Outcomes of Low Urinary Symptoms, Resilience, and Post-Traumatic Stress in Post-Surgery Patients With Colorectal Cancer

Friday, 20 July 2018

Yu-Hua Lin, PhD, RN
Department of Nursing, I-Shou University, Kaohsiung, Taiwan

Purpose:

From medical perspective, cancer is considered a prolonged traumatic event that can improve or worsen depending on medical factors. Because of cancer’s high mortality rate, its treatment-related psychological suffering, and its status as a life‑threatening and feared diagnosis, it represents great physical harm to patients, potentially activating PTSD. Some studies have indicated that cancer patients experience posttraumatic stress symptoms (PTSS). Previous studies indicated there is a relationship between the resilience and posttraumatic stress symptoms (PTSS) in breast cancer patients in Korea. However, rare studies have explored these issue in post-surgery patients with colorectal cancer (CRC). The purpose of this study explore the long-term outcomes and the relationships among low urinary symptoms, resilience, and PTSS in post-surgery patients with CRC.

Methods: A cross-sectional study design was used and included 188 patients with diagnosed CRC who had undergone surgery over 24 months and were recruited from a hospital in southern Taiwan. The outcome measurements included a resilience scale, International Prostate Symptom Score (IPSS), the Chinese Davidson Trauma Scale, personal characteristics, and disease-related variables.

Results: The mean resilience score was 130.85 (SD=19.43) with a score ranging from 86 to 175; 27.7% for low, 50.5% for moderate, and 21.8% for high resilience. The mean score for the IPSS was 7.46 (SD=6.74) with a score ranging from 0 to 28; 61.7% for mild, 30.3% for moderate, and 8.0% for severe low urinary symptom. The overall PTSS scores ranged from 34 to 145, with a mean score of 49.86 (SD=19.94). There were significant relationships among age, self-reported physical status, perceived satisfied with recovery, urinary tract symptoms, resilience, and overall PTSS. The stepwise regression demonstrated that five factors, self-reported physical status, resilience, urinary tract symptoms, age and gender, and together explained 27.7% of overall PTSS variance (10.7%, 6.7%, 3.7%, 4.8% and 1.8% of variance, respectively).

Conclusion: The study demonstrate that patients with diagnosed colorectal cancers long-term outcomes of PTSS, urinary tract symptoms, and resilience after surgery; in addition, self-reported physical status, resilience, urinary tract symptoms, age and gender are the major predictors of PTSS. A better understanding of the long-term outcome of post-surgery in CRC patients and its related factors may help to decreasing the PTSS after surviving cancer.