@article{5125e651458a4f3f98c60c015fc2d198,
title = "Associations of Uncertainty With Psychological Health and Quality of Life in Older Adults With Advanced Cancer",
abstract = "Context: Older adults with advanced cancer face uncertainty related to their disease and treatment. Objectives: To evaluate the associations of uncertainty with psychological health and quality of life (QoL) in older adults with advanced cancer. Methods: Secondary cross-sectional analysis of baseline data from a national clustered geriatric assessment trial. Patients 70 years and older with advanced cancer considering a new line of chemotherapy were recruited. We measured uncertainty using the modified nine-item Mishel Uncertainty in Illness Scale. Dependent variables included anxiety (Generalized Anxiety Disorder-7), depression (Generalized Depression Scale-15), distress (distress thermometer), QoL (Functional Assessment of Cancer Therapy—General), and emotional well-being (Functional Assessment of Cancer Therapy—General subscale). We used multivariate linear regression analyses to evaluate the association of uncertainty with each dependent variable. We conducted a partial least squares analysis with a variable importance in projection (VIP) plot to assess the contribution of individual variables to the model. Variables with a VIP <0.8 were considered less influential. Results: We included 527 patients (median age 76 years; range 70–96). In multivariate analyses, higher levels of uncertainty were significantly associated with greater anxiety (β = 0.11; SE = 0.04), depression (β = 0.09; SE = 0.02), distress (β = 0.12; SE = 0.02), as well as lower QoL (β = −1.08; SE = 0.11) and emotional well-being (β = −0.29; SE = 0.03); the effect sizes were considered small. Uncertainty items related to disease and treatment were most strongly associated with psychological health and QoL scores (all VIP >0.8). Conclusion: Uncertainty among older patients with advanced cancer is associated with worse psychological health and QoL. Tailored uncertainty management strategies are warranted.",
keywords = "Uncertainty, older adults, oncologists, psychological health, quality of life",
author = "Verduzco-Aguirre, {Haydee C.} and Dilip Babu and Mohile, {Supriya G.} and Javier Bautista and Huiwen Xu and Eva Culakova and Beverly Canin and Yingzi Zhang and Megan Wells and Epstein, {Ronald M.} and Paul Duberstein and Colin McHugh and William Dale and Alison Conlin and James Bearden and Jeffrey Berenberg and Mohamedtaki Tejani and Loh, {Kah Poh}",
note = "Funding Information: This work was funded through a Patient-Centered Outcomes Research Institute Program contract (4634; Mohile); K99CA237744 (Loh), UG1CA189961 , R01CA177592 (Mohile), and R01CA168387 (Duberstein) from the National Cancer Institute ; K24AG056589 from the National Institute of Aging (Mohile), Wilmot Research Fellowship (Loh), and Union for International Cancer Control Technical Fellowship (Verduzco-Aguirre). This work was made possible by the generous donors to the Wilmot Cancer Institute geriatric oncology philanthropy fund. All statements in this report, including its findings and conclusions, are solely those of the authors, do not necessarily represent the official views of the funding agencies, and do not necessarily represent the views of the Patient-Centered Outcomes Research Institute , its Board of Governors, or Methodology Committee. The authors thank Ms. Shuhan Yang for the creation of the figure. Funding Information: This work was funded through a Patient-Centered Outcomes Research Institute Program contract (4634; Mohile); K99CA237744 (Loh), UG1CA189961, R01CA177592 (Mohile), and R01CA168387 (Duberstein) from the National Cancer Institute; K24AG056589 from the National Institute of Aging (Mohile), Wilmot Research Fellowship (Loh), and Union for International Cancer Control Technical Fellowship (Verduzco-Aguirre). This work was made possible by the generous donors to the Wilmot Cancer Institute geriatric oncology philanthropy fund. All statements in this report, including its findings and conclusions, are solely those of the authors, do not necessarily represent the official views of the funding agencies, and do not necessarily represent the views of the Patient-Centered Outcomes Research Institute, its Board of Governors, or Methodology Committee. The authors thank Ms. Shuhan Yang for the creation of the figure. The authors declare no conflicts of interest. Publisher Copyright: {\textcopyright} 2020 American Academy of Hospice and Palliative Medicine",
year = "2021",
month = feb,
doi = "10.1016/j.jpainsymman.2020.08.012",
language = "English (US)",
volume = "61",
pages = "369--376.e1",
journal = "Journal of Pain and Symptom Management",
issn = "0885-3924",
publisher = "Elsevier Inc.",
number = "2",
}