Distress and Quality of Life in Patients with Esophageal Cancer

Yeon Hwa Ju; Yeon Hee Kim; Jeong Hye Kim

doi:10.5388/aon.2018.18.1.40

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Ju, Kim, and Kim: Distress and Quality of Life in Patients with Esophageal Cancer

Original Article

Asian Oncol Nurs 2018;18(1):40-46.

Published online: 5 March 2018

DOI: https://doi.org/10.5388/aon.2018.18.1.40

Distress and Quality of Life in Patients with Esophageal Cancer

Yeon Hwa Ju¹, Yeon Hee Kim, Jeong Hye Kim²

¹Department of Nursing, Asan Medical Center, Seoul, Korea

²Department of Clinical Nursing, University of Ulsan, Seoul, Korea

^∗ The article is a revision of the first author's mater's thesis from Ulsan University.

Address reprint requests to: Kim Jeong Hye Department of Clinical Nursing, University of Ulsan, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea Tel: +82-2-3010-5335 Fax: +82-2-3010-5332 E-mail: kimjh@amc.seoul.kr

Received 28 Feb 201822 Mar 2018 Accepted 27 Mar 2018

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.

초록

Purpose

The purpose of this study was to identify the level of distress and quality of life (QoL) in esophageal cancer patients, and to identify the factors influencing QoL.

Methods

A sample of 103 patients who have esophageal cancer were included in a descriptive study. The instruments used were the Distress Thermometer and Problem List, and the Functional Assessment of Cancer Therapy-General (FACT-G) version 4.

Results

The mean distress score of the subjects was 4.06±2.04 out of 10. The total mean score of quality of life was 66.39±12.86 out of 108, the highest category was physical well-being with a mean item score of 21.78±5.51, the lowest was emotional well-being with a mean item score of 14.69±3.68. The levels of distress and QoL were negatively correlated (r=−.61, p<.001). Stepwise regression analysis revealed that the QoL of the patients was explained by type of treatment and distress. These variables explained 35% of the variance in QoL.

Conclusion

The QoL of patients with esophageal cancer was relatively low, and the type of treatment and distress was the most important factor affecting quality of life. Thus, to improve the QoL of patients with esophageal cancer, it is important to assess their distress and to provide appropriate interventions.

Keywords: Esophageal Cancer, Distress, Quality of Life

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Table 1.

Distress and Quality of Life according to General and Clinical Characteristics (N =103) Variables Categories n (%) Distress Quality of life

Varible	Categories	n(%)	Distress			Qualiaty of Life
Varible	Categories	n(%)	M ± SD	t or F	p	M ± SD	t or F	p
Gender	Male	93 (90.3)	4.00 ± 1.20	-0.88	.380	66.91 ± 12.63	0.29	.208
	Female	10 (9.7)	4.60 _± 2.50			61.50 _± 14.66
Age (year)	＜65	62 (60.2)	4.03 ± 2.23	-0.17	.868	66.10 ± 13.33	-0.28	.779
	≥65	41 (39.8)	4.10 ± 1.74			66.83 ± 12.26
Marital status	Single	5 (4.9)	4.40 _± 2.70	0.38	.703	72.40 _± 6.80	0.22	.286
	Married	98 (95.1)	4.04 ± 2.02			66.08 ± 13.04
Religion	Yes	42 (40.8)	3.93 ± 2.19	0.53	.595	64.55 ± 11.50	1.21	.230
	No	61 (59.2)	4.15 ± 1.95			67.66 ± 13.68
Education	≤ Middle school	40 (38.8)	3.53 ± 1.84	2.43	.093	68.90 ± 11.81	-1.51	.225
	High school University	45 (43.7) 18 (17.5)	4.31 ± 1.954.61 2.50			64.07 ± 13.6166.61 12.79
	≥ University	18 (17.5)	4.61 ± 2.50			66.61 ± 12.79
Perceived	High	4 (3.9)	3.50 ± 2.52	1.86	1.61	65.50 ± 12.76	0.02	.980
economical	Moderate	95 (92.2)	4.16 _± 2.01			66.46 _± 12.69
status	Low	4 (3.9)	2.25 ± 2.06			65.50 ± 20.27
Occupation	Yes	51 (49.5)	3.82 ± 1.20	-1.16	.250	69.39 ± 12.31	2.40	.018
	No	52 (50.5)	4.29 ± 2.08			63.44 ± 12.83
Stage of cancer	I ^a	47 (45.6)	3.77 ± 2.04	2.46	.067	71.04 ± 10.35	6.09	＜.001
	II ^b III^c	24 (23.3) 28 (27.2)	3.96 ± 2.274.29 1.56			65.29 ± 10.2261.75 15.31		d＜ a
	III ^c ^d	28 (27.2)	4.29 ± 1.56			61.75 ± 15.31
	IV ^d	4 (3.9)	6.50 ± 2.65			50.75 ± 13.96
Time period since	＜6	76 (73.8)	3.91 _± 2.14	-1.26	.212	68.75 _± 12.92	3.27	＜.001
diagnosis (month)	≥6	27 (26.2)	4.48 ± 1.72			59.74 ± 10.26
Comorbidity	Yes No	44 (42.7) 59 (57.3)	3.63 ± 1.964.64 2.02	-2.55	.012	68.32 ± 12.0363.80 13.61	0.43	.077
	No	59 (57.3)	4.64 ± 2.02			63.80 ± 13.61
Type of treatment	CCRT	44 (42.7)	4.57 ± 1.83	2.23	.028	60.84 ± 14.14	0.16	＜.001
	Planned surgery	59 (57.3)	3.68 ± 2.12			70.53 ± 10.10

CCRT₌ Combined chemotherapy and radiation therapy.

Table 2.

Level of Distress, Problem List of Distress and Quality of Life (N =103)

Variables	Categories	n (%)	M ± SD	Range (min~max)	Range of scale
Distress			4.06 ± 2.04	0~10	0~10
	＜4	43 (41.7)	2.16 ± 0.95
	≥4	60 (58.3)	5.42 ± 1.44
Problem list of dis-	Emotional problem		32.83 ± 23.42
tress (n=60)	Physical problem		12.63 ± 10.93
	Spiritual/religious concern		0.00 ± 0.00
	Family problem		4.75 ± 4.57
	Practical problem		23.33 _± 22.62
Quality of life			66.39 ± 12.86	31~105	0~108
	Physical well-being		21.78 ± 5.51	2~28	0~28
	Social/family well-being		14.71 ± 3.38	8~28	0~28
	Emotional well-being		14.69 ± 3.68	5~24	0~24
	Functional well-being		15.21 _± 4.66	3~28	0~28

Table 3.

Correlations between Distre and quality of life (N=103)

Variables	Distress
Variables	r (p)
Quality of life	-.58 (＜.001)
Physical well-being	-.54 (＜.001)
Social/family well-being	-.27 (.006)
Emotional well-being	-.40 (＜.001)
Functional well-being	-.46 (＜.001)

Table 4.

Influencing Factors on Quality of Life

Variables	B	SE	β	t	p	Tolerance	VIF
(Constant)	89.16	3.46		25.79	＜.001
Distress^†	-12.35	2.11	-.48	-5.86	＜.001	.97	1.03
Type of treatment^†	^† -7.54	2.10	-.29	-3.59	.001	.97	1.03
			Adj.R²=0.35, F₌28.08, p＜.001

CCRT= Concurrent chemotherapy and radiation therapy; ^† Dummy variables: distress (≥4= 1,＜4= 0); Type of treatment (CCRT= 1, Planned surgery= 0).

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