Relationship between Quality of Life for Patients with Neuroendocrine Tumors and Novel Biomarkers

Relationship between Quality of Life for Patients with Neuroendocrine Tumors and Novel Biomarkers by Stephanie L. Ford-Scheimer MPH, Eastern Virginia Medical School, 2005 BS, The College of William & Mary, 2003 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Health – Epidemiology Walden University January 2017 Abstract Research in the field of neuroendocrine tumors (NETs) has increased over the last decade, including studies focused on biochemical markers (biomarkers) of the disease. There is also growing interest in how NETs impact patients’ quality of life (QOL). Consequently, there is a paucity of information about whether the expression of the specific disease biomarkers affects QOL as well as whether the primary tumor site impacts QOL. Using the explanatory model of health promotion and quality of life in chronic disabling conditions as the theoretical framework and data collected with the Norfolk QOL-NET instrument, this study’s purpose was to fill that gap in knowledge through research questions addressing the relationship between the primary tumor site and NET patients’ total QOL score as well as the effect of specific NET biomarkers on NET patients’ total QOL score. Data were analyzed using descriptive statistics, one-way analysis of variance (ANOVA), regression analysis, and post hoc tests to determine significance. Results from an ANOVA showed that abnormal NET biomarkers affected total QOL (p = 0.011). In the analyses of whether the independent biomarker variables affected the dependent total QOL variable, only the result for Serotonin Normal was significant (p = 0.002). The presence of abnormal biomarker measurements also affected two of the Norfolk QOL-NET domains significantly, gastrointestinal and physical functioning (p = 0.005 and p = 0.030, respectively). By understanding the relationship between NETs and patient QOL, the potential positive social change implications are helping NET patients assess the severity of their condition, determining what affects their well-being, and using this information to help monitor their treatment/progress.Research in the field of neuroendocrine tumors (NETs) has increased over the last decade, including studies focused on biochemical markers (biomarkers) of the disease. There is also growing interest in how NETs impact patients’ quality of life (QOL). Consequently, there is a paucity of information about whether the expression of the specific disease biomarkers affects QOL as well as whether the primary tumor site impacts QOL. Using the explanatory model of health promotion and quality of life in chronic disabling conditions as the theoretical framework and data collected with the Norfolk QOL-NET instrument, this study’s purpose was to fill that gap in knowledge through research questions addressing the relationship between the primary tumor site and NET patients’ total QOL score as well as the effect of specific NET biomarkers on NET patients’ total QOL score. Data were analyzed using descriptive statistics, one-way analysis of variance (ANOVA), regression analysis, and post hoc tests to determine significance. Results from an ANOVA showed that abnormal NET biomarkers affected total QOL (p = 0.011). In the analyses of whether the independent biomarker variables affected the dependent total QOL variable, only the result for Serotonin Normal was significant (p = 0.002). The presence of abnormal biomarker measurements also affected two of the Norfolk QOL-NET domains significantly, gastrointestinal and physical functioning (p = 0.005 and p = 0.030, respectively). By understanding the relationship between NETs and patient QOL, the potential positive social change implications are helping NET patients assess the severity of their condition, determining what affects their well-being, and using this information to help monitor their treatment/progress. Relationship between Quality of Life for Patients with Neuroendocrine Tumors and Novel Biomarkers by Stephanie L. Ford-Scheimer MPH, Eastern Virginia Medical School, 2005 BS, The College of William & Mary, 2003 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Health Walden University January 2017 Dedication This dissertation is dedicated to my husband, Michael, for all of his support over the years. It is also dedicated to my mother, Susan, for inspiring me to pursue and achieve my academic dreams. Finally, to my little Arthur James: you can do anything you set your mind to—it just takes perseverance. Acknowledgments To my family, thank you from the bottom of my heart for your unwavering encouragement and love during this journey to my doctoral degree. I would not be where I am without you. To Mrs. Etta and Dr. Aaron Vinik, thank you for providing the data for this study. Your tremendous support and mentorship over my graduate career has meant the world to me. To Dr. Diana Naser, thank you for your guidance during the dissertation process and for being such a wonderful Chair.