Pictorial Representation of Illness and Self Measure-Revised 2 (PRISM-R2): an effective tool to assess perceived burden of thyroid cancer in mainland China

The relationship between suffering, loneliness, social interaction, and perceived symptoms in advanced cancer patients

PURPOSE

Understanding how different factors contribute to suffering, particularly social ones, enables designing more comprehensive and evidence-based interventions. This study examined the relationship between suffering, loneliness, social interaction, and symptom distress in patients with advanced cancer.

METHODOLOGY

The authors conducted a quantitative, observational, analytical cross-sectional study. Patients with advanced cancer attending a pain and palliative care unit of an oncology institution participated. Assessment instruments included PRISM (suffering), the UCLA Loneliness Scale, the Edmonton Symptom Assessment Questionnaire, and Cohen's Social Network Index (SNI). Univariate, bivariate, and multiple regression analyses were performed.

RESULTS

One-hundred forty-four patients participated, mostly women (68.1%), with a median age of 62 years, and 48.6% lived with a partner. About 75% reported moderate to severe suffering, 33% had clinically significant loneliness, and half reported a large social network and frequent interactions. Fatigue as the most common problem and well-being had a median score of 5. Suffering was significantly correlated with loneliness, pain, fatigue, depression, and anxiety, but not with levels of social interaction. According to the Multiple Regression Analysis, only loneliness showed a positive and significant contribution to suffering.

CONCLUSIONS

A high percentage of patients show significant suffering, and almost a third show clinical levels of loneliness. This contrasts with a relatively large social network with frequent interactions and a generally low symptomatic burden. Our findings indicate that loneliness influences the experience of illness, contributing to suffering. Future studies should delve deeper into the relationship between suffering and loneliness.

Perception of health and illness and quality of life after total thyroidectomy for differentiated thyroid carcinoma: the PERSAM study

Background

Differentiated thyroid carcinoma is the most common endocrine neoplasm; several studies have shown that individuals perceive the disease as being more severe than it actually is, resulting in a reduced quality of life. The primary aim of this study is to assess the quality of life and perception of illness among patients admitted for radiometabolic therapy, post total thyroidectomy for differentiated thyroid carcinoma. The secondary aim is to identify which patient characteristics are associated with a lower quality of life in order to improve and personalize care.

Methods

The study was conducted at the UOC of Radiotherapy Veneto Institute of Oncology IOV-IRCCS in Padua, Italy. Three questionnaires were administered: Psychological General Well-Being Index (PGWBI), the Illness Perception Questionnaire (IPQ-R) and the Short Form Survey (SF-12). A descriptive statistics analysis and multiple linear regression models were performed to explore the relationship between some of the variables.

Results

Significant associations emerged between the type of surgery and higher values on the PGWBI questionnaire (P = 0.022) and the score obtained in the 'emotional representations' dimension of the IPQ-R questionnaire (P = 0.028). Pathology staging was statistically significantly (P = 0.026) associated with the score obtained in the dimension 'identity'; age with the scores obtained in the dimensions 'emotional representations' (P = 0.035), 'personal control' (P = 0.004), 'consistency with pathology' (P < 0.001) and 'causes' (P = 0.004).

Conclusions

There is evidence of moderate distress in psychological well-being and good perception of pathology. There is less understanding of the disease in individuals with stage 3 and 4 thyroid cancer, in those who have undergone total thyroidectomy without lymphadenectomy and who are aged over 60. Physical well-being: limitations in self-care and moderately physically demanding activities. Mental health: more information to patients decreases the degree of stress and promotes 'positive' emotions. Physical health status: a long-term activity program, characterized by aerobic exercises to be performed in groups or at home, is useful. This study allows to transpose the results into clinical practice, evaluating the possibility and methods of providing personalized care to patients.

The Patient Experience of Thyroid Cancer

The 3 phases of thyroid cancer care are discussed: diagnosis, management, and survivorship. Drivers of quality of life (QOL) in each phase are described, and suggestions are made for mitigating the risk of poor QOL. Active surveillance is another emerging management strategy that has the potential to improve QOL by eliminating upfront surgical morbidity but will need to be studied prospectively.

Do the successful revision surgery for humeral nonunion solve all the effects on health-related quality of life? A retrospective cohort study

Background

The aim of this study is to evaluate the effects of successful revision operation on health quality of life(QoL) and functional outcome in humeral nonunion patients.

Methods

This retrospective study included 62 patients with humeral nonunion from Northwest China, who were admitted to the Department of Trauma Surgery, Honghui Hospital between March 2013 and September 2019. The following data were retrospectively evaluated: demographic data, clinical data, imaging findings, and treatment methods. The QoL assessment indicators for humeral nonunion patients included the SF-12 mental component summary (MCS) and physical component summary (PCS),brief pain inventory-severity(BPI-S) and brief pain inventory-interference (BPI-I). The mayo elbow performance score (MEPS) was used to assess the elbow function of the patients.

Results

Successful revision surgery significantly improved the patient's PCS, MCS, BPI-S and BPI-I scores (p<0.001). According to the MEPS criteria, the excellent and good rates were 95.16% in this study. The impact of humeral nonunion on mental health was comparable with the reported impact of stroke and type II diabetes (p>0.05).The impact of post-op on physical health was comparable with the reported impact of COPD, silicosis, hypertension, barrentt’s esophagus and lower urinary tract symptoms(p>0.05).

Conclusion

Humeral nonunion is a devastating chronic medical condition that negatively affects both physical and mental health as well as quality of life. Although the effects of pain in the body can be completely relieved by treatment, the entire medical process may cause everlasting psychological trauma to the patient.

Pictorial Representation of Illness and Self-Measure to assess the perceived burden in patients with chronic inflammatory vulvar diseases: an observational study

BACKGROUND

Chronic inflammatory vulvar diseases can have a huge detrimental impact on patient welfare. A few studies have addressed this issue so far, mainly measuring patients' quality of life or sexual dysfunction.

OBJECTIVE

To assess the burden of suffering in patients with chronic inflammatory vulvar diseases using the Pictorial Representation of Illness and Self-Measure (PRISM), a visual, non-verbal instrument. We also assessed (i) the concordance between PRISM and the Dermatology Life Quality Index (DLQI), (ii) whether some variables, both patient-related and disease-related, affect the patient's suffering and quality-of-life impairment.

METHODS

We evaluated for inclusion in this cross-sectional study all patients who attended our Vulva Unit over a 9-month period with histologically proven lichen sclerosus (LS), lichen planus (LP), lichen simplex chronicus (LSC), eczema, plasma cell vulvitis and psoriasis (at least five for each disease). Demographics and disease-related subjective and objective scores were recorded. The PRISM and DLQI were administered.

RESULTS

We included 87 patients affected with LS, 13 with LSC and seven with LP. Median PRISM values (0-273 mm) ranged from 95 to 120 mm, depending on the disease, and median DLQI scores (0-30) were five for all three groups. Neither PRISM nor DLQI scores differed significantly among the three groups. Moderate coherence was found between PRISM and DLQI (ρ = 0.5455, P < 0.001). Global subjective score was the only variable significantly associated with the degree of suffering and quality-of-life impairment.

CONCLUSIONS

Pictorial Representation of Illness and Self-Measure proved to be a valuable, highly reliable tool for measuring the perceived burden in these patients. In spite of a moderate correlation, PRISM resulted more sensitive in capturing patient distress than DLQI.