Self reported changes in quality of life, demands of illness, and sexual function in colon cancer survivors

Thesis (Ph.D.), College of Nursing, Washington State UniversityThe vast majority of research among colon cancer survivors has been conducted retrospectively, reported in aggregate, from a heterogeneous group of survivors. The purpose of this prospective longitudinal study was to describe the impact of surgery and chemotherapy on quality of life, demands of illness, sexual functioning and peripheral neuropathy in the acute survivorship period. Twenty-five men and women, newly diagnosed with colon cancer, completed study questionnaires pre-operatively (time 1), 4-6 weeks (time 2), 20-24 weeks (time 3) and 32-36 weeks (time 4) after surgical resection. Pearson’s correlation was used to analyze relationships between outcome variables. A 2 x 4 mixed design ANOVA was employed to assess changes over time, between groups (chemotherapy vs. no chemotherapy) and the interaction of time and chemotherapy. There were no significant differences in global health status scores over time or between chemotherapy groups. Fatigue, pain, insomnia, appetite, and financial difficulty were the top rated symptoms. Family demands were ranked as the highest demand in the total sample at time 2, and remained a top demand postoperatively, in those who received chemotherapy. Social functioning and role functioning were lower in the chemotherapy group. Fatigue correlated positively with the symptoms of pain, insomnia and financial difficulty at time 2 and with pain, appetite and diarrhea at time 4. Sexual function scores remained stable for all participants over time and at time 4 were positively correlated with baseline sexual function scores and negatively correlated with neuropathy scores among those receiving chemotherapy. Personal meaning demands declined in the sample over time and neurotoxicity scores significantly increased over time. There was also a significant interaction effect (chemotherapy x time) for financial difficulty, physical symptom demands, social relationship demands, monitoring symptom demands and neurotoxicity scores, whereby these variables increased among those in the chemotherapy group and decreased in the non-chemotherapy group by time 3, but then did not differ across chemotherapy groups at time 4. This longitudinal documentation of the study’s four major health outcomes provides data to help nurses provide anticipatory guidance to survivors in the first year after diagnosis and provides a framework for future survivorship research.College of Nursing, Washington State Universit