Effect of hospitalization on rest-activity rhythm and quality of life of cancer patients.

ABSTRACT

Rest-activity rhythm and quality of life (QoL) in three cohorts, namely (1) cancer in-patients, (2) out-patients, and (3) control subjects were studied. The patients of the former two groups were chosen randomly from the Regional Cancer Center, Raipur, India. All patients received chemotherapy for 3-4 consecutive days. The in-patients remained hospitalized for the entire period of chemotherapy plus one day post treatment. The out-patients, unlike the in-patients, went to their homes daily after treatment. Rest-activity rhythm of the patients was monitored using Actical. Quality of life (QoL) and psychological status of patients were assessed using EORTC QLQ-C30 and Hospital Anxiety & Depression Scale, respectively. Each subject exhibited significant circadian rhythm in rest-activity. The average values for Mesor, amplitude, peak activity, autocorrelation coefficient and dichotomy index of all three groups varied significantly between one group to the other in the following order in-patient < out-patient < control. Further, quality of life, measured from responses on functional and symptom scales, was better off in cancer out-patients compared to the in-patients. It is concluded that hospitalization alters rest-activity rhythm parameters markedly and deteriorates QoL in cancer patients. Nevertheless, further extensive investigation is desirable to support the above speculation and to ascertain if hospitalization produces similar effects on patients suffering from diseases other than cancer.