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Longitudinal Trends in Anxiety, Depression, and Quality of Life During Different Intermittent Periods of Adjuvant Breast Cancer Chemotherapy

Zhang, Jiayuan MD; Zhou, Yuqiu MD; Feng, Ziwei PhD; Xu, Yong PhD; Zeng, Guangchun MD

doi: 10.1097/NCC.0000000000000451

Background: Chemotherapy (CT) is an important adjuvant treatment that has been widely used for breast cancer (BC) patients. However, no research has focused on trends in emotions and quality of life (QOL) during intermittent periods between CT sessions that are critical for recovery.

Objective: The aim of this study was to investigate longitudinal trends in anxiety, depression, and QOL during the different intermittent periods between adjuvant CT for BC.

Methods: A longitudinal study design was adopted. Eighty-eight women undergoing CT for BC were selected using a purposive sampling method, and they completed the Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), and Functional Assessment of Cancer Therapy–Breast (FACT-B) at 5 points. A repeated-measures analysis-of-variance model was used to compare anxiety, depression, and QOL at different time points.

Results: The results showed a significant difference in SAS (F = 187.78, P < .00), SDS (F = 263.07, P < .00), and FACT-B (F = 140.82, P < .00) scores at the 5 time points. The SAS and SDS scores were highest at T3, whereas the FACT-B score was lowest at T3.

Conclusions: The BC patients had psychological distress during intermittent periods between adjuvant CT, as evidenced by anxiety and depression, which were highest in the third cycle. Meanwhile, QOL was lowest at the third CT cycle and highest at the first CT cycle.

Implications for Practice: Clinical staff should focus on critical time periods during CT, particularly during the third cycle, and provide additional support to patients to ensure that CT is delivered in an optimal fashion.

Author Affiliations: Department of Nursing Science, Harbin Medical University (Drs Zhang, Zhou, and Feng); and Department of Intensive Care Unit, The Fifth Affiliated Harbin Medical University, Daqing (Dr Xu); and Department of Pathology, The Third Affiliated Harbin Medical University, Harbin, Heilongjiang Province (Dr Zeng), People’s Republic of China.

The authors have no funding or conflicts of interest to disclose.

Correspondence: Yuqiu Zhou, MD, Department of Nursing Science, Harbin Medical University (Daqing), No. 1 Xinyang St, Daqing 163319, People’s Republic of China (

Accepted for publication September 20, 2016.

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