Longitudinal Trajectories of Psychological Distress and Its Influence Factors in Young and Middle-Aged Patients With Colorectal Cancer.

Aims: To identify the longitudinal trajectories of psychological distress and to explore the predictive factors of different trajectories among young and middle-aged colorectal cancer patients from diagnosis to 6 months postoperation.

Design: A longitudinal study was conducted, guided by the STROBE checklist.

Methods: A total of 214 patients were recruited from July 2021 to May 2022 at a cancer hospital in Guangzhou, China. Data were collected from diagnosis to 6 months post-surgery, using the Brief Symptom Inventory-18, Distress Disclosure Index, Connor-Davidson Resilience Scale and Social Support Rating Scale. We also collected socio-demographic and clinical characteristics at baseline. General estimation equation (GEE) was used to analyse the overall trend of psychological distress. To identify distinct distress trajectories, growth mixture modelling (GMM) and latent class growth modelling (LCGM) were both used.

Results: Longitudinal trajectories of psychological distress: the average score of psychological distress at different time points were 12.02 ± 9.87, 17.40 ± 9.73, 15.91 ± 10.05, 16.28 ± 11.24 and 16.31 ± 11.66. GEE showed four unique trajectories of psychological distress: chronic distress, no distress, steady increase and significantly increased. With reference to resilient group, multinomial logistic regression showed that education level, monthly income, minor offspring, stoma, residence, self-disclosure and psychological resilience were predictive factors of chronic distress class or increase-distress class.

Conclusion: From diagnosis to 6 months post-surgery, psychological distress increased at discharge, gradually stabilising thereafter. Meanwhile, results revealed heterogeneity in this population. To effectively alleviate distress, it is crucial to identify high-risk individuals through predictive factors and implement tailored interventions.

Implications For The Profession And/or Patient Care: This study offers the trajectory and predictors of psychological distress in the process of diagnosis and treatment, and can be used in the clinical identification and monitoring of high-risk patients.

Impact: The findings suggest that healthcare providers should regularly monitored and identified the psychological distress of patients, and took individualised intervention measures.

Reporting Method: This study is reported using the STROBE guidelines.

Patient Or Public Contribution: No patient or public engagement.