PURPOSE: This study was a descriptive survey research to identify the impact of bowel function, anxiety and depression on quality of life in patients with rectal cancer who had a sphincter-preserving resection. METHODS: articipants were 100 patients who had rectal cancer surgery at W hospital in Korea. Bowel function, anxiety & depression, and quality of life were measured using the BFI (Bowel Function Instrument), HADS (Hospital Anxiety-Depression Scale) and the FACT-C (Functional Assessment of Cancer Therapy-Colorectal). RESULTS: The mean scores were 39.81+/-5.16 for bowel function, 6.15+/-3.25 for anxiety, 7.24+/-3.13 for depression, and 72.50+/-13.27 for quality of life. There were significant negative correlations between quality of life and anxiety (r= -.59, p <.001) and between quality of life and depression (r= -.53, p <.001). But the correlation between quality of life and bowel function was significantly positive (r=.22, p =.025). The influence of the independent variables on the total quality of life was examined using multiple regression analysis. Anxiety (beta= -.38, p =.002), bowel function (beta= -.25, p =.028) and occupation (beta=.16, p =.048) were identified as factors affecting quality of life. The explanation power of this regression model was 44% and it was statistically significant (F=16.53, p <.001). CONCLUSION: The results of this study indicate that in order to improve the bowel function of patients after sphincter-preserving resection for rectal cancer, effective nursing interventions should be developed. As psychological problem such as anxiety and depression can relate to quality of life for these patients, nurses should work on improving the situation by providing continuous emotional nursing.
Adult ; Aged ; Aged, 80 and over ; *Anxiety ; Depression/*etiology ; Female ; Humans ; Male ; Middle Aged ; *Quality of Life ; Rectal Neoplasms/*psychology/surgery

OBJECTIVETo investigate the efficacy of biofeedback therapy for fecal incontinence in patients with mid or low rectal cancer.

METHODSTwenty-four patients with mid or low rectal cancer received biofeedback treatments after restorative resection and therapeutic efficacy was evaluated using anorectal manometry and Vaizey and Wexner scoring systems. Eighteen inpatients without defecating difficulties were selected as control group.

RESULTSThe parameters of anorectal manometry in patients with rectal cancer were significantly lower than those in the control group (P<0.01). After biofeedback therapy, the maximum squeeze pressure, resting pressure and maximum tolerated volume were significantly increased, from (118.3+/-42.9) mm Hg to (193.2+/-38.2) mm Hg, (27.8+/-9.0) mm Hg to (47.9+/-9.3) mm Hg,(97.5+/-52.8) ml to (189.1+/-39.0) ml, respectively (all P<0.01), while no significant difference in sensory threshold was observed (P=0.101). Post-treatment Vaizey (10.5+/-2.3 vs 12.9+/-2.8) and Wexner (7.5+/-2.5 vs 10.1+/-2.6) scores were significantly decreased compared with those before biofeedback (P<0.01).

CONCLUSIONBiofeedback therapy can improve the anal function in patients with rectal cancer after restorative resection.

Aged ; Anal Canal ; surgery ; Biofeedback, Psychology ; Fecal Incontinence ; etiology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Postoperative Complications ; therapy ; Pressure ; Rectal Neoplasms ; pathology ; surgery ; Treatment Outcome

OBJECTIVETo explore how to improve follow-up rate and follow-up quality in studies related to quality of life.

METHODSA retrospective cross-sectional study was performed in patients with rectal cancer who underwent primary surgery at the Gastrointestinal Surgery Department, The First Affiliated Hospital, Sun Yat-sen University from August 2002 to February 2011 using the European Organization for Research and Treatment of Cancer QLQ-C30 and CR-38 questionnaires. The influence factors of follow-up rate and reasons for missing sex-related items were analyzed.

RESULTSA total of 438 questionnaires were issued. Two hundred and eighty-five responses were received and the follow-up rate was 65.1%. Two hundred and sixty-two patients returned the questionnaires by mail. Responders and non-responders did not differ by sociodemographic and clinical characteristics including sex, age, postoperative time, complication, clinical stage and stoma. Significant differences were found when comparing the missing sex-related items grouped by sex, age, education and working status.

CONCLUSIONSFollow-up mode of mail supplemented by interview is suitable for current reality in China in studies on quality of life. Targeted methods should be adopted when investigating the different patient groups to improve follow-up rate of studies on quality of life and sexual function survey.

Cross-Sectional Studies ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Postoperative Period ; Quality of Life ; Rectal Neoplasms ; psychology ; surgery ; Retrospective Studies ; Surveys and Questionnaires

OBJECTIVEThe present study aims to investigate health-related quality of life (HRQOL) in disease-free survivors after radical surgery for mid-low rectal cancer.

METHODSA retrospective cross-sectional study was performed in patients with rectal cancer who underwent primary surgery between August 2002 and February 2011 by use of the European Organization for Research and Treatment of Cancer QLQ-C30 and CR-38 questionnaires (n = 330). The impact of clinical characteristics on HRQoL were assessed and compared by univariate and multivariate regression analyses.

RESULTSTwo hundred and four effective responses were received. Patients with stoma were more impaired in HRQoL than those without stoma, especially in the field of social psychology, such as emotional function (M(50) = 91.67, U = 2668.5, P = 0.026), social function (M(50) = 83.33, U = 2095.5, P < 0.001), financial difficulties (M(50) = 0, U = 2240.5, P < 0.001) and body image (M(50) = 88.89, U = 2507.0, P = 0.013). Only in the constipation scale (M(50) = 14.29, U = 2376.0, P = 0.001), nonstoma patients had a better score. The analysis in different types of surgical procedure paralleled those of stoma. Patients with complication had a poorer function in some symptom scales such as dyspnoea (M(50) = 0, U = 1505.0, P < 0.001), gastro-intestinal symptom (M(50) = 6.67, U = 1766.0, P = 0.034) and financial difficulties (M(50) = 33.33, U = 1795.5, P = 0.044), and in some functioning scales such as emotional function (M(50) = 83.33, U = 1608.5, P = 0.009), cognitive function (M(50) = 66.67, U = 1612.5, P = 0.010) and body image (M(50) = 66.67, U = 1617.0, P = 0.012). In our study, HRQoL after rectal cancer surgery improved with time. Our multivariate analysis displayed that stoma and postoperative time were the most significant characteristics. Variables associated with worse financial status were less postoperative months, occurrence of complications and presence of stoma.

CONCLUSIONSDifferent scales of HRQoL in patients of China after curative surgery for mid-low rectal cancer are significantly influenced by different clinical characteristics.

Adult ; Aged ; Aged, 80 and over ; Body Image ; Cross-Sectional Studies ; Female ; Humans ; Male ; Middle Aged ; Postoperative Period ; Quality of Life ; Rectal Neoplasms ; psychology ; surgery ; Retrospective Studies ; Surgical Stomas ; Surveys and Questionnaires