Social functioning of elderly persons with malignant diseases.

BACKGROUND/AIM: Malignant disease, its treatment and consequences of treatment can often lead to social marginalization and reduced quality of life. The aim of this research was to determine how elderly patients with malignant diseases function in their social environment. METHODS: Sociodemographic questionnaire and interview were used to investigate a group of 49 elderly persons undergoing adjuvant chemotherapy treatment against early carcinomas (P1), and a group of 51 elderly persons with advanced stages of cancer undergoing systemic chemotherapy (P2). There were two cycles of assessment: one just before the beginning of the first cycle of adjuvant or systemic chemotherapy, and the other three months later. The research paradigm was based on the relation between individual treatment and the impact of the malignant disease on functional and social incompetence. The obtained findings were compared with the group of 50 healthy elderly people (K) who share the same relevant features but do not suffer from malignant diseases. RESULTS: It was found that most healthy older people live in share house, whereas those who suffer from malignant diseases mostly live in separate households. In both groups of patients and healthy group older people are mostly taken care of by their children. Individuals in both groups of patients have been frequently visited by their relatives during initial stages of treatment, unlike the elderly people in the control group. However, the difference did not reach a statistical significance. Three months after the beginning of chemotherapy, there was a statistically relevant difference in favor of the group undergoing adjuvant treatment. Home visits eventually become less frequent, whereas communication by telephone becomes more frequent. It was also found that visits by friends and neighbors are statistically more frequent among subjects who undergo adjuvant treatment, both before the treatment began and three months later when compared to other groups. CONCLUSION: Our research shows that elderly people are subject to social exclusion, especially those with malignant diseases. Special care should be dedicated to monitoring of social functioning during treatment of patients with malignant disease considering the detected trend of deterioration and significance for further recover and cure.

Trends in use of and attitudes held towards alternative and complementary medicine among patients treated in a Department of Medical Oncology in Serbia. A several-years-apart time survey study.

PURPOSE: To determine the prevalence of concurrent use and attitude towards complementary and alternative medicine (CAM) by patients undergoing conventional therapy with anticancer agents at the National Cancer Center of Serbia (IORS). METHODS: The study sample comprised 300 subjects undergoing chemotherapy at the Medical Oncology Department of IORS. For the purposes of this research we constructed a special questionnaire with clearly defined questions. The research was carried out in 1993, in 2000 and in 2008. RESULTS: The percentage of patients who used CAM was over 50% in all 3 time periods. In 1993 and in 2000, 10% of the patients stated that their treating physicians were the ones who suggested using CAM, whereas this percentage rose to 30% in the 2008 survey (p<0.001). Most of the patients used CAM after recommendation by their family members or close friends. Patients believed that CAM would strengthen their immunity (this finding remained almost the same in all time periods, i.e. approximately 65%). Up to one third of CAM users believed that CAM will cure their malignant disease, whereas most of the patients expected better effects of the standard treatment if aided by CAM (p=0.012). The monthly expenditure for CAM was approximately €100. CONCLUSION: The results of this study may help oncologists to recognize features of CAM methods and understand why patients use them. Timely patient information about the disease and the treatment options will increase confidence in conventional therapies.

Health-related quality of life assessment in Serbian schoolchildren hospitalized for malignant disease.

BACKGROUND/AIM: Although long-term survival of childhood cancer patients is significantly improved, prolonged treatment and hospitalization might have negative impacts on child development. The aim of this study was to verify profile of health-related quality of life parameters in population of schoolchildren during hospitalization and treatment for malignant disease. METHODS: The Serbian version of Pediatric Quality of Life Inventory Version 4.0 (PedsQLTM4.0) Generic Core Scales was applied. A total of 120 schoolchildren were analyzed: 60 patients hospitalized for prolonged malignant disease treatment and 60 healthy schoolchildren from public schools. The study was done at the Institute for Oncology and Radiology of Serbia, as well as in four schools. RESULTS: Generally, schoolchildren hospitalized for cancer treatment demonstrated lower scores on physical, emotional, social and school functioning when compared to healthy schoolchildren from regular public schools. Significant differences were observed for all the 8 items of the Physical Health Scale, in 2 out of 5 items of the Emotional Functioning Scale, in 4 out of 5 items of the Social Functioning Scale, and 3 out of 5 items of the School Functioning Scale. CONCLUSIONS: The Serbian version of PedsQL 4.0 Generic Core Scales could be successfully used to evaluate physical, emotional, social and school functioning of hospitalized children and adolescent. Schoolchildren hospitalized for prolonged tumor treatment have poorer HRQOL scores compared to general healthy population, however the level of remaining physical, emotional and social parameters should provide solid foundation for their potential rehabilitation, education and inclusion.