Stress, coping and quality of life in patients with cancer

Abstract

Cancer is a demon which threatens the life of many both by its presence and likelihood of arrival in the present day world marked by stressful living. The main objectives of the proposed research were, to explore the level of stress, coping strategies, and quality of life of patients with cancer and to find out the relationship between the stress, coping strategies, quality of life, ECOGPS and the age of the patients with cancer pre- and post-medical intervention (Part A); to develop psychological intervention package based on Part A results; and to test the effectiveness of the developed package on a new sample of patients with cancer by measuring the same variables as in Part A, pre- and post-medical and psychological intervention (Part C). The study is a quasi-experimental design conducted in three parts. During the Part A, 105 patients and in Part C 30 patients with cancer between the ages of 28 - 65 years were included in the study with equal distribution of subjects from three types of cancer viz. lung, breast and head-neck-cancer in both Part A and Part C. The tools used were Questionnaire on Stress in Cancer Patients- Revised Version (QSC-R23) to measure stress level, Brief COPE for coping, European Organization for the Treatment and Research of Cancer Quality of Life Questionnaire-QLQ-C30, version 3.0 to assess the quality of life, during pre- and post- Medical Intervention Assessment (pre- and post-MIA) in Part A. A psychological intervention package was developed during Part B with psychoeducation, relaxation, and Cognitive Behaviour Therapy modules which were applied along with medical intervention in Part C. The impact of psychoeducation was measured using Cancer Information Scale, impact of relaxation by using Visual Analogue Scale and impact of cognitive behaviour therapy was measured by using Triple Column Technique pre- and post-MPIA inCancer is a demon which threatens the life of many both by its presence and likelihood of arrival in the present day world marked by stressful living. The main objectives of the proposed research were, to explore the level of stress, coping strategies, and quality of life of patients with cancer and to find out the relationship between the stress, coping strategies, quality of life, ECOGPS and the age of the patients with cancer pre- and post-medical intervention (Part A); to develop psychological intervention package based on Part A results; and to test the effectiveness of the developed package on a new sample of patients with cancer by measuring the same variables as in Part A, pre- and post-medical and psychological intervention (Part C). The study is a quasi-experimental design conducted in three parts. During the Part A, 105 patients and in Part C 30 patients with cancer between the ages of 28 - 65 years were included in the study with equal distribution of subjects from three types of cancer viz. lung, breast and head-neck-cancer in both Part A and Part C. The tools used were Questionnaire on Stress in Cancer Patients- Revised Version (QSC-R23) to measure stress level, Brief COPE for coping, European Organization for the Treatment and Research of Cancer Quality of Life Questionnaire-QLQ-C30, version 3.0 to assess the quality of life, during pre- and post- Medical Intervention Assessment (pre- and post-MIA) in Part A. A psychological intervention package was developed during Part B with psychoeducation, relaxation, and Cognitive Behaviour Therapy modules which were applied along with medical intervention in Part C. The impact of psychoeducation was measured using Cancer Information Scale, impact of relaxation by using Visual Analogue Scale and impact of cognitive behaviour therapy was measured by using Triple Column Technique pre- and post-MPIA inPart C. Again the tools to measure stress, coping and quality of life were used pre- and post- Medical and Psychological Intervention Assessment (pre- and post- MPIA). Statistical procedures used were descriptive statistics, paired and independent t test, Pearson r, Wilcoxon signed rank test (to measure the effect of relaxation) and ANCOVA (to find out whether treatment response of the patients varies according to the variation in intervention) with help of SPSS 16.0. The results indicated that the impact of medical and psychological intervention was clearly found on following parameters. There were differences in levels of stress, coping strategies and General Health Status/Quality of life (GHS/QoL) in functional and symptom scales during Part C i.e. pre- and post-medical and psychological intervention assessment. Whereas, no differences were found in GHS/QoL during Part A i.e. pre- and post-medical intervention assessment. Findings of part C indicated a change in myths and misconceptions, minimal changes in negative automatic thoughts and it was seen that the impact of relaxation was felt by the patients. These significantly seemed to have helped to significantly show the difference viz. reduce stress, fostering coping strategies and enhancing their quality of life when used alongside medical intervention. The psychological intervention when combined with medical intervention showed better results. This signifies the effectiveness of psychological intervention for the patients with LC, BC and HNC. Findings of the present study indicated that there is a wide scope/ importance of psychological intervention alongside medical intervention in the field of psychooncology. Limitations of the study and implications are also discussed