Survey And Analysis Of Psychological Distress And Quality Of Life In Advanced Cancer Patients Before And After Chemotherapy

Objectives This purposes of this study were:(1) to investigate the prevalences ofsignificant psychological distress of newly diagnosed hospitalized advanced cancerpatients before and after chemotherapy in the department of Medical Oncology of theFirst Affiliated Hospital of Anhui Medical University, and the main problems to causepsychological distress,and to analyze of possible risk factors.(2) to explore relationshipbetween psychological distress and quality of life, and the impact of chemotherapy onthe psychological distress and quality of life.Methods Our sample was consisted of patients whose had been newly diagnosed withadvanced cancer patients in the department of Medical Oncology of the First AffiliatedHospital of Anhui Medical University from May2011to August2011. Severalmeasuring scales were used in the investigation before and after three monthschemotherapy, which included Psychological distress thermometer (DT), the FACT-Grating scale and self-designed questionnaire including patient demographic informationand disease diagnosis and treatment information. All datas were entered by the Epi Data3.1software to establish a database and analyzed by IBM SPSS19.0software packagefor statistical analysis. T-test or2test was used to detect differences of demographicinformation, diagnosis and treatment information and quality of life between significantpsychological distress group and negative group before and after chemotherapy. Thepaired-samples t test was used to compare the DT value and quality of life scorechanges before and after chemotherapy.Person correlation analysis was used to analyze DT values and QOL difference using before and after chemotherapy.Results (1) The prevalence of significant psychological distress in142patients were43.0%and34.5%before and after chemotherapy, and DT score(2.82±2.03) afterchemotherapy lower than3.41±1.84before chemotherapy (P<0.05).(2) Three mainproblems were concern, eating and pain caused patients with psychological distressbefore chemotherapy, and concern， fatigue, sleep after chemotherapy.(3) Theprevalence of significant psychological distress in female, years of education≤9yearsand ECOG performance score of≥2points was higher before and after chemotherapy(P<0.05).(4) In addition to the social/family status dimension before chemotherapy(P=0.269), the various dimensions of quality of life scores were higher in undetectedsignificant psychological distress group before and after chemotherapy (P<0.05).(5) Inaddition to social/family status dimension, the correlation analysis between DT valuesand the other dimensions of quality of life score difference was negatively correlatedbefore and after chemotherapy (P<0.01).Conclusions (1) The prevalence of significant distress is relatively high in advancedcancer patients, which risk factors may consist of gender, education level and ECOGperformance score.(2) The main problems causing psychological distress in advancedpatients were worry, fatigue and some physical symptoms such as pain.(3) The level ofpsychological distress and quality of life is closely related.(4) Recent chemotherapy candecrease the level of distress and improve quality of life in advanced patients.