Health-related Quality of Life and Its Associated Factors among Gynecologic Cancer Patients in Oncology Centers in Northwest Ethiopia 2023: Structural Equation Modeling

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Abstract Background Gynecological cancer is a catch-all term for any cancer of the female reproductive system, which are the most frequently type of cancers diagnosed in the female population. It is becoming a serious health issue that affects patients' health-related quality of life. In Ethiopia, factors affecting the quality of life of gynecologic cancer patients is not well explored. Thus, this study aimed to assess health related quality of life (HRQoL) and its associated factors among gynecologic cancer patients attending in oncology centers in Northwest Ethiopia. Methods An institution-based cross-sectional study with a total sample size of 608 gynecologic cancer patients were employed. Data were collected by interview administered questionnaire, coded and entered into Epi Data version 4.6, and then exported to STATA version 17 for further analysis. Texts, Figures, and Tables were used to present descriptive result. Structural equation model analysis was employed to verify the relation among, exogenous and endogenous variables. Result The mean score of overall HRQoL was 41.62(± 7.22).The social functioning domain was the most affected domain with mean score of 22.01(±8.6) and cognitive functioning domain were the least affected domain with mean score of 77.85(±22.37). Marital status (single) had a direct (β= -0.5323, 95%CI (-0.990,-0.0740)) and indirect negative effect (β= -0.2317, 95%CI (-0.4438,-0.0195)) giving a negative total effect (β= -0.795, 95%CI (-1.192,-0.3981)) on global health domain of HRQoL Patients with old age had a better physical function(β = 0.028 (0.0216,0.0344)) and cognitive function (β = 0.0210, 95%CI(0.015, 0.026)) but worsening of the symptomatic domain (β=(0.0054, 95%CI(0.0029, 0.0078)). Conclusion and Recommendation: Patients with gynecologic cancer had poor quality of life in all domains of EORTC-QLQ30 and overall health-related quality of life except the cognitive domain. Socio-demographic factors, namely age, marital status, educational status, occupation status), disease and treatment related factors (stage of cancer, type of cancer and type of treatment received) were significantly associated factors with HRQoL of gynecologic cancer patients.

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