Determinants of quality of life in patients with cancer

BACKGROUND Because health‐related quality of life (QOL) is an important outcome in cancer management, the authors sought to better understand its determinants. To address this subject, they analyzed QOL, as measured with the Functional Assessment of Cancer Therapy‐General questionnaire (FACT‐G), Spanish Version 4, and depicted the complex relations among physical, psychological, social, and cultural factors, including spirituality. METHODS A cross‐sectional study design was used with a sample of 309 patients with cancer. The influence of several possible determinants was first studied by univariate regression analysis. Variables showing an association were included in a forward stepwise multivariate regression model. RESULTS Five regression models were studied, for the FACT‐G total score and its four subscales. Five variables explained 32.1% of the variance of the FACT‐G total score: tumor stage, spiritual well‐being, income, mood disorders, and mode of questionnaire administration. The type and relevance of the explanatory variables differed among the various dimensions of QOL. CONCLUSIONS The authors underlined the entwining of biologic, psychosocial, and spiritual factors as determinants of the QOL of patients with cancer, thus supporting the multidimensional definition and modeling of the construct. Cancer 2005. © 2005 American Cancer Society. The current study identified multiple determinants of quality of life (QOL) in patients with cancer that confirmed the multidimensional nature of the construct showing the intertwining of clinical, psychosocial, and cultural factors. Of special interest was the association between spiritual well‐being and QOL in a population with high rates of agnosticism.