Depression and Anxiety as Predictors of Perceived Quality of Life in Breast Cancer Survivors
Keywords:
Quality of life, depression, anxiety, breast cancer survivorsAbstract
Objective:
To investigate the impact of depression and anxiety levels on perceived quality of life (QoL) in breast cancer survivors (BCS) after one year of successful recovery from chemotherapy.
Materials & Methods:
A cross-sectional research design was followed to study breast cancer survivors (N= 52) on follow-ups from government hospitals of Lahore over a period of two months. The purposive sampling strategy was used. The study also examined the demographic correlates of depression and anxiety among breast cancer survivors. Quality of life (QoL) was measured by using Quality of Life Index-Cancer Version III. Depression and anxiety were measured by using Hospital Anxiety and Depression Scale.
Results:
A significant negative correlation among depression and overall QoL (r= -.40**), health and functioning wellbeing (r= -.42**), psychological and spiritual wellbeing (r= -.32*), as well as negative association of anxiety with overall QoL (r= -.29*), and health and functioning wellbeing (r= -.35*), indicated that increased levels of anxiety and depression reduced patients QoL. The multiple regression analysis found depression and anxiety as significant predictors of overall QoL, health and functioning wellbeing and spiritual and psychological wellbeing.
Conclusion:
Anxiety and depression appear to have a significant negative impact on the overall quality of life and psychological well being of breast cancer survivors. Regular follow-ups need to focus on psychological issues that are critical in influencing both physical health and psychological well-being.
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References
Straub R. Health psychology. USA: Worth Publisher; 2002.
American Cancer Society. What is breast cancer: Breast cancer detailed guide. 2013 (cited 2014 Jan 1). Available from: http://www.cancer.org/cancer/breastcancer/detailedguide/breast-cancer-what-is-breast-cancer.
Stephan P. When can I say I am a breast cancer survivor? About.com. 2014 (cited 2014 Jan 10). Available from:
http://breastcancer.about.com/od/whatisbreastcancer /f/breast-cancer-survivor-defin.htm.
Aziz Z, Sana S, Akram M, Saeed A. Socioeconomic status and breast cancer survival in Pakistani women. J Pak Med Assoc 2004; 54:448-53.
Bodurka-Bevers D, Basen-Endquist K, & Carmack CL. Depression, anxiety and quality of life in patients with epithelial ovarian cancer. Gynaecol Oncol 2000; 78:302-8.
Lynch ME. The assessment and prevalence of affective disorders in advanced cancer. J Palliat Care 1995; 11:10-8.
Razavi D, & Steifel F. Common psychiatric disorders in cancer patients: 1. Adjustment disorders and depressive disorders. Support Care Cancer 1994; 2:223-32.
Ferrans CF. Development of a quality of life index for patients with cancer. Oncol Nurs Forum 1990; 17:15-9.
Ganz P, Desmond K, Leedham B, Rowland J, Meyerzowitz B, Belin T. Quality of Life in long-term, disease-free
survivors of breast cancer: a follow-up study. J Natl Cancer Inst 2002; 94:39-49.
Hong-li C, Xiao-chun W, Jiang-bin W, Jing-bo Z, Yao W. Quality of life in patients with breast cancer and their rehabilitation needs. Pak J Med Sci 2014; 30:126-30.
Polikandrioti M, Evaggelou E, Zerva S, Zerdila M, Koukoularis D, Kyritsi E. Evaluation of depression in patients undergoing hemotherapy. HSJ 2008; 2:162-72.
Marsh G, Ling WM, Leung FY, Lo JC, Yeung M, Li GK. Anxiety, depression and quality of life among Chinese breast cancer patients during adjuvant therapy. Eur J Oncol Nurs 2010; 14:17-22.
Malik A, Kiran T. Psychological problems in breast cancer patients. Chemotherapy 2013; 2:1-6.
Zigmond AS. Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand Suppl 1983; 67:361-70.
Ferrans CF, Powers CE. Ferrans and Powers Quality of Life Index: published QLI research. Chicago: University of Illinois. 2008 (cited 2014 Feb 15). Available from http://www. uic.edu/orgs /qli/ publications/publicationshome.htm.
Sammarco A. Quality of life among older survivors of breast cancer. Cancer Nurs 2003; 26:431-8.
Rabin EG, Heldt E, Hirakata VN, Bittelbrunn AC, Chachamovich E, Fleck MP. Depression and perceptions of quality of life of breast cancer survivors and their male partners. Oncol Nurs Forum 2009; 36: 153-8.
Ho, SS, So, WK, Leung DY, Lai ET, Cahn CW. Anxiety, depression and quality of life in Chinese women with breast cancer during and after treatment: A comparative evaluation. Eur J Oncol Nurs 2013; 17: 877-82.
Soo HK, Son BH, Hwang SY, Han W, Yang JY, Lee S, Yun Y. Fatigue and depression in disease free breast cancer survivors; prevalence, correlates and associations with quality of life. J Pain Symptom Manage 2008; 35: 644-55.
Humpel N, Iverson DC. Depression and quality of life in cancer survivors: is there a relationship with physical activity? Int J Behav Nutr Phys Act 2007; 4:1-10.
Craft KL, Vanlterson EH, & Helenowski IB. Exercise effect on depressive symptoms in cancer survivors; a systematic review and meta analysis. Cancer Epidemiol Biomarkers Prev 2011; 21:3-19.
Huang CU, Hsu MC. Social support as a moderator between depressive symptoms and quality of life outcomes of breast cancer survivors. Eur J Oncol Nurs. 2013; 17:767-74.
Schlegel R, Manning M, Molix L. Predictors of depressive symptoms among breast cancer patients during the first year post diagnosis. Psychol Health. 2012; 27:277-93.
Nauert R. Women at risk for depression after breast cancer treatment. Psych Central. 2011 (cited 2014 Feb 20). Available from: http://psychcentral.com/ news /2011/11/03/ women-at-risk-for-depression-after-breast- cancer-treatment/31040.html.
Mehnert A, Koch U. Psychological comorbidity and health-related quality of life and its association with awareness, utilization, and need for psychosocial support in a cancer register-based sample of long-term breast cancer survivors. J Psychosom Res 2008; 64:383-91.
Castillo NG, Garcia AA, Villanueva IC, Lao CF, Rodriguez LD, Morales MA. Depressed mood in breast cancer survivors; association with physical activity, cancer related fatigue, quality of life, and fitness level. Eur J Oncol Nurs 2013; 18:1-5.
Dow KH, Ferrell BH, Leigh S, Ly J, Gulasekaram P. An evaluation of quality of life among long term survivors of breast cancer. Breast Cancer Res Treat 1996; 39:261-73.
Hutter N, Vogel B, Alexander T, Baumeister H, Helmes A, Bengel J. Are depression and anxiety determinants or indicators of quality of life in breast cancer patients?. Psychol Health Med 2012; 18:412-9.
Wilson IB, Cleary PD. Linking clinical variables with health related quality of life. A conceptual model of patients outcome. JAMA 1995; 273:59-65.
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