Page 68 - JCBP-3-2

Journal of Clinical and
Basic Psychosomatics Evaluation of biopsychosocial factors

and SF-36 (global and mental health components) scores the participants (male or female) was recorded, with the
with the 1-year mortality rate, assessing the relationship proportion being 43% female and 57% male.
between anxiety and depression with mortality in a chronic The remaining 30% of patients (36 individuals)
pain cancer population. A Kruskal–Wallis test was used to were unmarried. Of these, 5% were single (n = 6), 5%
explore the relationship between HADS with marital status were divorced, and 20% were widowed (n = 24). These data
(single, married, divorced, or widowed). A Mann-Whitney are presented in Figure 1.
test was performed to assess the relationship between
HADS with self-sufficiency (autonomous or dependent). Concerning individual autonomy or self-sufficiency,
most patients – specifically 63.6% (n = 77) – considered
Canonical correlation analysis (CCA) was used to themselves autonomous or self-sufficient, while 36.4%
evaluate the relationships among different constructs of (n = 43) reported being dependent (Figure 2).
anxiety, depression, QoL, and pain was carried out using.
The dimensions of each questionnaire were treated as The statistical analysis of correlations revealed
primary variables. For the BPI, the pain dimension and that depression is associated with marital status.
interference dimensions were considered, while for the Depression was more pronounced in widowed or
HADS, the anxiety and depression dimensions were used. divorced individuals (P < 0.05), less significant in
In the SF-36 questionnaire, the following dimensions were unmarried individuals (P = 0.042), and not relevant
included: “physical function,” “physical performance,” in the married group (P = 0.653). The values presented in
“body pain,” “general health,” “vitality,” “social function,” Table 1 represent the mean scores ± standard deviation
“emotional performance,” and “mental health.” for depression and anxiety in married and unmarried
populations. These values reflect the average scores, based
The relationship between the BPI and HADS on the maximum possible score of 21 on the HADS for
questionnaires was evaluated first. A CCA was then depression and anxiety. A 95% confidence level was used
performed to examine the relationship between the to determine statistical significance (Table 1).
dimensions of these two questionnaires and those of the
SF-36. A composite construct was created by combining The results related to marital status reveal a clear
the dimensions of the BPI and the HADS, which were imbalance between the number of married and unmarried
correlated with the dimensions of the SF36. The statistical individuals. Although the statistical evaluation considered
significance of the canonical correlation was assessed using
Wilks’ Lambda. The strength of the correlation between the
canonical variables was used to explore the relationships
between the constructs. In addition, the correlations
between the original variables (BPI/HADS and SF-36
dimensions) and the significant canonical variables were
examined. In cases where multiple canonical variables
were identified, the construct with the highest correlation
was interpreted as the most likely construct, based on its
relationship with the original variables.
3. Results and discussion Figure 1. Marital status of 120 patients: 84 married (70%) and 36 non-
The results were obtained through statistical correlations married (30%). Among the non-married patients, 6 were single (5%), 24
of the variables analyzed from the three questionnaires were widowed (20%), and 6 were divorced (5%).
selected for this study: HADS, BPI, and SF-36. These
questionnaires evaluate the dimensions of depression and
anxiety, the global dimensions related to pain, and the
QoL, respectively. A 95% confidence level was applied,
with results considered statistically significant at P < 0.05.

Regarding the demographic data, the study sample
consisted of 120 cancer patients. Of these, 70%
(84 patients) were classified as “married to partner,”
without distinguishing between the type of relationship
(heterosexual or homosexual) or legal/religious status Figure 2. Individual autonomy status of 120 patients: 77 self-sufficient
(civil marriage or “de facto” union). Only the gender of (63.6%) and 43 dependent patients (36.4%).

Volume 3 Issue 2 (2025) 62 doi: 10.36922/jcbp.4097