title: Type D personality is associated with delaying patients to medical assessment and poor quality of life among rectal cancer survivors.
abstract: OBJECTIVE
  The aim of this research was to explore quality of life (QoL), mental health status, type D personality, symptom duration, and emergency admissions of Chinese rectal cancer patients as well as the relationship between these factors.
  
  
  METHODS
  Type D personality was measured with the 14-item Type D Personality Scale (DS14). Mental health status was measured with the Hospital Anxiety and Depression Scale (HADS). The QoL outcomes were assessed longitudinally using the European Organization for Research and Treatment of Cancer QLQ-C30 and QLQ-CR38 questionnaires at the baseline and 6 months after diagnosis.
  
  
  RESULTS
  Of the 852 survivors who responded (94 %), 187 (22 %) had a type D personality. The proportion of patients with duration of symptoms >1 month and being diagnosed after emergency admissions in type D group is significantly higher than that in non-type D group. At both of the time points, type D patients reported statistically significant lower scores on most of the functional scales, global health status/QoL scales, and worse symptom scores compared to patients without a type D personality. At the 6-month time point, a higher percentage of patients in the type D group demonstrated QoL deterioration. Clinically elevated levels of anxiety and depression were more prevalent in type D than in non-type D survivors.
  
  
  CONCLUSIONS
  Type D personality was associated with poor QoL and mental health status among survivors of rectal cancer, even after adjustment for confounding background variables. Type D personality might be a general vulnerability factor to screen for subgroups at risk for longer symptom duration and emergency admissions in clinical practice.
authors.affiliation: Department of Gastroenterological Surgery and Cancer Center, The Fourth Affiliated Hospital of China Medical University, 4 Chongshan Road, Shenyang, 110032, P. R. China.
authors.forename: Jia-kui
authors.initials: JK
authors.lastname: Zhang
authors.affiliation: Department of Anesthesiology, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, 310009, People's Republic of China.
authors.forename: Li-li
authors.initials: LL
authors.lastname: Fang
authors.affiliation: Department of Gastroenterological Surgery and Cancer Center, The Fourth Affiliated Hospital of China Medical University, 4 Chongshan Road, Shenyang, 110032, P. R. China.
authors.forename: De-wei
authors.initials: DW
authors.lastname: Zhang
authors.affiliation: Department of Psychiatry, The Fourth Affiliated Hospital of China Medical University, Shenyang, 110032, People's Republic of China.
authors.forename: Qiu
authors.initials: Q
authors.lastname: Jin
authors.affiliation: Department of Clinical Epidemiology and Center of Evidence Based Medicine, The First Hospital of China Medical University, Shenyang, 110001, People's Republic of China.
authors.forename: Xiao-mei
authors.initials: XM
authors.lastname: Wu
authors.affiliation: Department of Gastroenterological Surgery and Cancer Center, The Fourth Affiliated Hospital of China Medical University, 4 Chongshan Road, Shenyang, 110032, P. R. China.
authors.forename: Ji-chao
authors.initials: JC
authors.lastname: Liu
authors.affiliation: Department of Gastroenterological Surgery and Cancer Center, The Fourth Affiliated Hospital of China Medical University, 4 Chongshan Road, Shenyang, 110032, P. R. China.
authors.forename: Chun-dong
authors.initials: CD
authors.lastname: Zhang
authors.affiliation: Department of Gastroenterological Surgery and Cancer Center, The Fourth Affiliated Hospital of China Medical University, 4 Chongshan Road, Shenyang, 110032, P. R. China. daidq1963@sina.com.
authors.forename: Dong-qiu
authors.initials: DQ
authors.lastname: Dai
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000150:complications; D003710:Demography; D003863:Depression / Q000150:complications; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D011788:Quality of Life; D012004:Rectal Neoplasms / Q000150:complications / Q000523:psychology*; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*; D064415:Type D Personality
keywords: Health status; Health-related quality of life; Rectal cancer; Referrals; Type D personality