Correlation of nutritional status and anxiety with quality of life among ovarian cancer patients undergoing chemotherapy: A cross-sectional study at a provincial referral hospital in Indonesia

Abstract

Ovarian cancer and its treatment are associated with substantial physical and psychological burden, which may adversely affect patients’ quality of life (QoL). While nutritional status and psychological factors are both considered important determinants of QoL, their contributions in patients undergoing chemotherapy remain unclear. This study aimed to evaluate the correlation between nutritional status and anxiety level with QoL among patients with ovarian cancer undergoing chemotherapy. A cross-sectional study was conducted at Dr. Zainoel Abidin Hospital, Banda Aceh, Indonesia, in 2025. Nutritional status was assessed using body mass index (BMI) and serum albumin levels; anxiety was measured using the Zung Self-Rating Anxiety Scale (SAS); and QoL was evaluated using the EORTC QLQ-C30 questionnaire. Data were analyzed using Pearson correlation tests followed with multivariate linear regression test. A total of 101 patients with ovarian cancer undergoing chemotherapy were included in this study. Nutritional status indicators, BMI and serum albumin, were not significantly correlated with QoL across all domains, with very weak correlation coefficients (r=−0.165 to 0.097). In contrast, anxiety level demonstrated significant negative correlations with global health status (r=−0.426), physical function (r=−0.449), emotional function (r=−0.427), cognitive function (r=−0.337), and social function (r=−0.466) (all p<0.05), but not with role function. Multivariate analysis confirmed that anxiety was the only independent predictor of QoL across these domains, whereas BMI and serum albumin showed no significant association. These findings indicate that anxiety plays a more prominent role than nutritional status in determining QoL among patients with ovarian cancer undergoing chemotherapy. Routine screening and management of anxiety could be beneficial to be integrated into oncologic care to improve patient outcomes.