title: Uterine cervical cancer: a holistic approach to mental health and it's socio-psychological implications.
abstract: This correlation study investigated outpatients with early stage uterine cervical cancer. The subjects' mental health and its' relationship with demographic characteristics, clinical characteristics, and quality of life were examined. One hundred and seventy six patients from three major hospitals in the Fukuoka area were surveyed with a structured questionnaire. The status of mental health measured by CES-D (Center for Epidemiologic Studies Depression Scale) indicated an average score of 13+/-8 (mean+/-SD). No clinical parameters were found to have significant correlation to CES-D. However, increased pain (p< 0.001) and the absence of a husband or a partner (p < 0 .01) had greater CES-D score which indicated worse mental health outcome. The QOL (Quality of Life) scale developed for this study consists of the four domains: "Feel satisfied with life" (r = -.526, p < 0. 01), "Find life worth living" (r= -.485, p < 0.01), "Feel no hindrance in daily life" (r= -.319, p<0.01), and "Feel no anxiety with illness" (r= -. 578, p < 0.01) all which have statistically significant correlations with CES-D scores respectively. Upon examination using the multi-regression model, a strong relationship between CES-D scores and "Feel no anxiety with illness" (r= -.331, p<0.001) was evident. This showed to be the strongest indicator affecting the depression outcome, followed by "Strong pain" (r= .231, p<0.01). Clinical parameters, such as performance status, clinical stage, and medical treatment did not show any correlation to CES-D scores. The research suggests that the mental health of outpatients with uterine cervical cancer was influenced by pain and quality of life, rather than the clinical parameters. The presence of a husband or a partner played the role as social support to reduce the level of depression. In order to provide complete care of patients, pain management, anxiety management, and spousal involvement are crucial to patients' mental health, especially in the ongoing care of uterine cervical cancer.
authors.affiliation: Department of Health Sciences, School of Medicine, Kyushu University.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Ohara-Hirano
authors.forename: Tsunehisa
authors.initials: T
authors.lastname: Kaku
authors.forename: Toshio
authors.initials: T
authors.lastname: Hirakawa
authors.forename: Yukari
authors.initials: Y
authors.lastname: Noguchi
authors.forename: Nobuko
authors.initials: N
authors.lastname: Hirata
authors.forename: Harumi
authors.initials: H
authors.lastname: Shinkoda
authors.forename: Etsuko
authors.initials: E
authors.lastname: Kitahara
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Saito
authors.forename: Satoshi
authors.initials: S
authors.lastname: Amada
authors.forename: Masafumi
authors.initials: M
authors.lastname: Ohki
mesh_terms: D001007:Anxiety; D003863:Depression; D005260:Female; D006694:Holistic Health; D006801:Humans; D008603:Mental Health; D010146:Pain; D011788:Quality of Life; D012944:Social Support; D018454:Spouses; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000523:psychology*