Factors Predicting the Health-Related Quality of Life in Premenopausal Women with Breast Cancer after Receiving Chemotherapy

Main Article Content

Yotaka Techapanya
Chongjit Saneha
Wimolrat Puwarawuttipanit
Nopadol Soparattanapaisarn


Purpose: This study aimed to study the predictive ability of menopause symptoms, health literacy, physical activity and anemia on health-related quality of life in premenopausal women with breast cancer after receiving chemotherapy.

 Design: Correlational predictive design.

Methods: The study sample included 129 premenopausal women with breast cancer who were completion of chemotherapy at a super-tertiary hospital in Bangkok. Data were collected by using a demographic questionnaire, Menopause Rating Scale, Health Literacy Questionnaire, Short Form International Physical Activity Questionnaire, and Health-related quality of life questionnaire (FACT-B). All data were analyzed by using descriptive statistics and multiple regression analysis.

Main findings: It was found that 39.5% of the sample had severe menopause symptoms, 69% high level of health literacy, 40.3% moderate physical activity and 47.3% anemia. A mean score of overall health-related quality of life among the sample was 113.4 (SD = 17.78). Menopause symptoms, health literacy, physical activity and anemia could account for 51 percent of the variances explained in health-related quality of life (adjusted R2 = .51, F = 27.15, p < .05). Only menopause symptoms (gif.latex?\beta = - .66, p < .01) and health literacy (gif.latex?\beta = .21, p < .01) could significantly predict the health-related quality of life.

Conclusions and recommendations: Nurses should assess menopause symptoms and health literacy, and take care patients with menopause symptoms as well as promote health literacy in order to improve health-related quality of life of this group of patients.

Article Details

How to Cite
Techapanya, Y., Saneha, C. ., Puwarawuttipanit, W. ., & Soparattanapaisarn, N. . (2022). Factors Predicting the Health-Related Quality of Life in Premenopausal Women with Breast Cancer after Receiving Chemotherapy. Nursing Science Journal of Thailand, 40(4), 95–109. Retrieved from https://he02.tci-thaijo.org/index.php/ns/article/view/254741
Research Papers


National Cancer Institute, Department of Medical Services, Ministry of Public Health. Hospital-based cancer registry 2018 [Internet]. Bangkok: National Cancer Institute; 2019 [cited 2020 Sep 18]. Available from: https://www.nci.go.th/th/File_download/Nci%20Cancer%20Registry/Hospital%20Based_2018.pdf. (in Thai).

National Cancer Institute, Department of Medical Services, Ministry of Public Health. Hospital-based cancer registry 2019 [Internet]. Bangkok: National Cancer Institute; 2020 [cited 2020 Sep 18]. Available from: https://www.nci.go.th/th/File_download/Nci%20Cancer%20Registry/Hospital-Based%202019%20NCI.pdf. (in Thai).

Kayl AE, Meyers CA. Side-effects of chemotherapy and quality of life in ovarian and breast cancer patients. Curr Opin Obstet Gynecol. 2006;18(1):24-8. doi: 10.1097/01.gco.0000192996.20040.24.

Farthmann J, Hanjalic-Beck A, Veit J, Rautenberg B, Stickeler E, Erbes T, et al. The impact of chemotherapy for breast cancer on sexual function and health-related quality of life. Support Care Cancer. 2016;24(6):2603-9. doi: 10.1007/s00520-015-3073-2.

Ferrans CE, Zerwic JJ, Wilbur JE, Larson JL. Conceptual model of health-related quality of life. J Nurs Scholarsh. 2005;37(4):336-42. doi: 10.1111/j.1547-5069.2005.00058.x.

Avis NE, Crawford S, Manuel J. Quality of life among younger women with breast cancer. J Clin Oncol. 2005;23(15):3322-30. doi: 10.1200/JCO.2005.05.130.

Han JA, Choi SY, Lee S. Effects of menopausal symptoms and depression on the quality of life of premenopausal women with breast cancer in Korea. J Transcult Nurs. 2019;30(1):8-16. doi: 10.1177/1043659618771475.

Lind M, Vernon C, Cruickshank D, Wilkinson P, Littlewood T, Stuart N, et al. The level of haemoglobin in anaemic cancer patients correlates positively with quality of life. Br J Cancer. 2002;86(8):1243-9. doi: 10.1038/sj.bjc.6600247.

Park H, Yoon HG. Menopausal symptoms, sexual function, depression, and quality of life in Korean patients with breast cancer receiving chemotherapy. Support Care Cancer. 2013;21(9):2499-507. doi: 10.1007/s00520-013-1815-6.

Park J-H, Lee DH, Kim SI, Kim NK, Jeon JY. Moderate to vigorous physical activity participation associated with better quality of life among breast and colorectal cancer survivors in Korea. BMC Cancer. 2020;20(1):365. doi: 10.1186/s12885-020-06819-z.

Kugbey N, Meyer-Weitz A, Oppong Asante K. Access to health information, health literacy and health-related quality of life among women living with breast cancer: depression and anxiety as mediators. Patient Educ Couns. 2019;102(7):1357-63. doi: 10.1016/j.pec.2019.02.014.

Phligbua W, Pongthavornkamol K, Knobf TM, Junda T, Viwatwongkasem C, Srimuninnimit V. Symptom clusters and quality of life in women with breast cancer receiving adjuvant chemotherapy. Pac Rim Int J Nurs Res. 2013;17(3):249-67.

Sivarux C, Pongthavornkamol K, Watanakijkrilert D, Tanticharoensin S. Factors predicting quality of life for breast cancer survivors at 1 year post-treatment, and thereafter. Thai Cancer Journal. 2012;32(1):2-14. (in Thai).

Nutbeam D. Defining and measuring health literacy: what can we learn from literacy studies. Int J Public Health. 2009;54(5):303-5. doi: 10.1007/s00038-009-0050-x.

Halverson JL, Martinez-Donate AP, Palta M, Leal T, Lubner S, Walsh MC, et al. Health literacy and health-related quality of life among a population-based sample of cancer patients. J Health Commun. 2015;20(11):1320-9. doi: 10.1080/10810730.2015.1018638.

Khamho M, Wanitkun N, Danaidutsadeekul S, Thephamongkhol K. Predictive model of quality of life in patients with head and neck cancer after radiotherapy. Nursing Science Journal of Thailand. 2018;36(2):54-66. (in Thai).

Caspersen CJ, Powell KE, Christenson GM. Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Rep. 1985;100(2):126-31.

Boing L, de Bem Fretta T, de Carvalho Souza Vieira M, Denig LA, Bergmann A, de Azevedo Guimarães AC. Physical activity, fatigue and quality of life during a clinical adjuvant treatment of breast cancer: a comparative study. Motricidade. 2018;14(2-3):59-70. doi: 10.6063/motricidade.13476.

Makluf DAS, Barra AA, de Figueiredo EM, da Silva GR, Ribeiro RFR, Barros CP, et al. Influence of physical activity on the quality of life of breast cancer patients. Biomed J Sci Tech Res. 2018;10(3):7787-90. doi: 10.26717/BJSTR.2018.10.001948.

Rodgers 3rd GM, Gilreath JA, Achebe MM, Alwan L, Arcasoy M, Bhat SA, et al. Cancer- and chemotherapy-induced anemia [Internet]. Plymouth Meeting, PA: NCCN Clinical Practice Guidelines in Oncology; 2017 [cited 2020 Sep 14]. Available from: https://oncolife.com.ua/doc/nccn/Cancer-and_Chemotherapy-Induced_Anemia.pdf.

Kirshner J, Hatch M, Hennessy DD, Fridman M, Tannous RE. Anemia in stage II and III breast cancer patients treated with adjuvant doxorubicin and cyclophosphamide chemotherapy. Oncologist. 2004;9(1):25-32. doi: 10.1634/theoncologist.9-1-25.

Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. Hillsdale, NJ: Lawrence Erlbaum Associates, Publishers; 1988. 567 p.

Heinemann LAJ, Potthoff P, Schneider HPG. International versions of the Menopause Rating Scale (MRS). Health Qual Life Outcomes. 2003;1:28. doi: 10.1186/1477-7525-1-28.

Wanitkun N, Pattaramongkolrit S, Vichathai C, Bhechrung B, Kloyahem S, Batterham R, et al. Thai health literacy [Internet]. Nonthaburi: Health Systems Research Institute; 2014 [cited 2019 Nov 16]. Available from: http://kb.hsri.or.th/dspace/handle/11228/3987. (in Thai).

Craig CL, Marshall AL, Sjöström M, Bauman AE, Booth ML, Ainsworth BE, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;35(8):1381-95. doi: 10.1249/01.MSS.0000078924.61453.FB.

Cella DF, Tulsky DS, Gray G, Sarafian B, Linn E, Bonomi A, et al. The functional assessment of cancer therapy scale: development and validation of the general measure. J Clin Oncol. 1993;11(3):570-9. doi: 10.1200/JCO.1993.11.3.570.

Collins RH, McGowan EL. Exploring associations of sedentary behavior and physical activity with quality of life in young adult cancer survivors. J Adolesc Young Adult Oncol. 2018;7(6):643-51. doi: 10.1089/jayao.2018.0032.

Muthanna FMS, Hassan BAR, Karuppannan M, Mohammed AH. Evaluation of the impact of anaemia on quality of life among breast cancer patients undergoing chemotherapy in Malaysia. J Pharm Health Serv Res. 2021;12(2):310-2. doi: 10.1093/jphsr/rmaa033.