Moderating effect of sense of coherence on the relationship between symptom distress and health-related quality of life in patients receiving cancer chemotherapy.

PURPOSE: This study is aimed at examining the buffering effect of sense of coherence (SOC) on symptom distress during cancer drug therapy, which thereby affects health-related quality of life (QoL), and obtaining suggestions for promoting supportive care. METHODS: We investigated health-related QoL (SF-8), symptom distress (using the Symptom Distress Scale (SDS)), and SOC (the SOC 13-item Scale) in 66 patients receiving adjuvant chemotherapy for non-small cell lung cancer. We employed descriptive statistics to seek the correlation of each variable; then, a hierarchical multiple regression analysis was conducted with SF-8 score as the dependent variable. RESULTS: Results showed that significant changes in bodily pain showed a buffering effect on the SDS and sense of comprehensibility (ß = - 0.658, p < 0.01, ß = - 0.319, p < 0.05), sense of manageability (ß = - 0.658, p < 0.01, ß = 0.398, p < 0.01), and meaningfulness (ß = - 0.658, p < 0.01, ß = - 0.257, p < 0.05). Significant changes in general health perception showed a buffering effect on the SDS and sense of manageability (ß = - 0.406, p < 0.01, ß = 0.329, p < 0.05). As a result of the simple inclination test, SOC proved to be effective under high levels of symptom distress; the buffering effect of sense of manageability was reversed regarding bodily pain; and when meaningfulness was lower, it had a positive effect on QoL. CONCLUSION: This study revealed that SOC exerts a buffering effect in situations where symptoms are highly painful. It also revealed that the effect of SOC was reversed for bodily pain and that a high SOC had a negative effect on QoL.

[The outpatient palliative care conference for the home palliative care shift (the second report)--the conference was used to look back on the case where the patient's QOL was kept and improved].

The patient was a 30-year-old woman with right tongue cancer and SCC (T4N2bM0). After it had relapsed, the outpatient palliative care conference intervened. The purpose of intervention was as follows: pain control, nutrition management, home recuperation support, and relief of a spiritual pain. We could achieve the patient's desire to recuperate at home as long as possible by sharing a goal and information. The patient was treated for a total of 457 days. Since the relapse, she was treated for 274 days, and was hospitalized for 49 days. By offering necessary home care supports, the patient and family fully demonstrated their potentials what they could do to recuperate and resulted in a long home stay. It was thought that our relationship with the patient and family appeared to have enhanced their self-resistance feelings against the disease. Consequently, we contributed the improvement of QOL.