Anxiety, depression and perceived stress in preoperative colorectal cancer patients: a cross-sectional study

Authors

DOI:

https://doi.org/10.33448/rsd-v11i8.30475

Keywords:

Anxiety; Depression; Colorectal Neoplasms; Stress, Psychological; Surgical stomas.

Abstract

Objective: To evaluate the symptoms of anxiety, depression, and perceived stress in patients in the immediate preoperative period of the first elective surgery for colorectal cancer, and investigate the association/correlation of these symptoms with sociodemographic and clinical variables. Methodology: an observational, analytical, cross-sectional study with 89 patients in a public university hospital in the State of São Paulo, Brazil. The Hospital Anxiety and Depression Scale (HADS) was used to assess symptoms of anxiety and depression, and the Brazilian Perceived Stress Scale (BPSS-10) for perceived stress, and a validated instrument to obtain sociodemographic and clinical data. Results: There was a slight predominance of women (50.6%); mean age of 61.8 years and 7.3 years of study; 78.7% declared themselves white; 60.7% with a partner, and 76.4% were unemployed. The mean score for anxiety was 7.4 (median=8.0, SD=4.1), for depression was 4.2 (median=3.0, SD=3.8) and for perceived stress was 20.0 (median=19, SD=7.6). Women and patients younger than 60 years old had more symptoms of anxiety and perceived stress; men and the elderly showed more symptoms of depression. There was a strong correlation between symptoms of anxiety, depression, and perceived stress, and a moderate correlation between perceived stress and time to start treatment, all of which were statistically significant. Conclusion: Although patients had different levels of anxiety, depression, and perceived stress in the immediate preoperative period, there was no statistically significant association/correlation between these symptoms and other sociodemographic and clinical variables.

References

Akyol, M., Ulger, E., Alacacioglu, A., Kucukzeybek, Y., Yildiz, Y., Bayoglu, V., ... & Tarhan, M. O. (2015). Sexual satisfaction, anxiety, depression and quality of life among Turkish colorectal cancer patients [Izmir Oncology Group (IZOG) study]. Japanese journal of clinical oncology, 45(7), 657–664. https://doi.org/10.1093/jjco/hyv051

Amin, M. B., Greene, F. L., Edge, S. B., Compton, C. C., Gershenwald, J. E., Brookland, R. K., ... & Winchester, D. P. (2017). AJCC Cancer Staging Manual. 8th ed. New York, NY: Springer; 2017 (pp. 252–254).

Andersen, B. L., DeRubeis, R. J., Berman, B. S., Gruman, J., Champion, V. L., Massie, M. J., ... & Rowland, J. H. (2014). Screening, assessment, and care of anxiety and depressive symptoms in adults with cancer: an American Society of Clinical Oncology guideline adaptation. Journal of Clinical Oncology, 32(15), 1605. https://dx.doi.org/10.1200%2FJCO.2013.52.4611

Apóstolo, J. L. A., Figueiredo, M. H., Mendes, A. C., & Rodrigues, M. A. (2011). Depression, anxiety and stress in primary health care users. Revista Latino-Americana de Enfermagem, 19(2), 348-353. https://doi.org/10.1590/S0104-11692011000200017

Arnold, M., Sierra, M. S., Laversanne, M., Soerjomataram, I., Jemal, A., & Bray, F. (2017). Global patterns and trends in colorectal cancer incidence and mortality. Gut, 66(4), 683-691. http://dx.doi.org/10.1136/gutjnl-2015-310912

Barrett-Bernstein, M., Carli, F., Gamsa, A., Scheede-Bergdahl, C., Minnella, E., Ramanakumar, A. V., & Tourian, L. Depression and functional status in colorectal cancer patients awaiting surgery: Impact of a multimodal prehabilitation program. Health psychology: official journal of the Division of Health Psychology, American Psychological Association, 38(10). https://doi.org/10.1037/hea0000781

Bianchi, E. R. F., & Costa, A. L. S. (2016). Repercussões do trauma anestésico-cirúrgico. In Enfermagem em centro cirúrgico e recuperação (pp. 281-295).

Botega, N. J., Pondé, M., Medeiros, P., Lima, M., & Guerreiro, C. (1998). Validação da escala hospitalar de ansiedade e depressão (HADS) em pacientes epilépticos ambulatoriais. Jornal Brasileiro de Psiquiatria, 47, 285-289. https://www.researchgate.net/publication/285727719

Brasil. Ministério da Saúde. Conselho Nacional de Saúde. Resolução n° 466, de 12 de dezembro de 2012. Diário Oficial da República Federativa do Brasil, Brasília, DF. https://bvsms.saude.gov.br/bvs/saudelegis/cns/2013/res0466_12_12_2012.html

Brasil. Ministério da Saúde. Secretaria de Atenção à Saúde. (2018) Caderneta de saúde da pessoa idosa. Brasília, DF. https://portalarquivos2.saude.gov.br/images/pdf/2017/setembro/27/CADERNETA-PESSOA-IDOSA-2017-Capa-miolo.pdf

Brasil. Instituto Nacional de Câncer José Alencar Gomes da Silva (INCA). (2019). Estimativa 2020: incidência de câncer no Brasil. Rio de Janeiro-RJ. https://www.inca.gov.br/publicacoes/livros/estimativa-2020-incidencia-de-cancer-no-brasil

Brasil. Ministério da Saúde. Secretaria de Atenção à Saúde. (2014). Protocolos clínicos e diretrizes terapêuticas em Oncologia. Brasília, DF. http://bvsms.saude.gov.br/bvs/publicacoes/protocolos_clinicos_diretrizes_terapeuticas_oncologia.pdf

Brasil. Presidência da República. Casa Civil. (2012). Lei nº 12.732, de 22 de novembro de 2012. Brasília, DF. http://www.planalto.gov.br/ccivil_03/_ato2011-2014/2012/lei/l12732.htm

Bulkley, J.E. et al. (2018). Ongoing ostomy self-care challenges of long-term rectal cancer survivors. Support Care Cancer. 26(11), 3933-3939. https://doi.org/10.1007/s00520-018-4268-0

Cardoso, G., Graca, J., Klut, C., Trancas, B., & Papoila, A. (2016). Depression and anxiety symptoms following cancer diagnosis: a cross-sectional study. Psychology, health & medicine, 21(5), 562-570. https://doi.org/10.1080/13548506.2015.1125006

Costa, A., Heitkemper, M. M., Alencar, G. P., Damiani, L. P., Silva, R., & Jarrett, M. E. (2017). Social Support Is a Predictor of Lower Stress and Higher Quality of Life and Resilience in Brazilian Patients With Colorectal Cancer. Cancer nursing, 40(5), 352–360. https://doi.org/10.1097/NCC.0000000000000388

Daian, M. R., Petroianu, A., Alberti, L. R., & Jeunon, E. E. (2012). Estresse em procedimentos cirúrgicos. ABCD. Arquivos Brasileiros de Cirurgia Digestiva, 25(2), 118-124. https://doi.org/10.1590/S0102-67202012000200012

Fayers, P. M., & Machin, D. (2007). Quality of life: Assessment, analyses and interpretation. 2. ed. Chichester, England: John Wiley & Sons.

Firmeza, M. A., Moraes, K. B. R. F. M., Oliveira, P. P., Rodrigues, A. B., Rocha, L. C., & Grangeiro, A. S. M. (2016). Anxiety in patients with malignant neoplasms in the mediate postoperative period: a correlational study. Online Brazilian Journal of Nursing, 15(2), 134–45. https://doi.org/10.17665/1676-4285.20165335

Foster, C., Haviland, J., Winter, J., Grimmett, C., Chivers Seymour, K., Batehup, L., ... & Study Advisory Committee. (2016). Pre-surgery depression and confidence to manage problems predict recovery trajectories of health and wellbeing in the first two years following colorectal cancer: results from the CREW cohort study. PLoS One, 11(5), e0155434. https://doi.org/10.1371/journal.pone.0155434

Garcia, A., Simão-Miranda, T. P., Carvalho, A., Elias, P., Pereira, M., & Carvalho, E. C. (2018). The effect of therapeutic listening on anxiety and fear among surgical patients: randomized controlled trial. Revista latino-americana de enfermagem, 26, e3027. https://doi.org/10.1590/1518-8345.2438.3027

García-García, T., Carmona-Bayonas, A., Jimenez-Fonseca, P., Jara, C., Beato, C., Castelo, B., ... & Calderón, C. Biopsychosocial and clinical characteristics in patients with resected breast and colon cancer at the beginning and end of adjuvant treatment (2019). BMC Cancer, 1143. https://doi.org/10.1186/s12885-019-6358-x

Hulley, S. B., Cummings, S. R., & Newman, T. B. (2015). Delineando estudos transversais e de coorte. Hulley SB, Cummings SR, Browner W, Grady DG, Newman TB. Delineando a pesquisa clínica. 4ª ed. Porto Alegre: Artmed.

International Ostomy Association. (1993). Charter of Ostomates Rights. http://ostomyinternational.org/about-us/charter.html

Jin, Y., Zhang, J., Zheng, M. C., Bu, X. Q., & Zhang, J. E. (2019). Psychosocial behaviour reactions, psychosocial needs, anxiety and depression among patients with rectal cancer before and after colostomy surgery: A longitudinal study. Journal of Clinical Nursing, 28(19-20), 3547-3555. https://doi.org/10.1111/jocn.14946

Laraia, M. T., & Stuart, G. W. (2001). Enfermagem psiquiátrica: princípios e prática. Artmed (pp. 607 – 639).

Macrae, F. A. (2020). Câncer colorretal: epidemiologia, fatores de risco e fatores de proteção. UpToDate. https://www.uptodate.com/contents/colorectal-cancer-epidemiology-risk-factors-and-protective-factors

Malta, M., Cardoso, L. O., Bastos, F. I., Magnanini, M. M., & Silva, C. M. (2010). STROBE initiative: guidelines on reporting observational studies. Revista de saude publica, 44(3), 559–565. https://doi.org/10.1590/s0034-89102010000300021

Mota, L. P., de Sousa, M. V. A., Eckhardt, A., do Nascimento, M. S., de Almeida, L. M. C., de Freitas, J. M., ... & de Sousa Sá, B. V. (2021). Importância do rastreamento do câncer colorretal: uma revisão. Research, Society and Development, 10(13), e472101321360-e472101321360. https://doi.org/10.33448/rsd-v10i13.21360

Pereira, A. C., Soares, V. L., Russo, T. M. S., Teles, A. A. S., Lenza, N. F. B., & Sonobe, H. M. (2016). Pre-operative education in the perspective of cancer patients. Rev Enferm UFPE, 10(2), 449-56. https://periodicos.ufpe.br/revistas/revistaenfermagem/article/view/10976

Reese, J. B., Finan, P. H., Haythornthwaite, J. A., Kadan, M., Regan, K. R., Herman, J. M., ... & Azad, N. S. (2014). Gastrointestinal ostomies and sexual outcomes: a comparison of colorectal cancer patients by ostomy status. Supportive care in cancer, 22(2), 461-468. https://doi.org/10.1007/s00520-013-1998-x

Reis, S.R., Ferreira Hino, A. A., & Romélio Rodriguez Añez, C. (2010). Perceived stress scale: reliability and validity study in Brazil. Journal of health psychology, 15(1), 107-114. https://doi.org/10.1177%2F1359105309346343

Rocha, J. J. R. (2011). Estomas intestinais (ileostomias e colostomias) e anastomoses intestinais. Medicina (Ribeirão Preto), 44(1), 51-56. https://doi.org/10.11606/issn.2176-7262.v44i1p51-56

Ross, L., Abild-Nielsen, A. G., Thomsen, B. L., Karlsen, R. V., Boesen, E. H., & Johansen, C. (2007). Quality of life of Danish colorectal cancer patients with and without a stoma. Supportive Care in Cancer, 15(5), 505-513. https://doi.org/10.1007/s00520-006-0177-8

Ruhaiyem, M. E., Alshehri, A. A., Saade, M., Shoabi, T. A., Zahoor, H., & Tawfeeq, N. A. (2016). Fear of going under general anesthesia: A cross-sectional study. Saudi journal of anaesthesia, 10(3), 317–321. https://doi.org/10.4103/1658-354X.179094

Sanft T., Denlinger C. S., Armenian S., Baker K. S., Broderick G., Demark-Wahnefried W., ... & Freedman-Cass D. A. (2019). NCCN Guidelines Insights: Survivorship, Version 2.2019. J Natl Compr Canc Netw, 1;17(7):784-94. https://doi.org/10.6004/jnccn.2019.0034

Santos, L. J. F., Garcia, J. B. D. S., Pacheco, J. S., Vieira, É. B. D. M., & Santos, A. M. D. (2014). Quality of life, pain, anxiety and depression in patients surgically treated with cancer of rectum. ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo), 27, 96-100. https://doi.org/10.1590/S0102-67202014000200003

Sasaki, V. D. M., Teles, A. D. S., Lima, M. D., Barbosa, J. C. C., Lisboa, B. B., & Sonobe, H. M. (2017). Rehabilitation of people with intestinal stomy: integration review. Rev Enferm UFPE [Internet], 11(4), 1745-54. https://periodicos.ufpe.br/revistas/revistaenfermagem/article/download/15271/18079

Silva, N. M., Santos, M. A. D., Barroso, B. C. T., Rosado, S. R., Teles, A. A. D. S., & Sonobe, H. M. (2019). Estratégias de atendimento psicológico a pacientes estomizados e seus familiares. Psicologia: Ciência e Profissão, 39. https://doi.org/10.1590/1982-3703003178982

Silva, N. M., Santos, M. A. D., Rosado, S. R., Galvão, C. M., & Sonobe, H. M. (2017). Psychological aspects of patients with intestinal stoma: integrative review. Revista latino-americana de enfermagem, 25.: http://dx.doi.org/10.1590/1518-8345.2231.2950

Sun, G. W., Yang, Y. L., Yang, X. B., Wang, Y. Y., Cui, X. J., Liu, Y., & Xing, C. Z. (2020). Preoperative insomnia and its association with psychological factors, pain and anxiety in Chinese colorectal cancer patients. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 28(6), 2911–2919. https://doi.org/10.1007/s00520-019-05151-y

Teles, A. A. S., Pantoni, L. A., Neves, W. F. S., Aguiar, J. C., Russo, T. M. S., Paraizo-Horvath, C. M. S., ... & Sonobe, H. M. (2021). Perioperative Nursing Care for Patients with Colorectal Cancer: Sociodemographic, Clinical and Therapeutic Characterization. Research, Society and Development, 10(7), e30310716599. https://doi.org/10.33448/rsd-v10i7.16599

Teles, A. A. S. (2021). Ansiedade, depressão e estresse percebido no perioperatório de pacientes com e sem estomização intestinal por câncer colorretal (Tese de Doutorado). https://doi.org/10.11606/T.22.2021.tde-14122021-171458

Teles, A. A. S., Eltink, C. F., Martins, L. M., Lenza, N. D. F., Sasaki, V. D. M., & Sonobe, H. M. (2017). Physical, psychosocial changes and feelings generated by intestinal ostomy for the patient: integrative review. Rev Enferm UFPE [Internet], 11(2), 1062-72. https://periodicos.ufpe.br/revistas/revistaenfermagem/article/viewFile/13477/16185

Tung, H. Y., Chao, T. B., Lin, Y. H., Wu, S. F., Lee, H. Y., Ching, C. Y., ... & Lin, T. J. (2016). Depression, fatigue, and QoL in colorectal cancer patients during and after treatment. Western Journal of Nursing Research, 38(7), 893-908. https://doi.org/10.1177%2F0193945916630256

Yang, Y., Sun, G., Dong, X., Zhang, H., Xing, C., & Liu, Y. (2019). Preoperative anxiety in Chinese colorectal cancer patients: The role of social support, self-esteem and coping styles. Journal of psychosomatic research, 121, 81-87. https://doi.org/10.1016/j.jpsychores.2019.02.009

Zhang, C., Cheng, Y., Luo, D., Wang, J., Liu, J., Luo, Y., … & Chen, H. (2021). Association between cardiovascular risk factors and colorectal cancer: A systematic review and meta-analysis of prospective cohort studies. EClinicalMedicine, 34, 100794. https://doi.org/10.1016/j.eclinm.2021.100794

Zhao, P., Wu, Z., Li, C., Yang, G., Ding, J., Wang, K., ... & Li, H. (2020). Postoperative analgesia using dezocine alleviates depressive symptoms after colorectal cancer surgery: A randomized, controlled, double-blind trial. PloS one, 15(5), e0233412. https://doi.org/10.1371/journal.pone.0233412

Published

07/06/2022

How to Cite

TELES, A. A. da S.; CORREA JÚNIOR, A. J. S. .; AGUIAR, J. C. .; NEVES, W. F. dos S. .; PARAIZO-HORVATH, C. M. S. .; RUSSO, T. M. da S. .; DESSOTTE, C. A. M. .; SONOBE, H. M. . Anxiety, depression and perceived stress in preoperative colorectal cancer patients: a cross-sectional study. Research, Society and Development, [S. l.], v. 11, n. 8, p. e3811830475, 2022. DOI: 10.33448/rsd-v11i8.30475. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/30475. Acesso em: 25 nov. 2024.

Issue

Section

Health Sciences