Research of the relationship among quality of care and quality of life in patients with breast cancer

Recent years have seen increased attention being given to measure care process and long-term outcome in breast cancer research. However, research focusing on the relationship between quality of care and quality of life in survivors is still very scarce. The aim of this study was to explore whether higher adherence to a set of breast cancer quality indicators applied to individuals is associated with better quality of life. A cross-sectional study was conducted by structured-questionnaire to breast cancer survivors in 19 hospitals during January to July in 2011. The quality indicators (2 pretreatment-related and 3 treatment-related indicators) were used to measure the quality of care. Adherence rate of each individual was based on the number of indicators adhered divided by the number of indicators applicable for the individual according to her stage. The European Organization for Research and Treatment of Cancer core questionnaire and breast module (EORTC QLQ-C30and QLQ-BR23) was employed to assess quality of life. A multiple regression and a hierarchical linear modeling were used for multivariate analysis. 670 female patients (average age of 53±9.9 years) were included in the study. 417(63.3%) participants reported over one year time-elapsed since initial treatment. Multivariate analysis revealed that higher quality of care related to better quality of life. Higher adherence rate was positively associated with role functioning, emotional functioning, body image, sexual function, sexual enjoyment and future perspective. Moreover, better care was negatively related to symptoms such as pain, financial difficulties, as well as systemic therapy side effects and breast symptoms.