Physical and Psychological Predictors of Quality of Life in Chinese Colorectal Cancer Patients During Chemotherapy.

Abstract

Maintaining quality of life (QOL) during chemotherapy is a critical aspect of cancer treatment. Instruments have been developed to assess symptom distress, self-efficacy, anxiety, depression, and other factors impacting QOL during cancer treatment, but Chinese versions have become available only recently. The aim of this study was to identify factors predictive of QOL during chemotherapy in Chinese colorectal cancer (CRC) patients. Patients completed Chinese versions of the Hospital Anxiety and Depression Scale, MD Anderson Symptom Inventory (a measure of symptom distress), Stanford Inventory of Cancer Patient Adjustment (a measure of self-efficacy), and Functional Assessment of Cancer Treatment-General (a measure of QOL) before and after 3 and 6 months of chemotherapy. Of 152 consecutive CRC patients (men/women, 98/54; mean age, 53.3 ± 11.3 years, 25-75 years; stage II/III, 59/93), 121 completed all questionnaires (79.6%). Self-efficacy dimensions "communication," "activity management," "personal management," and "affective management" improved progressively over 6 months (all P < .05). Fatigue, nausea, lack of appetite, disturbed sleep, and vomiting peaked at 3 months and declined thereafter (P < .05). Patients who are younger than 60 years, are male, and with stage II CRC exhibited higher 3- and 6-month QOL scores (all P < .05). Multiple regression identified self-efficacy, anxiety, and symptom distress as independent predictors of QOL at 6 months. Enhanced self-efficacy, reduced symptom distress, and lower general anxiety would improve QOL during chemotherapy for CRC patients.These instruments can help identify CRC patients at risk of low QOL for additional psychotherapy or specific treatment modifications.