The cortisol level, depression anxiety stress score, and quality of life in patient with advance stage cervical cancer after two years of psychorative intervention

摘要

Background : Cervical cancer is the second most cancer in women after breast cancer. Emotional stress is the most common comorbid attacking women with advanced-stage cervical cancer, where 13- 40% are depressed which can increase mortality by 39%. Management of cervical cancer has so far focused on standard chemoradiation treatment, but has paid less attention to other aspects such as cognitive, psychological, spiritual and physical. The study aims to determine cortisol levels, Depression Anxiety Stress (DAS) score and quality of life for patients with advanced-stage cervical cancer after two years of psychocurative intervention Methods : The pretest-posttest group design experimental study, continued previous studies, 30 subjects with advanced-stage cervical cancer patients, divided into 15 subjects received standard and psychocurative treatments, the other 15 as controls only received standard therapy. Psychocurative is done independently three times a week for two years based on psychocurative smart books. Home visits are conducted once per week to monitor, motivate the subject to do the psychocurative independently properly and discipline. Cortisol levels, DAS scores and quality of life were measured before and after treatment, the data were analysed by paired t-tests in the SPSS 25 program. Results : One control group subject died before the study was completed. Before and after psychocurative, cortisol levels in the treatment group were 12.29 ± 4.36 and 6.71 ± 3.88 with p<0.05. The Depressive scores were 14.13 ± 3.02 and 8.46 ± 3.07 with p<0.05. The Anxiety scores 12.13 ± 1.64 and 6.73 ± 2.40 with p<0.05. The Stress scores were 14.40 ± 2.64 and 7.27 ± 2.81 with p<0.05. The quality of life score of the physical domain were 55.00 ± 6.54 and 62.67 ± 8.63 with p <0.05. The Psychical domain was 57.00 ± 9.41 and 65.66 ± 8.42 with p <0.05. The Social domain was 33.67 ± 9.15 and 41.67 ± 10.29 with p <0.05. The Environmental domain was 63.00 ± 1.93 and 69.33 ± 7.76 with p <0.05 Conclusions: Psychocurative decreases serum cortisol levels, decreases depression, anxiety, and stress scores and improves the quality of life of the physical, psychological, social and environmental domains.