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Patient-reported mental health and well-being trajectories in oncology patients during radiation therapy: an exploratory retrospective cohort analysis using the Ontario Cancer Registry

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Abstract

Purpose

Mental health and well-being trajectories are not expected to be homogeneous in diverse clinical populations. This exploratory study aims to identify subgroups of patients with cancer receiving radiation therapy who have different mental health and well-being trajectories, and examine which socio-demographic, physical symptoms, and clinical variables are associated with such trajectories.

Methods

Retrospective analysis of radiation therapy patients diagnosed with cancer in 2017 was conducted using data from the Ontario Cancer Registry (Canada) and linked with administrative health data. Mental health and well-being were measured using items from the Edmonton Symptom Assessment System—revised questionnaire. Patients completed up to 6 repeated measurements. We used latent class growth mixture models to identify heterogeneous mental health trajectories of anxiety, depression, and well-being. Bivariate multinomial logistic regressions were conducted to explore variables associated with the latent classes (subgroups).

Results

The cohort (N = 3416) with a mean age of 64.5 years consisted of 51.7% females. Respiratory cancer was the most common diagnosis (30.4%) with moderate to severe comorbidity burden. Four latent classes with distinct anxiety, depression, and well-being trajectories were identified. Decreasing mental health and well-being trajectories are associated with being female; living in neighborhoods with lower income, greater population density, and higher proportion of foreign-born individuals; and having higher comorbidity burden.

Conclusions

The findings highlight the importance of considering social determinants of mental health and well-being, in addition to symptoms and clinical variables, when providing care for patients undergoing radiation therapy.

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Data availability

Data sharing agreements prohibit the dataset from being made publicly available. Access may be granted to those who meet pre-specified criteria for confidential access. The statistical analysis code is available from the corresponding author upon request.

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Acknowledgements

This research was undertaken, in part, thanks to funding from the Centre for Health Evaluation and Outcome Sciences at Providence Health Care (“http://www.cheos.ubc.ca”) and the Canada Research Chairs program in support of RS’s Chair in Person-Centered Outcomes. The funding bodies had no role in the design, analysis, and interpretation of the data, and in writing the manuscript.

Funding

The study was supported by the Centre for Health Evaluation and Outcome Sciences at Providence Health Care and the Canada Research Chairs program in support of Richard Sawatzky’s Chair in Person-Centred Outcomes.

Author information

Authors and Affiliations

  1. School of Nursing, University of Victoria, HSD Building A402A, PO Box 1700 STN CSC, Victoria, BC, V8W 2Y2, Canada

    Jae-Yung Kwon

  2. Institute on Aging and Lifelong Health, Victoria, Canada

    Jae-Yung Kwon

  3. School of Population and Public Health, University of British Columbia, Vancouver, Canada

    Jacek Kopec & Aslam H. Anis

  4. Centre for Health Services and Policy Research, School of Population and Public Health, University of British Columbia, Vancouver, Canada

    Jason M. Sutherland

  5. Nursing and Allied Health Research and Knowledge Translation, BC Cancer, Vancouver, Canada

    Leah K. Lambert

  6. School of Nursing, University of British Columbia, Vancouver, Canada

    Leah K. Lambert

  7. Centre for Health Evaluation and Outcome Sciences, Providence Research, Vancouver, Canada

    Aslam H. Anis & Richard Sawatzky

  8. School of Nursing, Trinity Western University, Langley, Canada

    Richard Sawatzky

  9. Sahlgrenska Academy, University of Gothenburg, 40530, Gothenburg, Sweden

    Richard Sawatzky

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  1. Jae-Yung Kwon
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Correspondence to Jae-Yung Kwon.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study was approved by the institutional ethics review board [Health Research Ethics Board of the Trinity Western University and the University of British Columbia-Providence Health Care (H18-01947)].

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Kwon, JY., Kopec, J., Sutherland, J.M. et al. Patient-reported mental health and well-being trajectories in oncology patients during radiation therapy: an exploratory retrospective cohort analysis using the Ontario Cancer Registry. Qual Life Res 32, 2899–2909 (2023). https://doi.org/10.1007/s11136-023-03430-0

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