Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 May 12;11(5):e0155434.
doi: 10.1371/journal.pone.0155434. eCollection 2016.

Pre-Surgery Depression and Confidence to Manage Problems Predict Recovery Trajectories of Health and Wellbeing in the First Two Years following Colorectal Cancer: Results from the CREW Cohort Study

Claire Foster  1   2 , Joanne Haviland  1   2 , Jane Winter  2   3 , Chloe Grimmett  1   2 , Kim Chivers Seymour  2 , Lynn Batehup  2 , Lynn Calman  1   2 , Jessica Corner  4 , Amy Din  1   2 , Deborah Fenlon  2 , Christine M May  1   2 , Alison Richardson  2   3 , Peter W Smith  5 ; Members of the Study Advisory Committee
Affiliations

Pre-Surgery Depression and Confidence to Manage Problems Predict Recovery Trajectories of Health and Wellbeing in the First Two Years following Colorectal Cancer: Results from the CREW Cohort Study

Claire Foster et al. PLoS One. .

Abstract

Purpose: This paper identifies predictors of recovery trajectories of quality of life (QoL), health status and personal wellbeing in the two years following colorectal cancer surgery.

Methods: 872 adults receiving curative intent surgery during November 2010 to March 2012. Questionnaires at baseline, 3, 9, 15, 24 months post-surgery assessed QoL, health status, wellbeing, confidence to manage illness-related problems (self-efficacy), social support, co-morbidities, socio-demographic, clinical and treatment characteristics. Group-based trajectory analyses identified distinct trajectories and predictors for QoL, health status and wellbeing.

Results: Four recovery trajectories were identified for each outcome. Groups 1 and 2 fared consistently well (scores above/within normal range); 70.5% of participants for QoL, 33.3% health status, 77.6% wellbeing. Group 3 had some problems (24.2% QoL, 59.3% health, 18.2% wellbeing); Group 4 fared consistently poorly (5.3% QoL, 7.4% health, 4.2% wellbeing). Higher pre-surgery depression and lower self-efficacy were significantly associated with poorer trajectories for all three outcomes after adjusting for other important predictors including disease characteristics, stoma, anxiety and social support.

Conclusions: Psychosocial factors including self-efficacy and depression before surgery predict recovery trajectories in QoL, health status and wellbeing following colorectal cancer treatment independent of treatment or disease characteristics. This has significant implications for colorectal cancer management as appropriate support may be improved by early intervention resulting in more positive recovery experiences.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Participant status and questionnaire return rates up to 24 months of follow-up.
Number of questionnaires sent and returned at each time-point up to 24 months, with details of deaths and withdrawals throughout the study.
Fig 2
Fig 2
Estimated trajectories for (a) QLACS-GSS (Generic Summary Score), (b) EQ-5D utility index and (c) Personal Wellbeing Index.
See this image and copyright information in PMC

References

    1. Shippee ND, Shah ND, May CR, Mair FS, Montori VM. Cumulative complexity: a functional, patient-centered model of patient complexity can improve research and practice. J Clin Epidemiol. 2012;65:1041–51. 10.1016/j.jclinepi.2012.05.005 - DOI - PubMed
    1. Foster C, Breckons M, Cotterell P, Barbosa D, Calman L, Corner J, et al. Cancer survivors' self-efficacy to self-manage in the year following primary treatment. J Cancer Surviv. 2015;9(1):9–11. - PMC - PubMed
    1. Foster C, Fenlon D. Recovery and self-management support following primary cancer treatment. Br J Cancer. 2011;105:S21–S28. 10.1038/bjc.2011.419 - DOI - PMC - PubMed
    1. Howsepian BA, Merluzzi TV. Religious beliefs, social support, self-efficacy and adjustment to cancer. Psychooncology. 2009;18(10):1069–79. 10.1002/pon.1442 - DOI - PubMed
    1. Mosher CE, Duhamel KN, Egert J, Smith MY. Self-efficacy for coping with cancer in a multiethnic sample of breast cancer patients: associations with barriers to pain management and distress. Clin J Pain. 2010;26(3):227–34. 10.1097/AJP.0b013e3181bed0e3 - DOI - PMC - PubMed

Publication types