Biopsychosocial factors underlying older patients treated for an incurable cancer in a two-tiered health care system in Brazil

Abstract

Background: Patients with advanced cancer experience symptoms that include pain, fatigue, and depression. We sought to describe prevalence and identify factors associated with biopsychosocial distress in older patients (65+) diagnosed with cancer stage IV. Methods: Participants were recruited from two different types of health care facilities, public [PUB] and private [PRI] institutions, in Brazil. A cross-sectional analysis of common biopsychosocial symptoms (anxiety, depression, pain, and fatigue), and quality of life reported by older patients undergoing chemotherapy treatment was performed. Results: Older patients (n=167) were enrolled (Mean age=73; SD=5.6); 59.3% from PUB. Majority were female (56.3%; 38.9% PUB), white (68.9%; 35.7% PRI, p <0.05). Mostly pain (B=1.8; B=-6.6), fatigue (B=0.8; B=-6.5) and sleep (B=1.2; B=-8.3) were associated with moderate to severe distress and worst QOL (all p