[Symptom Distress, Depression, and Quality of Life in Colorectal Cancer Patients at Different Disease Stages].

BACKGROUND: Quality of life is increasingly used as a primary outcome measure in studies that are designed to evaluate the effectiveness of treatment in cancer survivors.

PURPOSE: Analyze the symptom distress, depression, and quality of life in colorectal cancer patients and explore the relationship of related variables with changes in QoL (quality of life) during and after treatment.

METHODS: A cross-sectional study design was used for the present study. Patients (N = 138) with colorectal cancer were recruited from a district hospital in southern Taiwan. Data were collected using a self-report questionnaire. Questionnaire scales included the M.D. Anderson Symptom Inventory-Taiwan Form, the Center for Epidemiologic Studies Depression Scale, and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 Version 3 in Chinese as well as a demographic and disease-related variables datasheet. Descriptive data were presented using percentage, mean, and standard deviation. Chi-square test, independent t-test, one-way ANOVA, and hierarchical multiple regression were used for inferential statistics.

RESULTS: The post-treatment group showed a significantly higher average global health QOL score (68.68 vs. 59.54; p < .05). Hierarchical regression showed that the impact factor of quality of life has a depressive effect in many dimensions. The second most significant variable was symptom distress. Symptoms interfered with life activity functions and family income and impacted negatively on patient treatment. In survivorship, depressive tendencies was the variable that was most affected, followed by recurrence, symptoms interference, and surgical treatment, respectively. When controlling for the relevant variables, these predictors accounted for 38.5% and 40.9% of the total variance of global health quality of life.

CONCLUSIONS / IMPLICATIONS FOR PRACTICE: This study demonstrates that personal characteristics variables, depressive tendencies, and symptom distress all impact on the quality of life of colorectal cancer patients in terms of receiving treatment and survivorship. These findings imply that healthcare professionals must provide appropriate emotional support in order to decrease depression tendency at different stages. Thus, these patients should receive nursing interventions that effectively decrease depression and symptom distress and enhance quality of life at different disease stages.