A longitudinal study on psychological distress levels and influencing factors in nasopharyngeal carcinoma patients undergoing radiotherapy

Zhang Xiao; Long Xiaoli; Wang Pengyuan; Xiang Geng; Cheng Meiling; Yin Yangyang; Shi Juanli

doi:10.11986/j.issn.1673-873X.2025.05.02

Abstract：Objective To investigate the dynamic changes in psychological distress levels at different treatment stages in naso-pharyngeal carcinoma(NPC)patients undergoing radiotherapy and to analyze the influencing factors,aiming to provide a refer-ence for clinical decision-making.Methods Using convenience sampling,196 NPC patients undergoing radiotherapy at a hos-pital in Xi'an from January 2020 to January 2023 were selected as the research participants.A longitudinal survey method was used to investigate psychological distress levels(Distress Thermometer[DT]score),self-perceived burden(Self-Perceived Burden Scale[SPBS]score),and social support levels(Social Support Rating Scale[SSRS]score)at four time points:one day before radiotherapy(T0),at the end of the 2nd week of radiotherapy(T1),at the end of the 4th week of radiotherapy(T2),and at the end of the 6th week of radiotherapy(T3).Differences in measurement results across the time points were compared,and generalized estimating equations were used to analyze the influencing factors of psychological distress levels in NPC patients undergoing radiotherapy.Results The incidence rates of psychological distress in NPC patients undergoing radiotherapy at T0,T1,T2,and T3 were 64.29％,72.45％,67.86％,and 31.63％,respectively.Repeated measures analysis of variance showed statistically significant differences in DT,SPBS,and SSRS scores among NPC patients undergoing radiotherapy at different time points(P＜0.05).The DT score was highest at T1([4.96±1.48]points)and lowest at T3([2.44±0.74]points).Generalized estimating equation analysis showed that treatment stage,age,T-stage,education level,monthly household in-come per capita,daily sleep duration,presence or absence of complications,presence or absence of family history,self-per-ceived burden,and social support level were all influencing factors for psychological distress in NPC patients undergoing radio-therapy(P＜0.05).Conclusion Psychological distress is common among NPC patients undergoing radiotherapy,with levels showing dynamic changes and a decreasing trend as treatment progresses.The psychological distress level in these patients is mainly associated with factors including treatment stage,age,T-stage,education level,monthly household income per capita,daily sleep duration,presence or absence of complications,presence or absence of family history,self-perceived burden,and social support level.Therefore,targeted intervention measures based on these influencing factors can be implemented clinically to alleviate patients' psychological distress levels and reduce its incidence.