Resilience and its Associated Factors in Head and Neck Cancer Patients in Pakistan: An Analytical Cross-Sectional Study

Abstract Introduction: The study aimed to assess resilience and its associated factors in head and neck cancer patients, post-treatment in a low middle income country (LMIC), Pakistan. Methods: An analytical cross-sectional study was conducted from November 2019 to May 2020 among head and neck cancer patients aged at least 18 years at the largest private tertiary care hospital, in Karachi, Pakistan. Information regarding resilience was collected through Wagnild and Young’s Resilience scale comprising of 14 items (RS-14). Depression and anxiety were assessed via Hospital Anxiety and Depression Scale (HADS) and social support by Enriched Social Support Instrument (ESSI). Results: The data was analyzed by linear regression modeling. Unadjusted and adjusted beta coefficients with 95% CI were reported. Total 250 head and neck cancer patients were recruited, 79% were males. Mean age of the patients was 51.59 years with 93% having high social support and only 8% having severe depression and 3% having severe anxiety. After adjusting for covariates in multivariable analysis lower resilience was associated with severe depression (-17 [-20.98,-12.93]) or borderline depression (-4[-8.41,-0.39]), severe anxiety (-11 [-17.88,-4.18]), low social support (-6 [-9.62,-1.71 ]), family members > 6 in the household (- 2[-4.31,-0.29), smokeless tobacco quitters post- treatment (10 [ 5.79, 14.45]), and those who underwent tracheotomy (-4 [-7.67,-0.21]). There was significant interaction between education and role in the family (decision maker). Conclusion: Resilience and social support is highly prevalent in our part of the world where collectivist culture prevails, thus resulting in low prevalence of depression and anxiety. High resilience score is reported among current smokeless tobacco users as compared to quitters post treatment. Tracheotomy and Large family size are inversely related to resilience. Formal education and decision making power in the household are mediators to resilience, demonstrating protective effect on mental health in head and neck cancer patients. Resilience-building interventions should be formulated to aid head and neck cancer patients to cope with the disease.

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Resilience and its associated factors in head and neck cancer patients in Pakistan: an analytical cross-sectional study

BMC Cancer ◽

10.1186/s12885-021-08624-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Nida Zahid ◽

Wajeeha Zahid ◽

Wardah Khalid ◽

Iqbal Azam ◽

Mubasher Ikram ◽

...

Keyword(s):

Social Support ◽

Head And Neck Cancer ◽

Head And Neck ◽

Cancer Patients ◽

Neck Cancer ◽

Severe Depression ◽

Cross Sectional Study ◽

Post Treatment ◽

Cross Sectional ◽

The Family

Abstract Introduction The study aimed to assess resilience and its associated factors in head and neck cancer patients, post-treatment in a low middle income country (LMIC) such as Pakistan. Methods An analytical cross-sectional study was conducted from November 2019 to May 2020 among head and neck cancer patients aged at least 18 years at the largest private tertiary care hospital, in Karachi, Pakistan. Information regarding their resilience scores was collected through Wagnild and Young’s Resilience scale that comprises of 14 items (RS-14). Moreover, depression and anxiety were also assessed via Hospital Anxiety and Depression Scale (HADS) and social support was assessed by Enriched Social Support Instrument (ESSI). Results The data was analyzed by linear regression modeling. Unadjusted and adjusted beta coefficients with 95% CI were reported. A total of 250 head and neck cancer patients were recruited, 79% of them were males. Mean age of the patients was 51.59 years with 93% having high social support and only 8% having severe depression and 3% having severe anxiety. After adjusting for the covariates in multivariable analysis resilience was associated with severe depression (− 17[− 20.98,-12.93]) or borderline depression (− 4[− 8.41,-0.39]), severe anxiety (− 11 [− 17.88,-4.18]), low social support (− 6[− 9.62,-1.71]), having family members of > 6 in the household (− 2[− 4.31,-0.29), smokeless tobacco users post- treatment (10[5.79, 14.45]), and those who underwent tracheotomy (− 4[− 7.67,-0.21]). There was a significant interaction between education and role in the family (decision maker). Conclusion In Pakistan, a South Asian LMIC, collectivist culture prevails, family ties are greatly promoted thus resilience and social support is highly prevalent in head and neck cancer patients resulting in lower prevalence of depression and anxiety. Our study highlights that higher resilience is prevalent among small families less than six members, as the welfare of the individual is prioritized over multiple needs of the family. Formal Education and role in household/decision making power are effect modifiers in our study, demonstrating its protective effect on the mental health of head and neck cancer patients. High resilience scores were reported among current smokeless tobacco users as compared to quitters post treatment. Resilience-building interventions should be formulated to aid head and neck cancer patients to cope with the disease and its sequel.

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Subjective and objective appearance of head and neck cancer patients following microsurgical reconstruction and associated quality of life─A cross-sectional study

Journal of Cranio-Maxillofacial Surgery ◽

10.1016/j.jcms.2018.05.024 ◽

2018 ◽

Vol 46 (8) ◽

pp. 1275-1284 ◽

Cited By ~ 5

Author(s):

Katinka Kansy ◽

Jürgen Hoffmann ◽

Obada Alhalabi ◽

Nicole Mistele ◽

Kolja Freier ◽

...

Keyword(s):

Quality Of Life ◽

Head And Neck Cancer ◽

Head And Neck ◽

Cancer Patients ◽

Neck Cancer ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Microsurgical Reconstruction

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Assessment of hospital anxiety and depression in newly diagnosed head and neck cancer patients in cancer institutes — A cross-sectional study

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v11i4.3971 ◽

2020 ◽

Vol 11 (4) ◽

pp. 7811-7816

Author(s):

Sushanthi S ◽

Meignana Arumugham Indiran ◽

Pradeep Kumar Rathinavelu ◽

Arthi Balasubramaniam

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Cancer Patients ◽

Neck Cancer ◽

Cross Sectional Study ◽

Anxiety And Depression ◽

Newly Diagnosed ◽

Sectional Study ◽

Hospital Anxiety ◽

Cross Sectional

Individuals often encounter psychological distress after a diagnosis of cancer, especially head and neck cancer (HNC). Worries regarding restricted functions, facial disfigurement, waiting time for investigation and duration of hospital stay for treatment make them feel awful. Often this feeling goes unnoticed and is underestimated. We aimed to assess the prevalence of the dreadful feeling in terms of anxiety and depression in newly diagnosed head and neck cancer patients. A cross-sectional study was conducted in two cancer-treating institutions in South India. About 357 freshly diagnosed HNC patients participated in the study. Pre-validated Hospital Anxiety and Depression Scale (HADS) was used to assess the anxiety and depression levels. Descriptive statistics was done to report socio-demographic, clinical variables and mean scores. Independent t-test and correlation test were done for comparison and association, respectively. Mean depression score for males and females was 11.481, 11.865, respectively. Mean anxiety score for males was 11.708 and 11.792 for females. There was a strong positive correlation between depression and anxiety score (0.864) among patients. There was no statistically significant difference in the mean anxiety and depression scores among gender, socioeconomic status, marital status and cancer stages (p>0.05). Newly diagnosed HNC patients had an abnormal level of anxiety and depression, which needs special attention and care during treatment for a better outcome.

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Prevalence and Association Factors of Depression and Anxiety in Head and Neck Cancer Patients

Journal of the Medical Association of Thailand ◽

10.35755/jmedassocthai.2021.02.11469 ◽

2021 ◽

Vol 104 (2) ◽

pp. 207-213

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Cancer Patients ◽

Neck Cancer ◽

Protective Factor ◽

Education Level ◽

Depression And Anxiety ◽

Cross Sectional ◽

Bachelor Degree ◽

Diagnostic Time

Objective: To evaluate the prevalence of depression and anxiety in head and neck cancer patients and investigate the relationship of the associating factors. Materials and Methods: A cross-sectional study with self-completed questionnaire was conducted. Univariate and multivariate analyses with logistic regression were performed to assess the associated factors. Results: Total of 293 patients (71.7% male, 28.3% female) were enrolled. The mean ± SD age was 58.25±14.28 years. The prevalence of anxiety was 17.75% and depression was 16.04%. Diagnostic time >12 month (adjusted OR 4.79, 95% CI 1.48 to 15.54, p=0.009), and perception of disfigurement (adjusted OR 4.68, 95% CI 1.42 to 15.38, p=0.011) were associated with anxiety. Education level had a direct positive correlation with anxiety prevention (adjusted OR 95% CI 0.13, 0.03 to 0.57, p=0.006 and adjusted OR 0.07, 95% CI 0.01 to 0.48, p=0.007 for education level lower Bachelor degree and Bachelor degree or higher, respectively). For depression, patient age >65 years (adjusted OR 4.09, 95% CI 1.6 to 10.46, p=0.003), group staging 4 (adjusted OR 3.12, 95% CI 1.2 to 8.08, p=0.019), and fatigue (adjusted OR 5.7, 95% CI 1.92 to 16.93, p=0.002) were related to depression. While married status was a protective factor of depression (adjusted OR 0.38, 95% CI 0.16 to 0.94, p=0.037). Conclusion: Diagnostic time >12 months, and perception of disfigurement were associated with anxiety. Age >65 years, group staging 4, and fatigue were related to depression. Keywords: Depression and anxiety, Head and neck cancer

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COVID‐19 impact on anxiety and depression in head and neck cancer patients: a cross‐sectional study

Oral Diseases ◽

10.1111/odi.13876 ◽

2021 ◽

Author(s):

Leticia Rodrigues‐Oliveira ◽

Elisa Kauark‐Fontes ◽

Carolina Guimarães Bonfim Alves ◽

Juliana Ono Tonaki ◽

Luiz Alcino Gueiros ◽

...

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Cancer Patients ◽

Neck Cancer ◽

Cross Sectional Study ◽

Anxiety And Depression ◽

Sectional Study ◽

Cross Sectional

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Assessment of quality of life among head-and-neck cancer patients

Indian Journal of Medical Sciences ◽

10.25259/ijms_344_2021 ◽

2021 ◽

Vol 0 ◽

pp. 1-5

Author(s):

Afsana Nizar ◽

Betty Rani Isaac

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Cancer Patients ◽

Neck Cancer ◽

Cross Sectional Study ◽

Sectional Study ◽

Interview Schedule ◽

Cross Sectional ◽

High Degree

Objectives: To assess QOL of different head and neck cancer patients. Material and Methods: A cross sectional study of 35 subjects with HNC was selected based on the type of cancer. After a background study, 35 subjects were chosen classifying on the type of cancer and were assessed using an interview schedule. Results: Physical as well as emotional score was poor among the group (312.5 and 349.5). The results had a high degree of variation. Conclusion: QOL among HNC patients were concluded to be poor.

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