HEALTH-RELATED QUALITY OF LIFE OF EXPATRIATE PATIENTS LIVING WITH CANCER IN ABU DHABI

Abstract

Background: Advancements in cancer treatments have revolutionized cancer care; however, while effective in combating the disease, toxicities are often introduced that significantly impact a patient’s quality of life1. The United Arab Emirates has witnessed remarkable progress in specialized oncology care services2. The diverse population, predominantly composed of expatriates from various nationalities3, presents unique challenges. An expatriate in Abu Dhabi, diagnosed with and undergoing treatment for cancer, could face an increased risk of lower health-related quality of life (HRQoL). Purpose: To describe and explore the determinants of HRQoL of expatriate patients living with cancer in Abu Dhabi and subsequently facilitate the recognition of patients at risk for suboptimal HRQoL.

Methods: This was a quantitative study that recruited patients with hematological and oncological malignancies. Patients were assessed for HRQoL measured by the Functional Assessment of Cancer Therapy – General [FACT-G] scale, depression and anxiety measured using the Hospital Anxiety and Depression Scale [HADS], performance status using the Eastern Cooperative Oncology Group [ECOG] score, and acculturation using the Brief Acculturation Scales. Independent t-Test, ANOVA, and Pearson correlation were used for analysis. Regression analysis was used to study the associations with the determinants of HRQoL.

Results: A total of 100 cancer patients [mean age 48.5 ± 14.17 years, 65% females] were included. The mean score of FACT-G scale was 78.52 ±18.77, indicating a good overall HRQoL. Lower HRQoL was associated with increased age (r=0.22; p=0.02), lack of an employment visa (mean HRQoL score of 44 ± 15.55 versus 80.84 ± 17.28; p=0.039 for those with employment visa), lower psychological adaptation (r= -0.27; p<0.01), higher anxiety (r= -0.56; p<0.01), higher depression (r= -0.75; p<0.01), and worse performance status [t(98)=3.9; p<0.001]. Patients who had difficulty in communicating with doctors/nurses (mean=47.01 ± 27; p=0.002) and in accessing their healthcare information (mean=61.48 ± 25.76; p=0.014) also scored lower on the FACT-G scale. Based on the stepwise multiple linear regression, worse performance status, higher depression, visa type, and difficulty accessing healthcare information predicted 63% of the variance in patients' HRQoL [F(4, 95) = 43.071; p<0.001].

Conclusion: Results of this study suggest that patients’ functionality, psychological well-being, visa status, and their ability to effectively access their healthcare information have an independent and substantial relationship to their health-related quality of life. Understanding these patients’ experiences can aid the healthcare practitioners, expatriates themselves, to tailor their treatment options and improve their quality of life.