The responders considered that the staff gave higher priority to patients with cancer-related pain, than to patients with other pain. There was a discrepancy between the physicians' and the nurses' answers to the question whether optimal pain relief was obtained. In the cancer pain group, 94% of the physicians and 78% of the nurses assumed that optimal pain relief was obtained fairly often or very often. The corresponding figures in the non-cancer pain group were 53% for the physicians and 35% for the nurses. Only 46% assumed that a planned pain assessment was done as a routine. Physicians and nurses alike experienced great inadequacy in their work with patients in pain. This was expressed more clearly in connection with pain not caused by cancer.

Analgesia↗
PubMed1996

Spiritual healing among Norwegian hospitalised cancer patients and patients' religious needs and preferences of pastoral services.

In a national questionnaire-based multicentre study, the use of 'alternative medicine', here called non-proven therapy (NPT), was examined. Five questions about the patients' religious beliefs and their preferences concerning pastoral services in the hospitals were included. Among the 911 invited patients, 642 (70.5%) were included in the analysis. Spiritual healing, defined as faith healing and healing by hand, was the most frequently used NPT among Norwegian cancer patients. Almost 50% of cancer patients using spiritual healing had used NPTs, mainly spiritual healing, prior to the diagnosis of cancer. Women, elderly people and patients using faith healing described themselves more often as religious. 139 (23%) of the responding patients reported a strengthening of their religious belief after the diagnosis of cancer. Patients less than 45 years of age and better educated patients expressed more frequently that all patients should be offered pastoral services during the hospital stay. Older patients, in spite of being more religious, expressed that the patients themselves had to request such services.

Adolescent↗
PubMed1996

Attitudes toward informing the cancer patient--a survey of Norwegian physicians.

To examine Norwegian physicians' attitudes to informing patients of a diagnosis of cancer, a random sample of 1467 were surveyed. The respondents rated their level of agreement to 14 statements, and the responses were analysed by chi-squared statistics. 990 physicians responded (67%). Only 30.5% of the responding physicians had treated more than 10 cancer patients the previous year, which included 7.8% who had treated more than 50. 40.4% had treated none. The great majority (81%) preferred full information of the diagnosis. Physicians with increasing age preferred relatives not being present and gave priority to factual information and informing patients with the same diagnosis identically. Hospital physicians (39.5%) more often preferred other health professionals being present than physicians in private practice (18%) (P < 0.001). Number of cancer patients treated was not associated with attitudes toward the disclosure of information. Norwegian physicians prefer revealing the cancer diagnosis to patients, but have divergent opinions about how to do so. Some of these indicate suboptimal information-giving.

Adult↗
PubMed1996

Treatment intention in hospitalized cancer patients in oncological wards in Norway: a national survey.

Clinicians often do not agree whether a treatment is given with a palliative or curative intent. A common clear definition does not exist. This study has assessed the usefulness of dividing the goal of treatment into three distinct categories: curative treatment; palliative, symptom preventive treatment; and palliative, symptom relieving treatment. In a cross-sectional study among all cancer centres in Norway, a total of 629 patients were included into the study. Of these patients, 60% received palliative treatment, with an equal distribution between symptom preventive and symptom relieving. The definitions were found easy to use by the physicians. It gave important information of differences between cancer diagnosis with respect to the number of patients receiving palliative treatment. In order to refine the classification system, the authors will, in future studies, include a fourth category, life prolonging treatment, which is located between curative and palliative treatment with respect to treatment intensity.

Cross-Sectional Studies↗
PubMed1996

Prognostic factors and survival in a heterogeneous sample of cancer patients.

This study examines the prognostic value of clinical assessments, including a 3-fold classification of cancer patients by treatment intention. It is based upon a sample of 253 patients with different cancer diagnoses who filled out a 108-item questionnaire. Cox regression analysis (the proportional hazards model) was used to analyse the relationship of the three groups of covariates (clinical, demographic and psychosocial) with survival. The univariate analysis showed that several clinical, demographic and psychosocial covariates are significantly related to survival. The study located two main prognostic factors: the 3-fold classification by treatment intention being the most important one, followed by physical functioning which may be seen as a proxy for performance status. Several additional covariates including psychosocial ones were related to survival when considered separately. However, their effects disappeared when controlling for treatment intention and physical functioning. Thus, the additional psychosocial covariates did no add to the prognostic value of the model.

Adult↗
PubMed1996

Measurement of health-related quality of life in multiple myeloma. Nordic Myeloma Study Group.

When a randomized trial (NMSG 4/90) comparing treatment with melphalan/prednisone to melphalan/ prednisone + interferon alpha-2b in newly diagnosed multiple myeloma was initiated in 1990, a quality-of-life assessment was integrated into the study. We used the questionnaire (QLQ-C30) developed by the European Organization of Research and Treatment of Cancer (EORTC) Study Group on Quality of Life. The QLQ-C30 incorporates five functional scales, three symptom scales, a global health and quality-of life scale and some single symptom measures. The questionnaire was completed prior to treatment and after 1, 6, 12, 24, 36 and 48 months. 524 (90.2%) of 581 patients enrolled in the NMSG 4/90 completed the first questionnaire, and 484 (83.3%) completed all questionnaires given to them. All but one of the scales met the minimum criteria of reliability (Cronbach's alpha >/ 0.70). Validity was shown by (1) the ability of the scales to discriminate clearly between patients differing in clinical status as defined by pretreatment W.H.O. performance index and Durie & Salmon stage, and (2) the sensitivity to changes in objective disease status (response and relapse). This is the first report of the measurement of health-related quality of life in a prospective clinical trial in multiple myeloma. The results demonstrate that the QLQ-C30 is a reliable and valid instrument for the measurement of quality of life in these patients. The data will be used for a cost-utility analysis of the results of the NMSG 4/90 trial.

Aged↗
PubMed1996

Effect of interferon on the health-related quality of life of multiple myeloma patients: results of a Nordic randomized trial comparing melphalan-prednisone to melphalan-prednisone + alpha-interferon. The Nordic Myeloma Study Group.

In a Nordic multi-centre trial, 583 previously untreated multiple myeloma patients were randomized to receive melphalan-prednisone or melphalan-prednisone+ interferon alpha-2b at a dose of 5 million units subcutaneously, 3 d/week. A quality-of-life study was integrated into the trial, using the EORTC QLQ C-30 questionnaire supplemented with 11 questions concerning interferon toxicity. The questionnaire was completed prior to treatment and after 1, 6, 12, 24, 36 and 48 months. 90% of the patients participated in the quality-of-life study, and 83% completed all questionnaires submitted to them. During the first year of treatment the patients on interferon reported significantly more fever, chills, dry skin, fatigue, pain, nausea/vomiting and appetite loss than the control patients. There was a moderate reduction of the global quality-of-life score and slight, non-significant, reductions of physical, emotional, cognitive, social and role functioning scores. After the first year there were no statistically significant differences in any toxicity, symptom or quality-of-life score, except for an increased frequency of dizziness in the interferon group. As only 60% of the patients remained on interferon after 24 months, our data probably underestimate the potential toxicity of the drug. Although there was no significant survival benefit for the interferon patients, a 5-6 months prolongation of the response and plateau phase duration was observed. However, by intention-to-treat analysis, there was no late quality-of-life benefit for the interferon patients to compensate for the early impairment. Thus, the clinical significance of the plateau-phase prolongation is uncertain.

Activities of Daily Living↗