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Wang S, Zheng M, Xu W, Zhang L, Zhu Y, Wan H. Cancer patients' perceptions of the meaning in life: a protocol for a meta-synthesis of qualitative research. BMJ Open 2024; 14:e078357. [PMID: 38862219 PMCID: PMC11168129 DOI: 10.1136/bmjopen-2023-078357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 04/09/2024] [Indexed: 06/13/2024] Open
Abstract
INTRODUCTION The onset of cancer compels patients to grapple with existential questions. Enabling individuals with cancer, irrespective of the disease stage, to experience meaningful lives is of utmost importance in enhancing their overall quality of life. This study will synthesise qualitative research evidence to understand cancer patients' perceptions and perspectives regarding their meaning in life. Such insights ultimately contribute to enhancing the profound experience of meaning throughout the life course of cancer patients. METHODS AND ANALYSIS The English and Chinese databases we will search include the Cochrane Library, PubMed, MEDLINE, Web of Science, EMbase, CINAHL, PsycINFO, China National Knowledge Infrastructure, Wan Fang Data, Chinese Biomedical Literature Database and VIP Database for Chinese Technical Periodicals. Two independent reviewers will assess the quality of the included studies using the standard JBI Critical Appraisal Checklist for Qualitative Research and extract data using the standard JBI Data Extraction Tool for Qualitative Research. The JBI meta-aggregation approach will be employed to compare, analyse and summarise the original results. To enhance confidence in the synthesised results of the qualitative study, the final synthesised study results will be graded using the JBI ConQual approach. ETHICS AND DISSEMINATION External ethical approval is not necessary for this review since it involves a retrospective analysis of publicly available primary data through secondary analysis. The findings of the review will be disseminated by publishing them in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER CRD42023447664.
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Affiliation(s)
- Shuman Wang
- Department of Nursing, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, China
- Shanghai Key Laboratory of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Shanghai, China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai Proton and Heavy Ion Center, Shanghai, China
| | - Mimi Zheng
- Zhongshan Hospital Fudan University, Shanghai, China
| | - Wenjie Xu
- Department of Nursing, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, China
- Shanghai Key Laboratory of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Shanghai, China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai Proton and Heavy Ion Center, Shanghai, China
| | - Lijuan Zhang
- Department of Nursing, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, China
- Shanghai Key Laboratory of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Shanghai, China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai Proton and Heavy Ion Center, Shanghai, China
| | - Yu Zhu
- Department of Nursing, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, China
- Shanghai Key Laboratory of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Shanghai, China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai Proton and Heavy Ion Center, Shanghai, China
| | - Hongwei Wan
- Department of Nursing, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, China
- Shanghai Key Laboratory of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Shanghai, China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai Proton and Heavy Ion Center, Shanghai, China
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Otto AK, Prinsloo S, Natori A, Wagner RW, Gomez TI, Ochoa JM, Tworoger SS, Ulrich CM, Ahmed S, McQuade JL, Peoples AR, Antoni MH, Bower JE, Cohen L, Penedo FJ. Impact of COVID-19-related experiences on health-related quality of life in cancer survivors in the United States. PLoS One 2024; 19:e0297077. [PMID: 38484002 PMCID: PMC10939216 DOI: 10.1371/journal.pone.0297077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 12/27/2023] [Indexed: 03/17/2024] Open
Abstract
OBJECTIVE Little evidence exists on the impact of the COVID-19 pandemic on cancer survivors, limiting recommendations to improve health-related quality of life (HRQoL) in this population. We describe survivors' pandemic experiences and examine associations between COVID-19-related exposures, psychosocial experiences, and HRQoL. METHODS Between May 2020-April 2021, survivors completed cross-sectional questionnaires capturing COVID-19-related exposures (e.g., exposure to virus, job loss); psychosocial experiences (i.e., COVID-19-related anxiety/depression, disruptions to health care and daily activities/social interactions, satisfaction with providers' response to COVID, financial hardship, perceived benefits of the pandemic, social support, and perceived stress management ability); and HRQoL. RESULTS Data were collected from N = 11,325 survivors in the United States. Participants were mostly female (58%), White (89%) and non-Hispanic (88%), and age 63 on average. Breast cancer was the most common diagnosis (23%). Eight percent of participants reported being exposed to COVID-19; 1% tested positive. About 6% of participants lost their jobs, while 24% lost household income. Nearly 30% avoided attending in-person oncology appointments because of the pandemic. Poorer HRQoL was associated with demographic (younger age; female; non-Hispanic White), clinical (Medicare; stage IV disease; hematologic/digestive/respiratory system cancer), and psychosocial factors (low perceived benefits and stress management ability; more disruption to health care and daily activities/social interactions; financial hardship). CONCLUSIONS COVID-19-related stressors were associated with various psychosocial experiences in cancer survivors, and these psychosocial experiences were associated with HRQoL above and beyond demographic and clinical factors.
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Affiliation(s)
- Amy K. Otto
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL, United States of America
- Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, Miami, FL, United States of America
| | - Sarah Prinsloo
- Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, TX, United States of America
- Department of Neurosurgery, The University of Texas M.D. Anderson Cancer Center, Houston, TX, United States of America
| | - Akina Natori
- Division of Medical Oncology, Department of Medicine, Miller School of Medicine, University of Miami, Miami, FL, United States of America
| | - Richard W. Wagner
- Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, TX, United States of America
| | - Telma I. Gomez
- Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, TX, United States of America
| | - Jewel M. Ochoa
- Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, TX, United States of America
| | - Shelley S. Tworoger
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, United States of America
| | - Cornelia M. Ulrich
- Huntsman Cancer Institute, University of Utah, Salt Lake City, CT, United States of America
- Department of Population Health Sciences, University of Utah, Salt Lake City, CT, United States of America
| | - Sairah Ahmed
- Department of Lymphoma and Myeloma, The University of Texas M.D. Anderson Cancer Center, Houston, TX, United States of America
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, TX, United States of America
| | - Jennifer L McQuade
- Department of Melanoma Medical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX, United States of America
| | - Anita R. Peoples
- Huntsman Cancer Institute, University of Utah, Salt Lake City, CT, United States of America
- Department of Population Health Sciences, University of Utah, Salt Lake City, CT, United States of America
| | - Michael H. Antoni
- Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, Miami, FL, United States of America
- Department of Psychology, University of Miami, Miami, FL, United States of America
- Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, Miami, FL, United States of America
| | - Julienne E. Bower
- Department of Psychology, University of California Los Angeles, Los Angeles, CA, United States of America
- Department of Psychiatry/Biobehavioral Sciences, University of California Los Angeles, CA, United States of America
| | - Lorenzo Cohen
- Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, TX, United States of America
| | - Frank J. Penedo
- Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, Miami, FL, United States of America
- Department of Psychology, University of Miami, Miami, FL, United States of America
- Department of Medicine, Miller School of Medicine, University of Miami, Miami, FL, United States of America
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Bahlburg H, Tully KH, Bach P, Butea-Bocu MC, Reike M, Roghmann F, Noldus J, Müller G. Improvements in urinary symptoms, health-related quality of life, and psychosocial distress in the early recovery period after radical cystectomy and urinary diversion in 842 German bladder cancer patients: data from uro-oncological rehabilitation. World J Urol 2024; 42:111. [PMID: 38421452 PMCID: PMC10904548 DOI: 10.1007/s00345-024-04839-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 01/16/2024] [Indexed: 03/02/2024] Open
Abstract
PURPOSE This study aims to investigate urinary symptoms (continence and stoma care), health-related quality of life (HRQoL) and psychosocial distress (PD) in the early postoperative period after radical cystectomy (RC) and urinary diversion for ileal conduit (IC) and ileal neobladder (INB) to obtain a better basis for patient counseling. METHODS Data for 842 bladder cancer patients, who underwent 3 weeks of inpatient rehabilitation (IR) after RC and urinary diversion (447 IC, 395 INB) between April 2018 and December 2019 were prospectively collected. HRQoL, PD, and urinary symptoms were evaluated by validated questionnaires at the beginning (T1) and the end of IR (T2). In addition, continence status and micturition volume were objectively evaluated in INB patients by 24-h pad test and uroflowmetry, respectively. RESULTS Global HRQoL was severely impaired at T1, without significant difference between the two types of urinary diversion. All functioning and symptom scales of HRQoL improved significantly from T1 to T2. In INB patients, all continence parameters improved significantly during IR, while patients with an IC reported fewer problems concerning urostomy management. The proportion of patients suffering from high PD decreased significantly from 50.7 to 34.9%. Age ≤ 59 years was the only independent predictor of high PD. Female patients and patients ≤ 59 years were more likely to use individual psycho-oncological counseling. CONCLUSION HRQoL, PD and urinary symptoms improved significantly in the early recovery period after RC. Patients with urinary continence reported higher HRQoL and less PD. Psychosocial support should be offered especially to younger patients.
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Affiliation(s)
- Henning Bahlburg
- Department of Urology, Marien Hospital Herne, Ruhr-University Bochum, Hölkeskampring 40, 44625, Herne, Germany.
| | - Karl Heinrich Tully
- Department of Urology, Marien Hospital Herne, Ruhr-University Bochum, Hölkeskampring 40, 44625, Herne, Germany
| | - Peter Bach
- Department of Urology, Marien Hospital Herne, Ruhr-University Bochum, Hölkeskampring 40, 44625, Herne, Germany
| | | | - Moritz Reike
- Department of Urology, Marien Hospital Herne, Ruhr-University Bochum, Hölkeskampring 40, 44625, Herne, Germany
| | - Florian Roghmann
- Department of Urology, Marien Hospital Herne, Ruhr-University Bochum, Hölkeskampring 40, 44625, Herne, Germany
| | - Joachim Noldus
- Department of Urology, Marien Hospital Herne, Ruhr-University Bochum, Hölkeskampring 40, 44625, Herne, Germany
| | - Guido Müller
- Department of Urology, Marien Hospital Herne, Ruhr-University Bochum, Hölkeskampring 40, 44625, Herne, Germany
- Center for Urological Rehabilitation, Kliniken Hartenstein, Bad Wildungen, Germany
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Tang M, Su Z, He Y, Pang Y, Zhou Y, Wang Y, Lu Y, Jiang Y, Han X, Song L, Wang L, Li Z, Lv X, Wang Y, Yao J, Liu X, Zhou X, He S, Zhang Y, Song L, Li J, Wang B, Tang L. Physical symptoms and anxiety and depression in older patients with advanced cancer in China: a network analysis. BMC Geriatr 2024; 24:185. [PMID: 38395756 PMCID: PMC10893698 DOI: 10.1186/s12877-024-04788-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 02/06/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Little is understood about the association between psychosomatic symptoms and advanced cancer among older Chinese patients. METHODS This secondary analysis was part of a multicenter cross-sectional study based on an electronic patient-reported outcome platform. Patients with advanced cancer were included between August 2019 and December 2020 in China. Participants (over 60 years) completed the MD Anderson Symptom Inventory (MDASI) and Hospital Anxiety and Depression Scale (HADS) to measure symptom burden. Network analysis was also conducted to investigate the network structure, centrality indices (strength, closeness, and betweenness) and network stability. RESULTS A total of 1022 patients with a mean age of 66 (60-88) years were included; 727 (71.1%) were males, and 295 (28.9%) were females. A total of 64.9% of older patients with advanced cancer had one or more symptoms, and up to 80% had anxiety and depression. The generated network indicated that the physical symptoms, anxiety and depression symptom communities were well connected with each other. Based on an evaluation of the centrality indices, 'distress/feeling upset' (MDASI 5) appears to be a structurally important node in all three networks, and 'I lost interest in my own appearance' (HADS-D4) had the lowest centrality indices. The network stability was relatively high (> 0.7). CONCLUSION The symptom burden remains high in older patients with advanced cancer in China. Psychosomatic symptoms are highly interactive and often present as comorbidities. This network can be used to provide targeted interventions to optimize symptom management in older patients with advanced cancer in China. TRIAL REGISTRATION Chinese Clinical Trial Registry (ChiCTR1900024957), registered on 06/12/2020.
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Affiliation(s)
- Mo Tang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-oncology, Peking University Cancer Hospital & Institute, Fu-Cheng Road 52, Hai-Dian District, Beijing, 100142, China
| | - Zhongge Su
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-oncology, Peking University Cancer Hospital & Institute, Fu-Cheng Road 52, Hai-Dian District, Beijing, 100142, China
| | - Yi He
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-oncology, Peking University Cancer Hospital & Institute, Fu-Cheng Road 52, Hai-Dian District, Beijing, 100142, China
| | - Ying Pang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-oncology, Peking University Cancer Hospital & Institute, Fu-Cheng Road 52, Hai-Dian District, Beijing, 100142, China
| | - Yuhe Zhou
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-oncology, Peking University Cancer Hospital & Institute, Fu-Cheng Road 52, Hai-Dian District, Beijing, 100142, China
| | - Yu Wang
- Department of Breast Cancer Radiotherapy, Chinese Academy of Medical Sciences, Cancer Hospital, Shanxi Medical University, Taiyuan, China
| | - Yongkui Lu
- The Fifth Department of Chemotherapy, The Affiliated Cancer Hospital of Guangxi Medical University, Guangxi Zhuang Autonomous Region, Nanning, China
| | - Yu Jiang
- Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Xinkun Han
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-oncology, Peking University Cancer Hospital & Institute, Fu-Cheng Road 52, Hai-Dian District, Beijing, 100142, China
| | - Lihua Song
- Department of Breast Medical Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University, Shandong Academy of Medical Sciences, Jinan, China
| | - Liping Wang
- Department of Oncology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zimeng Li
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-oncology, Peking University Cancer Hospital & Institute, Fu-Cheng Road 52, Hai-Dian District, Beijing, 100142, China
| | - Xiaojun Lv
- Department of Oncology, Xiamen Humanity Hospital, Xiamen, China
| | - Yan Wang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-oncology, Peking University Cancer Hospital & Institute, Fu-Cheng Road 52, Hai-Dian District, Beijing, 100142, China
| | - Juntao Yao
- Department of Integrated Chinese and Western Medicine, Shaanxi Provincial Cancer Hospital Affiliated to Medical College of Xi'an Jiaotong University, Xi'an, China
| | - Xiaohong Liu
- Department of Clinical Spiritual Care, The Affiliated Cancer Hospital of Xiangya School of Medicine, Hunan Cancer Hospital, Central South University, Changsha, China
| | - Xiaoyi Zhou
- Radiotherapy Center, Hubei Cancer Hospital, Wuhan, China
| | - Shuangzhi He
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-oncology, Peking University Cancer Hospital & Institute, Fu-Cheng Road 52, Hai-Dian District, Beijing, 100142, China
| | - Yening Zhang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-oncology, Peking University Cancer Hospital & Institute, Fu-Cheng Road 52, Hai-Dian District, Beijing, 100142, China
| | - Lili Song
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-oncology, Peking University Cancer Hospital & Institute, Fu-Cheng Road 52, Hai-Dian District, Beijing, 100142, China
| | - Jinjiang Li
- Department of Psycho-oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University, Shandong Academy of Medical Sciences, Jinan, China
| | - Bingmei Wang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-oncology, Peking University Cancer Hospital & Institute, Fu-Cheng Road 52, Hai-Dian District, Beijing, 100142, China
| | - Lili Tang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-oncology, Peking University Cancer Hospital & Institute, Fu-Cheng Road 52, Hai-Dian District, Beijing, 100142, China.
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Baye AA, Bogale SK, Delie AT, Melak Fekadie M, Wondyifraw HG, Tigabu ME, Kebede M. Psychosocial distress and associated factors among adult cancer patients at oncology: a case of Ethiopia. Front Oncol 2023; 13:1238002. [PMID: 38192622 PMCID: PMC10772143 DOI: 10.3389/fonc.2023.1238002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 11/24/2023] [Indexed: 01/10/2024] Open
Abstract
Background Psychosocial distress is a chronic burden for cancer survivors, which impacts both their quality of life and their oncologic prognosis. Although the national cancer prevention and control program in Ethiopia has made efforts in cancer prevention, control, and management by implementing the national cancer control plan 2016-2020, there was no enough evidence about psychosocial distress among adult cancer patients. So, it is critical to understand the magnitude of psychosocial distress and the factors that contribute to it. Objective The purpose of this study was to assess the prevalence of psychosocial distress and associated factors among adult cancer patients at oncology units in the Amhara regional state, Ethiopia. 2022. Methods A multicenter institution-based cross-sectional study was conducted among a sample of 605 adult cancer patients from 30 April to 22 June 2022. A systematic random sampling technique was employed to select the study units. In addition, data were collected through interviewers administered questionnaires by using the validated and pretested tools. Distress was assessed using the Questionnaire on Stress in Cancer Patients Revised 10. Both bivariable and multivariable logistic regression was used to describe the association between dependent and independent variables. Independent variable with p < 0.25 in the bivariable logistic regression analyses were entered into multivariable logistic regression model. Variables with p < 0.05 in the multivariable logistic regression analyses were considered as statistically significant associated factors of psychosocial distress. Result A total of 593 adult cancer patients took part in this study with mean age of 46.86 ± 14.5 years. The overall prevalence of psychosocial distress was 63.74%. Variables such as being female [AOR = 1.98, 95% confidence interval (CI): 1.24-3.17], patients who lives in rural areas (AOR = 2.3, 95% CI: 1.49-3.54), community-based health insurance utilization (AOR = 0.34, 95% CI: 0.23-0.51), patients on chemotherapy treatment (AOR = 2.72, 95% CI: 1.38-5.39), patients with comorbidity (AOR = 3.2, 95% CI: 1.67-6.10), and symptom burdens such as severe fatigue (AOR = 1.65, 95% CI:1.09-2.39) and severe nausea (AOR = 2.07, 95% CI: 1.43-3.00) were statistically associated with psychosocial distress. Conclusion and recommendation In general, the findings of this study showed a relatively high magnitude in which around two-thirds of patients experienced psychosocial distress. It is better to establish and enforce the integration and coordination of psychosocial oncology service programs at national level with parallel guidelines and policies.
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Affiliation(s)
- Astewle Andargie Baye
- Department of Adult Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Sitotaw Kerie Bogale
- Department of Adult Health Nursing, School of Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Abebu Tegenaw Delie
- Department of Adult Health Nursing, School of Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Mengistu Melak Fekadie
- Department of Pediatric and Child Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | | | - Mengistu Ewunetu Tigabu
- Department of Adult Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Mulu Kebede
- Department of Adult Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
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Tsiouris A, Mayer A, Wiltink J, Ruckes C, Beutel ME, Zwerenz R. Recruitment of Patients With Cancer for a Clinical Trial Evaluating a Web-Based Psycho-Oncological Intervention: Secondary Analysis of a Diversified Recruitment Strategy in a Randomized Controlled Trial. JMIR Cancer 2023; 9:e42123. [PMID: 38010774 DOI: 10.2196/42123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 12/17/2022] [Accepted: 08/29/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Participant recruitment poses challenges in psycho-oncological intervention research, such as psycho-oncological web-based intervention studies. Strict consecutive recruitment in clinical settings provides important methodological benefits but is often associated with low response rates and reduced practicability and ecological validity. In addition to preexisting recruitment barriers, the protective measures owing to the COVID-19 pandemic restricted recruitment activities in the clinical setting since March 2020. OBJECTIVE This study aims to outline the recruitment strategy for a randomized controlled trial evaluating the unguided emotion-based psycho-oncological online self-help (epos), which combined traditional and web-based recruitment. METHODS We developed a combined recruitment strategy including traditional (eg, recruitment in clinics, medical practices, cancer counseling centers, and newspapers) and web-based recruitment (Instagram, Facebook, and web pages). Recruitment was conducted between May 2020 and September 2021. Eligible participants for this study were adult patients with any type of cancer who were currently receiving treatment or in posttreatment care. They were also required to have a good command of the German language and access to a device suitable for web-based interventions, such as a laptop or computer. RESULTS We analyzed data from 304 participants who were enrolled in a 17-month recruitment period using various recruitment strategies. Web-based and traditional recruitment strategies led to comparable numbers of participants (151/304, 49.7% vs 153/304, 50.3%). However, web-based recruitment required much less effort. Regardless of the recruitment strategy, the total sample did not accurately represent patients with cancer currently undergoing treatment for major types of cancer in terms of various sociodemographic characteristics, including but not limited to sex and age. However, among the web-recruited study participants, the proportion of female participants was even higher (P<.001), the mean age was lower (P=.005), private internet use was higher (on weekdays: P=.007; on weekends: P=.02), and the number of those who were currently under treatment was higher (P=.048). Other demographic and medical characteristics revealed no significant differences between the groups. The majority of participants registered as self-referred (236/296, 79.7%) instead of having followed the recommendation of or study invitation from a health care professional. CONCLUSIONS The combined recruitment strategy helped overcome general and COVID-19-specific recruitment barriers and provided the targeted participant number. Social media recruitment was the most efficient individual recruitment strategy for participant enrollment. Differences in some demographic and medical characteristics emerged, which should be considered in future analyses. Implications and recommendations for social media recruitment based on personal experiences are presented. TRIAL REGISTRATION German Clinical Trials Register DRKS00021144; https://drks.de/search/en/trial/DRKS00021144. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1016/j.invent.2021.100410.
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Affiliation(s)
- Angeliki Tsiouris
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Anna Mayer
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Jörg Wiltink
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Christian Ruckes
- Interdisciplinary Center for Clinical Trials, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Rüdiger Zwerenz
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
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7
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Rausch R, Bäuerle A, Rentrop V, Jansen C, Nensa F, Palm S, Tewes M, Schadendorf D, Skoda EM, Teufel M. Falling off the screening grid-Predictors for postponed utilization of psycho-oncological support in cancer patients and its implications for distress assessment and management. Psychooncology 2023; 32:1727-1735. [PMID: 37789593 DOI: 10.1002/pon.6226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 09/18/2023] [Accepted: 09/19/2023] [Indexed: 10/05/2023]
Abstract
OBJECTIVE Distress assessment of cancer patients is considered state-of-the-art. In addition to distress scores, individual care needs are an important factor for the initiation of psycho-oncological interventions. In a mono-centric, observational study, we aimed for characterization of patients indicating a subjective need but declining to utilize support services immediately to facilitate implementation of adapted screenings. METHODS This study analyzed retrospective data from routine distress screening and associated data from hospital records. Descriptive, variance and regression analyses were used to assess characteristics of postponed support utilization in patients with mixed cancer diagnoses in different treatment settings. RESULTS Of the total sample (N = 1863), 13% indicated a subjective need but postponed support utilization. This subgroup presented as being as burdened by symptoms of depression (p < 0.001), anxiety (p < 0.001) and distress (p < 0.001) as subjectively distressed patients with intent to directly utilize support. Time periods since diagnosis were shorter (p = 0.007) and patients were more often inpatients (p = 0.045). CONCLUSIONS Despite high heterogeneity among the subgroups, this study identified distress-related factors and time since diagnosis as possible predictors for postponed utilization of psycho-oncological interventions. Results suggest the necessity for time-individualized support which may improve utilization by distressed patients.
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Affiliation(s)
- Raya Rausch
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital, University of Duisburg-Essen, Essen, Germany
- West German Cancer Center, University Hospital Essen, Essen, Germany
| | - Alexander Bäuerle
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital, University of Duisburg-Essen, Essen, Germany
- West German Cancer Center, University Hospital Essen, Essen, Germany
| | - Vanessa Rentrop
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital, University of Duisburg-Essen, Essen, Germany
- West German Cancer Center, University Hospital Essen, Essen, Germany
| | - Christoph Jansen
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital, University of Duisburg-Essen, Essen, Germany
- West German Cancer Center, University Hospital Essen, Essen, Germany
| | - Felix Nensa
- West German Cancer Center, University Hospital Essen, Essen, Germany
- Institute for Artificial Intelligence in Medicine, University Hospital Essen, Essen, Germany
| | - Stefan Palm
- West German Cancer Center, University Hospital Essen, Essen, Germany
| | - Mitra Tewes
- West German Cancer Center, University Hospital Essen, Essen, Germany
- Department of Palliative Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Dirk Schadendorf
- West German Cancer Center, University Hospital Essen, Essen, Germany
- Department of Dermatology, University Hospital Essen, NCT West and West German Cancer Center Consortium, Essen, Germany
| | - Eva-Maria Skoda
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital, University of Duisburg-Essen, Essen, Germany
- West German Cancer Center, University Hospital Essen, Essen, Germany
| | - Martin Teufel
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital, University of Duisburg-Essen, Essen, Germany
- West German Cancer Center, University Hospital Essen, Essen, Germany
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8
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Aburizik A, Raque TL, Spitz N, Mott SL, McEnroe A, Kivlighan M. Responding to distress in cancer care: Increasing access to psycho oncology services through integrated collaborative care. Psychooncology 2023; 32:1675-1683. [PMID: 37724636 DOI: 10.1002/pon.6217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 08/15/2023] [Accepted: 09/05/2023] [Indexed: 09/21/2023]
Abstract
OBJECTIVE Despite increased attention to the utility of collaborative care models for promoting whole-person care in cancer populations, there is a paucity of empirical research testing the impact of these care models on effectively identifying and serving highly distressed cancer patients. This study sought to experimentally test the effectiveness of a year-long collaborative care program on referral rates to psycho-oncology services for patients with moderate to high distress. METHODS Data for this study consisted of 11,467 adult patients with cancer who were screened for psychosocial distress 6-months prior to, and following, the integrated collaborative care intervention. Psychosocial referral rates pre-, peri- and post- intervention were analyzed. RESULTS Findings indicated high distress patients were at 3.76 (95% CI [2.40, 5.87]), 5.03 (95% CI [3.25, 7.76]), and 7.62 (95% CI [5.34, 10.87]) times increased odds of being referred during the pre-intervention, peri-intervention, and post-intervention, respectively, when compared to low distress patients, and these differences across time were significantly different (p = 0.04). CONCLUSION Findings from this study suggest that the successful initiation of a collaborative care model within a comprehensive cancer center contributed to significantly greater referral rates of cancer patients with moderate to high distress to psycho-oncology services. This study contributes to the growing consensus that collaborative care models can positively impact the care of complex medical patients.
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Affiliation(s)
- Arwa Aburizik
- Department of Internal Medicine, University of Iowa Hospitals & Clinics, Iowa City, Iowa, USA
- Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
- Holden Comprehensive Cancer Center, University of Iowa Hospitals & Clinics, Iowa City, Iowa, USA
| | - Trisha L Raque
- Department of Counseling Psychology, University of Denver, Denver, Colorado, USA
| | - Nathen Spitz
- Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
| | - Sarah L Mott
- Holden Comprehensive Cancer Center, University of Iowa Hospitals & Clinics, Iowa City, Iowa, USA
| | - Aubrey McEnroe
- Department of Psychological and Quantitative Foundations, University of Iowa, Iowa City, Iowa, USA
| | - Martin Kivlighan
- Department of Psychological and Quantitative Foundations, University of Iowa, Iowa City, Iowa, USA
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Kleisiaris C, Maniou M, Karavasileiadou S, Togas C, Konstantinidis T, Papathanasiou IV, Tsaras K, Almegewly WH, Androulakis E, Alshehri HH. Psychological Distress and Concerns of In-Home Older People Living with Cancer and Their Impact on Supportive Care Needs: An Observational Survey. Curr Oncol 2023; 30:9569-9583. [PMID: 37999112 PMCID: PMC10670276 DOI: 10.3390/curroncol30110692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 10/24/2023] [Accepted: 10/26/2023] [Indexed: 11/25/2023] Open
Abstract
(1) Background: Cancer patients are experiencing psychological problems after diagnosis, such as emotional distress and social anxiety, which may increase their demands for emotional and supportive care. This study aimed to assess the influence of both emotional distress and concerns on the supportive care needs of cancer patients receiving home-based healthcare. (2) Methods: In this door-to-door screening program, 97 cancer patients were approached, with a mean age of 73 years old (mean = 73.43; SD = 6.60). (3) Results: As expected, 42.3% of patients highlighted their treatment as their main psychological priority, with 20.6% identifying concerns about the future of their family in this regard. No significant associations with respect to sex were identified in terms of focus, though females reported the need for more frequent psychological support (58.7% vs. 37.3%, respectively, p = 0.035) compared to males. Patients who had experienced an increased number of concerns during the last weeks (IRR = 1.02; 95% CI: 1.00-1.03, p = 0.007) had a significantly greater risk of presenting an increased rate of supportive care needs. Notably, male patients with bone cancer presented a significantly greater number of supportive care needs (mean rank 45.5 vs. 9.0, p = 0.031) respectively, in comparison to those with other types of cancer. (4) Conclusions: Supportive care needs arise from a greater concern and specific type of cancer, highlighting the need for supportive care, such as psychosocial and psychological support. This may have significant implications for treatment and patient outcomes in home care settings.
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Affiliation(s)
- Christos Kleisiaris
- Department of Nursing, Faculty of Health Sciences, Hellenic Mediterranean University, 71410 Heraklion, Greece; (C.K.); (M.M.); (T.K.)
| | - Maria Maniou
- Department of Nursing, Faculty of Health Sciences, Hellenic Mediterranean University, 71410 Heraklion, Greece; (C.K.); (M.M.); (T.K.)
| | - Savvato Karavasileiadou
- Department of Community Health Nursing, College of Nursing, Princess Nourah bint Abdulrahman University, Riyadh 11671, Saudi Arabia;
| | - Constantinos Togas
- Department of Social Service, Ministry of Public Order, 22100 Tripolis, Greece;
| | - Theocharis Konstantinidis
- Department of Nursing, Faculty of Health Sciences, Hellenic Mediterranean University, 71410 Heraklion, Greece; (C.K.); (M.M.); (T.K.)
| | | | - Konstantinos Tsaras
- Department of Nursing, University of Thessaly, 41500 Larissa, Greece; (I.V.P.); (K.T.)
| | - Wafa Hamad Almegewly
- Department of Community Health Nursing, College of Nursing, Princess Nourah bint Abdulrahman University, Riyadh 11671, Saudi Arabia;
| | - Emmanouil Androulakis
- Department of Statistics and Insurance Science, University of Piraeus, 18534 Piraeus, Greece;
| | - Hanan Hamdan Alshehri
- Department of Medical-Surgical Nursing, College of Nursing, Princess Nourah bint Abdulrahman University, Riyadh 116711, Saudi Arabia;
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10
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Silva S, Paredes T, Teixeira RJ, Brandão T, Dimitrovová K, Marques D, Sousa J, Leal M, Dias A, Neves C, Marques G, Amaral N. Emotional Distress in Portuguese Cancer Patients: The Use of the Emotion Thermometers (ET) Screening Tool. Healthcare (Basel) 2023; 11:2689. [PMID: 37830726 PMCID: PMC10572115 DOI: 10.3390/healthcare11192689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 09/27/2023] [Accepted: 09/27/2023] [Indexed: 10/14/2023] Open
Abstract
Cancer patients may experience significant distress. The "Emotion Thermometers" (ETs) are a short visual analogue scale used to screen patients for psychosocial risk. This study aimed to assess emotional distress in a large sample of cancer patients attending psychological services at an non-governmental organization (NGO), and to explore factors that may contribute to it. The ETs were answered by 899 cancer patients. They were, on average, 59.9 years old, the majority were female, had breast cancer, were under treatment or were disease-free survivors, and reported high levels of emotional distress, above the cut-off (≥5). A Generalized Linear Model was used to measure the association between the level of distress, age, gender, disease phase and 33 items of the problem list. Four items-sadness, depression, sleep and breathing-were found to be significantly related to a higher level of distress. Additionally, women and patients who were in the palliative phase also had significantly higher levels of distress. The results confirm the need for early emotional screening in cancer patients, as well as attending to the characteristics of each patient. Additionally, they highlight the utility of the ETs for the clinical practice, allowing to optimize the referral to specialized psychosocial services.
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Affiliation(s)
- Sónia Silva
- Portuguese Cancer League (Central Branch), Rua Dr. António José de Almeida, nº 329—2º Sl 56, 3000-045 Coimbra, Portugal; (T.P.); (N.A.)
| | - Tiago Paredes
- Portuguese Cancer League (Central Branch), Rua Dr. António José de Almeida, nº 329—2º Sl 56, 3000-045 Coimbra, Portugal; (T.P.); (N.A.)
| | - Ricardo João Teixeira
- REACH—Mental Health Clinic, 4000-138 Porto, Portugal;
- CINEICC, Faculty of Psychology and Educational Sciences, University of Coimbra, 3004-531 Coimbra, Portugal
| | - Tânia Brandão
- William James Center for Research, ISPA—Instituto Universitário, 1149-041 Lisboa, Portugal;
| | - Klára Dimitrovová
- Comprehensive Health Research Center, CHRC, NOVA University Lisboa, 1150-082 Lisboa, Portugal;
- MOAI Consulting, 1350-346 Lisboa, Portugal; (D.M.); (J.S.)
| | - Diogo Marques
- MOAI Consulting, 1350-346 Lisboa, Portugal; (D.M.); (J.S.)
| | - Joana Sousa
- MOAI Consulting, 1350-346 Lisboa, Portugal; (D.M.); (J.S.)
| | - Monick Leal
- Portuguese Cancer League (North Branch), 4200-172 Porto, Portugal;
| | - Albina Dias
- Portuguese Cancer League (South Branch), 1099-023 Lisboa, Portugal;
| | - Carole Neves
- Portuguese Cancer League (Madeira Branch), 9050-023 Funchal, Portugal;
| | - Graciete Marques
- Portuguese Cancer League (Azores Branch), 9700-171 Angra do Heroísmo, Açores, Portugal;
| | - Natália Amaral
- Portuguese Cancer League (Central Branch), Rua Dr. António José de Almeida, nº 329—2º Sl 56, 3000-045 Coimbra, Portugal; (T.P.); (N.A.)
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Wang S, Zheng M, Zhu Y, Zhang L, Li X, Wan H. Exploring the experience of meaning-centered group psychotherapy among Chinese cancer patients during active treatment: a descriptive qualitative study. Front Psychiatry 2023; 14:1264257. [PMID: 37867777 PMCID: PMC10590054 DOI: 10.3389/fpsyt.2023.1264257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 09/21/2023] [Indexed: 10/24/2023] Open
Abstract
Objective Meaninglessness poses a significant psychological challenge for cancer patients, negatively affecting their quality of life and increasing the risk of suicide. Meaning-Centered Group Therapy (MCGP) is an intervention designed specifically to enhance the meaning of life of cancer patients. Extensive research has documented its effectiveness across various cultures and populations. However, limited research has been conducted on the subjective experiences and perspectives of participants engaged in MCGP. Thus, the purpose of this study was to employ a qualitative design to explore the experiences and viewpoints of Chinese cancer patients who have undergone MCGP. Methods Within a two-week timeframe following the conclusion of MCGP, semi-structured interviews were administered to twenty-one participants who had engaged in the therapy. The interview data were transcribed and subjected to thematic analysis. Results Four main themes were identified: (a) Self-perceived personal change, (b) Overall experience of group therapy, (c) Barriers to participation of MCGP, and (d) Suggestions for future interventions. Conclusion Despite the barriers to participation in the MCGP process, the overall experience for Chinese cancer patients undergoing active treatment is valuable and positive, providing multiple benefits. Future studies could explore the adaptation of MCGP to a broader range of cancer populations and diverse study populations.
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Affiliation(s)
- Shuman Wang
- Department of Nursing, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, China
- Shanghai Key Laboratory of Radiation Oncology, Shanghai Proton Heavy Ion Hospital, Shanghai, China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai Proton Heavy Ion Hospital, Shanghai, China
| | - Mimi Zheng
- Department of Nursing, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, China
- Shanghai Key Laboratory of Radiation Oncology, Shanghai Proton Heavy Ion Hospital, Shanghai, China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai Proton Heavy Ion Hospital, Shanghai, China
| | - Yu Zhu
- Department of Nursing, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, China
- Shanghai Key Laboratory of Radiation Oncology, Shanghai Proton Heavy Ion Hospital, Shanghai, China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai Proton Heavy Ion Hospital, Shanghai, China
| | - Lijuan Zhang
- Department of Nursing, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, China
- Shanghai Key Laboratory of Radiation Oncology, Shanghai Proton Heavy Ion Hospital, Shanghai, China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai Proton Heavy Ion Hospital, Shanghai, China
| | - Xiaoru Li
- Department of Nursing, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, China
- Shanghai Key Laboratory of Radiation Oncology, Shanghai Proton Heavy Ion Hospital, Shanghai, China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai Proton Heavy Ion Hospital, Shanghai, China
| | - Hongwei Wan
- Department of Nursing, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, China
- Shanghai Key Laboratory of Radiation Oncology, Shanghai Proton Heavy Ion Hospital, Shanghai, China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai Proton Heavy Ion Hospital, Shanghai, China
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12
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Wang S, Zhu Y, Wang Z, Zheng M, Li X, Zhang Y, Wan H. Efficacy of meaning-centered group psychotherapy in Chinese patients with cancer: A randomized controlled trial. Palliat Support Care 2023; 21:773-781. [PMID: 37558651 DOI: 10.1017/s1478951523000998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/11/2023]
Abstract
OBJECTIVES Meaninglessness is one of the most common psychological problems in cancer patients, which can lead to anxiety, depression and psychological distress, and diminished quality of life. Recent evidence indicates that meaning-centered group psychotherapy (MCGP) effectively enhances the meaning in life among cancer patients. This study aimed to evaluate the impact of MCGP on the meaning in life, post-traumatic growth, psychological distress, and fear of recurrence among Chinese cancer patients with a favorable prognosis. METHODS Sixty-six cancer patients were randomly assigned to either the MCGP group (n = 33) or the control group (n = 33). Participants in the MCGP group underwent a 4-week, 8-session MCGP, while those in the control group received usual care. Meaning in life, post-traumatic growth, psychological distress, and fear of recurrence were assessed at both baseline and postintervention to evaluate the impact of the intervention. The intervention outcomes were analyzed using paired t-tests or analysis of covariance, as appropriate. RESULTS Patients in the MCGP group demonstrated significant improvements in meaning in life, post-traumatic growth, and fear of recurrence from baseline to postintervention. In comparison to the control group, the MCGP group displayed positive effects on meaning in life and post-traumatic growth following the intervention. However, no significant effects were observed in terms of psychological distress and fear of recurrence. SIGNIFICANCE OF RESULTS Our research offers evidence supporting the effectiveness of MCGP in enhancing meaning in life and post-traumatic growth among Chinese cancer patients with a favorable prognosis.
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Affiliation(s)
- Shuman Wang
- Department of Nursing, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, China
- Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai Proton Heavy Ion Hospital, Shanghai, China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai Proton Heavy Ion Hospital, Shanghai, China
| | - Yu Zhu
- Department of Nursing, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, China
- Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai Proton Heavy Ion Hospital, Shanghai, China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai Proton Heavy Ion Hospital, Shanghai, China
| | - Ziying Wang
- Department of Nursing, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, China
- Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai Proton Heavy Ion Hospital, Shanghai, China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai Proton Heavy Ion Hospital, Shanghai, China
| | - Mimi Zheng
- Department of Nursing, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, China
- Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai Proton Heavy Ion Hospital, Shanghai, China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai Proton Heavy Ion Hospital, Shanghai, China
| | - Xiaoru Li
- Department of Nursing, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, China
- Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai Proton Heavy Ion Hospital, Shanghai, China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai Proton Heavy Ion Hospital, Shanghai, China
| | - Yu Zhang
- Department of Nursing, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, China
- Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai Proton Heavy Ion Hospital, Shanghai, China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai Proton Heavy Ion Hospital, Shanghai, China
| | - Hongwei Wan
- Department of Nursing, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, China
- Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai Proton Heavy Ion Hospital, Shanghai, China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai Proton Heavy Ion Hospital, Shanghai, China
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13
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Raff JP, Sege J, Braiotta R, Jafri FN, Cook B, Steiner-Grossman P, Cohen F. The Impact of a Narrative Medicine Life Story Pilot Program on Press Ganey™ Scores in an Outpatient Cancer Center. HEALTH COMMUNICATION 2023:1-11. [PMID: 37691170 DOI: 10.1080/10410236.2023.2255761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
Oncology patients face challenges beyond those directly affecting their cancer management. Guided personal narrative programs have been shown to help patients with chronic conditions and life-framing events. Few such narrative programs have been reported for cancer patients or analyzed for their impact on patient experience. We established our Life Story Narrative Program, modeled on the United States Veterans Affairs' "My Life, My Story" for outpatient oncology patients in our hospital's cancer center. Press Ganey™ patient experience scores from program participants were compared retrospectively with scores from patients who were not participants. Over an eight-month period, we invited 30 cancer center outpatients to participate. Twenty-seven individuals accepted, and 18 had their stories edited, approved, and scanned into their electronic health record. Cohort matching yielded a control arm consisting of 255 responses from 48 surveys, while the intervention arm consisted of 68 responses from 12 surveys. 78.4% of responses from the control arm were rated 5 compared with 100% in the intervention arm. The mean Press Ganey™ score response in the control arm was 4.71 compared with 5.00 from the intervention arm. Wilcoxon U value was 10,540 with p < .001. An outpatient narrative medicine program for cancer patients to tell their life stories can easily be organized. Patients were willing to participate, enrollment was brisk, and the use of resources was limited. Although our sample size was small, participation in our Life Story Narrative Pilot Program resulted in a statistically significant improvement in Press Ganey™ scores.
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Affiliation(s)
- Joshua P Raff
- Section of Medical Oncology and Hematology, White Plains Hospital
| | | | | | | | - Brennan Cook
- Robert Wood Johnson School of Medicine, Rutgers University
| | - Penny Steiner-Grossman
- Departments of Family & Social Medicine and Pediatrics, Albert Einstein College of Medicine
| | - Fredda Cohen
- Department of Pastoral Care and Education, White Plains Hospital
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Wang IY, Jane SW, Hsu HC, Lin YC, Tsai WS, Young CY, Beaton RD, Huang HP. The Longitudinal Trends of Care Needs, Psychological Distress, and Quality of Life and Related Predictors in Taiwanese Colorectal Cancer Survivors. Semin Oncol Nurs 2023; 39:151424. [PMID: 37100635 DOI: 10.1016/j.soncn.2023.151424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 02/26/2023] [Accepted: 03/15/2023] [Indexed: 04/28/2023]
Affiliation(s)
- I-Ya Wang
- Department of Nursing, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan
| | - Sui-Whi Jane
- Department of Nursing, Chang Gung University of Science and Technology, Taiwan; Division of Hematology/Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Lin-Kou, Taiwan
| | - Hung-Chih Hsu
- Division of Hematology/Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Lin-Kou, Taiwan; College of Medicine, Chang Gung University, Tao-Yuan City, Taiwan
| | - Yung-Chang Lin
- Division of Hematology/Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Lin-Kou, Taiwan
| | - Wen-Sy Tsai
- Division of Colorectal Surgery, Department of Surgery, Chang Gung Memorial Hospital, Lin-Kou, Taiwan
| | - Chia-Yung Young
- Division of Hematology/Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Lin-Kou, Taiwan
| | - Randal D Beaton
- Psychosocial & Community Health and Health Services, Schools of Nursing and Public Health, University of Washington, Seattle
| | - Hsiang-Ping Huang
- Department of Nursing, Chang Gung University of Science and Technology, Taiwan.
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Frank T, Pichler T, Maier S, Batenhorst I, Abawi T, Harbeck N, Algül H, Heinemann V, Hermelink K, Mumm F, Dinkel A. Stressors related to the COVID-19 pandemic and their association with distress, depressive, and anxiety symptoms in cancer out-patients. Front Psychol 2023; 14:1100236. [PMID: 37333585 PMCID: PMC10272444 DOI: 10.3389/fpsyg.2023.1100236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 03/30/2023] [Indexed: 06/20/2023] Open
Abstract
Patients with cancer might be particularly prone to stress caused by the COVID-19 pandemic. The aim of this study was to investigate the impact of pandemic-related stressors on oncological patients' psychological well-being. During the second wave of the COVID-19 pandemic in Germany 122 cancer out-patients of the Comprehensive Cancer Center Munich reported on COVID-19-related stressors (information satisfaction, threat perception, and fear of disease deterioration) and answered standardized questionnaires for psychosocial distress (DT) as well as depression and anxiety symptoms (PHQ-2, GAD-2). Multiple linear regression analyses were used to identify associations of the COVID-19-related stressors with psychological symptoms, controlling for sociodemographic, psychological (self-efficacy, ASKU) and clinical (somatic symptom burden, SSS-8) variables. Initially, satisfaction with information was significantly negatively associated with all three outcome variables. Fear of disease deterioration was associated with distress and depressive symptoms. After controlling for additional variables, only satisfaction with information remained an independent determinant of anxiety (β = -0.35, p < 0.001). All three outcomes were most strongly determined by somatic symptom burden (β ≥ 0.40, p < 0.001). The results of this study tentatively suggest that physical well-being overrides the relevance of some COVID-19-related stressors for oncological patients' psychological wellbeing. Physical symptoms are strongly tied to personal wellbeing as they are associated with suffering from cancer, which might be more central to personal wellbeing than the possibility of getting infected with SARS-CoV-2. However, satisfaction with the information received seems to be important beyond physical wellbeing, as this emerged as an independent determinant of anxiety.
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Affiliation(s)
- Tamara Frank
- Comprehensive Cancer Center Munich, Munich, Germany
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | | | | | | | - Tanja Abawi
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Nadia Harbeck
- Comprehensive Cancer Center Munich, Munich, Germany
- Department of Obstetrics and Gynecology, LMU University Hospital, Munich, Germany
| | - Hana Algül
- Comprehensive Cancer Center Munich, Munich, Germany
- Mildred-Scheel-Professor of Tumor Metabolism, Technical University of Munich, Munich, Germany
| | - Volker Heinemann
- Comprehensive Cancer Center Munich, Munich, Germany
- Department of Internal Medicine III, LMU University Hospital, Munich, Germany
| | - Kerstin Hermelink
- Department of Obstetrics and Gynecology, LMU University Hospital, Munich, Germany
| | - Friederike Mumm
- Comprehensive Cancer Center Munich, Munich, Germany
- Department of Internal Medicine III, LMU University Hospital, Munich, Germany
| | - Andreas Dinkel
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
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Zanotto A, Goodall K, Ellison M, McVittie C. 'Make Them Wonder How You Are Still Smiling': The Lived Experience of Coping With a Brain Tumour. QUALITATIVE HEALTH RESEARCH 2023; 33:601-612. [PMID: 37026898 DOI: 10.1177/10497323231167345] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
A brain tumour can be a life-threatening illness and cause unique symptoms compared to other types of cancer, such as cognitive or language deficits, or changes in personality. It is an exceptionally distressing diagnosis which can affect quality of life, even for those with a low-grade tumour or many years after the diagnosis. This study sought to gain an in-depth understanding of the lived experience of adjustment to living with a brain tumour. Twelve individuals (83% female) with a primary brain tumour (83% low-grade) took part in the study. Participants were aged 29-54 years, on average 43 months following the diagnosis, and were recruited through the charitable support organisations in the United Kingdom. In-depth semi-structured interviews were conducted, transcribed verbatim, and analysed using interpretative phenomenological analysis (IPA). Six inter-related themes were identified: making sense of the diagnosis, seeking empowerment, feeling appreciative, taking charge of coping, learning to accept, and negotiating a new normality. Notions of empowerment, gratitude, and acceptance throughout the illness journey were prominent in the participants' narratives. Receiving sufficient information and initiating treatment were important in negotiation of control. The results highlighted what facilitates and hinders adaptive coping. Aspects which facilitated positive coping were as follows: trust in clinician, feeling in control, feeling grateful, or accepting. Participants on a 'watch and wait' approach, while feeling appreciative, perceived the lack of treatment as difficult and frustrating. Implications for patient-clinician communication are discussed, particularly for patients on a 'watch and wait' who might need additional support in adjusting.
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Affiliation(s)
- Anna Zanotto
- Division of Psychology, Sociology and Education, Queen Margaret University, Edinburgh, UK
- Department of Occupational Therapy Education, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, USA
| | - Karen Goodall
- Department of Clinical Psychology, University of Edinburgh, Edinburgh, UK
| | - Marion Ellison
- Division of Psychology, Sociology and Education, Queen Margaret University, Edinburgh, UK
| | - Chris McVittie
- Division of Psychology, Sociology and Education, Queen Margaret University, Edinburgh, UK
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Bahlburg H, Hellmann T, Tully K, Butea-Bocu MC, Reike M, Roghmann F, Noldus J, Müller G. Psychosocial distress and quality of life in patients after radical cystectomy - one year follow-up in 842 German patients. J Cancer Surviv 2023:10.1007/s11764-023-01400-6. [PMID: 37162683 DOI: 10.1007/s11764-023-01400-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 05/04/2023] [Indexed: 05/11/2023]
Abstract
PURPOSE This study aims to report on psychosocial distress and QoL in bladder cancer patients after radical cystectomy (RC) and urinary diversion to obtain a better basis for patient counseling and postoperative care. METHODS The study relied on prospectively collected data for 842 patients, who underwent three weeks of inpatient rehabilitation after RC and creation of an ileal conduit (IC) or ileal neobladder (INB). Data on QoL and psychosocial distress were collected by validated questionnaires. Multivariate logistic regression was performed to identify predictors for high psychosocial distress. RESULTS Four-hundred and forty-seven patients (326 male, 121 female) received an IC, while 395 patients (357 male, 38 female) received an INB. Health-related QoL improved steadily in the whole cohort during follow-up. Patients with an INB reported better physical function but suffered more from diarrhea and financial worries. Patients with an IC reported reduced satisfaction with their body image, increased worries about the future, and suffered more from constipation. Psychosocial distress increased significantly during follow-up. One year after surgery, 43.1% of patients suffered from high psychosocial distress. Multivariate regression analysis identified age ≤ 59 years (OR 1.731; CI 1.056-2.838; p = 0.030) and lymph node metastases (OR 2.073; CI 1.133-3.793; p = 0.018) as independent predictors for high psychosocial distress. CONCLUSION QoL improves significantly in all patients one year after RC. However, psychosocial distress remains high in a substantial number of patients. IMPLICATIONS FOR CANCER SURVIVORS To prevent chronic psychological disorders, easily accessible opportunities for psycho-oncological counseling are needed for patients following RC.
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Affiliation(s)
- Henning Bahlburg
- Department of Urology, Marien Hospital Herne, Ruhr-University Bochum, Hölkeskampring 40, 44625, Herne, Germany.
| | - Tabea Hellmann
- Department of Urology, Marien Hospital Herne, Ruhr-University Bochum, Hölkeskampring 40, 44625, Herne, Germany
| | - Karl Tully
- Department of Urology, Marien Hospital Herne, Ruhr-University Bochum, Hölkeskampring 40, 44625, Herne, Germany
| | | | - Moritz Reike
- Department of Urology, Marien Hospital Herne, Ruhr-University Bochum, Hölkeskampring 40, 44625, Herne, Germany
| | - Florian Roghmann
- Department of Urology, Marien Hospital Herne, Ruhr-University Bochum, Hölkeskampring 40, 44625, Herne, Germany
| | - Joachim Noldus
- Department of Urology, Marien Hospital Herne, Ruhr-University Bochum, Hölkeskampring 40, 44625, Herne, Germany
| | - Guido Müller
- Department of Urology, Marien Hospital Herne, Ruhr-University Bochum, Hölkeskampring 40, 44625, Herne, Germany
- Center for Urological Rehabilitation, Kliniken Hartenstein, Bad Wildungen, Germany
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Mehnert-Theuerkauf A, Hufeld JM, Esser P, Goerling U, Hermann M, Zimmermann T, Reuter H, Ernst J. Prevalence of mental disorders, psychosocial distress, and perceived need for psychosocial support in cancer patients and their relatives stratified by biopsychosocial factors: rationale, study design, and methods of a prospective multi-center observational cohort study (LUPE study). Front Psychol 2023; 14:1125545. [PMID: 37151329 PMCID: PMC10157044 DOI: 10.3389/fpsyg.2023.1125545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 03/31/2023] [Indexed: 05/09/2023] Open
Abstract
Background Despite remarkable progress, cancer remains a life-threatening disease for millions of people worldwide, also resulting in significant psychosocial limitations. High-quality, comprehensive cancer care requires patient and family involvement and the provision of needs-based, targeted psychosocial services. Although progress has been made in understanding the occurrence of mental comorbidity and psychosocial distress in cancer patients, comparatively little is known about the course of psychological comorbidity and psychosocial distress in early survivorship among patients and their families. We therefore aim to estimate the prevalence of mental disorders according to the DSM-5, psychosocial distress, perceived needs for psychosocial support and utilization of psychosocial support offers in newly diagnosed cancer patients and their relatives, taking into account potential contributing biopsychosocial factors for the occurrence of psychological comorbidity. Methods/design This study follows a prospective multi-center observational cohort design across four measurement time points: within 2 months after cancer diagnosis (t1), and in the follow-up period at 6 months (t2), at 12 months (t3), and at 18 months (t4) after t1. Patients older than 18 years who have a confirmed initial diagnosis of a malignant solid tumor and are scheduled for cancer treatment at one of the participating cancer centers are eligible for study participation. Relatives of eligible patients are also eligible for study participation if they are older than 18 years. Patients are interviewed using the Structured Clinical Interview for DSM-5 Disorders (SCID-5-CV). In addition, patients and relatives receive a set of validated questionnaires at each measurement time point, covering comorbid conditions and functional performance, perceived psychological distress and quality of life, partnership aspects and social relationships, supportive care needs and use of psychosocial support services, health literacy, and health behavior and meaning in life. Discussion This prospective multi-center observational cohort study has a major focus on increasing quality of care and quality of life in cancer survivors through providing rigorous longitudinal data for the development and implementation of target group-specific psychosocial support services. Trial registration NCT04620564, date of registration 9/11/2020; DKG OnkoZert: Registrier-No.: ST-U134, date of registration 5/11/2021.
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Affiliation(s)
- Anja Mehnert-Theuerkauf
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
| | - Julia Marie Hufeld
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
| | - Peter Esser
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
| | - Ute Goerling
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Charité Comprehensive Cancer Center, Berlin, Germany
| | - Myriel Hermann
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Charité Comprehensive Cancer Center, Berlin, Germany
| | - Tanja Zimmermann
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Hannah Reuter
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Jochen Ernst
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
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Goerling U, Hinz A, Koch-Gromus U, Hufeld JM, Esser P, Mehnert-Theuerkauf A. Prevalence and severity of anxiety in cancer patients: results from a multi-center cohort study in Germany. J Cancer Res Clin Oncol 2023:10.1007/s00432-023-04600-w. [PMID: 36757620 PMCID: PMC10356888 DOI: 10.1007/s00432-023-04600-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 01/25/2023] [Indexed: 02/10/2023]
Abstract
PURPOSE Anxiety is an accompanying symptom in cancer patients that can have a negative impact on patients. The aim of the present analyses is to determine the prevalence of anxiety, taking into account sociodemographic and medical variables, and to determine the odds ratio for the occurrence of anxiety in cancer patients compared to general population. METHODS In this secondary analyses, we included 4,020 adult cancer patients during and after treatment from a multi-center epidemiological study from 5 regions in Germany in different treatment settings and a comparison group consisting of 10,000 people from the general population in Germany. Anxiety was measured with the Generalized Anxiety Disorder (GAD-7) questionnaire. In multivariate analyses adjusted for age and sex, we calculated the odds of being anxious. RESULTS The prevalence of anxiety was observed to be 13.8% (GAD-7 ≥ 10). The level of anxiety was significant higher for patients in rehabilitation, compared to patients during inpatient and outpatient treatment (p = .013). Comparison with the general population yielded a 2.7-fold increased risk for anxiety among cancer patients (95% CI 2.4-3.1; p < .001). Patients with bladder cancer (OR, 5.3; 95% CI 3.0-9.4) and testicular cancer (OR, 5.0; 95% CI 2.1-12.1) showed the highest risk of having high levels of anxiety. CONCLUSION The results highlight the importance of identifying anxiety in cancer patients.
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Affiliation(s)
- Ute Goerling
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charité Comprehensive Cancer Center, Charitéplatz 1, 10117, Berlin, Germany.
| | - Andreas Hinz
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
| | - Uwe Koch-Gromus
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Julia Marie Hufeld
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
| | - Peter Esser
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
| | - Anja Mehnert-Theuerkauf
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
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20
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Blasco T, Jovell E, Mirapeix R, Leon C. Patients' Desire for Psychological Support When Receiving a Cancer Diagnostic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14474. [PMID: 36361350 PMCID: PMC9654838 DOI: 10.3390/ijerph192114474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 10/27/2022] [Accepted: 11/01/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Factors related to the desire of receiving psychological help in cancer patients are not well known. The aim of this study is to assess the prevalence of patients who would ask for psychological assistance in the first weeks following diagnosis, and to identify their psychosocial and disease-related profile. METHOD This cross-sectional study assessed 229 consecutive cancer outpatients at a visit with their oncologist to be informed about the treatment they will receive. Disease-related and medical characteristics were assessed, and patients were asked about their mood states, levels of self-efficacy, and difficulties coping with the disease. Finally, patients were asked about their desire to receive psychological assistance. RESULTS Only 20% of patients expressed a desire for psychological help. These patients were lower in age and had previous history of mood disorders and reported higher discouragement and coping difficulties. These variables explained 30.6% of variance. CONCLUSIONS Although psycho-oncologists can provide helpful interventions, the percentage of patients interested in receiving psychological assistance in this study is low. Although further studies are needed, results from this study suggest methods that could easily be used by oncologists and nurses to identify patients who would like to receive psychological support.
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Affiliation(s)
- Tomás Blasco
- GIES, Grup d’Investigació en Estrès i Salut, Departament de Psicologia Bàsica, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain
| | - Esther Jovell
- Hospital de Terrassa, Unidad de Epidemiología y Evaluación Asistencial, 08227 Terrassa, Spain
| | - Rosanna Mirapeix
- GIES, Grup d’Investigació en Estrès i Salut, Departament de Psicologia Bàsica, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain
| | - Concha Leon
- GIES, Grup d’Investigació en Estrès i Salut, Departament de Psicologia Bàsica, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain
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21
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Gomes P, Matos PM, Silva ER, Silva J, Silva E, Sales CMD. Distress facing increased genetic risk of cancer: The role of social support and emotional suppression. PATIENT EDUCATION AND COUNSELING 2022; 105:2436-2442. [PMID: 35339327 DOI: 10.1016/j.pec.2022.03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 03/15/2022] [Accepted: 03/18/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVES Healthy individuals from hereditary cancer families undergoing genetic testing for cancer susceptibility (GTC) report more distress when they perceive their social support as low and suppress their emotions. This study aimed to explore how suppressing emotions and perceiving others as unsupportive are related with cancer-risk distress. METHODS We performed a regression-based mediation analysis to assess if expressive suppression mediates or is mediated by perceived social support in the relation with cancer-risk distress. Participants were 125 healthy adults aged over 18 (M = 36.07, SD = 12.86), mostly female (72,4%), who undergone GTC to assess the presence of hereditary breast and ovarian cancer or Lynch syndromes. RESULTS Controlling for age and gender, we found a moderate size indirect effect of social support on cancer-risk distress through expressive suppression (β = -0.095) and a direct effect of expressive suppression on cancer-risk distress. CONCLUSIONS When healthy individuals from hereditary cancer families perceive their social network as less responsive, they tend to not express their emotions, which relates to increased distress facing GTC. PRACTICE IMPLICATIONS Practitioners may assess cancer-risk related distress before the GTC and offer distressed individuals interventions focused on changing emotion regulation strategies in a safe group context.
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Affiliation(s)
- Pedro Gomes
- Centre for Psychology at University of Porto (CPUP), Faculty of Psychology and Education Sciences at University of Porto (FPCEUP), 4200-135 Porto, Portugal; Cancer Genetics Group, Research Centre of IPO Porto (CI-IPOP)/RISE@CI-IPOP (Health Research Network), Portuguese Oncology Institute of Porto (IPO Porto)/Porto Comprehensive Cancer Centre (Porto.CCC), 4200-072 Porto, Portugal.
| | - Paula Mena Matos
- Centre for Psychology at University of Porto (CPUP), Faculty of Psychology and Education Sciences at University of Porto (FPCEUP), 4200-135 Porto, Portugal.
| | - Eunice R Silva
- Cancer Genetics Group, Research Centre of IPO Porto (CI-IPOP)/RISE@CI-IPOP (Health Research Network), Portuguese Oncology Institute of Porto (IPO Porto)/Porto Comprehensive Cancer Centre (Porto.CCC), 4200-072 Porto, Portugal; Psychology Service, Portuguese Oncology Institute of Porto, 4200-072 Porto, Portugal.
| | - João Silva
- Cancer Genetics Group, Research Centre of IPO Porto (CI-IPOP)/RISE@CI-IPOP (Health Research Network), Portuguese Oncology Institute of Porto (IPO Porto)/Porto Comprehensive Cancer Centre (Porto.CCC), 4200-072 Porto, Portugal; Medical Genetics Service, Portuguese Oncology Institute of Porto, 4200-072 Porto, Portugal.
| | - Eliana Silva
- Centre for Psychology at University of Porto (CPUP), Faculty of Psychology and Education Sciences at University of Porto (FPCEUP), 4200-135 Porto, Portugal.
| | - Célia M D Sales
- Centre for Psychology at University of Porto (CPUP), Faculty of Psychology and Education Sciences at University of Porto (FPCEUP), 4200-135 Porto, Portugal.
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22
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Sutton TL, Koprowski MA, Gold JA, Liu B, Grossblatt-Wait A, Macuiba C, Lehman A, Hedlund S, Rocha FG, Brody JR, Sheppard BC. Disparities in Electronic Screening for Cancer-Related Psychosocial Distress May Promote Systemic Barriers to Quality Oncologic Care. J Natl Compr Canc Netw 2022; 20:765-773.e4. [PMID: 35830889 DOI: 10.6004/jnccn.2022.7015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 03/25/2022] [Indexed: 01/22/2023]
Abstract
BACKGROUND Screening for cancer-related psychosocial distress is an integral yet laborious component of quality oncologic care. Automated preappointment screening through online patient portals (Portal, MyChart) is efficient compared with paper-based screening, but unstudied. We hypothesized that patient access to and engagement with EHR-based screening would positively correlate with factors associated with digital literacy (eg, age, socioeconomic status). METHODS Screening-eligible oncology patients seen at our Comprehensive Cancer Center from 2014 through 2019 were identified. Patients with active Portals were offered distress screening. Portal and screening participation were analyzed via multivariable logistic regression. Household income in US dollars and educational attainment were estimated utilizing zip code and census data. RESULTS Of 17,982 patients, 10,279 (57%) had active Portals and were offered distress screening. On multivariable analysis, older age (odds ratio [OR], 0.97/year; P<.001); male gender (OR, 0.89; P<.001); Black (OR, 0.47; P<.001), Hawaiian/Pacific Islander (OR, 1.54; P=.007), and Native American/Alaskan Native race (OR, 0.67; P=.04); Hispanic ethnicity (OR, 0.76; P<.001); and Medicare (OR, 0.59; P<.001), Veteran's Affairs/military (OR, 0.09; P<.01), Medicaid (OR, 0.34; P<.001), or no insurance coverage (OR, 0.57; P<.001) were independently associated with lower odds of being offered distress screening; increasing income (OR, 1.05/$10,000; P<.001) and educational attainment (OR, 1.03/percent likelihood of bachelor's degree or higher; P<.001) were independently associated with higher odds. In patients offered electronic screening, participation rate was 36.6% (n=3,758). Higher educational attainment (OR, 1.01; P=.03) was independently associated with participation, whereas Black race (OR, 0.58; P=.004), Hispanic ethnicity (OR, 0.68; P=.01), non-English primary language (OR, 0.67; P=.03), and Medicaid insurance (OR, 0.78; P<.001) were independently associated with nonparticipation. CONCLUSIONS Electronic portal-based screening for cancer-related psychosocial distress leads to underscreening of vulnerable populations. At institutions using electronic distress screening workflows, supplemental screening for patients unable or unwilling to engage with electronic screening is recommended to ensure efficient yet equal-opportunity distress screening.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Flavio G Rocha
- 4Knight Cancer Institute.,5Division of Surgical Oncology, Department of Surgery, and
| | - Jonathan R Brody
- 1Department of Surgery.,6Brenden-Colson Center for Pancreatic Care, Oregon Health & Science University, Portland, Oregon
| | - Brett C Sheppard
- 1Department of Surgery.,6Brenden-Colson Center for Pancreatic Care, Oregon Health & Science University, Portland, Oregon
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23
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Muzzatti B, Agostinelli G, Bomben F, Busato S, Flaiban C, Gipponi KM, Mariutti G, Mella S, Piccinin M, Annunziata MA. Intensity and Prevalence of Psychological Distress in Cancer Inpatients: Cross-Sectional Study Using New Case-Finding Criteria for the Hospital Anxiety and Depression Scale. Front Psychol 2022; 13:875410. [PMID: 35558694 PMCID: PMC9087277 DOI: 10.3389/fpsyg.2022.875410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 03/31/2022] [Indexed: 11/13/2022] Open
Abstract
Psychological distress includes all negative subjective experiences elicited by a disease and its treatments. Since psychological distress in oncology is associated with negative outcomes, its detection and description are helpful for designing tailored supportive interventions. This study used the Hospital Anxiety and Depression Scale (HADS) to assess the intensity and prevalence of psychological distress (i.e., anxiety and depression) in cancer inpatients and examined the relationships between these variables and sociodemographic and clinical factors. An existing dataset of HADS results, from 2021 consecutive adult cancer inpatients at a single hospital, was analyzed. Only those questionnaires with complete responses were used. The intensity of anxiety and depression was determined from HADS sub-scores. The prevalence of anxiety and depression was calculated using, as case-finding criteria, cut-offs of ≥ 10 and ≥ 8, respectively. The mean HADS scores describing intensity were 7.3 for anxiety (n = 1,990) and 5.8 (n = 1,970) for depression. The prevalence rates for anxiety and depression were 26.6 and 28.6%, respectively. Among the 1,916 patients who completed both subscales, 17.2% had both anxiety and depression, 21.0% had either anxiety or depression, and 61.7% had neither. Gender, age, occupational status, and cancer diagnosis were associated with anxiety intensity or prevalence, while age, occupational status, and cancer diagnosis were associated with depression intensity or prevalence. Anxiety intensity was affected by the interaction effect between gender and diagnosis. Our study showed anxiety and depression being distinct entities, with more intense anxiety overall. From a research perspective, it reaffirms the usefulness for assessing both intensity and prevalence concurrently to gain a more detailed description of anxiety and depression.
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Affiliation(s)
- Barbara Muzzatti
- Unit of Oncological Psychology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Giulia Agostinelli
- Unit of Oncological Psychology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Francesca Bomben
- Unit of Oncological Psychology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Sara Busato
- Unit of Oncological Psychology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Cristiana Flaiban
- Unit of Oncological Psychology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Katiuscia Maria Gipponi
- Unit of Oncological Psychology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Giulia Mariutti
- Unit of Oncological Psychology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Sara Mella
- Unit of Oncological Psychology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Marika Piccinin
- Unit of Oncological Psychology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
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Sutton TL, Koprowski MA, Grossblatt-Wait A, Brown S, McCarthy G, Liu B, Gross A, Macuiba C, Hedlund S, Brody JR, Sheppard BC. Psychosocial distress is dynamic across the spectrum of cancer care and requires longitudinal screening for patient-centered care. Support Care Cancer 2022; 30:4255-4264. [PMID: 35089365 DOI: 10.1007/s00520-022-06814-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 01/03/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE Screening for cancer-related psychosocial distress is recommended for patients with cancer; however, data on the long-term prevalence of distress and its natural history in survivors are scarce, preventing recommendations for screening frequency and duration. We sought to evaluate longitudinal distress in cancer patients. METHODS We evaluated longitudinal distress screening data for patients with cancer treated or surveilled at our institution from 2010 to 2018. Anxiety, depression, insurance/financial, family, memory, and strength-related distress were separately assessed and analyzed. Multivariable logistic regression was utilized to evaluate factors associated with distress subtypes. RESULTS In 5660 patients, distress was the highest at diagnosis for anxiety, depression, financial, and overall distress. On multivariable analysis, factors independently associated with distress at diagnosis included younger age, female gender, disease site/stage, payor, and income, varying by subtype-specific analyses. Severe distress in at least one subtype persisted in over 30% of survivors surveyed through 10 years after diagnosis. Over half of patients with initially severe distress at diagnosis improved within 12 months; however, distress worsened in 20-30% of patients with moderate, low, and no initial distress, regardless of the distress subtype. CONCLUSION Psychosocial distress in cancer survivors is a long-lasting burden with implications for quality of life and oncologic outcomes. Severe distress remains prevalent through 10 years after diagnosis in survivors receiving continued care at cancer centers and results from both persistent and new sources of distress in a variety of psychosocial domains. Longitudinal distress screening is an invaluable tool for providing comprehensive patient-centered cancer care and is recommended to detect new or recurrent distress in cancer survivors.
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Affiliation(s)
- Thomas L Sutton
- Department of Surgery, Oregon Health & Science University (OHSU), Portland, OR, 97239, USA
| | - Marina Affi Koprowski
- Department of Surgery, Oregon Health & Science University (OHSU), Portland, OR, 97239, USA
| | - Alison Grossblatt-Wait
- Knight Cancer Institute, Oregon Health & Science University (OHSU), Portland, OR, 97239, USA
| | - Samantha Brown
- Department of Surgery, Oregon Health & Science University (OHSU), Portland, OR, 97239, USA
| | - Grace McCarthy
- Department of Surgery, Oregon Health & Science University (OHSU), Portland, OR, 97239, USA
| | - Benjamin Liu
- Department of Psychiatry, Oregon Health & Science University (OHSU), Portland, OR, 97239, USA
| | - Anne Gross
- Department of Psychiatry, Oregon Health & Science University (OHSU), Portland, OR, 97239, USA
| | - Caroline Macuiba
- Knight Cancer Institute, Oregon Health & Science University (OHSU), Portland, OR, 97239, USA
| | - Susan Hedlund
- Knight Cancer Institute, Oregon Health & Science University (OHSU), Portland, OR, 97239, USA
| | - Jonathan R Brody
- Department of Surgery, Oregon Health & Science University (OHSU), Portland, OR, 97239, USA
| | - Brett C Sheppard
- Department of Surgery, Oregon Health & Science University (OHSU), Portland, OR, 97239, USA.
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25
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Kim H, Kim H, Lee HJ, Cho E, Koh SJ, Ahmed O, Chung S. The Validation Study of the Stress and Anxiety to Viral Epidemics-6 Scale Among Patients With Cancer in the COVID-19 Pandemic. Front Psychiatry 2022; 13:811083. [PMID: 35492734 PMCID: PMC9046784 DOI: 10.3389/fpsyt.2022.811083] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 03/18/2022] [Indexed: 01/12/2023] Open
Abstract
INTRODUCTION The study aimed to explore the psychometric properties of the Stress and Anxiety to Viral Epidemics-6 (SAVE-6) scale among patients with cancer who are in serious situations in the current COVID-19 pandemic. METHODS The survey included questions on the participants' demographic information, clinical history of cancer (including cancer type, stage, current treatment or diagnosis of complete remission), and scores on rating scales, including the SAVE-6 scale, Coronavirus Anxiety Scale (CAS), and the Patient Health Questionnaire-9 (PHQ-9). RESULTS The confirmatory factor analysis (CFA) results determined that the model fits the single factor structure of the SAVE-6 scale among patients with cancer. The multi-group CFA showed that SAVE-6 can measure the anxiety response in a similar way across multiple variables, such as sex, presence of clinical depression, being in a state of complete remission, or currently undergoing cancer treatment. The SAVE-6 scale showed good reliability (Cronbach's alpha = 0.819) and convergent validity with the rating scales, such as CAS [r = 0.348 (95% CI, 0.273-0.419), p < 0.001] and PHQ-9 items score [r = 0.251 (95% CI, 0.172-0.328), p < 0.001]. CONCLUSIONS This study confirms SAVE-6 as a reliable and valid rating scale for measuring the anxiety response of patients with cancer during the current COVID-19 pandemic.
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Affiliation(s)
- Hyeyeong Kim
- Department of Hematology and Oncology, Ulsan University Hospital, University of Ulsan College of Medicine, Seoul, South Korea
| | - Harin Kim
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Hyuk Joo Lee
- Department of Public Medical Service, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Eulah Cho
- Department of Psychiatry, Seoul Medical Center, Seoul, South Korea
| | - Su-Jin Koh
- Department of Hematology and Oncology, Ulsan University Hospital, University of Ulsan College of Medicine, Seoul, South Korea
| | - Oli Ahmed
- Department of Psychology, University of Chittagong, Chattogram, Bangladesh.,National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT, Australia
| | - Seockhoon Chung
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
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Pichler T, Marten-Mittag B, Hermelink K, Telzerow E, Frank T, Ackermann U, Belka C, Combs SE, Gratzke C, Gschwend J, Harbeck N, Heinemann V, Herkommer K, Kiechle M, Mahner S, Pigorsch S, Rauch J, Stief C, Mumm F, Heußner P, Herschbach P, Dinkel A. Distress in hospitalized cancer patients: Associations with personality traits, clinical and psychosocial characteristics. Psychooncology 2021; 31:770-778. [PMID: 34894364 DOI: 10.1002/pon.5861] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 10/28/2021] [Accepted: 11/12/2021] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To improve allocation of psychosocial care and to provide patient-oriented support offers, identification of determinants of elevated distress is needed. So far, there is a lack of evidence investigating the interplay between individual disposition and current clinical and psychosocial determinants of distress in the inpatient setting. METHODS In this cross-sectional study, we investigated 879 inpatients with different cancer sites treated in a German Comprehensive Cancer Center. Assessment of determinants of elevated distress included sociodemographic, clinical and psychosocial characteristics as well as dimensions of personality. Multiple linear regression was applied to identify determinants of psychosocial distress. RESULTS Mean age of the patients was M = 61.9 (SD = 11.8), 48.1% were women. In the multiple linear regression model younger age (β = -0.061, p = 0.033), higher neuroticism (β = 0.178, p = <0.001), having metastases (β = 0.091, p = 0.002), being in a worse physical condition (β = 0.380, p = <0.001), depressive symptoms (β = 0.270, p = <0.001), not feeling well informed about psychological support (β = 0.054, p = 0.046) and previous uptake of psychological treatment (β = 0.067, p = 0.020) showed significant associations with higher psychosocial distress. The adjusted R2 of the overall model was 0.464. CONCLUSION Controlling for sociodemographic characteristics and dispositional vulnerability, that is neuroticism, current clinical and psychosocial characteristics were still associated with hospitalized patients' psychosocial distress. Psycho-oncologists should address both, the more transient emotional responses, such as depressive symptoms, as well as more enduring patient characteristics, like neuroticism.
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Affiliation(s)
- Theresia Pichler
- Comprehensive Cancer Center Munich (CCC Munich), Munich, Germany.,Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Birgitt Marten-Mittag
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Kerstin Hermelink
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Munich, Germany
| | - Eva Telzerow
- Department of Internal Medicine III, University Hospital, LMU Munich, Munich, Germany
| | - Tamara Frank
- Comprehensive Cancer Center Munich (CCC Munich), Munich, Germany.,Department of Psychosomatic Medicine and Psychotherapy, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Ulrike Ackermann
- Department of Obstetrics and Gynecology, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Claus Belka
- Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany
| | - Stephanie E Combs
- Department of Radiation Oncology, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany.,Department of Radiation Medicine, Helmholtz Zentrum München (HMGU), Oberschleißheim, Germany.,Deutsches Konsortium für Translationale Krebsforschung (DKTZ), Partner Site Munich, Munich, Germany
| | - Christian Gratzke
- Department of Urology, University Hospital of Freiburg, Freiburg, Germany.,Department of Urology, University Hospital, LMU Munich, Munich, Germany
| | - Jürgen Gschwend
- Department of Urology, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Nadia Harbeck
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Munich, Germany.,Department of Obstetrics and Gynecology, Breast Center, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | - Volker Heinemann
- Comprehensive Cancer Center Munich (CCC Munich), Munich, Germany.,Department of Internal Medicine III, University Hospital, LMU Munich, Munich, Germany
| | - Kathleen Herkommer
- Department of Urology, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Marion Kiechle
- Department of Obstetrics and Gynecology, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Sven Mahner
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Munich, Germany
| | - Steffi Pigorsch
- Department of Radiation Oncology, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Josefine Rauch
- Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany
| | - Christian Stief
- Department of Urology, University Hospital, LMU Munich, Munich, Germany
| | - Friederike Mumm
- Comprehensive Cancer Center Munich (CCC Munich), Munich, Germany.,Department of Internal Medicine III, University Hospital, LMU Munich, Munich, Germany
| | - Pia Heußner
- Department of Internal Medicine III, University Hospital, LMU Munich, Munich, Germany.,Cancer Center Oberland, Garmisch-Partenkirchen General Hospital, Garmisch-Partenkirchen, Germany
| | - Peter Herschbach
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Andreas Dinkel
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
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Quality of life, distress, and posttraumatic growth 5 years after colorectal cancer diagnosis according to history of inpatient rehabilitation. J Cancer Res Clin Oncol 2021; 148:3015-3028. [PMID: 34874489 PMCID: PMC9508041 DOI: 10.1007/s00432-021-03865-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 11/18/2021] [Indexed: 11/13/2022]
Abstract
Purpose In Germany, almost every other colorectal cancer (CRC) patient undergoes inpatient cancer rehabilitation (ICR), but research on long-term outcomes is sparse. We aimed to assess health-related quality of life (HRQOL), distress, and posttraumatic growth among former rehabilitants and non-rehabilitants as well as respective differences and to estimate disease-related quality of life deficits in both groups. Methods HRQOL (EORTC-QLQ-C30/CR29), distress (QSC-R10), and posttraumatic growth (PTGI) were assessed according to past ICR in patients 5-year post-CRC-diagnosis in the German DACHS study. Least square mean differences in HRQOL scores and elevated distress levels (QSC-R10 > 14 points) by ICR were estimated by confounder-adjusted linear and logistic regression, respectively. Differences in PTGI scales were tested for statistical significance. EORTC-QLQ-C30 reference scores from population controls were accessed from the LinDE study to estimate disease-related deficits in both treatment groups. Results 49% of the included 1906 CRC survivors had undergone ICR. Rehabilitants reported lower HRQOL scores than non-rehabilitants in several dimensions of the EORTC-QLQ-C30/CR29. Differences were pronounced among younger survivors (< 70 years). In younger survivors, past ICR also predicted elevated distress. However, rehabilitants showed higher posttraumatic growth. When compared to 934 population controls, non-rehabilitants and older rehabilitants reported HRQOL scores (EORTC-QLQ-C30) similar to controls except higher levels of bowel dysfunctions, whereas younger rehabilitants experienced deficits regarding most scales (13/15). Conclusion Our findings suggest a high disease burden 5 years after diagnosis in particular among younger CRC survivors who had undergone ICR. Observed HRQOL deficits are possibly linked to the initial indication for ICR and rehabilitants may benefit from effective follow-up concepts after ICR. Supplementary Information The online version contains supplementary material available at 10.1007/s00432-021-03865-3.
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28
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Giesler JM, Weis J, Caspari R, Dauelsberg T, Hoffmann W, Körber J, Bartsch HH. Patient competencies, coping self-efficacy, and coping: Do they change during oncological inpatient rehabilitation and beyond? Psychooncology 2021; 31:577-586. [PMID: 34676636 DOI: 10.1002/pon.5839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 10/17/2021] [Accepted: 10/18/2021] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The construct of Patient Competencies (PCs) has been suggested to allow a more comprehensive understanding of cancer patients' abilities to confront emotion- and problem-focused coping tasks arising from the diagnosis, treatment and survivorship of cancer. While providing a reliable and valid measure of PCs, research thus far has not clarified whether PCs change across time and/or through intervention. This study asks whether PCs change during oncological inpatient rehabilitation and beyond. METHODS N = 377 breast, colorectal, and prostate cancer patients from clinics for oncological rehabilitation were included to complete self-report measures of PC, coping and self-efficacy for coping with cancer at the beginning and the end of rehabilitation and 9 months afterward. In order to determine differences between tumor diagnostic groups and changes across time 3 (tumor site) x 3 (time) repeated measures analyses of variance were computed. RESULTS Tumor diagnostic groups differed only marginally in PCs, coping self-efficacy and coping. The PCs of self-regulation and managing distress and coping self-efficacy improved slightly during rehabilitation but returned to initial levels at 9 months. Differential improvement was evident in the competencies of seeking information and interest in social services. Two of five coping behaviors decreased markedly from the end of rehabilitation to follow-up. CONCLUSIONS This study suggests that oncological inpatient rehabilitation may contribute to advancing PCs, albeit to a limited extent. Aside from addressing conceptual, diagnostic and measurement issues, future research should clarify which interventions may be most effective for advancing problem- and emotion-focused PCs.
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Affiliation(s)
- Juergen M Giesler
- Section of Health Services Research and Rehabilitation Research, Institute of Medical Biometry and Statistics, University of Freiburg Medical Center, Freiburg, Germany
| | - Joachim Weis
- Department of Self-Help Research, Comprehensive Cancer Center, University of Freiburg Medical Center, Freiburg, Germany
| | - Reiner Caspari
- Niederrhein Center for Oncological Rehabilitation, Bad Neuenahr-Ahrweiler, Germany
| | - Timm Dauelsberg
- Center for Oncological Rehabilitation at the Tumor Biology Center, University of Freiburg Medical Center, Freiburg, Germany
| | - Wilfried Hoffmann
- Park Therme Center for Oncological Rehabilitation, Hamm-Kliniken GmbH, Badenweiler, Germany
| | - Jürgen Körber
- Nahetal Center for Oncological Rehabilitation, Hamm-Kliniken GmbH, Bad Kreuznach, Germany
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29
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Zimmermann T, Brederecke J, Kopsch F, Herschbach P. Psychometric Properties of the Questionnaire on Stress in Partners of Cancer Patients. Eval Health Prof 2021; 45:147-156. [PMID: 34047201 PMCID: PMC9109585 DOI: 10.1177/01632787211021134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A cancer disease can be associated with psychological stress for both patients
and partners. To date, no psychometrically tested measuring instrument has been
available for the assessment of cancer-specific distress in partners of cancer
patients. The Questionnaire on Stress in Partners of Cancer Patients (QSC-P) was
developed to close this gap. This study validates the QSC-P in two subsamples of
n1 = 227 and n2 = 297 partners of cancer patients by application of exploratory
factor analysis methods in n1 and confirmatory factor analysis methods in n2.
Additionally, correlations with common measures of anxiety, depression, and
quality of life were calculated. A cut-off for high distress was determined. A
three-factor structure with 23 items that was generated in n1 could be
replicated in n2. Reliability and validity analyses resulted in good to very
good characteristic values of the resulting QSC-P (α = .84– .93). A cut-off of
68.5 with good sensitivity and specificity was calculated. The QSC-P proved to
be a valid and reliable measuring instrument for psychological distress of
partners of cancer patients and a helpful tool for clinical care and research.
Future directions include development of a short-form and detailed comparison of
the sexes.
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Affiliation(s)
- Tanja Zimmermann
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Germany
| | - Jan Brederecke
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Germany
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30
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Peters L, Brederecke J, Franzke A, de Zwaan M, Zimmermann T. Psychological Distress in a Sample of Inpatients With Mixed Cancer-A Cross-Sectional Study of Routine Clinical Data. Front Psychol 2020; 11:591771. [PMID: 33329254 PMCID: PMC7734182 DOI: 10.3389/fpsyg.2020.591771] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 11/09/2020] [Indexed: 01/30/2023] Open
Abstract
Background The diagnosis and treatment of cancer are associated with psychological distress that often leads to a significant reduction in emotional and physical well-being and quality of life. Early detection of psychological distress is therefore important. This study aims to assess the psychological distress of inpatient cancer patients using routine clinical data. Furthermore, variables and problems most strongly associated with psychological distress should be identified. Materials and Methods N = 1,869 inpatients were investigated (mean age = 60.89 years; 35.94% female) using the National Comprehensive Cancer Network Distress Thermometer and problem checklist to assess distress as well as multiple possible problem areas. Visceral oncological cancer (31.6%) was the most common tumor diagnosis, followed by skin cancer (26.2%) and urological cancer (21.7%). Results 65.9% of the sample experienced high levels of distress (Distress Thermometer ≥ 5). Female sex, stage 4 of disease, and visceral and head and neck cancer emerged as risk factors for high distress. A younger age (<65 years) was significantly correlated with higher distress. The most frequently self-reported problems were fears (50.1%), worry (49.9%), and fatigue (49.1%). Patients with all 3 of these problems had 24 times higher risk [odds ratio (OR) = 23.9] for high levels of distress than patients without these problems. Women reported significantly more practical, emotional, and physical problems than men. Younger (<50 years) and middle-aged patients (50-64 years) reported increased levels of practical, family, and emotional problems compared with older patients (≥65 years). Discussion Almost two-thirds of the sample reported high levels of distress. The most frequently reported problem areas were emotional and physical problems. These results can help to identify patients with high risk for psychological distress and, therefore, be used to optimize psychosocial and psycho-oncological care for patients with cancer.
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Affiliation(s)
- Luisa Peters
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hanover, Germany
| | - Jan Brederecke
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hanover, Germany
| | - Anke Franzke
- Department of Hematology and Oncology, Hannover Medical School, Hanover, Germany
| | - Martina de Zwaan
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hanover, Germany
| | - Tanja Zimmermann
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hanover, Germany
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