Relationships among Mood Status, Social Support, Symptom Experience and Quality of Life in Colorectal Cancer Patients - based on the Theory of Unpleasant Symptoms

Hyun Jeong Seo; Eun Jung Ryu; Ham Mi Young

doi:10.5388/aon.2018.18.2.104

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Seo, Ryu, and Young: Relationships among Mood Status, Social Support, Symptom Experience and Quality of Life in Colorectal Cancer Patients - based on the Theory of Unpleasant Symptoms

Original Article

Asian Oncol Nurs 2018;18(2):104-113.

Published online: 5 June 2018

DOI: https://doi.org/10.5388/aon.2018.18.2.104

Relationships among Mood Status, Social Support, Symptom Experience and Quality of Life in Colorectal Cancer Patients - based on the Theory of Unpleasant Symptoms

Hyun Jeong Seo¹, Eun Jung Ryu², Ham Mi Young³

¹Department of Nursing, Inha University Hospital, Incheon, Korea

²Department of Nursing, Chung-Ang University, Seoul, Korea

³Department of Nursing, Kyungmin University, Ujeongbu-si, Korea

^∗ This article is based on a part of the first author's master's thesis from Chung-Ang University.

Address reprint requests to: Ryu, Eun Jung Department of Nursing, Chung-Ang University 84 Heukseok-ro, Dongjak-gu, Seoul 06974, Korea. Tel: +82-2-820-5681 Fax: +82-2-824-7961 E-mail: go2ryu@cau.ac.kr

Received 26 Jun 201827 Jun 2018 Accepted 28 Jun 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

This study is to determine the effects of Colorectal Neoplasms patients’ stage, location of disease, functional status (physio-logical factor), mood (psychological factor), and social support (situational factor) on their symptom experience, and to verify the relationship between symptom experience and the quality of life.

Methods

The Theory of Unpleasant Symptoms was the framework for the study. A descriptive correlational design was used in analysis of data obtained from a sample of 113 Colorectal Neoplasms patients who were undergoing chemotherapy.

Results

Total mood disturbance and symptom experiences were negatively correlated with physical component score (PCS) and mental component score (MCS) of quality of life (r −.33 to r=−.51, p<.001; r=.40 to r=.50, p<.001). Multiple regression analysis revealed that the functional status and symptoms interference variables explained 29.2% of the variance in PCS of quality of life. Symptoms interference and age explained 30.6% of the variance in MCS of quality of life.

Conclusion

Although overall depression levels were low in this sample, these findings suggest that insomnia and fatigue are related to depression and that depression is more closely associated with quality of life than are insomnia and fatigue.

Keywords: Colorectal Neoplasms, mood, Social Support, Quality of Life

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Fig. 1.

Conceptual framework of this study.

Table 1.

Descriptive Statistics for Study Variables (N =113)

Variables	Categories	M ± SD	Minimum	Maximum	Range
POMS	Tension-anxiety	5.08 ± 3.93	0	18	18
	Depression-dejection	4.01 ± 3.89	0	17	17
	Anger-hostility	4.04 ± 3.40	0	17	17
	Vigor-activity	6.26 ± 3.88	0	20	20
	Fatigue-inertia	4.27 ± 3.56	0	16	16
	Confusion-bewilderment	6.69 ± 3.19	1	15	14
	Total mood disturbance	17.84 ± 17.70	−18	81	99
MPASS	Significant others	3.87 ± 0.72	2	5	3
	Family	4.03 ± 0.88	1	5	4
	Friends	3.67 ± 0.69	1.25	5	3.75
MDASI-GI	Severity	3.39 ± 2.14	0	8.44	8.44
	Interference	3.55 ± 2.70	0	9.33	9.33
SF-12	Physical functioning	59.51 ± 32.78	0	100	100
	Role physical	56.08 ± 29.41	0	100	100
	Bodily pain	68.36 ± 28.15	25	100	75
	General health	48.63 ± 22.63	0	85	85
	Vitality	47.79 ± 30.17	0	100	100
	Social functioning	69.91 ± 30.82	0	100	199
	Role emotional	58.96 ± 30.04	0	100	100
	Mental health	64.49 ± 23.35	0	100	100
	Physical component score	44.63 ± 8.18	22.02	61.20	39.18
	Mental component score	45.54 ± 9.98	19.25	64.66	45.41

POMS= Profile of mood states-brief; MPASS= The multidimensional scale of perceived social support; MDASI-GI= The MD anderson symptom inventory-gastrointestinal cancer Module; SF-12= Short form-12.

Table 2.

Demographic and Quality Of Life according to Sample's Characteristics

Variables	Categories	n (%) or M ± SD	Physical component score			Mental component score
Variables	Categories	n (%) or M ± SD	M ± SD	F or t	p	M ± SD	F or t	p
Gender (year)		58.1 ± 8.22		0.69	.493		0.45	.653
	Male	69 (61.1)	45.06 ± 8.60			45.88 ± 9.35
	Female	44 (38.9)	43.97 ± 7.52			45.01 ± 10.98
Education	None	4 (3.5)	42.51 ± 2.91	0.53	.714	45.95 ± 14.26	1.00	.410
	Elementary school	13 (11.5)	41.91 ± 8.85			41.24 ± 12.04
	Middle school High school	22 (19.5) 49 (43.4)	45.18 ± 5.0644.80 9.01			44.30 ± 9.7946.15 8.55
	High school	49 (43.4)	44.80 ± 9.01			46.15 ± 8.55
	≥ College	25 (22.1)	45.58 ± 9.02			47.60 ± 10.96
Marital status	Single	5 (4.4)	41.94 ± 9.31	0.93	.430	45.58 ± 2.20	0.25	.865
	Married	95 (84.1)	45.09 ± 8.40			45.36 ± 10.47
	Widowed	8 (7.1)	40.61 ± 4.18			45.24 ± 8.96
	Others	5 (4.4)	45.20 ± 7.26			49.31 ± 6.76
Religion	None	46 (40.7)	45.84 ± 8.39	1.23	.304	46.84 ± 11.15	0.84	.504
	Buddhist	24 (21.2)	44.66 ± 8.24			46.13 ± 8.44
	Christianity	26 (23.1)	41.73 ± 7.71			43.03 ± 8.40
	Catholic	17 (15.0)	45.45 ± 7.59			45.96 ± 10.67
	Others		48.56 ± 13.21			38.98 ± 15.91
Job	Yes	48 (42.5)	43.56 ± 8.38	−1.63	.105	44.88 ± 10.30	−0.82	.417
	No	65 (57.5)	46.09 ± 7.75			46.43 ± 9.57
Monthly income (10,000 won)	＜100	24 (21.2)	42.04 ± 7.45	1.34	.262	42.73 ± 10.32	1.48	.213
	100~200	33 (29.2)	46.05 ± 7.80			44.70 ± 9.95
	200~300	26 (23.0)	43.37 ± 9.17			45.53 ± 9.10
	300~400	16 (14.2)	45.88 ± 8.79			47.34 ± 8.80
	≥ 400	14 (12.4)	46.69 ± 7.10			50.29 ± 11.51
Living with others	Alone	10 (8.8)	45.72 ± 7.70	0.19	.662	45.31 ± 8.29	0.01	.940
	Family	103 (91.2)	44.53 ± 8.25			45.56 ± 10.16
Number of chemotherapy		5.61 ± 4.98
ECOG PSR	0	17 (15.1)
	1	84 (74.3)
	2	12 (10.6)

ECOG PSR= The eastern cooperative oncology group performance status scale.

Table 3.

Quality Of Life according to Disease-related Characteristics (N =113)

Variables	Categories	Physical component score (PCS)				Mental component score (MCS)
Variables	Categories	M ± SD	t or F	p	Bonferroni	M ± SD	t or F	p	Bonferroni
Stage of colorectal neoplasms	Stage 1	46.40 ±	0.68	.563		44.45 ± 10.19	1.02	.385
	Stage 2	44.39 ± 8.30				47.93 ± 10.20
	Stage 3	43.65 ± 9.04				44.65 ± 9.57
	Stage 4	44.28 ± 2.63				42.56 ± 10.90
Location of colorectal neoplasms	Ascending Colon^a	45.88 ± 7.57	0.13	.973		50.08 ± 8.45	3.16	.017	b＞ a＞ e
	Transverse Colon^b	44.20 ± 15.21				57.47 ± 3.56
	Descending Colon^c	44.89 ± 6.21				46.18 ± 9.27
	Sigmoid colon^d	44.44 ± 9.17				44.55 ± 10.37
	Rectum^e	44.33 ± 7.37				43.58 ± 9.70
Type of treatment	Operation	44.25 ± 8.60	0.08	.925		43.84 ± 9.60	1.90	.155
	Operation + CTX	44.91 ± 7.56				47.50 ± 9.93
	Operaion + CTX+RTX	44.78 ± 9.33				43.94 ± 10.58
ECOG PS	0^a	47.92 ± 7.01	5.60	.005	a, b＞ c	49.03 ± 7.97	1.95	.147
	1^b 2^c	44.90 ± 8.1238.15 6.99				45.38 ± 9.6141.74 13.77
	2^c	38.15 ± 6.99				41.74 ± 13.77

PCS= Physical component score; MCS= Mental component score; CTX= Chemotherapy; RTX= Radiotherapy; ECOG PS= Eastern cooperative Oncology group performance satus.

Table 4.

Correlations among the Study Variables (N =113)

Variables	Mood		Social support	Symptom		QOL
	Total mood disturbance	Vigor	Social support	Severity	Interference	PCS	MCS
	r (p)	r (p)	r (p)	r (p)	r (p)	r (p)	r (p)
Total mood disturbance	1
Vigor	−.44 (＜.001)	1
MSPSS	−.11 (.262)	.16 (.096)	1
Symptom severity	.55 (＜.001)	−.10 (.306)	−.07 (.461)	1
Symptom interference	.61 (＜.001)	−.18 (.051)	−.13 (.173)	.58 (＜.001)	1
Physical component score	−.40 (＜.001)	.15 (.111)	.04 (.503)	−.33 (＜.001)	−.52 (＜.001)	1
Mental component score	−.45 (＜.001)	.27 (.003)	.15 (.105)	−.41 (＜.001)	−.51 (＜.001)	.35 (＜.001)	1

MSPSS= The multidimensional scale of perceived social support; QOL= Quality of life; PCS= Physical component score; MCS= Mental component score.

Table 5.

The Predictors of SF Score (N =113)

Variables	Categories	B	Std. error	β	t	p	Adjusted R²	Durbin-Watson
PCS	(Constant)	52.86	1.53		34.59	＜.001
	ECOG PR	−3.21	1.31	−.20	−2.46	.016
	Symptom interference	−1.45	0.25	−.48	−5.92	＜.001	.29	1.73
MCS	(Constant)	70.71	6.20		11.41	＜.001
	Age	−0.24	0.10	−.20	−2.53	.013
	Symptom interference	−1.80	0.30	−.49	−5.91	＜.001
	Unpleasant symptoms	s -1.47	0.70	−.17	−2.11	.037	.31	2.01

SF= Short form; PCS= Physical component score; MCS= Mental component score; ECOG PR= Eastern cooperative oncology group performance rating.

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