Associations of Uncertainty With Psychological Health and Quality of Life in Older Adults With Advanced Cancer
| Autor: | Jeffrey L. Berenberg, Megan Wells, Alison Conlin, William Dale, Dilip Sankar Babu, Beverly Canin, Kah Poh Loh, Javier Bautista, Colin McHugh, Haydee Cristina Verduzco-Aguirre, Huiwen Xu, Yingzi Zhang, Paul R. Duberstein, Eva Culakova, Supriya G. Mohile, Ronald M. Epstein, Mohamedtaki Abdulaziz Tejani, James D. Bearden |
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| Rok vydání: | 2020 |
| Předmět: |
Multivariate analysis
Context (language use) Disease Anxiety Article 03 medical and health sciences 0302 clinical medicine Quality of life Bayesian multivariate linear regression Neoplasms Medicine Humans 030212 general & internal medicine General Nursing Depression (differential diagnoses) Aged Aged 80 and over business.industry Depression Uncertainty Distress Anesthesiology and Pain Medicine Cross-Sectional Studies Mental Health 030220 oncology & carcinogenesis Quality of Life Neurology (clinical) medicine.symptom business Clinical psychology |
| Zdroj: | J Pain Symptom Manage |
| ISSN: | 1873-6513 |
| Popis: | Context Older adults with advanced cancer face uncertainty related to their disease and treatment. Objectives To evaluate the associations of uncertainty with psychological health and quality of life (QoL) in older adults with advanced cancer. Methods Secondary cross-sectional analysis of baseline data from a national clustered geriatric assessment trial. Patients 70 years and older with advanced cancer considering a new line of chemotherapy were recruited. We measured uncertainty using the modified nine-item Mishel Uncertainty in Illness Scale. Dependent variables included anxiety (Generalized Anxiety Disorder-7), depression (Generalized Depression Scale-15), distress (distress thermometer), QoL (Functional Assessment of Cancer Therapy—General), and emotional well-being (Functional Assessment of Cancer Therapy—General subscale). We used multivariate linear regression analyses to evaluate the association of uncertainty with each dependent variable. We conducted a partial least squares analysis with a variable importance in projection (VIP) plot to assess the contribution of individual variables to the model. Variables with a VIP Results We included 527 patients (median age 76 years; range 70–96). In multivariate analyses, higher levels of uncertainty were significantly associated with greater anxiety (β = 0.11; SE = 0.04), depression (β = 0.09; SE = 0.02), distress (β = 0.12; SE = 0.02), as well as lower QoL (β = −1.08; SE = 0.11) and emotional well-being (β = −0.29; SE = 0.03); the effect sizes were considered small. Uncertainty items related to disease and treatment were most strongly associated with psychological health and QoL scores (all VIP >0.8). Conclusion Uncertainty among older patients with advanced cancer is associated with worse psychological health and QoL. Tailored uncertainty management strategies are warranted. |
| Databáze: | OpenAIRE |
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