Symptom status, body perception, and risk of anxiety and depression in breast cancer patients receiving paclitaxel: a prospective longitudinal study.

Abstract

BackgroundPaclitaxel regimen which is widely used in clinical treatment causes many negative physical and psychological consequences on women with breast cancer (BC). This longitudinal study firstly aimed to investigate symptom status, body perception changes, and the risk of anxiety and depression in BC patients receiving during paclitaxel regimen.Materials and methodsThis descriptive and prospective study was conducted with 84 BC patients receiving paclitaxel regimen. “Chemotherapy Symptom Assessment Scale (C-SAS),” “Body Perception Scale (BPS),” and “Hospital Anxiety and Depression Scale (HADS)” were applied at five time points (T1, before the first Paclitaxel infusion; T2, at the end of first cycle; T3, at the end of fourth cycle; T4, at the end of eighth cycle; T5, at the end of twelfth cycle). Data was analyzed using descriptive statistics, Cochrane Q, and linear mix model regression analysis.ResultsThe frequency of needling and numbness in hands and feet, pain, and skin or nail changes significantly increased in the subsequent assessment points (T2, T3, T4, and T5) compared to the initial assessment (T1) (p < 0.05). The mean scores of BPS significantly decreased at T2, T4, and T5 compared to T1 (F = 8.152, p < 0.001). The mean scores of the anxiety subscale of the HADS scale decreased at the T3, T4, and T5 compared to T1 (F = 6.865, p < 0.001), and the mean scores of the depression subscale significantly increased at the T5 compared to T1 (F = 3.708, p = 0.006).ConclusionsThe oncology nurse should comprehensively evaluate the patients who scheduled to receive paclitaxel treatment, and provide counseling to the patients during these specific weeks. Better management of the symptoms that increase with the paclitaxel regimen with repeated interviews under the supervision of the nurse will also prevent the deterioration of body perception. In addition, since the risk of depression increases over time in patients receiving paclitaxel, nurses should periodically screen the risk of depression, and timely consult the patients for the appropriate support.