Psychosocial distress and its effects on the health-related quality of life of primary brain tumor patients.

Abstract

9553 Background: Primary brain tumor patients experience a high level of psychosocial distress, not only due to their diminished functional and neurocognitive capacities, but also due to the psychosocial stigma of being a primary brain cancer patient. The purpose of this study is to evaluate the level of psychosocial distress, the different sources of this stress, and its effect on health-related quality of life (HRQoL) in primary brain tumor patients. Methods: Demographic and clinical information in the PRoGREss registry at Duke’s Preston Robert Tisch Brain Tumor Center was queried retrospectively for December 2013 through February 2014. Data was also obtained from patient-reported outcome questionnaires including the National Comprehensive Cancer Network’s Distress Thermometer (NCCN-DT), the Functional Assessment of Cancer Therapy-Brain Cancer (FACT-Br), and the Functional Assessment of Chronic Illness Therapy- Fatigue (FACIT-F). Results: Among the 845 subjects completing the NCCN-DT, 385 (46%) were female and 460 (54%) were male. 98% reported physical problems with the most frequent being memory/concentration (40%) and fatigue (42%), and 41% complained of an emotional problem with nervousness (22%) and worry (29%) being the most reported concerns. 12% reported insurance/financial concerns. 94% of the subjects completed the distress thermometer with a mean score of 2.68 (SD = 2.70). There was no difference in distress between tumor grades (low grade: mean = 2.73, SD = 2.89; high grade: mean = 2.67, SD = 2.62; p = 0.8297). Females (mean = 3.05, SD = 2.81) experienced significantly more distress than males (mean = 2.39, SD = 2.57; p = 0.0007), as well as a higher rate of practical (p = 0.0026), family (p = 0.0209) and emotional (p < 0.0001) problems. Patients who reported at least one practical, family, or emotional problem had significantly lower HRQoL scores (p < 0.0001). Conclusions: Primary brain tumor patients experience memory dysfunction, fatigue, nervousness, worry, and financial concerns which have a negative effect on the patient’s HRQoL. By identifying and addressing these stressors during a clinic visit, it may be possible to improve patient HRQoL.