Health-Related Quality of Life in Patients with Colorectal Cancer: A Comparison Between Those With and Without Colostomy Amirmohammad Dahouri, Mohammad Hassan Sahebihagh, Neda Gilani, Leila Sheikhnezhad Journal of Caring Sciences, 2025 Introduction: Colorectal cancer (CRC), as a leading cause of cancer-related morbidity and mortality worldwide, often requires surgical interventions such as colostomy, which can substantially affect patients’ health-related quality of life. The presence of a colostomy adversely affects deferent aspects of patient’s life. The aim of this study is to compare the health-related quality of life in patients with and without a colostomy. Methods: In this comparative cross-sectional study, 256 patients with CRC were included through convenience sampling, comprising 127 patients with a colostomy (49.6%) and 129 without a colostomy (50.4%). The data collection tools included the demographic information form and the shortened form of the health-related quality of life questionnaire (SF-36). Statistical analyses were performed using IBM SPSS Statistics version 13, including descriptive statistics, independent samples t-tests, general linear modeling, and multiple regression analyses. Results: In this study, the health-related quality of life score (range: 0–100) was 43.03±17.08 in patients with a colostomy and 51.38±15.57 in those without a colostomy. Also, there was a statistically significant difference in physical functioning, role limitation due to physical health, role limitation due to emotional problems and health-related quality of life in people with and without colostomies (P<0.05). Finally, in sex stratified exploratory analyses, differences were evident among women but not among men. Conclusion: This study demonstrates that patients with CRC, particularly those with a colostomy, experience significantly lower health-related quality of life. The findings emphasize the importance of early and targeted interventions to improve physical and psychosocial well-being in this population. Greater attention should be given to the needs of patients with colostomy in both hospital and community care settings to enhance their overall quality of life.
Factors associated with sexual dysfunction in patients with colorectal cancer in Iran: a cross-sectional study Amirmohammad Dahouri, Mohammad Hassan Sahebihagh, Neda Gilani Scientific Reports, 2024 Sexual dysfunction is a prevalent issue among individuals diagnosed with colorectal cancer (CRC), significantly impacting their quality of life. However, limited research has explored the factors associated with sexual dysfunction in CRC patients in Iran. This cross-sectional study aimed to identify the demographic factors that may contribute to sexual dysfunction in this population. A cross-sectional study involving CRC patients was conducted from April 1, 2022, to May 1, 2022, in Tabriz, Iran. Ethical approvals were obtained, and convenience sampling was employed at outpatient chemotherapy centers in five Tabriz hospitals. Validated questionnaires, including participants characteristics form, the Female Sexual Function Index (FSFI) for females and International Index of Erectile Function (IIEF) for males, were utilized. Data were analyzed using IBM SPSS Statistics version 24, employing descriptive statistics and stepwise linear regression to assess association between mentioned factors and sexual function. Among 256 participants, 50.4% were males, 49.6% were females, and 80.5% were married. The predominant age range was 50–60 years. The study findings revealed a high prevalence of sexual dysfunction among both female (Mean ± SD: 10.91 ± 8.67, Min–Max: 3.20–33.00) and male (Mean ± SD: 27.64 ± 16.28, Min–Max: 11–62) CRC patients. Factors such as the presence of a colostomy for FSFI (P < 0.001), type of treatment received for both FSFI and IIEF (P < 0.001), type of housing for both FSFI and IIEF (P < 0.001), occupation for FSFI (P < 0.001), presence of other diseases for FSFI (P = 0.047), and time since the last chemotherapy session for FSFI (P = 0.018), Education for IIEF (P = 0.026), and Age for IIEF (P = 0.002) were identified as significant factors of sexual dysfunction. These demographic factors demonstrated varying effects on sexual function, underscoring the complexity of this issue. The results underscore the significance of addressing sexual health concerns in CRC patients and highlight the necessity for tailored interventions to enhance their overall well-being. Healthcare providers should recognize the influence of demographic factors on sexual function and contemplate integrating sexual health assessments and interventions into the care of CRC patients. Further research is needed to comprehend better the underlying mechanisms and devise effective strategies for managing sexual dysfunction in this population.
Predictive factors associated with health-related quality of life in patients with colorectal cancer in Iran: A cross-sectional study Amirmohammad Dahouri, Mohammad Hasan Sahebihagh, Neda Gilani BMJ Open, 2024 ObjectivesThis study aims to identify the primary factors influencing health-related quality of life (HRQoL) in patients with colorectal cancer (CRC), hypothesising that specific patient characteristics and clinical factors significantly impact HRQoL.DesignThis was a cross-sectional study conducted over 1 month, from 1 April 2022 to 1 May 2022.SettingThe study was conducted in five hospitals in the northwest region of Iran, focusing on outpatient chemotherapy services.ParticipantsA total of 251 patients diagnosed with colon and rectal cancer participated in the study. Inclusion criteria included a confirmed diagnosis by an oncologist, ability to communicate, willingness to participate and being aware of their diagnosis and treatment. Exclusion criteria were the presence of other chronic diseases, cognitive disorders, known mental disorders and unwillingness to participate.InterventionsNo interventions were applied as this was an observational study.Primary and secondary outcome measuresThe primary outcome was the HRQoL of patients with CRC, measured using a standardised SF-36 (36-Item Short Form Health Survey) questionnaire. Secondary outcomes included the impact of demographic and clinical factors on HRQoL.ResultsThe total score of HRQoL in these patients is 47.22±16.78, which indicates that HRQoL is disturbed in these patients. Also, the results of the stepwise multiple regression revealed that among all the participants’ characteristics considered, seven factors: not having another disease besides cancer (p<0.001, β: 12.91, 95% CI 8.40, 17.42), only receiving chemotherapy (p<0.001, β: 9.10, 95% CI 4.12, 14.09), not having colostomy (p<0.001, β: 10.27, 95% Cl 5.70, 14.84), female sex (p=0.046, β: −4.52, 95% Cl −8.95, –0.08), living in their own house (p=0.001, β: 11.25, 95% Cl 4.77, 17.73), living in city (p=0.002, 17.74, 95% Cl 6.51, 28.96) and finally not having a job (p=0.003, β: −7.47, 95% Cl −12.31, –2.63), including are the factors that have the most predictive power in HRQoL.ConclusionsThe findings of this study encourage health service providers and planners to pay special attention to the characteristics of patients with CRC as identified in this study. Notably, several HRQoL scores in patients with CRC are low, and the study found that patient characteristics, such as the presence of colostomy, unemployment, female gender and comorbidities, significantly predict the overall HRQoL score. Future research should focus on interventional studies aimed at minimising the adverse effects of disease symptoms on HRQoL in these vulnerable patients.
Comparison of sexual function of people with colorectal cancer with and without colostomy bag in Iran: a comparative cross-sectional study Amirmohammad Dahouri, Mohammad Hassan Sahebihagh, Neda Gilani Scientific Reports, 2023 The aim of this study was to investigate and compare sexual function in individuals with colorectal cancer, with and without a colostomy bag. A quantitative, descriptive-comparative design was employed, and a cluster random sampling method was used to recruit 252 patients with colorectal cancer. Data collection tools included a participants characteristics form, the International Index of Erectile Function (IIEF) for men, and the Female Sexual Function Index (FSFI) for women. The mean IIEF total score for men with a colostomy was 26.17 ± 15.30, and for men without a colostomy, it was 29.05 ± 17.14. The mean FSFI total score for women with a colostomy was 6.40 ± 7.21, and for women without a colostomy, it was 9.10 ± 14.67. There was no statistically difference in IIEF scores between men with and without colostomy bags (p > 0.05). However, women with colostomy bags had significantly lower FSFI scores compared to women without colostomy bags (p < 0.05). Addressing sexual concerns in individuals with colorectal cancer is crucial for enhancing their sexual well-being and overall quality of life. Comprehensive support, timely interventions, and targeted services are essential to help patients navigate the challenges and improve their overall well-being.
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