Health and personal resources in older patients with cancer undergoing chemotherapy

Abstract

Objectives The purpose of this study was to gather preliminary data on both direct and moderating effects of health status, the social environment, and perceived personal control on the older cancer patient’s symptom distress and QOL during a treatment regimen of chemotherapy. Materials and Methods Participants were cancer patients aged ≥ 65 years being treated with a variety of chemotherapy regimens specific to their particular diagnosis. Using a longitudinal study design, we measured patients at baseline prior to beginning chemotherapy, midpoint in the regimen, and upon discharge (approximately 2 weeks after chemotherapy completion). Outcomes of interest were symptom distress and QOL. Multivariate linear regression was used to determine the association between the predictors and outcomes, controlling for demographic and clinical characteristics. Results Our final sample consisted of 94 cancer patients (35 male; 59 female; mean age 73.5 years). In the health status domain, lower body strength was inversely associated with symptom distress (p=0.025) and positively associated with QOL (p=0.015). In the social environment domain, social support was inversely associated with fatigue (p=0.001) and depression (p<0.001), and positively associated with QOL (p=0.016 and p=0.029 at midpoint and endpoint, respectively). Personal control variables, mastery and self-efficacy, were significantly associated with multiple outcomes of interest. Discussion Mastery was the best predictor of symptom distress and QOL. Self-efficacy, social support, and lower body functioning are important predictors of these outcomes among older cancer patients undergoing chemotherapy.

Childhood maltreatment, psychological resources, and depressive symptoms in women with breast cancer

“…For each item, participants indicated their level of agreement with a given statement according to a four-point Likert-type scale where response options ranged from “Strongly Agree” to “Strongly Disagree.” Example items include, “I have little control over the things that happen to me” and “I often feel helpless in dealing with the problems of life.” Higher scores indicate higher mastery. This scale is widely used in health research with cancer patients (e.g., Buffart et al, 2014; Robb, Lee, Jacobsen, Dobbin, & Extermann, 2013) and demonstrated high internal reliability within this sample, α = .88.…”

Association between cognitive impairment and guideline adherence for application of chemotherapy in older patients with breast cancer: Results from the prospective multicenter BRENDA II study

“…As almost one third of older patients with breast cancer are concerned by cognitive impairment, it is essential to evaluate cognitive impairment prior to the tumor board . Especially beyond the background that older patients or patients with cognitive impairment have a greater risk of certain complications from chemotherapy resulting in serious side effects and in a lower tolerance of the toxicity of the chemotherapy treatment compared to younger patients . Previous studies showed that older patients with breast cancer have a higher dropout rate from chemotherapy due to toxicity compared to younger patients .…”

The influence of demographics, psychological factors and self-efficacy on symptom distress in colorectal cancer patients undergoing post-surgical adjuvant chemotherapy

“…Helping people with chronic illnesses to change their health-related behavior is important to encourage patients' self-management and to achieve the best possible results of treatment. In cancer treatment, this approach has been particularly effective in disease prevention, early detection, and helping patients adjust to having cancer and receiving treatment (Mystakidou et al, 2010;Robb et al, 2013). Cancer patients who have difficulty maintaining a sense of control report more psychological disorders than do patients who have a greater feeling of control (Kohno et al, 2010).…”