The influence of demographics, psychological factors and self-efficacy on symptom distress in colorectal cancer patients undergoing post-surgical adjuvant chemotherapy

European Journal of Oncology Nursing

Available online 13 September 2014

• Mei-fen Zhang^{a, , 1,} ,
• Mei-chun Zheng^{b, 1},
• Wei-yan Liu^{c, 1},
• Yong-shan Wen^b,
• Xiao-dan Wu^b,
• Qian-wen Liu^b

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Abstract

Purpose

To explore the influence of self-efficacy and demographic, disease-related, and psychological factors on symptom distress among Chinese colorectal cancer patients receiving postoperative adjuvant chemotherapy.

Methods

Two-hundred and fifty-two colorectal cancer patients who had undergone postoperative adjuvant chemotherapy completed Chinese versions of M. D. Anderson Symptom Inventory (MDASI-GI), Stanford Inventory of Cancer Patient Adjustment (SICPA), and Hospital Anxiety and Depression Scale (HADS). Associations between patients' self-efficacy and demographic, disease-related, psychological factors and symptom distress were examined.

Results

Patients' overall symptom distress level was mild; MDASI median subscale scores showed mild symptom severity and symptom interference. Anxiety and depression were positively associated with symptom distress. Multivariable analysis showed that more severe symptoms were associated with age ≥60 years, female gender, suburban residence, body mass index <18.5, and stage III cancer. Age ≥60 years, female gender, marital status of single or divorced, and suburban residence were associated with greater symptom interference with daily activities. Greater self-efficacy was associated with milder symptoms severity and less symptom interference with daily life. After adjusting for confounders, patients with higher SICPA scores had less symptom distress.

Conclusions

Self-efficacy is strongly associated with reduced symptom severity and symptom interference with daily life in CRC patients. Symptom severity is associated with age >60 years, female gender, body mass index <18.5, suburban residence and stage III disease. Nurse-administered self-efficacy interventions may help to improve self-efficacy and reduce symptom distress.