title: Mental adjustment to cancer and its relation to anxiety, depression, HRQL and survival in patients with laryngeal cancer - a longitudinal study.
abstract: BACKGROUND
  Using a longitudinal design, aim of this study was to investigate the relation between mental adjustment to cancer and anxiety, depression, health-related quality of life (HRQL) and survival in patients treated for laryngeal cancer.
  
  
  METHODS
  95 patients with Tis-T4 laryngeal cancer were assessed at one and 12 months after start of treatment, respectively, using the Mini-Mental Adjustment to Cancer Scale (Mini-MAC), the European Organisation for Research and Treatment of Cancer (EORTC) Study Group on Quality of Life core questionnaire (EORTC QLQ-C30) supplemented with the Head and Neck cancer module (QLQ-H&N35) and the Hospital Anxiety and Depression (HAD) Scale. For survival analyses patients were followed up for a median time of 4.22 years from inclusion.
  
  
  RESULTS
  The most commonly used adjustment response at both occasions was Fighting Spirit. The use of adjustment responses was relatively stable over time. Correlation analyses showed that patients using Helpless-Hopeless and Anxious Preoccupation responses reported more anxiety and depression, as well as decreased HRQL. Tumour site and stage showed no effect on adjustment response. Survival analysis indicated that use of a Helpless-Hopeless response was related to poorer survival (HR 1.17, p 0.001).
  
  
  CONCLUSIONS
  The relation between adjustment responses Helpless-Hopeless and Anxious Preoccupation and anxiety, depression, HRQL and possibly poorer survival indicate that assessment of mental adjustment should be considered when planning treatment and rehabilitation in laryngeal cancer patients.
authors: Department of Otolaryngology, Sahlgrenska University Hospital, SE 431 80 Mölndal, Sweden. mia.johansson@gu.se
authors: Mia
authors: M
authors: Johansson
authors: Anna
authors: A
authors: Rydén
authors: Caterina
authors: C
authors: Finizia
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D001007:Anxiety / Q000453:epidemiology / Q000209:etiology*; D001294:Attitude to Health; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology / Q000209:etiology*; D005500:Follow-Up Studies; D006801:Humans; D017567:Karnofsky Performance Status; D007822:Laryngeal Neoplasms / Q000401:mortality / Q000523:psychology*; D008875:Middle Aged; D008960:Models, Psychological; D011446:Prospective Studies; D011788:Quality of Life; D057566:Self Report; D011795:Surveys and Questionnaires; D016019:Survival Analysis; D017741:Survivors / Q000523:psychology*; D013548:Sweden / Q000453:epidemiology