Examination of the stress level perceived by gynecological oncology patient's and their caregivers, the social support perceived by the patients and the caregiving stress level of the patients' caregivers: A cross-sectional study

Abstract

Objective: Gynecologic oncology patients and their caregivers often experience high levels of stress during the treatment process. This cross-sectional study aimed to measure the perceived stress levels of patients and caregivers and identify factors related to perceived social support. Materials and Methods: A survey was conducted with 100 gynecologic oncology patients and 62 caregivers at Baskent University Ankara Hospital. The survey included the Turkish translated versions of the Perceived Stress Scale (PSS), the Multidimensional Scale of Perceived Social Support (MSPSS), and the Caregiver Strain Index (CSI), along with a sociodemographic form. Results: The majority of patients had their spouses or daughters as their caregivers (63%). The study found a strong correlation between stress levels and the perceived social support scores of caregivers (r=0.747; p<0.001), indicating that caregivers experience higher levels of stress. Female caregivers reported higher stress and caregiver strain than male caregivers (p=0.021, p=0.009, respectively). Married patients reported less stress and discomfort than unmarried patients (p=0.005). The family sub-scale scores of the MPSSS were higher in married women (p=0.027) indicating greater perceived support from family. The total PSS scores were found to differ by the number of children (p=0.043) with the greatest difference between patients who had no children and those who had three (p=0.032). Conclusion: The results of the study emphasize the need for a multidisciplinary approach in the care of gynecologic oncology patients. It is crucial for future research to concentrate on devising effective interventions that can reduce stress and improve the quality of life of both patients and their caregivers.

Keywords

• Caregiver
• Gynecological Neoplasm
• Patient Care
• Psychosocial Support System
• Women Health Services

Supporting Institution

Baskent University

Project Number

KA22/291

Ethical Statement

The study was approved by the Baskent University Institutional Review Board and Ethics Committee (Project no: KA22/291, July 5, 2022) and supported by Baskent University Research Fund.

Jinekolojik onkoloji hastası ve yakınlarının algıladıkları stres düzeyinin, hastaların algıladıkları sosyal desteğin ve hasta yakınlarının bakım verme stres düzeylerinin incelenmesi

Abstract

Amaç: Jinekolojik onkoloji hastaları ve bakım verenleri tedavi sürecinde sıklıkla yüksek düzeyde stres yaşarlar. Tarafların stres düzeylerinin, hastaların destek algılarının belirlenmesi amaçlanmıştır. Gereç ve Yöntem: Başkent Üniversitesi Ankara Hastanesi’nde 100 jinekolojik onkoloji hastası ve onlara bakım veren 62 yakını görüşüldü. Görüşmede verilerini toplamada Algılanan Stres Ölçeği (ASÖ), Çok Boyutlu Algılanan Sosyal Destek Ölçeği (ÇBASDÖ) ve Bakım Verenin Stres İndeksi (BVSİ) ve sosyodemografik form kullanıldı. Bulgular: Bakım verenlerin çoğunluğu hastanın eşi veya kızıydı (%63). Bakım verenlerin stres düzeyleri ile algılanan sosyal destek puanları arasında güçlü bir ilişki bulundu (r=0,747; p<0,001). Bu durum bakım verenlerin daha yüksek düzeyde stres yaşadıklarını göstermektedir. Kadın bakım verenler, erkek bakım verenlere göre daha fazla stres ve zorlanma bildirdiler (sırasıyla p=0,021, p=0,009). Evli hastalar, evli olmayan hastalara göre daha az stres ve rahatsızlık bildirdi (p=0,005). ÇBASDÖ’nin aile alt boyutu puanları evli kadınlarda daha yüksekti (p=0,027), bu da aileden algılanan desteğin daha fazla olduğunu gösteriyordu. Toplam ASÖ puanlarının çocuk sayısına göre farklılık gösterdiği (p=0,043), en fazla farkın çocuğu olmayan ve üç çocuğu olan hastalar arasında olduğu (p=0,032) belirlendi. Sonuç: Çalışmanın sonuçları jinekolojik onkoloji hastalarının bakımında multidisipliner bir yaklaşımın gerekliliğini vurgulamaktadır. Gelecekteki hasta hizmetleri için, hem hastaların hem de bakım verenlerin stresini azaltabilecek ve yaşam kalitesini iyileştirebilecek etkili önlemlere ihtiyaç vardır.

Keywords

• Bakıcı
• Hasta Bakımı
• Jinekolojik Neoplazm
• Kadın Sağlığı Hizmetleri
• Psikososyal Destek Sistemi

Supporting Institution

Başkent Üniversitesi

Project Number

KA22/291

Ethical Statement

Bu çalışma Başkent Üniversitesi Tıp ve Sağlık Bilimleri Araştırma Kurulu ve Etik Kurulu tarafından onaylanmış (Proje no:KA22/291, 5 Temmuz, 2022) ve Başkent Üniversitesi Araştırma Fonunca desteklenmiştir.

References

1. Management of Symptomatic Uterine Leiomyomas: ACOG Practice Bulletin, Number 228. Obstet Gynecol, 2021. 137(6): 100-115.
2. Naz S ,Rehman A, Riyaz A, Jehangir F, Naeem S, Iqbal T. Leiomyoma: Its Variants And Secondary Changes A Five-Year Study. J Ayub Med Coll Abbottabad, 2019; 31(2): 192-195.
3. Sikora-Szczęśniak, D.L. Prevalence of cellular leiomyoma and partially cellular leiomyoma in postoperative samples - analysis of 384 cases. Ginekol Pol, 2016; 87(9): 609-616.
4. Wang C, Zheng X, Zhou Z, Shi Y, Wu Q, Lin K. Differentiating cellular leiomyoma from uterine sarcoma and atypical leiomyoma using multi-parametric MRI. Front Oncol, 2022; 12: 1005191.
5. Ip, P.P., K.Y. Tse, K.F. Tam. Uterine smooth muscle tumors other than the ordinary leiomyomas and leiomyosarcomas: a review of selected variants with emphasis on recent advances and unusual morphology that may cause concern for malignancy. Adv Anat Pathol, 2010;17(2): 91-112.
6. World Health Organization. WHO Classification of Tumours: Female Genital Tumours. 2020 (Accessed 2022 July 5); Available from: https://www.iarc.who.int/news-events/publication-of-the-who-classification-of-tumours-5th-edition-volume-4-female-genital-tumours.
7. Guan, R., W. Zheng, M. Xu. A retrospective analysis of the clinicopathologic characteristics of uterine cellular leiomyomas in China. Int J Gynaecol Obstet, 2012; 118(1): 52-55.
8. Kang M, Kang SK, Yu JH. et al., Benign metastasizing leiomyoma: metastasis to rib and vertebra. Ann Thorac Surg, 2011;91(3): 924-926.

9. Mulayim, N, F. Gucer. Borderline smooth muscle tumors of the uterus. Obstet Gynecol Clin North Am, 2006; 33(1):171-181.
10. Gebre-Medhin S, Nord KH, Möller E et al. Recurrent rearrangement of the PHF1 gene in ossifying fibromyxoid tumors. Am J Pathol, 2012; 181(3): 1069-1677.
11. Schoolmeester JK, Sukov WR, Maleszewski JJ, Bedroske PP, Folpe AL, Hodge JC. JAZF1 rearrangement in a mesenchymal tumor of nonendometrial stromal origin: report of an unusual ossifying sarcoma of the heart demonstrating JAZF1/PHF1 fusion. Am J Surg Pathol, 2013; 37(6): 938-942.
12. Dundr P, Gregová M, Hojný J et al. Uterine cellular leiomyomas are characterized by common HMGA2 aberrations, followed by chromosome 1p deletion and MED12 mutation: morphological, molecular, and immunohistochemical study of 52 cases. Virchows Arch, 2022; 480(2): 281-291.
13. Sharma P, Chaturvedi KU, Gupta R, Nigam S. Leiomyomatosis peritonealis disseminata with malignant change in a post-menopausal woman. Gynecol Oncol, 2004; 95(3):742-745.
14. Rothmund R, Kurth RR, Lukasinski NM et al. Clinical and pathological characteristics, pathological reevaluation and recurrence patterns of cellular leiomyomas: a retrospective study in 76 patients. Eur J Obstet Gynecol Reprod Biol, 2013;171(2): 358-361.
15. Barnaś E, Książek MÖ, Raś R, Skręt A, Skręt-Magierło J, Dmoch-Gajzlerska E. Benign metastasizing leiomyoma: A review of current literature in respect to the time and type of previous gynecological surgery. PLoS One, 2017;12(4): 0175875.
16. Wei, J.J. Leiomyoma with nuclear atypia: Rare diseases that present a common diagnostic problem. Semin Diagn Pathol, 2022; 39(3): 187-200.
17. Nava, H.J., Highly Cellular Leiomyoma Mixed With a Focus of Adenomyosis. Cureus, 2022; 14(8):28129.
18. Taran FA, Weaver AL, Gostout BS, Stewart EA. Understanding cellular leiomyomas: a case-control study. Am J Obstet Gynecol, 2010; 203(2):109.e1-6.