Kanser Hastalarında Radyoterapiye Bağlı Anksiyete ve Depresyonun Yaşam Kalitesine Etkisi

Abstract

Giriş ve Amaç: Bu çalışmanın amacı, kanser hastalarının radyoterapi öncesi ve sonrası anksiyete ve depresyon düzeylerinin ve yaşam kalitelerinin incelenmesidir. Gereç ve Yöntemler: Bu çalışma prospektif tanımlayıcı bir çalışmadır. Radyoterapi öncesi ve sonrası veri toplamak için Hasta Bilgi Formu, Hastane Anksiyete Depresyon Ölçeği (HADS) ve Yaşam Kalitesi Ölçeği (EORTC QLQ–C30) kullanıldı. Veriler ki-kare testi, t-testi ve çok değişkenli regresyon analizi ile analiz edildi. Bulgular: Radyoterapi öncesi ve sonrası yaşam kalitesi ölçeğinin alt ölçek puan ortalamaları arasında istatistiksel olarak anlamlı fark belirlendi. Radyoterapi öncesi anksiyete ve depresyonun emosyonel fonksiyon alt ölçeğini %52, radyoterapi sonrası anksiyeteyi ise %67 oranında etkilediği belirlendi. Sonuç: Bu çalışmanın bulguları, radyoterapi alan kanser hastalarında yaş, kemoterapi, metastaz varlığı, anksiyete ve depresyonun yaşam kalitesi üzerindeki anlamlı etkisini vurgulamaktadır. Onkoloji hemşirelerinin radyoterapi alan kanser hastalarında anksiyete ve depresyonu değerlendirmeleri ve eğitim vermeleri önerilir.

Keywords

• Radyoterapi
• anksiyete
• depresyon
• yaşam kalitesi

The Effect of Radiotherapy-Related Anxiety and Depression on Quality of Life in Cancer Patients

Abstract

Objective: This study aimed to investigate anxiety and depression levels and quality of life in cancer patients before and after radiotherapy. Materials and Methods: This study is a prospective descriptive study. Data were collected via patient information form, Hospital Anxiety Depression Scale (HADS) and European Organization for Research and Treatment (EORTC QLQ-C30) before and after radiotherapy. Data were analyzed by chi-squared test, t-test, and multivariate regression analysis. Results: There was a statistically significant difference between the mean scores for the subdimensions of the QOL scale before and after radiotherapy. Anxiety and depression before radiotherapy were found to affect the emotional function subdimension by 52% and anxiety after radiotherapy by 67%. Conclusion: The findings of this study emphasise the significant effect of age, chemotherapy, presence of metastasis, anxiety and depression on quality of life in cancer patients receiving radiotherapy. We recommend that oncology nurses should evaluate anxiety and depression and provide training in cancer patients receiving radiotherapy

Keywords

• Radiotherapy
• anxiety
• depression
• quality of life
• Radyoterapi

Thanks

The authors thank Professor Mehmet Ziya Fırat for his help with the statistics.

References

1. Nikoloudi, M, Lymvaios, I, Zygogianni, A, Parpa, E, Strikou, D.A, Tsilika, E, et al., Quality of life, anxiety, and depression in the head-and-neck cancer patients, undergoing intensity-modulated radiotherapy treatment, Indian Journal of Palliative Care, 2020,26(1),54.
2. Holtzman, A.L, Pereira, D.B, Yeung, A.R, Implementation of depression and anxiety screening in patients undergoing radiotherapy, BMJ Open Quality, 2018,7(2), e000034.
3. Firouzbakht, M, Hajian-Tilaki, K, Moslemi, D, Analysis of quality of life in breast cancer survivors using structural equation modelling: the role of spirituality, social support and psychological well-being, International Health, 2020,12(4), 354-363.
4. Subramaniam, S, Kong, Y.C, Chinna, K, Kimman, M, Ho, Y.Z, Saat, N., et al., Health‐related quality of life and psychological distress among cancer survivors in a middle‐income country, Psycho‐oncology, 2018,27(9),2172-2179.
5. Williams, P.A, Cao, S, Yang, D, Jennelle, R.L, Patient-reported outcomes of the relative severity of side effects from cancer radiotherapy, Supportive Care Cancer, 2020,28(1),309-316.
6. Yan, X, Chen, X, Li, M, Zhang, P, Prevalence and risk factors of anxiety and depression in Chinese patients with lung cancer： a cross-sectional study, Cancer Management and Research, 2019,11,4347.
7. Miller, J., & Scherbak, C, Radiation Therapy: Understanding the patient experience, Clinical Journal of Oncology Nursing, 2021, 25(6).
8. Kousoulou, M., Suhonen, R., & Charalambous, A, Associations of individualized nursing care and quality oncology nursing care in patients diagnosed with cancer, European Journal of Oncology Nursing, 2019, 41, 33-40.

9. Zeppegno, P, Krengli, M, Ferrante, D, Bagnati, M, Burgio, V., Farruggio, S, et al., Psychotherapy with music intervention improves anxiety, depression and the redox status in breast cancer patients undergoing radiotherapy: a randomized controlled clinical trial, Cancers, 2021,13(8),1752.
10. Rutkowski, J, Szymanik, M, Blok, M, Kozaka, J., Zaucha, R, Prospective evaluation of anxiety, depression and quality of life in medically inoperable early stage non-small cell lung cancer patients treated with stereotactic ablative radiotherapy, Reports of Practical Oncology and Radiotherapy, 2017,22(3),217-222.
11. Annunziata, M.A, Muzzatti, B, Bidoli, E, Flaiban, C, Bomben, F, Piccinin, M, et al., Hospital Anxiety and Depression Scale (HADS) accuracy in cancer patients, Supportive Care Cancer, 2020, 28(8), 3921-3926.
12. Şirin, T, Göksel, F, Investigation of the spiritual care effects on anxiety, depression, psychological distress and spiritual levels of Turkish Muslim radiotherapy patients, Journal of Religion and Health, 2021,60(4),2484-2502.
13. Fernandes, D.T, Prado-Ribeiro, A.C, Markman, R.L, Morais, K, Moutinho, K, Tonaki, J.O, et al., The impact of an educational video about radiotherapy and its toxicities in head and neck cancer patients. Evaluation of patients’ understanding, anxiety, depression, and quality of life, Oral Oncology, 2020, 106,104712.
14. Oh, P. J., & Cho, J. R, Changes in fatigue, psychological distress, and quality of life after chemotherapy in women with breast cancer: a prospective study, Cancer Nursing, 2020, 43(1), 54-60.
15. Li, J., & Liu, X, Incremental patient care program decreases anxiety, reduces depression and improves the quality of life in patients with colorectal cancer receiving adjuvant chemotherapy, Experimental and Therapeutic Medicine, 2019,18(4), 2789-2798.
16. Cohen, J, Statistical power analysis, Current Directions in Psychological Sciences, 1992,1,98-101.
17. Hauth, F, De-Colle, C, Weidner, N, Heinrich, V, Zips, D, Gani, C, Quality of life and fatigue before and after radiotherapy in breast cancer patients, Strahlentherapie und Onkologie, 2021,197(4),281-287.
18. De Ruysscher, D, Niedermann, G, Burnet, N.G, Siva, S, Lee, A.W.M, Hegi-Johnson, F.H, Radiotherapy toxicity, Nature Reviews Disease Primers, 2019,5(1),1-20.
19. Jitender, S, Mahajan, R, Rathore, V, Choudhary, R, Quality of life of cancer patients, Journal of Experimental Therapeutics & Oncology, 2017,12(3).
20. Zigmond, A.S, Snaith, R.P, The hospital anxiety and depression scale, Acta Psychiatrica Scandinavica, 1983, 67(6),361-370.
21. Akel, R, El Darsa, H, Anouti, B, Mukherji, D, Temraz, S, Raslan, R, et al, Anxiety, depression and quality of life in breast cancer patients in the levant, Asian Pacific Journal of Cancer Prevention, 2017,18(10),2809.
22. Aydemir, Ö, Guvenir, T, Kuey, L, Kültür, S, Validity and reliability of Turkish version of hospital anxiety and depression scale, Türk Psikiyatri Dergisi, 1997,8(4),280-7.
23. Aaronson, N.K, Ahmedzai, S, Bergman, B, Bullinger, M, Cull, A, Duez, N.J, et al., The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of life instrument for use in international clinical trials in oncology, Journal of the National Cancer Institute, 1993,85(5),365-376.
24. Guzelant, A, Goksel, T, Ozkok, S, Tasbakan, S, Aysan, T, Bottomley, A, The European Organization for Research and Treatment of Cancer QLQ‐C30: an examination into the cultural validity and reliability of the Turkish version of the EORTC QLQ‐C30, European Journal of Cancer Care, 2004,13(2),135-144.
25. Olausson, K, Sharp, L, Fransson, P, Nyholm, T, Zackrisson, B, Östlund, U, What matters to you? Free-text comments in a questionnaire from patients undergoing radiotherapy, Technical Innovations & Patient Support in Radiation Oncology, 2020,13,11-16.
26. Mohan, G, TP AH, AJ, J, K.M, S.D, Narayanasamy, A, Vellingiri, B, Recent advances in radiotherapy and its associated side effects in cancer—a review, The Journal of Basic and Applied Zoology, 2019,80(1),1-10.
27. Chow, S, Wan, B.A, Pidduck, W, Zhang, L, Deangelis, D, Chan, S, et al., Symptom clusters in patients with breast cancer receiving radiation therapy, European Journal of Oncology Nursing, 2019,42,14-20.
28. O’steen, L, Lockney, N.A, Morris, C.G, Mallard, V.J, Pereira, D, Amdur, R.J, A prospective randomized trial of the influence of music on anxiety in patients starting radiation therapy for cancer, International Journal of Radiation Oncology, Biology, Physics, 2021,109(3),670-674.
29. Arscott, W. T, Emmett, J, Ghiam, A. F, Jones, J. A, Palliative radiotherapy: Inpatients, outpatients, and the changing role of supportive care in radiation oncology, Hematology/Oncology Clinics, 2020, 34(1), 253-277. Murray, S.A, Cavers, D, Carduff, E, Moine, S, Palliative radiotherapy and holistic palliative care together, BMJ, 2018,821,29572337.
30. Schofield, P., Gough, K., Lotfi-Jam, K., Bergin, R., Ugalde, A., Dudgeon, P., et al., Nurse-led group consultation intervention reduces depressive symptoms in men with localised prostate cancer: a cluster randomised controlled trial. BMC Cancer, 2016, 16(1), 1-12.
31. Sung, H, Ferlay, J, Siegel, R.L, Laversanne, M, Soerjomataram, I, Jemal, A, Bray, F, Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries, CA: A Cancer Journal for Clinicians, 2021,71(3),209-249.
32. Shapiro, C.L, Cancer Survivorship, New England Journal of Medicine, 2018,379,25.
33. West, K, Schneider, M, Wright, C, Beldham‐Collins, R, Coburn, N, Tiver, K, Gebski, V, Stuart, K.E, Radiation‐induced oesophagitis in breast cancer: Factors influencing onset and severity for patients receiving supraclavicular nodal irradiation. Journal of Medical Imaging and Radiation Oncology, 2020,64(1),113-119.
34. Ge, X, Liao, Z, Yuan J, Mao, D, Li, Y, Yu, E, Wang, X, Ding, Z. Radiotherapy-related quality of life in patients with head and neck cancers: a meta-analysis, Supportive Care in Cancer, 2020,28(6), 2701-2712.
35. Bektas, D.K, Demir, S, Anxiety, depression levels and quality of life in patients with gastrointestinal cancer in Turkey, Asian Pacific Journal of Cancer Prevention, 2016,17(2),723-731.