Prevalence of anxiety and depression and related factors in breast cancer patients receiving chemotherapy.

Abstract

Introduction : Breast cancer is considered a systemic disease rather than a localized one. Therefore, surgery and radiation which are local treatment may not be enough. Systemic treatment such as chemotherapy may be needed as an additional therapy. Although chemotherapy is an effective treatment, but it has side effects on physical and psychological aspects anxiety and depression which are the most common symptoms in breast cancer patients.

Objective : To study the prevalence of anxiety and depression and related factors in breast cancer patients receiving chemotherapy at King Chulalongkorn Memorial Hospital.

Setting : Chemotherapy Center, Outpatient Department of King Chulalongkorn Memorial Hospital.

Research design : Cross - sectional descriptive study.

Patients : Female breast cancer patients receiving chemotherapy, age above 18 years old. 

Methods : Two hundred and thirty-six female breast cancer patients receiving chemotherapy, were recruited into the study from October 2008 - February 2009. All subjects were requested to completed four questionnaires: 1) demographic data, 2) Thai - Hospital Anxiety and Depression Scales (Thai - HADS), 3) Life Stress Event questionnaires, 4) Social Support questionnaires. Data analysis was performed by using SPSS software version 16. Statistics figures include percentage, mean, standard deviation, Chi-square, One-way ANOVA, and Stepwise Multiple Linear Regression, level of significance is set at 0.05.

Result : The prevalence of anxiety and depression in breast cancer patients Conclusion receiving chemotherapy were 8.9% and 9.3%. Factors associated with anxiety are as follows: status, age of diagnosis, severity of pain from breast cancer, side effects before and after receiving chemotherapy and life stressful events. Factors associated with depression are as follows: age, status, age of diagnosis, severity of pain from breast cancer, side effects before and after receiving chemotherapy, stressful events and social supports. The factors which predicted anxiety were insomnia symptoms after receiving chemotherapy, severity of pain from breast cancer, stressful events, social supports, fever and diarrhea symptoms after receiving chemotherapy. The predictive power was 23.9% (R² = .239) of the variance. The factors which predicted depression are fatigue symptoms before receiving chemotherapy, social support, stressful events, age of diagnosis to breast cancer, age and anemia symptoms after receiving chemotherapy. The predictive power was 27.9% (R² = .279) of the variance.

Conclusion : This study found the level of anxiety and depression less than earlier studies, but caring for patients to endure side effects is still important. Because many factors which predicted anxiety and depression are side effects after receiving chemotherapy, social supports, stressful event, age of diagnosis and age. Consequently, treatment of breast cancer patients receiving chemotherapy should focus on reduction of patients showing disturbing symptoms and lessening the treatment complications. Moreover, being alert on patients' emotional reactions is essential.