1. TEXILA AMERICAN UNIVERSITY
Correlation of Anxiety & Depression with QOL of cancer patients during Chemotherapy or Radiotherapy
Submitted By: Ms. Kavita Gupta
Ph.D. Research Scholar (TAU)
TEXILA AMERICAN UNIVERSITY
(GEORGETOWN) 1

2. QOL of Cancer patients = Anxiety + Depression
SUMMARY
Study: Non-interventional, prospective, observational and descriptive pilot study.
Objective: The primary objective was to analyze the association of anxiety, and depression levels and their impacting factors on QOL in homogenous surviving cancer patients receiving chemotherapy or radiotherapy sessions.
Methods: 3 QLQ were used on 30 patients undergoing Chemotherapy, and 30 patients undergoing Radiotherapy.
Results: CT group patients were more affected due to Anxiety & Depression as compared to RT group patients.
Conclusion: WHOQOL-Bref, ZSAS and ZSDS scale could be used as a predictor of Anxiety and Depression during Chemotherapy or Radiotherapy sessions for cancer patients.
Interpretation: Depression= Living in the past; Anxiety= Tension about future. Therefore, 2
QOL of Cancer patients = Anxiety + Depression

3. Importance & Relevance of the study
SO WHAT?
Importance & Relevance of the study
There is no “gold standard” of QOL measurement for QOL in cancer patients because no one instrument would be appropriate for all situations. Thus, the present 3 QLQ could help in debriefing the levels of Anxiety and Depression during the Chemotherapy or Radiotherapy sessions.
The proposed study was considered valuable since it emphasized on quality of life as one of the possible outcomes during cancer treatment that stressed on the significant factor of anxiety and depression during Chemotherapy or Radiotherapy sessions. 3

4. Problem statement
Which domain in the WHOQOL-Bref was most frequent and most affected by the specific factors of ZSAS and ZSDS.
What was the mean level of quality of life and anxiety and depression in patients with cancer during Chemotherapy or Radiotherapy sessions? 4

5. Flowchart of the study protocol
BACKGROUND 5
Flowchart of the study protocol

6. METHODS
Data Collection: Treatment-related symptoms were assessed by using a series of interviews through standard questionnaires of WHOQOL-Bref (26 Questions), followed by Zung Self-rating Anxiety Scale (ZSAS) (20 Questions) and Zung Self Rating Depression Scale (ZSDS) (20 Questions). The inclusion criteria for participation were patients aged 18 years or older, cancer diagnosis confirmed by biopsy or FNAC, undergoing the treatment and voluntarily agreed to join the study.
Statistical Analyses: By using SPSS v.17 software, Paired t-test, Student’s t-test, Pearson Correlation coefficient test, Pearson χ2 test .
A p-value < 0.05 was considered as statistical significant 6

7. RESULTS The mean age of the patients undergoing CT were 54.37
(SD: 11.08) [Range: 32-75]
The mean age of the patients undergoing RT were 54.21
(SD:11.07) [Range: 32-75]
Cronbach's alpha coefficient for WHOQOL-Bref: (α = 0.672) ;
(α = 0.742) for ZSAS, and (α = 0.532) for ZSDS
The mean scores of Anxiety and Depression in the CT group were and respectively.
The mean scores of Anxiety and Depression in the RT group were and respectively.
Anxiety affected the Physical domain (p = 0.007), Environmental domain (p = 0.036) in the CT group and Social domain (p = 0.016) in the RT group. On the other hand, Depression affected the Social domain (p = 0.043) in CT group, and Social domain (p = 0.012) in the RT group. 7

8. discussion
H0: According to the null hypothesis generated, it was expected that Sociodemographic variables, Clinical characteristics, anxiety and depression levels did not have a significant impact or correlation (relationship) on domains of QOL of cancer patients during CT or RT.
H1: According to the Alternative hypothesis generated, it was expected that Sociodemographic variables, Clinical characteristics, anxiety and depression levels did have a significant impact or correlation (relationship) on domains of QOL of cancer patients during CT or RT.
HA: According to the Alternative hypothesis (A) generated, it was expected that Sociodemographic variables, Clinical characteristics, anxiety and depression levels had a significant positive impact (relationship) on domains of QOL of cancer patients during CT or RT.
Ha: According to the Alternative hypothesis generated (a), it was expected that Sociodemographic variables, Clinical characteristics, anxiety and depression levels had a significant negative impact (relationship) on domains of QOL of cancer patients during CT or RT. 8

9. interpretation
In the study, 6(20%) were males and 24(80%) were females in the chemotherapy group, and, 15(50%) were males and 15(50%) were females in the radiotherapy group.
Majority of the patients 32(53.34%) were in the age range of years.
Null Hypothesis (H0): Rejected = False
Alternative Hypothesis (Ha): Accepted = True
Therefore, anxiety and depression levels had a significant negative impact (relationship) on domains of QOL of cancer patients during Chemotherapy or Radiotherapy treatment. 9

10. CONCLUSION
The results suggested that WHOQOL-Bref, ZSAS, and ZSDS could be used as a reliable predictor of association and correlation of anxiety and depression with that of quality of life in the cancer patients.
Patients on chemotherapy were more badly affected in some domains of quality of life, compared to those on radiotherapy.
This study showed that the increase in anxiety or depression level subsequently reduced or decreased the QOL of the cancer patients either undergoing Chemotherapy or Radiotherapy treatment. 10

11. FUTURE STEPS
Prospective longitudinal multicenter study with large sample size is recommended
Strong participation of non-governmental organizations and care groups to cope the disease for long- term survivors
Psycho-Oncology Clinic should be made functional at every hospital for the needy cancer patients
To investigate the usefulness and feasibility of QLQ intervention 11

12. 12
ANY QUERIES ?

13. THANK YOU 13