Health related quality of life, anxiety and depression of cervical cancer patients in Nepal.

Thesis Report.

ABSTRACT: Cervical cancer is the most common cancer among women causing highest cancer related mortality. Cancer being chronic by nature effects health quality of life and phychological wellbeing of patients. Study was undertaken to assess health related quality of life, anxiety and depression among cervical cancer group. Cross sectional study design incorporating both qualitative and quantitative approach was conducted in one specialized cancer treatment cancer. HrQoL, anxiety and depression of cancer group from hospitals was compared with non cancer group from community. Study subjects were interviewed by researcher for EORTC QLQ-C30 and EORTC QLQ-CX 24 for HrQoL and HADS was used to assess anxiety and depression. From July to October, 2012 total two hundred four samples were taken with fifty percent study group maintaining all the ethical considerations. Analysis was done by SPSS V-16. Meant± SD was calculated for descriptive statistics. Inferential statistics Chi square, Mann Whitney U, Spearman Rank Correlation and Logistic regression, total score were calculated for quantitative data whereas a case study was done for qualitative analysis. HrQol of cervical cancer group was poorer in functional, single item and global health scales with more severe symptoms in EORTC QLQ C30 as well as in EORTC QLQ CX 24. HrQoL of cancer group had significant association and was relate with financial difficulty. Method of treatment, external radiation, was partially correlated with HrQoL, Majority of the cancer group had anxiety (71.6%) and depression (61.8%), with use of hormonal contraceptive (OR=3.308, 95% C1-1.14-12.68) and smoking (0.52**, 0.12-0.23) for anxiety and gravid (2.705, 1.13-6.44), employment (3.47*,1.06-11.3), smoking (0.202*, 0.07-0.54) and income (2.5*, 1.08-5.73) for depression as their predictors. Severe symptoms had significant positive correlation with anxiety and depression. Potential case study also supports the quantitative data. Cervical cancer group has poorer HrQoL than non cancer group from community, with majority of them facing anxiety and depression. Most of the demographic factors are predictors of HrQoL, anxiety and depression. There is urgent need of effective clinical approaches to identify the risk factors of poor HrQoL, anxiety and depression among cervical cancer patients. Key words: Health Related quality of Life, Anxiety, Depression, Cervical Cancer, Nepal