Effect of Viewing Disney Movies During Chemotherapy on Self-Reported Quality of Life Among Patients With Gynecologic Cancer: A Randomized Clinical Trial

Abstract

Importance: In addition to treatment efficacy, evaluation of adverse effects and quality of life assessments have become increasingly relevant in oncology.

Objective: To evaluate the association of watching Disney movies during chemotherapy with emotional and social functioning and fatigue status.

Design, setting, and participants: This randomized clinical trial was performed from December 2017 to December 2018 at a cancer referral center in Vienna, Austria. A consecutive sample of women with gynecologic cancers was recruited through July 2018. Inclusion criteria included age older than 18 years, written informed consent, and planned 6 cycles of chemotherapy with either carboplatin and paclitaxel or carboplatin and pegylated liposomal doxorubicin. Exclusion criteria were inadequate knowledge of the German language or receipt of other chemotherapy regimens. Data analysis was performed from February 2019 to April 2019.

Intervention: Participants were either shown Disney movies or not during 6 cycles of chemotherapy. Before and after every cycle, they completed standardized questionnaires from the European Organisation for Research and Treatment of Cancer (EORTC).

Main outcomes and measures: Primary outcomes were change of quality of life, as defined by the EORTC Core-30 (version 3) questionnaire, and fatigue, as defined by the EORTC Quality of Life Questionnaire Fatigue, during 6 cycles of chemotherapy.

Results: Fifty-six women entered the study, and 50 completed it, including 25 women in the Disney group (mean [SD] age, 59 [12] years) and 25 women in the control group (mean [SD] age, 62 [8] years). In the course of 6 cycles of chemotherapy, patients in the Disney group felt less tense and worried less than patients in the control group according to their responses to the questions about emotional functioning (mean [SD] score, 86.9 [14.3] vs 66.3 [27.2]; maximum test P = .02). Furthermore, watching Disney movies was associated with less encroachment on patients' family life and social activities, as evaluated by the social functioning questions (mean [SD] score, 86.1 [23.0] vs 63.6 [33.6]; maximum test P = .01). Moreover, this intervention led to fewer fatigue symptoms (mean [SD] score, 85.5 [13.6] vs 66.4 [22.5]; maximum test P = .01). Perceived global health status was not associated with watching Disney movies (mean [SD] score, 75.9 [17.6] vs 61.0 [25.1]; maximum test P = .16).

Conclusions and relevance: These findings suggest that watching Disney movies during chemotherapy may be associated with improvements in emotional functioning, social functioning, and fatigue status in patients with gynecologic cancers.

Trial registration: ClinicalTrials.gov Identifier: NCT03863912.

Conflict of interest statement

Conflict of Interest Disclosures: Dr. Pils reported receiving honoraria as a speaker from MSD and travel expenses from Roche, Pharma Mar, and MSD. Dr Ott reported receiving personal fees and remuneration for lecturing from Lenus Pharma GesmbH outside the submitted work. Dr Reinthaller reported receiving travel expenses and honoraria as a speaker and for serving on the advisory boards of Roche, Astra Zeneca, Amgen, Pharma Mar, GSK, Tesaro, and Clovis. No other disclosures were reported.

Figures

Figure 1.. CONSORT 2010 Flow Diagram

Figure 2.. Emotional Functioning, Social Functioning, Fatigue, and Global Health Status Scores During 6 Cycles of Chemotherapy in Patients Watching Disney Movies or Not

Graphs show mean scores for emotional functioning (A), social functioning (B), fatigue (C), and global health status (D). Odd-numbered visits represent prechemotherapy survey, and subsequent even-numbered visits represent postchemotherapy surveys on the same day. Error bars correspond to 1 SE of the mean. The maximum test P values for the between-group comparison of mean trajectories were P = .02 (A), P = .01 (B), P = .01 (C) and P = .16 (D).