Psychological Factors and Treatment Experiences Associated With Chemotherapy Side-Effect Expectations and Symptom...

Patients' expectations may influence how chemotherapy side effects are perceived and could contribute to symptom amplification. Psychological distress and prior treatment experiences are assumed to shape these expectations, yet their interplay and impact on side-effect burden remain unclear.

This study examined how prior treatment experiences, psychological distress, hope, and self-efficacy affect expectations of side effects and predict the severity of chemotherapy-related symptoms such as nausea, peripheral neuropathy, and fatigue.

In a prospective longitudinal study, 101 adult patients with cancer initiating outpatient chemotherapy were assessed at T1 (start of the second cycle) and T2 (8-12 weeks later). Expectations of side effects (G-EEE), chemotherapy-related symptom severity (GASE), hope (HHI-D), self-efficacy (CBI-B-D), and psychological distress (PHQ-2, GAD-2) were assessed using standardized questionnaires. Prior treatment experiences, sociodemographic and illness-related variables were documented. Multiple linear regressions identified predictors of expectations and symptom severity.

Of 101 patients, 73 completed both assessments. Higher side effect expectations were predicted by prior chemotherapy, anxiety, lower hope, and negative treatment reports from others. At T2, depressive symptoms predicted neuropathy and fatigue; lower self-efficacy predicted neuropathy; and lower hope predicted fatigue. Expectations improved model fit but did not independently predict symptom severity.

Findings highlight the relevance of personal and vicarious treatment experiences, psychological distress, and resilience factors in shaping both expectations and patients' symptom experiences related to chemotherapy side effects. While expectations were linked to psychological variables, hope, self-efficacy, and depression were stronger predictors of symptom severity. These patient characteristics may help identify patients who could benefit from supportive care and patient-centered communication in oncology.

German Clinical Trials Register (DRKS00028791).