Assessment of Anxiety, Depression, Stress and Holistic Needs of Lung Cancer Patients That Undergo Oncology Treatments during the COVID-19 Pandemic

Introduction: Lung cancer is associated with high morbidity and mortality with symptoms deriving from both the disease and its treatment, resulting in mental disorders such as anxiety, stress and depression which have been aggravated amidst the COVID-19 pandemic. Aim: This paper aims to investigate the prevalence of anxiety, stress and depression among lung cancer patients undergoing chemotherapy/immunotherapy during the COVID-19 pandemic as well as investigate the association of these mental disorders with the psychological distress experienced by lung cancer patients. Material and Method: DASS-21 was used to assess the prevalence of anxiety, depression and stress experienced by lung cancer patients, and the Distress Thermometer was used to assess the level of their distress. Results: 160 lung cancer patients under treatment participated in the present study at the Oncology Outpatients’ Clinic, “Sotiria” Athens’ Chest Diseases Hospital in Athens, Greece. The prevalence of depression was 22%, of anxiety 35% and of stress 17.6%, with the majority experiencing moderate levels (45.7%, 35.7% and 53.6% respectively). The total mean score of DASS-21 was 21.0 ± 18.1 and its subscales mean scores were 9.7 ± 6.7 for stress, 5.9 ± 6.6 for anxiety and 5.3 ± 6.4 for depression, with women having significantly higher scores in all subscales compared to men (p = .018, .010 & .44 respectively). The mean score of DT was 3.8 ± 2.5 and 62.5% of the patients had Practical problems, 24.4% Family problems, 70.6% Emotional problems, 9.4% Spiritual problems and 95% Physical Problems. The subscales of DASS-21 and DT were positively correlated (p mptoms they exhibit and vice versa. Emotional problems are a predictive factor for Stress (p = .001) and physical and emotional problems for Anxiety (p = .009 & .020 respectively). Conclusions: Lung cancer patients under treatment during the COVID-19 pandemic are in need of a holistic approach so as to prevent or alleviate psychological and distress symptoms, thus enhancing their quality of life.