caa a22 4500 475846672 CHVBK 20180406123916.0 cr unu---uuuuu 170329e20000201xx s 000 0 eng 10.1023/A:1008995814965 doi (NATIONALLICENCE)springer-10.1023/A:1008995814965 Patterns over time in quality of life, coping and psychological adjustment in late stage melanoma patients: An application of multilevel models [Elektronische Daten] [J.E. Brown, M.T. King, P.N. Butow, S.M. Dunn, A.S. Coates] Background: Quality of life (QOL) assessment is an important component within cancer research. There is often variability in QOL scores both between patients and across time. Understanding this variability in terms of personal characteristics and psychosocial factors would be useful but is often obstructed by the types of analyses that are applied to longitudinal data sets. Improved understanding can be gained with the application of multi-level or hierarchical models that allow for greater flexibility for modelling individual patterns of change over time. Methods and patients: Questionnaires were sent to a cohort of stage IV melanoma patients seen at the Sydney Melanoma Unit between 1991 and 1996, approximately every 3 months for up to 2 years. The data reported here are from a sub-sample of 44 patients who each completed between 3 and 8 questionnaires. Three aspects of QOL were measured (effort to cope, mood and physical well-being), each with a single LASA line. Multilevel techniques were used to model the patterns of QOL over time. Covariates were added to explain variation between patients in their average QOL and change in QOL over time. Results: The scores of each of the three QOL measures showed marked fluctuations over time. However, there was little systematic change during the study in either effort to cope ( p = 0.32) or mood ( p = 0.06). In contrast, the physical well-being scores of some patients improved while others deteriorated ( p < 0.001). On average, physical well-being deteriorated ( p < 0.001). Variability between patients accounted for 60% (effort to cope), 45% (mood) and 44% (physical well-being) of the total variance of each scale. A range of psycho-social factors including active and avoidant coping styles and psychological adjustment accounted for significant amounts of the variability between patients in each QOL measure. Conclusion: Individual coping and psychological adjustment are related to individual changes in QOL and to differences among patients' QOL. The study illustrates the use of multi-level techniques to further our understanding of differences between patients in their QOL and how it changes over time. Kluwer Academic Publishers, 2000 Adjustment nationallicence Coping nationallicence Longitudinal nationallicence Melanoma nationallicence Multi-level models nationallicence Quality of life (QOL) nationallicence Brown J.E. The Medical Psychology Unit, Australia aut King M.T. Centre for Health Economics Research and Evaluation, University of Sydney, Australia aut Butow P.N. The Medical Psychology Unit, Australia aut Dunn S.M. The Medical Psychology Unit, Australia aut Coates A.S. The Australian Cancer Society, Australia aut Quality of Life Research Kluwer Academic Publishers 9/1(2000-02-01), 75-85 0962-9343 9:1<75 2000 9 11136 https://doi.org/10.1023/A:1008995814965 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1023/A:1008995814965 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Brown J.E. The Medical Psychology Unit, Australia aut NATIONALLICENCE 700 1- King M.T. Centre for Health Economics Research and Evaluation, University of Sydney, Australia aut NATIONALLICENCE 700 1- Butow P.N. The Medical Psychology Unit, Australia aut NATIONALLICENCE 700 1- Dunn S.M. The Medical Psychology Unit, Australia aut NATIONALLICENCE 700 1- Coates A.S. The Australian Cancer Society, Australia aut NATIONALLICENCE 773 0- Quality of Life Research Kluwer Academic Publishers 9/1(2000-02-01), 75-85 0962-9343 9:1<75 2000 9 11136 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer