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dc.contributor.authorGrotmol, Kjersti Støen
dc.contributor.authorLie, Hanne Cathrine
dc.contributor.authorHjermstad, Marianne Jensen
dc.contributor.authorAass, Nina Kathrine
dc.contributor.authorCurrow, David
dc.contributor.authorKaasa, Stein
dc.contributor.authorMoum, Torbjørn Åge
dc.contributor.authorPigni, Alessandra
dc.contributor.authorLoge, Jon Håvard
dc.date.accessioned2018-01-29T11:47:25Z
dc.date.available2018-01-29T11:47:25Z
dc.date.created2018-01-18T10:45:22Z
dc.date.issued2017
dc.identifier.citationJournal of Pain Symptom and Management. 2017, 54 889-897.nb_NO
dc.identifier.issn0885-3924
dc.identifier.urihttp://hdl.handle.net/11250/2480247
dc.description.abstractContext Quality of life (QoL) and depression are important patient-reported outcomes in cancer care. However, the relative importance of depression severity in predicting QoL remains unclear because of few methodologically sound studies. Objectives To examine whether depression contributes to impairment of QoL irrespective of prognostic factors and symptom burden. Methods A total of 563 patients were included from the European Palliative Care Research Collaborative–Computerized Symptom Assessment Study, an international, multi-center, cross-sectional study. The relative importance of prognostic factors (systemic inflammation [modified Glasgow Prognostic Score—mGPS]), co-morbidities and physical performance (Karnofsky Performance Status), symptom burden (loss of appetite, breathlessness, nausea [Edmonton Symptom Assessment Scale], and pain [Brief Pain Inventory]), and depression severity (Patient Health Questionnaire 9) in predicting Global Health/QoL (European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire [EORTC-QLQ-C30]) were assessed using hierarchical multiple regression models. Results Fifty-five percent were women, median age was 64 years, 87% had metastatic disease, median Karnofsky Performance Status was 70, and mean global QoL was 50.5 (SD = 23.3). Worse QoL was associated with increased systemic inflammation (mGPS = 1 β = −0.12, P = 0.003; mGPS = 2 β = −0.09, P = 0.023), lower physical performance (β = 0.17, P < 0.001), reduced appetite (β = −0.15, P < 0.001), breathlessness (β = −0.11, P = 0.004), pain (β = −0.14, P = 0.002), and higher depression severity (β = −0.27, P < 0.001). The full model accounted for 29% of the observed variance in QoL scores. The strongest predictor was depression severity, accounting for 5.8% of the variance. Conclusion Depression severity was the strongest single predictor of poorer QoL in this sample of patients with advanced cancer, after accounting for a wide range of clinically relevant variables. Future studies should investigate the contribution of psychosocial variables on QoL. Our findings emphasize the importance of managing depression to achieve the best possible QoL for these patients.nb_NO
dc.language.isoengnb_NO
dc.publisherElseviernb_NO
dc.titleDepression-A Major Contributor to Poor Quality of Life in Patients With Advanced Cancernb_NO
dc.typeJournal articlenb_NO
dc.description.versionsubmittedVersionnb_NO
dc.source.pagenumber889-897nb_NO
dc.source.volume54nb_NO
dc.source.journalJournal of Pain Symptom and Managementnb_NO
dc.identifier.doi10.1016/j.jpainsymman.2017.04.010
dc.identifier.cristin1546103
dc.description.localcodeThis is a submitted manuscript of an article published by Elsevier Ltd in Journal of Pain and Symptom Management, 10 August 2017.nb_NO
cristin.unitcode194,65,15,0
cristin.unitnameInstitutt for klinisk og molekylær medisin
cristin.ispublishedtrue
cristin.fulltextpreprint
cristin.qualitycode1


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