Quality of Life Research, 7, pp. 495–500
© 1998 Kluwer Academic Publishers Quality of Life Research
.
Vol 7
.
1998 495
Psychological well-being among cancer patients
receiving radiotherapy – a prospective study
P. S. Chandra,* S. K. Chaturvedi, S. M. Channabasavanna,
N. Anantha, B. K. M. Reddy, S. Sharma and S. Rao
Departments of Psychiatry (P.S. Chandra, S.K. Chaturvedi, S.M. Channabasavanna)
and Biostatistics (S. Rao), National Institute of Mental Health and Neurosciences,
Bangalore, India; Department of Radiotherapy, Kidwai Memorial Institute of
Oncology, Bangalore, India (N. Anantha, B.K.M. Reddy, S. Sharma)
The impact of cancer on the psychological well-being
of newly diagnosed cancer patients before and
during the course of radiotherapy was assessed in
70 consecutive cancer patients. Most of the patients
were over 40 years of age, women, illiterate and from
a lower socioeconomic group. During the course of
treatment there was a decrease in the well-being
scores on some dimensions such as perceived family
and primary group support. Improvements were seen
in the dimensions of positive feelings, coping, social
support other than the family and spiritual well-being.
There were no changes in the dimensions of negative
feelings and perceived ill-health. The results give a
profile on well-being and the changes observed
during radiotherapy.
Qual. Life Res. 7:495–500 © 1998 Kluwer Academic Publishers
Key words: Well-being; radiotherapy; quality of life.
Introduction
The importance of issues related to quality of life
(QoL) in cancer and its treatment is being increasingly
recognized. One measure of QoL is the person's
psychological well-being. Well-being is a measure of a
state and changes periodically based on internal
coping mechanisms and interactions with the outside
world. Bech
1
emphasized that any measure of QoL
concerned with health status should include an
assessment of multiple domains. He emphasized the
PCASEE axes, which measure the physical, cognitive,
affective and social aspects with economy and ego
functions as additional measures for a comprehensive
evaluation of QoL in illnesses.
2
It is evident from the literature on studies of QoL in
cancer that the ideal way of assessing QoL is to evolve
measures for all dimensions of life rather than
focusing on purely physical and health-related
concerns.
3,4
Hence, the tools used to measure QoL
have to include physical, psychological, social and
spiritual domains.
5–7
It may also be better not to view
QoL mainly in negative terms, as any change in the
life of a person may bring about both positive and
negative coping patterns and the former also need to
be studied.
6,7
Rather than being merely a cross-sectional
measure, QoL in cancer patients is important in
assessing changes over the course of the illness and
changes with treatment.
8,9
QoL at onset or at the initial
diagnosis may be different compared to life concerns
in the middle phase or at the termination of treatment.
Through the illness–treatment–recovery path, patients
may have to reappraise their life domains, their goals
and plans may have to be reviewed and their satis-
faction with life themes may alter. More importantly,
different degrees of resignation or coming to terms
with the illness may influence perceptions of QoL
rather than the more objective and measurable aspects
which may have important implications in inter-
vention and psychosocial management.
10–13
The aim of the current study was to assess life
concerns and satisfaction as measured by subjective
well-being in cancer patients undergoing radio-
therapy. A prospective study design was used for the
purpose and the patients were followed up from the
time of diagnosis until termination of treatment.
Method
The study included 70 patients diagnosed as having
cancer and requiring radiotherapy. The patients were
*To whom correspondence should be addressed at
Department of Psychiatry, National Institute of Mental Health
and Neurosciences, Bangalore, 560029, India. Fax: 91-80-
6631830; email: chandra@nimhans.ren.nic.in