Objective
Emotional symptoms are frequently reported among patients with cancer. We evaluated the association between emotional symptoms and problem‐related distress in a sample of patients with cancer about to initiate chemotherapy within a private hospital in Brazil.
Methods
Patients were assessed before initiating chemotherapy, treatment mid‐point, and on the last day of treatment for anxiety and depression (Hospital Anxiety and Depression Scale [HADS]) and for problem‐related distress (Distress Thermometer Problem List). Problem‐related distress variable was computed as the sum of practical, physical, spiritual and familial problems. Mixed‐model analysis was applied to determine the association between HADS and problem‐related distress, adjusting for age and gender.
Results
A total of 655 consecutive patients were enrolled. There was a significant main effect of time (F = 8.99, p = 0.0001), showing that emotional symptoms improve over time. A significant main effect was observed for problem‐related distress (F = 371.56, p < 0.0001) revealing that patients with elevated problem‐related distress at baseline tend to have higher HADS across the three time points, compared to patients with lower problem‐related distress. There was an interaction effect between problem‐related distress and time (F = 85.22, p < 0.0001), suggesting that HADS scores decreased differently over time, depending on patients' initial level of problem‐related distress.
Conclusion
Overall, emotional symptoms, while decreasing over time, remained associated with problem‐related distress after chemotherapy in Brazil. The potential benefit of implementing a psychosocial intervention remains high throughout cancer treatment.