Asian Oncol Nurs AON Asian Oncology Nursing 2287-2434 2287-447X Korean Oncology Nursing Society 10.5388/aon.2015.15.3.149 Original Article Chemotherapy-induced Peripheral Neuropathy and Depression in Cancer Patients Kim Kyung Yeon 1 Lee Seung Hee 1 Oh Pok Ja 2 Korea Institude of Radiological & Medical Science, Seoul, Korea. Department 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 09 2015 30 09 2015 15 3 149 155 06 03 2015 08 08 2015 21 09 2015 © 2015 Korean Oncology Nursing Society 2015 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. 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.

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Variables Categories n (%) M±SD CIPN* Depression
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)
Female 70 (67.3) 4.24 ± 1.97 1.05 ± 0.60
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)
Unemployed 68 (66.7) 3.88 ± 1.83 1.04 ± 0.59
Diagnosis Breast cancera 39 (37.5) 4.62 ± 2.21 3.75(.007)b,d<c 1.14 ± 0.69 1.18(.326)
Colorectal/Stomach cancerb 32 (30.8) 3.80 ± 1.60 0.87 ± 0.47
Uterus cancerc 5 (4.8) 5.58 ± 0.79 1.23 ± 0.08
Lung cancerd 22 21.2) 3.05 ± 1.18 1.08 ± 0.63
Otherse 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)
No 63 (61.8) 4.05 ± 1.84 1.08 ± 0.60
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 Taxanesa 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)
Platinumb 38 (36.2) 1,537.79 ± 1076.24 mg 3.65 ± 1.60 0.88 ± 0.57
Taxanes + Doxorubinc 21 (20.0) 1,161.78 ± 483.85 mg 5.30 ± 2.24 1.04 ± 0.58
Platinum + Taxanesd 20 (19.0) 3,375.40 ± 1479.47 mg 3.74 ± 1.75 1.16 ± 0.60
Otherse 15 (14.3) 1,537.79 ± 1076.24 mg 3.60 ± 2.33 1.20 ± 0.60

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

 Frequency, Suffering, and Experience of Chemotherapy-induced Peripheral Neuropathy (<italic>N</italic>=105)
Variables n (%) Suffering Level of CIPN* experience
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.

 Severe Time and Frequency of Chemotherapy-induced Peripheral Neuropathy (<italic>N</italic>=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.

 Relationship between Suffering of Chemotherapy-induced Peripheral Neuropathy and Depression (<italic>N</italic>=105)
Variables Depression
r (p)
Suffering of chemotherapy induced peripheral neuropathy .38 (<.001)
The Influence of Suffering of Chemotherapy-induced Peripheral Neuropathy on Depression in Cancer Patients (<italic>N</italic>=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