The relationship between emotional functioning of the EORTC QLQ-C30 and a measure of anxiety and depression (HADS) in cancer patients

Abstract

Objectives: In order to reduce suffering in cancer patients from answering different questionnaires, this study aimed to explore whether the emotional functioning (derived from subscale of the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire-EORTC QLQ-C30) could quantify anxiety and depression in patients with different carcinomas. Methods: Sample of patients with gastrointestinal cancer attending to Tehran Cancer Institute were studied. Patients were asked to complete two questionnaires: the emotional functioning (EF-derived from the EORTC QLQ-C30) and the hospital anxiety and depression scale (HADS). The Pearson’s correlation coefficient (r) and logistic regression analyses were performed in order to examine the association between emotional functioning (EF), anxiety, and depression. Results: In total 137 patients with gastrointestinal cancer were included in the study. The mean age of patients was 54.6 (SD = 13.8) years old; most were married (87%), male (55.5%), and without any normal education (55.5%). The mean emotional functioning score was 69.3 (SD = 27.3) and it was 7.7 (SD = 4.5) for anxiety and 8.5 (SD = 3.9) for depression. Significant negative correlations were found between EF subscale of the EORTC QLQ-C30 and both subscales of the HADS (Anxiety: r =-0.62, P < 0.0001; Depression: r =-0.54, P < 0.0001). The results obtained from logistic regression analysis showed strong associations between emotional functioning, anxiety, and depression (odds ratio for anxiety: 0.94, 95%; CI: 0.92-0.96, P < 0.0001; odds ratio for depression: 0.96, 95%; CI: 0.94-0.98; P < 0.0001). No other variables studied showed significant results. Conclusions: The findings demonstrated that emotional functioning subscale of the EORTC QLQ-C30 covers both anxiety and depression. Indeed it is robust to use emotional functioning subscale to assess psychological distress in cancer patients.