Physical and Psychological Predictors of Quality of Life in Chinese Colorectal Cancer Patients During Chemotherapy

Background: Maintaining quality of life (QOL) during chemotherapy is a critical aspect of cancer treatment. Instruments have been developed to assess symptom distress, self-efficacy, anxiety, depression, and other factors impacting QOL during cancer treatment, but Chinese versions have become available only recently. Objective: The aim of this study was to identify factors predictive of QOL during chemotherapy in Chinese colorectal cancer (CRC) patients. Methods: Patients completed Chinese versions of the Hospital Anxiety and Depression Scale, MD Anderson Symptom Inventory (a measure of symptom distress), Stanford Inventory of Cancer Patient Adjustment (a measure of self-efficacy), and Functional Assessment of Cancer Treatment-General (a measure of QOL) before and after 3 and 6 months of chemotherapy. Results: Of 152 consecutive CRC patients (men/women, 98/54; mean age, 53.3 11.3 years, 25-75 years; stage II/III, 59/93), 121 completed all questionnaires (79.6%). Self-efficacy dimensions communication, activity management, personal management, and affective management improved progressively over 6 months (all P < .05). Fatigue, nausea, lack of appetite, disturbed sleep, and vomiting peaked at 3 months and declined thereafter (P < .05). Patients who are younger than 60 years, are male, and with stage II CRC exhibited higher 3- and 6-month QOL scores (all P < .05). Multiple regression identified self-efficacy, anxiety, and symptom distress as independent predictors of QOL at 6 months. Conclusions: Enhanced self-efficacy, reduced symptom distress, and lower general anxiety would improve QOL during chemotherapy for CRC patients. Implications for Practice: These instruments can help identify CRC patients at risk of low QOL for additional psychotherapy or specific treatment modifications.