Effects of inpatient rehabilitation on health-related quality of life in breast cancer patients

Background: Major endpoint for the assessment of a complex inpatient rehabi litation program is the health-related quality of life. In a prospective lo ngitudinal study we evaluated the subjective well-being of breast cancer pa tients by different methods. Patients and Methods: 183 breast cancer patien ts were asked to complete six different questionnaires at three different t ime points: t1: start of treatment, t2: end of treatment, t3: 3 months afte r t2. Results: In the Hospital Anxiety and Depression Scale (HADS-D) we obs erved high mean scores for anxiety (8.73) and depression (5.55), as compare d to a healthy control population (5.8 and 3.34, respectively). There was a significant improvement for both scores at t2 (6.84 and 4.77, respectively ) and for anxiety at t3 (7.68). This was confirmed by the FBK questionnaire showing a significant decrease of the psychological distress in the t1/t2 and t1/t3 time periods as well. The global health score of the QLQ-C30 inst rument increased significantly at the end of the rehabilitation and was mai ntained at the 3-month follow-up. This was true for most of the functional subscales as well. Older widowed women with 3-4 accompanying diseases had t he most profit from the program. Using the Perceived Adjustment to Chronic Illness Scale (PACTS), we observed significantly less effort of coping with the illness at t2 and t3. Conclusions: At the end of a complex rehabilitat ion program for breast cancer patients, the health-related quality of life improved in several domains. While after a 3-month follow-up the scores wer e still better than before the treatment, anxiety and depression increased again. Therefore, the good results of the rehabilitation program should be maintained by continuous ambulatory treatment.