Psychosocial adjustment in gynecologic cancer survivors: A longitudinal study on risk factors for maladjustment

Objective. The objective was to describe the change in psychosocial state o ver time and to identify risk factors for maladjustment in gynecologic canc er survivors. Awareness of these issues is important for planning supportiv e care services for cancer patients. Methods. A longitudinal prospective study of patients with newly diagnosed gynecologic cancer using individual patients as their own control was perfo rmed. Patients were interviewed after confirmation of the diagnosis and wer e reassessed at 6 and 18 months after completion of treatment and with no e vidence of recurrent disease. Psychological adjustment was measured by self -rating on self-esteem, outlook on life, self-role, and femininity. Neuroti cism and anxiety were assessed using a neuroticism score and the Hamilton A nxiety Scale. Depressive symptoms were questioned directly. Social adjustme nt was assessed by changes in working capacity or work status, leisure acti vity, marital relationship, and sexual activity. Results. Seventy-four women participated. Adjustment problems did not occur in the majority of patients. Psychosocial adjustment was different for pat ients receiving different types of treatments. Improvement in feminism (P = 0.050) and neuroticism (P = 0.010) was observed for patients receiving che motherapy and deterioration was observed in patients treated with surgery. Deterioration in neuroticism was associated with lower education level (P = 0.032). With religious belief, there was better family support and more si gnificant improvement in social activity (P = 0.038). Conclusion. Most patients adapted well. Patients at risk for psychosocial m aladjustment include those who are treated surgically, less educated, and w ithout religious belief. (C) 2001 Academic Press.