Clinical nutrition (Edinburgh, Scotland) · 2025
Quality of life and depression in cancer patients qualified for home enteral nutrition: A cross-sectional study.
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Folwarski Marcin, Maciejewska-Cebulak Magdalena, Sumlet Magdalena, Kwella Bogna, Balul Gabriela, Matras Przemysław, Bartoszewska Lidia, Frankiewicz Mikołaj, Pęksa Rafał, Schneider Stéphane M, Kłęk Stanisław
Аннотация
BACKGROUND: Quality of Life (QoL) is a critical concern for cancer patients, especially those eligible for Home Enteral Nutrition (HEN). There is limited data on baseline QoL at the initiation of HEN, particularly in relation to depression, coping strategies, physical activity, and sleep disorders. This study aimed to evaluate the impact of various psychosocial, nutritional, and physical factors on QoL among patients with upper gastrointestinal (GI) and head and neck cancers on HEN.
METHODS: Fifty-two patients undergoing qualification for HEN at four home nutrition centers participated in this study. QoL was assessed using the EORTC QLQ-C30 questionnaire. Additional measures included Beck's Depression Inventory for depression, the Pittsburgh Sleep Quality Index (PSQI) for sleep quality, the Mini-Mental Adjustment to Cancer (Mini-MAC) scale for cancer adaptation patterns, and the International Physical Activity Questionnaire (IPAQ) for physical activity. Nutritional status was evaluated according to the Global Leadership Initiative on Malnutrition (GLIM) Criteria. Multivariable linear regression analysis was utilized to identify predictors of QoL, with a focus on depression, sleep quality, physical activity, and coping strategies.
RESULTS: The study population primarily consisted of patients with head and neck cancers (67.31 %). The mean global QoL score did not significantly differ between patients with head and neck vs. upper GI cancer. QoL was inversely associated with depression (β = -1.81, p < 0.001), adjusted for sleeping quality, physical activity, weight loss and the balance between constructive and destructive coping strategies (R2 = 0.67). Depression scores were directly associated with sleep quality (PSQI) (β = 0.92, p < 0.001), and inversely associated with the balance between constructive and destructive coping strategies (β = -0.63, p < 0.001), adjusted for weight loss, global information and physical activity levels (R2 = 0.72). Patients with depression had higher scores for destructive coping strategies (p < 0.001) and lower constructive-destructive balance (p < 0.001). No difference was observed between head and neck and upper digestive tract cancer patients.
CONCLUSION: Depression, sleep quality, and physical activity levels significantly impact the QoL of cancer patients eligible for HEN. Early psychological support and activity-promoting strategies should be integrated into nutritional care.
METHODS: Fifty-two patients undergoing qualification for HEN at four home nutrition centers participated in this study. QoL was assessed using the EORTC QLQ-C30 questionnaire. Additional measures included Beck's Depression Inventory for depression, the Pittsburgh Sleep Quality Index (PSQI) for sleep quality, the Mini-Mental Adjustment to Cancer (Mini-MAC) scale for cancer adaptation patterns, and the International Physical Activity Questionnaire (IPAQ) for physical activity. Nutritional status was evaluated according to the Global Leadership Initiative on Malnutrition (GLIM) Criteria. Multivariable linear regression analysis was utilized to identify predictors of QoL, with a focus on depression, sleep quality, physical activity, and coping strategies.
RESULTS: The study population primarily consisted of patients with head and neck cancers (67.31 %). The mean global QoL score did not significantly differ between patients with head and neck vs. upper GI cancer. QoL was inversely associated with depression (β = -1.81, p < 0.001), adjusted for sleeping quality, physical activity, weight loss and the balance between constructive and destructive coping strategies (R2 = 0.67). Depression scores were directly associated with sleep quality (PSQI) (β = 0.92, p < 0.001), and inversely associated with the balance between constructive and destructive coping strategies (β = -0.63, p < 0.001), adjusted for weight loss, global information and physical activity levels (R2 = 0.72). Patients with depression had higher scores for destructive coping strategies (p < 0.001) and lower constructive-destructive balance (p < 0.001). No difference was observed between head and neck and upper digestive tract cancer patients.
CONCLUSION: Depression, sleep quality, and physical activity levels significantly impact the QoL of cancer patients eligible for HEN. Early psychological support and activity-promoting strategies should be integrated into nutritional care.