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Zh. Zhelev K, Conev NV, Zahariev ZI, Mihaylova IS, Tonev ID, Sht. Donev I. Time estimation is associated with the levels of distress in patients prior to starting radiotherapy. Tech Innov Patient Support Radiat Oncol 2024; 31:100258. [PMID: 39070541 PMCID: PMC11278554 DOI: 10.1016/j.tipsro.2024.100258] [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: 03/14/2024] [Revised: 06/02/2024] [Accepted: 06/24/2024] [Indexed: 07/30/2024] Open
Abstract
Purpose or Objective The aim of this study was to explore the potential relationship between the time estimation and psychological distress in patients with solid tumors prior to starting radiotherapy. Materials and Methods In this multicenter study were included a total of 344 patients with solid tumors (197 with and 147 without metastatic disease). The time estimation was assessed by evaluating each subjects prospective estimation of how fast 1 min passed compared to the actual time. The median value (35sec) of subjective perception of time was used to group cases into two categories for experience of time. We used the National Comprehensive Cancer Network Distress Thermometer at the beginning of treatment to determine the levels of distress, where it measures distress on a scale from 0 to 10. Patients scoring 4 or above (73.5 %) were regarded as having high levels of distress. Results The time estimation distributions significantly changed according to the level of distress. ROC analysis revealed that at the optimal cut off value of time estimation, patients with low and high distress levels can be discriminated with an AUC = 0.80 (95 % CI: 0.75- 0.85, p < 0.001) and with a sensitivity of 77.8 % and specificity of 73.3 %. In a multivariate logistic regression model, fast time estimation was an independent predictor of high levels of distress (OR 0.136; 95 % CI, 0.072---0.256, p < 0.001). Conclusion Time estimation is a novel potent indicator of high levels of distress in cancer patients prior starting of radiotherapy.
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Affiliation(s)
- Kiril Zh. Zhelev
- Department of Radiotherapy and Radiosurgery, “Heart and Brain Center of Clinical Excellence”, Pleven, Bulgaria, Pierre Curie, str., 2, Postal Code 5800
| | - Nikolay V. Conev
- Clinic of Medical Oncology, UMHAT “St. Marina, Varna, Bulgaria, Hristo Smirnenski, str. 1, Postal Code 9000
| | - Zahari I. Zahariev
- Department of Radiotherapy, Uni Hospital, Panagyurishte, Bulgaria, Georgi Benkovski, str.100, Postal Code 4500
| | - Iglika S. Mihaylova
- Department of Radiotherapy, USHAT in Oncology, Sofia, Bulgaria, Plovdivsko pole, str. 6, Postal Code 1000
| | - Ivan D. Tonev
- Department of Medical Oncology, Complex Cancer Center, Plovdiv, 2A, Alexander Stamboliiski, Blvd, Code 4000
| | - Ivan Sht. Donev
- Clinic of Medical Oncology, MHAT “Nadezhda”, Sofia, Bulgaria, Blaga Vest, str.2, Postal Code 1000
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van den Berg K, Knegt A, Fons G, Lok CAR, Aarts JWM. Patients' preferences, experiences and expectations with wait time until surgery in gynaecological oncology: a mixed-methods study in two gynaecological oncological centres in the Netherlands. BMJ Open 2024; 14:e085932. [PMID: 39153775 PMCID: PMC11331850 DOI: 10.1136/bmjopen-2024-085932] [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: 02/29/2024] [Accepted: 07/30/2024] [Indexed: 08/19/2024] Open
Abstract
OBJECTIVES Patient-centredness of care during wait time before surgery can be improved. In this study we aimed to assess (1) patients' experiences with and preferences regarding wait time before surgery; (2) the impact of wait time on quality of life (QoL) and (3) which factors influence patients' wait time experience. DESIGN, SETTING, PARTICIPANTS We performed an exploratory sequential mixed-methods study among women with gynaecological cancer in two tertiary hospitals. We conducted semistructured interviews and identified aspects of QoL and factors that influenced wait time acceptability through thematic analysis. We developed a questionnaire from this thematic analysis which was completed by 97 women. Descriptive statistics and univariate and multivariate regression analyses were performed. RESULTS Average ideal wait time was 3.5 weeks (±1.7 weeks), minimum and maximum acceptable wait times were 2.2 and 5.6 weeks. Many patients scored above the threshold of the Hospital Anxiety and Depression Scale for anxiety (48%) or depression (34%), had sleeping problems (56%) or experienced pain (54%). A number of factors were more common in patients who indicated that their wait time had been too long: low education level (OR 7.4, 95% CI 0.5 to 5.0, p=0.007), time to surgery >4 weeks (OR 7.0, 95% CI 0.8 to 4.4, p=0.002) and experienced sleep disturbance (OR 3.27, 95% CI 0.0 to 3.1, p=0.05). If patients expectation of wait time was >4 weeks (OR 0.20, 95% CI -4.0 to -0.5 p=0008) or if patients experienced pain (OR 0.26, 95% CI -3.6 to -0.3, p=0.03), they less frequently indicated that wait time had been too long. CONCLUSION To improve patient-centredness of care, healthcare providers should aim to reduce wait time to 3-4 weeks and ensure that patients are well informed about the length of wait time and are aware of high levels of anxiety, depression and pain during this time. Future studies should evaluate what interventions can improve QoL during wait time.
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Affiliation(s)
- Kim van den Berg
- Amsterdam UMC Locatie De Boelelaan, Amsterdam, The Netherlands
- Flevoziekenhuis, Almere, Netherlands
| | - Anne Knegt
- Amsterdam UMC Locatie De Boelelaan, Amsterdam, The Netherlands
| | - Guus Fons
- Amsterdam UMC Locatie De Boelelaan, Amsterdam, The Netherlands
- Centre for Gynaecologic Oncology Amsterdam, Amsterdam, Netherlands
| | - Christianne A R Lok
- Centre for Gynaecologic Oncology Amsterdam, Amsterdam, Netherlands
- Gynaecologic Oncology, Antoni van Leeuwenhoek Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Johanna W M Aarts
- Amsterdam UMC Locatie De Boelelaan, Amsterdam, The Netherlands
- Centre for Gynaecologic Oncology Amsterdam, Amsterdam, Netherlands
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Güner P, Kocaman Yıldırım N, İnci F, Sancı K, Semerci R. Psychometric Properties of a Turkish Version of The Psychosocial Needs Inventory; Sampling from Oncology Patients. Semin Oncol Nurs 2024; 40:151678. [PMID: 38897857 DOI: 10.1016/j.soncn.2024.151678] [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: 03/14/2024] [Revised: 05/11/2024] [Accepted: 05/19/2024] [Indexed: 06/21/2024]
Abstract
OBJECTIVES This study aimed to assess the reliability and validity of the Psychosocial Needs Inventory (PNI) among Turkish oncology patients. METHODS A methodological study was conducted with 1,547 oncology patients. This validation study was divided into two phases. Phase 1 included translation of the PNI according to World Health Organization recommendations, investigation of content validity by experts, and a pilot study involving 136 participants. Phase 2 included a validity and reliability analysis of the PNI. Data analysis comprised exploratory (EFA) and confirmatory factor analyses (CFA), Cronbach's alpha, test-retest reliability, Hotelling's T2 test and item-total score correlation, and the Content Validity Index (CVI). RESULTS For the phase 1, the CVI for items and scale were >.75 and .883, respectively. Cronbach's alpha values of the subdimensions ranged between 0.84 and 0.94. The test-retest analyses of the subdimensions showed correlation coefficients based on the pilot test (p < .001). For the phase 2, based on the fit indices in confirmatory factor analysis, the structures of the dimensions "Importance" and "Satisfaction" were acceptable. Cronbach's alpha values of the subdimensions ranged between 0.84 to 0.94 in the "Importance" dimension and 0.86 to 0.94 in the "Satisfaction" dimension. As a result of EFA, the Kaiser-Meyer-Olkin, Bartlett's test (p < 0.001) and PNI Importance explained at 68.46% and PNI Satisfaction at 70.15% of the total variance by the six-factor structure. CFA showed that the indices and validity, including content validity, convergent validity were satisfactory. CONCLUSION The PNI, which was found to be a valid and reliable measurement tool, can be used to determine the psychosocial needs of cancer patients. IMPLICATIONS FOR NURSING PRACTICE Health professionals need to use the PNI to measure their importance to cancer patients' psychosocial needs and assess their satisfaction with meeting them to improve holistic care and support.
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Affiliation(s)
- Perihan Güner
- Istanbul Bilgi University Faculty of Health Sciences, Nursing Department, Istanbul, Türkiye.
| | | | - Figen İnci
- Ömer Halisdemir University Zubeyde Hanım School of Health, Nursing Department, Niğde, Türkiye
| | | | - Remziye Semerci
- Koç University, School of Nursing, Department of Child Health and Disease Nursing, İstanbul, Turkey
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Nunez JJ, Leung B, Ho C, Ng RT, Bates AT. Predicting which patients with cancer will see a psychiatrist or counsellor from their initial oncology consultation document using natural language processing. COMMUNICATIONS MEDICINE 2024; 4:69. [PMID: 38589545 PMCID: PMC11001970 DOI: 10.1038/s43856-024-00495-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 03/28/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND Patients with cancer often have unmet psychosocial needs. Early detection of who requires referral to a counsellor or psychiatrist may improve their care. This work used natural language processing to predict which patients will see a counsellor or psychiatrist from a patient's initial oncology consultation document. We believe this is the first use of artificial intelligence to predict psychiatric outcomes from non-psychiatric medical documents. METHODS This retrospective prognostic study used data from 47,625 patients at BC Cancer. We analyzed initial oncology consultation documents using traditional and neural language models to predict whether patients would see a counsellor or psychiatrist in the 12 months following their initial oncology consultation. RESULTS Here, we show our best models achieved a balanced accuracy (receiver-operating-characteristic area-under-curve) of 73.1% (0.824) for predicting seeing a psychiatrist, and 71.0% (0.784) for seeing a counsellor. Different words and phrases are important for predicting each outcome. CONCLUSION These results suggest natural language processing can be used to predict psychosocial needs of patients with cancer from their initial oncology consultation document. Future research could extend this work to predict the psychosocial needs of medical patients in other settings.
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Affiliation(s)
- John-Jose Nunez
- BC Cancer, Vancouver, BC, Canada.
- Department of Computer Science, University of British Columbia, Vancouver, BC, Canada.
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.
| | | | | | - Raymond T Ng
- Department of Computer Science, University of British Columbia, Vancouver, BC, Canada
| | - Alan T Bates
- BC Cancer, Vancouver, BC, Canada
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
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Rothschild CB, Balistreri KA, Mulligan K, Lee KJ, Karst J, Privatt M, Magner K, Lee HJ, Scanlon M, Davies WH. Acceptability and Feasibility of Text Message Interface to Assess Parents' Real-time PICU Experiences. J Intensive Care Med 2024; 39:159-169. [PMID: 37605433 DOI: 10.1177/08850666231195754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/23/2023]
Abstract
INTRODUCTION Parents of children in the pediatric intensive care unit (PICU) experience substantial stress; a parent's perception of their child's illness severity, more than objective measures, predicts psychological outcomes. No tools exist to assess parents' real-time experiences. This pilot study evaluated the feasibility and acceptability of a text-based tool to measure parental experience. METHODS Inclusion criteria included PICU stay >48 h, physician approval, smartphone access, and English-speaking caregiver. Eligible parents received a text-based baseline survey and surveys every other day while hospitalized regarding their mood/experiences and optional open-ended questions regarding stressors. They received post-discharge follow-up surveys at 1 week and 1, 3, and 6 months. Follow-up surveys assessed mood and symptoms of depression, anxiety, and post-traumatic stress. Interviews and surveys about the interface were conducted 1 week and 3 months following discharge. Feasibility was assessed by descriptive statistics (eg, response rates), and acceptability was assessed by descriptive statistics (survey results) and thematic analyses of interviews. RESULTS Of 20 enrolled participants, the first 5 were excluded due to technical issues. Of the 15 included, results demonstrated feasibility and acceptability. Most participants (86%) completed all surveys during the PICU stay and continued to complete surveys at a high rate: 79%-94% 3 months post-discharge. All participants agreed that the system was easy to use and were satisfied with the system at discharge, and 91% remained satisfied 3 months post-discharge. Additionally, 76% reported comfort, and 69% reported benefit. From the interviews, participants lauded the system's convenience and applicability of content. Some proposed changes to improve ergonomics. Many suggested this interface could help teams better support families. CONCLUSIONS A text-based interface for measuring experience in the PICU is feasible and acceptable to parents. Further research can explore how this could identify parents most at risk of adverse psychological sequelae and lead to earlier supportive interventions.
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Affiliation(s)
| | | | - Kathryn Mulligan
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA
| | - K Jane Lee
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Jeffrey Karst
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Miranda Privatt
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Kristin Magner
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Han-Joo Lee
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Matthew Scanlon
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA
| | - W Hobart Davies
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
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de Hond A, van Buchem M, Fanconi C, Roy M, Blayney D, Kant I, Steyerberg E, Hernandez-Boussard T. Predicting Depression Risk in Patients With Cancer Using Multimodal Data: Algorithm Development Study. JMIR Med Inform 2024; 12:e51925. [PMID: 38236635 PMCID: PMC10835583 DOI: 10.2196/51925] [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: 08/17/2023] [Revised: 11/11/2023] [Accepted: 12/08/2023] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND Patients with cancer starting systemic treatment programs, such as chemotherapy, often develop depression. A prediction model may assist physicians and health care workers in the early identification of these vulnerable patients. OBJECTIVE This study aimed to develop a prediction model for depression risk within the first month of cancer treatment. METHODS We included 16,159 patients diagnosed with cancer starting chemo- or radiotherapy treatment between 2008 and 2021. Machine learning models (eg, least absolute shrinkage and selection operator [LASSO] logistic regression) and natural language processing models (Bidirectional Encoder Representations from Transformers [BERT]) were used to develop multimodal prediction models using both electronic health record data and unstructured text (patient emails and clinician notes). Model performance was assessed in an independent test set (n=5387, 33%) using area under the receiver operating characteristic curve (AUROC), calibration curves, and decision curve analysis to assess initial clinical impact use. RESULTS Among 16,159 patients, 437 (2.7%) received a depression diagnosis within the first month of treatment. The LASSO logistic regression models based on the structured data (AUROC 0.74, 95% CI 0.71-0.78) and structured data with email classification scores (AUROC 0.74, 95% CI 0.71-0.78) had the best discriminative performance. The BERT models based on clinician notes and structured data with email classification scores had AUROCs around 0.71. The logistic regression model based on email classification scores alone performed poorly (AUROC 0.54, 95% CI 0.52-0.56), and the model based solely on clinician notes had the worst performance (AUROC 0.50, 95% CI 0.49-0.52). Calibration was good for the logistic regression models, whereas the BERT models produced overly extreme risk estimates even after recalibration. There was a small range of decision thresholds for which the best-performing model showed promising clinical effectiveness use. The risks were underestimated for female and Black patients. CONCLUSIONS The results demonstrated the potential and limitations of machine learning and multimodal models for predicting depression risk in patients with cancer. Future research is needed to further validate these models, refine the outcome label and predictors related to mental health, and address biases across subgroups.
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Affiliation(s)
- Anne de Hond
- Clinical AI Implementation and Research Lab, Leiden University Medical Centre, Leiden, Netherlands
- Department of Biomedical Data Sciences, Leiden University Medical Centre, Leiden, Netherlands
- Department of Medicine (Biomedical Informatics), Stanford Medicine, Stanford University, Stanford, CA, United States
| | - Marieke van Buchem
- Clinical AI Implementation and Research Lab, Leiden University Medical Centre, Leiden, Netherlands
- Department of Biomedical Data Sciences, Leiden University Medical Centre, Leiden, Netherlands
- Department of Medicine (Biomedical Informatics), Stanford Medicine, Stanford University, Stanford, CA, United States
| | - Claudio Fanconi
- Department of Medicine (Biomedical Informatics), Stanford Medicine, Stanford University, Stanford, CA, United States
- Department of Electrical Engineering and Information Technology, ETH Zürich, Zürich, Switzerland
| | - Mohana Roy
- Department of Medical Oncology, Stanford Medicine, Stanford University, Stanford, CA, United States
| | - Douglas Blayney
- Department of Medical Oncology, Stanford Medicine, Stanford University, Stanford, CA, United States
| | - Ilse Kant
- Clinical AI Implementation and Research Lab, Leiden University Medical Centre, Leiden, Netherlands
- Department of Digital Health, University Medical Centre Utrecht, Utrecht, Netherlands
| | - Ewout Steyerberg
- Clinical AI Implementation and Research Lab, Leiden University Medical Centre, Leiden, Netherlands
- Department of Biomedical Data Sciences, Leiden University Medical Centre, Leiden, Netherlands
| | - Tina Hernandez-Boussard
- Department of Medicine (Biomedical Informatics), Stanford Medicine, Stanford University, Stanford, CA, United States
- Department of Biomedical Data Science, Stanford University, Stanford, CA, United States
- Department of Epidemiology & Population Health (by courtesy), Stanford University, Stanford, CA, United States
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Noel CW, Sutradhar R, Chan WC, Fu R, Philteos J, Forner D, Irish JC, Vigod S, Isenberg-Grzeda E, Coburn NG, Hallet J, Eskander A. Gaps in Depression Symptom Management for Patients With Head and Neck Cancer. Laryngoscope 2023; 133:2638-2646. [PMID: 36748910 DOI: 10.1002/lary.30595] [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: 11/08/2022] [Revised: 12/27/2022] [Accepted: 01/16/2023] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To understand practice patterns and identify care gaps within a large-scale depression screening program for patients with head and neck cancer (HNC). STUDY DESIGN Retrospective cohort study. METHODS This was a population-based study of adults diagnosed with a HNC between January 2007 and October 2020. Each patient was observed from time of first symptom assessment until end of study date, or death. The exposure of interest was a positive depressive symptom screen on the Edmonton Symptom Assessment System (ESAS). Outcomes of interest included psychiatry/psychology assessment, social work referral, or palliative care assessment. Cause specific hazard models with a time-varying exposure were used to investigate the exposure-outcome relationships. RESULTS Of 14,054 patients with HNC, 9016 (64.2%) reported depressive symptoms on at least one ESAS assessment. Within 60 days of first reporting depressive symptoms, 223 (2.7%) received a psychiatry assessment, 646 (7.9%) a social work referral, and 1131 (13.9%) a palliative care assessment. Rates of psychiatry/psychology assessment (HR 3.15 [95% CI 2.67-3.72]), social work referral (HR 1.83 [95% CI 1.64-2.02]), and palliative care assessment (HR 2.34 [95% CI 2.19-2.50]) were higher for those screening positive for depression. Certain patient populations were less likely to receive an assessment including the elderly, rural residents, and those without a prior psychiatric history. CONCLUSION A high proportion of head and neck patients report depressive symptoms, though this triggers a referral in a small number of cases. These data highlight areas for improvement in depression screening care pathways. LEVEL OF EVIDENCE 3 Laryngoscope, 133:2638-2646, 2023.
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Affiliation(s)
- Christopher W Noel
- Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Evaluative Clinical Sciences, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Rinku Sutradhar
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
| | | | - Rui Fu
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Evaluative Clinical Sciences, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Justine Philteos
- Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
| | - David Forner
- Division of Otolaryngology-Head and Neck Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Jonathan C Irish
- Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
- Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Simone Vigod
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | | | - Natalie G Coburn
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Evaluative Clinical Sciences, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Division of Surgical Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Julie Hallet
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Evaluative Clinical Sciences, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Division of Surgical Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Antoine Eskander
- Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Evaluative Clinical Sciences, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Division of Surgical Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
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Park H, Kim KE, Moon E, Kang T. Psychometric Properties of Assessment Tools for Depression, Anxiety, Distress, and Psychological Problems in Breast Cancer Patients: A Systematic Review. Psychiatry Investig 2023; 20:395-407. [PMID: 37253465 DOI: 10.30773/pi.2022.0316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 03/19/2023] [Indexed: 06/01/2023] Open
Abstract
OBJECTIVE Various and accurate psychiatric assessments in patients with breast cancer who frequently suffer from psychological problems due to long-term survivors are warranted. This systematic review aimed to investigate the current evidence on psychometric properties of psychiatric assessment for evaluating psychological problems in breast cancer patients. METHODS This systematic review progressed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. Four electronic databases such as Web of Science, PubMed, Embase, and Cumulative Index to Nursing and Allied Health Literature were searched. This study protocol was registered on Open Science Framework. RESULTS Of the 2,040 articles, 21 papers were finally included. Among them, only five studies showed the performance of psychiatric assessment tools. Among 13 assessment tools used in the selected articles, the Hospital Anxiety and Depression Scale (HADS), Distress Thermometer (DT), or Mini-Mental Adjustment to Cancer Scale was frequently used for the evaluation of psychological problems. The DT and Psychosocial Distress Questionnaire-Breast Cancer showed acceptable performances for the prediction of depression and anxiety assessed by the HADS. CONCLUSION This systematic review found psychiatric assessment tools with acceptable reliability and validity for breast cancer patients. However, comparative studies on reliability and validity of various scales are required to provide useful information for the selection of appropriate assessment tools based on the clinical settings and treatment stages of breast cancer. Joint research among the fields of psychiatry and breast surgery is needed for research to establish the convergent, concurrent, and predictive validity of psychiatric assessment tools in breast cancer patients.
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Affiliation(s)
- Heeseung Park
- Breast Cancer Clinic, Busan Cancer Center, Pusan National University Hospital, Busan, Republic of Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Kyoung-Eun Kim
- Breast Cancer Clinic, Busan Cancer Center, Pusan National University Hospital, Busan, Republic of Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Eunsoo Moon
- Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
- Department of Psychiatry, Pusan National University, Busan, Republic of Korea
- Department of Psychiatry, Pusan National University School of Medicine, Yangsan, Republic of Korea
| | - Taewoo Kang
- Breast Cancer Clinic, Busan Cancer Center, Pusan National University Hospital, Busan, Republic of Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
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Schulze JB, Coker P, von Känel R, Euler S, Günther MP. Early Impact of the COVID-19 Pandemic on Psycho-Oncological Support: A Latent Class Analysis. Oncology 2023; 101:389-396. [PMID: 36977398 PMCID: PMC10871688 DOI: 10.1159/000530353] [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: 01/17/2023] [Accepted: 03/07/2023] [Indexed: 03/30/2023]
Abstract
INTRODUCTION Research suggests a global shortfall of psycho-oncological assessment and care during the COVID-19 pandemic in addition to delayed diagnosis of cancer. The present study is the first to explore the effect of the pandemic on the provision of psycho-oncological care, stage of cancer at first diagnosis, and duration of hospitalizations. METHOD Retrospective latent class analysis of 4,639 electronic patient files with all types, treatment types, and stages of cancer, 370 of which were treated during the pandemic prior to availability of vaccinations. DISCUSSION Latent class analysis identified four subgroups based on differences in screening for distress, provision of psycho-oncological support (consultation with a psychiatrist or clinical psychologist), administration of psychotropic medication, use of 1:1 observation, stage of cancer at first diagnosis, and duration of hospitalizations. Yet, the pandemic had no effect on subgrouping. Thus, the COVID-19 pandemic had no effect on the provision of psycho-oncological support. CONCLUSION Results are contrary to prior research. The efficiency and quality of procedures implemented to provide psycho-oncological support during and prior to the pandemic are critically reflected.
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Affiliation(s)
- Jan Ben Schulze
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Penelope Coker
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Roland von Känel
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Sebastian Euler
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Moritz Philipp Günther
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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Enzlin R, Vervoort SCJM, Suelmann BBM, Meijer RP, Teunissen SCCM, Zweers D. The prevalence and intensity of late effects in patients with testicular germ cell tumors: A first step of instrument development using a stepwise approach. Eur J Oncol Nurs 2023; 64:102303. [PMID: 36931098 DOI: 10.1016/j.ejon.2023.102303] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 02/13/2023] [Accepted: 02/19/2023] [Indexed: 03/05/2023]
Abstract
PURPOSE Patients with Testicular Germ Cell Tumors (TGCT) may suffer from several late effects due to their diagnosis or treatment. Follow-up care aims to identify the recurrence of cancer and support patients with TGCT in their experienced late effects. In the Netherlands, the validated Dutch version of the Edmonton Symptom Assessment System, Utrecht Symptom Diary (USD) is used to assess and monitor patient reported symptoms. As a first step to develop a specific USD module for TGCT-patients, it was necessary to identify the prevalence and intensity of late effects in patients with TGCT, covering the physical, social, psychical and existential domains of care. METHODS A cross-sectional study was conducted. First, literature was systematically assessed to create a comprehensive list of symptoms. This generated list was reviewed by expert healthcare professionals and the research group. Lastly, a survey was distributed amongst patients with TGCT in follow-up care in the University Medical Center Utrecht (UMCU) outpatient clinic. RESULTS In total, 65 TGCT-patients completed the survey. All described late effects were recognized by TGCT-patients, with 'fatigue', 'disturbed overall well-being', 'concentration problems' and 'neuropathy', indicated as most prevalent and scored with highest intensity. When prioritizing these late effects, patients assigned 'neuropathy' as most important. CONCLUSIONS This study provided insight into prevalence and intensity of late effects, as indicated by TGCT-patients. In clinical practice, follow-up care can improve by empowering patients to discuss important items in daily life with their health-care professionals.
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Affiliation(s)
- Roos Enzlin
- Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066CX, Amsterdam, the Netherlands; University Medical Center Utrecht, Department Medical Oncology, Heidelberglaan 100, 3584CX, Utrecht, the Netherlands.
| | - Sigrid C J M Vervoort
- University Medical Center Utrecht, Department of Nursing Science, Julius Center for Health Sciences and Primary Care, Heidelberglaan 100 3584CX, Utrecht, the Netherlands.
| | - Britt B M Suelmann
- University Medical Center Utrecht, Department Medical Oncology, Heidelberglaan 100, 3584CX, Utrecht, the Netherlands.
| | - Richard P Meijer
- University Medical Center Utrecht, Department of Oncological Urology, Heidelberglaan 100, 3584CX, Utrecht, the Netherlands.
| | - Saskia C C M Teunissen
- University Medical Center Utrecht, Department of Primary Care, Heidelberglaan 100, 3584CX, Utrecht, the Netherlands.
| | - Danielle Zweers
- University Medical Center Utrecht, Department Medical Oncology, Heidelberglaan 100, 3584CX, Utrecht, the Netherlands.
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11
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Grigelat A, Mumm F. [Cancer medicine in a state of flux - Where does psycho-oncology stand? : New challenges for cancer patients and treating physicians]. INNERE MEDIZIN (HEIDELBERG, GERMANY) 2023; 64:34-39. [PMID: 36598527 DOI: 10.1007/s00108-022-01454-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/01/2022] [Indexed: 01/05/2023]
Abstract
Despite significantly improved supportive measures, oncological treatment is still exhausting and is accompanied by organ loss, disability and functional limitations. In the longer term those affected have to cope with the loss of important life commodities and after the end of treatment to live under the much-cited "sword of Damocles". Around one third of all people diagnosed with cancer develop a mental disorder at some point during the course of the illness that requires treatment and pronounced stress reactions occur at key points over the course of treatment. Both mental disorders and subsyndromic distress can be successfully treated with psychotherapeutic and psycho-oncological interventions. Therefore, every cancer patient should be informed about the availability and potential benefit of psycho-oncological support after the diagnosis or in the further course of treatment.
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Affiliation(s)
- Angela Grigelat
- Praxis für Psychotherapie, Sendlinger-Tor-Platz 11, 80336, München, Deutschland.
| | - Friederike Mumm
- Medizinische Klinik und Poliklinik III, Klinikum der Universität München, LMU München, Comprehensive Cancer Center München (CCCM), München, Deutschland
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12
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Philteos J, Noel CW, Hallet J, Eskander A. Mental health considerations in patients undergoing complex head and neck reconstruction. Curr Opin Otolaryngol Head Neck Surg 2022; 30:380-383. [PMID: 35924661 DOI: 10.1097/moo.0000000000000827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW To summarize recent advances in the psycho-oncology literature, with a focus on findings relevant to the head and neck cancer patient. RECENT FINDINGS Patients with cancer are at an increased risk of suicide and self-harm. Head and neck cancer patients are among the highest risk compared with other cancer patients. Unique challenges pertaining to disfigurement and voicelessness may, in part, explain these observations. Patient-reported outcome measures can be used to help identify high-risk patients. SUMMARY Psychosocial support needs are highest for head and neck cancer patients. Patient-reported outcome measures should be integrated within clinical workflows to identify high-risk patients.
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Affiliation(s)
- Justine Philteos
- Department of Otolaryngology-Head and Neck Surgery, Sunnybrook Health Sciences Centre and Michael Garron Hospital
| | - Christopher W Noel
- Department of Otolaryngology-Head and Neck Surgery, Sunnybrook Health Sciences Centre and Michael Garron Hospital.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto
| | - Jullie Hallet
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto.,Division of Surgical Oncology, Odette Cancer Centre-Sunnybrook Health Sciences Centre, Toronto, Ontario.,Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Antoine Eskander
- Department of Otolaryngology-Head and Neck Surgery, Sunnybrook Health Sciences Centre and Michael Garron Hospital.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto
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13
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Wald T, Zebralla V, Boege M, Kunz V, Neumuth T, Dietz A, Wichmann G, Wiegand S. Web-Based Patient-Reported Outcomes for ENT Patients-Evaluation of the Status Quo, Patients' View, and Future Perspectives. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191811773. [PMID: 36142048 PMCID: PMC9517261 DOI: 10.3390/ijerph191811773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 09/10/2022] [Accepted: 09/16/2022] [Indexed: 05/05/2023]
Abstract
BACKGROUND Patient-reported outcomes (PRO) assess disease burden and indicate unmet needs. Home-based electronic PRO measures (ePROMs) can support tumor aftercare (TAC). Creating an ePROM is the next step after implementing the software "OncoFunction" to assess PROs during TAC of head- and neck-cancer patients (HNC). Therefore, internet use and perception on ePROMs of ENT and TAC patients were evaluated. METHODS From May-July 2020, ENT patients at a high-volume outpatient department aged >18 without need for emergency treatment were invited to complete a questionnaire concerning internet use and access, hardware, and opinion on the chances, requirements, and designs of ePROMs. RESULTS 415 questionnaires were evaluated; 46.3% of the respondents visited the common consultation hour (CCH) and 44.3% TAC; 71.9% were internet users, being younger than non-internet users; and 36.4% of TAC patients were non-internet users and 16.3% of them were without a web-enabled device. Significant differences existed in age and assessment of future perspectives between internet-/non-internet users and TAC/CCH patients, respectively. Regarding the design of ePROMs, patients preferred quarterly and short surveys. Data safety and feedback were important. CONCLUSIONS ePROMs are not suitable for everyone because of missing internet access and experience. A tailored approach to implement ePROMs in TAC is needed.
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Affiliation(s)
- Theresa Wald
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Leipzig Medical Centre, 04103 Leipzig, Germany
- Correspondence:
| | - Veit Zebralla
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Leipzig Medical Centre, 04103 Leipzig, Germany
| | - Maren Boege
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Leipzig Medical Centre, 04103 Leipzig, Germany
| | - Viktor Kunz
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Leipzig Medical Centre, 04103 Leipzig, Germany
| | - Thomas Neumuth
- Innovation Center Computer Assisted Surgery, University of Leipzig, 04103 Leipzig, Germany
| | - Andreas Dietz
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Leipzig Medical Centre, 04103 Leipzig, Germany
| | - Gunnar Wichmann
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Leipzig Medical Centre, 04103 Leipzig, Germany
| | - Susanne Wiegand
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Leipzig Medical Centre, 04103 Leipzig, Germany
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14
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McElroy JA, Waindim F, Weston K, Wilson G. A systematic review of the translation and validation methods used for the national comprehensive cancer network distress thermometer in non-English speaking countries. Psychooncology 2022; 31:1267-1274. [PMID: 35757974 DOI: 10.1002/pon.5989] [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: 01/10/2022] [Revised: 06/10/2022] [Accepted: 06/20/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The National Comprehensive Cancer Network (NCCN) distress thermometer (DT) was developed as a brief screening tool for detecting distress in cancer patients. Conceptually, distress was considered a more acceptable and inclusive term than other psychological terms such as depression or anxiety. It is used extensively in the United States and other English-speaking countries. We aim to describe the translation and validation methods of the DT and describe the recommended cutoff scores used to identify cancer patients experiencing clinically significant distress. METHODS Nine bibliographic databases were searched using keywords to identify original research studies for non-English speaking countries' cancer patients. Full articles were independently assessed for inclusion and data extraction by two authors. RESULTS The review of 4442 articles yielded 39 articles that validated the DT. We identified 20 languages in 25 countries. In all but one country, investigators were able to agree upon a word or phrase that meant distress in their native language that was subsequently validated against standardized instruments. Asian, Middle Eastern and European counties recommended cutoff score of 4 or 5 to identify clinically significant distress; however, European Union countries had a range of 2 to 7. CONCLUSIONS Use of the translated DT with non-English speaking cancer patients provides a simple and quick tool to identify high distress. Similar to NCCN, the cutoff score of 4 or 5 was suggested by 78% of the studies; however, more studies of different types of cancer and within and among more countries will strengthen a recommended global DT cutoff score.
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Affiliation(s)
- Jane A McElroy
- Department of Family and Community Medicine, University of Missouri, Columbia, Missouri, USA
| | - Flevis Waindim
- School of Medicine, University of Missouri, Columbia, Missouri, USA
| | - Karry Weston
- Department of Family and Community Medicine, University of Missouri, Columbia, Missouri, USA.,School of Nursing, University of Missouri, Columbia, Missouri, USA
| | - Gwendolyn Wilson
- Department of Family and Community Medicine, University of Missouri, Columbia, Missouri, USA
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15
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Mott NM, Mierzwa ML, Casper KA, Shah JL, Mallen-St Clair J, Ho AS, Zumsteg ZS, Prince ME, Dossett LA, Chen MM. Financial Hardship in Patients With Head and Neck Cancer. JCO Oncol Pract 2022; 18:e925-e937. [PMID: 35167324 PMCID: PMC9797234 DOI: 10.1200/op.21.00683] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
PURPOSE Financial hardship is a growing concern for patients with cancer. Patients with head and neck cancer (HNC) are particularly vulnerable, given that a third leave the workforce following treatment. The goal of our study was to characterize financial hardship in the psychologic response (response to increased expenses) and coping behaviors (behaviors patients adopt to manage their care in the setting of increased expenses) domains in patients with HNC compared with patients with other cancers. METHODS This was a retrospective cohort study of nationally representative public survey data from 2013 to 2018 in the National Health Interviews Survey, an annual cross-sectional household survey. We included respondents age ≥ 18 years who reported a diagnosis of cancer and identified a subset of patients with HNC. Our main outcomes were financial hardship in the psychologic response and coping behaviors domains. RESULTS Our sample included a weighted population of 357,052 patients with HNC and 21.4 million patients with other cancers. Compared with patients with other cancers, patients with HNC reported greater levels of coping behaviors hardship (31% v 23%, P = .015), but similar levels of psychologic financial hardship (73% v 72%, P = .787). Medicaid or uninsured patients more often reported coping behaviors hardship. On multivariable analysis, HNC (odds ratio, 1.51; 95% CI, 1.01 to 2.24) was independently associated with coping behaviors hardship. CONCLUSION To our knowledge, this is the first study to evaluate financial hardship in patients with HNC compared with patients with other cancers that includes Medicaid and uninsured patients, who are more often to have financial hardship. Patients with HNC have greater levels of hardship in the coping behaviors domain compared with patients with other cancers, but similar levels in the psychologic response domain.
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Affiliation(s)
| | | | - Keith A. Casper
- Department of Otolaryngology, University of Michigan, Ann Arbor, MI
| | - Jennifer L. Shah
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI
| | - Jon Mallen-St Clair
- Samuel Oschin Comprehensive Cancer Institute, Los Angeles, CA,Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Allen S. Ho
- Samuel Oschin Comprehensive Cancer Institute, Los Angeles, CA,Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Zachary S. Zumsteg
- Samuel Oschin Comprehensive Cancer Institute, Los Angeles, CA,Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Mark E.P. Prince
- Department of Otolaryngology, University of Michigan, Ann Arbor, MI
| | - Lesly A. Dossett
- Department of Surgery, University of Michigan, Ann Arbor, MI,Center for Bioethics and Social Sciences in Medicine (CBSSM), University of Michigan, Ann Arbor, MI,Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI
| | - Michelle M. Chen
- Samuel Oschin Comprehensive Cancer Institute, Los Angeles, CA,Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA,Michelle M. Chen, MD, MHS, Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, 8635 West Third St, Suite 590W, Los Angeles, CA 90048; e-mail:
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16
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Cruzado JA, Martínez-García V, González IP, Gutiérrez VS, Jarabo-Sarceda JR, Calatayud-Gastardi J, Teresa LDV, Fernández-Martín E, Gómez-Martínez AM, Hernando-Trancho F. Preoperative detection and evaluation of the need for psychological intervention in cancer and non-cancer patients referred to thoracic surgery. Cir Esp 2022; 100:359-366. [PMID: 35718372 DOI: 10.1016/j.cireng.2022.06.014] [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: 07/20/2020] [Accepted: 03/13/2021] [Indexed: 06/15/2023]
Abstract
OBJECTIVES (a) to evaluate and compare the psychological treatment needs of patients with cancer and non-cancer, who are going to undergo scheduled thoracic surgery, and (b) evaluate and compare the diagnostic accuracy of the screening tests of psychological treatment needs for cancer and non-cancer patients. METHOD The need for psychological treatment was evaluated in a total of 169 patients prior to thoracic surgery, through a clinical interview. The screening tests used were: the physician's judgment (yes/no), the Hospital Anxiety and Depression Scale (HADS) and, the single-item interview to assess depression "Do you feel depressed?" (DEPQ). RESULTS The number of patients who needed psychological treatment in the total sample was 47 (27.81%), in non-cancer-patients: 22 (30.99%) and in cancer patients: 25 (25.51%). The participants with treatment needs were more often young women with primary education levels, with more fears and concerns regarding their disease. With respect to the screening tests, the HADS-T (cut-off point ≥13) obtained a sensitivity (SE) of 0.75 and Specificity (SP) of 0.81 in the total sample. In patients with cancer, the HADS total score (cut-off point ≥10) obtained an SE=0.84 and SP=0.80, and, in non-cancer patients, the HADS total score (cut-off point ≥13) showed an SE=0.59 and SP=0.84. The DEPQ and the physician's judgment did not achieve adequate levels of precision. CONCLUSIONS A high percentage of patients have psychological treatment needs before performing thoracic surgery, which are similar for cancer and non-cancer patients. Preoperative detection of patients who need psychological intervention is feasible with a simple screening test: HADS, which achieves greater precision in cancer patients.
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Affiliation(s)
- Juan Antonio Cruzado
- Facultad de Psicología, Universidad Complutense de Madrid, Campus Somosaguas, 28040 Madrid, Spain.
| | - Vanesa Martínez-García
- Facultad de Psicología, Universidad Complutense de Madrid, Campus Somosaguas, 28040 Madrid, Spain
| | - Irene Pacheco González
- Facultad de Psicología, Universidad Complutense de Madrid, Campus Somosaguas, 28040 Madrid, Spain
| | - Verónica Salas Gutiérrez
- Facultad de Psicología, Universidad Complutense de Madrid, Campus Somosaguas, 28040 Madrid, Spain
| | - José Ramón Jarabo-Sarceda
- Thoracic Surgery Service, Hospital Clínico San Carlos de Madrid, Departamento Cirugía, Universidad Complutense de Madrid, Madrid, Spain
| | - Joaquín Calatayud-Gastardi
- Thoracic Surgery Service, Hospital Clínico San Carlos de Madrid, Departamento Cirugía, Universidad Complutense de Madrid, Madrid, Spain
| | - Laura Del Valle Teresa
- Facultad de Psicología, Universidad Complutense de Madrid, Campus Somosaguas, 28040 Madrid, Spain
| | - Elena Fernández-Martín
- Thoracic Surgery Service, Hospital Clínico San Carlos de Madrid, Departamento Cirugía, Universidad Complutense de Madrid, Madrid, Spain
| | - Ana María Gómez-Martínez
- Thoracic Surgery Service, Hospital Clínico San Carlos de Madrid, Departamento Cirugía, Universidad Complutense de Madrid, Madrid, Spain
| | - Florentino Hernando-Trancho
- Thoracic Surgery Service, Hospital Clínico San Carlos de Madrid, Departamento Cirugía, Universidad Complutense de Madrid, Madrid, Spain
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17
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Hayes T, Cunningham M, Trepanier A. Investigating factors that influence genetic counselors' decisions to refer patients to mental health providers. J Genet Couns 2022; 31:1113-1124. [PMID: 35460529 DOI: 10.1002/jgc4.1582] [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: 08/13/2021] [Revised: 04/06/2022] [Accepted: 04/11/2022] [Indexed: 11/09/2022]
Abstract
Genetic counselors (GC) serve patients who are often in distress at the time of their consultation. GC competency includes providing short-term, client-centered counseling, while using community resources, such as mental health providers (MHPs), for psychosocial support. The purpose of this study was to assess the mental health referral practices of GCs; specifically, the rate of referrals, factors influencing a GC's decision to refer, and barriers to referrals. GCs working in direct patient care for at least one year were recruited to take a novel 27 question survey created based on the results of a previous qualitative study. A link to the web-based survey was distributed through the National Society of Genetic Counselors Student Research Program and American Board of Genetic Counselors by email. A total of 144 individuals opened the survey for an estimated response rate of 3%. A majority of respondents (54.3%) reported they assess a patient's need for a mental health referral at least half of the time. The mean number of referrals made in the past 12 months was 5.13. After post-hoc analyses, there were no differences in referral rates between specialties. Common referral indications included patient history of mental illness, distress about having a genetic condition, and limited social support. Common barriers to referral were financial or insurance related, patient receptiveness, and the patient not perceiving a benefit. GCs felt that providing psychosocial support is within their scope of practice, but that MHPs are better equipped to manage long-term needs and those related to a mental health condition. This study provides insight into how GCs decide when they can manage patient distress, circumstances that prompt a referral to MHPs, and barriers. Recognizing common referral indications and barriers may lead to better strategies for connecting patients with such services.
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Affiliation(s)
- Taylor Hayes
- Center for Molecular Medicine and Genetics, Wayne State University School of Medicine, Detroit, Michigan, USA.,Henry Ford Health System, Detroit, Michigan, USA
| | - Mitchell Cunningham
- Center for Molecular Medicine and Genetics, Wayne State University School of Medicine, Detroit, Michigan, USA.,Mercy Clinic - Genetics, Mercy Hospital St. Louis, St. Louis, Missouri, USA
| | - Angela Trepanier
- Center for Molecular Medicine and Genetics, Wayne State University School of Medicine, Detroit, Michigan, USA
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18
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Brédart A, Kop JL, Tüchler A, De Pauw A, Cano A, Dick J, Rhiem K, Devilee P, Schmutzler R, Stoppa-Lyonnet D, Dolbeault S. Assessment of psychosocial difficulties by genetic clinicians and distress in women at high risk of breast cancer: a prospective study. Eur J Hum Genet 2022; 30:1067-1075. [PMID: 35399119 PMCID: PMC9437045 DOI: 10.1038/s41431-022-01096-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 03/03/2022] [Accepted: 03/22/2022] [Indexed: 12/12/2022] Open
Abstract
We examined how often genetic clinicians correctly identify psychosocial difficulties in women at high breast cancer risk and explored effects of this assessment and the genetic test result on counselees’ distress. A prospective observational study of counselee–clinician dyads was performed in three French, German and Spanish genetic clinics, involving 709 counselees (participation rate, 83.4%) and 31 clinicians (participation rate, 100%). Counselee–clinician agreement in perceived psychosocial difficulties was measured after the pre-test genetic consultation. Multivariate mixed linear models accounting for clinicians were tested. Predicted distress levels were assessed after the pre- (T1) and post-test result disclosure consultations (T2). Depending on the difficulty domain, clinicians adequately assessed the presence or absence of difficulties in 51% (“familial issues”) to 59% (“emotions”) of counselees. When counselees’ and clinicians’ perceptions disagreed, difficulties were generally underestimated by clinicians. Counselees’ distress levels remained stable from T1 to T2, irrespective of clinicians’ appraisal adequacy, and the genetic test result disclosure. Psychological referral need were found in 20–42% of counselees, more frequently observed for difficulties in the “emotions” domain. Our findings suggest that the genetic test result is a suboptimal indicator for psychological referral. Instead, clinicians should focus on emotions expressed by counselees to appraise their needs for psychological support.
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Affiliation(s)
- Anne Brédart
- Institut Curie, Supportive Care Department, Psycho-oncology Unit, 26 rue d'Ulm, 75005, Paris Cedex 05, France. .,Psychopathology and Health Process Laboratory UR4057, Psychology Institute, Paris University, 71 Avenue Edouard Vaillant, 92774, Boulogne-Billancourt, France.
| | - Jean-Luc Kop
- Université de Lorraine, 2LPN, 3 Place Godefroy de Bouillon, 54015, Nancy Cedex, France
| | - Anja Tüchler
- Center for Hereditary Breast and Ovarian Cancer, Faculty of Medicine and University Hospital Cologne, University Hospital of Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Antoine De Pauw
- Institut Curie, Department of Genetics, INSERM U830, Paris University, 26 rue d'Ulm, 75005, Paris Cedex 05, France
| | - Alejandra Cano
- University Autónoma of Barcelona, Clinical and Health Psychology Department, Barcelona, Spain
| | - Julia Dick
- Center for Hereditary Breast and Ovarian Cancer, Faculty of Medicine and University Hospital Cologne, University Hospital of Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Kerstin Rhiem
- Center for Hereditary Breast and Ovarian Cancer, Faculty of Medicine and University Hospital Cologne, University Hospital of Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Peter Devilee
- Leiden University Medical Centre, Department of Human Genetics, Department of Pathology, S4-P, P.O. Box 9600, 2300 RC, Leiden, The Netherlands
| | - Rita Schmutzler
- Center for Hereditary Breast and Ovarian Cancer, Faculty of Medicine and University Hospital Cologne, University Hospital of Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Dominique Stoppa-Lyonnet
- Institut Curie, Department of Genetics, INSERM U830, Paris University, 26 rue d'Ulm, 75005, Paris Cedex 05, France
| | - Sylvie Dolbeault
- Institut Curie, Supportive Care Department, Psycho-oncology Unit, 26 rue d'Ulm, 75005, Paris Cedex 05, France.,CESP, University Paris-Sud, UVSQ, INSERM, University Paris-Saclay, 16 Avenue Paul Vaillant-Couturier, 94807, Villejuif Cedex, France
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19
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Günther MP, Kirchebner J, Schulze JB, von Känel R, Euler S. Towards identifying cancer patients at risk to miss out on psycho-oncological treatment via machine learning. Eur J Cancer Care (Engl) 2022; 31:e13555. [PMID: 35137480 PMCID: PMC9286797 DOI: 10.1111/ecc.13555] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 07/14/2021] [Accepted: 01/24/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVE In routine oncological treatment settings, psychological distress, including mental disorders, is overlooked in 30% to 50% of patients. High workload and a constant need to optimise time and costs require a quick and easy method to identify patients likely to miss out on psychological support. METHODS Using machine learning, factors associated with no consultation with a clinical psychologist or psychiatrist were identified between 2011 and 2019 in 7,318 oncological patients in a large cancer treatment centre. Parameters were hierarchically ordered based on statistical relevance. Nested resampling and cross validation were performed to avoid overfitting. RESULTS Patients were least likely to receive psycho-oncological (i.e., psychiatric/psychotherapeutic) treatment when they were not formally screened for distress, had inpatient treatment for less than 28 days, had no psychiatric diagnosis, were aged 65 or older, had skin cancer or were not being discussed in a tumour board. The final validated model was optimised to maximise sensitivity at 85.9% and achieved an area under the curve (AUC) of 0.75, a balanced accuracy of 68.5% and specificity of 51.2%. CONCLUSION Beyond conventional screening tools, results might contribute to identify patients at risk to be neglected in terms of referral to psycho-oncology within routine oncological care.
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Affiliation(s)
- Moritz Philipp Günther
- Department of Consultation‐Liaison‐Psychiatry and Psychosomatic Medicine, University Hospital ZurichUniversity of ZurichZurichSwitzerland
| | - Johannes Kirchebner
- Department of Forensic PsychiatryUniversity Hospital of Psychiatry ZurichZurichSwitzerland
| | - Jan Ben Schulze
- Department of Consultation‐Liaison‐Psychiatry and Psychosomatic Medicine, University Hospital ZurichUniversity of ZurichZurichSwitzerland
| | - Roland von Känel
- Department of Consultation‐Liaison‐Psychiatry and Psychosomatic Medicine, University Hospital ZurichUniversity of ZurichZurichSwitzerland
| | - Sebastian Euler
- Department of Consultation‐Liaison‐Psychiatry and Psychosomatic Medicine, University Hospital ZurichUniversity of ZurichZurichSwitzerland
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20
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Galindo Vázquez O, Rivera S, Lerma A, Calderillo Ruiz G, Espinoza Bello M, Meneses A, Lerma C. Detection of psychosocial distress in cancer patients: A survey of Mexican oncologists. J Psychosoc Oncol 2021; 40:708-723. [PMID: 34845973 DOI: 10.1080/07347332.2021.1986765] [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: 10/19/2022]
Abstract
Purpose: Identification of patients' distress is relevant for an on-time referral to psychosocial treatment. The objective was to assess the implementation of the guidelines for distress managing in Mexican oncologists based on the NCCN guidelines.Design: The study was non-experimental and cross-sectional.Sample: Two hundred thirty-one oncologists participated with an average age of 38 ± 11 years.Methods: The likelihood of distress assessment was quantitatively evaluated.Findings: A high percentage of oncologists knew and used procedures to assess psychosocial discomfort. However, a smaller percentage used a valid and reliable instrument. Factors associated with performing distress identification procedures were knowing the distress guidelines and lack of time. Factors for questionnaire usage are the availability of brief instruments and the percentage of patients suffering from stress.Implications for Psychosocial Providers: Psychosocial providers should develop strategies to educate and ensure that oncologists are familiar with guidelines on distress in oncology. More dissemination of screening procedures and referral to psychosocial programs in oncology is required. Integrating a distress screening program involving psychosocial providers and oncologists should be approached as a routine in high-quality cancer care, to reduce the stigma associated with mental health services.
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Affiliation(s)
- Oscar Galindo Vázquez
- Service of Psycho-Oncology, Research and Development Unit of Psycho-Oncology, National Cancer Institute of Mexico, INCan, Mexico, Mexico
| | | | - Abel Lerma
- Institute of Health Sciences (ICSa), Autonomous University of the Hidalgo State, Pachuca, Mexico
| | | | | | - Abelardo Meneses
- Psicooncología, National Cancer Institute of Mexico, INCan, Mexico, Mexico
| | - Claudia Lerma
- National Cardiology Institute of Mexico, INCar, Mexico, Mexico
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21
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Fang S, Wang Y, He PK, Han XN, Yang Y, Hong T, Gong YJ. Cardiogenic shock caused by Takotsubo syndrome complicated with severe anxiety: A case report and literature review. Medicine (Baltimore) 2021; 100:e27812. [PMID: 34766592 PMCID: PMC8589232 DOI: 10.1097/md.0000000000027812] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 10/20/2021] [Accepted: 10/29/2021] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Takotsubo syndrome (TTS) is characterized by transient and reversible left ventricular systolic dysfunction, which are often associated with acute physical or emotional stressors. Cancer is one of the comorbidities in TTS, and TTS is even considered as a paraneoplastic syndrome, but its mechanism remains unclear. We report a patient in whom cancer and untreated mental disorders triggered TTS. PATIENT CONCERNS A 59-year-old man was transferred to the Department of Cardiology because of acute onset of severe chest pain and dyspnea before cystoscopy. He presented with hematuria, had been diagnosed with a high-grade urothelial bladder cancer, and underwent transurethral resection of bladder tumors 4 months previously. He had severe anxiety regarding recurrence and death from cancer, especially after the hematuria recurred. DIAGNOSIS TTS and severe anxiety. INTERVENTIONS The results of coronary angiography, a left ventriculogram, echocardiography, and the clinical outcome led to the diagnosis of TTS. The patient was treated with extracorporeal membrane oxygenation support, mechanical ventilation, and drugs for heart failure and anxiety. OUTCOMES Echocardiography showed normal wall motion on day 6 of symptom onset. Six months after symptom onset, the anxiety score was reduced from 12 to 11, and the patient had no episodes of any discomfort, and no evidence of cancer recurrence was observed. LESSONS Patients with cancer and TTS have a higher level of stress, and physicians need to pay more attention to early screening and early treatment of mental disorders in these patients. Prompt and effective multidisciplinary treatment, including psychological counseling and antianxiety drugs, can improve the prognosis in such cases.
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Affiliation(s)
- Shu Fang
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Yu Wang
- Department of Endocrinology, Peking University First Hospital, Beijing, China
| | - Peng-Kang He
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Xiao-Ning Han
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Ying Yang
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Tao Hong
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Yan-Jun Gong
- Department of Cardiology, Peking University First Hospital, Beijing, China
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22
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Burden of depression and anxiety disorders per disease codes in patients with lymphoma in Germany. Support Care Cancer 2021; 30:2387-2395. [PMID: 34761297 PMCID: PMC8795002 DOI: 10.1007/s00520-021-06677-w] [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: 08/25/2021] [Accepted: 11/02/2021] [Indexed: 11/06/2022]
Abstract
Purpose The aim of this study was to explore the incidence of depression and anxiety disorder diagnoses in a large German cohort of patients with Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL) diagnoses in comparison to patients without cancer over a 10-year time frame. Methods Patients with HL (n=687) and NHL (n=4130) were matched to cohorts without a cancer diagnosis (n=687 and 4130) by age, sex, and yearly consultation frequency. The primary outcome of the study was the incidence of depression and anxiety disorders. The relationship between lymphoma, separated into HL and NHL, and both depression and anxiety disorders was investigated using Cox regression models. Results We compared 687 patients with HL with 687 matched non-cancer individuals and 4130 patients with NHL with 4130 matched non-cancer individuals. Within 10 years of the index date, 24.0% of patients with HL and 22.3% of patients with NHL were diagnosed with depression. Anxiety disorders were diagnosed in 6.7% and 5.3% of patients with HL and NHL, respectively. On regression analyses, HL (HR 2.30, 95% CI 1.65–3.21, p<0.001) and NHL (HR 2.09, 95% CI 1.81–2.41, p<0.001) were positively associated with incident depression. The HR for anxiety disorders was 1.64 (95% CI 1.24–2.16, p<0.001) in patients with NHL, while HL was not associated with incident anxiety disorders (HR 1.21, 95% CI 0.71–2.07, p<0.478). Conclusion Lymphoma constitutes a risk factor for emerging depression and anxiety disorders. Following the diagnosis of lymphoma, screening and strategies to prevent the occurrence of these diseases seem warranted.
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23
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Licková K, Čoček A, Ambruš M, Soumarová R, Vránová J, Klézl P, Mitchell AJ, Raudenská J, Javůrková A. Rapid screening of depression and anxiety in cancer patients: Interview validation of emotion thermometers. Asian J Psychiatr 2021; 65:102827. [PMID: 34560569 DOI: 10.1016/j.ajp.2021.102827] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 08/19/2021] [Accepted: 08/26/2021] [Indexed: 01/06/2023]
Abstract
BACKGROUND AND OBJECTIVE This study aimed to determine the degree of depression and anxiety in cancer patients using the Emotion Thermometers (ET) and confirming their clinical usefulness compared to the gold standard interview, as well as determining optimal cut-off values for the appropriate identification of cancer patients' distress. METHODS We included 238 cancer patients and we used ET (Emotion Thermometers) to screen depression and anxiety and the Beck depression inventory for adults (BDI-II), the Generalized Anxiety Disorder 7-item scale (GAD-7) and the Mini-International Neuropsychiatric Interview (M.I.N.I) was used as the criterial validity standard. RESULTS The prevalence of anxiety on the M.I.N.I. was 24% and depression was 11%. The optimal value for diagnosis of depression from ET (Dep ET) appears to be > 4.5 (AUC 0.928) against M.I.N.I. Optimal score for anxiety from ET (AnxT ET) compared to GAD according to M.I.N.I. we determined the value of 3.5 (AUC 0.899). To determine the cut off score for distress using from ET (DT), we compared against GAD-7 and BDI-II RS (raw total score) and the most optimal was 4.5 (AUC 0.953). For analysis of the cut off score for quality of life (QoL) against the total sums of all parts of the ET, the value of 14.5 (AUC 0.892) forms the cut off between the negative and the positive clinical finding. CONCLUSIONS The results of the study support the use of ET as a rapid screening tool for the detection of depression, anxiety and distress in cancer patients.
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Affiliation(s)
- K Licková
- Radiotherapy and Oncology Department, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czechia
| | - A Čoček
- Department of Ear, Nose and Throat, Thomayer Hospital, Prague, Czechia
| | - M Ambruš
- Radiotherapy and Oncology Department, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czechia
| | - R Soumarová
- Radiotherapy and Oncology Department, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czechia
| | - J Vránová
- Institute of Medical Biophysics and Medical Informatics, Third Faculty of Medicine, Charles University, Prague, Czechia
| | - P Klézl
- Department of Urology, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czechia
| | - A J Mitchell
- Department of Psycho-oncology, University of Leicester, Leicester LE1 5WW, UK
| | - J Raudenská
- Department of Nursing, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czechia
| | - A Javůrková
- Department of Nursing, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czechia; Department of Clinical Psychology, University Hospital Kralovske Vinohrady, Prague, Czechia.
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24
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Seib C, Lazenby M, Dunn J, Chambers S. Considerations about risk of ongoing distress: what can we learn from repeat screening? Support Care Cancer 2021; 30:1011-1014. [PMID: 34697675 DOI: 10.1007/s00520-021-06621-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 10/08/2021] [Indexed: 10/20/2022]
Abstract
The importance of routine distress screening in cancer patients is widely acknowledged, though non-compliance with screening protocols is common. Cited reasons for non-adherence include lack of time and expertise and concerns about the resources associated with the identification and management of clinically relevant distress. This commentary examines changes in distress among people with cancer who participated in a tele-based psychosocial intervention, from the point of initial distress screening to 12 months after commencing the intervention. The goal is to contribute to the discussion about the potential infrastructure requirements of implementing screening programs among screening 'hesitant' cancer care services. Secondary analysis showed a general downward distress trajectory though the greatest reduction occurred between recruitment and baseline and before receiving a low-intensity psychosocial intervention (β = - 1.84, 95% CI - 2.12, - 1.56). While acknowledging transience of distress in some patients, our results support the possible therapeutic benefit of assessing and validating individuals' distress in the hope of preventing the development of more overt health problems associated with undiagnosed and untreated symptoms.
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Affiliation(s)
- Charrlotte Seib
- Menzies Health Institute Queensland, Griffith University, Clinical Sciences 2 Building, Parklands Drive, Southport, Queensland, 4215, Australia.
| | - Mark Lazenby
- School of Nursing, University of Connecticut, Mansfield, CT, USA
| | - Jeffrey Dunn
- Centre for Health Research, University of Southern Queensland, Darling Heights, Australia.,Prostate Cancer Foundation of Australia, Sydney, New South Wales, Australia.,Australian Catholic University, Brisbane, Australia
| | - Suzanne Chambers
- Menzies Health Institute Queensland, Griffith University, Clinical Sciences 2 Building, Parklands Drive, Southport, Queensland, 4215, Australia.,Centre for Health Research, University of Southern Queensland, Darling Heights, Australia.,Australian Catholic University, Brisbane, Australia.,Exercise Medicine Research Institute, Edith Cowan University, Perth, Australia
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25
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Nguyen TQ, Do TM, Pham TA. Screening for Psychological Distress in Vietnamese Cancer Patients: An Evaluation of the Distress Thermometer. Cancer Med 2021; 10:7793-7803. [PMID: 34559957 PMCID: PMC8559463 DOI: 10.1002/cam4.4298] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 08/02/2021] [Accepted: 08/11/2021] [Indexed: 12/16/2022] Open
Abstract
Background Psychological distress is prevalent in patients with cancer, negatively affecting their treatment and quality of life. Clinical guidelines recommended screening all cancer patients routinely for psychological problems using simple measures such as the Distress Thermometer (DT) and Problem List (PL). This study is the first research in Vietnam to identify the optimal DT cutoff point to screen distress and the relationship with PL items among cancer patients. Methods 300 cancer patients were recruited from 10 departments at Vietnam National Cancer Hospital (K hospital) and completed the DT and PL. Participants also completed the Patient Health Questionnaire‐9 (PHQ‐9) and the Generalized Anxiety Disorder‐7 (GAD‐7) with standard cutoff scores for identifying significant depression and anxiety. Results Receiver operating characteristic (ROC) curve analyses showed that a DT cutoff score of 4 had an area under the ROC curve of 0.81 and 0.82 using the PHQ‐9 and GAD‐7 cutoff scores of 10 as the criterion, respectively. This indicated good overall accuracy. This cutoff also showed a sensitivity of 0.87 and 0.92 for PHQ‐9 and GAD‐7 total score defined cases, respectively. Both specificity values were 0.58. In terms of the PL, 164 distressed patients (54.7%) reported significantly more emotional problems, family issues, and practical and physical problem, implying various causes contribute to psychological distress among cancer patients. Conclusions The study showed that the DT with a cutoff of 4 accompanied with PL is a simple and effective instrument compared to previous, longer measures commonly used to detect psychosocial distress in Vietnamese cancer patients. This cutoff point also identified patients with problems contributing towards distress.
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Affiliation(s)
| | - Tuyet Mai Do
- Vietnam National Cancer Hospital, Hanoi, Vietnam
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26
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Prevalence of Depression and Cancer - A systematic review. ZEITSCHRIFT FUR PSYCHOSOMATISCHE MEDIZIN UND PSYCHOTHERAPIE 2021; 68:74-86. [PMID: 34494936 DOI: 10.13109/zptm.2021.67.oa11] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Objective: While comorbidity of different forms of cancer and clinical depression is reported for many single studies, representative and global overviews are scarce. Methods: A systematic review was carried out (mainly based on Medline, Embase, Cochrane, PsychLit, and Psyndex) to identify studies in adult cancer patients from 2007 to 2019. Studies with noncancer populations and cancer survivors were excluded. Assessment methods of depression were chart-based diagnoses, interview-based and self-report questionnaires. Quality and plausibility were checked using the adapted Downs & Black checklist. Results: For all 210 included studies the prevalence rate of clinical depression varied from 7.9 % to 32.4 %, with a mean of 21.2 % depression for different (mixed) cancer entities. The different methods of assessment have led to under- (especially charts-based diagnoses) as well as overreporting for some forms of cancer. In general, the different assessment forms show an acceptable variation in prevalence. Conclusions: The risk for a cancer patient to suffer a clinical depression during the first year after diagnoses is 15 % to 20 %, meaning every fifth or sixth patients. Different cancer entities, stage of cancer and treatments as well as different cultural and medical backgrounds show only slight variation in prevalence rates.
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27
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Grandizio LC, Gehrman MD, Graham J, Dwyer CL, Sharma J, Goldberg S, Klena JC. The Ability of Upper Extremity Surgeons to Assess Patient's Functional Status. J Hand Surg Am 2021; 46:819.e1-819.e8. [PMID: 33846024 DOI: 10.1016/j.jhsa.2021.02.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 11/25/2020] [Accepted: 02/04/2021] [Indexed: 02/02/2023]
Abstract
PURPOSE To compare surgeon and patient assessment of upper extremity functional status at the time of initial consultation. We hypothesized that surgeons and patients demonstrate low levels of agreement with respect to assessing pain scores, functional status, and self-efficacy. METHODS One hundred forty-three consecutive new patients were evaluated by 1 of 5 fellowship-trained upper extremity surgeons. Patients completed a Numeric Pain Rating Scale as well as the Patient-Reported Outcomes Measurement Information System (PROMIS) Upper Extremity (UE), Pain Interference (PI), and Self-Efficacy (SE) instruments. Surgeons provided their own estimates of patient function on each questionnaire at the conclusion of the visit and were blinded to the results of the patient-reported outcome measures (PROMs) for the duration of the study. Estimation errors, which represent the absolute value of the difference between the patient's actual score and the surgeon's estimated score on each questionnaire, were calculated for each questionnaire. RESULTS As a group, surgeons assumed that the PROMIS UE and SE scores were higher than the patients' actual scores and assumed that patients had lower PROMIS PI scores than were actually reported. Mean estimation errors for all PROMIS instruments were greater than 10 points and larger than the SD for these instruments in the general population. CONCLUSIONS Upper extremity surgeons demonstrate difficulty assessing their patient's self-reported functional status, pain interference, and level of self-efficacy during initial consultations. CLINICAL RELEVANCE Although formalized PROMs are infrequently administered in orthopedic clinics, increased utilization of these questionnaires would allow for a more accurate baseline functional assessment. When evaluating new patients in the outpatient clinic, surgeons should recognize the potential limitations of their assessments of patient-reported function.
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Affiliation(s)
- Louis C Grandizio
- Department of Orthopaedic Surgery, Geisinger Medical Center, Danville, PA.
| | - Max D Gehrman
- Department of Orthopaedic Surgery, Geisinger Medical Center, Danville, PA
| | - Jove Graham
- Department of Orthopaedic Surgery, Geisinger Medical Center, Danville, PA
| | - C Liam Dwyer
- Department of Orthopaedic Surgery, Geisinger Medical Center, Danville, PA
| | - Jyoti Sharma
- Department of Orthopaedic Surgery, Geisinger Medical Center, Danville, PA
| | - Steven Goldberg
- Department of Orthopaedic Surgery, Geisinger Medical Center, Danville, PA
| | - Joel C Klena
- Department of Orthopaedic Surgery, Geisinger Medical Center, Danville, PA
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Şirin T, Göksel F. Investigation of the Spiritual Care Effects on Anxiety, Depression, Psychological Distress and Spiritual Levels of Turkish Muslim Radiotherapy Patients. JOURNAL OF RELIGION AND HEALTH 2021; 60:2484-2502. [PMID: 33128709 DOI: 10.1007/s10943-020-01117-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/16/2020] [Indexed: 06/11/2023]
Abstract
The aim of this study is to examine the spiritual care support given to Muslim cancer patients undergoing radiotherapy with an experimental study on the spirituality, anxiety, depression and distress levels of these patients. In this study, experimental research design with experimental control group was used. Personal information form designed by researchers, HAD scale, DT scale and Spirituality Scale was used for personal information. In conclusion, it was determined that the support for Islamic spiritual care had positive effects on hospitalized radiotherapy patients. According to the results obtained, it is recommended to examine in larger sample groups in different treatment programs in order to reveal the effect of spiritual care support.
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Affiliation(s)
- Turgay Şirin
- Islamic Sciences Faculty, Department of Psychology of Religion, Istanbul Sabahattin Zaim University, Halkalı Street, No: 281 Halkalı, Küçükcekmece, Istanbul, 34303, Turkey.
| | - Fatih Göksel
- Department of Radiation Oncology, SBÜ Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Mehmet Akif Ersoy Street, Yenimahalle, 06200, Ankara, Turkey
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29
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Meggiolaro E, De Padova S, Ruffilli F, Bertelli T, Bragagni M, Prati S, Pisotti L, Massa I, Foca F, Tamberi S, De Giorgi U, Zerbinati L, Tiberto E, Grassi L. From Distress Screening to Uptake: An Italian Multicenter Study of Cancer Patients. Cancers (Basel) 2021; 13:cancers13153761. [PMID: 34359662 PMCID: PMC8345103 DOI: 10.3390/cancers13153761] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 07/22/2021] [Accepted: 07/23/2021] [Indexed: 01/30/2023] Open
Abstract
INTRODUCTION Little consideration is given to the referral and uptake of available supportive services after distress screening. However, identifying the reasons for accepting or refusing help is mandatory for implementing a screening policy. The present study explored the practical usefulness of and potential barriers to the application of distress management. METHODS 406 cancer patients were consecutively selected and asked to complete the Distress Thermometer (DT) and Problem Check List (PL). All patients with a DT score ≥6 were invited for a post-DT telephone interview with a trained psychologist. RESULTS The 112 patients who refused to take part were more often older, retired, at a more advanced stage of illness, and with no previous experience of psychological intervention with respect to those who accepted. Of the 78 patients with a score ≥6 who were referred to the Psycho-Oncology Service, 65.4% accepted the telephone interview. Twenty-two patients rejected the initial invitation immediately for various reasons including logistic difficulties, physical problems, and feeling embarrassed about opening up to a psychologist. CONCLUSIONS Our study confirms that screening per sé is insufficient to deal with the problem of distress and that more emphasis should be placed on implementing referral and treatment.
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Affiliation(s)
- Elena Meggiolaro
- Psycho-Oncology Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, Italy; (S.D.P.); (F.R.); (T.B.)
- Correspondence: ; Tel.: +39-0543-739260; Fax: +39-0543-739151
| | - Silvia De Padova
- Psycho-Oncology Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, Italy; (S.D.P.); (F.R.); (T.B.)
| | - Federica Ruffilli
- Psycho-Oncology Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, Italy; (S.D.P.); (F.R.); (T.B.)
| | - Tatiana Bertelli
- Psycho-Oncology Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, Italy; (S.D.P.); (F.R.); (T.B.)
| | - Marina Bragagni
- Nursing and Technical Administration, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, Italy; (M.B.); (S.P.); (L.P.)
| | - Sabrina Prati
- Nursing and Technical Administration, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, Italy; (M.B.); (S.P.); (L.P.)
| | - Lidia Pisotti
- Nursing and Technical Administration, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, Italy; (M.B.); (S.P.); (L.P.)
| | - Ilaria Massa
- Healthcare Administration, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, Italy;
| | - Flavia Foca
- Unit of Biostatistics and Clinical Trials, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, Italy;
| | - Stefano Tamberi
- Medical Oncology Unit, Ospedale degli Infermi, 48018 Faenza, Italy;
| | - Ugo De Giorgi
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, Italy;
| | - Luigi Zerbinati
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, 44121 Ferrara, Italy; (L.Z.); (E.T.); (L.G.)
| | - Elisa Tiberto
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, 44121 Ferrara, Italy; (L.Z.); (E.T.); (L.G.)
| | - Luigi Grassi
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, 44121 Ferrara, Italy; (L.Z.); (E.T.); (L.G.)
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Günther MP, Schulze JB, Jellestad L, Mehnert-Theuerkauf A, von Känel R, Euler S. Mental disorders, length of hospitalization, and psychopharmacy-New approaches to identify barriers to psychological support for patients with cancer. Psychooncology 2021; 30:1773-1781. [PMID: 34089283 DOI: 10.1002/pon.5743] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 05/04/2021] [Accepted: 06/01/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND Despite abundant evidence that emotional distress is frequent in cancer patients and associated with adverse health outcomes, distress screening rates and adequate referrals to psychological support programs among those in need are insufficient in many cancer centers. We therefore aimed to analyze patient- and treatment-related barriers to distress screening and referrals to psychological support as a mandatory component of best-practice cancer care. METHOD In the present explorative study, latent class analysis was used to identify homogeneous subgroups among 4837 patients diagnosed with cancer between 2011 and 2019. RESULTS Four subgroups were identified. Patients with a mental disorder and psychopharmacology were least probable to be screened for distress. Together with patients aged 65 or older and male patients, they were also less likely to receive psychological support. Patients hospitalized for 28 days or longer were most likely to be both screened and to receive psychological support. CONCLUSIONS Clinicians and researchers are recommended not neglect patients with mental disorders and psychopharmacological treatment as well as male and elderly patients when screening for distress and providing access to psychological support.
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Affiliation(s)
- Moritz Philipp Günther
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Jan Ben Schulze
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Lena Jellestad
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Anja Mehnert-Theuerkauf
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
| | - Roland von Känel
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Sebastian Euler
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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Cruzado JA, Martínez-García V, González IP, Gutiérrez VS, Jarabo-Sarceda JR, Calatayud-Gastardi J, Teresa LDV, Fernández-Martín E, Gómez-Martínez AM, Hernando-Trancho F. Preoperative detection and evaluation of the need for psychological intervention in cancer and non-cancer patients referred to thoracic surgery. Cir Esp 2021; 100:S0009-739X(21)00113-5. [PMID: 33972062 DOI: 10.1016/j.ciresp.2021.03.010] [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: 07/20/2020] [Revised: 02/16/2021] [Accepted: 03/13/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVES (a) to evaluate and compare the psychological treatment needs of patients with cancer and non-cancer, who are going to undergo scheduled thoracic surgery, and (b) evaluate and compare the diagnostic accuracy of the screening tests of psychological treatment needs for cancer and non-cancer patients. METHOD The need for psychological treatment was evaluated in a total of 169 patients prior to thoracic surgery, through a clinical interview. The screening tests used were: the physician's judgment (yes/no), the Hospital Anxiety and Depression Scale (HADS) and, the single-item interview to assess depression "Do you feel depressed?" (DEPQ). RESULTS The number of patients who needed psychological treatment in the total sample was 47 (27.81%), in non-cancer-patients: 22 (30.99%) and in cancer patients: 25 (25.51%). The participants with treatment needs were more often young women with primary education levels, with more fears and concerns regarding their disease. With respect to the screening tests, the HADS-T (cut-off point ≥13) obtained a sensitivity (SE) of 0.75 and Specificity (SP) of 0.81 in the total sample. In patients with cancer, the HADS total score (cut-off point ≥10) obtained an SE=0.84 and SP=0.80, and, in non-cancer patients, the HADS total score (cut-off point ≥13) showed an SE=0.59 and SP=0.84. The DEPQ and the physician's judgment did not achieve adequate levels of precision. CONCLUSIONS A high percentage of patients have psychological treatment needs before performing thoracic surgery, which are similar for cancer and non-cancer patients. Preoperative detection of patients who need psychological intervention is feasible with a simple screening test: HADS, which achieves greater precision in cancer patients.
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Affiliation(s)
- Juan Antonio Cruzado
- Facultad de Psicología, Universidad Complutense de Madrid, Campus Somosaguas, 28040 Madrid, Spain.
| | - Vanesa Martínez-García
- Facultad de Psicología, Universidad Complutense de Madrid, Campus Somosaguas, 28040 Madrid, Spain
| | - Irene Pacheco González
- Facultad de Psicología, Universidad Complutense de Madrid, Campus Somosaguas, 28040 Madrid, Spain
| | - Verónica Salas Gutiérrez
- Facultad de Psicología, Universidad Complutense de Madrid, Campus Somosaguas, 28040 Madrid, Spain
| | - José Ramón Jarabo-Sarceda
- Thoracic Surgery Service, Hospital Clínico San Carlos de Madrid, Departamento Cirugía, Universidad Complutense de Madrid, Madrid, Spain
| | - Joaquín Calatayud-Gastardi
- Thoracic Surgery Service, Hospital Clínico San Carlos de Madrid, Departamento Cirugía, Universidad Complutense de Madrid, Madrid, Spain
| | - Laura Del Valle Teresa
- Facultad de Psicología, Universidad Complutense de Madrid, Campus Somosaguas, 28040 Madrid, Spain
| | - Elena Fernández-Martín
- Thoracic Surgery Service, Hospital Clínico San Carlos de Madrid, Departamento Cirugía, Universidad Complutense de Madrid, Madrid, Spain
| | - Ana María Gómez-Martínez
- Thoracic Surgery Service, Hospital Clínico San Carlos de Madrid, Departamento Cirugía, Universidad Complutense de Madrid, Madrid, Spain
| | - Florentino Hernando-Trancho
- Thoracic Surgery Service, Hospital Clínico San Carlos de Madrid, Departamento Cirugía, Universidad Complutense de Madrid, Madrid, Spain
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Bergerot CD, Razavi M, Clark KL, Philip EJ, Pal SK, Loscalzo M, Dale W. Emotional problem-related distress screening and its prevalence by cancer type: Assessment by patients' characteristics and level of assistance requested. Psychooncology 2021; 30:1332-1338. [PMID: 33797817 DOI: 10.1002/pon.5685] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 03/09/2021] [Accepted: 03/24/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Emotional problem-related distress is a common issue faced by patients with cancer. However, patients suffering with this emotional burden do not typically seek assistance. This study sought to determine the prevalence of emotional problem-related distress by cancer type, and identify factors correlated with the level of assistance requested. METHODS Using the SupportScreen®, patients were screened for emotional problem-related distress at their first or second visit to an NCI designated Comprehensive Cancer Center. General Linear Model was used to test the association between emotional problem-related distress and type of cancer, and the relationship between level of assistance requested and patients' characteristics. RESULTS A total of 2,421 patients were included in this analysis. Patients were mostly female (62%), diagnosed with breast (24%), gynecological (16%) or gastrointestinal (15%) cancers. Highest levels of emotional problem-related distress were reported by patients diagnosed with lung, gynecological, breast and gastrointestinal cancers. Level of assistance requested were significantly associated with problem-related distress scores (p < 0.001), which were higher among patients with lower household incomes (p < 0.001) and Spanish as primary language (p = 0.001). CONCLUSION Our study found an association between Level of assistance requested and emotional problem-related distress, which were heightened by lower income and Spanish-speaking. Intervention strategies should be considered to increase access to psychosocial support services.
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Affiliation(s)
- Cristiane Decat Bergerot
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Marianne Razavi
- Department of Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Karen Lynn Clark
- Department of Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Errol J Philip
- Medical School, University of California San Francisco, San Francisco, California, USA
| | - Sumanta Kumar Pal
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Matthew Loscalzo
- Department of Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - William Dale
- Department of Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, California, USA
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Götz A, Kröner A, Jenewein J, Spirig R. Wie erleben und beurteilen Pflegende das Screening von stationären onkologischen Patient_innen mit dem Belastungsthermometer? Pflege 2021; 34:71-79. [PMID: 33535833 DOI: 10.1024/1012-5302/a000790] [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: 11/19/2022]
Abstract
How do nurses experience and interpret the screening of hospitalised cancer patients by means of the distress thermometer? - A qualitative study Abstract. Background: People with cancer experience distress and may need professional support. In 2012, the University Hospital Zurich introduced its distress thermometer (DT) screening, whereby all inpatients were to be screened to gauge their support need. However, after five years, the screening rate was 40 % and the referral rate to psycho oncology was 7.9 %, surprisingly low. Aim: The aim of this qualitative study was to describe how nurses experience the screening and how they interpret the screening and referral rate. Methods: The evaluation of three focus group interviews with 14 nurses followed the principles of qualitative content analysis according to Mayring. Results: The analysis revealed four main categories. The first category "Trying to perform useful screening in a complex daily routine" comprises three subcategories: "Using the benefits of screening for comprehensive care", "The best way to recognize the individuality of the counterpart" and "Failing due to structural and personal barriers". Three further main categories addressing nurses' personal attitudes complete the screening experience: "Experiencing fewer difficulties due to competence and experience", "Being careful due to hesitations", and "Reflecting one's responsibility". Conclusions: Nurses want to use the DT. However, they need more practical and scientific support to usefully integrate screening into their everyday life.
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Affiliation(s)
- Anna Götz
- Comprehensive Cancer Center Zürich, Universitätsspital Zürich.,PhD Programm, Department für Pflegewissenschaft, Universität Witten / Herdecke
| | | | - Josef Jenewein
- Triaplus Ag - Integrierte Psychiatrie Uri, Schwyz und Zug
| | - Rebecca Spirig
- PhD Programm, Department für Pflegewissenschaft, Universität Witten / Herdecke.,Institut für Pflegewissenschaft, Universität Basel
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Hammermüller C, Hinz A, Dietz A, Wichmann G, Pirlich M, Berger T, Zimmermann K, Neumuth T, Mehnert-Theuerkauf A, Wiegand S, Zebralla V. Depression, anxiety, fatigue, and quality of life in a large sample of patients suffering from head and neck cancer in comparison with the general population. BMC Cancer 2021; 21:94. [PMID: 33482771 PMCID: PMC7825198 DOI: 10.1186/s12885-020-07773-6] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 12/26/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Treatment of head and neck cancer (HNC) often leads to visible and severe functional impairments. In addition, patients often suffer from a variety of psychosocial problems, significantly associated with a decreased quality of life. We aimed to compare depression, anxiety, fatigue and quality of life (QoL) between HNC patients and a large sample of the general population in Germany and to examine the impact of sociodemographic, behavioral and clinical factors on these symptoms. METHODS We assessed data of HNC patients during the aftercare consultation at the Leipzig University Medical Center with a patient reported outcome (PRO) tool named "OncoFunction". Depression, anxiety, fatigue and QoL were assessed using validated outcome measures including the PHQ-9, the GAD-2, and the EORTC QLQ-C30 questionnaire. RESULTS A total of 817 HNC patients were included in our study and compared to a sample of 5018 individuals of the general German population. HNC patients showed significantly higher levels of impairment in all dimensions assessed. Examination of association between depression, anxiety, fatigue and QoL and clinical as well as sociodemographic variables showed significant relationships between occupational status, ECOG-state, body mass index and time since diagnosis. CONCLUSIONS HNC patients suffer significantly from psychological distress. The used questionnaires are suitable for the use in daily routine practice and can be helpful to increase the detection of depression, anxiety and fatigue and therefore can improve HNC aftercare.
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Affiliation(s)
- C Hammermüller
- Clinic of Otolaryngology, Head and Neck Surgery, University of Leipzig, Leipzig, Germany
| | - A Hinz
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - A Dietz
- Clinic of Otolaryngology, Head and Neck Surgery, University of Leipzig, Leipzig, Germany
| | - G Wichmann
- Clinic of Otolaryngology, Head and Neck Surgery, University of Leipzig, Leipzig, Germany
| | - M Pirlich
- Clinic of Otolaryngology, Head and Neck Surgery, University of Leipzig, Leipzig, Germany
| | - T Berger
- Clinic of Otolaryngology, Head and Neck Surgery, University of Leipzig, Leipzig, Germany
| | - K Zimmermann
- Clinic of Otolaryngology, Head and Neck Surgery, University of Leipzig, Leipzig, Germany
| | - T Neumuth
- Innovation Center Computer Assisted Surgery (ICCAS), University of Leipzig, Leipzig, Germany
| | - A Mehnert-Theuerkauf
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - S Wiegand
- Clinic of Otolaryngology, Head and Neck Surgery, University of Leipzig, Leipzig, Germany
| | - V Zebralla
- Clinic of Otolaryngology, Head and Neck Surgery, University of Leipzig, Leipzig, Germany.
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Chen L, Ma X, Zhu N, Xue H, Zeng H, Chen H, Wang X, Ma X. Facial Expression Recognition With Machine Learning and Assessment of Distress in Patients With Cancer. Oncol Nurs Forum 2021; 48:81-93. [PMID: 33337433 DOI: 10.1188/21.onf.81-93] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVES To estimate the effectiveness of combining facial expression recognition and machine learning for better detection of distress. SAMPLE & SETTING 232 patients with cancer in Sichuan University West China Hospital in Chengdu, China. METHODS & VARIABLES The Distress Thermometer (DT) and Hospital Anxiety and Depression Scale (HADS) were used as instruments. The HADS included scores for anxiety (HADS-A), depression (HADS-D), and total score (HADS-T). Distressed patients were defined by the DT cutoff score of 4, the HADS-A cutoff score of 8 or 9, the HADS-D cutoff score of 8 or 9, or the HADS-T cutoff score of 14 or 15. The authors applied histogram of oriented gradients to extract facial expression features from face images, and used a support vector machine as the classifier. RESULTS The facial expression features showed feasible differentiation ability on cases classified by DT and HADS. IMPLICATIONS FOR NURSING Facial expression recognition could serve as a supplementary screening tool for improving the accuracy of distress assessment and guide strategies for treatment and nursing.
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Affiliation(s)
| | - Xiangtian Ma
- University of Electronic Science and Technology of China
| | | | | | | | | | - Xupeng Wang
- University of Electronic Science and Technology of China
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Dreismann L, Goretzki A, Ginger V, Zimmermann T. What if… I Asked Cancer Patients About Psychological Distress? Barriers in Psycho-Oncological Screening From the Perspective of Nurses-A Qualitative Analysis. Front Psychiatry 2021; 12:786691. [PMID: 35153856 PMCID: PMC8825354 DOI: 10.3389/fpsyt.2021.786691] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 12/06/2021] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Screening questionnaires to assess psychological distress in cancer patients are well-established, but in practice there are difficulties in implementation screening up to referral to psycho-oncology. Interdisciplinary collaboration between psycho-oncology, physicians, and nursing is very important to this process. However, there are barriers and obstacles on all sides. OBJECTIVE The aim of this study is to capture in particular the barriers from the perspective of oncology nursing. MATERIALS AND METHODS Semi-structured interviews with nursing experts (n = 15; n = 10 female; 24-62 years) from different oncology departments of three university hospitals in Germanys were conducted and qualitative content analysis was carried out by two raters. RESULTS The Screening routine is variably well-integrated into daily clinical practice. Structural barriers such as time pressure and a lack of focus on mental distress in nursing are present. Barriers on the side of nurses are primarily a lack of knowledge and communication insecurities when dealing with patients. CONCLUSIONS There is a need for training and implementation of a disciplinary screening approach. The structural and organizational barriers, which are a challenge for the successful screening process due to unfavorable interdisciplinary team communication and clinical daily structure, should be addressed in further studies. Implications for Practice: In order to establish an interdisciplinary screening process and to overcome the barriers, trainings to deal with knowledge deficits and insecurities seem to be useful.
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Affiliation(s)
- Lara Dreismann
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hanover, Germany
| | - Alina Goretzki
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hanover, Germany
| | - Viktoria Ginger
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hanover, Germany
| | - Tanja Zimmermann
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hanover, Germany
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Kim KO, Jung SY, Chang YJ. A Qualitative Study on Discharge Planning Needs for Cancer Patients. ASIAN ONCOLOGY NURSING 2021. [DOI: 10.5388/aon.2021.21.2.110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Kyung Ok Kim
- Department of Nursing, Kyungbok University, Namyangju, Korea
| | - So-Youn Jung
- Center for Breast Cancer, National Cancer Center, Ilsan, Korea
| | - Yoon Jung Chang
- Division of Cancer Control and Policy, National Cancer Center, Ilsan, Korea
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Charalampopoulou M, Syrigos K, Filopoulos E, Megalooikonomou V, Vlachakis D, Chrousos G, Darviri C. Reliability and Validity of the Newly Diagnosed Breast Cancer Stress Scale in the Greek Population. JOURNAL OF MOLECULAR BIOCHEMISTRY 2020; 9:5-12. [PMID: 33553009 PMCID: PMC7861504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To examine the validity and the reliability of a novel measurement tool, the Newly Diagnosed Breast Cancer Stress Scale (NDBCSS) in the Greek population. The tool aimed to assess distress in patients recently diagnosed with breast cancer. METHODS We performed a principal component analysis (PCA) of the 17 items of the scale. RESULTS The PCA resulted in 4 factors: 1. Personal life, 2. Procedural issues, 3. Facing challenges and 4. Psychological load. All subscales showed satisfactory internal consistency and variance, relative to theoretical score ranges. Subscale scores and total score were significantly correlated with perceived stress and hospital anxiety and depression scale, implying good criterion validity. Associations with social, demographic and disease related information were also found. CONCLUSIONS The NDBCSS resulted in acceptable reliability and good validity, and was considered as a valuable tool for health-care workers and oncologists to measure psychological distress in early stage of breast cancer.
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Affiliation(s)
- Maria Charalampopoulou
- Postgraduate Course Stress Science and Health Promotion, School of Medicine, University Athens, Athens, Greece
| | - Konstantinos Syrigos
- Postgraduate Course Stress Science and Health Promotion, School of Medicine, University Athens, Athens, Greece, 3rd Oncology Unit GPP, Sotiria General Hospital, Athens, Greece
| | - Evaggelos Filopoulos
- Breast Cancer Department, Agios Savvas General Oncology Hospital, Athens, Greece
| | - Vasileios Megalooikonomou
- Computer Engineering and Informatics Department, School of Engineering, University of Patras, Patras 26500, Greece
| | - Dimitrios Vlachakis
- Laboratory of Genetics, Department of Biotechnology, School of Food, Biotechnology and Development, Agricultural University of Athens, 75 Iera Odos, 11855, Athens, Greece
- Lab of Molecular Endocrinology, Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - George Chrousos
- Postgraduate Course Stress Science and Health Promotion, School of Medicine, University Athens, Athens, Greece
| | - Christina Darviri
- Postgraduate Course Stress Science and Health Promotion, School of Medicine, University Athens, Athens, Greece
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Matis J, Svetlak M, Slezackova A, Svoboda M, Šumec R. Mindfulness-Based Programs for Patients With Cancer via eHealth and Mobile Health: Systematic Review and Synthesis of Quantitative Research. J Med Internet Res 2020; 22:e20709. [PMID: 33196452 PMCID: PMC7704284 DOI: 10.2196/20709] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 09/22/2020] [Accepted: 09/30/2020] [Indexed: 01/07/2023] Open
Abstract
Background eHealth mindfulness-based programs (eMBPs) are on the rise in complex oncology and palliative care. However, we are still at the beginning of answering the questions of how effective eMBPs are and for whom, and what kinds of delivery modes are the most efficient. Objective This systematic review aims to examine the feasibility and efficacy of eMBPs in improving the mental health and well-being of patients with cancer, to describe intervention characteristics and delivery modes of these programs, and to summarize the results of the included studies in terms of moderators, mediators, and predictors of efficacy, adherence, and attrition. Methods In total, 4 databases (PubMed, PsycINFO, Scopus, and Web of Knowledge) were searched using relevant search terms (eg, mindfulness, program, eHealth, neoplasm) and their variations. No restrictions were imposed on language or publication type. The results of the efficacy of eMBPs were synthesized through the summarizing effect estimates method. Results
A total of 29 published papers describing 24 original studies were included in this review. In general, the results indicate that eMBPs have the potential to reduce the levels of stress, anxiety, depression, fatigue, sleep problems, and pain, and improve the levels of mindfulness, posttraumatic growth, and some parameters of general health. The largest median of Cohen d effect sizes were observed in reducing anxiety and depression (within-subject: median −0.38, IQR −0.62 to −0.27; between-group:
median −0.42, IQR −0.58 to −0.22) and facilitating posttraumatic growth (within-subject: median 0.42, IQR 0.35 to 0.48;
between-group: median 0.32, IQR 0.22 to 0.39). The efficacy of eMBP may be comparable with that of parallel, face-to-face
MBPs in some cases. All studies that evaluated the feasibility of eMBPs reported that they are feasible for patients with cancer.
Potential moderators, mediators, and predictors of the efficacy, attrition, and adherence of eMBPs are discussed.
Conclusions Although the effects of the reviewed studies were highly heterogeneous, the review provides evidence that eMBPs are an appropriate way for mindfulness practice to be delivered to patients with cancer. Thus far, existing eMBPs have mostly attempted to convert proven face-to-face mindfulness programs to the eHealth mode. They have not yet fully exploited the potential of eHealth technology.
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Affiliation(s)
- Juraj Matis
- Department of Psychology, Faculty of Arts, Masaryk University, Brno, Czech Republic
| | - Miroslav Svetlak
- Department of Psychology and Psychosomatics, Faculty of Medicine, Masaryk University, Brno, Czech Republic.,Department of Psychiatry, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Alena Slezackova
- Department of Psychology, Faculty of Arts, Masaryk University, Brno, Czech Republic.,Department of Psychology and Psychosomatics, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Marek Svoboda
- Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Rastislav Šumec
- Department of Psychology and Psychosomatics, Faculty of Medicine, Masaryk University, Brno, Czech Republic.,First Department of Neurology, Faculty of Medicine, Masaryk University and St. Anne's University Hospital, Brno, Czech Republic
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Abd El-Aziz N, Khallaf S, Abozaid W, Elgohary G, Abd El-Fattah O, Alhawari M, Khaled S, AbdelHaffez A, Kamel E, Mohamed S. Is it the time to implement the routine use of distress thermometer among Egyptian patients with newly diagnosed cancer? BMC Cancer 2020; 20:1033. [PMID: 33109093 PMCID: PMC7592584 DOI: 10.1186/s12885-020-07451-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 09/22/2020] [Indexed: 01/30/2023] Open
Abstract
Background The distress thermometer (DT) is an effective tool for identifying distress among cancer patients worldwide. However, DT has not been studied in Egyptian patients. We aimed to study the prevalence of distress among Egyptian patients with different types of cancers using DT. Methods A total of 550 patients with newly diagnosed hematological and solid cancers who were followed up at 3 Oncology Centers in Egypt were enrolled. They completed a sociodemographic and clinical status questionnaire, the DT and the Problem List (PL) scale. Results At a DT cut-off score of ≥4, 46% of patients had significant distress, which was related to the tumor site and stage. The most frequent problems reported were treatment decision (64.4%), worry (47%), and fears (44.5%). In univariate logistic regression analysis, participants who had significant distress described 23 out of 36 problems in the practical, family, emotional, and physical areas. After adjustment to sociodemographic and clinical characteristics, multivariable analysis confirmed that insurance, depression, fear, sadness, worry, loss of interest in usual activity, and sleep were independent factors associated with significant distress in cancer patients. Conclusions Almost half of Egyptian patients newly diagnosed with cancer reported significant distress. Those who had significant distress described extra problems in the practical, family, emotional, and physical areas. We recommend the routine use of DT for screening Egyptian patients with cancer, as well as the involvement of the psycho-oncology and social services, at the time of their initial diagnosis.
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Affiliation(s)
- Nashwa Abd El-Aziz
- Department of Medical Oncology, South Egypt Cancer Institute, Assiut University, Assiut, Egypt.,Hematology-Oncology Department, King Khaled University hospital, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Salah Khallaf
- Department of Medical Oncology, South Egypt Cancer Institute, Assiut University, Assiut, Egypt
| | - Waleed Abozaid
- Department of Clinical Oncology, Faculty of Medicine, Mansura University, Mansura, Egypt
| | - Ghada Elgohary
- Hematology-Oncology Department, King Khaled University hospital, King Saud University, Riyadh, Kingdom of Saudi Arabia.,Department of Adult Hematology/Internal Medicine, Ain Shams University, College of Medicine, Cairo, Egypt
| | - Ola Abd El-Fattah
- Department of Adult Hematology/Internal Medicine, Ain Shams University, College of Medicine, Cairo, Egypt.,Department of Clinical Oncology, Faculty of medicine, Assiut University, Assiut, Egypt
| | - Mai Alhawari
- Hematology-Oncology Department, King Khaled University hospital, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Safaa Khaled
- Department of Internal Medicine, Clinical Hematology Unit/Unit of Bone Marrow Transplantation, South Egypt Cancer Institute, Assiut University, Assiut, Egypt
| | - Azza AbdelHaffez
- Department of Medical Physiology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Ehab Kamel
- Department of Pyschiatry, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Sherif Mohamed
- Department of Chest Diseases and Tuberculosis, Faculty of Medicine, Assiut University, Assiut, Egypt.
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Berezowska A, Passchier E, Bleiker E. Professional patient navigation in a hospital setting: a randomized controlled trial. Support Care Cancer 2020; 29:2111-2123. [PMID: 32864723 DOI: 10.1007/s00520-020-05721-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 08/26/2020] [Indexed: 11/24/2022]
Abstract
PURPOSE This study aimed to determine the effect of patient navigation on health-related quality of life, distress, self-care knowledge, self-efficacy, satisfaction, and healthcare usage. METHODS Patients newly diagnosed with ovarian, vulvar, endometrial, melanoma stage III/IV, lung, or renal cancer were randomly assigned to either care as usual or care as usual plus consultations with a patient navigator (i.e., specially trained oncology nurse who monitors, advises, and refers patients to supportive cancer care). Measures included the EORTC-QLQ-C30, distress thermometer, and study-specific questions inspired by the Symptom-Management Self-Efficacy Scale Breast Cancer, Patient Satisfaction with Cancer Care Scale, and the Medical Consumption Questionnaire. Measures were completed before randomization (baseline) and at 1 month, 3 months, and 5 months after baseline. RESULTS In the case of health-related quality of life, no significant difference was observed between the intervention (n = 42) and the control group (n = 47). Consumption of supportive cancer care was low for both the intervention and the control group but relatively lower for the intervention group. Also, participants who consulted the patient navigator seemed to have higher levels of self-efficacy and satisfaction. CONCLUSION Although the intervention sorted no relevant effects on health-related quality of life, it did affect patients' experience of cancer care and self-efficacy. We recommend that patient navigators monitor and advise on unmet supportive care needs, but only in the case of high-risk patients. Furthermore, considering current and prior research, it is wise to study patient navigation using more sensitive outcome measures than health-related quality of life.
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Affiliation(s)
- Aleksandra Berezowska
- Center for Quality of Life, Netherlands Cancer Institute, Mailbox 90203, 1006 BE, Amsterdam, Netherlands.,Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Mailbox 90203, 1006 BE, Amsterdam, Netherlands
| | - Ellen Passchier
- Center for Quality of Life, Netherlands Cancer Institute, Mailbox 90203, 1006 BE, Amsterdam, Netherlands
| | - Eveline Bleiker
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Mailbox 90203, 1006 BE, Amsterdam, Netherlands.
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Medina-Artom TR, Adashi EY. Patient-centered care in Israeli IVF units: divergent perceptions of patients and providers. Isr J Health Policy Res 2020; 9:39. [PMID: 32762771 PMCID: PMC7409630 DOI: 10.1186/s13584-020-00395-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 07/15/2020] [Indexed: 01/21/2023] Open
Abstract
Background Patient-centered care is particularly important for patients undergoing fertility treatment because of their emotional involvement and their constant contact with providers. To the best of our knowledge, to date, there have been no rigorous studies of the discrepancies between the patients’ perceptions of the care they received and the providers’ perceptions of the care that they provided, in specific dimensions and elements of patient-centered care. Objective To compare provider and patient perceptions of the extent to which care in Israeli IVF units is patient-centered. Methods A previously validated survey instrument was used to assess the patient and provider perceptions of ten dimensions of patient-centered care: accessibility of providers, provision of information and of explanations, communication skills of providers, patient involvement in the treatment, respect for patient values and needs, continuity and transition in treatment, professional competence, care organization, physical comfort, and emotional support. The patient survey and the provider survey were conducted in 2016–2017; both surveys were carried out in 8 of 25 hospital-based IVF units in Israel. Seventy-six providers and 524 patients (response rate 79%) participated in the surveys. Findings The perceptions of patients and providers were similar regarding seven of the ten dimensions of patient-centered care, although there were some differences in patient vs. provider scores by unit. There were three dimensions with substantial provider-patient score differences: Moderate-sized gaps were found relative to the provision of information and explanations (1.96 vs. 2.38, on a 0–3 scale) and respect for patient values and needs (1.92 vs. 2.47). A large gap was observed relative to emotional support (0.96 vs. 2.54). Conclusions Providers appear to underestimate the needs of fertility treatment patients for information, respect, and emotional support. The observed differences between what patients feel about their care and what providers assume they provide, especially regarding emotional support, indicates a need for ongoing, specific feedback to providers as to the patient-centeredness of the care they provide. The particularly large patient – provider gap relative to the provision of emotional support highlights the importance of increasing the attention paid to the psychological impact of fertility treatment and of giving patients an opportunity to consult a counselor who is familiar with problems associated with fertility treatments. Policy recommendations Efforts to improve the patient-centeredness in FT should begin by establishing a national ongoing feedback mechanism, involving all 25 IVF units operating in Israel working in collaboration with the Ministry of Health. The findings from this joint effort should be shared with the public. In addition, we recommended appointing one professional in each IVF unit to be in charge of promoting improvements in the patient-centered care for that unit. Assigning a mental health professional (psychologist or social worker) to each and every IVF unit is also of crucial importance.
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Affiliation(s)
- Tamar R Medina-Artom
- Myers-JDC Brookdale Institute, PO Box 3886, 91037, Jerusalem, Israel. .,The Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel.
| | - Eli Y Adashi
- The Warren Alpert Medical School, Brown University, RI 02906, Providence, USA
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Ullrich G. [Vindicating the psycho-oncological screening]. Urologe A 2020; 60:104-105. [PMID: 32749500 DOI: 10.1007/s00120-020-01290-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Gerald Ullrich
- Onkologisches Zentrum, Helios Kliniken Schwerin, Wismarsche Str. 393-397, 19055, Schwerin, Deutschland.
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Yusufov M, Grebstein L, Rossi JS, Redding CA, Ferszt GG, Prochaska JO. Development and Implementation of a Psychological Service for Patients With Cancer. COGNITIVE AND BEHAVIORAL PRACTICE 2020; 27:290-305. [DOI: 10.1016/j.cbpra.2020.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Rafn BS, Midtgaard J, Camp PG, Campbell KL. Shared concern with current breast cancer rehabilitation services: a focus group study of survivors' and professionals' experiences and preferences for rehabilitation care delivery. BMJ Open 2020; 10:e037280. [PMID: 32723743 PMCID: PMC7389511 DOI: 10.1136/bmjopen-2020-037280] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES Breast cancer survivors experience a wide spectrum of physical sequelae from cancer treatment. National and international guidelines recommend that rehabilitation is offered from the point of diagnosis. However, there is a lack of data on the translation of these recommendations into clinical care. The objective of this study was to explore the experiences of breast cancer survivors, rehabilitation professionals and breast surgeons on current rehabilitation services including preferences for care delivery, specific ways to promote early detection and timely management of upper body issues and attitudes towards self-managed surveillance and rehabilitation. DESIGN Qualitative focus groups. Breast cancer survivors completed a questionnaire about rehabilitation services received and experience of upper body issues. These quantitative data were collected to provide context for the qualitative data and increase transferability. Transcripts were analysed using content analysis. SETTING Five geographically distinct health authorities in British Columbia, Canada. PARTICIPANTS Eleven focus groups were conducted with 35 breast cancer survivors, 29 rehabilitation professionals and 5 breast surgeons. RESULTS Three categories captured participants' concern and wish for improved care: (1) cut the cancer out and goodbye; (2) you have to look out for yourself and (3) in a perfect world. All breast cancer survivors reported chronic upper body issues (mean 4.5 unique issues). Breast cancer survivors expressed worry and uncertainty in their solo management of the rehabilitation. The current services were reported to not enable early detection and timely management. Suggestions included reorganising the timing of patient education and improving the quality of and access to rehabilitation services by elevating the knowledge among healthcare professionals and providing multimodal self-management resources. CONCLUSIONS The results revealed a gap between oncology guidelines and the current clinical reality. The rehabilitation services were reported in need of revamping to increase equity of care. Multiple upper body issues were reported by many breast cancer survivors.
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Affiliation(s)
- Bolette Skjødt Rafn
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Julie Midtgaard
- The University Hospitals' Centre for Health Research (UCSF), Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Pat G Camp
- Centre for Heart Lung Innovation, St. Paul's Hospital, Vancouver, British Columbia, Canada
| | - Kristin L Campbell
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
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Suh J, Williams S, Fann JR, Fogarty J, Bauer AM, Hsieh G. Parallel Journeys of Patients with Cancer and Depression: Challenges and Opportunities for Technology-Enabled Collaborative Care. ACTA ACUST UNITED AC 2020; 4. [PMID: 32656502 DOI: 10.1145/3392843] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Depression is common but under-treated in patients with cancer, despite being a major modifiable contributor to morbidity and early mortality. Integrating psychosocial care into cancer services through the team-based Collaborative Care Management (CoCM) model has been proven to be effective in improving patient outcomes in cancer centers. However, there is currently a gap in understanding the challenges that patients and their care team encounter in managing co-morbid cancer and depression in integrated psycho-oncology care settings. Our formative study examines the challenges and needs of CoCM in cancer settings with perspectives from patients, care managers, oncologists, psychiatrists, and administrators, with a focus on technology opportunities to support CoCM. We find that: (1) patients with co-morbid cancer and depression struggle to navigate between their cancer and psychosocial care journeys, and (2) conceptualizing co-morbidities as separate and independent care journeys is insufficient for characterizing this complex care context. We then propose the parallel journeys framework as a conceptual design framework for characterizing challenges that patients and their care team encounter when cancer and psychosocial care journeys interact. We use the challenges discovered through the lens of this framework to highlight and prioritize technology design opportunities for supporting whole-person care for patients with co-morbid cancer and depression.
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Affiliation(s)
- Jina Suh
- University of Washington, USA and Microsoft Research, USA
| | | | - Jesse R Fann
- University of Washington, USA and Seattle Cancer Care Alliance, USA
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Jayani R, Markert RJ, Heard A, Kumar G. Distress evaluation in a veteran affairs oncology clinic. Support Care Cancer 2020; 29:1065-1071. [PMID: 32592034 DOI: 10.1007/s00520-020-05574-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 06/11/2020] [Indexed: 11/25/2022]
Abstract
Distress in oncology patients (pts) has a negative impact on quality of life, survival, and healthcare satisfaction. Higher distress leads to lower compliance with treatment and follow-up [1-8]. The 2012 American College of Surgeons Commission on Cancer (CoC) standard of care for oncology pts included an assessment for distress [1]. A screening process for distress allows the healthcare team to address these issues early and refer to appropriate resources [2-9]. This project was initiated to meet National Comprehensive Cancer Network (NCCN) and CoC standard of care, identify distress in veterans with cancer, and address these concerns. Patients who attended the Tuesday oncology clinic at the Dayton VAMC were given the NCCN Distress Thermometer (DT) during triage. The treating physician addressed problems identified. The Wilcoxon signed rank test and the Friedman test were used. DTs were completed by 296 pts from March to December 2016. Mean age was 68, 93% male, 83% white, 55% married, and 93% without PTSD. The distress level was not different from T1 through T3. Number of problems decreased over three time periods. Referrals to nutrition, mental health, and social work services increased over time. Although over time periods we found no decrease in distress scores, there was a decline in number of problems. The mean distress score at all but time 4 was < 4, which is considered mild distress. The mean distress score at T4 was 4.36 (n = 14), suggesting that the few pts who return to clinic more than three times may be experiencing more difficult personal and environmental circumstances. Patient sample ranged from those undergoing intensive cancer treatment (e.g., chemotherapy) to less intensive treatment (e.g., hormone injections) to those who completed treatment.
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Affiliation(s)
- Reena Jayani
- Department of Medicine, Dayton VA Medical Center, 4100 W. Third St, Dayton, OH, 45428, USA
| | - Ronald J Markert
- Department of Medicine, Dayton VA Medical Center, 4100 W. Third St, Dayton, OH, 45428, USA
| | - Amy Heard
- Department of Medicine, Dayton VA Medical Center, 4100 W. Third St, Dayton, OH, 45428, USA
| | - Geetika Kumar
- Department of Medicine, Dayton VA Medical Center, 4100 W. Third St, Dayton, OH, 45428, USA.
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Lugtenberg RT, Fischer MJ, de Jongh F, Kobayashi K, Inoue K, Matsuda A, Kubota K, Weijl N, Yamaoka K, Ramai SRS, Nortier JWR, Putter H, Gelderblom H, Kaptein AA, Kroep JR. Using a quality of life (QoL)-monitor: preliminary results of a randomized trial in Dutch patients with early breast cancer. Qual Life Res 2020; 29:2961-2975. [PMID: 32529343 PMCID: PMC7591431 DOI: 10.1007/s11136-020-02549-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2020] [Indexed: 11/30/2022]
Abstract
Purpose The diagnosis and treatment of cancer negatively affect patients’ physical, functional and psychological wellbeing. Patients’ needs for care cannot be addressed unless they are recognized by healthcare providers (HCPs). The use of quality of life (QoL) assessments with feedback to HCPs might facilitate the identification and discussion of QoL-topics. Methods 113 patients with stage I–IIIB breast cancer treated with chemotherapy were included in this randomized controlled trial. Patients were randomly allocated to receive either usual care, or usual care with an intervention consisting of a QoL-monitor assessing QoL, distress and care needs before every chemotherapy cycle visit. Patients completed questionnaires regarding QoL, illness perceptions, self-efficacy, and satisfaction with communication. From the 2nd visit onwards, patients in the intervention arm and their HCPs received a copy of the QoL overview and results were shown in patients’ medical files. Audio-recordings and patients’ self-reports were used to investigate effects on communication, patient management and patient-wellbeing. A composite score for communication was calculated by summing the number of QoL-topics discussed during each consultation. Results Use of the QoL-monitor resulted in a higher communication score (0.7 topics increase per visit, p = 0.04), especially regarding the disease-specific and psychosocial issues (p < 0.01). There were no differences in patient management, QoL, illness perceptions or distress. Patients in the experimental arm (n = 60) had higher scores on satisfaction with communication (p < 0.05). Conclusions Use of a QoL-monitor during chemotherapy in patients with early breast cancer might result in a more frequent discussion of QoL-topics, associated with high levels of patients’ satisfaction. Electronic supplementary material The online version of this article (10.1007/s11136-020-02549-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- R T Lugtenberg
- Department of Medical Oncology, Leiden University Medical Center, Albinusdreef 2, P.O. Box 9600, 2300 RC, Leiden, The Netherlands.
| | - M J Fischer
- Department of Medical Oncology, Leiden University Medical Center, Albinusdreef 2, P.O. Box 9600, 2300 RC, Leiden, The Netherlands.,Department of Medical Psychology, Leiden University Medical Center, Leiden, The Netherlands
| | - F de Jongh
- Department of Medical Oncology, Leiden University Medical Center, Albinusdreef 2, P.O. Box 9600, 2300 RC, Leiden, The Netherlands.,Department of Medical Psychology, Leiden University Medical Center, Leiden, The Netherlands
| | - K Kobayashi
- Department of Respiratory Medicine, Saitama International Medical Center, Saitama, Japan
| | - K Inoue
- Division of Breast Oncology, Saitama Cancer Center, Saitama, Japan
| | - A Matsuda
- Department of Hygiene and Public Health, Teikyo University Graduate School of Public Health, Tokyo, Japan
| | - K Kubota
- Department of Pulmonary Medicine and Oncology, Nippon Medical School, Saitama, Japan
| | - N Weijl
- Department of Medical Oncology, HMC Bronovo Hospital, The Hague, The Netherlands
| | - K Yamaoka
- Department of Hygiene and Public Health, Teikyo University Graduate School of Public Health, Tokyo, Japan
| | - S R S Ramai
- Department of Pulmonology, Leiden University Medical Center, Leiden, The Netherlands
| | - J W R Nortier
- Department of Medical Oncology, Leiden University Medical Center, Albinusdreef 2, P.O. Box 9600, 2300 RC, Leiden, The Netherlands
| | - H Putter
- Department of Medical Statistics, Leiden University Medical Center, Leiden, The Netherlands
| | - H Gelderblom
- Department of Medical Oncology, Leiden University Medical Center, Albinusdreef 2, P.O. Box 9600, 2300 RC, Leiden, The Netherlands
| | - A A Kaptein
- Department of Medical Psychology, Leiden University Medical Center, Leiden, The Netherlands
| | - J R Kroep
- Department of Medical Oncology, Leiden University Medical Center, Albinusdreef 2, P.O. Box 9600, 2300 RC, Leiden, The Netherlands
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Granek L, Nakash O, Ariad S, Shapira S, Ben-David M. Strategies and Barriers in Addressing Mental Health and Suicidality in Patients With Cancer. Oncol Nurs Forum 2020; 46:561-571. [PMID: 31424452 DOI: 10.1188/19.onf.561-571] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To identify how oncology nurses address mental health distress and suicidality in patients, what strategies they employ in treating this distress, and the barriers they face in addressing distress and suicidality in patients with cancer. PARTICIPANTS & SETTING 20 oncology nurses at two cancer centers in Israel were interviewed. METHODOLOGIC APPROACH The grounded theory method of data collection and analysis was employed. FINDINGS Strategies used in addressing patients' mental health distress were being emotionally available, providing practical support, treating physical symptoms, and referring to counseling. Strategies in addressing suicidality were assessing the situation, offering end-of-life or palliative care, treating physical symptoms, and referring for assessment. Barriers to addressing distress were lack of training, stigma, workload or lack of time, and limited availability and accessibility of mental health resources. Barriers in addressing suicidality were lack of knowledge and training, patient reluctance to receive care, and lack of protocol. IMPLICATIONS FOR NURSING Developing guidelines for addressing and responding to mental health distress and suicidality is essential to improving patients' quality of life and reducing disease-related morbidity and mortality. Reducing mental healthcare stigma for patients is critical.
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Chua GP, Tan HK. A qualitative approach in determining the patient-centered information and supportive care needs of cancer patients in Singapore. BMJ Open 2020; 10:e034178. [PMID: 32114472 PMCID: PMC7050354 DOI: 10.1136/bmjopen-2019-034178] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES To qualitatively interpret the information and supportive care needs perceived by cancer patients undergoing treatment in order to get a deeper appreciation of patients' needs and concerns. The intended outcome is to provide baseline knowledge for improving patient-centred strategies to better meet the information and supportive needs of patients. DESIGN A qualitative research approach, based on conventional content analysis, was used throughout the research process. The three open-ended questions obtained from a previous quantitative study guided the researchers to explore the information and supportive care needs of patients. Data from patients' responses were analysed and coded in themes. PARTICIPANTS AND SETTING Patients attending the Ambulatory Treatment Unit of the National Cancer Centre Singapore were invited to participate in the study. We determined from these subjects the type of information that cancer patients need, and to measure the extent to which these information needs are met by measuring patients' level of satisfaction. Included in the quantitative study were three open-ended questions designed to gain a deeper understanding of their needs and concerns. All subjects were aged 21 years and above and able to understand and communicate in English/Mandarin. They were also aware of their diagnosis, they were not cognitively impaired and were not at the end-of-life situation. RESULTS A variety of information and supportive care needs were identified, and three specific areas of concerns were identified: (1) psychosocial and supportive care needs, (2) information needs and (3) information delivery by professionals. CONCLUSION The information and supportive care needs expressed were consistent with issues of cancer patients undergoing treatment. The strategies to improve patients' coping abilities through patient-centred care are discussed. Further studies assessing the barriers of information provision by healthcare professionals should provide more detailed knowledge about unmet information needs.
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Affiliation(s)
- Gek Phin Chua
- Patient and Family Education, National Cancer Centre Singapore, Singapore, Singapore
| | - Hiang Khoon Tan
- Division of Division of Community Outreach and Philanthropy, National Cancer Centre Singapore, Singapore, Singapore
- Division of Surgical Oncology, National Cancer Centre Singapore, Singapore, Singapore
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