Retrospective Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Apr 19, 2025; 15(4): 103510
Published online Apr 19, 2025. doi: 10.5498/wjp.v15.i4.103510
Anxiety, depression, and coping styles among cervical cancer patients during radiotherapy and their correlations with uncertainty in illness
Chen-Ying Ma, Jing Shang, Lu Zhang, Jie Chen, Ke-Yan Qian, Ju-Ying Zhou
Chen-Ying Ma, Lu Zhang, Jie Chen, Ke-Yan Qian, Ju-Ying Zhou, Department of Radiation Oncology, The First Affiliated Hospital of Soochow University, Suzhou 215123, Jiangsu Province, China
Jing Shang, Department of Psychiatry, The First Affiliated Hospital of Soochow University, Suzhou 215123, Jiangsu Province, China
Author contributions: Ma CY designed the research and wrote the first manuscript; Ma CY and Zhou JY conducted the analysis and provided guidance for the research; Ma CY, Shang J, Zhang L, Chen J, Qian KY and Zhou JY contributed to conceiving the research and analyzing data; all authors reviewed and approved the final manuscript.
Supported by National Natural Science Foundation of China, No. 81602792; The Natural Science Foundation of the Jiangsu Higher Education Institutions of China, No. 23KJB310023; Jiangsu Provincial Medical Key Discipline, No. ZDXK202235; The Maternal and Child Health Research Project of Jiangsu Province, No. F202210; The Project of State Key Laboratory of Radiation Medicine and Protection, Soochow University, No. GZK1202101; Suzhou Science and Technology Development Plan Project, No. KJXW2020008; BOXI Natural Science Cultivation Foundation of China of The First Affiliated Hospital of Soochow University, No. BXQN202107; Clinical Diagnosis and Treatment Technology Innovation Project Youth Characteristic Technology Project of The First Affiliated Hospital of Soochow University, No. 2100201.
Institutional review board statement: This study was approved by the Ethic Committee of the First Affiliated Hospital of Soochow University.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: There is no conflict of interest.
Data sharing statement: No additional data are available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ju-Ying Zhou, Department of Radiation Oncology, The First Affiliated Hospital of Soochow University, No. 188 Shizi Street, Gusu District, Suzhou 215123, Jiangsu Province, China. zhoujuyingsy@163.com
Received: January 8, 2025
Revised: February 20, 2025
Accepted: March 3, 2025
Published online: April 19, 2025
Processing time: 76 Days and 2.4 Hours
Abstract
BACKGROUND

Currently, there is limited research examining the relationship between anxiety, depression, coping styles, and illness uncertainty in patients with cervical cancer (CC) undergoing radiotherapy. Addressing this gap could provide valuable insights and more reliable evidence for clinical practice targeting this patient population.

AIM

To analyze the anxiety, depression, and coping styles of patients with CC undergoing radiotherapy and explore their correlations with illness uncertainty.

METHODS

A total of 200 patients with CC undergoing radiotherapy at The First Affiliated Hospital of Soochow University between June 2018 and June 2022 were enrolled. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS), comprising subscales for anxiety (HADS-A) and depression (HADS-D). Coping styles were evaluated using the Jalowiec Coping Scale (JCS-60), comprising dimensions such as confrontive, evasive, optimistic, fatalistic, emotive, palliative, supportive, and self-reliant. Illness uncertainty was measured using the Mishel Uncertainty in Illness Scale (MUIS), encompassing ambiguity, complexity, information deficit, and unpredictability. Correlations among anxiety, depression, coping styles, and illness uncertainty were analyzed.

RESULTS

During radiotherapy, the mean scores were 7.12 ± 3.39 for HADS-A, 6.68 ± 3.49 for HADS-D, 1.52 ± 0.23 for JCS-60, and 93.40 ± 7.44 for MUIS. Anxiety (HADS-A ≥ 8) was present in 39.5% of patients, depression (HADS-D ≥ 8) in 41.0%, and both in 14.0%. Anxiety was significantly positively correlated with ambiguity, unpredictability, and total MUIS score (P < 0.05). Depression was significantly positively correlated with ambiguity, information deficit, unpredictability, and total MUIS score (P < 0.05). Most patients adopted an optimistic coping style, whereas the emotive style was least utilized. Evasive, fatalistic, and emotive coping styles were significantly positively correlated with illness uncertainty, whereas the self-reliant style was significantly negatively correlated with unpredictability (P < 0.05).

CONCLUSION

Anxiety, depression, and coping styles in patients with CC undergoing radiotherapy correlate significantly with their level of illness uncertainty. Medical staff should address patients’ psychological status and coping strategies by providing targeted information to reduce negative emotions, foster adaptive coping styles, and decrease illness uncertainty.

Keywords: Cervical cancer; Radiotherapy; Anxiety; Depression; Coping styles; Uncertainty in illness

Core Tip: This study comprehensively analyzed anxiety, depression, and coping styles and their association with illness uncertainty in patients with cervical cancer (CC) undergoing radiotherapy. The study enrolled 200 patients with CC undergoing radiotherapy. Several key findings of this study include a 39.5% prevalence of anxiety and a 41.0% prevalence of depression among the patients. Anxiety, depression, and several coping styles correlated significantly with the level of illness uncertainty during radiotherapy. These findings highlight the importance of healthcare providers in addressing patients’ emotional states and coping strategies and providing customized psychological support plans tailored to help patients alleviate negative emotions and develop healthy coping strategies, thereby reducing their illness uncertainty. This study provides novel insights and empirical data to inform nursing care and clinical decision-making for patients with CC.