skip to main content

Factors Influencing the Quality of Life in Thai Cancer Patients Receiving Chemotherapy during COVID-19 Pandemic

*Supawan Jaiboon orcid  -  Department of Medical and Surgical Nursing, Kuakarun Faculty of Nursing, Navamindradhiraj University, Thailand
Arveewan Vittayatigonnasak  -  Chemotherapy Unit, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Thailand
Open Access Copyright (c) 2023 Nurse Media Journal of Nursing
Creative Commons License This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Citation Format:

Background: The Coronavirus disease (COVID-19) pandemic has physical and mental impacts on cancer patients receiving chemotherapy and this can lead to a decline in their quality of life (QoL). Little is currently known about the factors that affect QoL among cancer patients in Thailand during the COVID-19 pandemic.

Purpose: This study aimed to examine the factors influencing the QoL of cancer patients receiving chemotherapy during the COVID-19 pandemic.

Methods: This descriptive cross-sectional study was conducted among 102 cancer patients undergoing chemotherapy recruited using a simple random sampling technique. Four instruments were used; 1) Demographic and clinical characteristics questionnaires; 2) the Thai Hospital Anxiety and Depression Scale (Thai HADS); 3) the Revised Thai version of the Multidimensional Scale of Perceived Social Support (r-Thai MSPSS); and 4) the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQC-30, Thai version). Descriptive statistics and multiple linear regression were used for data analysis.

Results:  According to the findings, the study demonstrated that depression had a statistically significant negative influence on QoL, physical functioning, and emotional functioning (B=-2.196, p=0.001; B=-2.630, p<0.001; B=-1.605, p=0.009, respectively). Similarly, anxiety exhibited a negative influence on emotional functioning, cognitive functioning, and social functioning (B= -2.593, p<0.001; B=-1.508, p=0.037). However, social support did not significantly influence QoL.

Conclusion: The study underscores the negative impact of depression and anxiety on QoL, emphasizing the importance of addressing psychological well-being. While social support’s influence on QoL was not significant in this context, the research highlights the factors affecting cancer patients’ well-being during challenging times. These insights could inform interventions to enhance QoL and patient care.

Fulltext View|Download
Keywords: Anxiety and depression; cancer patients; COVID-19; quality of life; social support

Article Metrics:

  1. Aaronson, N. K., Ahmedzai, S., Bergman, B., Bullinger, M., Cull, A., Duez, N. J., Filiberti, A., Flechtner, H., Fleishman, S. B., de Haes, J. C., Kaasa, S., Klee, M., Osoba, D., Razavi, D., Rofe, P. B., Schraub, S., Sneeuw, K., Sullivan, M., & Takeda, F. (1993). The European organization for research and treatment of cancer QLQ-C30: A quality-of-life instrument for use in international clinical trials in oncology. Journal of the National Cancer Institute, 85(5), 365-376.
  2. Adzrago, D., Sulley, S., Tagoe, I., Ormiston, C. K., Odame, E. A., Mamudu, L., & Williams, F. (2022). Assessment of anxiety/depression among cancer patients before and during the COVID-19 pandemic. Psycho-Oncology, 31(10), 1681-1691.
  3. Aminisani, N., Nikbakht, H., Asghari Jafarabadi, M., & Shamshirgaran, S. M. (2017). Depression, anxiety, and health related quality of life among colorectal cancer survivors. Journal of Gastrointestinal Oncology, 8(1), 81-88.
  4. Ayubi, E., Bashirian, S., & Khazaei, S. (2021). Depression and anxiety among patients with cancer during covid-19 pandemic: A systematic review and meta-analysis. Journal of Gastrointestinal Cancer, 52(2), 499-507.
  5. Bergerot, C. D., Costas-Muñiz, R., Lee, D., & Philip, E. J. (2022). Social support as a protective factor for patients with cancer during the pandemic. Cancer Investigation, 40(6), 473-474.
  6. Boettcher, A. N., Hammoud, D. A., Weinberg, J. B., Agarwal, P., Mendiratta-Lala, M., & Luker, G. D. (2020). Cancer imaging and patient care during the COVID-19 pandemic. Radio Imaging Cancer, 2(6), e200058.
  7. Brooks, S. K., Webster, R. K., Smith, L. E., Woodland, L., Wessely, S., Greenberg, N., & Rubin, G. J. (2020). The psychological impact of quarantine and how to reduce it: Rapid review of the evidence. Lancet, 395(10227), 912-920.
  8. Bužgová, R., Jarošová, D., & Hajnová, E. (2015). Assessing anxiety and depression with respect to the quality of life in cancer inpatients receiving palliative care. European Journal of Oncology Nursing, 19(6), 667-672.
  9. Ciążyńska, M., Pabianek, M., Szczepaniak, K., Ułańska, M., Skibińska, M., Owczarek, W., Narbutt, J., & Lesiak, A. (2020). Quality of life of cancer patients during coronavirus disease (COVID-19) pandemic. Psychooncology, 29(9), 1377-1379.
  10. Davis, R. E., Trickey, A. W., Abrahamse, P., Kato, I., Ward, K., & Morris, A. M. (2021). Association of cumulative social risk and social support with receipt of chemotherapy among patients with advanced colorectal cancer. JAMA Network Open, 4(6), e2113533.
  11. Dehghan, M., Jazinizade, M., Malakoutikhah, A., Madadimahani, A., Iranmanesh, M. H., Oghabian, S., Mohammadshahi, F., Janfaza, F., & Zakeri, M. A. (2020). Stress and quality of life of patients with cancer: The mediating role of mindfulness. Journal of Oncology, 2020, 3289521.
  12. Faghani, S., Rahmani, A., Parizad, N., Mohajjel-Aghdam, A. R., Hassankhani, H., & Mohammadpoorasl, A. (2014). Social support and its predictors among Iranian cancer survivors. Asian Pacific Journal of Cancer Prevention, 15(22), 9767-9771.
  13. Fortune, E. E., Zaleta, A. K., & Morris, V. G. (2023). Perceived COVID-19 pandemic impact and protective factors predicting patient-reported depression and anxiety in individuals living with cancer. Journal of Patient-Reported Outcomes, 7(1), 29.
  14. Fujisawa, D., Inoguchi, H., Shimoda, H., Yoshiuchi, K., Inoue, S., Ogawa, A., Okuyama, T., Akechi, T., Mimura, M., Shimizu, K., & Uchitomi, Y. (2016). Impact of depression on health utility value in cancer patients. Psychooncology, 25(5), 491-49
  15. Grivas, P., Khaki, A. R., Wise-Draper, T. M., French, B., Hennessy, C., Hsu, C. Y., Shyr, Y., Li, X., Choueiri, T. K., Painter, C. A., S. Peters, Rini, B. I., Thompson, M.A., Mishra, S., Rivera, D.R., Acoba, J.D., Abidi, M.Z., Bakouny, Z., Bashir, B., ... Lopes, GdL. (2021). Association of clinical factors and recent anticancer therapy with COVID-19 severity among patients with cancer: A report from the COVID-19 and cancer consortium. Annals of Oncology, 32(6), 787–800.
  16. Heidary, Z., Ghaemi, M., Hossein Rashidi, B., Kohandel Gargari, O., & Montazeri, A. (2023). Quality of life in breast cancer patients: A systematic review of the qualitative studies. Cancer Control, 30, 10732748231168318.
  17. Hofman, A., Zajdel, N., Klekowski, J., & Chabowski, M. (2021). Improving social support to increase QoL in lung cancer patients. Cancer Management Research, 13, 2319-2327.
  18. Jeppesen, S. S., Bentsen, K. K., Jørgensen, T. L., Holm, H. S., Holst-Christensen, L., Tarpgaard, L. S., Dahlrot, R. H., & Eckhoff, L. (2021). Quality of life in patients with cancer during the COVID-19 pandemic - A Danish cross-sectional study (COPICADS). Acta Oncologica, 60(1), 4-12.
  19. Khue, P. M., Thom, V. T., Minh, D. Q., Quang, L. M., & Hoa, N. L. (2019). Depression and anxiety as key factors associated with quality of life among lung cancer patients in Hai Phong, Vietnam. Frontiers in Psychiatry, 10, 352.
  20. Lee, J. L., & Jeong, Y. (2019). Quality of life in patients with non-small cell lung cancer: Structural equation modeling. Cancer Nursing, 42(6), 475-483.
  21. Li, M. Y., Yang, Y. L., Liu, L., & Wang, L. (2016). Effects of social support, hope and resilience on quality of life among Chinese bladder cancer patients: A cross-sectional study. Health and Quality of Life Outcomes, 14, 73.
  22. Miaskowski, C., Paul, S. M., Snowberg, K., Abbott, M., Borno, H., Chang, S., Chen, L. M., Cohen, B., Hammer, M. J., Kenfield, S. A., Kober, K. M., Levine, J. D., Pozzar, R., Rhoads, K. F., Van Blarigan, E. L., & Van Loon, K. (2020). Stress and symptom burden in oncology patients during the COVID-19 pandemic. Journal of Pain and Symptom Management, 60(5), e25-e34.
  23. Momenimovahed, Z., Salehiniya, H., Hadavandsiri, F., Allahqoli, L., Günther, V., & Alkatout, I. (2021). Psychological distress among cancer patients during covid-19 pandemic in the world: A systematic review. Frontiers in Psychology, 12, 682154.
  24. Naseri, N., & Taleghani, F. (2012). Social support in cancer patients referring to Sayed Al-Shohada hospital. Iranian Journal of Nursing and Midwifery Research, 17(4), 279-283
  25. Nguyen, H. T. H., Duong, K. L., Nguyen, S. T., Trinh, Q., Hoang, H. T. L., Phung, T. Q., Lin, H. W., & Nguyen, H. T. L. (2022). Quality of life and its associated factors among cancer patients receiving chemotherapy at oncology hospitals in Vietnam after the third wave of the COVID-19 pandemic. Cancer Management and Research, 14, 2429-2444.
  26. Nilchaikovit, T., Lortrakul, M., & Phisanuthideth, U. (1996). Development of Thai version of hospital anxiety and depression scale in cancer patients. Journal of Psychiatric Association of Thailand, 41, 18-30
  27. Nnaji, C. A., & Moodley, J. (2021). Impact of the COVID-19 pandemic on cancer diagnosis, treatment and research in African health systems: A review of current evidence and contextual perspectives. Ecancermedicalscience, 15, 1170.
  28. Obispo-Portero, B., Cruz-Castellanos, P., Jiménez-Fonseca, P., Rogado, J., Hernandez, R., Castillo-Trujillo, O. A., Asensio-Martínez, E., González-Moya, M., Carmona-Bayonas, A., & Calderon, C. (2022). Anxiety and depression in patients with advanced cancer during the COVID-19 pandemic. Supportive Care in Cancer, 30(4), 3363-3370.
  29. Park, C. L., Russell, B. S., Fendrich, M., Finkelstein-Fox, L., Hutchison, M., & Becker, J. (2020). Americans' COVID-19 stress, coping, and adherence to CDC guidelines. Journal of General Internal Medicine, 35(8), 2296-2303.
  30. Qian, Y., Wu, K., Xu, H., Bao, D., Ran, F., Wei, W., Cheng, T., Huang, D., Lin, X., Bruera, E., Hu, D., & Wu, Y. (2020). A survey on physical and mental distress among cancer patients during the COVID-19 epidemic in Wuhan, China. Journal of Palliative Medicine, 23(7), 888-889.
  31. Ramasubbu, S. K., Pasricha, R. K., Nath, U. K., Rawat, V. S., & Das, B. (2021). Quality of life and factors affecting it in adult cancer patients undergoing cancer chemotherapy in a tertiary care hospital. Cancer Reports (Hoboken), 4(2), e1312.
  32. Raz, D. J., Sun, V., Kim, J. Y., Williams, A. C., Koczywas, M., Cristea, M., Reckamp, K., Hayter, J., Tiep, B., & Ferrell, B. (2016). Long-term effect of an interdisciplinary supportive care intervention for lung cancer survivors after surgical procedures. Annals of Thoracic Surgery, 101(2), 495-502; discussion 502-493.
  33. Salari, N., Hosseinian-Far, A., Jalali, R., Vaisi-Raygani, A., Rasoulpoor, S., Mohammadi, M., Rasoulpoor, S., & Khaledi-Paveh, B. (2020). Prevalence of stress, anxiety, depression among the general population during the COVID-19 pandemic: A systematic review and meta-analysis. Globalization and Health, 16, 57.
  34. Sharafeldin, N., Bates, B., Song, Q., Madhira, V., Yan, Y., Dong, S., Lee, E., Kuhrt, N., Shao, Y. R., Liu, F., Bergquist, T., Guinney, J., Su, J., & Topaloglu, U. (2021). Outcomes of COVID-19 in patients with cancer: Report from the National COVID Cohort Collaborative (N3C). Journal of Clinical Oncology, 39(20), 2232-2246.
  35. Silpakit, C., Sirilerttrakul, S., Jirajarus, M., Sirisinha, T., Sirachainan, E., & Ratanatharathorn, V. (2006). The European organization for research and treatment of cancer quality of life questionnaire (EORTC QLQ-C30): Validation study of the Thai version. Quality of Life Research, 15(1), 167-172.
  36. Sinaga, M. R. E., Simanjuntak, S. R, & Locsin, R. C. (2022). Factors affecting the quality of life of older people during the COVID-19 pandemic. Nurse Media Journal of Nursing, 12(2), 185-195.
  37. Sukhokanjanachusak, K. (2021). The Coronavirus 2019 (Covid-19) pandemic on treatment outcome and requirement of the cancer patient in Suratthani hospital; 2021. Region 11 Medical Journal, 35(1).
  38. Sumdaengrit, B., & Limthongkul, M. (2014). Factors predicting quality of life in breast cancer patients after treatment in university hospital. Journal of Nursing and Health Care, 32(4), 85-93
  39. Tian, J., Yuan, X., Xiao, J., Zhong, Q., Yang, C., Liu, B., Cai, Y., Lu, Z., Wang, J., Wang, Y., Liu, S., Cheng, B., Wang, J., Zhang, M., Wang, L., Niu, S., Yao, Z., Deng, X., Zhou, F., … Wang, Z. (2020). Clinical characteristics and risk factors associated with COVID-19 disease severity in patients with cancer in Wuhan, China: A multicentre, retrospective, cohort study. The Lancet Oncology, 21(7), 893-903.
  40. Wang, Y., Duan, Z., Ma, Z., Mao, Y., Li, X., Wilson, A., Qin, H., Ou, J., Peng, K., Zhou, F., Li, C., Liu, Z., & Chen, R. (2020). Epidemiology of mental health problems among patients with cancer during COVID-19 pandemic. Translational Psychiatry, 10(1), 263.
  41. Wondie, Y., Mehnert, A., & Hinz, A. (2020). The hospital anxiety and depression scale (HADS) applied to Ethiopian cancer patients. PLoS One 15(12), e0243357.
  42. Waterhouse, D. M., Harvey, R. D., Hurley, P., Levit, L. A., Kim, E. S., Klepin, H. D., Mileham, K. F., Nowakowski, G., Schenkel, C., Davis, C., Bruinooge, S. S., & Schilsky, R. L. (2020). Early impact of COVID-19 on the conduct of oncology clinical trials and long-term opportunities for transformation: Findings from an American Society of Clinical Oncology Survey. Journal of Oncology Practice, 16(7), 417-421.
  43. Wongpakaran, N., & Wongpakaran, T. (2012). A revised Thai multi-dimensional scale of perceived social support. Spanish Journal of Psychology, 15(3), 1503-1509.
  44. Wongpakaran, T., Wongpakaran, N., Sirirak, T., Arunpongpaisal, S., & Zimet, G. (2018). Confirmatory factor analysis of the revised version of the Thai multidimensional scale of perceived social support among the elderly with depression. Aging and Mental Health, 22(9), 1143-1148.
  45. Zhang, Y., Cui, C., Wang, Y., & Wang, L. (2020). Effects of stigma, hope and social support on quality of life among Chinese patients diagnosed with oral cancer: A cross-sectional study. Health and Quality of Life Outcomes, 18, 112.

Last update:

No citation recorded.

Last update: 2024-06-16 23:26:51

No citation recorded.