Journal of Korean Academy of Nursing (대한간호학회지)

Korean Society of Nursing Science (한국간호과학회)
권호 표지
DOI QR코드

DOI QR Code

Impact of Bowel Function, Anxiety and Depression on Quality of Life in Patients with Sphincter-preserving Resection for Rectal Cancer

항문보존술을 받은 직장암 환자의 배변기능, 불안 및 우울이 삶의 질에 미치는 영향

  • 권현준 (원주세브란스기독병원) ;
  • 신윤희 (연세대학교 원주의과대학 간호학과)
  • Received : 2015.02.25
  • Accepted : 2015.07.06
  • Published : 2015.10.31
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: This study was a descriptive survey research to identify the impact of bowel function, anxiety and depression on quality of life in patients with rectal cancer who had a sphincter-preserving resection. Methods: Participants were 100 patients who had rectal cancer surgery at W hospital in Korea. Bowel function, anxiety & depression, and quality of life were measured using the BFI (Bowel Function Instrument), HADS (Hospital Anxiety-Depression Scale) and the FACT-C (Functional Assessment of Cancer Therapy-Colorectal). Results: The mean scores were $39.81{\pm}5.16$ for bowel function, $6.15{\pm}3.25$ for anxiety, $7.24{\pm}3.13$ for depression, and $72.50{\pm}13.27$ for quality of life. There were significant negative correlations between quality of life and anxiety (r= -.59, p <.001) and between quality of life and depression (r= -.53, p <.001). But the correlation between quality of life and bowel function was significantly positive (r=.22, p =.025). The influence of the independent variables on the total quality of life was examined using multiple regression analysis. Anxiety (${\beta}$= -.38, p =.002), bowel function (${\beta}$= -.25, p =.028) and occupation (${\beta}$=.16, p =.048) were identified as factors affecting quality of life. The explanation power of this regression model was 44% and it was statistically significant (F=16.53, p <.001). Conclusion: The results of this study indicate that in order to improve the bowel function of patients after sphincter-preserving resection for rectal cancer, effective nursing interventions should be developed. As psychological problem such as anxiety and depression can relate to quality of life for these patients, nurses should work on improving the situation by providing continuous emotional nursing.

Keywords

References

  1. Statistics Korea. Cancer registration statistics [Internet]. Daejeon: Author; 2013 [cited 2015 March 27]. Available from: http://kosis.kr/eng/statisticsList/statisticsList_01List.jsp?vwcd=MT_ETITLE&parentId=D.
  2. National Cancer Center. Cancer facts & figures 2013 in the Republic of Korea. Goyang: National Cancer Center, Ministry of Health and Welfare; 2013.
  3. Korean Oncology Nursing Society. Oncology nursing: Treatment and care. 2nd ed. Seoul: FORNURSE; 2013.
  4. Kim JW. The quality of life after rectal cancer surgery. The Korean Journal of Gastroenterology. 2006;47(4):295-299.
  5. Knowles G, Haigh R, McLean C, Phillips HA, Dunlop MG, Din FV. Long term effect of surgery and radiotherapy for colorectal cancer on defecatory function and quality of life. European Journal of Oncology Nursing. 2013;17(5):570-577. http://dx.doi.org/10.1016/j.ejon.2013.01.010
  6. Bartlett L, Sloots K, Nowak M, Ho YH. Biofeedback therapy for symptoms of bowel dysfunction following surgery for colorectal cancer. Techniques in Coloproctology. 2011;15(3):319-326. http://dx.doi.org/10.1007/s10151-011-0713-5
  7. Park UC. Biofeedback therapy in patients with functional evacuation disorders. Journal of the Korean Society of Coloproctology. 2003;19(4):260-269.
  8. Lim SM. The relationships among bowel function, health locus of control, anxiety, depression in patients with rectal cancer [master' s thesis]. Seoul: Ewha Womans University; 2013.
  9. Kim HK. Health-related quality of life and its related factors in patients with rectal cancer [master's thesis]. Seoul: Yonsei University; 2003.
  10. Neuman HB, Schrag D, Cabral C, Weiser MR, Paty PB, Guillem JG, et al. Can differences in bowel function after surgery for rectal cancer be identified by the European Organization for Research and Treatment of Cancer Quality of Life Instrument? Annals of Surgical Oncology. 2007;14(5):1727-1734. http://dx.doi.org/10.1245/s10434-006-9283-6
  11. Kim MY. Transition of symptoms and quality of life in cancer patients on chemotherapy. Journal of Korean Academy of Nursing. 2009;39(3):433-445. http://dx.doi.org/10.4040/jkan.2009.39.3.433
  12. Park HM, Ha NS. Influencing predictors of quality of life in colorectal cancer patient with colostomy. Clinical Nursing Research. 2006;12(2):123-131. https://doi.org/10.1177/1054773803012002001
  13. Denost Q, Laurent C, Capdepont M, Zerbib F, Rullier E. Risk factors for fecal incontinence after intersphincteric resection for rectal cancer. Diseases of the Colon and Rectum. 2011;54(8):963-968. http://dx.doi.org/10.1097/DCR.0b013e31821d3677
  14. Pucciarelli S, Del Bianco P, Efficace F, Toppan P, Serpentini S, Friso ML, et al. Health-related quality of life, faecal continence and bowel function in rectal cancer patients after chemoradiotherapy followed by radical surgery. Supportive Care in Cancer. 2010;18(5):601-608. http://dx.doi.org/10.1007/s00520-009-0699-y
  15. Valsdottir EB, Yarandi SS, Marks JH, Marks GJ. Quality of life and fecal incontinence after transanal endoscopic microsurgery for benign and malignant rectal lesions. Surgical Endoscopy. 2014;28(1):193-202. http://dx.doi.org/10.1007/s00464-013-3155-5
  16. Chen TY, Emmertsen KJ, Laurberg S. Bowel dysfunction after rectal cancer treatment: A study comparing the specialist's versus patient's perspective. BMJ Open. 2014;4(1):e003374. http://dx.doi.org/10.1136/bmjopen-2013-003374
  17. Emmertsen KJ, Laurberg S. Impact of bowel dysfunction on quality of life after sphincter-preserving resection for rectal cancer. The British Journal of Surgery. 2013;100(10):1377-1387. http://dx.doi.org/10.1002/bjs.9223
  18. Kim HJ. Nutritional risk, physical activity, depression and quality of life among patients with colorectal cancer [master's thesis]. Seoul: Yonsei University; 2011.
  19. Bennis M, Parc Y, Lefevre JH, Chafai N, Attal E, Tiret E. Morbidity risk factors after low anterior resection with total mesorectal excision and coloanal anastomosis: A retrospective series of 483 patients. Annals of Surgery. 2012;255(3):504-510. http://dx.doi.org/10.1097/SLA.0b013e31824485c4
  20. Temple LK, Bacik J, Savatta SG, Gottesman L, Paty PB, Weiser MR, et al. The development of a validated instrument to evaluate bowel function after sphincter-preserving surgery for rectal cancer. Diseases of the Colon and Rectum. 2005;48(7):1353-1365. http://dx.doi.org/10.1007/s10350-004-0942-z
  21. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica. 1983;67(6):361-370. https://doi.org/10.1111/j.1600-0447.1983.tb09716.x
  22. Oh SM, Min KJ, Park DB. A study on the standardization of the hospital anxiety and depression scale for Koreans: A comparison of normal, depressed and anxious groups. Journal of Korean Neuropsychiatric Association. 1999;38(2):289-296.
  23. Kim H, Yoo HJ, Kim YJ, Han OS, Lee KH, Lee JH, et al. Development and validation of Korean functional assessment cancer therapy-general (FACT-G). The Korean Journal of Clinical Psychology. 2003;22(1):215-229.
  24. Bossema ER, Seuntiens MW, Marijnen CA, Baas-Thijssen MC, van de Velde CJ, Stiggelbout AM. The relation between illness cognitions and quality of life in people with and without a stoma following rectal cancer treatment. Psycho-Oncology. 2011;20(4):428-434. http://dx.doi.org/10.1002/pon.1758
  25. American Society of Clinical Oncology. Managing emotions [Internet]. Alexandria, VA: Author; 2012 [cited 2013 December 28]. Available from: http://www.cancer.net/coping-and-emotions/managing-emotions.
  26. Choi KS, Park JA, Lee J. The effect of symptom experience and resilience on quality of life in patients with colorectal cancers. Asian Oncology Nursing. 2012;12(1):61-68. http://dx.doi.org/10.5388/aon.2012.12.1.61
  27. Stephenson LE, Bebb DG, Reimer RA, Culos-Reed SN. Physical activity and diet behaviour in colorectal cancer patients receiving chemotherapy: Associations with quality of life. BMC Gastroenterology. 2009;9:60. http://dx.doi.org/10.1186/1471-230x-9-60
  28. Camilleri-Brennan J, Steele RJ. The impact of recurrent rectal cancer on quality of life. European Journal of Surgical Oncology. 2001;27(4):349-353. http://dx.doi.org/10.1053/ejso.2001.1115
  29. Rauch P, Miny J, Conroy T, Neyton L, Guillemin F. Quality of life among disease-free survivors of rectal cancer. Journal of Clinical Oncology. 2004;22(2):354-360. http://dx.doi.org/10.1200/jco.2004.03.137
  30. Peng J, Shi D, Goodman KA, Goldstein D, Xiao C, Guan Z, et al. Early results of quality of life for curatively treated rectal cancers in Chinese patients with EORTC QLQ-CR29. Radiation Oncology. 2011;6:93. http://dx.doi.org/10.1186/1748-717x-6-93
  31. Yoo YS, Cho OH. Relationship between quality of life and nurseled bedside symptom evaluations in patients with chemotherapyinduced peripheral neuropathy. Asian Nursing Research. 2014;8(1):36-41. http://dx.doi.org/10.1016/j.anr.2013.11.002

Cited by

  1. Psychosocial behaviour reactions, psychosocial needs, anxiety and depression among patients with rectal cancer before and after colostomy surgery: A longitudinal study vol.28, pp.19, 2015, https://doi.org/10.1111/jocn.14946
  2. Predictors of Quality of Life and Social Support as a Mediator between Defecation Function and Quality of Life among Rectal Cancer Patients vol.31, pp.5, 2015, https://doi.org/10.7475/kjan.2019.31.5.487
  3. Effectiveness and safety of acupuncture and moxibustion for defecation dysfunction after sphincter-preserving surgery for rectal cancer: protocol for systematic review and meta-analysis vol.10, pp.5, 2020, https://doi.org/10.1136/bmjopen-2019-034152
  4. The Relationships among Social Support, Bowel Function Symptoms and Uncertainty in Rectal Cancer Patients vol.28, pp.4, 2015, https://doi.org/10.7739/jkafn.2021.28.4.421