English abstract
Background: The diagnosis and treatment of cancer can be a traumatic and life-changing event
for patients, leading to increased levels of stress and psychological trauma, which can
significantly impact their quality of life.
Objective: This study aimed to identify the prevalence of post-traumatic stress disorder (PTSD)
among adult cancer patients in Oman, determine predictors influencing the development of
PTSD and investigate its relationship with social support and quality of life.
Method: A descriptive correlational cross-sectional study was conducted involving 343
adult patients with cancer undergoing treatment at three tertiary care centers in Oman, which
were Sultan Qaboos Comprehensive Cancer Care and Research Centre, Royal Hospital and
Sultan Qaboos University Hospital. PTSD was assessed using the Diagnostic and Statistical
Manual of Mental Disorders, Fifth Edition (PTSD Checklist for DSM-5; PCL-5), while
perceived social support was measured using the Multidimensional Scale of Perceived Social
Support (MSPSS). Quality of life was assessed using the European Organization for Research
and Treatment of Cancer (EORTC QLQ-C30) scale. Data were analyzed by using The Statistical
Package for Social Science (SPSS) software version 25. To assess PTSD prevalence, symptom
cluster criteria was used and compared against a scoring threshold of 32 and 33.The relationship
between social support and PTSD was examined using simple logistic regression, while the
Mann-Whitney U test was utilized to determine if quality-of-life scores differed significantly
CANCER-RELATED POST-TRAUMATIC STRESS DISORDER
between patients with and without PTSD. Additionally, multiple logistic regression was
employed to identify predictors of PTSD among Omani adult cancer patients.
Result: The study showed that the prevalence of PTSD among Omani adult patients with cancer
was 27.4%. Importantly, a significant negative association was observed between social support
and PTSD (odds ratio [OR] = 0.95; 95% confidence interval [CI] = 0.93 - 0.97; p < 0.001),
indicating that higher levels of social support acted as a protective factor against the development
of PTSD in this population.
Patients diagnosed with PTSD exhibited significantly lower mean ranks for global health
status/quality of life (mean rank = 97.3) in comparison to patients without PTSD (mean rank =
200.2) (p < 0.001). Similarly, patients with PTSD also demonstrated lower mean ranks for the
total functional scale (mean rank = 76.7) compared to those without PTSD (mean rank = 208.0)
(p < 0.001). Conversely, patients with PTSD had a higher mean rank for the total symptoms
scale (mean rank = 253.5) in contrast to patients without PTSD (mean rank = 140.4) (p < 0.001).
Furthermore, several predictors of PTSD were identified within this population. A shorter time
since diagnosis (OR = 0.98, 95% CI = 0.97-0.99, p = 0.017), absence of a psychiatric referral
(OR = 0.46, 95% CI = 0.23-0.96, p = 0.04), and inadequate social support (OR = 0.96, 95% CI =
0.94-0.98, p < 0.001) were significantly associated with an increased likelihood of developing
PTSD among patients with cancer. Conclusion: The study revealed that PTSD is a significant
mental health issue among patients with cancer, with a prevalence rate of 27.4%. The study
highlights the critical role of social support in reducing the risk of PTSD and emphasizes the
need for routine assessment and psychiatric referral to improve the quality of life of patients with
cancer especially those who are newly diagnosed.
