Document Type : Original Article
Authors
1 Research Scholar, Management, KIIT Deemed to be University, Bhubaneswar, India
2 Professor, School of Management, KIIT Deemed to be University, Bhubaneswar, India
3 Senior Professor, School of Management, KIIT Deemed to be University, Bhubaneswar, India
Abstract
The meaning of “Quality of Life” (QoL) varies from person to person. A person’s perception of the term depends on the situation. This research study makes an attempt to analyse various facets of QoL with respect to blood cancer victims within the investor community in the area of study. The research includes comprehending the QoL influence on blood cancer patients in the state of Odisha, India, to decode the opinion differences among people of various age categories. As declared by the Ministry of Health and Family Welfare of Odisha, an average of 50,000 cancer patients is identified resulting in 25,000 deaths in the state every year. This is more than other states with the same population size in the country. Data collection and analysis was conducted by employing three variables; namely, physical health, mental health, and socio-economic status on blood cancer patients to enhance their QoL. Findings of the study revealed the majority of participants believed weakness, insomnia, pain, and psychological disorders were the prominent challenges blood cancer victims had to overcome. Rural areas of Odisha lack healthcare infrastructure when compared to the urban areas. Moreover, socially and financially weaker respondents are more optimistic regarding treatment and life than their richer counterparts.
Graphical Abstract
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Main Subjects
Introduction
According to the World Health Organization (WHO), there are over 2.2 million blood cancer cases detected every year with around 1.7 million deaths [1]. 14.1 per 100,000 men and women are diagnosed with blood cancer annually, out of which 6 succumb to it [2]. This makes blood cancer a leading cause of death globally [1, 2]. There are numerous factors contributing towards the development and unfortunate death because of blood cancer such as the stage of cancer, family history, chemotherapy, etc. which are subjected to change [3]. Developmental issues lead to variation in type of tumour, treatment prescribed, and diagnosis. Lack of cancer knowledge and its etiology are the causes for this issue [3]. The average age of blood cancer detection in developed countries like the USA is 60. Breast cancer is usually diagnosed after 50 years of age while lung and colon cancer are diagnosed at an average age of 70 and 68, respectively. Colorectal cancer is diagnosed much earlier when compared to other types of cancer. Adults develop the risk of blood cancer after the age of 45 and children can be affected by the deadly disease at a very young age of 2 [4]. Blood cancer can be detected by physical examination, blood tests, and bone marrow tests. The disease can then be treated by chemotherapy, targeted therapy, radiation, bone marrow transplant, immunotherapy, immune cells engineering, and clinical trials [5]. Elderly patients are averse to radiation therapy as they are afraid of the process [6, 7].
Blood cancer is often diagnosed in the Stages I, II, or III where patients undergo chemotherapy, targeted therapy, or radiation while Stage IV patients undergo bone marrow transplant and other advanced treatments [8]. Blood cancer survival rates have improved with progress in medical science and active treatment. There are 70-80% chances of survival for patients below 60 years of age, 26% for chronic blood cancer patients, and 65% for acute blood cancer patients. However, long-term intense blood cancer treatment comes with its own set of side-effects like kidney damage, heart complications, central nervous system damage, digestive track disturbances, hair loss, and variation in blood cell count [9].
Previous studies have revealed physical exercise as key to improve the health of blood cancer patients. Blood cancer survivors tend to live a long and stable life if they keep themselves physically active. Exercise is a major way of keeping oneself active and can also assist in improving the QoL and health of blood cancer survivors [10]. Moreover, research has further established that lifestyle of cancer patients shares a negative relationship with anxiety and overall well-being. This makes men and women realize their lifestyle has contributed towards developing blood cancer [11, 12].
In addition, socio-economic status of cancer survivors plays a crucial role in maintaining their QoL. Blood cancer survivors belonging to poorer families find it difficult to get access to proper treatment and hence, are not able to maintain their lifestyle [13]. A blood cancer survivor has to be financially stable to be able to afford a good quality life for his own [14]. A blood cancer survivor may be negatively influenced by nascent social channels and comprehension [15]. Cancer death rates share a significant relationship with social engagement and general wellbeing [16, 17]. There is no extensive research in India in this context. Hence, it calls for a study to be conducted to fill up this gap.
Literature Review
Blood cancer is a deadly disease that comes with a very expensive and long-term treatment process. Its survivors and their near and dear ones undergo immense stress in every way, physically, mentally, and economically, which affects their lifestyle [18].
Blood cancer is an exhaustive disease. The already existing physical, mental, and economic stress due to cancer results in lifestyle changes and affects the QoL of the blood cancer survivor [19].
QoL of a blood cancer survivor is affected because its diagnosis negatively influences the lifestyle of the patient majorly because of the long-term treatment and financial burden [20].
Cancer in any form is preventable. For blood cancer survivors to have a long and healthy life, it is crucial for them to make lifestyle changes and enhance their QoL [21].
Blood cancer and lifestyle share a significant relationship with each other. The risk of blood cancer development and re-occurrence is reduced if one maintains a healthy lifestyle and enhances the QoL [22].
The multi-ethnic cohort study revealed blood cancer risk is related to lifestyle apart from genes. Thus, lifestyle management is necessary to either avoid the dreaded disease or control it [23].
Cancer development is associated with QoL. It can be controlled, and its re-occurrence can be avoided if lifestyle and dietary changes are made mandatory among patients [24].
Blood cancer patients undergo massive mental turmoil during the tenure of their treatment. Anxiety, depression, and distress levels are common among them even after successful completion of treatment. Therefore, exercise and lifestyle changes are suggested by doctors and researchers [25].
Psychological issues in a blood cancer survivor increase at least twice in case of re-occurrence. It also increases physical symptoms. This affects the survivors’ mental and physical health which can be controlled by implementing lifestyle changes [26].
Healthy diet, body weight, physical activity, limited alcohol consumption, and avoidance of smoking contribute towards avoidance and control of blood cancer by assisting a person in maintaining a sustainable lifestyle and QoL [27].
Cancers like blood cancer and ovarian cancer can be detected before they occur in case of family history. Maintaining a high QoL by making changes in lifestyle can ensure such cancers are prevented [28].
Cancer, being a long-term and exhaustive disease, causes psychological disorders like obsessive compulsive disorder, paranoia, depression, and hysteria among its survivors. This affects their mental health [29].
As cancer involves the long-term treatment, there are chances of medication errors in the process. This affects the physical and mental health of the patients [30].
Families with children suffering from cancer undergo a lot of financial and mental stress, especially mothers. This leads to deterioration of mental health among the family members [31].
Cancer affects the self-efficacy of a patient and decreases cognitive and behavioural functioning. Hence, QoL is negatively impacted.
During Covid-19, cancer treatment was hampered the most. This led to a lot physical, mental, and financial hardship among the patients. Hence, their QoL was affected [32, 33].
Research Objectives
- To examine the QoL influence on blood cancer patients in the study area.
- To study the differences of opinion relating to respondents of various age brackets
Scope of the study
This study covers the state of Odisha in India. Data collection was limited to Cuttack, Khurdha, Puri, and Deogarh districts of the state. There are 20 blocks in total such as Baranga, Cuttack Sadar, Kantapada, Mahanga, Niali, Nischintakoili, Salepur, Tangi, and Choudwar. Two prominent cities of the state were also included- Bhubaneswar, the provincial capital and Cuttack. All the participating investors had forms of blood cancer. The respondents were in the age group of 21-70 years old.
Table 1 indicates that 35% of investors did not have any family history of any form of cancer while the rest had. The majority of the respondents belonged to 21-40 age group, followed by 50-70. 20% of the respondents had other health issues like diabetes, hypertension, obesity, etc. 15% of the participants belonged to negative blood groups while others had positive blood groups. The majority of them had monthly income > 50,000 INR, most of whom were married, succeeded by single. 85% were undergraduates with 35% having 0-5 years of work experience.
Martials and Methods
Research methodology
The present study includes both primary and secondary data. Secondary data was collected from various journals, websites, newspapers, books, etc. In the case of primary data, 29 variables were recognized after conducting a thorough literature review and 5 core group discussion each constituting of 6 members.
A well-structured close ended questionnaire was prepared. It was divided into 2 parts. The first part consisted of demographics related questions and the second part included questions with respect to each variable. A pilot study was conducted on it to test the reliability and validity of variables. 50 participants from each variable were considered, out of which 22 variables were retained. A likert scale has been used for this study ranging from 5 (represents “Strongly Agree”) to 1 (represents “Strongly Disagree”). 250 questionnaires were circulated for data collection, 230 filled-up questionnaires were collected amounting to approximately 92% of the total questionnaires. After due scrutiny of filled-up questionnaires, 30 questionnaires were found incomplete either concerning demographic or any specific question. The final sample size taken was 200 for the study. A total of 5 months, from September 2022 to February 2023, was required to complete the study. Non-probability sampling method (convenient sampling technique) was used for collecting the sample of the study. As indicated in Table 2, the first month was utilized to conceptualize and draw the research paradigm, the second month for review of literature, the third and the fourth month involved gap finding and data collection, and the last month included data analysis and conclusion work of the research study.
Table 3 indicates the upper and lower limits of weight assigned to each of the participant. The scores are being calculated on the basis of number of respondents multiplied by highest or lowest weight as the case may be with and multiplied with number of variables.
Sample size of the study
The sample size will be based on a ratio between 1:4 and 1:10 in this study (Rummel, 1970; Schwab, 1980). As mentioned in the above method, the smallest sample size is 4x the items and the largest sample size is 10x the items. The current study has 22 variables. Hence, the sample size should be between 88 and 220. The considered sample size is 200, which is within the limit.
Framing of hypothesis
Focused on physical health.
H0: Blood cancer patients have significant opinion difference with respect to the relationship between QoL and physical health.
H1: Blood cancer patients have no significant opinion difference with respect to the relationship between QoL and physical health.
Focused on mental health.
H0: Blood cancer patients have significant opinion difference with respect to the relationship between QoL and mental health.
H1: Blood cancer patients have no significant opinion difference with respect to the relationship between QoL and mental health.
Focused on socio-economic status.
H0: Blood cancer patients have a significant opinion difference with respect to the relationship between QoL and socio-economic status.
H1: Blood cancer patients have no significant opinion difference with respect to the relationship between QoL and socio-economic status.
Hypothesis analysis
Focused on physical health.
H0: Blood cancer patients have a significant opinion difference with respect to the relationship between QoL and physical health.
H1: Blood cancer patients have no significant opinion difference with respect to the relationship between QoL and physical health.
As it can be seen in Table 5, the p-value is less than 0.05 and the F- value is 42.23 which is less than the F-critical value of 4.56. This is concluded that H0 is rejected. Hence, QoL and physical health share a significant positive relationship with each other.
Focused on mental health.
H0: Blood cancer patients have a significant opinion difference with respect to the relationship between QoL and mental health.
H1: Blood cancer patients have no significant opinion difference with respect to the relationship between QoL and mental health.
As per Table 6, the p-value is less than 0.05 and the F- value is 731.17 which is less than the F-critical value of 3.46. This is concluded that H0 is rejected. Hence, QoL and mental health share a significant positive relationship with each other.
Focused on socio-economic status.
H0: Blood cancer patients have significant opinion difference with respect to the relationship between QoL and socio-economic status.
H1: Blood cancer patients have no significant opinion difference with respect to the relationship between QoL and socio-economic status.
As it can be seen Table 7, the p-value is less than 0.05 and the F- value is 827.43, which is less than the F-critical value of 3.46. This concludes that H0 is rejected. Hence, QoL and socio-economic status share a significant positive relationship with each other.
Results and Discussion
As presented in Table 4, when asked about QoL and physical health, respondents from all the age groups had 77.76%, 80%, 94%, and 83% of actual weighted scores to the maximum possible score, respectively.
Data analysis of each of the participant’s age bracket in Tables 8, 9, 10, and 11 was used to calculate the above figures. It is concluded all the variables corresponding to QoL and physical health are related to blood cancer patients significantly and positively irrespective of age group.
Similarly, in case of QoL and mental health, it is observed respondents from all age groups had 85%, 93%, 94%, and 96% of the actual weighted scores to the maximum possible score, respectively. It is suggested that all the variables corresponding to QoL and mental health share a significant and positive connection with blood cancer patients irrespective of the age group.
Regarding QoL and socio-economic status, it was found respondents from all age groups had 82%, 95%, 92%, and 91% of the actual weighted scores to the maximum possible score, respectively. Hence, QoL of blood cancer survivors is highly influenced by socio-economic status.
Figure 1 demonstrates various stages of cell mutation that ultimately results in a cancer cell. When this spreads further and other cells go through the same mutation, blood cancer is detected in an individual. Figure 2 is the graphical representation of Table 4.
Conclusion
QoL is a serious concern for blood cancer patients and their families. This research covers the physical health, mental health, and socio-economic status of blood cancer survivors. They influence their QoL with respect to three constructs. The study concluded that younger patients had a better QoL than their older counterparts. This is due to age, fitness, lifestyle, more income, and optimism. However, overall ground reality remains the same. We all should be empathetic towards the cause of cancer and lend a helping hand to the ones suffering from this deadly disease. Families of cancer victims also go through a lot of emotional and financial trauma in the process, more so in the case of death. They should also be paid equal attention and assistance should be provided for recovery. Blood cancer patients had no difference in opinion on QoL with respect to physical health, mental, and socio-economic status. Government should also implement healthcare policies to provide medical and financial support to patients suffering from diseases with extremely high cost of treatment. We cannot change destiny, but can ensure that life experience for an individual is pleasant.
Acknowledgements
We are thankful to all the participants of Cuttack, Khurdha, Puri, and Deogarh districts of Odisha, India. This study would not have been possible without their active support.
Disclosure Statement
No potential conflict of interest was reported by the authors.
Funding
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Authors' Contributions
All authors contributed to data analysis, drafting, and revising of the paper and agreed to be responsible for all the aspects of this work.
Orcid
Stutee Mohanty
https://orcid.org/0000-0001-6067-6983
B. Chandra Mohan Patnaik
https://orcid.org/0000-0002-5979-0989
Ipseeta Satpathy
https://orcid.org/0000-0002-0155-5548
HOW TO CITE THIS ARTICLE
Stutee Mohanty, B. Chandra Mohan Patnaik, Ipseeta Satpathy. Quality of Life of Blood Cancer Investors in India. J. Med. Chem. Sci., 2023, 6(10) 2259-2272
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