Contribution of non-socioeconomic factors to healthy quality of life in socioeconomically deprived patients with advanced gastrointestinal cancer: Measuring attributable fraction

J Adv Nurs. 2024 Mar;80(3):1154-1165. doi: 10.1111/jan.15862. Epub 2023 Sep 14.

Abstract

Background: The quality of life of patients with advanced gastrointestinal cancer is seriously impaired, and socioeconomic deprivation often has a serious impact on their quality of life. However, little is known about the relative contribution of non-socioeconomic factors to the quality of life of patients with advanced gastrointestinal cancer with socioeconomic deprivation.

Aim: This study aims to investigate the situation and predictors of quality of life of patients with socioeconomic deprivation and evaluate the independent effects of some non-socioeconomic factors.

Design: A retrospective study based on cross-sectional design.

Methods: Data were obtained from 1075 patients with advanced gastrointestinal cancer who received family palliative treatment in the hospice ward of Zhongnan Hospital of Wuhan University from March 2010 to October 2020, including demographic and clinical questionnaires, Karnofsky Performance Status scale and Cancer Pain and Quality of Life Questionnaire of Chinese Cancer Patients.

Results: The quality of life of patients with advanced gastrointestinal cancer with socioeconomic deprivation is impaired and is affected by gait, self-care ability, abdominal distension, nutritional status, weight loss, constipation and posture. Improvement in six of these factors-gait, self-care ability, abdominal distension, nutritional status, weight loss and posture-has an independent positive impact on the development of a healthy quality of life for patients.

Conclusions: Gait, self-care ability, abdominal distension, nutritional status, weight loss and posture are important determinants of healthy quality of life in patients with advanced gastrointestinal cancer with socioeconomic deprivation, and early identification and strength management of these non-socioeconomic factors may neutralize the negative impact of socioeconomic factors on the quality of life.

Implications for practice: This study provides new ideas and intervention entry points for global nurses in practice innovations to improve the quality of life of socioeconomically deprived patients with advanced gastrointestinal cancer. It enables them to focus on the effectiveness of non-socioeconomic factors in the development and implementation of targeted care plans for patients with advanced gastrointestinal cancer experiencing socioeconomic deprivation globally.

Reporting method: This study was reported in strict compliance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guideline.

Patient or public contribution: No patient or public contribution.

Keywords: advanced cancer; attributable fraction; gastrointestinal; healthy; non-socioeconomic factors; nursing; quality of life; quantitative research; retrospective; socioeconomic deprivation.

Publication types

  • Observational Study

MeSH terms

  • Cross-Sectional Studies
  • Gastrointestinal Neoplasms*
  • Humans
  • Quality of Life*
  • Retrospective Studies
  • Socioeconomic Factors
  • Weight Loss