Comparative study of Depression, Anxiety and Stress among Cancer patients

In this research, the depression, anxiety and stress levels among Cancer patients in their initial and final stages are being measured and compared. For this the patients are divided into two groups: one consisting of cancer patients in their initial stages who are undergoing treatment and the other of patients in their final stages of cancer. Each group consists of thirty male cancer patients from Apollo Cancer Centre, Filmnagar, Hyderabad. These patients are administered the Depression, Anxiety and Stress scale and their corresponding levels of depression, anxiety and stress levels are measured and compared.

INTRODUCTION

A benign tumor is basically harmless whereas a malignant tumor is dangerous and may spread to other parts of the body. The malignant tumor is better known as cancer which is a class of disease in which a group of cells display uncontrolled growth, invade and destruct adjacent tissues and spread to other parts of the body through blood. Depending on the type, location and extent of growth of cancer, different methods of treatment and cure are used according to the stage of cancer. Multiple staging scales are in use. TNM staging is most commonly used. The descriptions of TNM can be grouped together into a simpler set of five progressive stages as 0, I, II, III and IV, based on severity. In the first three stages also known as initial stages, chemotherapy, radiation therapy and surgery are the most common methods of treatment. When cancer reaches the final stage, it is usually no longer treatable and the patient is not expected to live long. People who no longer respond to cancer have to face the fact that they will probably die soon. The person may be in pain, in bed or able to walk only a few steps or may be confused. Different people react in different ways to this stage. They may avoid others and retreat into themselves showing signs of depression as is evident to people around them.

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Depression is a general term that has been used to describe transient feelings, a psychological disorder and a health problem that is characterized by a group of related symptoms (Beeber, 1998). Depression is a state of emotional dejection (Sr. Christine Fernandes, 2007). Anxiety is a mood-state characterized by marked negative affects, bodily symptoms of tensions and apprehension about the future (American Psychological Association, 1994). Anxiety is also closely related to depression (Barlow, Chorpita, and Turovsky, 1996; Mineka, Watson, and Clark, 1998). Stress is a condition or feeling experienced when a person perceives that ” demands exceed the personal and social resources the individual is able to mobilize. Stress is a state of tension that is created when a person responds to the demands and pressures that come from work, family and other external sources (Dr. Hans Selye, Stress Management Society, 2009). All people will experience reactions of sadness and grief periodically throughout diagnosis, treatment, and survival of cancer. When people find out they have cancer, they often have feelings of disbelief, denial, or despair. They may also experience difficulty in sleeping, loss of appetite, anxiety, and a preoccupation with worries about the future. These symptoms and fears usually lessen as a person adjusts to the diagnosis.  People who face a diagnosis of cancer will experience different levels of stress and emotional upset.

They may develop high levels of depression, anxiety and stress when going through the process of diagnosis and treatment which include radiation and chemotherapy which may result in symptoms like nausea, fatigue, hair loss, mood swings and pain. They shall need to adjust themselves to these side effects. They are also uncertain of the outcome of the treatment and also of their future. However, incase the treatment is stopped due to their unresponsiveness, then they know for sure what their future holds. Hence they may not be in a constant state of worry over the outcome of their treatment and its side effects. So they may have lower levels of anxiety, stress and depression. This is the basis of the present research in which the depression, anxiety and stress levels of the patients in their initial stages and those in the terminal stages of cancer are measured and compared.

Hence, the hypothesis of this study is that the levels of anxiety, depression and stress are comparatively lesser in patients who are in the terminal stage of cancer than those in the initial treatable stages.

METHODOLOGY

The sample group consists of male cancer patients of Apollo Cancer Centre, Hyderabad. The sampling is convenience sampling through simple random assignment where two experimental groups of 30 cancer patients each, who are in their initial and terminal stages respectively are used. The main statistical methods used are t-ratio and Pearson’s Product Moment Method.

RELEVANCE

Sadness and grief are normal reactions to the crises faced during cancer, and will be experienced at times by all people. Because sadness is common, it is important to distinguish between normal levels of sadness and depression. (Watson, Greer, Rowden, Gorman, Robertson, Blissand and Tunmore, 1991).There have been several studies on the increase in DAS in cancer patients while undergoing diagnosis, medication and treatments( Nordin, Berglund, Glimelius, Sjödén; 2000). However, there have been no researches comparing DAS levels of people in different stages of cancer. The number of people with cancer is on the rise. The study of depression, anxiety and stress levels at different stages in cancer may contribute to and help in increasing the optimal levels of coping among patients

EVALUATION

In order to keep track of all the different variables, only male patients of Apollo hospitals are being taken as a sample. Finding at least 30 patients in their terminal stages of cancer at once may prove challenging. Permission is to be taken not only from the hospital but also from the patient’s family before conducting the study.

CONCLUSION

Hence, in this study, convenience sampling is used in selecting patients from Apollo hospital according to simple random sampling into two groups who are administered the DAS scale to compare their levels. There may be some inconvenience while collecting samples. Since research with these conditions has not been conducted particularly in India and specifically among cancer patients in different stages of illness, this research may prove useful in conducting further researches and in developing and maintaining maximum optimal environmental conditions for the patient’s mental wellbeing.