Chemotherapy-induced Peripheral Neuropathy and Depression in Cancer Patients

Kyung Yeon Kim; Seung Hee Lee; Pok Ja Oh

doi:10.5388/aon.2015.15.3.149

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Kim, Lee, and Oh: Chemotherapy-induced Peripheral Neuropathy and Depression in Cancer Patients

Original Article

Asian Oncology Nursing 2015; 15(3): 149-155.

Published online: 30 September 2015

DOI: https://doi.org/10.5388/aon.2015.15.3.149

Chemotherapy-induced Peripheral Neuropathy and Depression in Cancer Patients

Kyung Yeon Kim¹, Seung Hee Lee¹, Pok Ja Oh²

¹Korea Institude of Radiological & Medical Science, Seoul, Korea.

²Department of Nursing, Sahmyook University, Seoul, Korea.

Address reprint requests to: Oh, Pok-Ja. Department of Nursing, Sahmyook University, 815 Hwarang-ro, Nowon-gu, Seoul 01795, Korea. Tel: +82-2-3399-1589, Fax: +82-2-3399-1594, ohpj@syu.ac.kr

Received 6 March 2015 Revised 8 August 2015 Accepted 21 September 2015

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of this study was to assess chemotherapy induced peripheral neuropathy (CIPN) and to examine the relationship between CIPN and depression.

Methods

A purposive sample of 105 patients treated with chemotherapy were recruited in the cross-sectional survey design. Data were collected using self-report questionnaires. The instruments used were the Chemotherapy Induced Peripheral Neuropathy Assessment Tool (CIPNAT) and Hospital Anxiety Depression Scale (HADS).

Results

The most frequent suffering symptom of CIPN was 'tingling feeling in the hand and foot'. Of the motor symptoms, 'muscle weakness' was the most frequent symptom and 'muscle or joint aches' was the strongest suffering symptom of CIPN. The mean score for suffering of CIPN was 4.1. The mean score was 1.04 for depression and the prevalence was 48.5%. CIPN was significantly positively correlated with depression (r=.38, p<.001). The result of simple regression analysis revealed that CIPN was predictive of depression (R²=.136, p<.001).

Conclusion

Based on the findings of this study, nursing intervention programs focusing on CIPN management and alleviating depression are recommended.

Keywords: Peripheral Neuropathies, Neoplasms, Depression

Figures and Tables

Table 1

General Characteristics of the Subject (N=105)

Variables	Categories	n (%)	M±SD	CIPN^*		Depression
Variables	Categories	n (%)	M±SD	M±SD	t or F (p)	M±SD	t or F (p)
Gender	Male	34 (32.7)		3.66 ± 1.68	- 1.47 (.143)	1.04 ± 0.62	- 0.08 (.935)
Gender	Female	70 (67.3)		4.24 ± 1.97	- 1.47 (.143)	1.05 ± 0.60	- 0.08 (.935)
Age (year)	≤ 49	26 (26.7)	55.4 ± 10.59	4.04 ± 1.93	0.34 (.794)	0.97 ± 0.55	0.20 (.898)
	50~59	40 (38.1)		4.29 ± 2.07		1.08 ± 0.72
	60~69	22 (20.9)		4.13 ± 1.68		1.06 ± 0.50
	≥ 70	15 (14.3)		3.69 ± 2.15		1.06 ± 0.52
Education	Under middle school	30 (29.4)		3.42 ± 1.44	2.20 (.115)	0.97 ± 0.55	0.38 (.682)
	High school	47 (46.1)		4.31 ± 2.08		1.09 ± 0.59
	Over college	25 (24.5)		4.13 ± 1.84		1.06 ± 0.71
Occupation	Employed	34 (33.3)		4.24 ± 1.93	0.92 (.685)	1.06 ± 0.64	0.18 (.900)
Occupation	Unemployed	68 (66.7)		3.88 ± 1.83	0.92 (.685)	1.04 ± 0.59	0.18 (.900)
Diagnosis	Breast cancer^a	39 (37.5)		4.62 ± 2.21	3.75 (.007) b,d<c	1.14 ± 0.69	1.18 (.326)
	Colorectal/Stomach cancer^b	32 (30.8)		3.80 ± 1.60		0.87 ± 0.47
	Uterus cancer^c	5 (4.8)		5.58 ± 0.79		1.23 ± 0.08
	Lung cancer^d	22 21.2)		3.05 ± 1.18		1.08 ± 0.63
	Others^e	6 (5.7)		4.07 ± 2.12		1.21 ± 0.67
Stage	I	14 (13.7)		4.04 ± 1.39	1.76 (.160)	1.31 ± 0.68	1.48 (.226)
	II	27 (26.5)		4.22 ± 2.06		1.09 ± 0.71
	III	44 (43.1)		4.35 ± 2.02		0.93 ± 0.49
	IV	17 (16.7)		3.14 ± 1.47		1.08 ± 0.60
Metastasis	Yes	39 (38.2)		4.07 ± 1.99	0.05 (.555)	1.02 ± 0.62	- 0.54 (.808)
Metastasis	No	63 (61.8)		4.05 ± 1.84	0.05 (.555)	1.08 ± 0.60	- 0.54 (.808)
Total chemotherapy cycles	1~5	28 (26.7)	8.08 ± 4.8	3.37 ± 1.61	2.82 (.064)	1.06 ± 0.74	1.42 (.246)
	6~10	50 (47.6)		4.37 ± 2.10		0.96 ± 0.48
	> 11	27 (25.7)		4.37 ± 1.86		1.2 ± 0.63
Months with CIPN^*	1~3	27 (25.7)	10.92 ± 14.58	3.67 ± 1.80	0.65 (.582)	1.08 ± 0.68	1.89 (.137)
	4~6	34 (32.4)		4.16 ± 1.84		0.96 ± 0.47
	7~12	18 (17.1)		4.43 ± 1.98		0.85 ± 0.40
	> 13	26 (24.8)		4.25 ± 2.24		1.25 ± 0.74
Doctor and nurse's response to CIPN^*	Not applicable	18 (18.0)		3.25 ± 1.91	2.40 (.096)	0.97 ± 0.56	0.29 (.750)
	Passive	32 (32.0)		4.24 ± 1.93		1.05 ± 0.51
	Active	50 (50.0)		4.40 ± 1.97		1.10 ± 0.68
Chemotherapy regimen	Taxanes^a	11 (10.5)	1,303.05 ± 974.27 mg	4.73 ± 1.38	3.48 (.010) b,d<c^†	1.19 ± 0.69	1.40 (.241)
	Platinum^b	38 (36.2)	1,537.79 ± 1076.24 mg	3.65 ± 1.60		0.88 ± 0.57
	Taxanes + Doxorubin^c	21 (20.0)	1,161.78 ± 483.85 mg	5.30 ± 2.24		1.04 ± 0.58
	Platinum + Taxanes^d	20 (19.0)	3,375.40 ± 1479.47 mg	3.74 ± 1.75		1.16 ± 0.60
	Others^e	15 (14.3)	1,537.79 ± 1076.24 mg	3.60 ± 2.33		1.20 ± 0.60

^*CIPN=Chemotherarpy-induced peripheral neuropathy; ^†Duncan test.

Table 2

Frequency, Suffering, and Experience of Chemotherapy-induced Peripheral Neuropathy (N=105)

Variables	n (%)	Suffering	Level of CIPN^* experience
Variables	n (%)	M ± SD	M ± SD
Sensory symptoms
Numbness (hand)	57 (54.3)	3.93 ± 2.67	4.51 ± 3.14
Numbness (foot)	65 (61.9)	4.41 ± 2.89	4.88 ± 3.35
Tingling (hand)	86 (81.9)	4.50 ± 2.57	5.02 ± 2.99
Tingling (foot)	80 (76.2)	4.96 ± 2.86	5.29 ± 3.24
Cold sensitivity	55 (52.4)	4.20 ± 3.07	4.30 ± 3.28
Nerve pain	61 (58.1)	3.71 ± 2.88	3.81 ± 2.97
Motor symptoms
Muscle or joint aches	48 (45.7)	4.07 ± 3.15	3.86 ± 3.10
Weakness of extremities	55 (52.4)	3.86 ± 2.93	3.82 ± 3.10
Balance disturbance	34 (32.4)	3.83 ± 2.63	2.82 ± 2.59
Total	4.16 (range: 1~9.44)

^*CIPN=Chemotherapy-induced peripheral neuropathy.

Table 3

Severe Time and Frequency of Chemotherapy-induced Peripheral Neuropathy (N=105)

	Morning	Afternoon	Evening	Night	Not applicable
	n (%)	n (%)	n (%)	n (%)	n (%)
Sensory symptoms
Numbness (hand)	40 (38.1)	18 (17.1)	28 (26.7)	24 (22.9)	38 (36.2)
Numbness (foot)	40 (38.1)	21 (20.0)	31 (29.5)	26 (24.8)	33 (31.4)
Tingling (hand)	47 (44.8)	27 (25.7)	33 (31.4)	34 (32.4)	21 (20.0)
Tingling (foot)	45 (42.9)	25 (23.8)	34 (32.4)	36 (34.3)	24 (22.9)
Cold sensitivity	37 (35.2)	22 (21.0)	26 (24.8)	20 (19.0)	48 (45.7)
Nerve pain	39 (37.1)	24 (22.9)	26 (24.8)	34 (32.4)	39 (37.1)
Motor symptoms
Muscle or joint aches	17 (16.2)	8 (7.6)	15 (14.3)	27 (25.7)	57 (54.3)
Weakness of extremities	24 (22.9)	24 (22.9)	22 (21.0)	18 (17.1)	47 (44.8)
Balance disturbance	20 (19.0)	15 (14.3)	15 (14.3)	14 (13.3)	65 (61.9)

Note. Multiple response.

Table 4

Relationship between Suffering of Chemotherapy-induced Peripheral Neuropathy and Depression (N=105)

Variables	Depression
Variables	r (p)
Suffering of chemotherapy induced peripheral neuropathy	.38 (<.001)

Table 5

The Influence of Suffering of Chemotherapy-induced Peripheral Neuropathy on Depression in Cancer Patients (N=105)

Variables	B	SE	β	t	p	Adj. R²	F	p
(Constant)	.56	.13		4.41	< .001
Suffering of chemotherapy induced peripheral neuropathy	.12	.03	.38	4.17	< .001	.14	17.43	< .001

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