Study On Influencing Factor And Change Of Quality Of Life And Anxiety And Depression Before And After Chemotherapy Among Lung Cancer Patients

Objective:With development of modern medicine, medical workers should not only prolong the survival time and improve the survival rate of lung cancer patients,but also improve the quality of life and reduce and eliminate psychological barriers. The aim of this study is to observe influencing factor of quality of life and anxiety and depression among lung cancer patients, and to explore the change of quality of life and anxiety and depression before and after chemotherapy to provide reference for clinical treatment..Methods: Selected one hundred patients who had been confirmed with advanced lung cancer for the first time from the Department of oncology, General Hospital Affiliated to Tianjin Medical University from2013January to2013December. Recorded patient’s general data and recorded physical indexes of plasma albumin, hemoglobin level and BMI. Lung cancer patients were assessed with clinical outcomes and the EORTC QLQ-C30questionnaires and Zung questionnaires before chemotherapy, one week after two cycles of chemotherapy, one week after four cycles of chemotherapy. Seventy of one hundred patients completed the four cycles chemotherapy and three times questionnaire.Results:1Analysis of quality of life of100patients before chemotherapy:(1) Analysis of the influence factors of global quality of life:. men, non small cell lung cancer, less than sixty years old, high education level, stage III, without the basis of disease, not smoking, higher monthly income, married, having health care, non low protein and non anemia group general health scores was higher But, there was no significant difference between these groups(P>0.05). There was no significant difference in global quality of life between deferent BMI(P>0.05).(2) The general condition of the patients’ comparative analysis in the EORTCQLQ-30other objectives:Female has higher scores of appetite loss item than male(P<0.05); above the age of sixty years old has higher scores in nausea、appetite loss and constipation item than below sixty years old (P<0.05); Low plasma albumin group has lower social function scores than normal plasma albumin group (P<0.05); low education group has higher scores insomnia than the high degree of culture group (P＜0.05); smoking group has higher scores in economic difficulty item than the non smoking group (P<0.05); married group has higher emotional item scores than the non married group (P<0.05);having basic disease group has higher scores in fatigue item than having no disease group(P<0.05).There was significant difference between these groups.2After two cycles chemotherapy, the effective rate of chemotherapy was42.86%after four cycles chemotherapy; the effective rate of chemotherapy was31.43%.3The change of quality of life of before and after chemotherapy in seventy cases of patients with advanced lung cancer:There was no obvious change in physical、emotional、social and global quality of life after two cycles of chemotherapy than before chemotherapy. After four cycles of chemotherapy physical、emotional、social and global quality of life were lower than after two cycles of chemotherapy and before chemotherapy. Nause and vomiting、appetite loss and economical difficulty were higher after two cycles of chemotherapy than before chemotherapy. Nause and vomiting、appetite loss and economic difficulty were higher after four cycles of chemotherapy than after two cycles of chemotherapy and before chemotherapy. Insomnia item score was higher after four cycles of chemotherapy than before chemotherapy. There was significant difference between these groups. This showed that chemotherapy affects the quality of life of patients in a certain extent.4Analysis of anxiety:(1) Changes in anxiety before and after chemotherapy of patients: Before chemotherapy there was twenty-six anxiety patients. After two cycles chemotherapy anxiety patients was forty-two cases. After four cycles chemotherapy anxiety patients was forty-three cases. With the prolonged cycles of chemotherapy, anxiety became more and more serious (P<0.05), and more and more patients became anxiety. The difference was statistically significant.(2) Analysis of the influence factors of anxiety before chemotherapy:Anxiety score of stage IV lung cancer patients was higher than stage III patients (P<0.05). There was statistically significant difference between groups. Married patients compared to other types of marriage patients anxiety scores was lower (P<0.05). Anxiety score of anemia group was higher than the non anemia group (P<0.05).There were no significant difference within group of other factors(P>0.05).5Analysis of depression:(1) Changes in depression before and after chemotherapy: Before chemotherapy there was thirty-two depression patients. After two cycles chemotherapy depression patients was forty-four cases. After four cycles chemotherapy depression patients was forty-six cases. With the prolonged cycles of chemotherapy, depression became more and more serious (P＜0.05), and more and more patients became depression. The difference was statistically significant.(2) Analysis of the influence factors of depression before chemotherapy Depression score of stage IV lung cancer patients was higher than stage III patients (P＜0.05). There was statistically significant difference between groups. There were no significant difference within group of other factors(P>0.05).Conclusion:1After two cycles chemotherapy,42.86%patients’ symptoms were relieved. After four cycles chemotherapy,31.43%patients’ symptoms were relieved.2After chemotherapy, quality of life of some patients decreased because of the side effects of chemotherapy. With the prolonged cycles of chemotherapy, especially after four cycles chemotherapy, physical、emotional、social and global quality of life became bad. Nause and vomiting、appetite loss became serious. Economical difficulty became obvious..Insomnia was more serious after chemotherapy.337.14%patients with advanced lung cancer had anxiety. With the prolonged cycles of chemotherapy, more and more people became anxious. After four cycles chemotherapy, the number of anxious patients rose to61.43%. With the prolonged cycles of chemotherapy, anxiety became more and more serious. The IV patients were more anxious than the III patients. The non married were more anxious than the married. The anemia group was more serious than the non anemia group in anxiety.445.71%patients with advanced lung cancer had depression. With the prolonged cycles of chemotherapy, more and more people became depressive. After four cycles chemotherapy, the number of depressive patients rose to65.71%. With the prolonged cycles of chemotherapy, depression became more and more serious. The IV patients were more depressive than the III patients.5After the chemotherapy, patients’ the lesion of cancer became smaller and clinical symptoms relieved, but some patients’ appetite loss, nausea and vomiting symptom deteriorated and economic difficulties increased obviously. Quality of life of lung cancer patients decreased. We should pay more attention to the adverse reactions of chemotherapy and cope with them and improve patients’ nutrition to improve the quality of life. Meanwhile, along with chemotherapy, a growing number of people suffered from anxiety and depression, anxiety and depression became more and more serious. Medical works, patients’ family members, the members of the society should highly concerned about lung cancer patients and pay attention to the psychological changes of patients. We should give them psychological support and timely psychological counseling and intervention treatment to alleviate the symptoms of anxiety and depression in patients with depression and anxiety and reduce the incidence of depression and anxiety. We should pay attention to not only patients’symptom, but also psychological and social factors.