The physical and psychological aspects of quality of life mediates the effect of radiation‐induced urgency syndrome on disability pension in gynecological cancer survivors
Abstract Background Radiation‐induced fecal urgency syndrome is highly prevalent in gynecological cancer survivors. It is associated with decreased quality of life (QoL) and with disability pension. The literature remains unclear about the mediating role of physical and psychological aspects of QoL...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2023-08-01
|
| Series: | Cancer Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/cam4.6356 |
| _version_ | 1827307645277569024 |
|---|---|
| author | Adnan Noor Baloch Mats Hagberg Sara Thomée Gunnar Steineck Helena Sandén |
| author_facet | Adnan Noor Baloch Mats Hagberg Sara Thomée Gunnar Steineck Helena Sandén |
| author_sort | Adnan Noor Baloch |
| collection | DOAJ |
| description | Abstract Background Radiation‐induced fecal urgency syndrome is highly prevalent in gynecological cancer survivors. It is associated with decreased quality of life (QoL) and with disability pension. The literature remains unclear about the mediating role of physical and psychological aspects of QoL in the association between urgency syndrome and disability pension. Identifying the pathways between urgency syndrome and disability pension may help to create effective and timely interventions for increasing QoL and reducing disability pension among gynecological cancer survivors. Methods We used patient‐reported outcome measures from working‐age gynecological cancer survivors (n = 247) and data on their disability pension from the official register. The mediating role of physical and psychological aspects of QoL was studied by utilizing mediation analysis based on the counterfactual framework, appropriate for binary outcome, binary mediator with an exposure–mediator interaction. The total effect (TE) was divided into direct and indirect effects using single mediation analysis. Adjusted relative risks and percentage mediated (95% confidence intervals) were calculated. All statistical tests were two‐sided. Results Urgency syndrome increased the risk of disability pension both directly and indirectly (via QoL). Satisfaction with sleep mediated half of the TE (RR = 2.2 (1.1–4.1)) of urgency syndrome on disability pension. Physical health also mediated a similar proportion of the TE (RR = 2.1 (1.2–3.9)). The proportions mediated were higher for physical aspects of QoL (35%–71%) than for psychological aspects (2%–47%). Conclusions The investigated aspects of the self‐assessed QoL of gynecological cancer survivors may play a role in these women's continuing work‐life. It appears that physical health, satisfaction with sleep, psychological well‐being, and other investigated aspects of QoL mediate the urgency syndrome–disability pension association. |
| first_indexed | 2024-03-12T00:55:06Z |
| format | Article |
| id | doaj.art-55b126101e3a4db682e5f6c26db3ed6f |
| institution | Directory Open Access Journal |
| issn | 2045-7634 |
| language | English |
| last_indexed | 2024-04-24T18:43:07Z |
| publishDate | 2023-08-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj.art-55b126101e3a4db682e5f6c26db3ed6f2024-03-27T09:11:00ZengWileyCancer Medicine2045-76342023-08-011216173771738810.1002/cam4.6356The physical and psychological aspects of quality of life mediates the effect of radiation‐induced urgency syndrome on disability pension in gynecological cancer survivorsAdnan Noor Baloch0Mats Hagberg1Sara Thomée2Gunnar Steineck3Helena Sandén4Biostatistics, School of Public Health & Community Medicine, Institute of Medicine at Sahlgrenska Academy University of Gothenburg Gothenburg SwedenOccupational & Environmental Medicine, School of Public Health & Community Medicine, Institute of Medicine at Sahlgrenska Academy University of Gothenburg Gothenburg SwedenDepartment of Psychology University of Gothenburg Gothenburg SwedenClinical Cancer Epidemiology, Department of Oncology, Institute of Clinical Sciences University of Gothenburg Gothenburg SwedenOccupational & Environmental Medicine, School of Public Health & Community Medicine, Institute of Medicine at Sahlgrenska Academy University of Gothenburg Gothenburg SwedenAbstract Background Radiation‐induced fecal urgency syndrome is highly prevalent in gynecological cancer survivors. It is associated with decreased quality of life (QoL) and with disability pension. The literature remains unclear about the mediating role of physical and psychological aspects of QoL in the association between urgency syndrome and disability pension. Identifying the pathways between urgency syndrome and disability pension may help to create effective and timely interventions for increasing QoL and reducing disability pension among gynecological cancer survivors. Methods We used patient‐reported outcome measures from working‐age gynecological cancer survivors (n = 247) and data on their disability pension from the official register. The mediating role of physical and psychological aspects of QoL was studied by utilizing mediation analysis based on the counterfactual framework, appropriate for binary outcome, binary mediator with an exposure–mediator interaction. The total effect (TE) was divided into direct and indirect effects using single mediation analysis. Adjusted relative risks and percentage mediated (95% confidence intervals) were calculated. All statistical tests were two‐sided. Results Urgency syndrome increased the risk of disability pension both directly and indirectly (via QoL). Satisfaction with sleep mediated half of the TE (RR = 2.2 (1.1–4.1)) of urgency syndrome on disability pension. Physical health also mediated a similar proportion of the TE (RR = 2.1 (1.2–3.9)). The proportions mediated were higher for physical aspects of QoL (35%–71%) than for psychological aspects (2%–47%). Conclusions The investigated aspects of the self‐assessed QoL of gynecological cancer survivors may play a role in these women's continuing work‐life. It appears that physical health, satisfaction with sleep, psychological well‐being, and other investigated aspects of QoL mediate the urgency syndrome–disability pension association.https://doi.org/10.1002/cam4.6356cancer survivorshipdisability pensionearly retirementgynecological cancerquality of lifereturn to work |
| spellingShingle | Adnan Noor Baloch Mats Hagberg Sara Thomée Gunnar Steineck Helena Sandén The physical and psychological aspects of quality of life mediates the effect of radiation‐induced urgency syndrome on disability pension in gynecological cancer survivors Cancer Medicine cancer survivorship disability pension early retirement gynecological cancer quality of life return to work |
| title | The physical and psychological aspects of quality of life mediates the effect of radiation‐induced urgency syndrome on disability pension in gynecological cancer survivors |
| title_full | The physical and psychological aspects of quality of life mediates the effect of radiation‐induced urgency syndrome on disability pension in gynecological cancer survivors |
| title_fullStr | The physical and psychological aspects of quality of life mediates the effect of radiation‐induced urgency syndrome on disability pension in gynecological cancer survivors |
| title_full_unstemmed | The physical and psychological aspects of quality of life mediates the effect of radiation‐induced urgency syndrome on disability pension in gynecological cancer survivors |
| title_short | The physical and psychological aspects of quality of life mediates the effect of radiation‐induced urgency syndrome on disability pension in gynecological cancer survivors |
| title_sort | physical and psychological aspects of quality of life mediates the effect of radiation induced urgency syndrome on disability pension in gynecological cancer survivors |
| topic | cancer survivorship disability pension early retirement gynecological cancer quality of life return to work |
| url | https://doi.org/10.1002/cam4.6356 |
| work_keys_str_mv | AT adnannoorbaloch thephysicalandpsychologicalaspectsofqualityoflifemediatestheeffectofradiationinducedurgencysyndromeondisabilitypensioningynecologicalcancersurvivors AT matshagberg thephysicalandpsychologicalaspectsofqualityoflifemediatestheeffectofradiationinducedurgencysyndromeondisabilitypensioningynecologicalcancersurvivors AT sarathomee thephysicalandpsychologicalaspectsofqualityoflifemediatestheeffectofradiationinducedurgencysyndromeondisabilitypensioningynecologicalcancersurvivors AT gunnarsteineck thephysicalandpsychologicalaspectsofqualityoflifemediatestheeffectofradiationinducedurgencysyndromeondisabilitypensioningynecologicalcancersurvivors AT helenasanden thephysicalandpsychologicalaspectsofqualityoflifemediatestheeffectofradiationinducedurgencysyndromeondisabilitypensioningynecologicalcancersurvivors AT adnannoorbaloch physicalandpsychologicalaspectsofqualityoflifemediatestheeffectofradiationinducedurgencysyndromeondisabilitypensioningynecologicalcancersurvivors AT matshagberg physicalandpsychologicalaspectsofqualityoflifemediatestheeffectofradiationinducedurgencysyndromeondisabilitypensioningynecologicalcancersurvivors AT sarathomee physicalandpsychologicalaspectsofqualityoflifemediatestheeffectofradiationinducedurgencysyndromeondisabilitypensioningynecologicalcancersurvivors AT gunnarsteineck physicalandpsychologicalaspectsofqualityoflifemediatestheeffectofradiationinducedurgencysyndromeondisabilitypensioningynecologicalcancersurvivors AT helenasanden physicalandpsychologicalaspectsofqualityoflifemediatestheeffectofradiationinducedurgencysyndromeondisabilitypensioningynecologicalcancersurvivors |