Information-Stressors and Cancer Patients' Quality of Life: Responses to Deviant Information-Stressors Due to Pre-Postoperative Stage Discordance

Abstract

This study assessed preoperative quality of life (QoL) of gastric cancer patients exposed to inconsistent illness information by pre-post-operative stage discordance. The impact of information-stressors on patients' QoL was investigated to determine information processing as a potential target for QoL management. Early-stage gastric cancer (EsGC) and late-stage gastric cancer (LsGC) groups based on their final stage were categorized by the consistency of preoperative staging information that was being shared. Those with consistent preoperative staging information were rated as EsGC (n=1,420) and LsGC (n=153) controls. EsGC and LsGC patients with misdirected information about their LsGC and EsGC were categorized as EsGC/iLsGC (n=32) and LsGC/iEsGC (n=55), respectively. Preoperative QoL data was obtained using EORTC QLQ-C30 and -STO22. QoL outcomes of EsGC/iLsGC and LsGC/iEsGC were compared with those of the EsGC and LsGC controls. QoL outcomes of the EsGC/iLsGC group matched that of EsGC control, but were significantly better than those of LsGC control on multiple scales including global health status/QoL, physical/role/social-functioning, and ten symptom scales/items. On the other hand, QoL outcomes of LsGC/iEsGC group were significantly better than those of LsGC control on multiple scales (global health status/QoL, physical/role-functioning, and nine symptom scales/items) while they roughly matched with those of EsGC control. Intensified information-stressors did not exacerbate QoL beyond the influence of the patients' medical condition, while de-intensified information-stressor improved QoL. Fear of negatively impacting QoL should not prevent the sharing of stressful illness information. As the de-intensified information-stressor improves QoL, information processing is recommended as a potential target for QoL management in cancer patients.

Keywords: Health Communication; Neoplasm Staging; Quality of Life; Stomach Neoplasms.

FIG. 1. Study design. (A) Overview of consistency rating of preoperative information-stressor, given the stage discordance between pre/post-operative stages. (B) Comparison diagram. IS: information-stressor, EsGC: early-stage gastric cancer, LsGC: late-stage gastric cancer, iEsGC: information of early-stage gastric cancer, iLsGC: information of late-stage gastric cancer.

FIG. 2. Baseline QoL characteristics of EsGC and LsGC patients without pre-postoperative stage discordance, indicating QoL scales influenced by cancer progression. ^*p<0.05. ^aHigher score indicates better QoL; ^bLower score indicates better QoL. EsGC: early-stage gastric cancer, LsGC: late-stage gastric cancer, EORTC QLQ: European Organisation for Research and Treatment of Cancer quality of life questionnaire, QoL: quality of life.