J Korean Acad Nurs.  2015 Aug;45(4):604-612. 10.4040/jkan.2015.45.4.604.

Factors Influencing Quality of Life during Chemotherapy for Colorectal Cancer Patients in South Korea

• Baek Y
• Yi M

• KMID: 2164401
• DOI: http://doi.org/10.4040/jkan.2015.45.4.604

Abstract

PURPOSE
The purpose of this study was to investigate the levels of physical symptoms, anxiety, depression, and quality of life (QOL) during chemotherapy for colorectal cancer patients in South Korea and to identify factors influencing their QOL.
METHODS
Data were collected from 144 colorectal cancer patients receiving chemotherapy during 2012 at one general hospital located in Seoul. Physical symptoms were measured by the M. D. Anderson Symptom Inventory-Gastrointestinal Cancer Module, and anxiety and depression were measured by the Hospital Anxiety Depression Scale. QOL was measured by the Functional Assessment of Cancer Therapy-Colorectal. Data were analyzed using descriptive statistics, t-test, one-way ANOVA, Scheffe post hoc test, Pearson correlation and stepwise multiple regression.
RESULTS
Mean age of the participants was 56.6 and most of them were not employed. In terms of cancer stage, 38.2% were in stage 3, followed by stage 4 (34.7%). The most frequent symptom was lack of appetite, followed by sleep disturbance and fatigue. The mean score for anxiety was 5.40 with a prevalence of 23% and that of depression 8.85 with a prevalence of 64.6%. The mean score for quality of life was 81.93 out of 136 and 75.3% of the variance in QOL was explained by depression, symptoms, anxiety, treatment place, and occupational status. Depression was the strongest predictive factor.
CONCLUSION
Oncology professionals need to pay special attention to relieving depression as well as physical symptoms to improve QOL during chemotherapy for colorectal cancer patients.

Keyword

Colorectal cancer; Quality of life; Symptom; Anxiety; Depression

MeSH Terms

Adult
Aged
Antineoplastic Agents/therapeutic use
Anxiety
Colorectal Neoplasms/drug therapy/pathology/*psychology
Depression/epidemiology
Fatigue
Female
Humans
Male
Middle Aged
Neoplasm Metastasis
Neoplasm Staging
Prevalence
*Quality of Life
Republic of Korea
Surveys and Questionnaires
Antineoplastic Agents

Reference

1. National Cancer Information Center. Cancer information service [Internet]. Goyang: Author;2013. cited 2015 January 8. Available from: http://www.cancer.go.kr/mbs/cancer/subview.jsp?id=cancer_100100000000.

2. Hong YS, Kim TW. Chemotherapy for colorectal cancer. Korean J Gastroenterol. 2009; 54(6):355–363. DOI: 10.4166/kjg.2009.54.6.355.

3. Choi KS, Park JA, Lee J. The effect of symptom experience and resilience on quality of life in patients with colorectal cancers. Asian Oncol Nurs. 2012; 12(1):61–68. DOI: 10.5388/aon.2012.12.1.61.

4. Kim JH, Choi KS, Kim TW, Hong YS. Quality of life in colorectal cancer patients with chemotherapy-induced peripheral neuropathy. J Korean Oncol Nurs. 2011; 11(3):254–262. DOI: 10.5388/jkon.2011.11.3.254.

5. Kim MY. Transition of symptoms and quality of life in cancer patients on chemotherapy. J Korean Acad Nurs. 2009; 39(3):433–445. DOI: 10.4040/jkan.2009.39.3.433.

6. Alacacioglu A, Binicier O, Gungor O, Oztop I, Dirioz M, Yilmaz U. Quality of life, anxiety, and depression in Turkish colorectal cancer patients. Support Care Cancer. 2010; 18(4):417–421. DOI: 10.1007/s00520-009-0679-2.

7. Lynch BM, Steginga SK, Hawkes AL, Pakenham KI, Dunn J. Describing and predicting psychological distress after colorectal cancer. Cancer. 2008; 112(6):1363–1370. DOI: 10.1002/cncr.23300.

8. Min HS, Kim JY. Health-related quality of life of patients with rectal cancer. J Korean Soc Coloproctol. 2009; 25(2):100–106. DOI: 10.3393/jksc.2009.25.2.100.

9. Pachler J, Wille-Jorgensen P. Quality of life after rectal resection for cancer, with or without permanent colostomy. Cochrane Database Syst Rev. 2012; 12:CD004323. DOI: 10.1002/14651858.CD004323.pub4.

10. Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. Hillsdale, NJ: Lawrence Erlbaum;1988.

11. Cleeland CS, Mendoza TR, Wang XS, Chou C, Harle MT, Morrissey M, et al. Assessing symptom distress in cancer patients: The M. D. Anderson symptom inventory. Cancer. 2000; 89(7):1634–1646.

12. Wang XS, Williams LA, Eng C, Mendoza TR, Shah NA, Kirkendoll KJ, et al. Validation and application of a module of the M. D. Anderson symptom inventory for measuring multiple symptoms in patients with gastrointestinal cancer (the MDASI-GI). Cancer. 2010; 116(8):2053–2063. DOI: 10.1002/cncr.24920.

13. Yun YH, Mendoza TR, Kang IO, You CH, Roh JW, Lee CG, et al. Validation study of the Korean version of the M. D. Anderson symptom inventory. J Pain Symptom Manage. 2006; 31(4):345–352. DOI: 10.1016/j.jpainsymman.2005.07.013.

14. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983; 67(6):361–370.

15. Oh SM, Min KJ, Park DB. A study on the standardization of the hospital anxiety and depression scale for Koreans: A comparison of normal, depressed and anxious groups. J Korean Neuropsychiatr Assoc. 1999; 38(2):289–296.

16. Ward WL, Hahn EA, Mo F, Hernandez L, Tulsky DS, Cella D. Reliability and validity of the functional assessment of cancer therapy-colorectal (FACT-C) quality of life instrument. Qual Life Res. 1999; 8(3):181–195.

17. Kim H, Yoo HJ, Kim YJ, Han OS, Lee KH, Lee JH, et al. Development and validation of Korean functional assessment cancer therapy-general (FACT-G). Korean J Clin Psychol. 2003; 22(1):215–229.

18. Kim YJ, Yoo HJ, Kim JC, Han OS. Preoperative quality of life in rectal cancer patients: Male vs female. Korean J Clin Psychol. 2003; 22(4):743–762.

19. Peddle CJ, Au HJ, Courneya KS. Associations between exercise, quality of life, and fatigue in colorectal cancer survivors. Dis Colon Rectum. 2008; 51(8):1242–1248. DOI: 10.1007/s10350-008-9324-2.

20. Lee SH. A study on professional medical team suppor and information needs of patients with colon cancer [master's thesis]. Seoul: Yonsei University;2006.

21. Jeong JY, So HS, Hong JE, Chae MJ, Han G. Related factors to quality of life among hospitalized cancer patients undergoing chemotherapy. Asian Oncol Nurs. 2012; 12(1):84–91. DOI: 10.5388/aon.2012.12.1.84.

22. Byun HS, Kim GD. Impacts of fatigue, pain, anxiety, and depression on the quality of life in patients with breast cancer. Asian Oncol Nurs. 2012; 12(1):27–34. DOI: 10.5388/aon.2012.12.1.27.

23. Suh YO. Predictors of quality of life in women with breast cancer. J Korean Acad Nurs. 2007; 37(4):459–466.

24. Miaskowski C, Cooper BA, Paul SM, Dodd M, Lee K, Aouizerat BE, et al. Subgroups of patients with cancer with different symptom experiences and quality-of-life outcomes: A cluster analysis. Oncol Nurs Forum. 2006; 33(5):E79–E89. DOI: 10.1188/06.onf.e79-e89.

25. So WK, Marsh G, Ling WM, Leung FY, Lo JC, Yeung M, et al. The symptom cluster of fatigue, pain, anxiety, and depression and the effect on the quality of life of women receiving treatment for breast cancer: A multicenter study. Oncol Nurs Forum. 2009; 36(4):E205–E214. DOI: 10.1188/09.onf.e205-e214.

26. Dodd MJ, Miaskowski C, Paul SM. Symptom clusters and their effect on the functional status of patients with cancer. Oncol Nurs Forum. 2001; 28(3):465–470.

27. Redeker NS, Lev EL, Ruggiero J. Insomnia, fatigue, anxiety, depression, and quality of life of cancer patients undergoing chemotherapy. Sch Inq Nurs Pract. 2000; 14(4):275–290.

28. Tsunoda A, Nakao K, Hiratsuka K, Yasuda N, Shibusawa M, Kusano M. Anxiety, depression and quality of life in colorectal cancer patients. Int J Clin Oncol. 2005; 10(6):411–417. DOI: 10.1007/s10147-005-0524-7.

29. Theobald DE. Cancer pain, fatigue, distress, and insomnia in cancer patients. Clin Cornerstone. 2004; 6:Suppl 1D. S15–S21.

30. Hofman M, Ryan JL, Figueroa-Moseley CD, Jean-Pierre P, Morrow GR. Cancer-related fatigue: The scale of the problem. Oncologist. 2007; 12:Suppl 1. 4–10. DOI: 10.1634/theoncologist.12-S1-4.