Impact of psychosocial determinants on chemotherapy-induced nausea and vomiting and its association with health-related quality of life among gastrointestinal cancer patients

BackgroundChemotherapy-induced nausea and vomiting (CINV) remain a significant challenge for cancer patients, including those with gastrointestinal (GI) cancer, with negative impact on quality of life (QoL). This study aims to determine the relationship of psychosocial determinants with CINV and its impact on health-related quality of life (HR-QoL) among patients diagnosed with Gastrointestinal cancer.MethodologyA prospective observational study was conducted for six months among 80 GI cancer patients meeting the inclusion criteria, in the in-patient Department of Oncology of a tertiary care hospital. Before chemotherapy, the Distress Thermometer (DT) was used to assess emotional distress, and the Mini-Mental Adjustment to Cancer (Mini-MAC) scale was used to assess coping style. Participants were then followed up via phone call for five days after chemotherapy to record CINV. Functional Living Index for Emesis (FLIE) was used to assess the impact on CINV-related QoL.Results and DiscussionPatients who experienced CINV (47.5%) reported significant emotional distress, while those without CINV (52.5%) did not. When assessing coping styles, the Mini-MAC dimensions of Cognitive Avoidance (CA) and Anxious Preoccupation (AP) were significantly associated with vomiting (p < 0.05). Additionally, all Mini-MAC dimensions, including Hopelessness/Helplessness (H), Anxious Preoccupation (AP), Fighting Spirit (FS), Cognitive Avoidance (CA), and Fatalism (F), were significantly associated with nausea (p < 0.05). However, coping mechanisms were found to have no statistical significance with CINV-related QoL. On multivariable analysis adjusting for age, gender, cancer stage, surgery, radiation therapy, and chemotherapy emetogenicity, none of the Mini-MAC domains remained independently associated with nausea, suggesting that the univariate associations may be substantially explained by clinical and treatment-related factors.conclusionUnivariate associations between psychosocial determinants and CINV were observed, particularly for nausea, but these did not persist after adjusting for clinical and treatment-related factors. These findings should therefore be regarded as exploratory and hypothesis-generating rather than evidence that psychosocial assessment independently identifies patients at risk of CINV. Larger, adequately powered studies with multivariable adjustment are needed to confirm whether psychosocial coping style contributes independently to CINV risk and to inform the potential development of interventions to reduce the emotional burden of cancer and its treatment.