CNA514: Oncology Nursing Literature Review on Quality of Life

This report presents a literature review exploring the factors that modulate the health-related quality of life (HRQOL) of cancer patients and individuals with terminal illnesses. The review synthesizes findings from 15 peer-reviewed articles, identifying key influencing factors such as diet and nutrition, the availability of specialized palliative care, socioeconomic and demographic factors, and the availability of social support. The research highlights the importance of positive food experiences, the role of supplements, and the impact of psychosocial and cognitive factors. The review also discusses the implications for nursing practice, including the need for psychological interventions, palliative care referrals, and mindfulness interventions. Recommendations include further research into palliative care standards, exercise prescriptions, and the development of models for care delivery outside of hospital settings. The review underscores the significance of addressing these factors to enhance the quality of life and end-of-life care for oncology patients.

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FACTORS THAT MODULATES THE HEALTH-RELATED QUALITY OF LIFE OF
THE PATIENTS SUFFERING FROM CANCER OR THE PATIENTS WHO ARE
TERMINALLY ILL DUE TO RAPID PROGRESSION OF CANCER
By (Name)
Course
Tutor
University
Date

Oncology Nursing 2
Abstract
Cancer patients often experience reduced quality of life due to a number of modulating
factors. The literature review aims to describe the modulating factors of quality of life among
cancer patients and patients with terminal illness. Some factors that were identified include
diet and nutrition, availability of specialized palliative care, socioeconomic and demographic
factors, and social support. The selection of articles yielded 15 articles that describe various
factors, interventions and research gaps in the management of cancer patients. Some factors
that were identified include diet and nutrition, availability of specialized palliative care,
socioeconomic and demographic factors, and social support. Areas that require further
research are identified in the study.
Objective/Purpose
This paper presents a literature review that describes the modulating factors of quality of life
among cancer patients and patients with terminal illness. The paper comprises of the
synthesis table and a subsequent description of the findings from the studies. The aim of the
paper is to elaborate of nursing care among cancer patients and present recommendations for
future research.The purpose of this literature review is to describe the modulating factors of
quality of life among cancer patients and patients with terminal illness and future of practice
in enhancing quality of life in cancer patients. The objective of the research is and evaluation
criteria for this research is demonstrated in Appendix A.
Background
Terminally ill patients experience face two major problems at the end of life which are the
high cost of healthcare and inadequate quality care. Terminally ill cancer patients can arise
from various problems such as emotional support, inadequate practical, uncontrolled
symptoms, unexpected financial burdens inadequate communication and negligence for

Oncology Nursing 3
family goals preferences and prolonged dying process. These problems can significantly
affect the quality of life for cancer patients (Dalal, & Bruera, 2017). It is critical to explore
the factors that modulate quality of care among cancer patients. The focus of this literature
review is to explore factors and literature gaps in the field of oncology.
Methods and Inclusion/Exclusion criteria
The literature review entails a critical analysis of 15 peer-reviewed articles in the field of
oncology. The articles were obtained from online databases including Cochrane, PubMed,
Medline, EbscoHost and ProQuest the search terms used in the analysis include ‘health-
related quality of life’, ‘quality of life’, ‘modulating factors’, ‘cancer patients’, and ‘patients
with terminal illness’. A combination of search terms using conjunctions, such as in, and, or,
was used to for phrases. The phrases were useful in identifying the best and most relevant
articles. The phrases included ‘modulating factors of quality of life in cancer patients’,
‘quality of life in cancer patients’, ‘quality of life in patients with terminal illness’. The
selection was used to yield articles with a relevant tittle (n=36). The next step included
reviewing the article abstracts to assess their relevance. The selection yielded 24 articles
(n=24). Finally, the review of the full articles yielded 15 articles (n=15). A summary of the
identified articles in demonstrated in the synthesis matrix (Appendix A).
Results and Discussions
The results of the literature search are demonstrated in the synthesis table in Appendix.
From the literature, it is evident that a variety of researchers have explained the factors that
modulate quality of life among cancer patients. Zhang, Nilsson and Prigerson (2012)
outlined nine major factors that affect end of life among cancer patients which include stay
in the ICU during the final week, worry of the patient at the baseline, cancer care site,
feeding-tube use in the final week, pastoral care within the hospital/clinic, exposure to

Oncology Nursing 4
chemotherapy during the final week, hospital deaths, religious meditation or prayer at
baseline and patient-physician therapeutic alliance at baseline. However, a large portion of
the factors that contribute to reduced quality of life is still not explained.
Nutrition is also a critical factor in determining the quality of life among cancer patients.
Bazzan et al. (2013) conducted a literature review and explained that a positive food
experience is vital in improving the cancer patients’ quality of life. The food needs to be
fresh, wholesome and with little or no processing. Cancer patients in palliative care need a
positive food experience so that they can have enhanced comfort and normality.
Supplements are also important among cancer survivors as they contain cancer-fighting
nutrients, and reduce inflammation and oxidative stress, and consequently improve quality
of life among cancer patients.
Additionally, psychosocial and cognitive factors cannot be ignored. Bahrami et al. (2017)
explained that the major factors that affect the quality of life among cancer patients include
cognitive emotional regulatory strategies and goal adjustments. de la Torre-Luque et al.
(2016) explained that psychological interventions are critical in enhancing quality of life
among patients in cancer contexts. Ehooman et al. (2019) added that psychosocial
interventions are critical in enhancing the health-related quality of life among cancer
patients who have been discharged from hospital. The interventions may include physical
and psychosocial rehabilitation programs. These programs may be initiated while the patient
is still in the ICU and continue in the process of recovery. The rehabilitation may also
enhance management of patients after the ICU. Further Pham et al. (2019) explained that
depression, low response to treatment and incapacity to cater for treatment expenses, and
the side effects of treatment is associated with reduced quality of life among cancer patients.
Therefore, it is important to care for the psychological aspects of cancer treatment among
patients. Similarly, Sheikhalipour et al. (2019) explained that financial burden is a critical

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factor that determines the quality of life among women with breast cancer. The financial
burden resulted in cognitive and emotional distress demonstrated through, insomnia and
fatigue.
Fatigue also influences the quality of life among patients. Mortensen and Salomo (2016)
explained that disease symptoms and toxicity as a result of treatment are important factors
that determine physical and cognitive functioning among cancer patients. Also, concerns
about the disease, disability and relapse also reduced the quality of life among cancer
patients. NautiyaLal et al. (2015) explained that fatigue is another critical factor that
determines the quality of life among patients with head and neck cancer. Cancer increases the
score of fatigue among patients. The incidence of fatigue increases as a result of radiotherapy.
Fatigue among cancer patient decreases after treatment, but does not reach normality.
Similarly, Wang et al. (2018) explained that radiotherapy results in psychological distress
among cancer patients and consequently, reduced quality of life.
Socioeconomic and demographic factors are also critical determinants of quality of life.
Kelley and Morrison (2015) explained that some factors that hinder effectiveness of
palliative care include racial and ethnic factors, socioeconomic factors, and availability and
accessibility of palliative care to patients. Additionally, Lim (2016) explained that
inadequate knowledge among clinicians is critical in determining the quality of life among
cancer patients. The need for knowledge is as a result of increased cases of lung cancer
patients succumbing to illness within 5 years of diagnosis.
Implications for Practice
From the review, there are significant insights on various practices that can be adopted in the
clinical setting particularly in the management of cancer patients. Kelley and Morrison
(2015) explained that palliative care is critical in reducing symptoms, enhancing healthcare
utilization and improving the quality of life, and satisfaction among family members.

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Therefore, the researcher recommended that patients should be referred to specialists for
advanced palliative care immediately after diagnosis. de la Torre-Luque et al.(2016)
explained that there is need to include psychological treatments in management of cancer
patients.
Additionally, psychosocial and psychological interventions should be initiated for the patients
immediately they are diagnosed with cancer. Mortensen and Salomo (2016) noted that the
quality of life can be improved through the management of initial shock after diagnosis
among patients. This can be enhanced by reassurance of high manageability of multiple
myeloma, among other cancer patients. Additionally, there is need to change the manner in
which oncologists interacts with patients regarding cancer management. Most of the
interactions are related to cancer control rather than health-related quality of life. Mortensen
and Salomo (2016) explained that adequate information and emotional support among newly
diagnosed patients is essential in enhancing manageability of multiple myeloma.
Ngamkham, Holden and Smith (2019) explained that mindfulness interventions are critical in
reducing anxiety, severity of pain depression and anxiety among cancer patients. This is
achieved by diverting the attention of the patients from their pain and consequently
enhancing pain tolerance. Zhang et al. (2012) explained that patents who avoid intensive care
an hospitalization, avoid worrying too much, engage in prayer and meditation, are visited by
pastors at the hospital and who engage in therapeutic alliances with their physicians have
improved quality of life at the end of life.
Sheikhalipour et al. (2019) recommended that nursing interventions are critical for elevating
cancer-related symptoms. Also, reducing the effects of financial burden on the patients’
quality of life can be achieved through support from insurance and governmental agencies.
Hayes et al. (2019) explained that scientific evidence, clinical experience and principles of
exercise science show that exercise ranging from multimodal, high-intensity and moderate

Oncology Nursing 7
exercises are essential in benefiting cancer patients and improving their quality of life.
Recommendations
Various recommendations can be drawn from the literature search. It is important to pay
adequate attention to palliative care. Dalal and Bruera (2017) asserted that palliative care is
essential in enhancing quality of life at the end of life of terminally ill patients. However, the
field of palliative care has not received enough attention from researchers. Therefore, there is
need for further research on the quality metrics and creation of standards for end-o-life care.
The knowledge is critical in enhancing increasing training among palliative care; enhance
responsiveness and communication to the patient and family needs. Developing standards and
metrics is important for promoting standard, coordinated and streamlined end-of-life care to
enhance quality of life among terminally ill patients.
Exercises are also recommendable for terminally ill cancer patients. Hayes et al. (2019)
appreciated the importance of exercises prescription characterized by behavior change advice
and support is essential for cancer patients. However, there is inadequate certainty on the
dosage of exercise prescription among this group of patients. Therefore, there is need for
evidence-based research to understand how exercises should be carried out.
Further research is also required in the field of oncology. Kelley and Morrison (2015)
explained that there is need for further research in several areas relating to palliative care
such as biologic bases and treatment of symptoms associated with cancer, complex care
needs for patients with different coexisting conditions associated with cancer, and
development of palliative care delivery models that can be actualized outside the hospital
settings. Also, there is need to explore strategies that can enhance knowledge and skills
training in the field of palliative care.
Conclusion

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From the literature review, it is evident that the field of oncology has received overwhelming
attention from researchers. Various researchers have explained the factors that modulate
quality of life among patients as presented in the study and subsequent recommendations for
addressing the factors. However, as presented in the review, there exists knowledge on
various factors that modulate the quality of life among cancer patients which include diet and
nutrition, availability of specialized palliative care, socioeconomic and demographic factors,
and social support. Research is required in the fields of management of cancer patients to
enhance their quality of life and improve their end-of-life for terminally ill patients.

Oncology Nursing 9
References
Bahrami, B., Mashhadi, A., Kareshki, H., & Bahrami, A. 2017, ‘Role of mediating cognitive
emotion regulation strategies and goal adjustment in relationship between personality
characteristics and quality of life of patients with cancer,’ International Journal of Cancer
Management, vol. 10, no. 12. Retrieved from
http://intjcancermanag.com/en/articles/9317.html
Bazzan, A. J., Newberg, A. B., Cho, W. C., & Monti, D. A. 2013, ‘Diet and nutrition in
cancer survivorship and palliative care,’ Evidence-based Complementary and Alternative
Medicine. doi:10.1155/2013/917647
Dalal, S., & Bruera, E. 2017, ‘ End-of-life care matters: palliative cancer care results in better
care and lower costs,’ The Oncologist, vol. 22, no .4, pp. 361–368.
doi:10.1634/theoncologist.2016-0277
de la Torre-Luque, A., Gambara, H., López, E., & Cruzado, J. A. 2016, ‘Psychological
treatments to improve quality of life in cancer contexts: A meta-analysis,’ International
Journal of Clinical and Health Psychology : IJCHP, vol. 16, no. 2, pp. 211–219.
doi:10.1016/j.ijchp.2015.07.005
Ehooman, F., Biard, L., Lemiale, V., Contou, D., de Prost, N., Mokart, D., ... & Vincent, F.
2019, ‘ Long-term health-related quality of life of critically ill patients with haematological
malignancies: a prospective observational multicenter study,’ Annals of Intensive Care, vol.9,
no. 1, p. 2. Retrieved from
https://annalsofintensivecare.springeropen.com/articles/10.1186/s13613-018-0478-3
Hayes, S. C., Newton, R. U., Spence, R. R., & Galvão, D. A. 2019, ‘The Exercise and Sports
Science Australia position statement: Exercise medicine in cancer management,’ Journal of
Science and Medicine in Sport. doi:10.1016/j.jsams.2019.05.003
Kelley, A. S., & Morrison, R. S. 2015, ‘Palliative care for the seriously ill,’ The New
England Journal of Medicine, vol. 373 no. 8, pp. 747–755. doi:10.1056/NEJMra1404684

Oncology Nursing 10
Lim R. B. 2016, ‘End-of-life care in patients with advanced lung cancer,’ Therapeutic
Advances in Respiratory Disease, vol. 10, no. 5, pp. 455–467.
doi:10.1177/1753465816660925
Mortensen, G. L., & Salomo, M. 2016, ‘Quality of life in patients with multiple myeloma: a
qualitative study,’ Journal of Cancer Science and Therapy, vol. 8, pp. 289-93. doi:
10.4172/1948-5956.1000430
Nautiyal, V., Lal, P., Verma, M., Yadav, R., Singh, N., & Kumar, S. 2015, ‘Evaluation of
fatigue in head and neck cancer patients undergoing (intensity modulated radiation therapy)
radiotherapy: A prospective study,’ Asian Journal of Oncology, vol. 1, no. 01, pp. 044-048.
doi: 10.4103/2454-6798.165111
Ngamkham, S., Holden, J. E., & Smith, E. L. 2019, ‘A systematic review: mindfulness
intervention for cancer-related pain,’ Asia-Pacific Journal of Oncology Nursing,’ vol. 6, no.
2, pp. 161. Retrieved from http://www.apjon.org/text.asp?2019/6/2/161/251293
Pham M. K., Vu T. T., Dao Q. M., Le M. Q., & Nguyen L.H. 2019, ‘Depression and anxiety
as key factors associated with quality of life in lung cancer patients in Hai Phong,’
Vietnam,’ Frontiers in Psychiatry, vol. 10, p.352.
Sheikhalipour, Z., Ghahramanian, A., Fateh, A., Ghiahi, R., & Onyeka, T. C. 2019, Journal
of Caring Sciences, vol. 8 no. 1, pp. 9–15. doi:10.15171/jcs.2019.002
Wang, X., Lv, Y., Li, W., Gan, C., Chen, H., Liu, Y., ... & Cheng, H. 2018, ‘Correlation
between Psychosocial Distress and Quality of Life in Patients with Nasopharyngeal
Carcinoma following Radiotherapy,’ Journal of Oncology doi:10.1155/2018/3625302
Zhang, B., Nilsson, M. E., & Prigerson, H. G. 2012, ‘Factors important to patients' quality of
life at the end of life,’ Archives of Internal Medicine, vol. 172, no. 15, pp. 1133–1142.
doi:10.1001/archinternmed.2012.2364

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Appendix A: Objective 1 and Evaluation Criteria
Name:
Topic: Oncology and Cancer Care
Objective 1: To presents a literature review that describes the modulating factors of quality
of life among cancer patients and patients with terminal illness.The purpose of this
literature review is to describe the modulating factors of quality of life among cancer
patients and patients with terminal illness and future of practice in enhancing quality of life
in cancer patients.
Evaluation Criteria:
I will ask my lecturer to check and validate the review conducted by me. This will help to
understand the depth of knowledge or the evidence-based practice that has been stated in
the review.
I will conduct the review and request my lecturer to check and validate my work so as to
better understand evidence-based practice.
I will develop conclusions on the knowledge goals and the experiences and outcomes of
patients
I will incorporate all available evidence by demonstrating database searchers, data
collection and methods
I will ensure Harvard referencing
I will demonstrate the learning process clearly
I will participate in 2 peer discussion boards
I will provide support to my peers
I will support the review for marking in Portfolio

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Appendix B. Synthesis Matrix
Authors Name Article title Publicatio
n year
Main purpose of the
article
Methodology of
research design
Participants/
articles in reviews
Results Conclusion
Bahrami,
Mashhadi,
Kareshki, &
Bahrami
Role of
Mediating
Cognitive
Emotion
Regulation
Strategies and
Goal
Adjustment in
Relationship
between
Personality
Characteristics
and Quality of
Life of Patients
with Cancer.
2017
To investigate the
mediating roles of
the cognitive
emotion regulation
strategies (CERS)
and goal adjustment
in relationship
between personality
characteristics and
quality of life of
patients with
cancer.
Quantitative
descriptive-
explanatory
156 patients with
cancer (males: 49,
females: 107)
referred to 4 health
care centres
The extroversion
and neuroticism
variables,
respectively, have
positive and
negative direct
effects on the
quality of life of
patients with
cancer. Also,
extroversion has a
positive indirect
effect due to the
adaptive strategies
of CERS and goal
adjustment, and the
neuroticism
variable has indirect
negative effects on
the quality of life of
these patients due
to the adaptive
strategies of CERS
and goal adjustment
2 major factors
affecting the
quality of life of
patients with
cancer are goal
adjustment and
CERS; this
relationship
should be taken
into account in
the training for
treatment
programs
involving CERS
and especially
adaptive
strategies as
well as goal
adjustment.
Bazzan,
Newberg, Cho,
& Monti
Diet and
nutrition in
cancer
survivorship
2013 To review the
current data on diet
and nutrition as it
pertains to a wide
Literature Review Studies on diet and
nutrition were
reviewed in this
study
A nutrient-dense
food diet should be
combined with
choosing food for
It is important
to consider the
diet and
nutritional

Oncology Nursing 13
and palliative
care.
range of cancer
patients in the
palliative care
setting.
freshness,
wholesomeness, and
a decrease in the
degree of processing.
Importantly, food
should also be, as
much as possible, a
pleasurable
experience since a
positive food
experience can help
provide comfort and
a sense of normality
for palliative care
patients.
planning for
patients in the
palliative care
setting, focusing
on foods and
supplements
that provide
cancer fighting
nutrients,
reduce oxidative
stress and
inflammation
can help overall
quality of life,
and have a
beneficial effect
on their cancer
and other
medical
conditions.
Dalal, &
Bruera
End-of-Life
Care Matters:
Palliative
Cancer Care
Results in
Better Care and
Lower Costs
2017 To review the
current state of end‐
of‐life care,
analyzes the clinical
and financial impact
of palliative care,
and proposes areas
of future research
and development.
Literature review Studies related to
end-of life care for
cancer patients
When integrated
with standard
oncological care,
palliative care
improves patient
outcomes, including
symptom burden,
quality of life, and
end‐of‐life
outcomes, all
achieved with lower
associated costs.
Substantial
work and
research are still
warranted at all
levels to
formulate
quality metrics
that create
explicit
standards in
end‐of‐life care,
to increase

Oncology Nursing 14
palliative care ‐
trained
workforce and
resources, to
improve
communication
and
responsiveness
to patient's and
family's needs
and preferences,
to develop a
system of
seamless,
coordinated
end‐of‐life care,
and to support
quality research
in palliative
care and end‐of‐
life care.
de la Torre-
Luque,
Gambara,
López, &
Cruzado,
Psychological
treatments to
improve quality
of life in cancer
contexts: A
meta-analysis.
2016
To analyze the
effects of
psychological
treatments on
quality of life
among cancer
patients and
survivors.
Meta-analysis of
scientific studies
1970 and 2012
78 studies were
analyzed
Quality of life is
improved by
psychological
interventions,
especially when
patients have to
cope with medical
treatment or with
adjustment after the
disease is treated.
Providing
psychological
treatments
should be
considered as
crucial for the
patient's health
in cancer
contexts
Ehooman, Long-term 2019 To assess post- Quantitative 1011 patients Health-related Recovery after

Oncology Nursing 15
Biard, Lemiale,
Contou, Prost,
Mokart,... &
Vincent
health-related
quality of life
of critically ill
patients with
hematological
malignancies: a
prospective
observational
multicenter
study.
intensive care unit
(ICU) burden and
HRQOL of
critically ill patients
with HMs and to
identify risk factors
for quality-of-life
(QOL) impairment.
TRIALOH study with hematologica
l malignancies
(HMs) and who
required ICU
admission in 17
ICUs in France
and Belgium
quality of life
(HRQOL) is
strongly impaired in
critically ill patients
with HMs at
3 months and 1 year
after ICU
discharge. Sepsis-
related organ failure
assessment (SOFA)
score and disease
status are strongly
correlated with
quality of life.
the ICU is not
consistent in all
dimensions of
HRQOL
Future studies
should focus on
specific physical
and psychosocial
rehabilitation
programs that
may start in the
ICU. They may
then continue
after ICU
discharge and
could lead to
improved
management of
patients with
HMs after their
stay in the ICU.
Hayes,
NewtonSpence
, & Galvão
The Exercise
and Sports
Science
Australia
position
statement:
Exercise
medicine in
cancer
management
2019 To update Exercise
and Sports Science
Australia
(ESSA) position
statement on
cancer-specific
exercise
prescription.
Literature review Current scientific
evidence,
alongside clinical
experience and
exercise science
principles
While for the
majority,
multimodal,
moderate to high
intensity exercise
will be appropriate,
there is no set
prescription and
total weekly dosage
that would be
considered
Targeted exercise
prescription,
which includes
the provision of
behavior change
advice and
support, is
needed to ensure
greatest benefit
(as defined by the
patient) in the

Oncology Nursing 16
evidence-based for
all cancer patients.
short and longer
term, with low
risk of harm.
Kelley &
Morrison
Palliative Care
for the
Seriously Ill
2015 To understand key
concepts of
palliative care and
recent
developments in the
field
Literature review Observational
studies and recent
randomized,
controlled trials
 Palliative care has
led to reductions
in patients’
symptoms, health
care utilization,
improvements in
quality of life and
family
satisfaction
 Recommendation
s support referral
to specialist-level
palliative care at
the time of
diagnosis for
patients with
advanced cancer
 Some barriers to
palliative care
include palliative
care specialist
regional,
socioeconomic,
and racial and
ethnic-group
determinants
influence access
to palliative care.
Research needs
to focus on:
 Biologic bases
of nonpain
symptoms and
treatments for
symptoms
such as
breathlessness
, fatigue,
pruritus,
delirium, and
even pain
 Identifying
ways to
improve care
for patients
with those
symptoms.
 Complex care
needs of
patients with
multiple
coexisting
conditions.
 Providing data
to guide care
for seriously
ill children

Oncology Nursing 17
and for adults
with end-stage
dementia
 Development
and evaluation
of palliative
care–delivery
models
outside
hospitals.
 Strategies to
expand
specialist level
palliative care
training and
generalist
training in
core palliative
care
knowledge
and skills
Lim End-of-life care
in patients with
advanced lung
cancer.
2016 To enhance
familiarly and
sensitivity to the
needs of patients
facing the end of
life as this
comprises a large
proportion of lung
cancer care
Review of
literature
Studies related to
end-of-life care for
lung cancer
patients
Despite advances in
the management of
lung cancer, the
majority of patients
still succumb to
their illness within
5 years of
diagnosis, and
death from lung
cancer can be
associated with
Clinicians
should be more
aware of the
needs of such
patients and
learn the basic
skills required
to care for
patients at this
stage of their
illness.

Oncology Nursing 18
many symptoms
and poor quality of
life.
Mortensen&
Salomo
Quality of life
in patients with
multiple
myeloma: a
qualitative
study.
2016 To gain in-depth
knowledge about
health related QoL
in patients with
relapsing- remitting
Multiple myeloma
(RRMM).
Qualitative
phenomenologica
l study
8 Danish
myeloma patients,
including 4 women
and 4 men
Physical and
cognitive
functioning was
reduced from
disease symptoms
and treatment
related toxicity.
Initial shock of
receiving a cancer
diagnosis was
reduced by
reassurance of the
high manageability
of MM
Quality of life was
reduced by
concerns about
underlying disease,
relapse and
disability.
Ability to uphold a
social role and
meaningful
activities was
crucial to their
quality of life.
Patients rarely
discussed health-
related quality of
Long-term
quality of life in
patients with
MM may be
over-estimated.
Newly
diagnosed
patients may
need emotional
support and
information
about the
improved
manageability
of MM.

Oncology Nursing 19
life with their
oncologists as
consultations
majorly focused on
cancer control
NautiyaLal,
Verma, Yadav,
Singh, &
Kumar
Evaluation of
fatigue in head
and neck cancer
patients
undergoing
(intensity
modulated
radiation
therapy)
radiotherapy: A
prospective
study.
2015 to study temporal
variation in fatigue
levels in head and
neck cancer (HNC)
patients when they
were treated by
radiotherapy (RT)
using intensity
modulated radiation
therapy techniques
Prospective study
was carried out
from August 2009
to October 2011
at Department of
Radiotherapy
SGPGIMS,
Lucknow.
26 proven head and
neck cancer patients
At baseline, fatigue
score was
significantly high
(22.4) among
patients with head
and neck cancer
and 12.8 among
controls. The
average score
increased to 30 in 3
weeks due to
radiotherapy and
rose to 33.2 at the
end of radiotherapy.
3 months after
radiotherapy.
Average fatigue
score decreased to
22.8 and remained
between 23 and 20
at 6 and 12 months
respectively.
Average fatigue
was higher among
patients in the
advanced stage
Head and neck
cancer patients
suffer greater
fatigue than
age-matched
healthy
individuals
which is further
aggravated by
RT. It gradually
comes back to
the pretreatment
level by 3
months
following
treatment, but
does not reach
to a normal
healthy level
even at 12
months
following
treatment.

Oncology Nursing 20
Ngamkham,
Holden, &
Smith
A Systematic
Review:
Mindfulness
Intervention for
Cancer-Related
Pain.
2019 To describe the
effectiveness of
mindfulness
interventions for
pain and its
underlying
pathophysiologic
mechanisms
systematic review Empirical studies
published from
2008 to 2017
Mindfulness-based
interventions may
decrease pain
severity, anxiety,
and depression and
can improve quality
of life. When
patients practice
mindfulness
meditation, they
become less
cognitively focused
on their pain; thus,
pain tolerance is
enhanced.
Studies to date
have been
conducted in
limited study
populations, and
findings are
inconsistent
across studies.
Therefore,
future
intervention
research is
needed to test
whether
mindfulness
interventions
will lead to
better pain
outcomes for a
variety of
cancer
populations,
including for
Eastern (Asian)
populations
where
mindfulness
practices are
well accepted
and a routine
component of
daily life.

Oncology Nursing 21
Pham, Vu, Dao
& Le
Depression and
anxiety as key
factors
associated with
quality of life
in lung cancer
patients in Hai
Phong, Viet
Nam.
2019 The study aims to
identify factors
associated with the
QoL of patients
with lung cancer at
the oncology
department of Viet
Tiep Hospital, Hai
Phong city,
Vietnam
Quantitative
cross-sectional
study
125 lung cancer
inpatients in Hai
Phong city,
Vietnam
The multivariate
analyses showed
that a low quality of
life score was
significantly
associated with
depression,
incapacity to pay,
low response to
treatment, and
presence of side
effects.
Taking care of
psychological
aspects of
Vietnamese
people suffering
from lung
cancer can help
to improve the
quality of life
Sheikhalipour,
Ghahramanian,
Fateh,
AGhiahi, &
Onyeka,
Quality of Life
in Women with
Cancer and Its
Influencing
Factors.
2019 To investigate the
quality of life in
women with cancer
and its influencing
factors.
Cross-sectional
study
150 women
diagnosed with
cancer
In the function
dimension of
quality of life, the
highest and lowest
scores belonged to
the cognitive and
emotional domains,
respectively.
Women who had
the symptoms of
insomnia and
fatigue, and
reported the
pressure due to
financial burden of
cancer treatment
had a significantly
lower quality of
life.
Nursing
interventions
are required to
relieve cancer-
related
symptoms.
Governmental
and insurance
agencies should
help with the
costs paid by
the patients and
prevent from
reducing their
quality of life.

Oncology Nursing 22
Wang, Lv, Li,
Gan, Chen,
Liu, Chao, Li,
& Cheng
Correlation
between
Psychosocial
Distress and
Quality of Life
in Patients with
Nasopharyngea
l Carcinoma
(NPC)followin
g Radiotherapy
2018 To investigate the
relationship
between
psychosocial
distress and quality
of life (QOL) in
patients with
nasopharyngeal
carcinoma (NPC)
after radiotherapy
DT and FACT-
H&N surveys
were all
administered
within one week
before and after
radiation therapy.
53 patient with an
initial diagnosis of
NPC
Psychological
distress to be
negatively is
correlated with
QOL in NPC
patients after
radiotherapy. This
means that the more
severe the
psychological
distress, the lower
the QOL
Reducing
psychological
distress may be
an important
means to
improving the
QOL of NPC
survivors.
Therefore, NPC
patients should
be provided
with assistance
following
radiotherapy to
maintain their
quality of life.
Zhang,
Nilsson, &
Prigerson
Factors
important to
patients' quality
of life at the
end of life.
2012
To determine the
factors that most
influence quality of
life at the end-of-
life, thereby,
identifying
promising targets
for interventions to
promote quality of
life at the end of life
longitudinal
cohort study
396 advanced
cancer patients
The 9 factors that
explained the most
variance in patients’
end of life quality
of life included ICU
stays in the final
week (4.40%),
hospital deaths
(2.70%), patient
worry at baseline
(2.70%), religious
prayer or
meditation at
baseline (2.50%),
site of cancer care
(1.80%), feeding-
Advanced
cancer patients
who avoid
hospitalizations
and intensive
care, who are
not worried,
who pray or
meditate, who
are visited by a
pastor in the
hospital/clinic,
and who feel a
therapeutic
alliance with
their physicians

Oncology Nursing 23
tube use in the final
week (1.10%),
pastoral care within
the hospital/clinic
(1.10%),
chemotherapy in
the final week
(0.90%), and
patient-physician
therapeutic alliance
(0.70%) at baseline.
Most of the
variance (82.3%)in
end of life quality
of life, however,
remained
unexplained.
have the highest
quality of life at
the end of life