Factors Affecting Occurrence of Depression in Patients with Cervical Cancer at Dr. Moewardi Hospital Surakarta, Central Java: A Path Analysis Model

Dewi Shinta, Didik Gunawan Tamtomo, RB Soemanto

Abstract

Background: Cervical cancer is in the second place among the incidence of new cases and in thethird highest death from cancer. Cancer depression and severity generally occur together with psychological problems, such as anxiety, pain and fatigue. Most studies in cancer patients have focused on morbidity or mortality more due to the risk of depression. The purpose of this study was to analyze the factors that influence depression in cervical cancer patients.

Subjects and Method: A cross sectional study was conducted at Dr. Moewardi Hospital, Surakarta, Central Java, from September to October 2019. A sample of 200 cervical cancer patients was selected by simple random sampling. The dependent variable was depression. The independent variables were marital status, education, occupation, family income, peer support, family support, health personnel support, coping strategy, cancer stage, frequency of chemothe­rapy, and length of illness from diagnosis. Depression was measured by the Beck Depression Inventory-II (BDI-II) questionnaire. The other data were collected by medical record and question­naire. The data were analyzed by path analysis run on Stata 13.

Results: Severe depression in cervical cancer patients was directly increased by the frequency of chemotherapy 3 times (b= 1.80; 95% CI= 0.11 to 3.49; p= 0.037), advanced stage (b= 2.50; 95% CI= 0.18 to 4.82; p= 0.035), and length of illness from diagnosis ≥11 months (b= 2.27; 95% CI= 0.57 to 3.96; p= 0.009). Severe depression was directly decreased by high coping strategy (b= -6.33; 95% CI= -8.68 to -3.98; p<0.001). Severe depression was indirectly affected by peer support, family support, support of health personnel, family income, occupation, education, and marital status.

Conclusion: Severe depression in cervical cancer patients is directly increased by the frequency of chemotherapy 3 times, advanced stage, and length of illness from diagnosis ≥11 months. Severe depression is directly decreased by high coping strategy. Severe depression is indirectly affected by peer support, family support, support of health personnel, family income, occupation, education, and marital status.

Keywords: depression, cervical cancer, path analysis

Correspondence: Dewi Shinta. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta, Central Java, Indonesia. Email: shintadw94@gmail.com. Mobile: 08236495­0175

Journal of Epidemiology and Public Health (2019), 4(4): 338-350
https://doi.org/10.26911/jepublichealth.2019.04.04.09

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References

Adriani RB, Martono, Sulistyowati EC (2017). The effect of depression on the quality 0f life of patient with cervical cancer at Dr. Moewardi Hospital in Surakarta. Indones J Med, 01(02): 121–128. https://doi.org/10.26911/theijmed.2016.01.02.06.


Bener A, Alsulaiman R, Doodson L, Agathangelou T (2017). Depression, hopelessness and social support among breast cancer patients: in highly endogamous population. Asian Pac J Cancer Prev, 18: 1889–1896. https://doi.org/10.22034/APJCP.2017.18.7.1889.


Brink RHS van den, Schutter N, Hanssen D JC, Elzinga BM, RabelingKeus IM, Stek ML, Comijs HC, et al. (2017). Prognostic significance of social network, social support and loneliness for course of major depressive disorder in adulthood and old age.Epidemiol Psych Sci, 1–12. https://doi.org/10.1017/S2045796017000014.


Caruso R, Giuliananni M, Riba MB, Sabato S, Grassi L (2017). Depressive spectrum disorders in cancer: diagnostic issues and intervention. A critical review. Curr Psychiatry Rep, 19(33): 1–10. https://doi.org/10.1007/s1192001707857.


DelgadoGuay M, Ferrer J, Rieber AG, Rhondali W, Tayjasanant S, Ochoa J, Cantu H, Chisholm G et al. (2015). Financial distress and its associations with physical and emotional symptoms and quality of life among advanced cancer patients. The Oncologist,1092–1098. https://doi.org/10.1634/theoncologist.2015-0026.


Fadhilla HN, Mudigdo A, Rahardjo SS (2017). Effect of age and socioeconomic status on the quality of life of patients with cervical cancer undertaking chemotherapy at Dr. Moewardi Hospital Surakarta. J Epidemiol Public Healt, 02(01): 11–19. https://doi.org/10.26911/jepublichealth.2017.02.01.02.


Fervaha G, Izard JP, Tripp DA, Rajan S, Leong DP, Siemens DR (2018). Depression and prostate cancer: A focused review for the clinician. Urol Oncol, 000: 1–7. https://doi.org/10.1016/j.urolonc.2018.12.020.


Geyikci R, Cakmak S, Demirkol ME, Uguz S (2018). Correlation of anxiety and depression levels with attitudes towards coping with illness and sociodemographic characteristics in patients with a diagnosis of breast cancer. J Neurol Neurosurg Psychiatry, 31(3): 246–257. https://doi.org/10.5350/DAJPN2018310302.


Global Burden Cancer (2019). Indonesia fact sheets. International agency for research on cancer, 256. Retrieved from http://gco.iarc.fr/today/factsheetspopulations.


Götze H, Friedrich M, Taubenheim S, Dietz A, Lordick F, Mehnert A (2019). Depression and anxiety in longterm survivors 5 and 10 years after cancer diagnosis. Supportive Care Cancer, 1–10. https://doi.org/https://doi.org/10.1007/s00520-019-04805-1.


Hu Y, Ma Z, Zhang H, Gao T, Gao J, Kong Y, Qin Z, Mei S (2018). Prevalence of and factors related to anxiety and depression symptoms among married patients with gynecological malignancies in China. Asian J Psychiatr, 37: 90–95. https://doi.org/10.1016/j.ajp.2018.08.015.


Inhestern L, Beierlein V, Bultmann JC, Möller B, Romer G, Koch U, Bergelt C (2017). Anxiety and depression in working age cancer survivors: A registerbased study. BMC Cancer, 1–8. https://doi.org/10.1186/s1288501733479.


Jia Y, Li F, Liu YF, Zhao JP, Leng MM, Chen L (2017). Depression and cancer risk: A systematic review and meta-analysis. Public Health, 149: 138–148. https://doi.org/10.1016/j.puhe.2017.04.026.


Lusiatun, Mudigdo A, Murti B (2017). The effect of selfefficacy, family support, and socioeconomic factors on the quality of life of patients with breast cancer at Dr. Moewardi Hospital, Surakarta. J Epidemiol Public Health, 01 (03): 182–194. https://doi.org/10.26911/jepublichealth.2016.01.03.05.


Ministry of Health RI (2018). Decree of the Minister of Health of the Republic of Indonesia number HK.01.07/ MENKES/349/2018 concerning national guidelines for medical services for the treatment of cervical cancer (15). https://doi.org/10.22201/fq.187-08404e.2004.3.66178.


Murti B (2018). Prinsip dan Metode Riset Epidemiologi Edisi ke Empat. Surakarta: Prodi Ilmu Kesehatan Masyarakat, Program Pascasarjana UNS.


Ng GC, Mohamed S, Sulaiman AH, Zainal NZ (2017). Anxiety and depression in cancer patients: the association with religiosity and religious coping. J Religion Health, 56(2): 575–590. https://doi.org/10.1007/s109430160267y.


Nipp RD, Powell E, Chabner B, Moy B (2015). Recognizing the financial burden of cancer patients in clinical trials. The Oncologist, 572–575. https://doi.org/10.1634/theoncologist.20150068.


Nuryati S, Mudigdo A, Murti B (2018). Path analysis on the influence of educational level, stages of cancer, social support, and coping strategy toward the quality of life of breast cancer patients in Dr. Moewardi Hospital, Surakarta. J Epidemiol Public Health, 02(03): 225–235. https://doi.org/10.26911/jepublichealth.2017.02.03.04.


Ogoncho IM, Omuga BO, Wakasiaka S, Mulva M (2016). Quality of life among gynaecological cancer patients receiving palliative care in Kenya: A cross-sectional study. African Journal of Midwifery and Women’s Health, 10(1): 2016–2019. https://doi.org/https://doi.org/10.12968/ajmw.2016.10.1.15.


Paul C, Boyes A, Hall A, Bisquera A, Miller A, Brien LO (2016). The impact of cancer diagnosis and treatment on employment, income, treatment decisions and financial assistance and their relationship to socioeconomic and disease factors. Supportive Care Cancer. https://doi.org/10.1007/s00520-016-3323-y.


Quist M, Adamsen L, Rørth M, Laursen JH, Christensen KB, Langer SW (2015). The impact of a multidimensional exercise intervention on physical and functional capacity, anxiety, and depression in patients with advancedstage lung cancer undergoing chemotherapy.SAGE, 1–9. https://doi.org/10.1177/1534735415572887.


Ramadas A, Qureshi AM, Dominic NA, Botross P, Riad A, Arasoo VJT, Elangovan S (2015). Sociodemography and medical history as predictors of health-related quality of life of breast cancer survivors. Asian Pac J Cancer Prev, 16: 1479–1485. http: //dx.doi.org/10.7314/APJCP.2015.16.4.1479.


Salakari M, Pylkkanen L, Sillanmaki L, Nurminen R, Rautava P, Koskenvuo M, Suominen S (2017). Social support and breast cancer: A comparatory study of breast cancer survivors, women with mental depression, women with hypertension and healthy female controls. The Breast, 35. https://doi.org/10.1016/j.breast.2017.06.017.


Santini ZI, Koyanagi A, Tyrovolas S, Mason C (2015). The association between social relationships and depression: A systerovolas, stefanos mason, catherine maria, josepmatic review. J Affect Disord, 175: 53–65. https://doi.org/10.1016/j.jad.2014.12.049.


Sharp L, Timmons A (2015). Prediagnosis employment status and financial circumstances predict cancer-related financial stress and strain among breast and prostate cancer survivors. Support Care Cancer. https://doi.org/10.1007/s00520-015-2832-4.


Shyu IL, Hu LY, Chen YJ, Wang PH, Huang BS (2019). Risk factors for developing depression in women with cervical cancer: A nationwide population based study in Taiwan. Int J Womens Health, 11: 135–141. https://doi.org/10.2147/ijwh.s193003.


Song L, Rini C, Ellis KR, Northouse LL (2016). Appraisals, perceived dyadic communication, and quality of life over time among couples coping with prostate cancer. Supportive Care Cancer. https://doi.org/10.1007/s00520-016-3188-0.


Srivastava V, Ansari MA, Kumar A, Shah AG, Meena K, Sevach P, Singh OP (2016). Study of anxiety and depression among breast cancer patients from north India. iMedPub J, 1–7. https://doi.org/10.21767/24719854.100017.


Tsaras K, Papathanasiou IV, Mitsi D, Kelesi M, Zyga S, Fradelos EC (2018). Assessment of depression and anxiety in breast cancer patients: prevalence and associated factors. Psychological Distress in Breast Cancer, 19: 1661–1669. https://doi.org/10.22034/APJCP.2018.19.6.1661.


Wang B, Li B, Tan S, Zhai J, Chen M (2019). Risk factors for anxiety and depression in Chinese patients under-going surgery for endometrial cancer 1 Psychiatry Department, Jining Psychiatric Hospital 2 Medical Department, Jining No. 1 People’s Hospital 3 School of Mental Health, Jining Medical. Can J Physiol Pharmacol, (1): 1–17. https://doi.org/10.1139/cjp-p-2019-0302.


Wen S, Xiao H, Yang Y (2018). The risk fac-tors for depression in cancer patients undergoing chemotherapy: A systematic review. Supportive Care Cancer, 57–67. https://doi.org/10.1007/s00520-018-4466-9.


WHO. (2019). Cervical cancer. Retrieved from https://www.who.int/cancer/cervicalcancer.


Wondimagegnehu A, Abebe W, Abraha A, Teferra S (2019). Depression and social support among breast cancer patients in Addis Ababa, Ethiopia. BMC Cancer, 1–8. https://doi.org/https://doi.org/10.1186/s12885-019-6007-4.


Yang H, Brand JS, Fang F, Chiesa F, Johansson ALV, Hall P, Czene K. (2016). Disorders in patients with invasive and in situ breast cancer. Int J Cancer. https://doi.org/10.1002/ijc.30514.


Yoo W, Shah DV, Shaw BR, Kim E, Smaglik P, Roberts LJ, Hawkins RP, Pingree S et al. (2014). The role of the family environment and computer-mediated social support on breast cancer patients coping strategies. J Health Commun, 37–41. https://doi.org/10.1080/10810730.2013.864723.


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