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

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Purpose

This paper identifies predictors of recovery trajectories of quality of life (QoL), health status and personal wellbeing in the two years following colorectal cancer surgery.

Methods

872 adults receiving curative intent surgery during November 2010 to March 2012. Questionnaires at baseline, 3, 9, 15, 24 months post-surgery assessed QoL, health status, wellbeing, confidence to manage illness-related problems (self-efficacy), social support, co-morbidities, socio-demographic, clinical and treatment characteristics. Group-based trajectory analyses identified distinct trajectories and predictors for QoL, health status and wellbeing.

Results

Four recovery trajectories were identified for each outcome. Groups 1 and 2 fared consistently well (scores above/within normal range); 70.5% of participants for QoL, 33.3% health status, 77.6% wellbeing. Group 3 had some problems (24.2% QoL, 59.3% health, 18.2% wellbeing); Group 4 fared consistently poorly (5.3% QoL, 7.4% health, 4.2% wellbeing). Higher pre-surgery depression and lower self-efficacy were significantly associated with poorer trajectories for all three outcomes after adjusting for other important predictors including disease characteristics, stoma, anxiety and social support.

Conclusions

Psychosocial factors including self-efficacy and depression before surgery predict recovery trajectories in QoL, health status and wellbeing following colorectal cancer treatment independent of treatment or disease characteristics. This has significant implications for colorectal cancer management as appropriate support may be improved by early intervention resulting in more positive recovery experiences.

Related collections

Most cited references 24

Record: found
Abstract: found
Article: not found

EuroQol: the current state of play.

R. Brooks (1996)

The EuroQol Group first met in 1987 to test the feasibility of jointly developing a standardised non-disease-specific instrument for describing and valuing health-related quality of life. From the outset the Group has been multi-country, multi-centre, and multi-disciplinary. The EuroQol instrument is intended to complement other forms of quality of life measures, and it has been purposefully developed to generate a cardinal index of health, thus giving it considerable potential for use in economic evaluation. Considerable effort has been invested by the Group in the development and valuation aspects of health status measurement. Earlier work was reported upon in 1990; this paper is a second 'corporate' effort detailing subsequent developments. The concepts underlying the EuroQol framework are explored with particular reference to the generic nature of the instrument. The valuation task is reviewed and some evidence on the methodological requirements for measurement is presented. A number of special issues of considerable interest and concern to the Group are discussed: the modelling of data, the duration of health states and the problems surrounding the state 'dead'. An outline of some of the applications of the EuroQol instrument is presented and a brief commentary on the Group's ongoing programme of work concludes the paper.

0 comments Cited 837 times – based on 0 reviews      Review now

Record: found
Abstract: found
Article: not found

The MOS social support survey.

C D Sherbourne, A L Stewart (1991)

This paper describes the development and evaluation of a brief, multidimensional, self-administered, social support survey that was developed for patients in the Medical Outcomes Study (MOS), a two-year study of patients with chronic conditions. This survey was designed to be comprehensive in terms of recent thinking about the various dimensions of social support. In addition, it was designed to be distinct from other related measures. We present a summary of the major conceptual issues considered when choosing items for the social support battery, describe the items, and present findings based on data from 2987 patients (ages 18 and older). Multitrait scaling analyses supported the dimensionality of four functional support scales (emotional/informational, tangible, affectionate, and positive social interaction) and the construction of an overall functional social support index. These support measures are distinct from structural measures of social support and from related health measures. They are reliable (all Alphas greater than 0.91), and are fairly stable over time. Selected construct validity hypotheses were supported.

0 comments Cited 456 times – based on 0 reviews      Review now

Record: found
Abstract: found
Article: not found

Effect of a self-management program on patients with chronic disease.

K Lorig, D S Sobel, P Ritter … (2002)

For patients with chronic disease, there is growing interest in "self-management" programs that emphasize the patients' central role in managing their illness. A recent randomized clinical trial demonstrated the potential of self-management to improve health status and reduce health care utilization in patients with chronic diseases. To evaluate outcomes of a chronic disease self-management program in a real-world" setting. Before-after cohort study. Of the 613 patients from various Kaiser Permanente hospitals and clinics recruited for the study, 489 had complete baseline and follow-up data. The Chronic Disease Self-Management Program is a 7-week, small-group intervention attended by people with different chronic conditions. It is taught largely by peer instructors from a highly structured manual. The program is based on self-efficacy theory and emphasizes problem solving, decision making, and confidence building. Health behavior, self-efficacy (confidence in ability to deal with health problems), health status, and health care utilization, assessed at baseline and at 12 months by self-administered questionnaires. At 1 year, participants in the program experienced statistically significant improvements in health behaviors (exercise, cognitive symptom management, and communication with physicians), self-efficacy, and health status (fatigue, shortness of breath, pain, role function, depression, and health distress) and had fewer visits to the emergency department (ED) (0.4 visits in the 6 months prior to baseline, compared with 0.3 in the 6 months prior to follow-up; P = 0.05). There were slightly fewer outpatient visits to physicians and fewer days in hospital, but the differences were not statistically significant. Results were of about the same magnitude as those observed in a previous randomized, controlled trial. Program costs were estimated to be about $200 per participant. We replicated the results of our previous clinical trial of a chronic disease self-management program in a "real-world" setting. One year after exposure to the program, most patients experienced statistically significant improvements in a variety of health outcomes and had fewer ED visits.

0 comments Cited 368 times – based on 0 reviews      Review now

All references

Author and article information

Contributors

John Souglakos: Role: Editor

Journal

Journal ID (nlm-ta): PLoS One

Journal ID (iso-abbrev): PLoS ONE

Journal ID (publisher-id): plos

Journal ID (pmc): plosone

Title: PLoS ONE

Publisher: Public Library of Science (San Francisco, CA USA )

ISSN (Electronic): 1932-6203

Publication date (Electronic): 12 May 2016

Publication date Collection: 2016

Volume: 11

Issue: 5

Electronic Location Identifier: e0155434

Affiliations

[1 ]Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom

[2 ]Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom

[3 ]University Hospital Southampton NHS Foundation Trust, Southampton, SO16 6YD, United Kingdom

[4 ]Executive Office, University of Nottingham, Nottingham, NG7 2RD, United Kingdom

[5 ]Social Statistics and Demography, Social Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom

University General Hospital of Heraklion and Laboratory of Tumor Cell Biology, School of Medicine, University of Crete, GREECE

Author notes

Competing Interests: The authors have declared that no competing interests exist.

Conceived and designed the experiments: CF DF JC AR. Performed the experiments: CF KCS JW JH CMM PWS AD. Analyzed the data: JH. Wrote the paper: CF JH JW CG. Contributed to interpretation of data: JH PWS JW CG CF. Reviewed manuscript: CF JH JW CG KCS LB LC JC AD DF CMM AR PWS, Members of Study Advisory Committee.

¶ Membership of the Study Advisory Committee is listed in the Acknowledgments.

* E-mail: C.L.Foster@ 123456soton.ac.uk

Article

Publisher ID: PONE-D-16-00609

DOI: 10.1371/journal.pone.0155434

PMC ID: 4865190

PubMed ID: 27171174

SO-VID: 0b083dcb-1d84-4f54-8b20-8c468535bdf9

License:

This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

History

Date received : 7 January 2016

Date accepted : 28 April 2016

Page count

Figures: 2, Tables: 3, Pages: 18

Funding

Funded by: Macmillan Cancer Support

Award Recipient : Claire Foster

The study was funded by Macmillan Cancer Support as part of the Macmillan Survivorship Research Group programme (Chief Investigator: CF). CF, KCS, JH, AD, CMM and LC were funded by the Macmillan Survivorship Research Group. DF was funded by the Macmillan Survivorship Research Group during recruitment for CREW and subsequently by University of Southampton. AR and PWS are funded by University of Southampton. JW is funded by University Hospital Southampton NHS Foundation Trust. JC is funded by University of Nottingham. Macmillan Cancer Support had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Custom metadata

Data Availability All relevant data are within the paper and its Supporting Information files.