Loneliness, Spiritual Well-Being, Anxiety, Depression, and Attitude to Death of Gastrointestinal Cancer Patients Treated with Rumor Resection

Abstract

Gastrointestinal cancer (GIC) patients with tumor resection may experience surgical complications, economic burden, and weakened social connection, which could lead to adverse psychological status. Thus, this study aimed to explore multidimensional psychological status of these patients, encompassing loneliness, spiritual well-being, anxiety, depression, and attitudes to death. Totally, 210 GIC patients with tumor resection and 50 healthy controls (HCs) were enrolled to complete the University of California Los Angeles loneliness (UCLA-LS), functional assessment of chronic illness therapy-spiritual well-being (FACIT-Sp), hospital anxiety and depression scale-anxiety/depression (HADS-A/D), and death attitude profile-revised (DAP-R) scales. UCLA-LS score was increased (P < 0.001), while FACIT-Sp score was decreased (P < 0.001) in GIC patients than HCs. Additionally, HADS-A score (P < 0.001), anxiety rate (P < 0.001), moderate to severe anxiety rate (P < 0.001), HADS-D score (P < 0.001), depression rate (P < 0.001), and moderate to severe depression rate (P = 0.011) were all elevated in GIC patients versus HCs. Concerning attitude to death, DAP-R scores for fear of death (P < 0.001) and death avoidance (P < 0.001) were increased, and the scores for neutral (P < 0.001) and approach (P = 0.010) acceptance were declined in GIC patients than HCs. Notably, female sex, unmarried status, and drinking history were independently linked with increased UCLA-LS score, but gastric cancer was independently associated with decreased UCLA-LS score (all P < 0.050). Neoadjuvant therapy was independently related to anxiety (P = 0.012). Female sex was independently correlated with depression (P = 0.006). In conclusion, GIC patients with tumor resection experience loneliness, anxiety, depression, and reduced spiritual well-being. They tend to fear and avoid, rather than accept death.