Health and Personal Resources in Older Cancer Patients Undergoing Chemotherapy

Objectives: The purpose of this study was to gather preliminary data on both direct and moderating effects of health status, the social environment, and perceived personal control on the symptom distress and quality of life (QOL) for older patients with cancer during a treatment regimen of chemotherapy.

Materials and Methods: Participants were patients with cancer aged ≥ 65 years being treated with a variety of chemotherapy regimens specific to their particular diagnosis. Using a longitudinal study design, we measured patients at baseline prior to beginning chemotherapy, midpoint in the regimen, and upon discharge (approximately 2 weeks after chemotherapy completion). Outcomes of interest were symptom distress and QOL. Multivariate linear regression was used to determine the association between the predictors and outcomes, controlling for demographic and clinical characteristics.

Results: Our final sample consisted of 94 patients with cancer (35 males; 59 females; mean age 73.5 years). In the health status domain, lower body strength was inversely associated with symptom distress (p = 0.025) and positively associated with QOL (p = 0.015). In the social environment domain, social support was inversely associated with fatigue (p = 0.001) and depression (p < 0.001), and positively associated with QOL (p = 0.016 and p = 0.029 at midpoint and endpoint, respectively). Personal control variables, mastery and self-efficacy, were significantly associated with multiple outcomes of interest.

Discussion: Mastery was the best predictor of symptom distress and QOL. Self-efficacy, social support, and lower body functioning are important predictors of these outcomes among older patients with cancer undergoing chemotherapy.