Targeting those with decreased meaning and peace: a supportive care opportunity.

Authors:
Alaina J Brown
Alaina J Brown
The University of Texas MD Anderson Cancer Center
United States
Charlotte C Sun
Charlotte C Sun
The University of Texas MD Anderson Cancer Center
United States
Diana Urbauer
Diana Urbauer
The University of Texas MD Anderson Cancer Center
United States
Donna S Zhukovsky
Donna S Zhukovsky
The University of Texas M. D. Anderson Cancer Center
Charles Levenback
Charles Levenback
The University of Texas M. D. Anderson Cancer Center
United States
Michael Frumovitz
Michael Frumovitz
The University of Texas MD Anderson Cancer Center
United States
Premal H Thaker
Premal H Thaker
Washington University School of Medicine
United States
Diane C Bodurka
Diane C Bodurka
The University of Texas M. D. Anderson Cancer Center
United States

Support Care Cancer 2015 Jul 18;23(7):2025-32. Epub 2014 Dec 18.

Department of Gynecologic Oncology and Reproductive Medicine, Unit 1362F, The University of Texas MD Anderson Cancer Center, 1155 Herman Pressler, Houston, TX, 77030, USA,

Purpose: To evaluate if an individual's level of meaning/peace (M/P) predicts various quality of life (QOL) and mental well-being measures. To identify targets that might enhance the overall spiritual well-being and QOL of ovarian cancer patients.

Methods: Multi-site analysis of women with newly diagnosed stages II-IV ovarian, primary peritoneal, or fallopian tube cancer. Patients completed the following surveys: Functional Assessment of Chronic Illness Therapy-Ovarian (FACT-O), Functional Assessment of Chronic Illness Therapy-Spiritual (FACIT-Sp), Edmonton Symptom Assessment System (ESAS), Hospital Anxiety and Depression Scale (HADS), Templer's Death Anxiety Scale (DAS), Herth Hope Index (HHI), and Brief Multidimensional Measure of Religiousness/Spirituality (BMMRS). Linear regression models were created to examine the effect of M/P (FACIT-Sp) upon QOL, symptoms, and other measures of mental well-being. These models adjusted for the effect of site, race, age, stage, anaphylaxis to chemotherapy, and partner status as potential confounders.

Results: This study enrolled 104 patients from three separate sites. After adjusting for potential confounders, it was found that higher M/P predicted better QOL (FACT-O) (p < 0.0001). Higher M/P also predicted decreased death anxiety, depression, and anxiety (p ≤ 0.005). Finally, higher M/P predicted increased hope and coping scores (p ≤ 0.0005).

Conclusions: Level of M/P is associated with several important mental and physical health states. This information may allow providers to identify patients at increased risk for mental/physical distress and may facilitate early referral to targeted psychotherapy interventions focused on improving patient QOL and decreasing anxiety and depression.

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http://dx.doi.org/10.1007/s00520-014-2568-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4449799PMC
July 2015
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