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Santana da Silveira PL, Nobre Nogueira G, Bezerra de Araújo M, Gomes de Matos E Souza F, Weber Bisol L. The Endeavor to Predict Depression and Anxiety Trajectories in the Context of Chronic Diseases Remains a Formidable Challenge. PSYCHOTHERAPY AND PSYCHOSOMATICS 2024:1-2. [PMID: 38615655 DOI: 10.1159/000538385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 03/14/2024] [Indexed: 04/16/2024]
Affiliation(s)
| | | | | | - Fabio Gomes de Matos E Souza
- School of Medicine, Federal University of Ceará, Fortaleza, Brazil
- Clinical Medicine Department, Psychiatric Service, University Hospital Walter Cantídio, Fortaleza, Brazil
| | - Luísa Weber Bisol
- School of Medicine, Federal University of Ceará, Fortaleza, Brazil
- Clinical Medicine Department, Psychiatric Service, University Hospital Walter Cantídio, Fortaleza, Brazil
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Li C, Tao M, Chen D, Wei Q, Xiong X, Zhao W, Tan W, Yang J, Han Y, Zhang H, Zhang S, Liu H, Cao JL. Transcranial Direct Current Stimulation for Anxiety During Laparoscopic Colorectal Cancer Surgery: A Randomized Clinical Trial. JAMA Netw Open 2024; 7:e246589. [PMID: 38635271 DOI: 10.1001/jamanetworkopen.2024.6589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/19/2024] Open
Abstract
Importance Perioperative anxiety is prevalent among patients undergoing surgical treatment of cancer and often influences their prognosis. Transcranial direct current stimulation (tDCS) has shown potential in the treatment of various anxiety-related disorders, but data on the impact of tDCS on perioperative anxiety are limited. Objective To evaluate the effect of tDCS in reducing perioperative anxiety among patients undergoing laparoscopic colorectal cancer (CRC) resection. Design, Setting, And Participants This randomized clinical trial was conducted from March to August 2023 at the Affiliated Hospital of Xuzhou Medical University. Patients aged 18 years or older undergoing elective laparoscopic radical resection for CRC were randomly assigned to either the active tDCS group or the sham tDCS group. Intention-to-treat data analysis was performed in September 2023. Interventions Patients were randomly assigned to receive 2 sessions of either active tDCS or sham tDCS over the left dorsolateral prefrontal cortex on the afternoon of the day before the operation and in the morning of the day of operation. Main Outcomes and Measures The main outcome was the incidence of perioperative anxiety from the day of the operation up to 3 days after the procedure, as measured using the Hospital Anxiety and Depression Scale-Anxiety (HADS-A) subscale (range: 0-21, with higher scores indicating more anxiety). Secondary outcomes included postoperative delirium (assessed by the Confusion Assessment Method or Confusion Assessment Method intensive care unit scale); pain (assessed by the 10-point Numeric Rating Scale [NRS], with scores ranging from 0 [no pain] to 10 [worst pain]); frailty (assessed by the Fatigue, Resistance, Ambulation, Illness and Loss of Weight [FRAIL] Index, with scores ranging from 0 [most robust] to 5 [most frail]; and sleep quality (assessed by the Pittsburgh Sleep Quality Index [PSQI], with scores ranging from 0 to 21 and higher scores indicating worse sleep quality) after the 2 sessions of the tDCS intervention. Results A total of 196 patients (mean [SD] age, 63.5 [11.0] years; 124 [63.3%] men) were recruited and randomly assigned to the active tDCS group (98 patients) or the sham tDCS group (98 patients). After the second tDCS intervention on the day of the operation, the incidence of perioperative anxiety was 38.8% in the active tDCS group and 70.4% in the sham tDCS group (relative risk, 0.55 [95% CI, 0.42-0.73]; P < .001). Patients in the active tDCS group vs the sham tDCS group were less likely to have postoperative delirium (8.2% vs 25.5%) and, at 3 days after the operation, had lower median (IQR) pain scores (NRS, 1.0 [1.0-1.0] vs 2.0 [2.0-2.0]), better median (IQR) sleep quality scores (PSQI, 10.5 [10.0-11.0] vs 12.0 [11.0-13.0]), and lower median (IQR) FRAIL Index (2.0 [1.0-2.0] vs 2.0 [2.0-3.0]). Conclusions and Relevance Findings of this randomized clinical trial indicate that administration of 2 preoperative sessions of tDCS was associated with a decreased incidence of perioperative anxiety in patients undergoing elective CRC resection. Active tDCS was also associated with better anxiety scores, pain levels, and sleep quality as well as reduced postoperative delirium and frailty. The findings suggest that tDCS may be a novel strategy for improving perioperative anxiety in patients undergoing CRC resection. Trial Registration Chinese Clinical Trial Register Identifier: ChiCTR2300068859.
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Affiliation(s)
- Chunyan Li
- Department of Anesthesiology, the Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- National Medical Products Administration Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou, China
- Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, China
- Jiangsu Key Laboratory of Applied Technology of Anesthesia and Analgesia, Xuzhou Medical University, Xuzhou, China
| | - Mingshu Tao
- Department of Anesthesiology, the Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- National Medical Products Administration Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou, China
- Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, China
- Jiangsu Key Laboratory of Applied Technology of Anesthesia and Analgesia, Xuzhou Medical University, Xuzhou, China
| | - Dexian Chen
- Department of Anesthesiology, the Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- National Medical Products Administration Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou, China
- Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, China
- Jiangsu Key Laboratory of Applied Technology of Anesthesia and Analgesia, Xuzhou Medical University, Xuzhou, China
| | - Qi Wei
- Department of Anesthesiology, the Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- National Medical Products Administration Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou, China
- Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, China
- Jiangsu Key Laboratory of Applied Technology of Anesthesia and Analgesia, Xuzhou Medical University, Xuzhou, China
| | - Xingyu Xiong
- Department of Anesthesiology, the Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- National Medical Products Administration Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou, China
- Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, China
- Jiangsu Key Laboratory of Applied Technology of Anesthesia and Analgesia, Xuzhou Medical University, Xuzhou, China
| | - Wenxin Zhao
- Department of Anesthesiology, the Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- National Medical Products Administration Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou, China
- Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, China
- Jiangsu Key Laboratory of Applied Technology of Anesthesia and Analgesia, Xuzhou Medical University, Xuzhou, China
| | - Wen Tan
- Department of Anesthesiology, the Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- National Medical Products Administration Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou, China
- Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, China
- Jiangsu Key Laboratory of Applied Technology of Anesthesia and Analgesia, Xuzhou Medical University, Xuzhou, China
| | - Jie Yang
- Department of Anesthesiology, the Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- National Medical Products Administration Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou, China
- Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, China
- Jiangsu Key Laboratory of Applied Technology of Anesthesia and Analgesia, Xuzhou Medical University, Xuzhou, China
| | - Yuan Han
- Department of Anesthesiology, Eye & ENT Hospital of Fudan University, Shanghai, China
| | - Hongxing Zhang
- Department of Anesthesiology, the Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- National Medical Products Administration Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou, China
- Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, China
- Jiangsu Key Laboratory of Applied Technology of Anesthesia and Analgesia, Xuzhou Medical University, Xuzhou, China
| | - Song Zhang
- Department of Anesthesiology, Renji Hospital and Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - He Liu
- Department of Anesthesiology & Clinical Research Center for Anesthesia and Perioperative Medicine, Huzhou Central Hospital, Huzhou, China
- Department of Anesthesiology & Clinical Research Center for Anesthesia and Perioperative Medicine, The Fifth School of Clinical Medicine of Zhejiang Chinese Medical University, Huzhou, China
- Department of Anesthesiology & Clinical Research Center for Anesthesia and Perioperative Medicine, The Affiliated Huzhou Hospital, Zhejiang University School of Medicine, Huzhou, China
- Department of Anesthesiology & Clinical Research Center for Anesthesia and Perioperative Medicine, The Affiliated Central Hospital, Huzhou University School of Medicine, Huzhou, China
| | - Jun-Li Cao
- National Medical Products Administration Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou, China
- Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, China
- Jiangsu Key Laboratory of Applied Technology of Anesthesia and Analgesia, Xuzhou Medical University, Xuzhou, China
- Huzhou Key Laboratory of Basic Research and Clinical Translation for Neuromodulation, The Fifth School of Clinical Medicine of Zhejiang Chinese Medical University, Huzhou, China
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Bender C, Karstens S, Muth F, Baskozos G, Schmid AB. Reliability of a clinical sensory test battery in patients with spine-related leg and arm pain. Eur J Pain 2024. [PMID: 38525884 DOI: 10.1002/ejp.2267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 12/13/2023] [Accepted: 03/07/2024] [Indexed: 03/26/2024]
Abstract
BACKGROUND The current standard to evaluate the presence of somatosensory dysfunctions is quantitative sensory testing, but its clinical utility remains limited. Low-cost and time-efficient clinical sensory testing (CST) batteries have thus been developed. Recent studies show moderate to substantial reliability in populations with neuropathic pain. This study evaluates the inter- and intra-tester reliability of people with spine-related leg and arm pain, representing mixed pain mechanisms. METHODS Fifty-three patients with spine-related leg (n = 41) and arm pain (n = 12) attended three CST sessions. The CST battery consisted of eleven tests, determining loss and gain of sensory nerve function. CST was performed by the same investigator twice and by an additional investigator to determine inter- and intra-tester reliability. Fleiss' (inter-tester) and Cohen's (intra-tester) kappa were calculated for dichotomized and intraclass correlation coefficients (ICC) for continuous outcomes. RESULTS Fleiss' kappa varied among modalities from fair to substantial (κ = 0.23-0.66). Cold, warm, and vibration detection thresholds and cold and pressure pain thresholds reached kappa >0.4 (moderate to substantial reliability). Cohen's kappa ranged from moderate to substantial (κ = 0.45-0.66). The reliability of the windup ratio was poor (ICC <0.18). CONCLUSION CST modalities with moderate to substantial inter-tester reliability could be of benefit as a screening tool. The moderate to substantial intra-tester reliability for all sensory modalities (except windup ratio) supports their potential use in clinical practice and research to monitor somatosensory changes over time in patients with spine-related limb pain of mixed pain mechanisms. SIGNIFICANCE We already know that most modalities of clinical sensory test (CST) batteries achieve moderate to substantial inter- and intra-tester reliability in populations with neuropathic pain. This study evaluates the reliability of a CST battery in populations with mixed pain mechanisms. We found inter-tester reliability varied from poor to substantial for sensory modalities, questioning the value of some CST modalities. The CST battery showed moderate to substantial intra-tester reliability, suggesting its usefulness to monitor sensory changes over time in this cohort.
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Affiliation(s)
- Cedric Bender
- School of Health Professions, Institute of Physiotherapy, Zurich University of Applied Sciences, Winterthur, Switzerland
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Sven Karstens
- Division of Therapeutic Sciences, Department of Computer Science, Trier University of Applied Sciences, Trier, Germany
| | - Fabian Muth
- MEDIAN Vesalius-Klinik, Bad Rappenau, Germany
| | - Georgios Baskozos
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Annina B Schmid
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
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Badaghi N, van Kruijsbergen M, Speckens A, Vilé J, Prins J, Kelders S, Kwakkenbos L. Group, Blended and Individual, Unguided Online Delivery of Mindfulness-Based Cognitive Therapy for People With Cancer: Feasibility Uncontrolled Trial. JMIR Form Res 2024; 8:e52338. [PMID: 38381493 PMCID: PMC10918539 DOI: 10.2196/52338] [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: 08/31/2023] [Revised: 11/29/2023] [Accepted: 01/14/2024] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND Online mindfulness based cognitive therapy (eMBCT) has been shown to reduce psychological distress in people with cancer. However, this population has reported lack of support and asynchronous communication as barriers to eMBCT, resulting in higher nonadherence rates than with face-to-face MBCT. Using a co-creation process, we developed 2 formats of eMBCT: group, blended (combination of therapist-guided group and individual online sessions) and individual, unguided (individual, unguided online sessions only). Group, blended eMBCT offers peer support and guidance, whereas individual, unguided eMBCT offers flexibility and the possibility of large-scale implementation. OBJECTIVE The objective of this nonrandomized feasibility study was to assess aspects of feasibility of the group, blended and individual, unguided eMBCT interventions. METHODS Participants were people with cancer who chose between group, blended and individual, unguided eMBCT. Both intervention conditions followed the same 8-week eMBCT program, including an introductory session and a silent day (10 sessions total). All sessions for individual, unguided eMBCT occurred via the platform Minddistrict, whereas group, blended eMBCT consisted of 3 online videoconference sessions guided by a mindfulness teacher and 5 sessions via Minddistrict. We assessed the feasibility of the intervention quantitatively and qualitatively by evaluating its acceptability among participants. Additionally, we assessed limited efficacy by looking at the number of questionnaires participants completed pre- and postintervention. RESULTS We included 12 participants for each eMBCT condition. Participants in group, blended eMBCT completed, on average, 9.7 of 10 sessions, compared with an average 8.3 sessions for individual, unguided eMBCT (excluding dropouts). Of the 24 participants, 13 (54%) agreed to be interviewed (5 unguided and 8 blended). Participants in both conditions reported positive experiences, including the convenience of not having to travel and the flexibility to choose when and where to participate. However, among the barriers for participation, participants in the group, blended condition reported a preference for more group sessions, and participants in the individual, unguided condition reported a lack of guidance. Additionally, for the group, blended condition, the effect sizes were small for all outcome measures (Hedges g range=0.01-0.36), except for fatigue, which had a moderate effect size (Hedges g=0.57). For the individual, unguided condition, the effect sizes were small for all outcome measures (Hedges g range=0.24-0.46), except for mindfulness skills (Hedges g=0.52) and engagement with the intervention (Hedges g=1.53). CONCLUSIONS Participants in this study had a positive experience with group, blended and individual, unguided eMBCT. Based on the results from this study, we will adjust the intervention prior to conducting a full-scale randomized controlled trial to evaluate effectiveness; we will add 1 group session to the group, blended eMBCT using Zoom as the platform for the group sessions; and we will send reminders to participants to complete questionnaires. TRIAL REGISTRATION ClinicalTrials.gov NCT05336916; https://clinicaltrials.gov/ct2/show/NCT05336916.
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Affiliation(s)
- Nasim Badaghi
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, Netherlands
| | | | - Anne Speckens
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, Netherlands
| | - Joëlle Vilé
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, Netherlands
| | - Judith Prins
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, Netherlands
| | - Saskia Kelders
- Department of Psychology, Health, and Technology, University of Twente, Enschede, Netherlands
- Optentia Research Unit, North West University, Vanderbijlpark, South Africa
| | - Linda Kwakkenbos
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, Netherlands
- Department of IQ Healthcare, Radboud University Medical Center, Nijmegen, Netherlands
- Department of Clinical Psychology, Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
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Côté A, Miquelon P, Trudel-Fitzgerald C. Physical Activity, Sedentary Time, and Psychosocial Functioning among Adults with Cancer: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:225. [PMID: 38397714 PMCID: PMC10888167 DOI: 10.3390/ijerph21020225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 02/07/2024] [Accepted: 02/11/2024] [Indexed: 02/25/2024]
Abstract
The post-treatment period (after the completion of primary cancer treatment) is a phase during which adults with cancer are particularly vulnerable to the physical and psychological side effects of treatment. Adopting healthy lifestyle habits during this time is essential to mitigate these effects. This scoping review investigated the associations of physical activity (PA) and sedentary time (ST) with two post-treatment psychosocial indicators among adults with cancer: psychological functioning and quality of life (QoL). An exhaustive search was performed in January 2023 across five databases, namely APA PsycInfo, MedLine, SPORTDiscuss, SCOPUS, and CINAHL, adhering to PRISMA guidelines for scoping reviews. Twenty articles met the inclusion criteria; 16 used a cross-sectional design, while 4 used a longitudinal one. PA and ST were assessed mainly with accelerometers (n = 17), and psychosocial indicators with self-reported questionnaires (n = 20). Most studies linked higher PA levels to reduced anxiety (n = 3) and depression (n = 4) symptoms, and elevated ST to higher psychological symptoms (n = 3). Opposite associations were observed for QoL (n = 5). Altogether, PA appeared to be more strongly related to psychological functioning and QoL than ST. This scoping review highlights associations of PA and ST with psychological functioning and QoL among adults with cancer in the post-treatment period. However, future studies must prioritize longitudinal designs to establish directionality.
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Affiliation(s)
- Arianne Côté
- Department of Psychology, Université du Québec à Trois-Rivières, Trois-Rivières, QC G8Z 4M3, Canada; (P.M.); (C.T.-F.)
- Research Center of Institut Universitaire en Santé Mentale de Montréal, Montréal, QC H1N 3V2, Canada
| | - Paule Miquelon
- Department of Psychology, Université du Québec à Trois-Rivières, Trois-Rivières, QC G8Z 4M3, Canada; (P.M.); (C.T.-F.)
| | - Claudia Trudel-Fitzgerald
- Department of Psychology, Université du Québec à Trois-Rivières, Trois-Rivières, QC G8Z 4M3, Canada; (P.M.); (C.T.-F.)
- Research Center of Institut Universitaire en Santé Mentale de Montréal, Montréal, QC H1N 3V2, Canada
- Lee Kum Sheung Center for Health and Happiness, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
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Garland SN, Tulk J, Rodriguez N, Rash JA, Fawcett JM, McCarthy J, Seal M, Laing K. Perceived Executive Functioning Deficits After Diagnosis in Women with Non-Metastatic Breast Cancer Prior to Adjuvant Therapies. Int J Behav Med 2024; 31:31-40. [PMID: 36720774 DOI: 10.1007/s12529-023-10153-6] [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] [Accepted: 01/09/2023] [Indexed: 02/02/2023]
Abstract
BACKGROUND Perceived deficits in executive functioning are among the many difficulties that women diagnosed with breast cancer experience. This study assessed the presence of perceived deficits in executive functioning among women with breast cancer prior to systemic treatment and radiation and associations between perceived deficits in executive function and comorbid fatigue, sleep, and mood disturbance. METHOD Participants were recruited following their breast cancer diagnosis and assessed using the Behavior Rating Inventory of Executive Function for Adults (BRIEF-A), subjective and objective measures of sleep duration and efficiency, and self-report measures of insomnia severity, sleep quality, fatigue, and mood disturbance. Hierarchical regression was used to examine associations between symptoms, adjusting for age and education. RESULTS The final sample included 92 women with a mean age of 60.7 years and 13.5 years of education. Thirteen percent of participants reported global executive dysfunction. After partitioning out variability from other independent variables, fatigue (p = < .001), perceived sleep quality (p = .030), and symptoms of insomnia (p = .008) accounted for 13.3%, 5.7%, and 8.5% of unique variance in perceived executive functioning, respectively. Emotional fatigue was most strongly associated with perceived deficits in executive functioning. Neither subjective or objective sleep duration or efficiency was associated with perceived deficits in executive functioning. CONCLUSION Fatigue, particularly emotional fatigue, insomnia, and poor sleep quality had the strongest associations with perceived deficits in executive functioning. Sleep interventions and fatigue management strategies may prove useful for women who seek to improve their perceived executive functioning.
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Affiliation(s)
- Sheila N Garland
- Department of Psychology, Faculty of Science, Memorial University, St. John's, Newfoundland and Labrador, A1B 3X9, Canada.
- Discipline of Oncology, Faculty of Medicine, Memorial University , St. John's, Newfoundland and Labrador, Canada.
- Beatrice Hunter Cancer Research Institute, Halifax, Nova Scotia, Canada.
| | - Joshua Tulk
- Department of Psychology, Faculty of Science, Memorial University, St. John's, Newfoundland and Labrador, A1B 3X9, Canada
| | - Nicole Rodriguez
- Department of Psychology, Faculty of Science, Memorial University, St. John's, Newfoundland and Labrador, A1B 3X9, Canada
| | - Joshua A Rash
- Department of Psychology, Faculty of Science, Memorial University, St. John's, Newfoundland and Labrador, A1B 3X9, Canada
| | - Jonathan M Fawcett
- Department of Psychology, Faculty of Science, Memorial University, St. John's, Newfoundland and Labrador, A1B 3X9, Canada
| | - Joy McCarthy
- Discipline of Oncology, Faculty of Medicine, Memorial University , St. John's, Newfoundland and Labrador, Canada
| | - Melanie Seal
- Discipline of Oncology, Faculty of Medicine, Memorial University , St. John's, Newfoundland and Labrador, Canada
| | - Kara Laing
- Discipline of Oncology, Faculty of Medicine, Memorial University , St. John's, Newfoundland and Labrador, Canada
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Negeri ZF, Levis B, Ioannidis JPA, Thombs BD, Benedetti A. An empirical comparison of statistical methods for multiple cut-off diagnostic test accuracy meta-analysis of the Edinburgh postnatal depression scale (EPDS) depression screening tool using published results vs individual participant data. BMC Med Res Methodol 2024; 24:28. [PMID: 38302928 PMCID: PMC10832258 DOI: 10.1186/s12874-023-02134-w] [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: 05/11/2023] [Accepted: 12/21/2023] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND Selective reporting of results from only well-performing cut-offs leads to biased estimates of accuracy in primary studies of questionnaire-based screening tools and in meta-analyses that synthesize results. Individual participant data meta-analysis (IPDMA) of sensitivity and specificity at each cut-off via bivariate random-effects models (BREMs) can overcome this problem. However, IPDMA is laborious and depends on the ability to successfully obtain primary datasets, and BREMs ignore the correlation between cut-offs within primary studies. METHODS We compared the performance of three recent multiple cut-off models developed by Steinhauser et al., Jones et al., and Hoyer and Kuss, that account for missing cut-offs when meta-analyzing diagnostic accuracy studies with multiple cut-offs, to BREMs fitted at each cut-off. We used data from 22 studies of the accuracy of the Edinburgh Postnatal Depression Scale (EPDS; 4475 participants, 758 major depression cases). We fitted each of the three multiple cut-off models and BREMs to a dataset with results from only published cut-offs from each study (published data) and an IPD dataset with results for all cut-offs (full IPD data). We estimated pooled sensitivity and specificity with 95% confidence intervals (CIs) for each cut-off and the area under the curve. RESULTS Compared to the BREMs fitted to the full IPD data, the Steinhauser et al., Jones et al., and Hoyer and Kuss models fitted to the published data produced similar receiver operating characteristic curves; though, the Hoyer and Kuss model had lower area under the curve, mainly due to estimating slightly lower sensitivity at lower cut-offs. When fitting the three multiple cut-off models to the full IPD data, a similar pattern of results was observed. Importantly, all models had similar 95% CIs for sensitivity and specificity, and the CI width increased with cut-off levels for sensitivity and decreased with an increasing cut-off for specificity, even the BREMs which treat each cut-off separately. CONCLUSIONS Multiple cut-off models appear to be the favorable methods when only published data are available. While collecting IPD is expensive and time consuming, IPD can facilitate subgroup analyses that cannot be conducted with published data only.
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Affiliation(s)
- Zelalem F Negeri
- Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Brooke Levis
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montréal, Québec, Canada
| | - John P A Ioannidis
- Department of Medicine, Department of Epidemiology and Population Health, Department of Biomedical Data Science, Department of Statistics, Stanford University, Stanford, CA, USA
| | - Brett D Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montréal, Québec, Canada
- Department of Psychiatry, McGill University, Montréal, Québec, Canada
- Department of Medicine, McGill University, Montréal, Québec, Canada
- Department of Psychology, McGill University, Montréal, Québec, Canada
- Biomedical Ethics Unit, McGill University, Montréal, Québec, Canada
| | - Andrea Benedetti
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montréal, Québec, Canada.
- Department of Medicine, McGill University, Montréal, Québec, Canada.
- Centre for Outcomes Research & Evaluation, Research Institute of the McGill University Health Centre, Montréal, Québec, Canada.
- Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montréal, Québec, Canada.
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Nakanishi N, Liu K, Hatakeyama J, Kawauchi A, Yoshida M, Sumita H, Miyamoto K, Nakamura K. Post-intensive care syndrome follow-up system after hospital discharge: a narrative review. J Intensive Care 2024; 12:2. [PMID: 38217059 PMCID: PMC10785368 DOI: 10.1186/s40560-023-00716-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: 10/27/2023] [Accepted: 12/28/2023] [Indexed: 01/14/2024] Open
Abstract
BACKGROUND Post-intensive care syndrome (PICS) is the long-lasting impairment of physical functions, cognitive functions, and mental health after intensive care. Although a long-term follow-up is essential for the successful management of PICS, few reviews have summarized evidence for the efficacy and management of the PICS follow-up system. MAIN TEXT The PICS follow-up system includes a PICS follow-up clinic, home visitations, telephone or mail follow-ups, and telemedicine. The first PICS follow-up clinic was established in the U.K. in 1993 and its use spread thereafter. There are currently no consistent findings on the efficacy of PICS follow-up clinics. Under recent evidence and recommendations, attendance at a PICS follow-up clinic needs to start within three months after hospital discharge. A multidisciplinary team approach is important for the treatment of PICS from various aspects of impairments, including the nutritional status. We classified face-to-face and telephone-based assessments for a PICS follow-up from recent recommendations. Recent findings on medications, rehabilitation, and nutrition for the treatment of PICS were summarized. CONCLUSIONS This narrative review aimed to summarize the PICS follow-up system after hospital discharge and provide a comprehensive approach for the prevention and treatment of PICS.
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Affiliation(s)
- Nobuto Nakanishi
- Division of Disaster and Emergency Medicine, Department of Surgery Related, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki, Chuo-Ward, Kobe, 650-0017, Japan
| | - Keibun Liu
- Critical Care Research Group, The Prince Charles Hospital, 627 Rode Rd, Chermside, QLD, 4032, Australia
- Institute for Molecular Bioscience, The University of Queensland, 306 Carmody Rd, St Lucia, QLD, 4067, Australia
- Non-Profit Organization ICU Collaboration Network (ICON), 2-15-13 Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan
| | - Junji Hatakeyama
- Department of Emergency and Critical Care Medicine, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-Machi, Takatsuki, Osaka, 569-8686, Japan
| | - Akira Kawauchi
- Department of Critical Care and Emergency Medicine, Japanese Red Cross Maebashi Hospital, 389-1, Asakura-Machi, Maebashi-Shi, Gunma, 371-0811, Japan
| | - Minoru Yoshida
- Department of Emergency and Critical Care Medicine, St. Marianna University School of Medicine, 2-16-1, Sugao, Miyamae-Ku, Kawasaki, Kanagawa, 216- 8511, Japan
| | - Hidenori Sumita
- Clinic Sumita, 305-12, Minamiyamashinden, Ina-Cho, Toyokawa, Aichi, 441-0105, Japan
| | - Kyohei Miyamoto
- Department of Emergency and Critical Care Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama, Wakayama, 641-8509, Japan
| | - Kensuke Nakamura
- Department of Critical Care Medicine, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawaku, Yokohama, 236-0004, Japan.
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9
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Johnston EA, Veenhuizen SGA, Ibiebele TI, Webb PM, van der Pols JC. Mental health and diet quality after primary treatment for ovarian cancer. Nutr Diet 2024. [PMID: 38192229 DOI: 10.1111/1747-0080.12861] [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: 07/04/2023] [Revised: 11/27/2023] [Accepted: 12/06/2023] [Indexed: 01/10/2024]
Abstract
AIMS To investigate anxiety and depression after primary treatment for ovarian cancer in relation to diet quality and intake. METHODS In a cohort of women with ovarian cancer in Australia, levels of anxiety and depression (normal, subclinical, and clinical) were assessed using the Hospital Anxiety and Depression Scale at 9 months post-diagnosis. Dietary intake was assessed using a validated food frequency questionnaire at 12 months post-diagnosis and scored using the Healthy Eating Index 2015. Multinomial logistic regression and bivariate analyses were used to investigate relationships between levels of anxiety and depression and subsequent diet quality and intake of food groups. RESULTS Of 595 women, anxiety and depression were identified among 128 (21%) and 80 (13%) women, respectively. Compared to women without anxiety or depression, women with subclinical anxiety (odds ratio = 0.49, 95% confidence interval: 0.25-0.98) and those with clinical depression (odds ratio = 0.25, 95% confidence interval: 0.07-0.93) were less likely to score in the highest quartile for diet quality. Separate adjustment for age, education, employment, disease stage, body mass index, and smoking status did not attenuate these associations. In bivariate analyses, women with subclinical anxiety were more likely to report higher intakes of sweet foods. Those with clinical depression were more likely to report lower intakes of orange vegetables and wholegrains, higher intakes of sweetened beverages, and not consume alcohol or soya foods. CONCLUSIONS Anxiety or depression after primary treatment for ovarian cancer may be associated with poorer diet quality. Efforts to improve diet quality post-treatment should consider support for mental health.
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Affiliation(s)
- Elizabeth A Johnston
- Population Health Program, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology (QUT), Kelvin Grove, Queensland, Australia
- Cancer Council Queensland, Fortitude Valley, Queensland, Australia
| | - Stefanie G A Veenhuizen
- Population Health Program, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
- Julius Centre for Health Sciences and Primary Care, University Medical Center Utrecht, Department of Epidemiology, Utrecht, The Netherlands
| | - Torukiri I Ibiebele
- Population Health Program, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
| | - Penelope M Webb
- Population Health Program, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
| | - Jolieke C van der Pols
- Population Health Program, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology (QUT), Kelvin Grove, Queensland, Australia
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10
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O'Riordan A, Howard S, Keogh TM, Gallagher S. Type D personality is associated with lower cardiovascular reactivity to stress in women. Psychol Health 2023; 38:1515-1535. [PMID: 35007443 DOI: 10.1080/08870446.2021.2025239] [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: 08/23/2021] [Revised: 11/16/2021] [Accepted: 12/15/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE This study examines if Type D personality is (1) associated with cardiovascular reactivity to acute stress in a healthy sample, and (2) has predictive utility for cardiovascular reactivity above its individual subcomponents (negative affect; NA, social inhibition; SI), as well as anxiety and depression. DESIGN Undergraduate students (n = 173) competed a standardised cardiovascular reactivity experimental protocol consisting of resting baseline and stressor phase (mental arithmetic), with systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) monitored throughout. MAIN OUTCOME MEASURES The main outcome measures were cardiovascular reactivity to the stressor, which was operationalised as the difference between resting baseline and the stressor phase for SBP, DBP and HR. RESULTS The continuous Type D interaction term (NA × SI) significantly predicted lower SBP reactivity to the mental arithmetic stressor amongst women, independent of NA, SI and confounding variables. Moreover, this remained significant after adjustment for anxiety and depressive symptoms. Depression, NA and SI were also significant independent predictors of SBP reactivity amongst women. CONCLUSION Type D personality is associated with lower SBP reactivity to acute stress in women, which may be indicative of blunted cardiovascular reactivity. This association was independent of NA, SI, Anxiety and Depression.
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Affiliation(s)
- Adam O'Riordan
- Department of Psychology, Centre for Social Issues Research, Study of Anxiety, Stress and Health Laboratory, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
| | - Siobhán Howard
- Department of Psychology, Centre for Social Issues Research, Study of Anxiety, Stress and Health Laboratory, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
| | - Tracey M Keogh
- Department of Psychology, Centre for Social Issues Research, Study of Anxiety, Stress and Health Laboratory, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
| | - Stephen Gallagher
- Department of Psychology, Centre for Social Issues Research, Study of Anxiety, Stress and Health Laboratory, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
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11
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Scribante A, Pellegrini M, Pulicari F, Ghizzoni M, Modugno FP, Spadari F. Pain Assessment in Oral Medicine through Its Different Dimensions: A Comprehensive Review. Dent J (Basel) 2023; 11:246. [PMID: 37999011 PMCID: PMC10670171 DOI: 10.3390/dj11110246] [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: 08/15/2023] [Revised: 10/14/2023] [Accepted: 10/20/2023] [Indexed: 11/25/2023] Open
Abstract
Orofacial pain is a complex experience made up of different features and involving various aspects of life. It has demonstrated a connection, especially when chronic, with conditions such as anxiety, depression, and sleep disorders, through paths that still have not been completely clarified. A deep understanding of orofacial pain and its impact on an individual's life is critical for planning accurate diagnostic and therapeutic approaches. This review seeks to provide a comprehensive overview of the components constituting the pain experience, its implications in an individual's life, the different tools for multidimensional pain assessment, and the specific applications for each tool. A comprehensive review was performed using the PubMed, Scopus, and Web of Science electronic databases. Ninety-five studies, including observational studies, clinical trials, case-control studies, and case reports, were included and analyzed in this review. Orofacial pain assessment exploits several methods, ranging from clinical evaluation to rating scales, questionnaires, and daily diaries. The choice of the correct instrument requires an evaluation of the type of pain experienced, of the patient's characteristics and abilities to complete particular tasks, and finally, of the assessment tool features.
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Affiliation(s)
- Andrea Scribante
- Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy; (M.G.); (F.P.M.)
| | - Matteo Pellegrini
- Maxillo-Facial Surgery and Dental Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (F.P.); (F.S.)
| | - Federica Pulicari
- Maxillo-Facial Surgery and Dental Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (F.P.); (F.S.)
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via della Commenda 10, 20122 Milan, Italy
| | - Martina Ghizzoni
- Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy; (M.G.); (F.P.M.)
| | - Francesco Paolo Modugno
- Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy; (M.G.); (F.P.M.)
| | - Francesco Spadari
- Maxillo-Facial Surgery and Dental Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (F.P.); (F.S.)
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via della Commenda 10, 20122 Milan, Italy
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12
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Sun Y, Tian Y, Cao S, Li L, Yu W, Ding Y, Wang X, Kong Y, Wang X, Wang H, Hui X, Qu J, Wang H, Duan Q, Yang D, Zhang H, Zhou S, Liu X, Li Z, Meng C, Kehlet H, Zhou Y. Multimodal prehabilitation to improve the clinical outcomes of frail elderly patients with gastric cancer: a study protocol for a multicentre randomised controlled trial (GISSG +2201). BMJ Open 2023; 13:e071714. [PMID: 37816552 PMCID: PMC10565164 DOI: 10.1136/bmjopen-2023-071714] [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: 01/17/2023] [Accepted: 09/19/2023] [Indexed: 10/12/2023] Open
Abstract
INTRODUCTION Gastric cancer (GC) diagnosed in the elderly population has become a serious public health problem worldwide. Given the combined effects of frailty and the consequences of cancer treatment, older individuals with GC are more likely than young patients to suffer from postoperative complications and poor clinical outcomes. Nutrition, functional capacity and psychological state-based multimodal prehabilitation, which is dominated by Enhanced Recovery After Surgery (ERAS) pathway management, has been shown to reduce postoperative complications, promote functional recovery and decrease hospitalisation time in certain malignancies. However, no previous studies have investigated the clinical application of multimodal prehabilitation in frail older patients with GC. METHODS AND ANALYSIS The study is a prospective, multicentre randomised controlled trial in which a total of 368 participants who meet the inclusion criteria will be randomised into either a prehabilitation group or an ERAS group. The prehabilitation group will receive multimodal prehabilitation combined with ERAS at least 2 weeks before the gastrectomy is performed, including physical and respiratory training, nutritional support, and therapy and psychosocial treatment. The ERAS group patients will be treated according to the ERAS pathway. All interventions will be supervised by family members. The primary outcome measures are the incidence and severity of postoperative complications. Secondary outcomes include survival, functional capacity and other short-term postoperative outcomes. Overall, the multimodal prehabilitation protocol may improve functional capacity, reduce the surgical stress response and concomitant systemic inflammation, and potentially modulate the tumour microenvironment to improve short-term and long-term clinical outcomes and patients' quality of life. ETHICS AND DISSEMINATION All procedures and participating centres of this study were approved by their respective ethics committees (QYFYKYLL 916111920). The final study results will be published separately in peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT05352802.
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Affiliation(s)
- Yuqi Sun
- Department of General Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yulong Tian
- Department of General Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Shougen Cao
- Department of General Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Leping Li
- Department of Gastrointestinal Surgery, Shandong Provincial Hospital, Jinan, China
| | - Wenbin Yu
- Department of Gastrointestinal Surgery, Qilu Hospital of Shandong University, Jinan, China
| | - Yinlu Ding
- Department of Gastrointestinal Surgery, The Second Hospital of Shandong University, Jinan, China
| | - Xixun Wang
- Department of Gastrointestinal Surgery, Yantai Yuhuangding Hospital, Yantai, China
| | - Ying Kong
- Department of Gastrointestinal Surgery, Jining No.1 People's Hospital, Jining, China
| | - Xinjian Wang
- Department of Gastrointestinal Surgery, Weihai Central Hospital, Weihai, China
| | - Hao Wang
- Department of General Surgery, Dongying People's Hospital, Dongying, China
| | - Xizeng Hui
- Department of General Surgery, Rizhao People's Hospital, Rizhao, China
| | - Jianjun Qu
- Department of Oncological Surgery, Weifang People's Hospital, Weifang, China
| | - HongBo Wang
- Department of Gastrointestinal Surgery, People's Hospital of Jimo District, Qingdao, People's Republic of China
| | - Quanhong Duan
- Department of Gastrointestinal Surgery, Affiliated Hospital of Weifang Medical University, Weifang, China
| | - Daogui Yang
- Department of Gastrointestinal Surgery, Liaocheng People's Hospital, Liaocheng, China
| | - Huanhu Zhang
- Department of Gastrointestinal Surgery, Weihai Municipal Hospital, Weihai, China
| | - Shaofei Zhou
- Department of Gastrointestinal Surgery, Qingdao Municipal Hospital Group, Qingdao, China
| | - Xiaodong Liu
- Department of General Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Zequn Li
- Department of General Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Cheng Meng
- Department of General Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Henrik Kehlet
- Section of Surgical Pathophysiology, Rigshospitalet Copenhagen University, Denmark, UK
| | - Yanbing Zhou
- Department of General Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
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13
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Vizin G, Szekeres T, Juhász A, Márton L, Dank M, Perczel-Forintos D, Urbán R. The role of stigma and depression in the reduced adherence among young breast cancer patients in Hungary. BMC Psychol 2023; 11:319. [PMID: 37814282 PMCID: PMC10561463 DOI: 10.1186/s40359-023-01355-4] [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: 04/16/2023] [Accepted: 09/28/2023] [Indexed: 10/11/2023] Open
Abstract
BACKGROUND The main aim of our study was to investigate the role of depression, stigmatization, body shame and self-compassion in the adherence of young Hungarian breast cancer patients aged between 18 and 45 years. METHODS In a cross-sectional online survey, data were collected from 99 young breast cancer patients (BC). Participants completed self-report questionnaires on socio-demographic and cancer-specific parameters as well as psychological factors (adherence: 12-item Medication Adherence Scale; depression: Hospital Anxiety and Depression Scale; stigmatization: Stigma Scale for Chronic Illnesses; body shame: Experience of Shame Scale; self-compassion: Self-Compassion Scale). We tested the predictors and mediators of adherence using hierarchical regression, mediation and moderation analysis among BC patients. RESULTS We found that adherence was significantly associated with body shame and stigmatization in our BC sample. In addition, stigmatization alone was a significant predictor of lower adherence. Finally, in mediation models, where body shame was a mediator, we found a significant direct effect between stigma and adherence, in other words body shame had a significant mediating effect between these variables. According to our moderation analysis, self-compassion as a significant moderator acts as a protective factor in the linear relationship between stigma and lower adherence. CONCLUSIONS Our results highlight the importance of stigma and body shame in the development of adherence in oncological care among young Hungarian BC patients aged between 18 and 45 years. Assessment of stigma, body shame, self-compassion, and the improvement of the availability of evidence-based psychological interventions may increase the adherence of young Hungarian BC patients, leading to more favourable rates of survival.
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Affiliation(s)
- Gabriella Vizin
- Institute of Psychology, Eötvös Loránd University, Izabella utca 46, Budapest, 1064, Hungary.
| | - Tamás Szekeres
- Faculty of General Medicine, Department of Clinical Psychology, Semmelweis University, Üllői út 25, Budapest, 1095, Hungary
| | - Anita Juhász
- Faculty of General Medicine, Department of Surgery, Transplantation and Gastroenterology, Semmelweis University, Üllői út 78, Budapest, 1082, Hungary
| | - Lilla Márton
- Institute of Psychology, Eötvös Loránd University, Izabella utca 46, Budapest, 1064, Hungary
| | - Magdolna Dank
- Faculty of General Medicine, Department of Internal Medicine and Oncology, Oncology Profile, Semmelweis University, Tömő u. 25-29, Budapest, 1st, 1083, Hungary
| | - Dóra Perczel-Forintos
- Faculty of General Medicine, Department of Clinical Psychology, Semmelweis University, Üllői út 25, Budapest, 1095, Hungary
| | - Róbert Urbán
- Institute of Psychology, Eötvös Loránd University, Izabella utca 46, Budapest, 1064, Hungary
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14
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Lee Y, Lin PY, Huang YC, Chiu NM, Hung CF, Wang LJ. The Morbidity and Associated Factors of Depression in Caregivers of Patients with Depressive Disorder. Neuropsychiatr Dis Treat 2023; 19:1853-1864. [PMID: 37645437 PMCID: PMC10461748 DOI: 10.2147/ndt.s415881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 08/10/2023] [Indexed: 08/31/2023] Open
Abstract
Objective Depressive disorder significantly impacts patients' daily living activities and quality of life. Caregivers of patients with depression may also suffer from psychological distress related to the chronic burden of caring for the patient's mood changes. The purpose of this study was to evaluate the morbidity and associated factors of depression in caregivers of patients with depressive disorder. Methods In this study, we used a cross-sectional design with consecutive sampling. Study subjects were recruited from the psychiatric outpatient clinic of a medical center from August 2021 to June 2022. Caregivers of depressive disorder patients were enrolled and assessed using the Mini International Neuropsychiatric Interview, Hospital Anxiety and Depression Scale (HADS), Suicide Assessment Scale (SAS), Stigma Scale of the Explanatory Model Interview Catalogue (EMIC), and Family APGAR Index. Results Of the 120 caregivers that completed the study, 59.2% (n=71) were females. The most common psychiatric diagnosis was depressive disorders (25.8%), followed by anxiety disorders (17.5%) and insomnia disorder (15.8%); 54.2% of the caregivers had a psychiatric diagnosis. Using logistic regression analysis, we found that anxiolytics/hypnotics use (OR=5.58; 95% CI, 1.84-16.96; p<0.01), higher suicide risk (SAS) (OR=1.10; 95% CI, 1.05-1.16; p<0.001), and lower family support (APGAR scores) (OR=0.82; 95% CI, 0.71-0.94; p<0.01) were three significant associated factors. Conclusion Depression was the most prevalent psychiatric diagnosis in caregivers of patients with depressive disorder. Early psychiatric diagnosis for caregivers of patients with depression is crucial to offering suitable support and treatment and may improve caregivers' quality of life.
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Affiliation(s)
- Yu Lee
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Pao-Yen Lin
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yu-Chi Huang
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Nien-Mu Chiu
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chi-Fa Hung
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Liang-Jen Wang
- Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
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15
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Omari M, Amaadour L, Zarrouq B, Al-Sheikh YA, El Asri A, Kriya S, Nadi S, Benbrahim Z, Mellas N, Rhazi KE, Ragala MEA, Hilaly JE, Giesy JP, Aboul-Soud MAM, Halim K. Evaluation of psychological distress is essential for patients with locally advanced breast cancer prior to neoadjuvant chemotherapy: baseline findings from cohort study. BMC Womens Health 2023; 23:445. [PMID: 37612725 PMCID: PMC10464406 DOI: 10.1186/s12905-023-02571-1] [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: 05/08/2023] [Accepted: 07/25/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND patients with locally advanced breast cancer (LABC) are often treated by neoadjuvant chemotherapy (NACT). This study aims to determine the prevalence of psychological distress and their sociodemographic and clinical factors in patients recently diagnosed with LABC and before NACT. METHODS A total of 209 LABC patients without metastatic localization were recruited between 2021 and 2022 in the oncology hospital at Fez. A structured questionnaire and the Hospital Anxiety and Depression Scale were used. A descriptive analysis and linear model were performed. RESULTS a mean age of participants was 47.43 ± 9.45 years. The prevalence of depression, anxiety and psychological distress among participants was 59.62% (95% CI: 52.61-33.34), 47.85% (95% CI: 40.91-54.85), and 65.07 (95% CI: 58.19-71.52) respectively. Depression was associated to age (< 50 years) (AOR = 2.19; 95% CI = 1.13-4.23) and health insurance (AOR = 3.64; 95% CI: 1.18-11.26). Anxiety was associated to age (< 50) (AOR = 2.21; 95% CI: 1.18-4.13) and right breast cancer (AOA = 2.01; 95% CI: 1.11-3.65). Psychological distress was associated to chronic illness (AOR = 2.78; 95% CI: 1.32-5.85) and lymph node status (AOR = 2.39; 95% CI: 1.26-4.57). CONCLUSIONS Based on the high prevalence of depression and anxiety it appears opportune to treat psychological distress among LABC patient candidates for NACT. Each psychological intervention should take into account sociodemographic and clinical factors found associated in our study. Psychological therapeutic interventions are crucial for LABC patients as early as the time of diagnosis and through subsequent steps in NACT to improve their overall mental health.
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Affiliation(s)
- Majid Omari
- Laboratory of Epidemiology and Research in Health Sciences, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdallah University, Fez, Morocco.
- Laboratory of Natural Substances, Pharmacology, Environment, Modeling, Health & Quality of Life, Faculty of Sciences Dhar El Mahraz, Sidi Mohamed Ben Abdellah University, Fez, Morocco.
| | - Lamiae Amaadour
- Department of Medical Oncology, Hassan II University Hospital, Fez, Morocco
| | - Btissame Zarrouq
- Laboratory of Epidemiology and Research in Health Sciences, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdallah University, Fez, Morocco
- Department of Biology and Geology, Teacher's Training College (Ecole Normale Supérieure), Sidi Mohamed Ben Abdallah University, Fez, Morocco
| | - Yazeed A Al-Sheikh
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh, 11433, Saudi Arabia
| | - Achraf El Asri
- Laboratory of Epidemiology and Research in Health Sciences, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdallah University, Fez, Morocco
| | - Salima Kriya
- Higher Institute of Nursing Professions and Health Techniques, Fez, Morocco
| | - Sara Nadi
- Higher Institute of Nursing Professions and Health Techniques, Fez, Morocco
| | - Zineb Benbrahim
- Department of Medical Oncology, Hassan II University Hospital, Fez, Morocco
| | - Nawfel Mellas
- Department of Medical Oncology, Hassan II University Hospital, Fez, Morocco
| | - Karima El Rhazi
- Laboratory of Epidemiology and Research in Health Sciences, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdallah University, Fez, Morocco
| | - Mohammed El Amine Ragala
- Laboratory of Natural Substances, Pharmacology, Environment, Modeling, Health & Quality of Life, Faculty of Sciences Dhar El Mahraz, Sidi Mohamed Ben Abdellah University, Fez, Morocco
- Department of Biology and Geology, Teacher's Training College (Ecole Normale Supérieure), Sidi Mohamed Ben Abdallah University, Fez, Morocco
| | - Jaouad El Hilaly
- Laboratory of Pedagogical and Didactic Engineering of Sciences and Mathematics, Regional Center of Education and Training (CRME F) of Fez, Fez, Morocco
- R.N.E Laboratory, Multidisciplinary Faculty of Taza, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - John P Giesy
- Toxicology Centre, University of Saskatchewan, Saskatoon, SK, S7N 5B3, Canada
- Department of Veterinary Biomedical Sciences, University of Saskatchewan, Saskatoon, SK, S7N 5B4, Canada
- Department of Integrative Biology, Michigan State University, East Lansing, MI, 48824, USA
- Department of Environmental Sciences, Baylor University, Waco, TX, 76706, USA
| | - Mourad A M Aboul-Soud
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh, 11433, Saudi Arabia
| | - Karima Halim
- Laboratory of Natural Substances, Pharmacology, Environment, Modeling, Health & Quality of Life, Faculty of Sciences Dhar El Mahraz, Sidi Mohamed Ben Abdellah University, Fez, Morocco
- Department of Human and Social Sciences - Education Sciences, Teachers Training College (Ecole Normale Superieure), Sidi Mohamed Ben Abdellah University, Fez, Morocco
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16
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Clavo B, Cánovas-Molina A, Díaz-Garrido JA, Cañas S, Ramallo-Fariña Y, Laffite H, Federico M, Rodríguez-Abreu D, Galván S, García-Lourve C, González-Beltrán D, Caramés MA, Hernández-Fleta JL, Serrano-Aguilar P, Rodríguez-Esparragón F. Effects of ozone therapy on anxiety and depression in patients with refractory symptoms of severe diseases: a pilot study. Front Psychol 2023; 14:1176204. [PMID: 37599784 PMCID: PMC10437070 DOI: 10.3389/fpsyg.2023.1176204] [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: 02/28/2023] [Accepted: 07/17/2023] [Indexed: 08/22/2023] Open
Abstract
Background Patients with refractory symptoms of severe diseases frequently experience anxiety, depression, and an altered health-related quality of life (HRQOL). Some publications have described the beneficial effect of ozone therapy on several symptoms of this kind of patient. The aim of this study was to preliminarily evaluate, in patients treated because of refractory symptoms of cancer treatment and advanced nononcologic diseases, if ozone therapy has an additional impact on self-reported anxiety and depression. Methods Before and after ozone treatment, we assessed (i) anxiety and depression according to the Hospital Anxiety and Depression Scale (HADS); (ii) the HRQOL (according to the EQ-5D-5L questionnaire), which includes a dimension on anxiety and depression and a visual analog scale (VAS) measuring self-perceived general health. Results Before ozone therapy, 56% of patients were on anxiolytic and/or antidepressant treatment. Before and after ozone therapy, the anxiety and depression HADS subscales (i) significantly correlated with the anxiety/depression dimension of the EQ-5D-5L questionnaire and (ii) inversely correlated with the health status as measured by the VAS. After ozone therapy, we found a significant improvement in anxiety and depression measured by both the (i) HADS subscales and (ii) EQ-5D-5L questionnaire. Conclusion The addition of ozone therapy for patients with refractory symptoms of cancer treatment and advanced chronic nononcologic diseases can decrease anxiety and depression severity levels. Additional, more focused studies are ongoing to provide the needed explanatory information for this finding.
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Affiliation(s)
- Bernardino Clavo
- Research Unit, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
- Chronic Pain Unit, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
- Radiation Oncology Department, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
- Fundación Canaria Instituto de Investigación Sanitaria de Canarias (FIISC), Las Palmas de Gran Canaria/Tenerife, Spain
- Universitary Institute for Research in Biomedicine and Health (iUIBS), Molecular and Translational Pharmacology Group, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
- Instituto Universitario de Enfermedades Tropicales y Salud Pública de Canarias de la Universidad de La Laguna, Santa Cruz de Tenerife, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Spanish Group of Clinical Research in Radiation Oncology (GICOR), Madrid, Spain
| | - Angeles Cánovas-Molina
- Research Unit, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
- Chronic Pain Unit, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
- Fundación Canaria Instituto de Investigación Sanitaria de Canarias (FIISC), Las Palmas de Gran Canaria/Tenerife, Spain
| | - Juan A. Díaz-Garrido
- Psychiatry Department, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | - Silvia Cañas
- Psychiatry Department, Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Yolanda Ramallo-Fariña
- Fundación Canaria Instituto de Investigación Sanitaria de Canarias (FIISC), Las Palmas de Gran Canaria/Tenerife, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Santa Cruz de Tenerife, Spain
- Servicio de Evaluación y Planificación del Servicio Canario de Salud (SESCS), Santa Cruz de Tenerife, Spain
- Instituto de Tecnologías Biomédicas (ITB), Universidad de la Laguna, Santa Cruz de Tenerife, Spain
| | - Horus Laffite
- Psychiatry Department, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | - Mario Federico
- Radiation Oncology Department, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | - Delvys Rodríguez-Abreu
- Medical Oncology Department, Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Saray Galván
- Medical Oncology Department, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | - Carla García-Lourve
- Research Unit, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
- Fundación Canaria Instituto de Investigación Sanitaria de Canarias (FIISC), Las Palmas de Gran Canaria/Tenerife, Spain
| | - Damián González-Beltrán
- Research Unit, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | - Miguel A. Caramés
- Chronic Pain Unit, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | - Jose L. Hernández-Fleta
- Psychiatry Department, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | - Pedro Serrano-Aguilar
- Fundación Canaria Instituto de Investigación Sanitaria de Canarias (FIISC), Las Palmas de Gran Canaria/Tenerife, Spain
- Instituto de Tecnologías Biomédicas (ITB), Universidad de la Laguna, Santa Cruz de Tenerife, Spain
| | - Francisco Rodríguez-Esparragón
- Research Unit, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
- Fundación Canaria Instituto de Investigación Sanitaria de Canarias (FIISC), Las Palmas de Gran Canaria/Tenerife, Spain
- Instituto Universitario de Enfermedades Tropicales y Salud Pública de Canarias de la Universidad de La Laguna, Santa Cruz de Tenerife, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
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17
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Cuninghame S, Jerath A, Gorsky K, Sivajohan A, Francoeur C, Withington D, Burry L, Cuthbertson BH, Orser BA, Martin C, Owen AM, Slessarev M. Effect of inhaled anaesthetics on cognitive and psychiatric outcomes in critically ill adults: a systematic review and meta-analysis. Br J Anaesth 2023; 131:314-327. [PMID: 37344338 DOI: 10.1016/j.bja.2023.05.004] [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: 03/02/2023] [Revised: 04/17/2023] [Accepted: 05/04/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND Sedation of critically ill patients with inhaled anaesthetics may reduce lung inflammation, time to extubation, and ICU length of stay compared with intravenous (i.v.) sedatives. However, the impact of inhaled anaesthetics on cognitive and psychiatric outcomes in this population is unclear. In this systematic review, we aimed to summarise the effect of inhaled anaesthetics on cognitive and psychiatric outcomes in critically ill adults. METHODS We searched MEDLINE, EMBASE, and PsycINFO for case series, retrospective, and prospective studies in critically ill adults sedated with inhaled anaesthetics. Outcomes included delirium, psychomotor and neurological recovery, long-term cognitive dysfunction, ICU memories, anxiety, depression, post-traumatic stress disorder (PTSD), and instruments used for assessment. RESULTS Thirteen studies were included in distinct populations of post-cardiac arrest survivors (n=4), postoperative noncardiac patients (n=3), postoperative cardiac patients (n=2), and mixed medical-surgical patients (n=4). Eight studies reported delirium incidence, two neurological recovery, and two ICU memories. One study reported on psychomotor recovery, long-term cognitive dysfunction, anxiety, depression, and PTSD. A meta-analysis of five trials found no difference in delirium incidence between inhaled and i.v. sedatives (relative risk 0.95 [95% confidence interval: 0.59-1.54]). Compared with i.v. sedatives, inhaled anaesthetics were associated with fewer hallucinations and faster psychomotor recovery but no differences in other outcomes. There was heterogeneity in the instruments used and timing of these assessments. CONCLUSIONS Based on the limited evidence available, there is no difference in cognitive and psychiatric outcomes between adults exposed to volatile sedation or intravenous sedation in the ICU. Future studies should incorporate outcome assessment with validated tools during and after hospital stay. SYSTEMATIC REVIEW PROTOCOL PROSPERO CRD42021236455.
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Affiliation(s)
- Sean Cuninghame
- Department of Medicine, Western University, London, ON, Canada
| | - Angela Jerath
- Department of Anesthesiology and Pain Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Department of Anesthesia, Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Schulich Heart Program, Sunnybrook Research Institute, Toronto, ON, Canada; Institute for Health Policy, Management and Evaluation, University of Toronto, ON, Canada
| | - Kevin Gorsky
- Department of Anesthesiology and Pain Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Asaanth Sivajohan
- Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Conall Francoeur
- Centre de Recherche CHU de Québec-Université Laval, Quebec City, QC, Canada
| | - Davinia Withington
- Department of Anesthesia, Montreal Children's Hospital, Montreal, QC, Canada; Department of Anesthesia, McGill University, Montreal, QC, Canada
| | - Lisa Burry
- Departments of Pharmacy and Medicine, Mount Sinai Hospital, Toronto, ON, Canada; Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
| | - Brian H Cuthbertson
- Department of Anesthesiology and Pain Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Institute for Health Policy, Management and Evaluation, University of Toronto, ON, Canada
| | - Beverley A Orser
- Department of Anesthesiology and Pain Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Department of Anesthesia, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Claudio Martin
- Department of Medicine, Western University, London, ON, Canada
| | - Adrian M Owen
- Western Institute for Neuroscience, Western University, London, ON, Canada; Department of Psychology and Department of Physiology and Pharmacology, Western University, London, Canada
| | - Marat Slessarev
- Department of Medicine, Western University, London, ON, Canada; Western Institute for Neuroscience, Western University, London, ON, Canada.
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18
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Sadowska K, Fong T, Horning DR, McAteer S, Ekwebelem MI, Demetres M, Reid MC, Shalev D. Psychiatric Comorbidities and Outcomes in Palliative and End-of-Life Care: A Systematic Review. J Pain Symptom Manage 2023; 66:e129-e151. [PMID: 37003308 PMCID: PMC10330030 DOI: 10.1016/j.jpainsymman.2023.03.007] [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: 01/21/2023] [Revised: 03/14/2023] [Accepted: 03/16/2023] [Indexed: 04/03/2023]
Abstract
BACKGROUND Although psychiatric comorbidities are common among individuals at end of life, their impact on outcomes is poorly understood. METHODS We conducted a systematic literature review of six databases following preferred reporting items for systematic reviews and meta-analyses guidelines and aimed at assessing the relationship between psychiatric comorbidities and outcomes in palliative and end-of-life care. Six databases were included in our search. This review is registered on PROSPERO (CRD42022335922). RESULTS Our search generated 7472 unique records. Eighty-eight full texts were reviewed for eligibility and 43 studies were included in the review. Clinically, psychiatric comorbidity was associated with poor quality of life, increased physical symptom burden, and low function. The impact of psychiatric comorbidity on health utilization varied, though many studies suggested that psychiatric comorbidity increased utilization of palliative care services. Quality of evidence was limited by lack of consistent approach to confounding variables as well as heterogeneity of the included studies. CONCLUSION Psychiatric comorbidity is associated with significant differences in care utilization and clinical outcome among patients at end of life. In particular, patients with psychiatric comorbidity and serious illness are at high risk of poor quality of life and high symptom burden. Our finding that psychiatric comorbidity is associated with increased utilization of palliative care likely reflects the complexity and clinical needs of patients with serious illness and mental health needs. These data suggest that greater integration of mental health and palliative care services may enhance quality-of-life among patients at end of life.
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Affiliation(s)
| | - Tina Fong
- Case Western Reserve University (T.F.), Cleveland, Ohio, USA
| | - Daniel R Horning
- Teacher's College (D.R.H.), Columbia University, New York, New York, USA
| | - Sandra McAteer
- School of Public Health (S.M.), University of Washington, Seattle, Washington, USA
| | - Maureen I Ekwebelem
- Division of Geriatrics and Palliative Medicine (M.I.E., M.C.R., D.S.), Weill Cornell Medicine, New York, New York, USA
| | - Michelle Demetres
- Samuel J. Wood Library & C.V. Starr Biomedical Information Center (M.D.), Weill Cornell Medicine, New York, USA
| | - M Carrington Reid
- Division of Geriatrics and Palliative Medicine (M.I.E., M.C.R., D.S.), Weill Cornell Medicine, New York, New York, USA
| | - Daniel Shalev
- Division of Geriatrics and Palliative Medicine (M.I.E., M.C.R., D.S.), Weill Cornell Medicine, New York, New York, USA; Department of Psychiatry (D.S.), Weill Cornell Medicine, New York, New York, USA.
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19
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Hansen JM, Kjaer TK, Mellemgård A, Stensøe Oksen M, Andersen I, Dalton SO. Association between anxiety and depression symptoms and completion of first-line treatment in newly diagnosed lung cancer patients. Acta Oncol 2023; 62:820-824. [PMID: 37162449 DOI: 10.1080/0284186x.2023.2207745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 04/23/2023] [Indexed: 05/11/2023]
Affiliation(s)
- Josephine Maffait Hansen
- Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Trille Kristina Kjaer
- Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Anders Mellemgård
- Department of Oncology, Herlev Hospital, University of Copenhagen, Herlev, Denmark
| | | | - Ingelise Andersen
- Department of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Susanne Oksbjerg Dalton
- Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
- Danish Research Center for Equality in Cancer, Department of Clinical Oncology and Palliative Care, Zealand University Hospital, Næstved, Denmark
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20
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Hagemeier A, Adams A, Krieger T, Salm S, Cecon-Stabel N, Dresen A, Hellmich M. The impact of COVID-19 on the interpretation of psycho-oncological support trial results: a quasi-experimental approach using the data from the new form of care "Integrated cross-sectoral psycho-oncology (nFC-isPO)". BMC Health Serv Res 2023; 23:556. [PMID: 37254172 DOI: 10.1186/s12913-023-09544-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 05/14/2023] [Indexed: 06/01/2023] Open
Abstract
OBJECTIVE In addition to the common difficulties of ongoing trials, the COVID-19 pandemic posed several challenges to scientists worldwide and created an additional burden for vulnerable patient groups. In the nFC-isPO of individualised treatment for anxiety and depression in newly diagnosed patients with cancer caregivers (e.g. psycho-oncologists) reported elevated HADS scores in newly enrolled patients after the outbreak of the COVID-19 pandemic. Accordingly, the question arises whether the pandemic affected HADS scores. Therefore, stratified analyses by the time of enrolment (T1) were performed for patients with 12 months of care (T3). METHODS Patients with 12 months of care (N = 1,140) were analysed. A comparison within the regression discontinuity design according to the time points at which patients completed the baseline (T1) HADS questionnaire was conducted to examine differences between patients recruited before Q2/2020 (pre-pandemic) and after the coronavirus outbreak. Furthermore, mean HADS scores at T1 and T3 for all quarters during the study were compared. RESULTS Mean T1 and T3 HADS scores of patients with cancer during the pandemic are only slightly higher than those of the pre-pandemic group. No significant treatment effect was observed in either the pre-pandemic (p = 0.5495, Late = 1.7711) or the post-pandemic group (p = 0.9098, LATE=-0.2933). In contrast, the average local treatment effect in the post-pandemic group suggests a minimal decrease in HADS score in the predefined range and thus a positive treatment effect for isPO. Comparison of mean HADS scores at T1 and T3 did not show a large increase by pandemic-related timepoints, however, a decrease of approximately 2-3 points over each quarter at 12 months compared to baseline is observed. CONCLUSION The existing nFC-isPO care is resilient to crisis and may counteract external influences such as the Corona pandemic. Accordingly, the pandemic had little influence on the fears of patients with cancer in the nFC-isPO. This emphasises that psycho-oncology is vital for the reduction of stress, anxiety and depression in patients with cancer. TRIAL REGISTRATION The study was registered in the German Clinical Trials Registry on 30 October 2018 under the ID "DRKS00015326".
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Affiliation(s)
- Anna Hagemeier
- Institute of Medical Statistics and Computational Biology (IMSB), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
| | - Anne Adams
- Institute of Medical Statistics and Computational Biology (IMSB), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Theresia Krieger
- Medicine Faculty, Human Sciences Faculty, Institute for Medical Sociology, Health Services Research, and Rehabilitation Science (IMVR), University of Cologne, University Hospital Cologne, Cologne, Germany
| | - Sandra Salm
- Medicine Faculty, Human Sciences Faculty, Institute for Medical Sociology, Health Services Research, and Rehabilitation Science (IMVR), University of Cologne, University Hospital Cologne, Cologne, Germany
- Goethe University Frankfurt, Institute of General Practice, Frankfurt, Germany
| | - Natalia Cecon-Stabel
- Medicine Faculty, Human Sciences Faculty, Institute for Medical Sociology, Health Services Research, and Rehabilitation Science (IMVR), University of Cologne, University Hospital Cologne, Cologne, Germany
| | - Antje Dresen
- Medicine Faculty, Human Sciences Faculty, Institute for Medical Sociology, Health Services Research, and Rehabilitation Science (IMVR), University of Cologne, University Hospital Cologne, Cologne, Germany
| | - Martin Hellmich
- Institute of Medical Statistics and Computational Biology (IMSB), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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21
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Galliardt M, Betz U, Birklein F, Drees P, Geber C. Falls during oxaliplatin-based chemotherapy for gastrointestinal malignancies - (lessons learned from) a prospective study. Open Med (Wars) 2023; 18:20230696. [PMID: 37251538 PMCID: PMC10224621 DOI: 10.1515/med-2023-0696] [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: 10/15/2022] [Revised: 02/21/2023] [Accepted: 03/20/2023] [Indexed: 05/31/2023] Open
Abstract
This prospective cohort study aimed to characterise the impact of oxaliplatin-based chemotherapy and its neurotoxic side effects (i.e., chemotherapy-induced neuropathy) on functional fall-risk and falls. Twenty chemotherapy-naïve participants (mean age, 59 years; 16 males) were consecutively included. A multimodal fall risk assessment was performed at four time points within 6 months. Polyneuropathy was assessed using the Neurologic Disability Scale; the fall risk was assessed by functional tests (Tinetti Test, Chair-Rising Test, and Timed up and Go Test). Patient-reported outcomes comprised the Hospitality Anxiety and Depression Scale (HADS), the Falls Efficacy Scale - International (FES-I) to assess the fear of falling, and the Physical Activity for the Elderly (PASE) questionnaire. Three falls occurred during the study. All fallen participants had a high fall risk-index (≥4 more risk factors) compared to only 30% of the non-fallen participants (p = 0.03) and suffered more frequently from pre-existing mild polyneuropathy (p = 0.049). Study discontinuation (n = 12) was associated with a higher rate of polypharmacy (p = 0.045), anxiety (HADS-A, p = 0.03), and specific fear of falling (FES-I, p = 0.025). In contrast, study completers (n = 8) reported an improvement in physical activity (PASE) (p = 0.018). In summary, pre-existing fall-risk factors impacted more falls than chemotherapy. A fall risk index offers a time-efficient screening option in an outpatient oncological setting.
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Affiliation(s)
- Melanie Galliardt
- Department of Neurology, University Medical Center, Johannes-Gutenberg-University, Mainz, Germany
- Department of Orthopaedics and Traumatology, University Medical Center, Johannes-Gutenberg-University, Mainz, Germany
| | - Ulrich Betz
- Institute of Physical Therapy, Prevention and Rehabilitation, University Medical Center, Johannes-Gutenberg-University, Mainz, Germany
| | - Frank Birklein
- Department of Neurology, University Medical Center, Johannes-Gutenberg-University, Mainz, Germany
| | - Philipp Drees
- Department of Orthopaedics and Traumatology, University Medical Center, Johannes-Gutenberg-University, Mainz, Germany
| | - Christian Geber
- Department of Neurology, University Medical Center, Johannes-Gutenberg-University, Mainz, Germany
- DRK Schmerz-Zentrum, Auf der Steig 14-16, Mainz, 55131, Germany
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22
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Naraev BG, Mailman J, Halfdanarson TR, Soares HP, Mittra ES, Hallet J. Consideration of quality-of-life in the treatment decision-making for patients with advanced gastroenteropancreatic neuroendocrine tumors. Expert Rev Anticancer Ther 2023; 23:601-615. [PMID: 37158050 DOI: 10.1080/14737140.2023.2207829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
INTRODUCTION Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are a complex and heterogenous family of solid malignancies that originate from neuroendocrine tissue in the gastrointestinal tract or pancreas. Most patients diagnosed with GEP-NETs present with advanced or metastatic disease, and quality of life (QoL) is often an important priority when selecting treatments for these patients. Patients with advanced GEP-NETs often experience a substantial and persistent symptom burden that undermines their QoL. Addressing a patient's individual symptoms through judicious selection of treatment may improve QoL. AREAS COVERED The objectives of this narrative review are to summarize the impact of advanced GEP-NETs on patient QoL, assess the potential value of current treatments for maintaining or improving patient QoL, and offer a clinical framework for how these QoL data can be translated to inform clinical decision-making for patients with advanced GEP-NETs. EXPERT OPINION Patients with advanced GEP-NETs experience a significant and persistent symptom burden that impacts their daily lifestyle, activities, work life, and financial health, leading to erosion of their QoL. Ongoing and future studies incorporating longitudinal QoL assessments and head-to-head treatment evaluations will further inform the incorporation of QoL into clinical decision-making.
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Affiliation(s)
- Boris G Naraev
- Anderson Family Cancer Institute, 1240 S Old Dixie Highway, Jupiter, Florida33458, USA
| | - Josh Mailman
- NorCal CarciNET Community, 946 N Ripon Rd, Ripon, CA 95366, USA
| | - Thorvardur R Halfdanarson
- Division of Medical Oncology, Mayo Clinic Cancer Center, 200 First St. SW, Rochester, Minnesota 55905, USA
| | - Heloisa P Soares
- Huntsman Cancer Institute at the University of Utah, 1950 Circle of Hope Dr. Salt Lake City, Utah 84112, USA
| | - Erik S Mittra
- Division of Nuclear Medicine and Molecular Imaging, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, Oregon97239, USA
| | - Julie Hallet
- Department of Surgery, University of Toronto, 27 King's College Cir, Toronto, Ontario M5S, Canada; Susan Leslie Clinic for Neuroendocrine Tumors - Odette Cancer Centre, Sunnybrook Health Sciences Centre, 2075 Bayview Ave, Toronto, Ontario M4N 3M5, Canada
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23
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Bootsma TI, Schellekens MPJ, van Woezik RAM, van der Lee ML, Slatman J. Navigating severe chronic cancer-related fatigue: an interpretative phenomenological analysis. Psychol Health 2023; 38:494-517. [PMID: 34474619 DOI: 10.1080/08870446.2021.1973468] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE This article presents a phenomenological study on the embodied experiences of patients with Chronic Cancer-Related Fatigue (CCRF), aiming to better understand this complex phenomenon. DESIGN Data collection consisted of individual interviews with 25 participants who suffered from severe CCRF for at least three months after cancer treatment was finished. MAIN OUTCOME MEASURES Against the theoretical background of philosophical phenomenology, we explored embodied experiences, incorporated temporal and spatial aspects of living with CCRF. We applied interpretative phenomenological analysis (IPA) to analyze the transcripts of the interviews. RESULTS Using IPA, we identified four themes on how chronic fatigue is experienced post-cancer: (1) Worn out; (2) Diminishment of one's 'I can'; (3) Invisibility; and (4) Regaining one's 'I can'. CONCLUSION For clinical practice, these results imply that professionals could focus more on the role of the body and limitations of one's 'I can' when treating CCRF. By studying these embodied CCRF experiences in individual patients, future research could help personalize and optimize treatment.
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Affiliation(s)
- Tom I Bootsma
- Center for Psycho-Oncology, Scientific Research Department, Helen Dowling Institute, Bilthoven, The Netherlands.,School of Humanities and Digital Sciences, Department of Culture Studies, Tilburg University, Tilburg, The Netherlands
| | - Melanie P J Schellekens
- Center for Psycho-Oncology, Scientific Research Department, Helen Dowling Institute, Bilthoven, The Netherlands.,School of Social and Behavioral Sciences, Department of Medical and Clinical Psychology and Center of Research on Psychological disorders and Somatic diseases (CoRPS), Tilburg University, Tilburg, The Netherlands
| | - Rosalie A M van Woezik
- Center for Psycho-Oncology, Scientific Research Department, Helen Dowling Institute, Bilthoven, The Netherlands
| | - Marije L van der Lee
- Center for Psycho-Oncology, Scientific Research Department, Helen Dowling Institute, Bilthoven, The Netherlands.,School of Social and Behavioral Sciences, Department of Medical and Clinical Psychology and Center of Research on Psychological disorders and Somatic diseases (CoRPS), Tilburg University, Tilburg, The Netherlands
| | - Jenny Slatman
- School of Humanities and Digital Sciences, Department of Culture Studies, Tilburg University, Tilburg, The Netherlands
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24
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Badaghi N, van Kruijsbergen M, Prins J, Kelders S, Cillessen L, Compen F, Donders R, Kwakkenbos L, Speckens A. Effect of blended and unguided online delivery of mindfulness-based cognitive therapy versus care as usual on distress among cancer patients and survivors: protocol for the three-arm parallel randomized controlled buddy trial. BMC Psychol 2023; 11:21. [PMID: 36698197 PMCID: PMC9875458 DOI: 10.1186/s40359-023-01052-2] [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: 12/22/2022] [Accepted: 01/13/2023] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND One third of cancer patients and survivors experience psychological distress. Previous studies have shown that online mindfulness-based cognitive therapy (eMBCT) supports cancer patients and survivors in managing distress. Lack of peer support and asynchronicity during online interventions have been reported as barriers for treatment adherence and can result in higher drop-out rates. Considering this, two new formats of eMBCT were created. The primary objective of the Buddy trial is to evaluate the (cost) effectiveness of blended and unguided eMBCT versus care as usual (CAU) on psychological distress among cancer patients and survivors. Secondary objectives include evaluating effects on other psychological outcomes and investigating working mechanisms and treatment effect moderators. METHODS The Buddy trial is a parallel three-armed randomized controlled trial. Participants will be randomly assigned to blended therapist-assisted eMBCT, unguided individual eMBCT or CAU. Eligible participants will be Dutch-speaking adult cancer patients or survivors with access to internet. The primary outcome will be psychological distress scores as assessed by the Hospital Anxiety and Depression scale immediately post-treatment. Secondary outcome measures include fear of cancer recurrence (FCRI), fatigue (CIS-F), rumination (RRQ), mindfulness skills (FFMQ), decentering (EQ), self-compassion (SCS-SF), positive mental health (MHCSF), health related quality of life (EQ-5D), and costs associated with psychiatric illness (TiC-P). Outcome measures will be evaluated at baseline, mid-treatment, immediately post-treatment, and three-, six-, and nine-months follow-up. Possible mediators, such as engagement with interventions (TWEETS), and moderators will be also analyzed. DISCUSSION There is room to improve eMBCT for cancer patients prior to implementation to ensure adherence and scalability. Blended and unguided eMBCT may reduce psychological distress and improve quality of life and be easily accessible to cancer patients and survivors. Trial registration clinicaltrials.gov, NCT05336916, registered on April 20th, 2022. https://clinicaltrials.gov/ct2/show/NCT05336916 .
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Affiliation(s)
- Nasim Badaghi
- Department of Psychiatry, Radboud University Medical Center, 966, Postbus 9101, 6500 HB, Nijmegen, The Netherlands.
| | - Mette van Kruijsbergen
- grid.10417.330000 0004 0444 9382Department of Psychiatry, Radboud University Medical Center, 966, Postbus 9101, 6500 HB Nijmegen, The Netherlands
| | - Judith Prins
- grid.10417.330000 0004 0444 9382Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Saskia Kelders
- grid.6214.10000 0004 0399 8953Department of Psychology, Health, and Technology, University of Twente, Enschede, The Netherlands ,grid.25881.360000 0000 9769 2525Optentia Research Unit, North-West University, Potchefstroom, South Africa
| | - Linda Cillessen
- grid.10417.330000 0004 0444 9382Department of Psychiatry, Radboud University Medical Center, 966, Postbus 9101, 6500 HB Nijmegen, The Netherlands
| | - Félix Compen
- grid.10417.330000 0004 0444 9382Department of Psychiatry, Radboud University Medical Center, 966, Postbus 9101, 6500 HB Nijmegen, The Netherlands
| | - Rogier Donders
- grid.10417.330000 0004 0444 9382Radboud Institute for Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Linda Kwakkenbos
- grid.10417.330000 0004 0444 9382Department of Psychiatry, Radboud University Medical Center, 966, Postbus 9101, 6500 HB Nijmegen, The Netherlands ,grid.5590.90000000122931605Behavioural Science Institute, Clinical Psychology, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Anne Speckens
- grid.10417.330000 0004 0444 9382Department of Psychiatry, Radboud University Medical Center, 966, Postbus 9101, 6500 HB Nijmegen, The Netherlands
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Almeida S, Rodrigues da Silva D, Frasquilho D, Costa B, Sousa B, Mourinho Baptista T, Grácio J, Lemos R, Oliveira-Maia AJ. Cross-cultural adaptation and psychometric evaluation of the Portuguese version of the family resilience questionnaire - short form (FaRE-SF-P) in women with breast cancer. Front Psychol 2023; 13:1022399. [PMID: 36733863 PMCID: PMC9887115 DOI: 10.3389/fpsyg.2022.1022399] [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: 08/24/2022] [Accepted: 12/19/2022] [Indexed: 01/18/2023] Open
Abstract
Background A diagnosis of cancer, and the resulting treatment process, can be perceived as a life-threatening event, affecting not only patients but also their social network and, more specifically, their relatives. While the ability to cope and adjust to difficult health situations may be challenging, family resilience may optimize a positive adaptation to adversity and contribute to enhance the patient's quality of life. The Family Resilience Questionnaire (FaRE) is a self-report measure of family resilience that assesses this construct systematically. We aimed to validate the Portuguese version of a short form of the FaRE (FaRE-SF-P) in a sample of women with breast cancer. Methods 147 women recently diagnosed with early breast cancer were recruited at the Champalimaud Clinical Centre in Lisbon. Participants completed psychometric assessment including the Portuguese version of the FaRE-SF-P, composed by two subscales of the original version - the FaRE Perceived Family Coping (FaRE-PFC) and the FaRE Communication and Cohesion (FaRE-CC). Confirmatory factor analysis (CFA) was performed to assess the factor structure of the FaRE-SF-P. Construct validity was assessed using the Hospital Anxiety and Depression Scale (HADS) for divergent validity, and the Modified Medical Outcomes Study Social Support Survey (mMOS-SS) as well as the social functioning subscale from the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) for convergent validity. Results The CFA results confirmed a correlated two-factor structure model consistent with the Perceived Family Coping and the Communication and Cohesion subscales. Internal consistency reliability indicated good values both for Perceived Family Coping and Communication and Cohesion subscales. The results for construct validity showed acceptable convergent and divergent validity. Discussion The FaRE-SF-P showed good psychometric properties demonstrating to be a valid and reliable family resilience measure to use in Portuguese women diagnosed with breast cancer. Since FaRE-SF-P is a short instrument it may be a useful screening tool in an oncological clinical practice routine.
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Affiliation(s)
- Sílvia Almeida
- Champalimaud Research and Clinical Centre, Champalimaud Foundation, Lisbon, Portugal,Graduate Programme in Clinical and Health Psychology, Faculdade de Psicologia da Universidade de Lisboa, Lisbon, Portugal
| | | | - Diana Frasquilho
- Breast Unit, Champalimaud Clinical Centre, Champalimaud Foundation, Lisbon, Portugal
| | - Beatriz Costa
- Champalimaud Research and Clinical Centre, Champalimaud Foundation, Lisbon, Portugal
| | - Berta Sousa
- Breast Unit, Champalimaud Clinical Centre, Champalimaud Foundation, Lisbon, Portugal
| | | | - Jaime Grácio
- Champalimaud Research and Clinical Centre, Champalimaud Foundation, Lisbon, Portugal,NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Raquel Lemos
- Champalimaud Research and Clinical Centre, Champalimaud Foundation, Lisbon, Portugal,ISPA-Instituto Universitário de Ciências Psicológicas, Sociais e da Vida, Lisbon, Portugal
| | - Albino J. Oliveira-Maia
- Champalimaud Research and Clinical Centre, Champalimaud Foundation, Lisbon, Portugal,NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade NOVA de Lisboa, Lisbon, Portugal,*Correspondence: Albino J. Oliveira-Maia,
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Labouvie H, Dietz T, Schiewer V, Kusch M. Früherkennung seelischer Belastung in der onkologischen Versorgungspraxis. DIAGNOSTICA 2023. [DOI: 10.1026/0012-1924/a000311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Zusammenfassung. Die Distress-Skala (DS) bildet ein Single-Item-Instrument in Form einer zehnstufigen Likertskala in 2 Varianten zur Identifikation psychosozialer Belastungen zum Krankheitsbeginn (Screening-Variante) sowie im Krankheitsverlauf (Verlaufsvariante). Die DS wurde an einer Stichprobe onkologisch erkrankter Patientinnen und Patienten mit einer Größe von N = 661 nahe am Diagnosezeitpunkt validiert. Bei N = 92 der Stichprobe lagen insgesamt 3 Erhebungszeitpunkte vor, anhand dessen die Validierung der Verlaufsvariante erfolgte. Unter Verwendung des HADS-Gesamtsummenscore-Schwellenwerts > 14 als externes Kriterium wurde für die Screening-Variante der DS ein Schwellenwert > 7 mit einer Sensitivität von 81 % bzw. 78 % und einer Spezifität von 71 % bzw. 75 % ermittelt. Die Verlaufsvariante der DS erzielte bei einem Schwellenwert von > 5 eine Sensitivität zu T2 von 77 % und zu T3 von 70 % und eine Spezifität zu T2 von 67 % und zu T3 von 78 %. Die Ergebnisse weisen eine gute Diskriminierungsfähigkeit auf und empfehlen den Einsatz der DS zu Beginn der Krebserkrankung bzw. im Krankheitsverlauf.
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Affiliation(s)
- Hildegard Labouvie
- Psychoonkologische Versorgungsforschung, Klinik I für Innere Medizin, Uniklinik Köln, Deutschland
| | - Thilo Dietz
- Psychoonkologische Versorgungsforschung, Klinik I für Innere Medizin, Uniklinik Köln, Deutschland
| | - Vera Schiewer
- Psychoonkologische Versorgungsforschung, Klinik I für Innere Medizin, Uniklinik Köln, Deutschland
| | - Michael Kusch
- Psychoonkologische Versorgungsforschung, Klinik I für Innere Medizin, Uniklinik Köln, Deutschland
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Mavragani A, Kreca S, van Dieren S, van der Wal-Huisman H, Romijn JA, Chaboyer W, Nieveen van Dijkum EJM, Eskes AM. Activating Relatives to Get Involved in Care After Surgery: Protocol for a Prospective Cohort Study. JMIR Res Protoc 2023; 12:e38028. [PMID: 36440980 PMCID: PMC9862329 DOI: 10.2196/38028] [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: 03/16/2022] [Revised: 10/31/2022] [Accepted: 11/02/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Postoperative complications and readmissions to hospital are factors known to negatively influence the short- and long-term quality of life of patients with gastrointestinal cancer. Active family involvement in activities, such as fundamental care activities, has the potential to improve the quality of health care. However, there is a lack of evidence regarding the relationship between active family involvement and outcomes in patients with gastrointestinal cancer after surgery. OBJECTIVE This protocol aims to evaluate the effect of a family involvement program (FIP) on unplanned readmissions of adult patients undergoing surgery for malignant gastrointestinal tumors. Furthermore, the study aims to evaluate the effect of the FIP on family caregiver (FC) burden and their well-being and the fidelity of the FIP. METHODS This cohort study will be conducted in 2 academic hospitals in the Netherlands. The FIP will be offered to adult patients and their FCs. Patients are scheduled for oncological gastrointestinal surgery and have an expected hospital stay of at least 5 days after surgery. FCs must be willing to participate in fundamental care activities during hospitalization and after discharge. Consenting patients and their families will choose to either participate in the FIP or be included in the usual care group. According to the power calculation, we will recruit 150 patients and families in the FIP group and 150 in the usual care group. The intervention group will receive the FIP that consists of information, shared goal setting, task-oriented training, participation in fundamental care, presence of FCs during ward rounds, and rooming-in for at least 8 hours a day. Patients in the comparison group will receive usual postoperative care. The primary outcome measure is the number of unplanned readmissions up to 30 days after surgery. Several secondary outcomes will be collected, that is, total number of complications (sensitive to fundamental care activities) at 30 and 90 days after surgery, emergency department visits, intensive care unit admissions up to 30 and 90 days after surgery, hospital length of stay, patients' quality of life, and the amount of home care needed after discharge. FC outcomes are caregiver burden and well-being up to 90 days after participating in the FIP. To evaluate fidelity, we will check whether the FIP is executed as intended. Univariable regression and multivariable regression analyses will be conducted. RESULTS The first participant was enrolled in April 2019. The follow-up period of the last participant ended in May 2022. The study was funded by an unrestricted grant of the University hospital in 2018. We aim to publish the results in 2023. CONCLUSIONS This study will provide evidence on outcomes from a FIP and will provide health care professionals practical tools for family involvement in the oncological surgical care setting. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/38028.
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Affiliation(s)
| | - Sani Kreca
- Department of Surgery, Amsterdam UMC, Cancer Center Amsterdam, University of Amsterdam, Amsterdam, Netherlands
| | - Susan van Dieren
- Department of Surgery, Amsterdam UMC, Cancer Center Amsterdam, University of Amsterdam, Amsterdam, Netherlands
| | | | | | - Wendy Chaboyer
- Menzies Health Institute Queensland and School of Nursing and Midwifery, Griffith University, Gold Coast, Australia
| | - Els J M Nieveen van Dijkum
- Department of Surgery, Amsterdam UMC, Amsterdam Gastroenterology Endocrinology Metabolism and Cancer Center Amsterdam, University of Amsterdam,, Amsterdam, Netherlands
| | - Anne M Eskes
- Department of Surgery, Amsterdam UMC, Cancer Center Amsterdam, University of Amsterdam, Amsterdam, Netherlands.,Menzies Health Institute Queensland and School of Nursing and Midwifery, Griffith University, Gold Coast, Australia
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Roche KN, Cooper D, Armstrong TS, King AL. The link between psychological distress and survival in solid tumor patients: A systematic review. Cancer Med 2023; 12:3343-3364. [PMID: 36602400 PMCID: PMC9939126 DOI: 10.1002/cam4.5200] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 06/27/2022] [Accepted: 07/05/2022] [Indexed: 01/06/2023] Open
Abstract
PURPOSE Research has demonstrated that solid tumor patients experience high levels of psychological distress at the time of diagnosis. While distress has been associated with many adverse clinical outcomes, little is known about how this symptom may influence the disease trajectory for cancer patients, affecting outcomes such as progression, recurrence, and survival. The purpose of this systematic review was to explore the literature linking distress with survival in solid tumor patients, which may guide future work exploring clinical outcomes as a function of distress. METHODS A systematic search of PubMed, Embase, and Web of Science was performed using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines with predefined eligibility criteria. Thirteen studies met the inclusion criteria and were selected for review. RESULTS Findings from this review demonstrated a weak-to-moderate relationship between cancer patients' experience of distress and overall survival, with most included studies (11/13) finding at least one predictive analysis to be significant when controlling for confounders. However, significant heterogeneity in the literature, particularly with study sample characteristics and varying methodologies, made direct comparisons across studies challenging. CONCLUSION Findings from this review suggest that psychological distress may have an impact on disease-related outcomes, including (but not limited to) survival. Future work should consider performing disease-specific analyses controlling for key prognostic factors to better understand the nuanced relationship between distress and clinical outcomes, which may allow further understanding of the biological underpinnings of this relationship and enable the development of targeted interventions for improving distress.
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Affiliation(s)
- Kayla N. Roche
- Neuro‐Oncology BranchNational Cancer Institute, National Institutes of HealthBethesdaMarylandUSA
| | - Diane Cooper
- National Institutes of Health LibraryBethesdaMarylandUSA
| | - Terri S. Armstrong
- Neuro‐Oncology BranchNational Cancer Institute, National Institutes of HealthBethesdaMarylandUSA
| | - Amanda L. King
- Neuro‐Oncology BranchNational Cancer Institute, National Institutes of HealthBethesdaMarylandUSA
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van Diest SL, den Oudsten BL, Aaronson NK, Beaulen A, Verboon P, Aarnoudse B, van Lankveld JJDM. Emotionally focused couple therapy in cancer survivor couples with marital and sexual problems: a replicated single-case experimental design. Front Psychol 2023; 14:1123821. [PMID: 37205090 PMCID: PMC10187887 DOI: 10.3389/fpsyg.2023.1123821] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 04/03/2023] [Indexed: 05/21/2023] Open
Abstract
Objective The current research examined the effect of Emotionally Focused Couples Therapy (EFCT) on perceived intimacy, affect, and dyadic connection in cancer survivor couples with relationship challenges. Method In this longitudinal replicated single-case study, positive and negative affect, intimacy, partner responsiveness, and expression of attachment-based emotional needs were reported every 3 days before and during treatment. Thirteen couples, with one partner having survived colorectal cancer or breast cancer, participated for the full duration of the study. Statistical analysis of the data was performed using randomization tests, piecewise regression, and multilevel analyses. Results Adherence to the therapeutic protocol was tested and found adequate. Compared with baseline, significant positive effects on affect variables were found during the therapeutic process. Positive affect increased and negative affect decreased. Partner responsiveness, perceived intimacy, and the expression of attachment-based emotional needs improved, but only in the later phase of treatment. Results at the group level were statistically significant, whereas effects at the individual level were not. Discussion This study found positive group-level effects of EFCT on affect and dyadic outcome measures in cancer survivors. The positive results warrant further research, including randomized clinical trials, to replicate these effects of EFCT in cancer survivor couples experiencing marital and sexual problems.
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Affiliation(s)
- Selma L. van Diest
- Department of Clinical Psychology, Open University of the Netherlands, Heerlen, Netherlands
| | - Brenda L. den Oudsten
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, Netherlands
| | - Neil K. Aaronson
- Department of Psychosocial Research, University of Amsterdam, Amsterdam, Netherlands
| | - Audrey Beaulen
- Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
| | - Peter Verboon
- Department of Methodology and Statistics, Open University of the Netherlands, Heerlen, Netherlands
| | | | - Jacques J. D. M. van Lankveld
- Department of Clinical Psychology, Open University of the Netherlands, Heerlen, Netherlands
- *Correspondence: Jacques J. D. M. van Lankveld,
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Staub-Bartelt F, Steinmann J, Radtke O, Hänggi D, Sabel M, Rapp M. Impact of COVID-19 Epidemic on Psycho-Oncological Distress in Neuro-Oncological Patients. Curr Oncol 2022; 30:358-369. [PMID: 36661678 PMCID: PMC9857307 DOI: 10.3390/curroncol30010029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 12/14/2022] [Accepted: 12/23/2022] [Indexed: 12/28/2022] Open
Abstract
Up to 40% of neuro-oncological patients already deal with high levels of distress under conventional circumstances. Due to COVID-19, pandemic hospital visitor rules have been restricted and patients did not receive the same level of supporting caregiver network as before COVID. The aim of the present study was to analyse the impact of the COVID pandemic on the prevalence of distress, anxiety and depression in neuro-oncological patients. Patients admitted for brain tumour surgery were screened regarding distress, anxiety and depression. Furthermore, aspects of patients' quality of life and clinical data were covered. Retrospectively available data of patients treated pre-pandemic (group A) and throughout the COVID-19 pandemic (group B) were statistically analysed using Chi-square tests and independent-sample t-tests, and regression analysis was performed to support statistical findings. Data from 110 patients were available. In all, 48 patients were included pre-COVID-19 and 62 during the COVID-19 pandemic. The authors found no significant difference between pre-COVID-19 prevalence of distress (p = 0.112), anxiety (p = 0.385) or depression (p = 0.084). Regression analyses additionally did not show any significant influence of COVID-19 on the above analysed parameter. Analyses of our cohort's data could not underline the negative impact of COVID-19 restrictions, shortcuts of professional and remodelled caregiver support on psycho-oncological outcomes.
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Fatigue, Depression, and Anxiety in Patients with COPD, Asthma and Asthma-COPD Overlap. J Clin Med 2022; 11:jcm11247466. [PMID: 36556082 PMCID: PMC9785292 DOI: 10.3390/jcm11247466] [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: 10/23/2022] [Revised: 11/29/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Asthma and COPD are extremely common respiratory diseases that have a serious impact on people's lives around the world. A disease characterized by symptoms characteristic for asthma and COPD is called asthma-COPD overlap (ACO). Fatigue and certain psychological disorders such as anxiety and depression are important comorbidities in these diseases. The purpose of this study was to assess the prevalence of fatigue, anxiety, and depression in patients with asthma, COPD, and ACO and to also consider their mutual correlations. MATERIAL AND METHODS A total of 325 patients were enrolled in the study. There were 159 women and 166 men and their mean age was 63. Two standardized questionnaires were used: the Modified Fatigue Impact Scale (MFIS) and the Hospital Anxiety and Depression Scale (HADS). RESULTS The mean total MFIS score for all patients was 33.03. Patients with asthma generally scored lower than patients with COPD and ACO. There were no statistical differences in the HADS for anxiety between the groups, although around half of the patients registered a score indicating some level of disorder. Patients with COPD and ACO were proven to suffer more from depression than patients with asthma. The HADS and MFIS scores were found to correlate significantly and positively. CONCLUSIONS Our study showed that patients with COPD, asthma, and ACO generally suffered from an increased level of fatigue and depression. Anxiety was high in all groups, but it was at a similar level for patients suffering from each of the three diseases under consideration. It is important to treat the physical symptoms as well as the psychological disorders since they greatly impact on the patient outcomes.
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Jesse MT, Haver DB. Current recommendations regarding evaluation of cognitive functioning in organ transplant candidates. Curr Opin Organ Transplant 2022; 27:523-529. [PMID: 36094545 DOI: 10.1097/mot.0000000000001021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
PURPOSE OF REVIEW Cognitive impairment is associated with negative effects on solid organ transplant candidates, recipients, and their care partners. However, because of the heterogeneity of mechanisms, presentations, and assessment measures, research suggests a wide array of impairments, patterns of impairments, and unclear trajectories posttransplant. This review provides an abbreviated synthesis of recent research on cognitive impairments observed in organ-eligible candidates and potential trajectories through posttransplant, current clinical recommendations regarding integration of assessment into routine clinical transplant practice, as well as recommendations for future research. RECENT FINDINGS Transplantation may resolve certain disease-contributing factors to cognitive impairments but also introduces new potential neurocognitive assaults. Recent studies in kidney and lung recipients document continued impairments in subsets of patients, particularly those identified as frail. For liver candidates, new assessment measures of hepatic encephalopathy have been developed and preliminarily tested with potential for translation into routine clinical care. Clinical implications, as well as ethical considerations are discussed. SUMMARY Although guidelines agree that cognitive assessment is an important part of the organ transplantation process, many questions remain of how to best assess cognition and intervene when cognitive impairment is identified in transplant populations. Further research should focus on prospective, longitudinal assessments in transplant-eligible populations through posttransplant.
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Affiliation(s)
- Michelle T Jesse
- Transplant Institute
- Internal Medicine, Henry Ford Health, Detroit, Michigan
| | - D Brian Haver
- Bio-behavioral Medicine, Medical University of South Carolina, Charleston, South Carolina, USA
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Ghiggia A, Bottiroli S, Lingiardi V, Tassorelli C, Galli F, Castelli L. Alexithymia and psychological distress in fibromyalgia and chronic migraine: A cross-sectional study. J Psychosom Res 2022; 163:111048. [PMID: 36228434 DOI: 10.1016/j.jpsychores.2022.111048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 09/01/2022] [Accepted: 09/24/2022] [Indexed: 01/14/2023]
Abstract
OBJECTIVE Several studies have shown a strong association between alexithymia and psychological distress in both healthy and clinical populations. The aim of this study was to investigate the prevalence and association between alexithymia and psychological distress in individuals with fibromyalgia (FM) and chronic migraine (CM) compared with healthy controls (HC). METHODS A cross-sectional study was conducted. Two hundred fifty women with FM (age: 51.2 ± 10.5) and 250 women with CM (age: 46.1 ± 11.5) were assessed with the Toronto Alexithymia Scale (TAS-20) and the Hospital Anxiety and Depression Scale (HADS) and compared with HCs (n = 280; age: 51.8 ± 9.0) by one-way analyses of variance. A moderation analysis was performed to examine the moderation effect of groups on the relationship between alexithymia and psychological distress. RESULTS Differences between groups showed significantly higher scores for TAS-20 [F(2,755) = 11.7, p < .001] and HADS [F(2,763) = 31.7, p < .001] in FM, compared with CM and HCs. The moderation analysis showed that both clinical groups and TAS-20 (β = 0.20, p < .001) were significant predictors, as well as the interaction terms. The slope of the correlation curve was more pronounced in the patient groups, indicating that the degree of alexithymia had a significantly higher influence on the HADS total score in the patient groups. CONCLUSION The results suggest a common psychological dysregulation in FM and CM, with a slight but greater prevalence of alexithymia and psychological distress in FM. These data suggest that although there is a similar psychological substrate, it is expressed in a different expression of somatic symptoms.
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Affiliation(s)
- Ada Ghiggia
- Department of Life Sciences, University of Trieste, Trieste, Italy; Clinical Psychology Unit, AOU Città della Salute e della Scienza di Torino, Italy
| | - Sara Bottiroli
- Giustino Fortunato University, Benevento, Italy; Headache Science and Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy
| | - Vittorio Lingiardi
- Department of Dynamic and Clinical Psychology, and Health Studies, Faculty of Medicine and Psychology, Sapienza University of Rome, Italy
| | - Cristina Tassorelli
- Headache Science and Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Federica Galli
- Department of Dynamic and Clinical Psychology, and Health Studies, Faculty of Medicine and Psychology, Sapienza University of Rome, Italy.
| | - Lorys Castelli
- Department of Life Sciences, University of Trieste, Trieste, Italy
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Clover K, Lambert SD, Oldmeadow C, Britton B, Mitchell AJ, Carter G, King MT. Convergent and criterion validity of PROMIS anxiety measures relative to six legacy measures and a structured diagnostic interview for anxiety in cancer patients. J Patient Rep Outcomes 2022; 6:80. [PMID: 35857151 PMCID: PMC9300804 DOI: 10.1186/s41687-022-00477-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 06/05/2022] [Indexed: 12/03/2022] Open
Abstract
Background Detecting anxiety in oncology patients is important, requiring valid yet brief measures. One increasingly popular approach is the Patient Reported Outcomes Measurement Information System (PROMIS); however, its validity is not well established in oncology. We assessed the convergent and criterion validity of PROMIS anxiety measures in an oncology sample.
Methods 132 oncology/haematology outpatients completed the PROMIS Anxiety Computer Adaptive Test (PROMIS-A-CAT) and the 7 item (original) PROMIS Anxiety Short Form (PROMIS-A-SF) along with six well-established measures: Hospital Anxiety and Depression Scale-Anxiety (HADS-A); Generalised Anxiety Disorder-7 (GAD-7); Depression, Anxiety and Stress Scale-Anxiety (DASS-A) and Stress (DASS-S); Distress Thermometer (DT) and PSYCH-6. Correlations, area under the curve (AUC) and diagnostic accuracy statistics were calculated with Structured Clinical Interview as the reference standard.
Results Both PROMIS measures correlated with all legacy measures at p < .001 (Rho = .56–.83). AUCs (> .80) were good for both PROMIS measures and comparable to or better than all legacy measures. At the recommended mild cut-point (55), PROMIS-A-SF had sensitivity (.67) comparable to or better than all the legacy measures, whereas PROMIS-A-CAT sensitivity (.59) was lower than GAD-7 (.67) and HADS-A (.62), but comparable to PSYCH-6 and higher than DASS-A, DASS-S and DT. Sensitivity for both was .79. A reduced cut-point of 51 on both PROMIS measures improved sensitivity (.83–.84) although specificity was only adequate (.61–.62). Conclusions The convergent and criterion validity of the PROMIS anxiety measures in cancer populations was confirmed as equivalent, but not superior to, established measures (GAD-7 and HADS-A). The PROMIS-A-CAT did not demonstrate clear advantages over PROMIS-A-SF.
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Baralo B, Paravathaneni M, Jain A, Buragamadagu B, Khanam A, Iqbal S, Hossain S, Mulla S, Choi E, Thirumaran R. Video education about side effects of chemotherapy and immunotherapy and its impact on the anxiety, depression, and distress level of cancer patients. BMC Psychol 2022; 10:278. [PMID: 36434673 PMCID: PMC9700903 DOI: 10.1186/s40359-022-00994-3] [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: 11/25/2021] [Accepted: 11/21/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Patients diagnosed with cancer are at higher risk of anxiety, depression, and overall distress. These mood disturbances are risk factors for non-adherence to cancer treatment, increased length of stay during hospital admissions, increased number of visits to the emergency department, and also impact survival. Although paper handouts about the potential side effects are widely used in the oncology practice studies have shown that digital educational material is known to work better when compared to traditional methods. However, the impact of video education on anxiety, depression, and distress have not been previously evaluated. Our study aimed to assess whether video education about potential chemotherapy and immunotherapy can reduce anxiety, depression, and distress levels. METHODS After IRB approval, we enrolled patients who were fluent in English, younger than 80 years of age, and who were able to provide informed consent. The Hospital Anxiety and Depression Scale and Distress Thermometer were used to assess distress, as well as depression and anxiety before and after watching video educational material. Paired t-test was used to compare the differences between the scores before and after watching educational videos. The statistical software GraphPad Prism 9, San Diego, California, was used to perform the statistical analysis. RESULTS We enrolled 29 patients, of whom 20 completed the study, six withdrew, two were lost to follow-up, and one did not complete the initial questionnaire. Of all patients that completed the study 85% of the patient found videos helpful, and they were 7/10 likely to recommend them to other patients who may experience symptoms. The mean depression score changed from 4.75 before to 4.9 after watching the videos (p 0.77), distress score from 2.3 to 2.65 (p 0.52), and anxiety scores changed from 4.85 to 6.15 (p 0.03). The feedback provided by the patients indicated that they were more willing to watch the videos related to the side effects they experienced at their free time and convenience. CONCLUSIONS Our study suggests that patients were open to video education and found it helpful and worth watching. However, the exposure of the patients to the videos about potential side effects of cancer treatment, including those patients do not experience, may lead to increased anxiety.
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Affiliation(s)
- Bohdan Baralo
- grid.492469.40000 0004 0440 1055Internal Medicine, Mercy Fitzgerald Hospital, Darby, PA 19023 USA
| | - Mahati Paravathaneni
- grid.492469.40000 0004 0440 1055Internal Medicine, Mercy Fitzgerald Hospital, Darby, PA 19023 USA
| | - Akhil Jain
- grid.492469.40000 0004 0440 1055Internal Medicine, Mercy Fitzgerald Hospital, Darby, PA 19023 USA
| | - Bhanusowmya Buragamadagu
- grid.492469.40000 0004 0440 1055Internal Medicine, Mercy Fitzgerald Hospital, Darby, PA 19023 USA
| | - Aliza Khanam
- grid.492469.40000 0004 0440 1055Internal Medicine, Mercy Fitzgerald Hospital, Darby, PA 19023 USA
| | - Sabah Iqbal
- grid.492469.40000 0004 0440 1055Internal Medicine, Mercy Fitzgerald Hospital, Darby, PA 19023 USA
| | - Samia Hossain
- grid.492469.40000 0004 0440 1055Internal Medicine, Mercy Fitzgerald Hospital, Darby, PA 19023 USA
| | - Sana Mulla
- grid.492469.40000 0004 0440 1055Internal Medicine, Mercy Fitzgerald Hospital, Darby, PA 19023 USA
| | - Eugene Choi
- grid.492469.40000 0004 0440 1055Medical Oncology, Mercy Fitzgerald Hospital, Darby, PA USA
| | - Rajesh Thirumaran
- grid.492469.40000 0004 0440 1055Medical Oncology, Mercy Fitzgerald Hospital, Darby, PA USA
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Russell K, Moghaddam N, Tickle A. Examining anxiety and depression in haematology cancer patients in ongoing treatment and under watchful waiting: A systematic review and meta-analysis. Eur J Cancer Care (Engl) 2022; 31:e13678. [PMID: 35977801 PMCID: PMC9787612 DOI: 10.1111/ecc.13678] [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] [Received: 12/17/2021] [Revised: 06/21/2022] [Accepted: 08/02/2022] [Indexed: 12/30/2022]
Abstract
INTRODUCTION The present review aimed to establish prevalence rates of anxiety and depression in adults with haematology cancer, with a focus on the differences between patients under treatment and patients under watchful waiting. METHOD Five databases (Scopus, Medline, PsycINFO, EThOS, CINAHL) were searched throughout June 2021. Key search terms included haematology cancer, anxiety, depression, in treatment and watchful waiting. Study and sample characteristics, prevalence rates and mean self-reported scores of anxiety and depression data were extracted. RESULTS A total of 18 eligible papers were included in the review. Quality appraisal indicated papers were of adequate standard. Depression data from 2720 participants (14.5% under watchful waiting) and anxiety data from 2520 participants (15.9% under watchful waiting) were analysed through subgroup meta-analyses. The prevalence of anxiety was 34% amongst adults receiving treatment and 24.5% amongst those under watchful waiting. The prevalence of depression amongst adults receiving treatment was 31.3%, significantly higher than 16.1% of adults under watchful waiting. CONCLUSION Overall, adults with haematology cancer were at greater risk of experiencing anxiety and depression than the general population, with greatest risk in those under treatment. The findings indicate the need for future research to examine availability and effectiveness of targeted psychological interventions.
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Affiliation(s)
- Katie Russell
- Division of Psychiatry and Applied Psychology, School of MedicineUniversity of NottinghamNottinghamUK
| | - Nima Moghaddam
- Division of Psychiatry and Applied Psychology, School of MedicineUniversity of LincolnLincolnUK
| | - Anna Tickle
- Division of Psychiatry and Applied Psychology, School of MedicineUniversity of NottinghamNottinghamUK
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Peres DS, Rodrigues P, Viero FT, Frare JM, Kudsi SQ, Meira GM, Trevisan G. Prevalence of depression and anxiety in the different clinical forms of multiple sclerosis and associations with disability: A systematic review and meta-analysis. Brain Behav Immun Health 2022; 24:100484. [PMID: 35856061 PMCID: PMC9287158 DOI: 10.1016/j.bbih.2022.100484] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 05/26/2022] [Accepted: 06/28/2022] [Indexed: 10/31/2022] Open
Abstract
Multiple sclerosis (MS) is a chronic neurodegenerative and autoimmune disease. Motor, sensory and cognitive deficits in MS are commonly accompanied by psychiatric disorders. Depression and anxiety affect the quality of life of MS patients, and the treatment is still not well-established. Prevalence rates in MS patients for depression and anxiety vary widely between studies. However, the prevalence of these psychiatric disorders in the subgroups of MS patients and their association with a disability has not been studied yet. Therefore, this systematic review and meta-analysis proposes to estimate the prevalence of depression and anxiety in MS and to perform subgroup analyses (study type, Extended Disability Status Scale/EDSS, duration of MS, region, type of MS) on observational studies. The protocol was registered in PROSPERO (4202125033). A computerized search on PubMed, EMBASE and Scopus for studies on depression and anxiety in MS was performed from 2015 to 2021, and 12 articles were included. Most of the studies in the meta-analysis had a low risk of bias. The prevalence of depression was 27.01% (MS), 15.78% (relapsing-remitting multiple sclerosis/RRMS), and 19.13% (progressive multiple sclerosis/PMS). For anxiety the prevalence was 35.19% (MS), 21.40% (RRMS), and 24.07% (PMS). The prevalence of depression/anxiety for patients with EDSS <3 was 26.69/45.56% and for EDSS >3 was 22.96/26.70%. Using HADS-A (8) the prevalence was 38.5% and for depression was 22.4%. Then, our study brought together current data regarding psychiatric disorders in MS patients, which are comorbidities that affect the quality of life of these patients. Prevalence of depression/anxiety for the MS patients was 27.01%/35.19%. Prevalence of depression was 15.78% (RRMS) and 19.13% (PMS). Prevalence of anxiety was 21.40% (RRMS) and 24.07% (PMS). Prevalence of depression/anxiety for the patients with EDSS <3 was 26.69/45.56% and for EDSS >3 was 22.96/26.70%. Prevalence of anxiety using HADS-A (8) was 38.5% and for depression was 22.4%.
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Özcan F, Gürçay E, Kalem Özgen AN, Demir Y. Outcomes and predictors of stress among Turkish family caregivers of patients with acquired brain injury. APPLIED NEUROPSYCHOLOGY. ADULT 2022:1-9. [PMID: 36075221 DOI: 10.1080/23279095.2022.2115909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE This study examined family caregiver stress and factors predicting the stress among caregivers of patients with acquired brain injury (ABI). METHODS Sixty caregivers of patients with ABI took part in this study. All participants completed assessments of Caregiver Strain Index, Pittsburgh Sleep Quality Index, Hospital Anxiety and Depression Scale, Nottingham Health Profile (NHP), and Satisfaction with Life Scale (SWLS). The patients with ABI were also assessed on the Functional Independence Measure, Disability Rating Scale, Rancho Los Amigos Cognitive Scale-revised, Functional Ambulation Classification Scale, and Neurobehavioral Rating Scale-revised. Relationship between caregiver's stress and clinical outcomes was analyzed, together with factors significantly associated with stress. RESULTS Elevated levels of stress were determined in 40% of caregivers. Higher stress was seen in caregivers of patients with shorter disease duration, worse functioning, who had more depression and anxiety, poorer perceived health status particularly for pain and emotional reaction domains, and less life satisfaction. Linear regression analysis demonstrated that caregiver's stress was predicted by NHP pain domain (β = 0.062, p = 0.016) and SWLS (β = -0.133, p = 0.040). CONCLUSION Caregivers with more pain and less life satisfaction are at higher risk of developing stress. In order to overcome this difficult process and improve the quality of care, it would be appropriate to reveal predictors of stress and produce appropriate interventions/approaches.
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Affiliation(s)
- Fatma Özcan
- Gaziler Physical and Rehabilitation Medicine Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Eda Gürçay
- Gaziler Physical and Rehabilitation Medicine Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Ayşe Naz Kalem Özgen
- Gaziler Physical and Rehabilitation Medicine Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Yasin Demir
- Gaziler Physical and Rehabilitation Medicine Training and Research Hospital, University of Health Sciences, Ankara, Turkey
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Jittla P, Graham DM, Zhou C, Halliwell J, O'Reilly S, Aruketty S, Azizi A, Germetaki T, Lowe J, Little M, Punnett G, McMahon P, Benson L, Carter L, Krebs MG, Thistlethwaite FC, Darlington E, Yorke J, Cook N. EPIC: an evaluation of the psychological impact of early-phase clinical trials in cancer patients. ESMO Open 2022; 7:100550. [PMID: 35994790 PMCID: PMC9420347 DOI: 10.1016/j.esmoop.2022.100550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 06/17/2022] [Accepted: 06/27/2022] [Indexed: 11/30/2022] Open
Abstract
Background Anxiety and depression in patients with cancer is associated with decreased quality of life and increased morbidity and mortality. However, these are often overlooked and untreated. Early-phase clinical trials (EPCTs) recruit patients with advanced cancers who frequently lack future treatment options, which may lead to increased anxiety and depression. Despite this, EPCTs do not routinely consider psychological screening for patients. Patients and methods This prospective observational study explored levels of anxiety and depression alongside impact of trial participation in the context of EPCTs. The Hospital Anxiety and Depression Scale and the Brief Illness Perceptions Questionnaire were completed at the point of EPCT consent, the end of screening and at pre-specified time points thereafter. Results Sixty-four patients (median age 56 years; median Eastern Cooperative Oncology Group performance status 1) were recruited. At consent, 57 patients returned questionnaires; 39% reported clinically relevant levels of anxiety whilst 18% reported clinically relevant levels of depression. Sixty-three percent of patients experiencing psychological distress had never previously reported this. Males were more likely to be depressed (P = 0.037) and females were more likely to be anxious (P = 0.011). Changes in anxiety or depression were observed after trial enrolment on an individual level, but not significant on a population level. Conclusions Patients on EPCTs are at an increased risk of anxiety and depression but may not seek relevant support. Sites offering EPCTs should consider including psychological screening to encourage a more holistic approach to cancer care and consider the sex of individuals when tailoring psychological support to meet specific needs. Early-phase cancer trial patients have an increased risk of anxiety and depression. Patients at risk were not seeking support for anxiety and depression. Male patients were more likely to be depressed; female patients were more likely to be anxious. This work highlights the need to screen for psychological symptoms in patients entering early-phase trials.
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Affiliation(s)
- P Jittla
- Experimental Cancer Medicine Team, The Christie NHS Foundation Trust, Manchester, UK
| | - D M Graham
- Experimental Cancer Medicine Team, The Christie NHS Foundation Trust, Manchester, UK; Division of Cancer Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - C Zhou
- CRUK Manchester Institute Cancer Biomarker Centre, University of Manchester, Manchester, UK
| | - J Halliwell
- Experimental Cancer Medicine Team, The Christie NHS Foundation Trust, Manchester, UK
| | - S O'Reilly
- Experimental Cancer Medicine Team, The Christie NHS Foundation Trust, Manchester, UK
| | - S Aruketty
- Experimental Cancer Medicine Team, The Christie NHS Foundation Trust, Manchester, UK
| | - A Azizi
- Experimental Cancer Medicine Team, The Christie NHS Foundation Trust, Manchester, UK
| | - T Germetaki
- Experimental Cancer Medicine Team, The Christie NHS Foundation Trust, Manchester, UK
| | - J Lowe
- Experimental Cancer Medicine Team, The Christie NHS Foundation Trust, Manchester, UK
| | - M Little
- Experimental Cancer Medicine Team, The Christie NHS Foundation Trust, Manchester, UK
| | - G Punnett
- Christie Patient Centred Research, The Christie NHS Foundation Trust, Manchester, UK
| | - P McMahon
- Medical Oncology, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK
| | - L Benson
- Division of Cancer Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - L Carter
- Experimental Cancer Medicine Team, The Christie NHS Foundation Trust, Manchester, UK; Division of Cancer Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - M G Krebs
- Experimental Cancer Medicine Team, The Christie NHS Foundation Trust, Manchester, UK; Division of Cancer Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - F C Thistlethwaite
- Experimental Cancer Medicine Team, The Christie NHS Foundation Trust, Manchester, UK; Division of Cancer Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - E Darlington
- Experimental Cancer Medicine Team, The Christie NHS Foundation Trust, Manchester, UK
| | - J Yorke
- Christie Patient Centred Research, The Christie NHS Foundation Trust, Manchester, UK
| | - N Cook
- Experimental Cancer Medicine Team, The Christie NHS Foundation Trust, Manchester, UK; Division of Cancer Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK.
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Vitou V, Gély-Nargeot MC, Jeandel C, Bayard S. The influence of Alzheimer's disease stigma on pain assessment in older persons. DEMENTIA 2022; 21:2418-2441. [PMID: 35976758 DOI: 10.1177/14713012221117907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Pain of nursing homes residents with Alzheimer's disease remains under detected compared to their cognitively intact counterparts. Communication difficulties may partly explain this poor quality of care but the influence of stigmatization on pain assessment has never been explored. RESEARCH QUESTION The objective of this research was to analyze whether a diagnosis label of Alzheimer's disease or the stage of the disease may bias pain assessment scores and empathic reactions of health care staff in nursing homes. METHODS Two studies were conducted based on a similar experimental between-subjects design with a video showing an older adult woman experiencing undefined pain. Different labels and vignettes were manipulated to characterize the subject of the video. In the first study, 84 certified nursing assistants were asked to watch the video and then to assess the pain intensity and their empathic reaction. Participants were randomized in two conditions that varied the disease label (Alzheimer's disease vs no diagnosis). In the second study, 67 certified nursing assistants were enrolled who did not participate in the first study. They watched the same video as in the first study and assessed the pain intensity and their empathic reaction. They were randomized in two conditions that varied the stage of the Alzheimer's disease (mild stage vs severe stage). RESULTS Alzheimer's disease label had no influence on assessment scores. In contrast, the stage of the disease had a significant effect on the health care staff assessments with severe stage associated with lower pain intensity scores and empathic reactions. CONCLUSION These results confirm that the Alzheimer's disease stigma is a real phenomenon that tends to be mainly elicited by the symptoms of the acute phase of the disease. These findings are crucial to better understand the stigma related to Alzheimer's disease and to enhance the pain management of this frail population.
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Affiliation(s)
- Valérie Vitou
- 27038EPSYLON, EA4556, Univ Paul Valéry Montpellier 3, F34000, Montpellier, France.,Fondation Partage et Vie, Montrouge, France
| | | | - Claude Jeandel
- Fondation Partage et Vie, Montrouge, France.,Département de Gériatrie, Université De Montpellier, 26905CHU de Montpellier, Montpellier, France
| | - Sophie Bayard
- 27038EPSYLON, EA4556, Univ Paul Valéry Montpellier 3, F34000, Montpellier, France
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Anxiety and Depression in Patients with Prostate Cancer, at Cancer Diagnosis and after a One-Year Follow-Up. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159122. [PMID: 35897487 PMCID: PMC9368515 DOI: 10.3390/ijerph19159122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 07/14/2022] [Accepted: 07/20/2022] [Indexed: 02/04/2023]
Abstract
Prostate cancer (PCa) is the most prevalent among men, and psychological symptoms may affect many patients. This study aims to describe the prevalence of probable anxiety and depression before PCa treatments and after one year and to identify sociodemographic and clinical factors associated with these outcomes. Between February 2018 and March 2020, 292 patients recently diagnosed with PCa were recruited at the Instituto Português de Oncologia—Porto. The Hospital Anxiety and Depression Scale (HADS) was used to define probable anxiety and depression (cutoff = 11). The prevalence of probable anxiety remained stable from baseline to one year (7.8% vs. 8.5%, p = 0.866) while there was an increase in probable depression (3.1% vs. 6.8%, p = 0.012). After one year, probable depression persisted in 55.6% of patients with probable depression at baseline and 47.8% of those with probable anxiety at the first assessment had normal anxiety scores. At baseline, anxiety was more frequent among dwellers in rural areas (adjusted odds ratio—aOR, 95%CI: 2.80, 0.91–8.58) and less frequent in patients with body mass index 25–29.9 kg/m2 (aOR, 95%CI: 0.33, 0.12–0.91) compared to 18.5–24.9 Kg/m2, while those living alone had higher odds of depression (aOR, 95%CI: 6.35, 1.43–28.30). The frequency of anxiety and depression fluctuated during the course of treatment. Monitoring these symptoms would identify the most affected patients, contributing for a better use of mental health services.
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Mazur M, Chorbińska J, Nowak Ł, Halska U, Bańkowska K, Sójka A, Małkiewicz B, Zdrojowy R, Pałęga A, Szydełko T, Krajewski W. Methods of coping with neoplastic disease in men with non‐muscle‐invasive bladder cancer. INTERNATIONAL JOURNAL OF UROLOGICAL NURSING 2022. [DOI: 10.1111/ijun.12329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Małgorzata Mazur
- University Center of Excellence in Urology Wroclaw Medical University Wrocław Poland
| | - Joanna Chorbińska
- Department of Minimally Invasive and Robotic Urology Wroclaw Medical University Wrocław Poland
| | - Łukasz Nowak
- Department of Minimally Invasive and Robotic Urology Wroclaw Medical University Wrocław Poland
| | - Urszula Halska
- Department of Physiotherapy Opole Medical School Opole Poland
| | - Kinga Bańkowska
- Department of Minimally Invasive and Robotic Urology Wroclaw Medical University Wrocław Poland
| | - Aleksandra Sójka
- Department of Minimally Invasive and Robotic Urology Wroclaw Medical University Wrocław Poland
| | - Bartosz Małkiewicz
- Department of Minimally Invasive and Robotic Urology Wroclaw Medical University Wrocław Poland
| | | | - Anna Pałęga
- Department of Psychiatry Wroclaw Medical University Wrocław Poland
| | - Tomasz Szydełko
- University Center of Excellence in Urology Wroclaw Medical University Wrocław Poland
| | - Wojciech Krajewski
- Department of Minimally Invasive and Robotic Urology Wroclaw Medical University Wrocław Poland
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Popiołek A, Brzoszczyk B, Jarzemski P, Piskunowicz M, Jarzemski M, Borkowska A, Bieliński M. Quality of Life of Prostate Cancer Patients Undergoing Prostatectomy and Affective Temperament. Cancer Manag Res 2022; 14:1743-1755. [PMID: 35620062 PMCID: PMC9129097 DOI: 10.2147/cmar.s358054] [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: 01/12/2022] [Accepted: 03/23/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Prostate cancer (PC) is one of the most common malignancies in men. The population of PC survivors is growing, and understanding the roles of different factors that affect quality of life (QoL) is important. We investigated the effects of affective temperament on the QoL of PC patients. Patients and Methods All subjects (n=100) underwent medical evaluation [including demographic data, medical history, physical examination, biochemical tests, and assessment of urinary incontinence (ICIQ-UI SF scale) and erectile dysfunction (ED) (IIEF-5 and subjective ED scale)] and psychological evaluation [including assessment of affective temperament using the TEMPS-A scale, depression and anxiety (using HADS), and QoL (EORTC-QLQ-C30 and EORTC-PR25)]. The relationships between individual variables were examined. Results Erection quality after treatment was associated with better QoL in most parameters. Similar strong relationships were observed between the urinary incontinence scale and QoL. Depressive, cyclothymic, irritable, and anxious temperaments were associated with decreased QoL. On the EORTC-PR25 scale, associations were observed between a depressive temperament and worse sexual function and urinary symptoms, between a cyclothymic temperament and worse urinary symptoms, and between an irritable temperament and worse sexual functioning. Multivariate analysis identified the severity of anxiety and depression symptoms measured by HADS as the most important psychological factors affecting QoL. Conclusion QoL in PC survivors depends on many factors, including age, interval since diagnosis, tumor stage, treatment, complications, and affective temperament profile. Depressive, cyclothymic, irritable, and anxious temperaments were associated with poorer QoL in selected domains, which was not observed for a hyperthymic temperament. The temperament profile of patients was associated with mood and anxiety level, which were important determinants of a poorer QoL.
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Affiliation(s)
- Alicja Popiołek
- Department of Clinical Neuropsychology, Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland
- Department of Internal Diseases, Jan Biziel University Hospital No.2 in Bydgoszcz, Bydgoszcz, Poland
| | - Bartosz Brzoszczyk
- Clinic of Urology, Jan Biziel University Hospital No. 2 in Bydgoszcz, Bydgoszcz, Poland
| | - Piotr Jarzemski
- Clinic of Urology, Jan Biziel University Hospital No. 2 in Bydgoszcz, Bydgoszcz, Poland
| | - Małgorzata Piskunowicz
- Department of Clinical Neuropsychology, Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland
| | - Marcin Jarzemski
- Clinic of Urology, Jan Biziel University Hospital No. 2 in Bydgoszcz, Bydgoszcz, Poland
| | - Alina Borkowska
- Department of Clinical Neuropsychology, Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland
| | - Maciej Bieliński
- Department of Clinical Neuropsychology, Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland
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Johnston EA, Ekberg S, Jennings B, Jagasia N, van der Pols JC, Webb PM. Dietary practices after primary treatment for ovarian cancer: A qualitative analysis from the OPAL Study. J Acad Nutr Diet 2022; 122:1607-1628.e12. [PMID: 35595188 DOI: 10.1016/j.jand.2022.05.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 04/22/2022] [Accepted: 05/12/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Little is known about dietary practices of women who have completed primary treatment for ovarian cancer, many of whom will go on to experience cancer recurrence and have further treatment. Knowledge of dietary practices is needed to optimize care. OBJECTIVE To identify dietary practices after primary treatment for ovarian cancer and evaluate how these practices differ by disease recurrence and treatment status. DESIGN Women with invasive epithelial ovarian cancer were provided with an open-ended question after completing a food frequency questionnaire (FFQ): "Is there anything we haven't asked you about your diet in the last 1-2 months that you feel is important?" PARTICIPANTS/SETTING Participants in the Ovarian cancer Prognosis And Lifestyle (OPAL) Study in Australia. MAIN OUTCOMES Dietary practices after primary treatment for ovarian cancer and factors affecting these practices. ANALYSIS Participants' responses were analyzed using content analysis. Individual content codes were categorized and reported by recurrence and treatment status at questionnaire completion. RESULTS 286 women provided responses on 363 questionnaires. Those undergoing further treatment for recurrence commonly reported dietary regimens with clinical indications (e.g., low fiber to avoid bowel obstructions, high energy/protein to minimize nutritional deficits). Those not undergoing further treatment frequently reported 'popular' diets (e.g., organic, plant-based, alkaline). For women with cancer recurrence, dietary practices were affected by poor appetite and treatment late effects. For women without recurrence, other comorbidities, geographical location, family and friends appeared to influence dietary practices. In both groups, nutrition information sources and personal beliefs informed dietary practices. Participant responses that referenced media or online sources often included misinformation. CONCLUSIONS Following primary treatment for ovarian cancer, women report dietary practices that may not be captured in standard FFQs. Dietary practices and factors affecting these practices likely differ by treatment and recurrence status. Improved access to evidence-based dietary information and support is needed.
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Affiliation(s)
- Elizabeth A Johnston
- PhD Candidate, Queensland University of Technology, School of Exercise and Nutrition Sciences, Brisbane, Queensland, Australia; Visiting PhD Student, QIMR Berghofer Medical Research Institute, Population Health Department, Brisbane, Queensland, Australia; Early Career Research Fellow, Viertel Cancer Research Centre, Cancer Council Queensland, Fortitude Valley, Queensland, Australia
| | - Stuart Ekberg
- Queensland University of Technology, School of Psychology and Counselling, Brisbane, Queensland, Australia
| | - Bronwyn Jennings
- Gynecology Oncology Clinical Nurse Consultant, Mater Hospital Brisbane, Department of Gynaeoncology, Brisbane, Queensland, Australia
| | - Nisha Jagasia
- Gynecological Oncologist, Mater Hospital Brisbane, Department of Gynaeoncology, Brisbane, Queensland, Australia
| | - Jolieke C van der Pols
- Queensland University of Technology, School of Exercise and Nutrition Sciences, Brisbane, Queensland, Australia; Visiting Scientist, QIMR Berghofer Medical Research Institute, Population Health Department, Brisbane, Queensland, Australia
| | - Penelope M Webb
- QIMR Berghofer Medical Research Institute, Population Health Department, Brisbane, Queensland, Australia;; Adjunct Professor, Queensland University of Technology, School of Public Health and Social Work, Brisbane, Queensland, Australia
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Kusch M, Labouvie H, Schiewer V, Talalaev N, Cwik JC, Bussmann S, Vaganian L, Gerlach AL, Dresen A, Cecon N, Salm S, Krieger T, Pfaff H, Lemmen C, Derendorf L, Stock S, Samel C, Hagemeier A, Hellmich M, Leicher B, Hültenschmidt G, Swoboda J, Haas P, Arning A, Göttel A, Schwickerath K, Graeven U, Houwaart S, Kerek-Bodden H, Krebs S, Muth C, Hecker C, Reiser M, Mauch C, Benner J, Schmidt G, Karlowsky C, Vimalanandan G, Matyschik L, Galonska L, Francke A, Osborne K, Nestle U, Bäumer M, Schmitz K, Wolf J, Hallek M. Integrated, cross-sectoral psycho-oncology (isPO): a new form of care for newly diagnosed cancer patients in Germany. BMC Health Serv Res 2022; 22:543. [PMID: 35459202 PMCID: PMC9034572 DOI: 10.1186/s12913-022-07782-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 03/15/2022] [Indexed: 11/15/2022] Open
Abstract
Background The annual incidence of new cancer cases has been increasing worldwide for many years, and is likely to continue to rise. In Germany, the number of new cancer cases is expected to increase by 20% until 2030. Half of all cancer patients experience significant emotional and psychosocial distress along the continuum of their disease, treatment, and aftercare, and also as long-term survivors. Consequently, in many countries, psycho-oncological programs have been developed to address this added burden at both the individual and population level. These programs promote the active engagement of patients in their cancer therapy, aftercare and survivorship planning and aim to improve the patients' quality of life. In Germany, the “new form of care isPO” (“nFC-isPO”; integrated, cross-sectoral psycho-oncology/integrierte, sektorenübergreifende Psycho-Onkologie) is currently being developed, implemented and evaluated. This approach strives to accomplish the goals devised in the National Cancer Plan by providing psycho-oncological care to all cancer patients according to their individual healthcare needs. The term “new form of care" is defined by the Innovation Fund (IF) of Germany's Federal Joint Committee as “a structured and legally binding cooperation between different professional groups and/or institutions in medical and non-medical care”. The nFC-isPO is part of the isPO project funded by the IF. It is implemented in four local cancer centres and is currently undergoing a continuous quality improvement process. As part of the isPO project the nFC-isPO is being evaluated by an independent institution: the Institute for Medical Sociology, Health Services Research, and Rehabilitation Science (IMVR), University of Cologne, Germany. The four-year isPO project was selected by the IF to be eligible for funding because it meets the requirements of the federal government's National Cancer Plan (NCP), in particular, the “further development of the oncological care structures and quality assurance" in the psycho-oncological domain. An independent evaluation is required by the IF to verify if the new form of care leads to an improvement in cross-sectoral care and to explore its potential for permanent integration into the German health care system. Methods The nFC-isPO consists of six components: a concept of care (C1), care pathways (C2), a psycho-oncological care network (C3), a care process organization plan (C4), an IT-supported documentation and assistance system (C5) and a quality management system (C6). The two components concept of care (C1) and care pathways (C2) represent the isPO clinical care program, according to which the individual cancer patients are offered psycho-oncological services within a period of 12 months after program enrolment following the diagnosis of cancer. The remaining components (C3-C6) represent the formal-administrative aspects of the nFC-isPO that are intended to meet the legally binding requirements of patient care in the German health care system. With the aim of systematic development of the nFC-isPO while at the same time enabling the external evaluators to examine its quality, effectiveness and efficiency under conditions of routine care, the project partners took into consideration approaches from translational psycho-oncology, practice-based health care research and program theory. In order to develop a structured, population-based isPO care program, reference was made to a specific program theory, to the stepped-care approach, and also to evidence-based guideline recommendations. Results The basic version, nFC-isPO, was created over the first year after the start of the isPO project in October 2017, and has since been subject to a continuous quality improvement process. In 2019, the nFC-isPO was implemented at four local psycho-oncological care networks in the federal state North Rhine-Westphalia, in Germany. The legal basis of the implementation is a contract for "special care" with the German statutory health insurance funds according to state law (§ 140a SCB V; Social Code Book V for the statutory health insurance funds). Besides the accompanying external evaluation by the IMVR, the nFC-isPO is subjected to quarterly internal and cross-network quality assurance and improvement measures (internal evaluation) in order to ensure continuous quality improvement process. These quality management measures are developed and tested in the isPO project and are to be retained in order to ensure the sustainability of the quality of nFC-isPO for later dissemination into the German health care system. Discussion Demands on quality, effectiveness and cost-effectiveness of in the German health care system are increasing, whereas financial resources are declining, especially for psychosocial services. At the same time, knowledge about evidence-based screening, assessment and intervention in cancer patients and about the provision of psychosocial oncological services is growing continuously. Due to the legal framework of the statutory health insurance in Germany, it has taken years to put sound psycho-oncological findings from research into practice. Ensuring the adequate and sustainable financing of a needs-oriented, psycho-oncological care approach for all newly diagnosed cancer patients, as required by the NCP, may still require many additional years. The aim of the isPO project is to develop a new form of psycho-oncological care for the individual and the population suffering from cancer, and to provide those responsible for German health policy with a sound basis for decision-making on the timely dissemination of psycho-oncological services in the German health care system. Trial registration The study was pre-registered at the German Clinical Trials Register (https://www.drks.de/DRKS00015326) under the following trial registration number: DRKS00015326; Date of registration: October 30, 2018.
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Affiliation(s)
- Michael Kusch
- Department of Internal Medicine I, Faculty of Medicine, Cologne University Hospital, University of Cologne, Cologne, Germany.
| | - Hildegard Labouvie
- Department of Internal Medicine I, Faculty of Medicine, Cologne University Hospital, University of Cologne, Cologne, Germany
| | - Vera Schiewer
- Department of Internal Medicine I, Faculty of Medicine, Cologne University Hospital, University of Cologne, Cologne, Germany
| | - Natalie Talalaev
- Department of Internal Medicine I, Faculty of Medicine, Cologne University Hospital, University of Cologne, Cologne, Germany
| | - Jan C Cwik
- Department of Clinical Psychology and Psychotherapy, Faculty of Human Sciences, University of Cologne, Cologne, Germany
| | - Sonja Bussmann
- Department of Clinical Psychology and Psychotherapy, Faculty of Human Sciences, University of Cologne, Cologne, Germany
| | - Lusine Vaganian
- Department of Clinical Psychology and Psychotherapy, Faculty of Human Sciences, University of Cologne, Cologne, Germany
| | - Alexander L Gerlach
- Department of Clinical Psychology and Psychotherapy, Faculty of Human Sciences, University of Cologne, Cologne, Germany
| | - Antje Dresen
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Institute of Medical Sociology Health Services Research, and Rehabilitation Science, Cologne, Germany
| | - Natalia Cecon
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Institute of Medical Sociology Health Services Research, and Rehabilitation Science, Cologne, Germany
| | - Sandra Salm
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Institute of Medical Sociology Health Services Research, and Rehabilitation Science, Cologne, Germany
| | - Theresia Krieger
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Institute of Medical Sociology Health Services Research, and Rehabilitation Science, Cologne, Germany
| | - Holger Pfaff
- University of Cologne, Faculty of Human Sciences & Faculty of Medicine and University Hospital Cologne, Institute of Medical Sociology Health Services Research, and Rehabilitation Science, Cologne, Germany
| | - Clarissa Lemmen
- Institute for Health Economics and Clinical Epidemiology (IGKE), Faculty of Medicine, University of Cologne, University Hospital Cologne, Cologne, Germany
| | - Lisa Derendorf
- Institute for Health Economics and Clinical Epidemiology (IGKE), Faculty of Medicine, University of Cologne, University Hospital Cologne, Cologne, Germany
| | - Stephanie Stock
- Institute for Health Economics and Clinical Epidemiology (IGKE), Faculty of Medicine, University of Cologne, University Hospital Cologne, Cologne, Germany
| | - Christina Samel
- Institute of Medical Statistics and Computational Biology, Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Anna Hagemeier
- Institute of Medical Statistics and Computational Biology, Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Martin Hellmich
- Institute of Medical Statistics and Computational Biology, Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Bernd Leicher
- Department of Computer Science (Medical Informatics), University of Applied Sciences and Arts Dortmund, Dortmund, Germany
| | - Gregor Hültenschmidt
- Department of Computer Science (Medical Informatics), University of Applied Sciences and Arts Dortmund, Dortmund, Germany
| | - Jessica Swoboda
- Department of Computer Science (Medical Informatics), University of Applied Sciences and Arts Dortmund, Dortmund, Germany
| | - Peter Haas
- Department of Computer Science (Medical Informatics), University of Applied Sciences and Arts Dortmund, Dortmund, Germany
| | - Anna Arning
- Krebsgesellschaft Nordrhein-Westfalen E.V, Düsseldorf, Germany
| | - Andrea Göttel
- Krebsgesellschaft Nordrhein-Westfalen E.V, Düsseldorf, Germany
| | | | - Ullrich Graeven
- Krebsgesellschaft Nordrhein-Westfalen E.V, Düsseldorf, Germany
| | - Stefanie Houwaart
- House of the Cancer Patient Support Associations of Germany, Bonn, Germany
| | - Hedy Kerek-Bodden
- House of the Cancer Patient Support Associations of Germany, Bonn, Germany
| | - Steffen Krebs
- Department of Internal Medicine I, Faculty of Medicine, Cologne University Hospital, University of Cologne, Cologne, Germany
| | - Christiana Muth
- Department of Internal Medicine I, Faculty of Medicine, Cologne University Hospital, University of Cologne, Cologne, Germany
| | | | - Marcel Reiser
- PIOH Köln - Praxis Internistischer Onkologie Und Hämatologie, Cologne, Germany
| | - Cornelia Mauch
- Department of Internal Medicine I, Faculty of Medicine, Cologne University Hospital, University of Cologne, Cologne, Germany
| | | | | | | | | | | | | | | | | | | | | | | | - Jürgen Wolf
- Department of Internal Medicine I, Faculty of Medicine, Cologne University Hospital, University of Cologne, Cologne, Germany
| | - Michael Hallek
- Department of Internal Medicine I, Faculty of Medicine, Cologne University Hospital, University of Cologne, Cologne, Germany
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Kasper G, Hart S, Samuel N, Fox C, Das S. Anxiety and depression in patients with intracranial meningioma: a mixed methods analysis. BMC Psychol 2022; 10:93. [PMID: 35395829 PMCID: PMC8994241 DOI: 10.1186/s40359-022-00797-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 03/29/2022] [Indexed: 12/05/2022] Open
Abstract
Background While diagnosis with a high-grade intracranial tumor is known to be associated with increased psychosocial burden, the burdens associated with meningioma are less well described. This study aimed to investigate the mental health burden in patients with meningiomas who have undergone surgical resection or serial observation, so as to identify and enhance awareness of gaps in care. Methods The Hospital Anxiety and Depression Scale (HADS) was administered to participants. Fisher’s Exact tests were performed to evaluate frequency distributions and t-tests were applied to compare postoperative and non-surgical patients’ HADS scores. Semi-structured interviews were completed on a subset of participants. Thematic analysis of interviews identified emerging themes. Results Thirty patients with intracranial meningiomas met inclusion criteria. The cohort’s mean age was 56.01 years and 66.67% were women (n = 20). Fourteen underwent surgery; sixteen were treated conservatively with observation. The average time since diagnosis of the sample was 37.6 months. Prevalence of mild to severe symptoms of anxiety was 28.6% amongst surgical management patients and 50% for active surveillance patients (p = 0.325). The prevalence of mild to severe symptoms of depression was 7.14% amongst surgical management patients and 6.25% for active surveillance patients (p = 0.533). Emerging themes from eight interviews reveal the influence of resilience, uncertainty and time, social support, interactions with medical experts, and difficulties during recovery on mental health. Conclusion The findings from the present study reveal that patients with meningiomas experience a significant mental health burden, illustrating the need for enhanced patient-centred care focusing on mental health. Supplementary Information The online version contains supplementary material available at 10.1186/s40359-022-00797-6.
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Affiliation(s)
- Graham Kasper
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Shannon Hart
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Nardin Samuel
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada.,Division of Neurosurgery, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada
| | - Colleen Fox
- Person-Centred Care, Ontario Health (Cancer Care Ontario), Toronto, ON, Canada
| | - Sunit Das
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada. .,Division of Neurosurgery, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada.
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Torres Blasco N, Costas Muñiz R, Zamore C, Porter L, Claros M, Bernal G, Shen MJ, Breitbart W, Castro EM. Cultural adaptation of meaning-centered psychotherapy for latino families: a protocol. BMJ Open 2022; 12:e045487. [PMID: 35379609 PMCID: PMC8981324 DOI: 10.1136/bmjopen-2020-045487] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Literature suggests couple-based interventions that target quality of life and communication can lead to positive outcomes for patients with cancer and their partners. Nevertheless, to date, an intervention to address the needs of Latino families coping with advanced cancer has not been developed. Meta-analytic evidence suggests that culturally adapted evidenced-based intervention targeting a specific cultural group is four times more effective. Our goal is to culturally adapt a novel psychosocial intervention protocol entitled 'Caregivers-Patients Support to Latinx coping advanced-cancer' (CASA). We hypothesised that combine two evidence-based interventions and adapting them, we will sustain a sense of meaning and improving communication as patients approach the end of life among the patient-caregiver dyad. METHODS AND ANALYSIS To culturally adapt CASA, we will follow an innovative hybrid research framework that combines elements of an efficacy model and best practices from the ecological validity model, adaptation process model and intervention mapping. As a first step, we adapt a novel psychosocial intervention protocol entitled protocol entitled 'Caregivers-Patients Support to Latinx coping advanced-cancer' (CASA). The initial CASA protocol integrates two empirically based interventions, meaning-centred psychotherapy and couple communication skills training. This is an exploratory and prepilot study, and it is not necessary for a size calculation. However, based on recommendations for exploratory studies of this nature, a priori size of 114 is selected. We will receive CASA protocol feedback (phase 1b: refine) by conducting 114 questionnaires and 15 semistructured interviews with patients with advanced cancer and their caregivers. The primary outcomes of this study will be identifying the foundational information needed to further the develop the CASA (phase IIa: proof-of-concept and phase IIb: pilot study). ETHICS AND DISSEMINATION The Institutional Review Board of Ponce Research Institute approved the study protocol #1907017527A002. Results will be disseminated through peer-reviewed publications.
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Affiliation(s)
| | - Rosario Costas Muñiz
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Carolina Zamore
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Laura Porter
- Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina, USA
| | - Maria Claros
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Guillermo Bernal
- Professor of Psychology (Retired), Universidad de Puerto Rico, San Juan, Puerto Rico
| | | | - William Breitbart
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - E M Castro
- SBBS, Ponce Health Sciences University, Ponce, Puerto Rico
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48
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Charles C, Bardet A, Larive A, Gorwood P, Ramoz N, Thomas E, Viari A, Rousseau-Tsangaris M, Dumas A, Menvielle G, Everhard S, Martin AL, Gbenou SYA, Havas J, El-Mouhebb M, Di Meglio A, André F, Pistilli B, Coutant C, Cottu P, Mérimèche A, Lerebours F, Tredan O, Vanlemmens L, Jouannaud C, Levy C, Vaz-Luis I, Michiels S, Dauchy S. Characterization of Depressive Symptoms Trajectories After Breast Cancer Diagnosis in Women in France. JAMA Netw Open 2022; 5:e225118. [PMID: 35420663 PMCID: PMC9011125 DOI: 10.1001/jamanetworkopen.2022.5118] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
IMPORTANCE Breast cancer (BC) diagnosis and treatment expose patients to a 5-fold higher risk of depression compared with the general population, with an estimated prevalence of 10% to 25%. A depressive episode in patients with BC has implications for the tolerance of and adherence to treatment, impairing quality of life and reducing life expectancy. OBJECTIVE To identify and characterize distinct longitudinal patterns of depressive symptoms in patients with BC from diagnosis to 3 years after treatment. DESIGN, SETTINGS, AND PARTICIPANTS The CANTO-DEePRESS (Deeper in the Understanding and Prevention of Depression in Breast Cancer Patients) cohort study included women in the French multicenter CANTO (CANcer TOxicities) cohort study (conducted between March 20, 2012 and December 11, 2018), who were 18 years or older with invasive stage I to III BC and no previous BC treatment. The study aimed to characterize toxicities over a 5-year period following stage I to III primary BC treatment. Assessments of depressive symptoms were performed on a subset of patients with available data at diagnosis and at least 2 other time points. All data were extracted from the CANTO database on October 1, 2020. MAIN OUTCOMES AND MEASURES The primary outcome was the level of depressive symptoms at each assessment time point measured with the Hospital Anxiety and Depression Scale and depression subscale at BC diagnosis and at 3 to 6, 12, and 36 months after the end of treatment. The group-based trajectory modeling was used to identify trajectory groups, and multinomial logistic regression models were used to characterize the following factors associated with trajectory group affiliation: demographic, socioeconomic, clinical, lifestyle, and quality-of-life data. RESULTS A total of 4803 women (mean [SD] age, 56.2 [11.2] years; 2441 patients [50.8%] with stage I BC) were included in the study. Six trajectory groups that described the heterogeneity in the expression of depressive symptoms were identified: noncases with no expression of symptoms (n = 2634 [54.8%]), intermediate worsening (1076 [22.4%]), intermediate improvement (480 [10.0%]), remission (261 [5.4%]), delayed occurrence (200 [4.2%]), and stable depression (152 [3.2%]). HADS-D scores at diagnosis were consistently associated with the 5 depressive trajectory group affiliations, with an estimated higher probability per point increase of experiencing subthreshold or clinically significant depressive symptoms between diagnosis and the 3 years after the end of BC treatment. The higher probabilities ranged from 1.49 (95% CI, 1.43-1.54) for the intermediate worsening group to 10.53 (95% CI, 8.84-12.55) for the stable depression group. Trajectory groups with depressive symptoms differed from the noncases group without symptoms by demographic and clinical factors, such as having dependent children, lower household income, cancer stage, family history of BC, previous psychiatric hospitalizations, obesity, smoking status, higher levels of fatigue, and depression at diagnosis. CONCLUSIONS AND RELEVANCE In this cohort study, nearly a third of patients with BC experienced temporary or lasting significant depressive symptoms during and after treatment. Improving early identification of women at risk of developing long-term or delayed depression is therefore critical to increase quality of life and overall survival. Subjected to validation, this study is an important first step toward personalized care of patients with BC at risk of depression.
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Affiliation(s)
- Cécile Charles
- Department of Prevention-Public Health, Institut Bergonié, Bordeaux, France
- Bordeaux Population Health, Institut National de la Santé et de la Recherche Médicale (INSERM) U1219, Université de Bordeaux, Bordeaux, France
| | - Aurélie Bardet
- Gustave Roussy, Université Paris-Saclay, Biostatistics and Epidemiology Office, Villejuif, France
- Oncostat U1018 INSERM, University Paris-Saclay, Ligue Contre le Cancer, Villejuif, France
| | - Alicia Larive
- Gustave Roussy, Université Paris-Saclay, Biostatistics and Epidemiology Office, Villejuif, France
- Oncostat U1018 INSERM, University Paris-Saclay, Ligue Contre le Cancer, Villejuif, France
| | - Philip Gorwood
- Institute of Psychiatry and Neuroscience of Paris, INSERM U1266, Université de Paris, Paris, France
- La Clinique des Maladies Mentales et de l'Encéphale, Le Groupe Hospitalier Universitaire Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France
| | - Nicolas Ramoz
- Institute of Psychiatry and Neuroscience of Paris, INSERM U1266, Université de Paris, Paris, France
| | - Emilie Thomas
- Fondation Synergie Lyon Cancer Plateforme Bioinformatique Gilles Thomas, Lyon, France
| | - Alain Viari
- Fondation Synergie Lyon Cancer Plateforme Bioinformatique Gilles Thomas, Lyon, France
| | | | - Agnès Dumas
- Épidémiologie Clinique et Évaluation Économique Appliquées aux Populations Vulnérables, Unité Mixte de Recherche 1123 INSERM, Université de Paris, Paris, France
| | - Gwenn Menvielle
- Épidémiologie Clinique et Évaluation Économique Appliquées aux Populations Vulnérables, Unité Mixte de Recherche 1123 INSERM, Université de Paris, Paris, France
| | | | | | | | - Julie Havas
- Gustave Roussy, INSERM U981, Université Paris-Saclay, Villejuif, France
| | | | - Antonio Di Meglio
- Gustave Roussy, INSERM U981, Université Paris-Saclay, Villejuif, France
| | | | - Barbara Pistilli
- Gustave Roussy, INSERM U981, Université Paris-Saclay, Villejuif, France
| | | | | | - Asma Mérimèche
- Centre Alexis Vautrin, Vandoeuvre les Nancy, Nancy, France
| | | | | | | | | | | | - Ines Vaz-Luis
- Gustave Roussy, INSERM U981, Université Paris-Saclay, Villejuif, France
| | - Stefan Michiels
- Gustave Roussy, Université Paris-Saclay, Biostatistics and Epidemiology Office, Villejuif, France
- Oncostat U1018 INSERM, University Paris-Saclay, Ligue Contre le Cancer, Villejuif, France
| | - Sarah Dauchy
- Department of Prevention-Public Health, Institut Bergonié, Bordeaux, France
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Jordi SBU, Lang BM, Auschra B, von Känel R, Biedermann L, Greuter T, Schreiner P, Rogler G, Krupka N, Sulz MC, Misselwitz B, Begré S. Depressive Symptoms Predict Clinical Recurrence of Inflammatory Bowel Disease. Inflamm Bowel Dis 2022; 28:560-571. [PMID: 34096587 DOI: 10.1093/ibd/izab136] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Inflammatory bowel disease (IBD) patients are at high risk for depression, and depression has been shown to affect disease course. We examined interrelations between depression, genetic risk factors for depression, and IBD flares. METHOD In 1973 patients (1137 Crohn's disease, 836 ulcerative colitis) of the Swiss IBD Cohort Study (SIBDCS), depressive status (hospital anxiety and depression subscale for depression, HADS-D ≥11) was assessed on a yearly basis. We investigated the impact of depression on IBD-relevant clinical outcomes in Cox proportional hazards models. We used active disease (CDAI ≥150 or MTWAI ≥10) and 2 published composite flare definitions-FNCE (physician-reported flare, nonresponse to therapy, new complication, or extraintestinal manifestation) and AFFSST (active disease, physician-reported flare, fistula, stenosis, and new systemic therapy)-as clinical end points. Additionally, 62 preselected single nucleotide polymorphisms (SNPs) were screened for cross-sectional associations with depression, and if present, their predictive value for future depression and clinical deterioration was assessed. RESULTS Depression was a strong risk factor for disease-related end points, including active disease (adjusted hazard ratio [aHR], 3.55; P < 0.001), AFFSST (aHR, 1.62; P < 0.001), and FNCE (aHR, 1.35; P = 0.019). The SNP rs2522833 was significantly associated with depression at enrollment (q = 0.059). The TC allele of rs588765 was negatively associated with the presence of depression at enrollment (q = 0.050) and after enrollment (aHR, 0.67; P = 0.035) and with fewer active disease states (aHR, 0.72; P = 0.045) during follow-up. CONCLUSION In IBD, depressive symptoms and inflammatory activity are intimately related. Depressive symptoms were a strong predictor of clinical deterioration, and genetic markers may play a role in this relationship.
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Affiliation(s)
- Sebastian Bruno Ulrich Jordi
- Clinic for Visceral Surgery and Medicine, Inselspital Bern and Bern University, Bern, Switzerland.,Department of Gastroenterology and Hepatology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Brian Matthew Lang
- Clinic for Transplantation Immunology and Nephrology (Swiss Transplant Cohort Study), University Hospital of Basel, Basel, Switzerland
| | - Bianca Auschra
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Roland von Känel
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Luc Biedermann
- Department of Gastroenterology and Hepatology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Thomas Greuter
- Department of Gastroenterology and Hepatology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Philipp Schreiner
- Department of Gastroenterology and Hepatology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Gerhard Rogler
- Department of Gastroenterology and Hepatology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Niklas Krupka
- Clinic for Visceral Surgery and Medicine, Inselspital Bern and Bern University, Bern, Switzerland
| | - Michael Christian Sulz
- Department of Gastroenterology and Hepatology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Benjamin Misselwitz
- Clinic for Visceral Surgery and Medicine, Inselspital Bern and Bern University, Bern, Switzerland.,Department of Gastroenterology and Hepatology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Stefan Begré
- Neurology, Department of Biomedical Research, Bern University Hospital, University of Bern, Bern, Switzerland.,Institute of Stress Diseases and Stressmanagement (ISFOM), Zurich, Switzerland
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Ardizzone A, Bavetta D, Garo ML, Santangelo D, Bongiorno A, Bono M. Impact of the Cognitive-Behavioral Approach and Psychoeducational Intervention in Breast Cancer Management: A Prospective Randomized Clinical Trial. Healthcare (Basel) 2022; 10:healthcare10040629. [PMID: 35455807 PMCID: PMC9025943 DOI: 10.3390/healthcare10040629] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 03/21/2022] [Accepted: 03/24/2022] [Indexed: 11/16/2022] Open
Abstract
(1) Background: Breast cancer (BC) is the most prevalent malignancy in women. High cancer-related psychological distress levels have been observed in BC patients, with a potentially relevant impact on disease management, compliance with disease treatments, and everyday life activities and relationships. This work evaluated the effectiveness of three individual cognitive−behavioral therapy psychoeducational sessions versus a self-managed informative guide with individual counseling sessions without specific psychological treatment. (2) Methods: the intervention group received three individual 50-min sessions of psychoeducational training, and the control group received a self-managed informative guide with individual counseling sessions without any kind of psychological treatment. The Hospital Anxiety Depression Scale (HADS), the Distress Thermometer (DT), and the EORTC (European Organization for Research and Treatment of Cancer) QLQ-C30 were administered at baseline and two months after study inclusion. (3) Results: A total of 60 participants were included in the study (intervention group: 30, control group: 30). Significant improvements were observed in both groups after two months (p < 0.05), but no statistically significant differences emerged between groups. (4) Conclusions: Psychoeducational interventions and CBT help BC patients manage disease-related fear and distress, allowing them to achieve a good quality of life.
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Affiliation(s)
- Antonella Ardizzone
- U.O. Oncologia Medica, Hospital Giovanni Paolo II, 92019 Sciacca, Italy;
- Samo Onlus, 92100 Agrigento, Italy
- Istituto Tolman Srl, 90121 Palermo, Italy;
- Correspondence: ; Tel.: +39-329-7211651
| | - Domenico Bavetta
- U.O. Ginecologia e Ostetricia Department, Hospital Giovanni Paolo II, 92019 Sciacca, Italy;
| | | | | | | | - Maria Bono
- C.S.M.—Hospital Giovanni Paolo II, 92019 Sciacca, Italy;
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