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ArticleCancer medicine2026

Psychological Factors and Treatment Experiences Associated With Chemotherapy Side-Effect Expectations and Symptom Severity: A Prospective Longitudinal Study.

Miriam Grapp, Kristin Lichtenberg, Marcel Wilhelm, Hans-Christoph Friederich, Till Johannes Bugaj

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Article in Cancer medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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4 · The record

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5 · Who and what money

Authors and funding

5 authors.

Miriam GrappDepartment of General Internal and Psychosomatic Medicine, University Hospital Heidelberg, Heidelberg, Germany.ORCID https://orcid.org/0000-0003-3837-0931
Kristin LichtenbergDepartment of Clinical Psychology and Psychotherapy, Philipps Universität, Marburg, Germany.
Marcel WilhelmDepartment of Clinical Psychology and Psychotherapy, Philipps Universität, Marburg, Germany.ORCID https://orcid.org/0000-0001-8055-9346
Hans-Christoph FriederichDepartment of General Internal and Psychosomatic Medicine, University Hospital Heidelberg, Heidelberg, Germany.ORCID https://orcid.org/0000-0003-4344-8959
Till Johannes BugajDepartment of General Internal and Psychosomatic Medicine, University Hospital Heidelberg, Heidelberg, Germany.ORCID https://orcid.org/0000-0001-8287-2635

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPatients' 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.

aimsThis 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.

methodsIn 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.

resultsOf 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.

conclusionsFindings 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.

trial registrationGerman Clinical Trials Register (DRKS00028791).

Indexed as

Antineoplastic AgentsDrug-Related Side Effects and Adverse ReactionsNeoplasmsAdultAgedAnxietyDepressionFatigueFemaleHopeHumansLongitudinal StudiesMaleMiddle AgedProspective StudiesPsychological DistressAntineoplastic Agentsanxietycancerchemotherapydepressionfatiguehopeoncologyself efficacytreatment outcome

Identifiers

PMID42449551
PMCPMC13369292

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