Farklı Kanser Türüne Sahip Bireyler ile Bakım Verenlerinde Fiziksel Aktivite, Yorgunluk Düzeyi ve Yaşam Kalitesinin İncelenmesi
Abstract
Amaç: Bu çalışma farklı kanser türüne sahip bireyler ile bakım verenlerinde fiziksel aktivite, yorgunluk ve yaşam kalitesinin incelenmesi amacıyla yapıldı.
Gereç ve Yöntemler: Çalışmaya akciğer kanseri (n=60, yaş: 55.77±7.27 yıl, Vücut Kütle İndeksi-VKİ; 20.22±1.12 kg/m2), meme kanseri (n=60, yaş:49.68±9.51 yıl, VKİ: 20.72±1.18 kg/m2) ve kolon kanseri (n=60, yaş: 52.53±7.77 yıl, VKİ: 19.57±0.92 kg/m2) olmak üzere 180 kanser hastası ve 180 bakım vereni dahil edildi. Fiziksel aktivite düzeyi Uluslararası Fiziksel Aktivite Anketi (IPAQ) ile, yorgunluk ise Piper Yorgunluk Ölçeği ile değerlendirildi. Yaşam kalitesi kanser hastalarında EORTC-QLQ-30, bakım verenlerde ise SF-36 yaşam kalitesi ölçeği ile değerlendirildi.
Bulgular: Yorgunluk akciğer kanseri ve bakım verenlerinde yüksek, meme kanseri ve bakım verenlerinde düşüktü (p<0.05). Yorgunluğun tüm alt boyutlarında akciğer ve kolon kanseri bakım verenleri, meme kanseri bakım verenlerine göre yüksekti (p<0.05). Meme ve kolon kanserli bireylerin fiziksel aktiviteleri
akciğer kanserine göre daha fazlaydı (p<0.05), bakım verenlerinde ise fark bulunmadı (p>0.05). Yaşam kalitesi (EORTC-QLQ-30) fiziksel alt boyut, bulantı-kusma, iştah kaybı, maddi zorluk haricinde diğer alt parametrelerinde fark bulundu (p<0.05). Akciğer kanserinde rol, kognitif ve sosyal alt boyut ile
dispne skorları daha yüksekti (p<0.05). Meme kanserinde fonksiyonel skor, emosyonel alt boyut, genel sağlık ve semptom skorları daha iyiyken, ağrı ve uyku bozukluğu alt boyut skorları ise kolon ve akciğer kanserinde daha yüksekti (p<0.05). Kabızlık ve diyare skorları sadece kolon kanserinde yüksekti (p<0.05).
Bakım verenlerde sadece SF-36 fiziksel fonksiyon parametresi meme kanserinde yüksek iken genel sağlık parametresi akciğer kanseri bakım verenlerinde düşüktü (p<0.05).
Sonuç: Akciğer kanseri ve bakım verenlerinde yorgunluk daha fazlaydı. Akciğer kanserinde fiziksel aktivite düzeyi ise meme ve kolon kanserine göre daha düşüktü. Bakım verenlerde kanser tipi yorgunluk açısından etkili olurken, fiziksel aktivite düzeyine etkisi olmadığı görüldü. Kanser hastalarının yaşam kaliteleri süreçten farklı şekilde etkilendiği görüldü.
Thanks
Sayın Prof. Dr Yavuz YAKUT’a çalışmamıza sunduğu değerli bilgiler ve veri analizindeki kıymetli katkıdan dolayı teşekkürlerimizi sunarız.
References
- Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M et al. Cancer incidence and mortality worldwide: Sources, methods and major patterns in GLOBOCAN 2012. Int. J Cancer. 2015;136(5):359-386.
- Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: Cancer J Clin. 2018;68(6):394-424.
- Segal R, Miller K, and Jemal A. Cancer statistics, 2018. CA: J Clin. 2018;68:7-30.
- Gültekin M, Boztaş G. Türkiye kanser istatistikleri. Sağlık Bakanlığı, Türkiye Halk Sağlığı Kurumu, 2014.43.
- Yang S, Chu S, Gao Y, Ai Q, Liu Y, Li X et al. A narrative review of cancer-related fatigue (CRF) and its possible pathogenesis. Cells. 2019;8(7):738.
- Barsevick AM, Irwin MR, Hinds P, Miller A, Berger A, Jacobsen P et al. Recommendations for high-priority research on cancer-related fatigue in children and adults. J Natl Cancer Inst. 2013;105(19):1432-1440.
- De Raaf P, De Klerk C, Van Der Rijt C. Elucidating the behavior of physical fatigue and mental fatigue in cancer patients: a review of the literature. Psycho‐Oncol. 2013;22(9):1919-1929.
- Corbett T, Groarke A, Devane D, Carr E, Walsh JC, Mcguire BE. The effectiveness of psychological interventions for fatigue in cancer survivors: systematic review of randomised controlled trials. Syst Rev. 2019;8(1):1-30.
- Mitchell SA. Cancer-related fatigue. Cancer nursing: Principles and practice, 2011:772-791.
- Marquez DX, Aguiñaga S, Vásquez PM, Conroy DE, Erickson KI, Hillman C et al. A systematic review of physical activity and quality of life and well-being. Transl Behav Med. 2020;10(5):1098- 1109.
- Muraca L, Leung D, Clark A, Beduz MA, Goodwin P. Breast cancer survivors: taking charge of lifestyle choices after treatment. Eur J Oncol Nurs. 2011;15(3):250-253.
- Fong DY, Ho JW, Hui BP, Lee AM, Macfarlane DJ, Leung SS et al. Physical activity for cancer survivors: meta-analysis of randomised controlled trials. BMJ. 2012;344: e70.
- Bag L, Ferreira E. Women with cancer and their relationship with physical activity. Rev Bras Cien and Mov. 2010;18(4):11-17.
- Lugo D, Pulido AL, Mihos CG, Issa O, Cusnir M, Horvath SA et al. The effects of physical activity on cancer prevention, treatment and prognosis: A review of the literature. Complement Ther Med. 2019;44:9-13.
- Eickmeyer SM, Gamble GL, Shahpar S, Do KD. The role and efficacy of exercise in persons with cancer. PM&R. 2012;4(11):874- 881.
- Joly F, Mcalpine J, Nout R, Åvall-Lundqvist E, Shash E, Friedlander M. Quality of life and patient-reported outcomes in endometrial cancer clinical trials: a call for action! Int J Gynecol Cancer. 2014;24:1693-1699.
- Smits A, Lopes A, Das N, Bekkers R, Massuger L, Galaal K. The effect of lifestyle interventions on the quality of life of gynaecological cancer survivors: A systematic review and meta-analysis. Gynecol Oncol. 2015;139(3):546-552.
- Canário ACG, Cabral PUL, Paiva LCd, Florencio GLD, Spyrides MH, Gonçalves AKdS. Physical activity, fatigue and quality of life in breast cancer patients. Rev Assoc Med Bras. 2016;62:38- 44.
- Van Roekel EH, Duchâteau J, Bours M, Van Delden L, Breedveld- Peters J, Koole J, et al. Longitudinal associations of light-intensity physical activity with quality of life, functioning and fatigue after colorectal cancer. Qual Life Res. 2020;29(11):2987- 2998.
- Ozdemir K, Keser I, Sen I, and Ozgur Tan M, Investigating the relationships between quality of life, fatigue and leisure time physical activity in prostate cancer patients. J Back Musculoskelet Rehabil. 2019;32(3):497-503.
- Hamidou Z, Auquier P, Leroy T, Barlesi F, Salas S, Chinot O et al. Dyadic effects of coping strategies, time perspectives, and personality on the quality of life of cancer patients and their caregivers. Psycho‐Oncol. 2018;27(2):590-599.
- Vrettos I, Kamposioras K, Kontodimopoulos N, Pappa E, Georgiadou E, Haritos D et al. Comparing health-related quality of life of cancer patients under chemotherapy and of their caregivers. Sci World J. 2012;2012:1-9.
- Jensen S, Given B. Fatigue affecting family caregivers of cancer patients. Support Care Cancer. 1993;1(6):321-325.
- Clark MM, Atherton PJ, Lapid MI, Rausch SM, Frost MH, Cheville AL et al. Caregivers of patients with cancer fatigue: a high level of symptom burden. Am J Hosp Palliat Care. 2014;31(2):121- 125.
- Girgis A, Lambert S, Johnson C, Waller A, Currow D. Physical, psychosocial, relationship, and economic burden of caring for people with cancer: a review. J Oncol Pract. 2013;9(4):197-202.
- Weitzner MA, Mcmillan SC, Jacobsen PB. Family caregiver quality of life: differences between curative and palliative cancer treatment settings. J Pain Symptom Manag. 1999;17(6):418-428.
- Beesley VL, Price MA, Webb PM. Loss of lifestyle: health behaviour and weight changes after becoming a caregiver of a family member diagnosed with ovarian cancer. Support Care Cancer. 2011;19(12):1949-1956.
- Piper BF, Dibble SL, Dodd MJ, Weiss MC, Slaughter RE, Paul SM. The revised Piper Fatigue Scale: psychometric evaluation in women with breast cancer. in Oncology nursing forum. 1998. Oncology Nursing Society.
- Can G. Meme kanserli hastalarda yorgunluğun ve bakım gereksinimlerinin değerlendirilmesi. İstanbul Üniversites Sağlık Bilimleri Enstitüsü. 2001, İstanbul.
- Saglam M, Arikan H, Savci S, Inal-Ince D, Bosnak-Guclu M, Karabulut E et al. International physical activity questionnaire: reliability and validity of the Turkish version. Percept Mot. Ski. 2010;111(1):278-284.
- Beser N, Öz F. Kemoterapi alan lenfomalı hastaların anksiyete- depresyon düzeyleri ve yaşam kalitesi. J Cumhuriyet Univ Sch Nurs. 2003;7:47-58.
- Koçyiğit H, Aydemir Ö, Fişek G, Ölmez N, Memiş AK. Form-36 (KF-36)’nın Türkçe versiyonunun güvenilirliği ve geçerliliği. Ilaç ve tedavi dergisi. 1999;12(2):102-106.
- Tang F, Wang J, Tang Z, Kang M, Deng Q, Yu J. Quality of life and its association with physical activity among different types of cancer survivors. PloS one. 2016;11(11):e0164971.
- Bag B. Kanser hastalarında yorgunluğa bağlı psikososyal sorunlar ve çözüm önerileri. Arşiv Kaynak Tarama Derg. 2012;21(4):253- 273.
- Butt Z, Rosenbloom SK, Abernethy AP, Beaumont JL, Paul D, Hampton D, et al. Fatigue is the most important symptom for advanced cancer patients who have had chemotherapy. J Natl Compr Canc Netw. 2008;6(5):448-455.
- Özkan M, Akın S. Evaluation of the effect of fatigue on functional quality of life in cancer patients. Florence Nightingale J Nurs. 2017;25(3):177-192.
- Grosshans DR, Meyers CA, Allen PK, Davenport SD, Komaki R. Neurocognitive function in patients with small cell lung cancer: effect of prophylactic cranial irradiation. Cancer. 2008;112(3):589-595.
- Miaskowski C, Lee KA. Pain, fatigue, and sleep disturbances in oncology outpatients receiving radiation therapy for bone metastasis: A pilot study. J Pain Symptom Manage. 1999;17(5):320- 332.
- Mota DD, Pimenta CA, Piper BF. Fatigue in Brazilian cancer patients, caregivers, and nursing students: a psychometric validation study of the Piper Fatigue Scale-Revised. Support Care Cancer. 2009;17(6):645-652.
- Aydıner A, Topuz E. Meme kanseri tanı tedavi takip. Nobel Tıp Kitabevleri, İstanbul 2007.
- Lin YY, Lai YF, Lu HI, Lai YL, Lin CC. Physical activity preferences among patients with lung cancer in Taiwan. Cancer Nurs. 2013;36(2):155-162
- Bowman KF, Rose JH, Deimling GT. Families of long‐term cancer survivors: health maintenance advocacy and practice. Psychooncology. 2005;14(12):1008-1017.
- Humpel N, Magee C, Jones SC. The impact of a cancer diagnosis on the health behaviors of cancer survivors and their family and friends. Support Care Cancer. 2007;15(6):621-630.
- Beesley VL, Price MA, Webb PM. Loss of lifestyle: health behaviour and weight changes after becoming a caregiver of a family member diagnosed with ovarian cancer. Support Care Cancer. 2011;19(12):1949-1956.
- Ryan JL, Carroll JK, Ryan EP, Mustian KM, Fiscella K, Morrow GR. Mechanisms of cancer-related fatigue. Oncologist. 2007;12(Supp1):22-34.
- Simeit R, Deck R, Conta-Marx B. Sleep management training for cancer patients with insomnia. Support Care Cancer. 2004;12(3):176-183.
- Ravasco P, Monteiro-Grillo I, Vidal PM, Camilo ME. Cancer: disease and nutrition are key determinants of patients’ quality of life. Support Care Cancer. 2004;12(4):246-252.
The Investigation of Quality of Life, Physical Activity and Fatigue Levels in Patients with Different Cancer Types and Caregiver
Abstract
Objective: This study was planned to investigate the quality of life, physical activity and fatigue levels in patients with different cancer types and their caregivers
Material and Methods: Total 180 caregivers and 180 cancer patient were recruited and divided lung cancer (n=60, age: 55.77±7.27 years, Body Mas Index-BMI: 20.22±1.12 kg/m2), breast cancer (n=60, age: 49.68±9.51 years, BMI: 20.72±1.18 kg/m2) and colon cancer (n=60, age: 52.53±7.77 years BMI: 19.57±0.92 kg/m2) in this study. Physical activity level was evaluated with the International Physical Activity Questionnaire (IPAQ), fatigue was evaluated with the Piper Fatigue Scale. Quality of life were assessed using the EORTC-QLQ-30 scale in cancer patients and the SF-36 scale in caregivers.
Results: Fatigue level was higher in lung cancer and caregivers, and lower in breast cancer and caregivers (p<0.05). All sub-dimensions of fatigue in lung and colon cancer caregivers were higher than breast cancer caregivers (p<0.05). Physical activities of breast and colon cancer patients were higher than lung cancer (p<0.05), no difference found in caregivers (p>0.05). The quality of life (EORTC-QLQ-30) was found to be different in sub-parameters except physical, nausea-vomiting, loss of appetite and financial difficulty (p<0.05). The role, cognitive, social, and dyspnea subdomain scores were higher in lung cancer (p<0.05). The functionality, emotionality, general health and symptom scores were lower in breast cancer patients, the pain and sleep disturbance scores were higher
in colon and lung cancer patients (p<0.05). Constipation and diarrhoea scores were higher only in colon cancer patients (p<0.05). SF-36 physical function parameter was higher in breast cancer caregivers, while general health parameter was lower in lung cancer caregivers (p<0.05).
Conclusion: Fatigue was higher in lung cancer and caregivers, while the physical activity of lung cancer was lower than breast and colon cancer. The cancer type was a parameter on fatigue in caregivers, but it did not affect the level of physical activity. It was observed that the quality of life of cancer patients was
affected differently from the process.
References
- Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M et al. Cancer incidence and mortality worldwide: Sources, methods and major patterns in GLOBOCAN 2012. Int. J Cancer. 2015;136(5):359-386.
- Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: Cancer J Clin. 2018;68(6):394-424.
- Segal R, Miller K, and Jemal A. Cancer statistics, 2018. CA: J Clin. 2018;68:7-30.
- Gültekin M, Boztaş G. Türkiye kanser istatistikleri. Sağlık Bakanlığı, Türkiye Halk Sağlığı Kurumu, 2014.43.
- Yang S, Chu S, Gao Y, Ai Q, Liu Y, Li X et al. A narrative review of cancer-related fatigue (CRF) and its possible pathogenesis. Cells. 2019;8(7):738.
- Barsevick AM, Irwin MR, Hinds P, Miller A, Berger A, Jacobsen P et al. Recommendations for high-priority research on cancer-related fatigue in children and adults. J Natl Cancer Inst. 2013;105(19):1432-1440.
- De Raaf P, De Klerk C, Van Der Rijt C. Elucidating the behavior of physical fatigue and mental fatigue in cancer patients: a review of the literature. Psycho‐Oncol. 2013;22(9):1919-1929.
- Corbett T, Groarke A, Devane D, Carr E, Walsh JC, Mcguire BE. The effectiveness of psychological interventions for fatigue in cancer survivors: systematic review of randomised controlled trials. Syst Rev. 2019;8(1):1-30.
- Mitchell SA. Cancer-related fatigue. Cancer nursing: Principles and practice, 2011:772-791.
- Marquez DX, Aguiñaga S, Vásquez PM, Conroy DE, Erickson KI, Hillman C et al. A systematic review of physical activity and quality of life and well-being. Transl Behav Med. 2020;10(5):1098- 1109.
- Muraca L, Leung D, Clark A, Beduz MA, Goodwin P. Breast cancer survivors: taking charge of lifestyle choices after treatment. Eur J Oncol Nurs. 2011;15(3):250-253.
- Fong DY, Ho JW, Hui BP, Lee AM, Macfarlane DJ, Leung SS et al. Physical activity for cancer survivors: meta-analysis of randomised controlled trials. BMJ. 2012;344: e70.
- Bag L, Ferreira E. Women with cancer and their relationship with physical activity. Rev Bras Cien and Mov. 2010;18(4):11-17.
- Lugo D, Pulido AL, Mihos CG, Issa O, Cusnir M, Horvath SA et al. The effects of physical activity on cancer prevention, treatment and prognosis: A review of the literature. Complement Ther Med. 2019;44:9-13.
- Eickmeyer SM, Gamble GL, Shahpar S, Do KD. The role and efficacy of exercise in persons with cancer. PM&R. 2012;4(11):874- 881.
- Joly F, Mcalpine J, Nout R, Åvall-Lundqvist E, Shash E, Friedlander M. Quality of life and patient-reported outcomes in endometrial cancer clinical trials: a call for action! Int J Gynecol Cancer. 2014;24:1693-1699.
- Smits A, Lopes A, Das N, Bekkers R, Massuger L, Galaal K. The effect of lifestyle interventions on the quality of life of gynaecological cancer survivors: A systematic review and meta-analysis. Gynecol Oncol. 2015;139(3):546-552.
- Canário ACG, Cabral PUL, Paiva LCd, Florencio GLD, Spyrides MH, Gonçalves AKdS. Physical activity, fatigue and quality of life in breast cancer patients. Rev Assoc Med Bras. 2016;62:38- 44.
- Van Roekel EH, Duchâteau J, Bours M, Van Delden L, Breedveld- Peters J, Koole J, et al. Longitudinal associations of light-intensity physical activity with quality of life, functioning and fatigue after colorectal cancer. Qual Life Res. 2020;29(11):2987- 2998.
- Ozdemir K, Keser I, Sen I, and Ozgur Tan M, Investigating the relationships between quality of life, fatigue and leisure time physical activity in prostate cancer patients. J Back Musculoskelet Rehabil. 2019;32(3):497-503.
- Hamidou Z, Auquier P, Leroy T, Barlesi F, Salas S, Chinot O et al. Dyadic effects of coping strategies, time perspectives, and personality on the quality of life of cancer patients and their caregivers. Psycho‐Oncol. 2018;27(2):590-599.
- Vrettos I, Kamposioras K, Kontodimopoulos N, Pappa E, Georgiadou E, Haritos D et al. Comparing health-related quality of life of cancer patients under chemotherapy and of their caregivers. Sci World J. 2012;2012:1-9.
- Jensen S, Given B. Fatigue affecting family caregivers of cancer patients. Support Care Cancer. 1993;1(6):321-325.
- Clark MM, Atherton PJ, Lapid MI, Rausch SM, Frost MH, Cheville AL et al. Caregivers of patients with cancer fatigue: a high level of symptom burden. Am J Hosp Palliat Care. 2014;31(2):121- 125.
- Girgis A, Lambert S, Johnson C, Waller A, Currow D. Physical, psychosocial, relationship, and economic burden of caring for people with cancer: a review. J Oncol Pract. 2013;9(4):197-202.
- Weitzner MA, Mcmillan SC, Jacobsen PB. Family caregiver quality of life: differences between curative and palliative cancer treatment settings. J Pain Symptom Manag. 1999;17(6):418-428.
- Beesley VL, Price MA, Webb PM. Loss of lifestyle: health behaviour and weight changes after becoming a caregiver of a family member diagnosed with ovarian cancer. Support Care Cancer. 2011;19(12):1949-1956.
- Piper BF, Dibble SL, Dodd MJ, Weiss MC, Slaughter RE, Paul SM. The revised Piper Fatigue Scale: psychometric evaluation in women with breast cancer. in Oncology nursing forum. 1998. Oncology Nursing Society.
- Can G. Meme kanserli hastalarda yorgunluğun ve bakım gereksinimlerinin değerlendirilmesi. İstanbul Üniversites Sağlık Bilimleri Enstitüsü. 2001, İstanbul.
- Saglam M, Arikan H, Savci S, Inal-Ince D, Bosnak-Guclu M, Karabulut E et al. International physical activity questionnaire: reliability and validity of the Turkish version. Percept Mot. Ski. 2010;111(1):278-284.
- Beser N, Öz F. Kemoterapi alan lenfomalı hastaların anksiyete- depresyon düzeyleri ve yaşam kalitesi. J Cumhuriyet Univ Sch Nurs. 2003;7:47-58.
- Koçyiğit H, Aydemir Ö, Fişek G, Ölmez N, Memiş AK. Form-36 (KF-36)’nın Türkçe versiyonunun güvenilirliği ve geçerliliği. Ilaç ve tedavi dergisi. 1999;12(2):102-106.
- Tang F, Wang J, Tang Z, Kang M, Deng Q, Yu J. Quality of life and its association with physical activity among different types of cancer survivors. PloS one. 2016;11(11):e0164971.
- Bag B. Kanser hastalarında yorgunluğa bağlı psikososyal sorunlar ve çözüm önerileri. Arşiv Kaynak Tarama Derg. 2012;21(4):253- 273.
- Butt Z, Rosenbloom SK, Abernethy AP, Beaumont JL, Paul D, Hampton D, et al. Fatigue is the most important symptom for advanced cancer patients who have had chemotherapy. J Natl Compr Canc Netw. 2008;6(5):448-455.
- Özkan M, Akın S. Evaluation of the effect of fatigue on functional quality of life in cancer patients. Florence Nightingale J Nurs. 2017;25(3):177-192.
- Grosshans DR, Meyers CA, Allen PK, Davenport SD, Komaki R. Neurocognitive function in patients with small cell lung cancer: effect of prophylactic cranial irradiation. Cancer. 2008;112(3):589-595.
- Miaskowski C, Lee KA. Pain, fatigue, and sleep disturbances in oncology outpatients receiving radiation therapy for bone metastasis: A pilot study. J Pain Symptom Manage. 1999;17(5):320- 332.
- Mota DD, Pimenta CA, Piper BF. Fatigue in Brazilian cancer patients, caregivers, and nursing students: a psychometric validation study of the Piper Fatigue Scale-Revised. Support Care Cancer. 2009;17(6):645-652.
- Aydıner A, Topuz E. Meme kanseri tanı tedavi takip. Nobel Tıp Kitabevleri, İstanbul 2007.
- Lin YY, Lai YF, Lu HI, Lai YL, Lin CC. Physical activity preferences among patients with lung cancer in Taiwan. Cancer Nurs. 2013;36(2):155-162
- Bowman KF, Rose JH, Deimling GT. Families of long‐term cancer survivors: health maintenance advocacy and practice. Psychooncology. 2005;14(12):1008-1017.
- Humpel N, Magee C, Jones SC. The impact of a cancer diagnosis on the health behaviors of cancer survivors and their family and friends. Support Care Cancer. 2007;15(6):621-630.
- Beesley VL, Price MA, Webb PM. Loss of lifestyle: health behaviour and weight changes after becoming a caregiver of a family member diagnosed with ovarian cancer. Support Care Cancer. 2011;19(12):1949-1956.
- Ryan JL, Carroll JK, Ryan EP, Mustian KM, Fiscella K, Morrow GR. Mechanisms of cancer-related fatigue. Oncologist. 2007;12(Supp1):22-34.
- Simeit R, Deck R, Conta-Marx B. Sleep management training for cancer patients with insomnia. Support Care Cancer. 2004;12(3):176-183.
- Ravasco P, Monteiro-Grillo I, Vidal PM, Camilo ME. Cancer: disease and nutrition are key determinants of patients’ quality of life. Support Care Cancer. 2004;12(4):246-252.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Araştırma Makaleleri |
| Authors | |
| Early Pub Date | July 11, 2022 |
| Publication Date | July 15, 2022 |
| Submission Date | May 19, 2021 |
| Acceptance Date | September 21, 2021 |
| Published in Issue | Year 2022 Volume: 17 Issue: 2 |
