Modeling hot flushes and quality of life in breast cancer survivors
- 11 February 2011
- journal article
- research article
- Published by Taylor & Francis Ltd in Climacteric
- Vol. 14 (1), 171-180
- https://doi.org/10.3109/13697131003717070
Abstract
Objectives To evaluate the relationships among measures of hot flushes, perceived hot flush interference, sleep disturbance, and measures of quality of life while controlling for potential covariates (patient and treatment variables). Methods Breast cancer survivors (n == 395) due to receive aromatase inhibitor therapy provided demographic information, physiological hot flush data via sternal skin conductance monitoring, hot flush frequency via written diary and electronic event marker, hot flush severity and bother via written diary, and questionnaire data via the Hot Flash Related Daily Interference Scale, Pittsburgh Sleep Quality Index, the EuroQOL, Hospital Anxiety and Depression Scale and the Center for Epidemiologic Studies Depression Scale. Results Confirmatory factor analysis supported a two-factor model for hot flush symptoms (frequency and severity). Although there was strong convergence among self-reported hot flush measures, there was a high degree of unexplained variance associated with physiological measures. This suggests that self-report and physiological measures do not overlap substantially. The structural model showed that greater hot flush frequency and severity were directly related to greater perceived interference with daily life activities. Greater perceived interference, in turn, directly predicted greater sleep disruption, which predicted lower perceived health state and more symptoms of anxiety and depression. Conclusions Findings suggest hot flush interference may be the most appropriate single measure to include in clinical trials of vasomotor symptom therapies. Measuring and ameliorating patients' perceptions of hot flush interference with life activities and subjective sleep quality may be the most direct routes to improving quality of life.Keywords
This publication has 56 references indexed in Scilit:
- Management of Postmenopausal Symptoms in Breast Cancer SurvivorsSeminars in Oncology, 2006
- Adherence to tamoxifen over the five-year courseBreast Cancer Research and Treatment, 2006
- Antidepressants and SleepDrugs, 2005
- Risks and Benefits of Estrogen Plus Progestin in Healthy Postmenopausal Women: Principal Results From the Women's Health Initiative Randomized Controlled TrialJAMA, 2002
- The Hot Flash Related Daily Interference Scale: A Tool for Assessing the Impact of Hot Flashes on Quality of Life Following Breast CancerJournal of Pain and Symptom Management, 2001
- Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternativesStructural Equation Modeling: A Multidisciplinary Journal, 1999
- PSYCHOMETRICS FOR TWO SHORT FORMS OF THE CENTER FOR EPIDEMIOLOGIC STUDIES-DEPRESSION SCALEIssues in Mental Health Nursing, 1998
- The psychometric properties of the center for epidemiological studies-depression scale (ces-d) when used with adults with physical disabilitiesPsychology & Health, 1992
- The Hospital Anxiety and Depression ScaleActa Psychiatrica Scandinavica, 1983
- The CES-D ScaleApplied Psychological Measurement, 1977