DOI QR코드

DOI QR Code

Impacts of Fatigue, Anxiety, Depression, and Cognitive Function on the Quality of Life in Gastrointestinal Cancer Patients Receiving Chemotherapy

항암화학요법을 받는 소화기암 환자의 피로, 불안, 우울, 인지기능이 삶의 질에 미치는 영향

  • Kim, Seong-A (Soonchunhyang University Cheonan Hospital) ;
  • Han, Suha (School of Nursing, Soonchunhyang University)
  • Received : 2021.09.26
  • Accepted : 2021.11.09
  • Published : 2021.11.30

Abstract

Purpose: This study aimed to investigate the effects of fatigue, anxiety, depression, and cognitive function on the quality of life of gastrointestinal cancer patients receiving chemotherapy. Methods: Data were collected from a total of 141 participants. The measurements used were Functional Assessment of Chronic Illness Therapy for fatigue (FACIT-F), Hospital Anxiety and Depression Scale (HADS) and Functional Assessment of Cancer Therapy for cognitive function (FACT-Cog). Results: Significant correlations were found among fatigue, anxiety, depression, cognitive function, and quality of life. The mean score of quality of life was 59.60 out of 108, and 68% of the variance in QOL was explained by fatigue, anxiety, depression, and cognitive function. Cognitive function was the most influential factor (β=.30), followed by anxiety (β=-.27), depression (β=-.24), and fatigue (β=-.18). We found that the better the cognitive function, the lower the anxiety and depression, and the lower the degree of fatigue, the higher the quality of life. Conclusion: A nursing program for managing the changes in fatigue, anxiety, depression, and cognitive function should be provided to enhance maintenance and the improvement of the quality of life for gastrointestinal cancer patients who receive chemotherapy.

Keywords

References

  1. Korea Central Cancer Registry. Annual report of cancer statistics in Korea in 2018. Ministry of Health and Welfare, 2021 January. Report No:11-1352000-000145-10
  2. National Cancer Center, National Cancer Control Institute [Internet]. Seoul: National Cancer Information Center; 2021 [cited 2021 November 7], Available from: https://www.cancer.go.kr/
  3. Cella DF, Tulsky DS, Gray G, Sarafian B, Linn E, Bonomi A, et al. The functional assessment of cancer therapy scale: development and validation of the general measure. Journal of Clinical Oncology. 1993; 11(3):570-9. https://doi.org/10.1200/JCO.1993.11.3.570
  4. Anwar S, Tan W, Yu J, Hutson A, Javle M, Iyer R. Quality-of-life (QoL) as a predictive biomarker in patients with advanced pancreatic cancer (APC) receiving chemotherapy: Results from a prospective multicenter phase 2 trial. Journal of Gastrointestinal Oncology. 2014;5(6):433-9. https://doi.org/10.3978/j.issn.2078-6891.2014.070
  5. Brem S, Kumar NB. Management of treatment-related symptoms in patients with breast cancer. Clinical Journal of Oncology Nursing. 2011; 15(1):63-71. https://doi.org/10.1188/11.CJON.63-71
  6. Tung HY, Chao TB, Lin YH, Wu SF, Lee HY, Ching CY, et al. Depression, fatigue, and QoL in colorectal cancer patients during and after treatment. Western Journal of Nursing Research. 2016;38(7):893-908. https://doi.org/10.1177/0193945916630256
  7. Vardy JL, Dhillon HM, Pond GR, Renton C, Dodd A, Zhang H, et al. Fatigue in people with localized colorectal cancer who do and do not receive chemotherapy: A longitudinal prospective study. Annals of Oncology. 2016;27(9):1761-7. https://doi.org/10.1093/annonc/mdw252
  8. Gernier F, Joly F, Klein D, Mercier M, Velten M, Licaj I. Cancer-related fatigue among long-term survivors of breast, cervical, and colorectal cancer: A French registry-based controlled study. Supportive Care in Cancer. 2020;28(12):5839-49. https://doi.org/10.1007/s00520-020-05427-8
  9. Tavoli A, Mohagheghi MA, Montazeri A, Roshan R, Tavoli Z, Omidvari S. Anxiety and depression in patients with gastrointestinal cancer: does knowledge of cancer diagnosis matter? BMC Gastroenterology. 2007;7(1):1-6. https://doi.org/10.1186/1471-230X-7-28
  10. Kim JH, Kim HJ. Influences of symptom experience and depression on quality of life in colorectal cancer patients with stoma reversal. Journal of Korean Biological Nursing Science. 2015;17(4):306-14. https://doi.org/10.7586/jkbns.2015.17.4.306
  11. Aminisani N, Nikbakht H, Asghari Jafarabadi M, Shamshirgaran SM. Depression, anxiety, and health related quality of life among colorectal cancer survivors. Journal of Gastrointestinal Oncology. 2017;8(1):81-8. https://doi.org/10.21037/jgo.2017.01.12
  12. Geda YE, Roberts RO, Mielke MM, Knopman DS, Christianson TJ, Pankratz VS, et al. Baseline neuropsychiatric symptoms and the risk of incident mild cognitive impairment: A population-based study. The American Journal of Psychiatry. 2014;171(5):572-81. https://doi.org/10.1176/appi.ajp.2014.13060821
  13. Calvio L, Peugeot M, Bruns GL, Todd BL, Feuerstein M. Measures of cognitive function and work in occupationally active breast cancer survivors. Journal of Occupational and Environmental Medicine. 2010;52 (2):219-27. https://doi.org/10.1097/JOM.0b013e3181d0bef7
  14. Kim KH, Chung BY, Kim GD, Byun HS, Choi EH, Cho EJ. Cognitive function in breast cancer patients receiving adjuvant chemotherapy. Asian Oncology Nursing. 2012;12(1):1-11. https://doi.org/10.5388/aon.2012.12.1.1
  15. Hutchinson AD, Hosking JR, Kichenadasse G, Mattiske JK, Wilson C. Objective and subjective cognitive impairment following chemotherapy for cancer: A systematic review. Cancer Treatment Reviews. 2012;38(7):926-34. https://doi.org/10.1016/j.ctrv.2012.05.002
  16. Oh PJ, Lee JR. Effect of cancer symptoms and fatigue on chemotherapyrelated cognitive impairment and depression in people with gastrointestinal cancer. Journal of Korean Academy of Nursing. 2016;46(3):420-30. https://doi.org/10.4040/jkan.2016.46.3.420
  17. Dhillon HM, Tannock IF, Pond GR, Renton C, Rourke SB, Vardy JL. Perceived cognitive impairment in people with colorectal cancer who do and do not receive chemotherapy. Journal of Cancer Survivorship. 2018;12(2):178-85. https://doi.org/10.1007/s11764-017-0656-6
  18. Kim HJ, Barsevick AM, Chan A, Chae JW. Chemotherapy-associated cognitive impairments in Korean cancer patients: Risk factors and functional outcome. Psycho-Oncology. 2018;27(8):1995-2001. https://doi.org/10.1002/pon.4759
  19. Mols F, Schoormans D, de Hingh I, Oerlemans S, Husson O. Symptoms of anxiety and depression among colorectal cancer survivors from the population-based, longitudinal PROFILES Registry: Prevalence, predictors, and impact on quality of life. Cancer. 2018;124(12):2621-8. https://doi.org/10.1002/cncr.31369
  20. Baek YA, Yi MS. Factors influencing quality of life during chemotherapy for colorectal cancer patients in South Korea. Journal of Korean Academy of Nursing. 2015;45(4):604-12. https://doi.org/10.4040/jkan.2015.45.4.604
  21. Oh PJ, Kim JH. Chemotherapy-related cognitive impairment and quality of life in people with colon cancer: the mediating effect of psychological distress. Journal of Korean Academy of Nursing. 2016;46(1):19-28. https://doi.org/10.4040/jkan.2016.46.1.19
  22. Wilson C, Giles K, Nettelbeck T, Hutchinson A. Locus of control, optimism, and recollections of depression and self-reported cognitive functioning following treatment for colorectal cancer. Psychooncology. 2018;27(2):676-82. https://doi.org/10.1002/pon.4567
  23. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica. 1983;67(6):361-70. https://doi.org/10.1111/j.1600-0447.1983.tb09716.x
  24. Wagner L, Sweet JJ, Butt Z, Lai J, Cella D. Measuring patient self-reported cognitive function: qualitative findings and initial development of the functional assessment of cancer therapy-cognitive function (FACT-COG) instrument. Journal of Supportive Oncology. 2009;7(6):W32-9.
  25. Kim MR. Symptom cluster and the relation of performance status, depression and quality of life in patients with gastrointestinal cancer [dissertation]. Seoul: Ewha Womans University; 2017. p. 1-91.
  26. Yeom JW, Suh YO. The effect of symptom experience, nutritional status, and self care on quality of life in elderly patients with colorectal cancer. The Korean Journal of Rehabilitation Nursing. 2019;22(1):48-57. https://doi.org/10.7587/kjrehn.2019.48
  27. Jones JM, Olson K, Catton P, Catton CN, Fleshner NE, Krzyzanowska MK, et al. Cancer-related fatigue and associated disability in posttreatment cancer survivors. Journal of Cancer Survivorship. 2016;10(1):51-61. https://doi.org/10.1007/s11764-015-0450-2
  28. Peng YN, Huang ML, Kao CH. Prevalence of depression and anxiety in colorectal cancer patients: a literature review. Journal of Environmental Research and Public Health. 2019;16(3):1-12. https://doi.org/10.3390/ijerph16030411
  29. Park JH, Jung YS, Jung YM, Bae SH. The role of depression in the relationship between cognitive decline and quality of life among breast cancer patients. Supportive Care in Cancer, 2019;27(7):2707-14. https://doi.org/10.1007/s00520-018-4546-x
  30. Vardy J, Dhillon HM, Pond GR, Rourke SB, Xu W, Dodd A, et al. Cognitive function and fatigue after diagnosis of colorectal cancer. Annals of Oncology. 2014;25(12):2404-12. https://doi.org/10.1093/annonc/mdu448