Factors associated with psychological distress in patients with bone tumors and 3-month changes during routine...

To examine clinical, functional, and psychosocial factors associated with psychological distress in patients with bone tumors and describe within-group changes during routine psychological management.

This prospective observational study included 160 patients with primary bone tumors. The primary analysis was cross-sectional because the explanatory variables and psychological distress were assessed concurrently at baseline. Multiple linear regression was used to examine factors associated with the continuous Symptom Checklist-90 (SCL-90) total score. Logistic regression based on screening status was performed as a supplementary analysis. Patients who screened positive received routine individualized psychological and supportive management and underwent reassessment after 3 months.

Fifty-two patients (32.5%) screened positive for psychological distress. Higher Visual Analog Scale (VAS), Body Image Scale (BIS), and Fear of Progression Questionnaire-Short Form (FoP-Q-SF) scores were associated with higher SCL-90 total scores, whereas higher Musculoskeletal Tumor Society (MSTS) and Social Support Rating Scale (SSRS) scores were associated with lower SCL-90 scores (all P < 0.01). The primary model explained 71.9% of the variance in SCL-90 scores. No important multicollinearity was detected. Among the 52 screening-positive patients, most SCL-90 dimension scores and the total score decreased at 3 months, whereas the change in paranoid ideation was not statistically significant.

Greater pain, body image disturbance, fear of progression, poorer limb function, and lower social support were associated with greater psychological distress. Symptom scores decreased among screening-positive patients, but without a comparison group, these findings are descriptive and hypothesis-generating, not evidence of management effects.