Trajectories And Related Factors Of Anxiety And Depression In Patients With Breast Cancer Undergoing Radiotherapy

Background and objectionWith the development of breast cancer treatment,the survival rate of breast cancer patients has improved significantly,and their mental health and quality of life have gradually received attention.At present,the associated factors of anxiety and depression symptoms in breast cancer patients are not clear.Especially related research on radiotherapy is rare.As a radiation therapist,understanding the psychological status of breast cancer patients during radiotherapy has certain clinical significance.The objectives of our study are mainly the following two points.Firstly,our study aims to explore the anxiety and depression symptoms trajectories in breast cancer patients during radiotherapy.Then analyzing the related factors of anxiety and depression symptoms in breast cancer patients is another research objection.Research significance:To provide a theoretical basis for radiation therapist to better manage breast cancer patients with radiotherapy and take appropriate interventions at appropriate times.MethodsA total of 189 breast cancer patients were selected from the department of radiation oncology,Nanfang Hospital,Southern Medical University,between November 2018 to December 2019.There were 180 cases can be used to analyze further.The questionnaire surveys were collected before,during,end and one month after radiation therapy.And patients were investigated by questionnaires including general information questionnaires,general anxiety disorder questionnaire(GAD-7),patient health questionnaire(PHQ-9),Pittsburgh sleep quality index scale(PSQI),and quality of life questionnaire-breast cancer module(QLQ-BR23).After the data were recorded,statistical analyses were conducted using SPSS Analytics software v24.0 and AMOS v23.0.ResultsA total of 54 breast cancer patients experienced anxiety symptoms,with an incidence rate of 30.0%,while a total of 69 breast cancer patients experienced depression symptoms,with an incidence of 38.3%.And there were 26.7%(48/180)breast cancer patients suffered from both anxiety and depression symptoms.Univariate analysis showed that the anxiety scores of breast cancer patients who were unemployed,severe life stress,negative personality traits,and Luminal A were significantly higher than those of other subgroups,with the statistical significance(P<0.05).There were no significant differences in anxiety scores with age,marital status,education level,monthly income level,family history of cancer,type of surgery,whether chemotherapy,type of radiotherapy,radiotherapy region,tumor T stage,and N stage,etc.(P>0.05).There were differences in depression scores in terms of employment status and personality traits,with statistical significance(P<0.05).Multivariate Logistic stepwise regression analysis showed that,employment status(χ2=4.542,P=0.033;χ2=4.136,P=0.042)and personality traits(χ2=13.012,P<0.001;χ2=7.486,P=0.006)were independent factors for anxiety and depression symptoms in breast cancer patients.And anxiety and depression symptoms in breast cancer patients were negatively related to the functional dimension of quality of life(P<0.001)and positively related to the symptom dimensions of quality of life(P<0.001).Structural equation modeling(SEM)further showed that personality traits of breast cancer patients indirectly affected their quality of life by anxiety and depression symptoms.The anxiety scores of 180 breast cancer patients from before radiotherapy(Time 1),during radiotherapy(Time 2),after radiotherapy(Time 3),and 1 month after radiotherapy(Time 4)were(3.48±4.69),(3.05±4.26),(3.11±4.34)and(2.11±3.26),respectively.The depression scores from Time 1 to Time 4 were(4.43±4.81),(4.39±4.97),(4.55±5.18),and(2.63±3.34),respectively.The anxiety and depression scores of breast cancer patients were stable during radiotherapy,but decreased significantly after radiotherapy,with a statistical difference in the follow-up time(P≤0.001).The mixed-effect model analysis showed that tumor T stage,employment status,personality traits and life stress were associated with the change of anxiety scores for breast cancer patients(P<0.05),while tumor T stage,employment status and personality traits were associated with the change of depression scores for breast cancer patients(P<0.05).The scores of sleep quality and symptom dimension of quality of life in breast cancer patients after radiotherapy were significantly lower than the score before radiotherapy,while the functional dimension after radiotherapy was significantly better than that before radiotherapy,and all the differences were statistically significant(P<0.05).ConclusionAnxiety and depression symptoms were still common in patients with breast cancer undergoing radiotherapy.Their mental health are affected by many factors,such as employment status,personality traits,and is closely related to their quality of life.And through surgery and chemotherapy,the anxiety and depression scores of breast cancer patients were stable during radiotherapy,but decreased significantly after radiotherapy,and the quality of sleep and life for patients with breast cancer improved at the same time.So,the mental health of them should be valued during radiotherapy,then the support and intervention measures should be provided in time to improve the quality of life of patients with breast cancer.