High demoralization in a minority of oophorectomized BRCA1/2 mutation carriers influences quality of life

Figures & data

Figure 1. Flow chart of recruitment.

Table 1. Demographic and clinical characteristics of the respondents (n = 288).

Variable	N (%)
Demographic characteristics
Age; mean (SD); range	51.3 (8.4); 36–76 years
Parity
0	34 (12)
1–2	163 (57)
≥3	91 (31)
Level of education
Primary education	10 (4)
Secondary education	191 (66)
Higher education	87 (30)
Clinical characteristics
Mutation
BRCA 1	182 (63)
BRCA 2	106 (37)
Personal history of breast cancer (missing = 1)
No	187 (65)
Yes	100 (35)
Risk-reducing mastectomy (missing = 1)
No	164 (57)
Yes	76 (27)
Contralateral mastectomy after breast cancer	47 (16)
Family cancer history (missing = 1)
No	5 (2)
Breast cancer	118 (41)
Ovarian cancer	19 (7)
Breast and ovarian cancer	139 (48)
Cancer, not further specified	6 (2)
Degree of family cancer history (missing = 3)
First degree	202 (72)
Only second degree	77 (28)
Age at RRSO; mean (SD)	45.7 (8.3)
Time since RRSO in months; median (range)	53.5 (2–235)
Hysterectomy (missing = 24)
No	247 (94)
Yes	17 (6)
Use of HRT^a (missing = 2)
Never	179 (63)
0–5 years	77 (26)
>5 years	30 (11)

Values are expressed as numbers with percentage or otherwise indicated.

^aCombined estrogen + progesterone therapy (n = 100); estrogen-only therapy (n = 3); missing (n = 4).

Table 2. Demoralization, quality of life and anxiety.

Variable	Mean (SD)	Normal ranges ofmeasures
Demoralization
Total demoralization score	17.8 (14.0)	0–96
Loss of meaning and purpose	1.9 (3.2)	0–20
Dysphoria	4.8 (3.4)	0–24
Disheartenment	4.6 (4.2)	0–20
Helplessness	2.7 (3.2)	0–16
Sense of failure	3.9 (2.3)	0–16
Health-related quality of life
Global health status/Quality of life	76.6 (17.1)	0–100
Physical functioning	93.5 (12.2)	0–100
Role functioning	91.8 (16.9)	0–100
Emotional functioning	84.2 (19.7)	0–100
Cognitive functioning	84.8 (20.7)	0–100
Social functioning	90.4 (18.0)	0–100
Anxiety
State anxiety	34.6 (11.4)	20–80
Trait anxiety	34.6 (11.0)	20–80
Cancer worries	10.7 (2.3)	8–32

Table 3. Correlations between demoralization and psychological and physical variables.

	Low demoralization	Moderate demoralization	High demoralization
	N = 243	N = 15	N = 30	Spearman’s rho
Global health status	80.3 (14.3)	60.7 (13.5)	55.2 (19.7)	−0.459*
Physical functioning	95.5 (9.4)	80.4 (17.9)	84.0 (18.8)	−0.319*
Role functioning	94.5 (12.4)	78.9 (29.1)	76.7 (26.8)	−0.314*
Emotional functioning	89.0 (14.7)	67.8 (14.7)	52.9 (24.9)	−0.506*
Cognitive functioning	88.1 (17.9)	71.4 (24.8)	63.8 (25.6)	−0.366*
Social functioning	93.9 (13.2)	70.8 (25.7)	70.6 (27.9)	−0.418*
State anxiety	31.5 (8.3)	43.7 (8.0)	54.9 (11.1)	0.537*
Trait anxiety	31.4 (7.6)	46.5 (5.5)	55.0 (10.7)	0.577*
Cancer worries	10.4 (1.9)	11.7 (2.1)	12.6 (3.2)	0.271*
Fatigue	13.2 (16.3)	28.1 (18.2)	37.8 (26.7)	0.338*
Nausea and vomiting	1.4 (6.7)	3.3 (6.9)	5.6 (10.1)	0.219*
Pain	8.3 (16.4)	24.4 (28.8)	26.7 (28.6)	0.269*
Dyspnoea	3.7 (11.3)	8.9 (19.8)	12.2 (18.5)	0.207*
Insomnia	19.9 (25.6)	42.2 (23.5)	46.7 (25.7)	0.349*
Appetite loss	1.9 (8.4)	0	16.7 (22.7)	0.298*
Constipation	6.5 (15.5)	24.4 (29.5)	12.2 (23.9)	0.168*
Diarrhea	2.6 (10.8)	0	6.7 (20.3)	0.042
Financial difficulties	2.1 (9.3)	11.9 (31.0)	21.8 (32.5)	0.327*

Values are expressed as mean (SD).

*p values <.01.

Table 4. Univariate logistic analysis for moderate to high demoralization (DS ≥30) by demographic and clinical factors.

	Exp(B)	95% CI	p value
Demographic factors
Age	1.004	0.97–1.04	.82
Having children	1.81	0.76–4.29	.18
Higher education	1.41	0.68–2.93	.36
Clinical factors
BRCA2 mutation	1.07	0.55–2.07	.85
History of breast cancer	0.69	0.36–1.32	.26
Risk-reducing mastectomy	1.53	0.70–3.35	.29
Family member with ovarian cancer	1.09	0.57–2.06	.80
Mother with breast or ovarian cancer	0.81	0.42–1.57	.53
Age at RRSO	0.996	0.96–1.04	.84
Time since RRSO	1.003	0.996–1.01	.39
RRSO >1 year ago	0.74	0.27–2.01	.56
HRT after RRSO	1.39	0.70–2.75	.34

RRSO: risk-reducing salpingo-oophorectomy; HRT: hormone replacement therapy.