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Hu S, Sun C, Chen M, Zhou J. Marital Status as an Independent Prognostic Factor in Patients with Glioblastoma: A Population-Based Study. World Neurosurg 2024; 182:e559-e569. [PMID: 38061540 DOI: 10.1016/j.wneu.2023.11.145] [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: 09/28/2023] [Revised: 11/28/2023] [Accepted: 11/29/2023] [Indexed: 12/29/2023]
Abstract
BACKGROUND This study was aimed to investigate the effects of marital status on overall survival (OS) and cancer-specific survival (CSS) in patients with glioblastoma (GBM) and to develop nomograms for predicting prognosis in GBM patients. METHODS All patients were selected from the Surveillance, Epidemiology, and End Results cancer registry program. We used propensity score matching to balance the baseline characteristics of married and unmarried patients. The effects of marital status on OS and CSS were then assessed using Kaplan-Meier curves and Cox proportional hazard regression, and the magnitude of each factor was visualized in the form of forest maps. The impact of marriage on the survival of GBM patients was further explored by stratifying several demographic factors. Finally, the nomograms were constructed and verified based on Cox proportional risk regression model. RESULTS A total of 17,517 patients with GBM (11,818 married patients, 67.5%) were enrolled in the study cohort. After propensity score matching, there were 5699 patients in both the married and unmarried groups. Multivariate Cox regression analysis showed that both married and single patients had better OS (married: hazard ratio [HR] 0.824, 95% confidence interval [CI]: 0.788-0.862, P < 0.001; single: HR 0.764, 95% CI: 0.722-0.808, P < 0.001) and CSS (married: HR 0.833, 95% CI: 0.796-0.872, P < 0.001; single: HR 0.761, 95% CI: 0.718-0.806, P < 0.001) than divorced, separated, and widowed patients. CONCLUSIONS Marital status was an independent prognostic factor in patients with GBM. The nomograms constructed in this study could help medical professionals to provide personalized prognostic assessment and treatment decisions for patients with GBM.
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Affiliation(s)
- Shaobo Hu
- Department of Neurosurgery, The Affiliated Li Huili Hospital, Ningbo University, Ningbo, Zhejiang, China.
| | - Chengfeng Sun
- Department of Neurosurgery, The Affiliated Li Huili Hospital, Ningbo University, Ningbo, Zhejiang, China
| | - Maosong Chen
- Department of Neurosurgery, The Affiliated Li Huili Hospital, Ningbo University, Ningbo, Zhejiang, China
| | - Jiang Zhou
- Department of Neurosurgery, The Affiliated Li Huili Hospital, Ningbo University, Ningbo, Zhejiang, China
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Gelse N, Bodschwinna D, Jarczok MN, Wanner M, Volz M, Mayer-Steinacker R, Huober J, Gündel H, Hönig K. Enhancing coping skills through brief interventions during cancer therapy - a quasi-experimental clinical pilot study. Front Psychol 2023; 14:1253423. [PMID: 37744600 PMCID: PMC10513768 DOI: 10.3389/fpsyg.2023.1253423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 08/07/2023] [Indexed: 09/26/2023] Open
Abstract
IntroductionPsycho-oncological interventions can reduce distress by activating individual resources and enhancing coping skills. Since medical cancer treatment is performed increasingly in outpatient settings, there is a growing need for evidence-based and brief interventions to be integrated seamlessly into these treatment procedures. The aim of the present pilot study is to examine the feasibility of brief interventions to cope with illness in this area.MethodsA single center quasi-experimental design was developed in oncological outpatients at the University Medical Center Ulm, Germany, including N = 60 individuals with cancer undergoing chemotherapy or immunotherapy. The intervention group (IG) consisted of N = 40 participants. These were assigned to either cognitive behavioral interventions (CBI) or hypnotherapeutic interventions (HTI). The interventions each comprised three individual one-hour sessions. In addition, a waiting control group (WCG of N = 20) was set up, receiving care-as-usual. Primary outcomes were feasibility measures such as recruitment rates, participant retention rates, and complete data rates. Clinical results were discussed for the feasibility of a comprehensive efficacy study.ResultsThe recruitment and completion rates illustrate demand and acceptance of the offer. Of the 208 individuals with cancer offered to participate in the study, 77 were interested in enrolling. This rate of 37% roughly corresponds to the use of psycho-oncological services in general. 17 individuals (22%) withdraw from participation before the intervention began due to severe deterioration in their disease. Once started, all 40 individuals of the IG (100%) completed the intervention, and 17 individuals of the WCG (85%) completed the accompanying questionnaires. Tentative results on clinical outcomes indicate that brief interventions on resource activation could have lasting effects on well-being and stress management.DiscussionWith this feasibility study, we aimed to explore the potential of brief interventions such as hypnotherapeutic and cognitive-behavioral approaches in psycho-oncology as an integral part of oncology day care. Even with a small number of participants results seem to indicate that the study design and brief interventions such as those presented can offer a low-threshold service that can be seamlessly integrated into oncological therapy. Given the promising results of this pilot study, we propose a full RCT on the effectiveness of such a brief intervention program.Clinical trial registrationhttps://www.drks.de, German Trials Register (DRKS00019095).
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Affiliation(s)
- Norbert Gelse
- Department of Psychosomatic Medicine and Psychotherapy, University Ulm Medical Center, Ulm, Germany
| | - Daniela Bodschwinna
- Department of Psychosomatic Medicine and Psychotherapy, University Ulm Medical Center, Ulm, Germany
- Comprehensive Cancer Center Ulm, University Ulm Medical Center, Ulm, Germany
| | - Marc N. Jarczok
- Department of Psychosomatic Medicine and Psychotherapy, University Ulm Medical Center, Ulm, Germany
| | - Magdalena Wanner
- Department of Psychosomatic Medicine and Psychotherapy, University Ulm Medical Center, Ulm, Germany
| | - Madeleine Volz
- Department of Psychosomatic Medicine and Psychotherapy, University Ulm Medical Center, Ulm, Germany
| | - Regine Mayer-Steinacker
- Comprehensive Cancer Center Ulm, University Ulm Medical Center, Ulm, Germany
- Department of Internal Medicine III, University Ulm Medical Center, Ulm, Germany
| | - Jens Huober
- Department of Gynecology and Obstetrics, University Ulm Medical Center, Ulm, Germany
- Cantonal Hospital, Breast Center St. Gallen, St. Gallen, Switzerland
| | - Harald Gündel
- Department of Psychosomatic Medicine and Psychotherapy, University Ulm Medical Center, Ulm, Germany
| | - Klaus Hönig
- Department of Psychosomatic Medicine and Psychotherapy, University Ulm Medical Center, Ulm, Germany
- Comprehensive Cancer Center Ulm, University Ulm Medical Center, Ulm, Germany
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Cioce M, Borrelli I, Cappucciati L, Giori M, Gobbi G, Lucifora R, Mabilia P, Marsullo M, Prendin C, Russo L, Zucca MS, Zega M, Sica S, Bacigalupo A, De Stefano V, Savoia V, Celli D, Garau P, Serra N, Botti S. The impact of education on patients' psycho-emotional status during allogeneic hematopoietic stem cell transplantation: a multicenter prospective study by thes Gruppo Italiano Trapianto di Midollo Osseo. J Psychosoc Oncol 2023; 41:687-703. [PMID: 36825453 DOI: 10.1080/07347332.2023.2181722] [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: 02/25/2023]
Abstract
PURPOSE Depressive disorders are the most common manifestation of psychological distress in allogenic hematopoietic stem cell transplantation. Few studies have yet investigated the relationship between therapeutic educational interventions and outcomes in these patients with specific attention to those related to mental health. Aim of this study was to understand how much educational intervention can represent a protective factor in preventing psycho-emotional distress-related issues in this setting. DESIGN A prospective observational study of a multicenter cohort was conducted. PARTICIPANTS Adult patients undergoing allogeneic hematopoietic stem cell transplantation. METHODS A pre-transplant therapeutic educational programme was offered to a cohort of adult patients undergoing allo-HSCT recruited in ten transplant centers of the GITMO network between May 2018 and January 2019. Depression, Anxiety and Stress scale was used to collect data on psycho-emotional distress at admission (T0), at the day of transplant (T1) and at discharge (T2). Descriptive data were collected and reported, and comparative analyses were done among patients who were compliant with the pre-transplant educational intervention and those who did not (for any reason). FINDINGS A cohort of 133 allo-HSCT patients was observed. In patients who did not receive pre-transplant educational intervention, higher levels of depression at admission (p = 0.01) and at the day of transplant (p = 0.03), higher levels of anxiety (p = 0.01 and p = 0.01 respectively) as well as higher levels of stress (p < 0.01 and p = 0.01) were observed. Problem solving and "face to face" interview were the best methods to provide education to patients. Those who received pre-transplant education through "face-to-face" interview reported significant low levels of depression during the whole hospital stay period (p < 0.01; p = 0.01; p = 0.01) and less anxiety and stress at admission (p < 0.05 and p = 0.01 respectively). Depression was more represented in female than male participants at T0 (16.5% vs 9.0%; p = 0.01), while among T0 and T2 the males had a significant higher increasing of depression than females (p = 0.03). CONCLUSION Our study demonstrated that pretreatment therapeutic educational programs with specific learning modalities can be effective in limiting the potential risk of developing moderate-to-severe anxiety-depressive states and stress symptoms related to allo-HSCT. IMPLICATIONS FOR PSYCHOSOCIAL PROVIDERS Further studies are needed to confirm our results and to understand whether containing psycho-emotional distress can have any relationship with medium- and long-term post-transplant complications.
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Affiliation(s)
- Marco Cioce
- Department UOC SITRA, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Ivan Borrelli
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Lorella Cappucciati
- U.O. Ematologia e Centro Trapianti, Ospedale Guglielmo da Saliceto, Piacenza, Italy
| | - Manuela Giori
- Terapia Onco-Ematologica Intensiva Trapianto CSE, A.O.U San Luigi Gonzaga Regione Gonzole 10, Orbassano (TO), Italy
| | - Giorgia Gobbi
- SC Ematologia Trapianto Midollo, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy
| | | | - Patrizia Mabilia
- U.O.C. di Ematologia e Trapianto Emopoietico A.O.R.N, San Giuseppe Moscati, Avellino, Italy
| | - Mauro Marsullo
- Trapianti di midollo osseo, Azienda Ospedaliero Universitaria Careggi, Firenze, Italy
| | - Chiara Prendin
- U.O. Ematologia, Azienda Ulss 8 "Berica", Ospedale San Bortolo, Vicenza, Italy
| | - Letteria Russo
- Hemato-Oncology and Radiotherapy Department, Grande OspedaleMetropolitano "Bianchi-Melacrino-Morelli", Reggio Calabria, RC, Italy
| | | | - Maurizio Zega
- Department UOC SITRA, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Simona Sica
- Department of Hematology, Fondazione Policlinico Universitario Gemelli IRCCS, Universita' Cattolica del Sacro Cuore, Rome, Italy
| | - Andrea Bacigalupo
- Department of Hematology, Fondazione Policlinico Universitario Gemelli IRCCS, Universita' Cattolica del Sacro Cuore, Rome, Italy
| | - Valerio De Stefano
- Department of Hematology, Fondazione Policlinico Universitario Gemelli IRCCS, Universita' Cattolica del Sacro Cuore, Rome, Italy
| | - Vezio Savoia
- UOS Psicologia Clinica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Danilo Celli
- Faculty of Medicine and Psychology, Università "La Sapienza", Rome, Italy
| | - Paola Garau
- Department UOC SITRA, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Nicola Serra
- Biostatistic Unit, Department of Public Health, University Federico II of Naples, Naples, Italy
| | - Stefano Botti
- Hematology Unit, Azienda USL-IRCCS of Reggio, Emilia, Italy
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Almeida M, Ramos C, Maciel L, Basto-Pereira M, Leal I. Meaning in life, meaning-making and posttraumatic growth in cancer patients: Systematic review and meta-analysis. Front Psychol 2022; 13:995981. [PMID: 36570997 PMCID: PMC9784472 DOI: 10.3389/fpsyg.2022.995981] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Accepted: 11/14/2022] [Indexed: 12/13/2022] Open
Abstract
Introduction The purpose of this systematic review and meta-analysis is to assess the association between meaning in life (MiL), meaning-making and posttraumatic growth (PTG) in the context of cancer. Methods A systematic search was conducted in eighteen electronic databases. The screening and selection process followed the PRISMA guidelines. For the purpose of the meta-analysis, the correlation coefficients between meaning in life and posttraumatic growth were extracted from the included studies. The effect size (r) was calculated using the restricted maximum-likelihood estimator, a random-effects model. Heterogeneity was assessed through the Q statistic, I2 index and forest plot, while publication bias was analyzed with the use of the funnel plot and Egger's test. Results 889 records were considered according to the inclusion criteria. A total of nine articles, published between 2006 and 2021, were included in the systematic review. More than half were published in the last five years. The sample was mostly diagnosed with breast cancer. The meta-analysis included five articles (N = 844) and the results indicate a significant moderate correlation between meaning in life and posttraumatic growth (r = 0.43, 95% IC [0.36, 0.50]). Discussion In conclusion, there is a clear association between meaning in life and posttraumatic growth in cancer patients. Future research should explore this relationship further, in order to better assist and guide meaning centered interventions that can potentiate a positive adjustment and possibly growth from the cancer experience.
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Affiliation(s)
- Margarida Almeida
- Ispa – Instituto Universitário, Lisbon, Portugal,*Correspondence: Margarida Almeida,
| | - Catarina Ramos
- LabPSI – Laboratório de Psicologia Egas Moniz, Centro de Investigação Interdisciplinar Egas Moniz, Instituto Universitário Egas Moniz, Caparica, Portugal
| | - Laura Maciel
- WJCR – William James Center for Research, Ispa – Instituto Universitário, Lisbon, Portugal
| | - Miguel Basto-Pereira
- WJCR – William James Center for Research, Ispa – Instituto Universitário, Lisbon, Portugal
| | - Isabel Leal
- WJCR – William James Center for Research, Ispa – Instituto Universitário, Lisbon, Portugal
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ElMokhallalati Y, Alaloul E, Shatat M, Shneewra T, El Massri S, Shaer O, Relton S, Abu-Odah H, Allsop MJ. The Symptom Burden and Quality of Life in Cancer Patients in the Gaza Strip, Palestine: A Cross-Sectional Study. PLoS One 2022; 17:e0262512. [PMID: 35025966 PMCID: PMC8758072 DOI: 10.1371/journal.pone.0262512] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 12/28/2021] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES Cancer is the second leading cause of death in the Gaza Strip, Palestine, but there is an absence of evidence systematically assessing symptom burden and quality of life (QoL) using validated tools. Our objective was to assess associations between socio-demographic and disease-related characteristics, symptom burden and QoL in a sample of cancer patients accessing outpatient services in the Gaza Strip. DESIGN A cross-sectional, descriptive survey using interviews and medical record review involving patients with cancer accessing oncology outpatient services at Al Rantisi Hospital and European Gaza Hospital (EGH) in the Gaza Strip was employed. Socio-demographic and disease-related data, the Lebanese version of the Memorial Symptom Assessment Scale (MSAS-Leb), and the Arabic version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (EORTC QLQ-C30) were collected. Multiple linear regression was used to judge the relative influence of determinants of QoL. RESULTS Of 414 cancer patients approached, 385 patients consented to participation. The majority were women (64.7%) with a mean age of 52 years (SD = 16.7). Common cancer diagnoses were breast (32.2%), haematological (17.9%) and colorectal (9.1%). The median number of symptoms was 10 (IQR 1.5-18.5). Mean overall QoL was 70.5 (SD 19.9) with common physical and psychological symptoms identified. A higher burden of symptoms was associated with marital status, education and income. Limited access to both opioids and psychological support were reported. CONCLUSIONS A high symptom burden was identified in outpatients with cancer. Increasing provision and access to supportive care for physical and psychological symptoms should be prioritised alongside exploring routine assessment of symptom burden and QoL.
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Affiliation(s)
- Yousuf ElMokhallalati
- Leeds Institute of Health Sciences, School of Medicine, University of Leeds, Leeds, United Kingdom
| | - Enas Alaloul
- Leeds Institute of Health Sciences, School of Medicine, University of Leeds, Leeds, United Kingdom
| | | | | | - Saad El Massri
- Faculty of Medicine, Islamic University, Gaza, occupied Palestinian territory
| | - Omar Shaer
- Faculty of Medicine, Islamic University, Gaza, occupied Palestinian territory
| | - Samuel Relton
- Leeds Institute of Health Sciences, School of Medicine, University of Leeds, Leeds, United Kingdom
| | - Hammoda Abu-Odah
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Matthew J. Allsop
- Leeds Institute of Health Sciences, School of Medicine, University of Leeds, Leeds, United Kingdom
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Life After Facing Cancer: Posttraumatic Growth, Meaning in Life and Life Satisfaction. J Clin Psychol Med Settings 2021; 29:92-102. [PMID: 34008123 DOI: 10.1007/s10880-021-09786-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2021] [Indexed: 01/07/2023]
Abstract
Although it is known that facing cancer may be accompanied by a range of chronic and acute stress reactions, it can also contribute to positive psychological changes and influence one's life perception. The aim of this cross-sectional study was to investigate relationship between posttraumatic growth (PTG), meaning in life and life satisfaction to determine whether the presence of meaning or the search for meaning mediated the relationship between PTG and life satisfaction. The study was conducted with 149 cancer survivors who were at least one-month post-completion of all medical cancer therapy. The results indicate positive associations between PTG, the presence of meaning in life, the search for meaning and life satisfaction. Moreover, the relationship between PTG and life satisfaction could be explained by the mediating effect of the presence of meaning in life. Thus, it is important for clinicians to systematically facilitate PTG, meaning in life and life satisfaction as protective factors to one's daily functioning.
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Shunmugasundaram C, Dhillon HM, Butow PN, Sundaresan P, Rutherford C. Enabling cross-cultural data pooling in trials: linguistic validation of head and neck cancer measures for Indian patients. Qual Life Res 2021; 30:2649-2661. [PMID: 33797687 DOI: 10.1007/s11136-021-02837-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Head and neck cancers (HNC) and their treatments cause dysfunction and distress. Ongoing psychological assessment using disease-specific patient-reported measures may optimize clinical decision-making, facilitate interventions to reduce psychosocial burden. As most such measures are developed in English, non-English speaking patients are disadvantaged. This study translated HNC-specific measures (Body Image Scale, Patient Concerns Inventory, Zung's Self-Rating Anxiety and Depression Scales and Patient Health Questionnaire-9) into three Indian languages (Hindi, Tamil and Telugu) and linguistically validated them. METHODS Translation followed established guidelines on translation and linguistic validation of measures. Process involved two independent forward translations, reconciliation, two independent backward translations by bilingual experts, and cognitive debriefing interviews with nine healthcare professionals (HCPs) and 29 HNC patients. Translated versions were compared with the original versions for semantic, cultural and conceptual equivalence. RESULTS Overall, 17 Hindi items, 19 Tamil items and 13 Telugu items were identified to have semantic, cultural and/or conceptual issues. These were resolved to achieve equivalence with the original measures. Interviews with HCPs indicated that equivalent terms for words such as anxiety, panicky, sexuality, and self-conscious might be difficult to understand. Interviews with patients indicated all items were understandable, easy, sensitive, unambiguous and relevant. Hence, no further revisions were made. CONCLUSIONS The translated Hindi, Tamil and Telugu versions of the Body image scale, Patient concerns inventory, Zung's self-rating anxiety and depression scales and Patient health questionnaire-9 measures are conceptually and linguistically validated and equivalent with the original English versions. Psychometric validation of these measures with relevant patient populations is needed.
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Affiliation(s)
- Chindhu Shunmugasundaram
- Centre for Medical Psychology and Evidence-based Decision-making, School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW, Australia. .,Psycho-Oncology Cooperative Research Group, University of Sydney, Sydney, Australia.
| | - Haryana M Dhillon
- Centre for Medical Psychology and Evidence-based Decision-making, School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW, Australia.,Psycho-Oncology Cooperative Research Group, University of Sydney, Sydney, Australia
| | - Phyllis N Butow
- Centre for Medical Psychology and Evidence-based Decision-making, School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW, Australia.,Psycho-Oncology Cooperative Research Group, University of Sydney, Sydney, Australia
| | - Puma Sundaresan
- Radiation Oncology Network, Western Sydney Local Health District, Sydney, Australia.,Sydney Medical School, University of Sydney, Sydney, Australia
| | - Claudia Rutherford
- Quality of Life Office, School of Psychology, Faculty of Science, University of Sydney, Sydney, Australia.,Sydney Nursing School, Cancer Nursing Research Unit (CNRU), University of Sydney, Sydney, Australia
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Kim SH, Ryu E, Kim EJ. A Narrative Inquiry into the Adjustment Experiences of Male Bladder Cancer Survivors with a Neobladder. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8260. [PMID: 33182293 PMCID: PMC7664886 DOI: 10.3390/ijerph17218260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 11/05/2020] [Accepted: 11/07/2020] [Indexed: 11/17/2022]
Abstract
This study aimed to explore three male bladder cancer survivors' adjustment experiences after neobladder reconstruction. A narrative inquiry method was adopted to closely investigate the individual experiences of bladder cancer survivors and the meaning of their experiences. Three themes emerged regarding physical and mental changes resulting from neobladder reconstruction: difficulty urinating or holding urine, sexual dysfunction and sexlessness, and stress resulting from urinary incontinence. Life changes following surgery varied across each participant and included 'unwanted retirement', 'quitting drinking and leaving work', and 'beginning of a restrained life'. The theme of adjustment experience emerged, comprising 'active exploration of resolutions', 'accepting change and partial return to daily life', and 'living in line with the health condition and family wishes'. Bladder cancer survivors with a neobladder, in this study, continue to adjust to changes in the voiding mechanism, various symptoms including incontinence, and life changes even after surgical cancer resection. The findings suggest that not only therapeutic interventions, but additional interventions are also needed to assist bladder cancer survivors with adjustment, rehabilitation, and return to society. These findings are also expected to be used both to educate bladder cancer survivors with a neobladder and to develop policies to help them.
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Affiliation(s)
- So Hee Kim
- Graduate School, Chung-Ang University, Seoul 06974, Korea;
| | - Eunjung Ryu
- Department of Nursing, Chung-Ang University, 84 Heuksuk-ro Dongjak-gu, Seoul 06974, Korea
| | - Eun-Ju Kim
- Department of English, Hanyang Women’s University, Seoul 04763, Korea;
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Elimimian EB, Elson L, Stone E, Butler RS, Doll M, Roshon S, Kondaki C, Padgett A, Nahleh ZA. A pilot study of improved psychological distress with art therapy in patients with cancer undergoing chemotherapy. BMC Cancer 2020; 20:899. [PMID: 32962660 PMCID: PMC7510066 DOI: 10.1186/s12885-020-07380-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 09/04/2020] [Indexed: 11/30/2022] Open
Abstract
Background Art therapy may improve the physical, mental, and emotional wellbeing of individuals for a variety of purposes. It remains understudied and underutilized in cancer care. We sought to determine the ability of a pilot art therapy program to improve the physical, mental, and emotional well-being of cancer patients. Methods Chemotherapy-recipients, age 18 years and older, diagnosed with any type or stage of cancer, were considered eligible to participate in this single arm, pilot study, using four visual analog scales (VAS) with visually-similar, 0–10 scale (10 being worst) thermometers assessing: 1) pain, 2) emotional distress, 3) depression, and 4) anxiety. Participants were asked to complete all 4 metrics, pre-treatment, post-treatment, and at 48–72 h follow-up, after an hour-long art therapy session. Primary endpoints included post-intervention changes from baseline in the 4 VAS metrics. Results Through a reasonable pilot sample (n = 50), 44% had breast cancer, 22% gastrointestinal cancers, 18% hematological malignancies, and 20% had other malignancies. A decrease in all VAS measures was noted immediately post-treatment but remained low only for pain and depression, not for emotional distress and anxiety upon follow up. There was a significant difference between the depression VAS scores of Hispanics (32%) compared to non-Hispanics (56%) (p = 0.009) at baseline. However, compared to non-Hispanics, Hispanics exhibited higher levels of depression after art therapy (P = 0.03) and during the follow-up intervals (p = 0.047). Conclusion Art therapy improved the emotional distress, depression, anxiety and pain among all cancer patients, at all time points. While depression scores were higher pre-intervention for Hispanic patients, Hispanic patients were noted to derive a greater improvement in depression scores from art therapy over time, compared to non-Hispanics patients. Discovering simple, effective, therapeutic interventions, to aid in distress relief in cancer patients, is important for ensuring clinical efficacy of treatment and improved quality of life.
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Affiliation(s)
- E B Elimimian
- Department of Hematology/Oncology, Maroone Cancer Center, Cleveland Clinic - Florida, 2950 Cleveland Clinic Blvd, Weston, FL, 33331, USA
| | - L Elson
- Department of Hematology/Oncology, Maroone Cancer Center, Cleveland Clinic - Florida, 2950 Cleveland Clinic Blvd, Weston, FL, 33331, USA
| | - E Stone
- Department of Hematology/Oncology, Maroone Cancer Center, Cleveland Clinic - Florida, 2950 Cleveland Clinic Blvd, Weston, FL, 33331, USA
| | - R S Butler
- Department of Radiation Oncology, Dana-Farber Cancer Institute/ Brigham and Women's Hospital, 75 Francis St, Boston, MA, 02115, USA
| | - M Doll
- Department of Hematology/Oncology, Maroone Cancer Center, Cleveland Clinic - Florida, 2950 Cleveland Clinic Blvd, Weston, FL, 33331, USA
| | - S Roshon
- Department of Hematology/Oncology, Maroone Cancer Center, Cleveland Clinic - Florida, 2950 Cleveland Clinic Blvd, Weston, FL, 33331, USA
| | - C Kondaki
- Department of Hematology/Oncology, Maroone Cancer Center, Cleveland Clinic - Florida, 2950 Cleveland Clinic Blvd, Weston, FL, 33331, USA
| | - A Padgett
- Charles E. Schmidt College of Medicine, Florida Atlantic University, 777 Glades Road BC-71, Boca Raton, FL, 33431, USA
| | - Z A Nahleh
- Department of Hematology/Oncology, Maroone Cancer Center, Cleveland Clinic - Florida, 2950 Cleveland Clinic Blvd, Weston, FL, 33331, USA.
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Freling TH, Yang Z, Saini R, Itani OS, Rashad Abualsamh R. When poignant stories outweigh cold hard facts: A meta-analysis of the anecdotal bias. ORGANIZATIONAL BEHAVIOR AND HUMAN DECISION PROCESSES 2020. [DOI: 10.1016/j.obhdp.2020.01.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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11
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Impact of Educational Interventions on Psychological Distress During Allogeneic Hematopoietic Stem Cell Transplantation: A Randomised Study. Mediterr J Hematol Infect Dis 2020; 12:e2020067. [PMID: 32952978 PMCID: PMC7485479 DOI: 10.4084/mjhid.2020.067] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 08/16/2020] [Indexed: 12/21/2022] Open
Abstract
Background Physical and psychological factors, like wrong attitudes and behaviours, can negatively influence the health outcomes of the patients receiving allogeneic hematopoietic stem cell transplantation (AHSCT). Educational interventions aiming to improve knowledge on side effects, risks, complications and preventive behaviour can reduce psychological distress, and improve quality of life (QoL). We aimed to compare a standard approach with therapeutic patient education (TPE) to analyse the impact on AHSCT patients’ QoL, psychological distress and knowledge of AHSCT side effects, risks complications and preventive behaviour. Material and methods A prospective interventional study was conducted analysing data of 36 patients who received one of two different educational approaches, which were a standard approach (not-exposed) or TPE (exposed). Results In the exposed group QoL improved 14 days after transplantation (42.2 vs 25.6; p<0.03) and at time of discharge (36.6 vs 54.4; p<0.005). Anxiety and depression were better controlled in the exposed group, both at hospitalisation and discharge (anxiety: 48.1 vs 53.2; 46.4 vs 51.6. p<0.04; depression: 49 vs 55.3; 48 vs 54.3, p<0.03). Knowledge of AHSCT risks and complications improved in exposed patients, both at admission (10.1/15 vs 8/15 correct answers; p<0.01) and discharge (10.7/15 vs 8.8/15 correct answer; p<0.03). Conclusions The TPE for AHSCT patients improved knowledge, reduced anxiety and depression, which consequently increasing QoL. Therefore, we recommend our approach to further engage patients in the treatment plan, which should specifically take place prior to AHSCT initiation.
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Zucchetti G, Ambrogio G, Bertolotti M, Besenzon L, Borghino F, Candela F, Galletto C, Fagioli F. Effects of a high-intensity psychosocial intervention among child-parent units in pediatric oncology. TUMORI JOURNAL 2020; 106:362-368. [PMID: 32539655 DOI: 10.1177/0300891620926226] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIM To compare the efficacy of a high-intensity psychosocial intervention with standardized usual care in countering psychosocial complexity among child-parent units in a pediatric oncology setting. METHODS Two hundred pediatric oncology patients and their parents were recruited from Italian hospitals. A total of 81 child-parent units were assigned to the high-intensity psychosocial intervention and 119 child-parent units to standardized usual care. Psychosocial factors were assessed before and 1 year after intervention to measure efficacy. RESULTS More improvements over time were observed in the high-intensity intervention group of child-parent units compared to the standard intervention group. CONCLUSION An intensive, structured, and tailored high-intensity intervention positively affects the psychosocial factors of child-parent units. Patients and families should have access to intensive psychosocial support throughout the cancer trajectory.
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Affiliation(s)
- Giulia Zucchetti
- Pediatric Oncology Division, Azienda Ospedaliera-Universitaria Città della Salute e della Scienza, Turin, Italy.,University of Turin, Turin, Italy
| | | | - Marina Bertolotti
- Pediatric Oncology Division, Azienda Ospedaliera-Universitaria Città della Salute e della Scienza, Turin, Italy
| | | | | | | | | | - Franca Fagioli
- Pediatric Oncology Division, Azienda Ospedaliera-Universitaria Città della Salute e della Scienza, Turin, Italy.,University of Turin, Turin, Italy
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13
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Abu-Odah H, Molassiotis A, Liu J. Challenges on the provision of palliative care for patients with cancer in low- and middle-income countries: a systematic review of reviews. BMC Palliat Care 2020; 19:55. [PMID: 32321487 PMCID: PMC7178566 DOI: 10.1186/s12904-020-00558-5] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 04/06/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Despite the significant benefits of palliative care (PC) services for cancer patients, multiple challenges hinder the provision of PC services for these patients. Low- and middle-income countries (LMICs) are witnessing a sharp growth in the burden of non-communicable diseases. There is a significant gap between demand and supply of PC in LMICs in current health services. This review aims to synthesise evidence from previous reviews and deliver a more comprehensive mapping of the existing literature about personal, system, policy, and organisational challenges and possible facilitators on the provision of PC services for cancer patients in LMICs. METHODS A systematic review of reviews was performed following PRISMA guidelines. PubMed, EMBASE, SCOPUS, PsycINFO, Web of Sciences, CINAHL, and Cochrane Library databases were searched to identify review papers published between 2000 and 2018 that considered challenges and possible facilitators to PC provision. A modified socioecological model was used as a framework for analysing and summarising findings. RESULTS Fourteen reviews were included. The reviews varied in terms of aim, settings, and detail of the challenges and possible facilitators. The main challenges of personal and health care systems included knowledge deficits and misunderstandings from patients, families, the general public, and health care providers about PC; and inadequate number of trained workforce. Besides, limited physical infrastructure, insufficient drugs for symptom relief and lack of a comprehensive national plan for implementing PC were the core organisational and policy level challenges that were recognised. Furthermore, the main possible facilitators that were identified included provision of adequate training for health care providers and health education for patients, families and the general public to enhance their knowledge, beliefs, and attitudes to PC. Finally, involvement of policymakers and making drugs available for symptom relief should also be in place to improve the health care systems. CONCLUSIONS Understanding challenges to the provision of PC for people with cancer could help in the development of a PC pathway in LMICs. This knowledge could be used as a guide to develop an intervention programme to improve PC. Political influence and support are also required to ensure the sustainability and the provision of high-quality PC.
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Affiliation(s)
- Hammoda Abu-Odah
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Alex Molassiotis
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Justina Liu
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong
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Jewett PI, Teoh D, Petzel S, Lee H, Messelt A, Kendall J, Hatsukami D, Everson-Rose SA, Blaes AH, Vogel RI. Cancer-Related Distress: Revisiting the Utility of the National Comprehensive Cancer Network Distress Thermometer Problem List in Women With Gynecologic Cancers. JCO Oncol Pract 2020; 16:e649-e659. [PMID: 32091952 DOI: 10.1200/jop.19.00471] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
PURPOSE The Distress Thermometer (DT) includes a measure of cancer-related distress and a list of self-reported problems. This study evaluated the utility of the DT problem list in identifying concerns most associated with distress and poorer quality of life (QOL) in survivors of gynecologic cancer. METHODS Demographic, clinical, psychosocial functioning, and DT data were described among 355 women participating in a gynecologic cancer cohort. Problems from the DT list were ranked by prevalence, distress, and QOL. Logistic regression models explored factors associated with problems that were common (≥ 25% prevalence) and associated with distress and QOL. RESULTS The average age of participants was 59.9 years (standard deviation [SD], 10.8 years). Most participants were non-Hispanic white (97%) and had ovarian (44%) or uterine (42%) cancer. The mean DT score was 2.7 (SD, 2.7); participants reported a mean of 7.3 problems (SD, 5.9 problems). The most common problems were fatigue (53.6%), worry (49.9%), and tingling (46.3%); least common problems were childcare (2.1%), fevers (2.1%), and substance abuse (1.1%). Report of some common problems, including tingling, sleep, memory, skin issues, and appearance, was not associated with large differences in distress or QOL. In contrast, some rarer problems such as childcare, treatment decisions, eating, housing, nausea, and bathing/dressing were associated with worse distress or QOL. Younger age, lower income, and chemotherapy were risk factors across common problems that were associated with worse distress or QOL (fatigue, nervousness, sadness, fears, and pain). CONCLUSION The DT problem list did not easily identify concerns most associated with distress and low QOL in patients with gynecologic cancer. Adaptations that enable patients to report their most distressing concerns would enhance clinical utility of this commonly used tool.
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Affiliation(s)
- Patricia I Jewett
- Department of Obstetrics, Gynecology, and Women's Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN.,Department of Medicine, Division of Hematology and Oncology, University of Minnesota, Minneapolis, MN
| | - Deanna Teoh
- Department of Obstetrics, Gynecology, and Women's Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN
| | - Sue Petzel
- Department of Obstetrics, Gynecology, and Women's Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN
| | - Heewon Lee
- Department of Obstetrics, Gynecology, and Women's Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN
| | - Audrey Messelt
- Department of Obstetrics, Gynecology, and Women's Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN
| | | | | | - Susan A Everson-Rose
- Department of Medicine, Division of General Internal Medicine, and Program in Health Disparities Research, University of Minnesota, Minneapolis, MN
| | - Anne H Blaes
- Department of Medicine, Division of Hematology and Oncology, University of Minnesota, Minneapolis, MN
| | - Rachel I Vogel
- Department of Obstetrics, Gynecology, and Women's Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN
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Effectiveness of couple psycho-oncological interventions in increasing patients and their partners’ adaptation to disease: A systematic review and a meta-analysis. CURRENT PSYCHOLOGY 2019. [DOI: 10.1007/s12144-019-00543-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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16
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Riba MB, Donovan KA, Andersen B, Braun II, Breitbart WS, Brewer BW, Buchmann LO, Clark MM, Collins M, Corbett C, Fleishman S, Garcia S, Greenberg DB, Handzo RGF, Hoofring L, Huang CH, Lally R, Martin S, McGuffey L, Mitchell W, Morrison LJ, Pailler M, Palesh O, Parnes F, Pazar JP, Ralston L, Salman J, Shannon-Dudley MM, Valentine AD, McMillian NR, Darlow SD. Distress Management, Version 3.2019, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw 2019; 17:1229-1249. [PMID: 31590149 PMCID: PMC6907687 DOI: 10.6004/jnccn.2019.0048] [Citation(s) in RCA: 325] [Impact Index Per Article: 65.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Distress is defined in the NCCN Guidelines for Distress Management as a multifactorial, unpleasant experience of a psychologic (ie, cognitive, behavioral, emotional), social, spiritual, and/or physical nature that may interfere with the ability to cope effectively with cancer, its physical symptoms, and its treatment. Early evaluation and screening for distress leads to early and timely management of psychologic distress, which in turn improves medical management. The panel for the Distress Management Guidelines recently added a new principles section including guidance on implementation of standards of psychosocial care for patients with cancer.
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Affiliation(s)
| | | | - Barbara Andersen
- The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute
| | - IIana Braun
- Dana-Farber/Brigham and Women's Cancer Center
| | | | | | | | | | | | | | | | - Sofia Garcia
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University
| | | | | | - Laura Hoofring
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
| | | | | | | | | | | | | | | | | | | | - Janice P Pazar
- St. Jude Children's Research Hospital/The University of Tennessee Health Science Center
| | - Laurel Ralston
- Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute
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Wang JHY, Gomez SL, Brown RL, Davis K, Allen L, Huang E, Chentsova Dutton Y, Schwartz MD. Factors associated with Chinese American and White cancer survivors' physical and psychological functioning. Health Psychol 2019; 38:455-465. [PMID: 31045429 PMCID: PMC6501801 DOI: 10.1037/hea0000666] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To examine whether health-related stressors and resources are associated with physical function, depression, and anxiety in Chinese American and White breast cancer survivors. METHOD During 2011-2013, this cross-sectional study enrolled Chinese American and White women from California cancer registries diagnosed with Stage 0-III breast cancer between 2006 and 2012. Survivors completed a telephone survey assessing health-related factors including comorbidity, treatment-related symptoms, medical communication, perceived threat, use of coping, and social support resources. Outcomes were assessed using the Patient-Reported Outcome Measurement Information System® (PROMIS®) short forms. Chinese were classified as low- or high-acculturated based on English proficiency, years in the United States, and interview language. Analyses were conducted using Tobit regression models. RESULTS Low-acculturated Chinese (n = 136) had worse physical functioning than Whites (n = 216), controlling for demographics, cancer stage, and time since diagnosis (β = -3.33, p = .01). This disparity was attenuated after adjusting for comorbidity and symptoms (β = -1.63, p = .18). Perceived threat, disengagement coping, and lack of social support were associated with poorer psychological outcomes, regardless of ethnicity. Although low-acculturated Chinese had lower scores on all health-related factors than Whites, the former reported significantly lower level of depression (β = -3.23) and anxiety (β = -5.8) after adjusting for covariates (both p < .05). High-acculturated Chinese (n = 84) did not differ from Whites except that the former had significantly lower anxiety. CONCLUSION Low-acculturated Chinese may benefit from interventions aimed to improve their physical problems. However, despite experiencing greater psychosocial stress, they reported better emotional functioning. Whether Chinese culture shapes this resiliency, or if it is a reporting bias will need further investigation. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Judy Huei-Yu Wang
- Department of Oncology, Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Georgetown University
| | | | - Roger L Brown
- Department of Family Medicine, School of Nursing, University of Wisconsin-Madison
| | - Kimberly Davis
- Department of Oncology, Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Georgetown University
| | | | - Ellen Huang
- Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Georgetown University
| | | | - Marc D Schwartz
- Department of Oncology, Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Georgetown University
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18
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Becker D, Grapendorf J, Greving H, Sassenberg K. Perceived Threat and Internet Use Predict Intentions to Get Bowel Cancer Screening (Colonoscopy): Longitudinal Questionnaire Study. J Med Internet Res 2018; 20:e46. [PMID: 29415872 PMCID: PMC5822037 DOI: 10.2196/jmir.9144] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 12/08/2017] [Accepted: 12/08/2017] [Indexed: 01/29/2023] Open
Abstract
Background Many people use the Internet for health-related information search, which is known to help regulate their emotional state. However, not much is known yet about how Web-based information search together with negative emotional states (ie, threat of cancer diagnosis) relate to preventive medical treatment decisions (ie, colonoscopy intentions). Objective The aim of this study was to investigate how frequency of health-related Internet use together with perceived threat of a possible (bowel) cancer diagnosis influences intentions to get a colonoscopy. Previous research has shown that people who experience threat preferentially process positive information in an attempt to downregulate the aversive emotional state. The Internet can facilitate this regulatory strategy through allowing self-directed, unrestricted, and thus biased information search. In the context of threat regarding a possible bowel cancer diagnosis, feelings of threat can still be effectively reduced through cancer screening (ie, colonoscopy). We, therefore, predict that in that particular context, feelings of threat should be related to stronger colonoscopy intentions, and that this relationship should be enhanced for people who use the Internet often. Methods A longitudinal questionnaire study was conducted among healthy participants who were approaching or just entering the bowel cancer risk group (aged 45-55 years). Perceived threat of a possible (bowel) cancer diagnosis, frequency of health-related Internet use, and intentions to have a colonoscopy were assessed at 2 time points (6-month time lag between the 2 measurement points T1 and T2). Multiple regression analyses were conducted to test whether threat and Internet use at T1 together predicted colonoscopy intentions at T2. Results In line with our predictions, we found that the threat of a possible (bowel) cancer diagnosis interacted with the frequency of Internet use (both T1) to predict colonoscopy intentions (T2; B=.23, standard error [SE]=0.09, P=.01). For people who used the Internet relatively often (+1 SD), the positive relationship between threat and colonoscopy intentions was significantly stronger (B=.56, SE=0.15, P<.001) compared with participants who used the Internet less often (−1 SD; B=.17, SE=0.09, P=.07). This relationship was unique to Web-based (vs other types of) information search and independent of risk factors (eg, body mass index [BMI] and smoking). Conclusions The results of this study suggest that health-related Internet use can facilitate emotion-regulatory processes. People who feel threatened by a possible (bowel) cancer diagnosis reported stronger colonoscopy intentions, especially when they used the Internet often. We propose that this is because people who experience threat are more likely to search for and process information that allows them to downregulate their aversive emotional state. In the present case of (bowel) cancer prevention, the most effective way to reduce threat is to get screened.
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Affiliation(s)
- Daniela Becker
- Social Processes Lab, Leibniz-Institut für Wissensmedien, Tübingen, Germany
| | | | - Hannah Greving
- Knowledge Construction Lab, Leibniz-Institut für Wissensmedien, Tübingen, Germany
| | - Kai Sassenberg
- Social Processes Lab, Leibniz-Institut für Wissensmedien, Tübingen, Germany.,University of Tübingen, Tübingen, Germany
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19
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Dispositional Mindfulness, Psychological Distress, and Posttraumatic Growth in Cancer Patients. JOURNAL OF LOSS & TRAUMA 2017. [DOI: 10.1080/15325024.2017.1384783] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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20
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Huang CI, Lin LC, Tien HC, Que J, Ting WC, Chen PC, Wu HM, Ho CH, Wang JJ, Wang RH, Yang CC. Hyperlipidemia and statins use for the risk of new-onset anxiety/depression in patients with head and neck cancer: A population-based study. PLoS One 2017; 12:e0174574. [PMID: 28362860 PMCID: PMC5375135 DOI: 10.1371/journal.pone.0174574] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2016] [Accepted: 03/10/2017] [Indexed: 02/05/2023] Open
Abstract
Objective Anxiety/depression is common among patients with head and neck cancer (HNC), and can negatively affect treatment compliance and outcome. The aim of this study was to assess the association between hyperlipidemia and the risk of new-onset anxiety/depression after the diagnosis of HNC and the influence of administering statins. Methods A matched longitudinal cohort study of 1632 subjects (408 HNC patients with preexisting hyperlipidemia and 1224 age- and sex-matched HNC patients without hyperlipidemia) was included and analyzed by using data from Taiwan’s National Health Insurance Research Database from January 1996 to December 2012. The incidence and hazard ratios (HRs) for the development of new-onset anxiety/depression were examined between the two groups. Cox proportional hazard regression was applied to estimate the relative risks of anxiety/depressive disorders adjusted for potential confounding factors. To estimate the risks of anxiety/depression in different sub-groups, a stratified analysis was also used. Results HNC patients with preexisting hyperlipidemia had a higher risk for comorbidities such as hypertension, diabetes mellitus, and cardiovascular disease (P <0.001). The incidence rate of anxiety/depression in the HNC patients with preexisting hyperlipidemia was also significantly higher than that among patients without hyperlipidemia (10.78% vs 7.27%, respectively; P = 0.03). A Cox regression model revealed that preexisting hyperlipidemia was an independent risk factor for anxiety/depression (aHR, 1.96; 95% CI, 1.30–2.94). Statins use was protective against anxiety/depression among HNC patients with hyperlipidemia (aHR, 0.85; 95% CI, 0.46–1.57), especially for individuals older than 65 years and for females. Conclusions Preexisting hyperlipidemia was associated with increased risk of new-onset anxiety/depression in the HNC patients. Statins use for HNC patients with hyperlipidemia could decrease the risk of anxiety/depression, especially for those older than 65 years and for female patients.
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Affiliation(s)
- Chung-I Huang
- Department of Radiation Oncology, E-Da Cancer Hospital, Kaohsiung, Taiwan
| | - Li-Ching Lin
- Department of Radiation Oncology, Chi-Mei Medical Center, Tainan, Taiwan
| | - Hung-Cheng Tien
- Department of Psychiatry, Pingtung Hospital, Ministry of Health and Welfare, Pingtung, Taiwan
| | - Jenny Que
- Department of Radiation Oncology, Chi-Mei Medical Center, Tainan, Taiwan
| | - Wei Chen Ting
- Department of Radiation Oncology, Chi-Mei Medical Center, Tainan, Taiwan
| | - Po-Chun Chen
- Department of Radiation Oncology, Pingtung Christian Hospital, Pingtung, Taiwan
| | - Hsin-Min Wu
- Department of Public Health, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chung-Han Ho
- Department of Medical Research, Chi-Mei Medical Center, Tainan, Taiwan
- Department of Pharmacy, Chia-Nan University of Pharmacy and Science, Tainan, Taiwan
| | - Jhi-Joung Wang
- Department of Medical Research, Chi-Mei Medical Center, Tainan, Taiwan
| | - Ren-Hong Wang
- Department of Clinical Pathology, Chi-Mei Medical Center, Tainan, Taiwan
- Department of Medical Laboratory Science and Biotechnology, Chung Hwa University of Medical Technology, Tainan, Taiwan
| | - Ching-Chieh Yang
- Department of Radiation Oncology, Chi-Mei Medical Center, Tainan, Taiwan
- Institute of Biomedical Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan
- Department of Biotechnology, Chia-Nan University of Pharmacy and Science, Tainan, Taiwan
- * E-mail:
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Ng CG, Lai KT, Tan SB, Sulaiman AH, Zainal NZ. The Effect of 5 Minutes of Mindful Breathing to the Perception of Distress and Physiological Responses in Palliative Care Cancer Patients: A Randomized Controlled Study. J Palliat Med 2016; 19:917-24. [DOI: 10.1089/jpm.2016.0046] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Chong Guan Ng
- Department of Psychological Medicine, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - Kiah Tian Lai
- School of Psychology, University of Leeds, Leeds, United Kingdom
| | - Seng Beng Tan
- Department of Medicine, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - Ahmad Hatim Sulaiman
- Department of Psychological Medicine, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - Nor Zuraida Zainal
- Department of Psychological Medicine, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
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Tang PL, Mayer DK, Chou FH, Hsiao KY. The Experience of Cancer Stigma in Taiwan: A Qualitative Study of Female Cancer Patients. Arch Psychiatr Nurs 2016; 30:204-9. [PMID: 26992872 DOI: 10.1016/j.apnu.2015.08.015] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Revised: 08/22/2015] [Accepted: 08/25/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND Cancer is the leading cause of death in Taiwan. Because the causes of cancer are often difficult to identify, a diagnosis of cancer is occasionally attributed to karma and the concept of stigma. These feelings lead to a life predicament, and stigma influences these perceptions. OBJECTIVE This study intended to understand how stigma is formed in the disease-related experiences of women with cancer. METHODS Ten participants were interviewed at the time of a confirmed diagnosis of advanced cancer and completed cancer treatment with regular follow-up after treatment, and all subjects underwent 2-3 interviews. The number of interviews conducted was determined by data saturation. A content analysis method was used. RESULTS The stigma of cancer includes the concepts of "cancer equals death", including the feeling of death approaching and an awareness of disease severity. "Cancer equals menace to social life" suggests that social life is affected and includes other individuals' uncomfortable attitudes toward cancer (shame, sympathy, pity, suffering, and over-cautiousness) and external physical changes. "Cancer equals cancer-ridden life" includes being sensitive to the topics of death and calculating the number of remaining survival days. CONCLUSIONS The process from early diagnosis to the decision to receive treatment is complicated for patients with cancer. After the diagnosis is confirmed, the stigma of diagnosis significantly affects patients. Regarding social stereotypes, educating the public to resolve individuals' negative responses to cancer and further convey social and public information to women in society is necessary.
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Affiliation(s)
- Pei-Ling Tang
- Department of Nursing, Kaohsiung Veterans General Hospital, Kaohsiung City, Taiwan
| | - Deborah K Mayer
- University of North Carolina School of Nursing, Chapell Hill, NC
| | - Fan-Hao Chou
- College of Nursing, Kaohsiung Medical University, Kaohsiung City, Taiwan.
| | - Kuan-Yin Hsiao
- Radiation Oncology Department, Kaohsiung Municipal United Hospital, Kaohsiung City, Taiwan
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Magro E, Bergot L, Cuchard S, Lebreton S, Coutte MB, Rolland-Lozachmeur G, Hieu PD, Seizeur R. Diagnosis Disclosure Process in Patients With Malignant Brain Tumors. Clin J Oncol Nurs 2016; 20:E49-54. [PMID: 26991723 DOI: 10.1188/16.cjon.e49-e54] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The way to disclose a cancer diagnosis has evolved, and psycho-oncology has developed a more prominent place in cancer care. The diagnosis disclosure process was established to improve the overall quality of patient care and the communication about a cancer diagnosis. OBJECTIVES The aim of this study was to assess the implementation of the disclosure process in a neurosurgical unit. METHODS This study was conducted prospectively during a one-year period. All patients were diagnosed with malignant brain tumors and received their diagnosis using the disclosure process. The communication between the provider and the patient during diagnosis disclosure was recorded for analysis, and patients completed a satisfaction survey. FINDINGS Ninety-one patients with a brain tumor diagnosis participated in the study. Twenty-six were unable to complete the satisfaction survey because they were either deceased or close to the end of their lives. In total, 65 questionnaires were sent to patients and their families, and 43 responded. Patients were satisfied with the quality of the disclosure process regarding information given, psychological support, and communication with all healthcare providers. This assessment allowed the authors to better characterize the impact of the disclosure process on the overall care of patients and to measure the effect of the components of the disclosure process on patient satisfaction.
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Affiliation(s)
- Elsa Magro
- Centre Hospitalier Regional Universitare
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Pranjic N, Bajraktarevic A, Ramic E. DISTRESS AND PTSD IN PATIENTS WITH CANCER: COHORT STUDY CASE. Mater Sociomed 2016; 28:12-6. [PMID: 27047260 PMCID: PMC4789727 DOI: 10.5455/msm.2016.28.12-16] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2015] [Accepted: 01/05/2015] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION embarrassed emotional experience may affect the ability to oncology patient effectively cope with cancer, symptoms and treatment. Distress extends a long period, from common, normal feelings of vulnerability, sadness and fears to problems of PTSD, depression, anxiety, panic, social isolation and the perception of spiritual crisis. The aim of the research is to determine the level of distress and PTSD in cancer patients. PATIENTS AND METHODS In a prospective, cohort study cases from 2011- 2014 were included patients with cancer who are treated under the supervision of his chosen family medicine doctor. Including a factor for the participation of patients in the study is that from the moment of diagnosis of malignant disease passed <12 months. The total sample was 174 of the planned 200 (response rate=87%). The subjects were divided into three groups. A key factor in the creation of the group was the time elapsed from the moment of acknowledgment and confirmation of the diagnosis: T1 <14 days, n=56 patients; T2>14 days-<6 months, n=79 patients; T3>6 months n=39 patients. To achieve the set goals of the research was used instruments of 3 questionnaires: Questionnaire on the clinical characteristics of patients with malignant disease, demographic and individual characteristics; questionnaire distress oncology patient-hospital scales of depression and anxiety, HADS scale (Hospital Anxiety and Depression Scale - HADS) and a rapid test for self-assessment of the symptoms of PTSD. RESULTS Age of patients was 54.63 ± 11:46 years, and the age of the respondents when they were diagnosed with cancer 54.34 ± 11.26 years. The prevalence of distress was a high 76% 82x higher than expected), and PTSD 55%. Predictors of burnout syndrome in cancer patients are all important determinants of malignant disease: the time elapsed since the diagnosis of the disease which determines the clinical status of malignant disease (β=0.280; P=0.001; 95% CI, 0742-2259), discovered metastases (β=0.304; P=0.001; 95% CI -2621 to 0978) and treatments (β=0.160; P=0.031, 95% CI 0050 to 1.060). CONCLUSION The problem of distress in cancer patients is widespread and has a high prevalence of 76% in our environment, while still absent intervention and treatment.
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Affiliation(s)
- Nurka Pranjic
- Department of Occupational Health, Faculty of Medicine, University of Tuzla, Bosnia and Herzegovina; Teaching Department for Professional Pathology and Toxicology, Health Center in Tuzla, Bosnia and Herzegovina
| | | | - Enisa Ramic
- Family Medicine, Health Centre Tuzla, Bosnia and Herzegovina
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Otis-Green S, Jones B, Zebrack B, Kilburn L, Altilio TA, Ferrell B. ExCEL in Social Work: Excellence in Cancer Education & Leadership: An Oncology Social Work Response to the 2008 Institute of Medicine Report. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2015; 30:503-513. [PMID: 25146345 PMCID: PMC4339672 DOI: 10.1007/s13187-014-0717-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
ExCEL in Social Work: Excellence in Cancer Education & Leadership was a multi-year National Cancer Institute (NCI)-funded grant for the development and implementation of an innovative educational program for oncology social workers. The program's curriculum focused upon six core competencies of psychosocial-spiritual support necessary to meet the standard of care recommended by the 2008 Institute of Medicine (IOM) Report: Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs. The curriculum was delivered through a collaborative partnership between the City of Hope National Medical Center and the two leading professional organizations devoted exclusively to representing oncology social workers--the Association of Oncology Social Work and the Association of Pediatric Oncology Social Workers. Initial findings support the feasibility and acceptability of this tailored leadership skills-building program for participating oncology social workers.
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Affiliation(s)
- Shirley Otis-Green
- Division of Nursing Research and Education, Department of Population Sciences, City of Hope National Medical Center, 1500 E. Duarte Rd., Duarte, CA, 91010, USA,
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Dunn J, Holland J, Hyde MK, Watson M. Psycho-oncology and primary prevention in cancer control plans: an absent voice? Psychooncology 2015. [PMID: 26211514 DOI: 10.1002/pon.3917] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND One third of cancer deaths are attributable to modifiable lifestyle, behaviour and psychosocial risk factors. Psycho-oncology can contribute significantly to prevention initiatives such as those described in national cancer control plans (NCCPs), to reduce or eliminate these risk factors. However, the extent to which psycho-oncology expertise has informed prevention objectives in plans is unclear. METHODS Accordingly, 35 English language NCCPs were located via existing databases and were searched using Adobe text searches ('psycho', 'social', 'behav' and 'intervention') to identify (a) representations of psycho-oncology, its dimensions (psychological, social and behavioural) and roles (e.g. psychologist); and (b) behaviour/lifestyle change interventions. RESULTS A third of NCCPs included the term psycho- or psychosocial-oncology; approximately half referred to a psycho-oncology dimension regarding prevention and early detection and half included actions/objectives relating to health professionals and provision of psychosocial care. The majority of cancer plans included prevention outcomes and focussed primarily on smoking cessation and alcohol reduction. Interventions commonly proposed were education, regulation and service provision; however, many were aspirational statements of intent rather than specific interventions. Psycho-oncology was represented in NCCPs but was limited in reference to prevention with few behavioural interventions utilised. CONCLUSIONS Psycho-oncology input is needed to prescribe evidence-based interventions in cancer plans that not only educate, regulate and provide resources but also motivate, empower and create a supportive normative environment for behaviour change. In this manuscript, and throughout this Special Issue on Cancer Prevention, important principles, ideas and evidence within psycho-oncology are outlined which, if properly implemented, can help reduce the global cancer burden. Copyright © 2015 John Wiley & Sons, Ltd.
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Affiliation(s)
- Jeff Dunn
- Cancer Council Queensland, Brisbane, Queensland, Australia.,School of Social Science, University of Queensland, St. Lucia, Queensland, Australia
| | - Jimmie Holland
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Melissa K Hyde
- Cancer Council Queensland, Brisbane, Queensland, Australia.,Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Queensland, Australia
| | - Maggie Watson
- Pastoral and Psychological Care, Royal Marsden Hospital, Sutton, Surrey, UK.,Research Department of Clinical, Health and Educational Psychology, University College London, UK
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Ferrer RA, Green PA, Barrett LF. Affective science perspectives on cancer control: strategically crafting a mutually beneficial research agenda. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2015; 10:328-45. [PMID: 25987511 PMCID: PMC4438787 DOI: 10.1177/1745691615576755] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Cancer control research involves the conduct of basic and applied behavioral and social sciences to reduce cancer incidence, morbidity, and mortality and improve quality of life. Given the importance of behavior in cancer control, fundamental research is necessary to identify psychological mechanisms underlying cancer risk, prevention, and management behaviors. Cancer prevention, diagnosis, and treatment are often emotionally laden. As such, affective science research to elucidate questions related to the basic phenomenological nature of emotion, stress, and mood is necessary to understand how cancer control can be hindered or facilitated by emotional experiences. To date, the intersection of basic affective science research and cancer control remains largely unexplored. The goal of this article is to outline key questions in the cancer control research domain that provide an ecologically valid context for new affective science discoveries. We also provide examples of ways in which basic affective discoveries could inform future cancer prevention and control research. These examples are not meant to be exhaustive or prescriptive but instead are offered to generate creative thought about the promise of a cancer research context for answering basic affective science questions. Together, these examples provide a compelling argument for fostering collaborations between affective and cancer control scientists.
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Affiliation(s)
- Rebecca A Ferrer
- Basic Biobehavioral and Psychological Sciences Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD
| | - Paige A Green
- Basic Biobehavioral and Psychological Sciences Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD
| | - Lisa Feldman Barrett
- Department of Psychology, Northeastern University, Boston, MA Department of Psychiatry and the Martinos Center for Biomedical Imaging, Massachusetts General Hospital/Harvard Medical School, Boston
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Ulrich CM. Who am I? Reflections on self-image among patients with cancer in clinical trials. Clin J Oncol Nurs 2015; 17:E68-70. [PMID: 24305493 DOI: 10.1188/13.cjon.e68-e70] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Patients with cancer who participate in research face difficult challenges. Their lives change in many ways, and they often question their self-image. Self-image includes how patients see themselves and who they want to become. The current commentary addresses the issue of self-image in patients with cancer who participate in clinical trials and how their sense of who they were changes as they shift from patients with cancer to research participants. Patients with cancer who participate in research may suffer from multiple identity transitions, ranging from physical alterations in appearance and bodily capabilities to psychological burdens of job loss and the inability to contribute financially to their families. The author aims to provide insight as to how researchers can help patients find meaning in their lives during the process of participation in clinical trials as they undergo identity transitions.
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Affiliation(s)
- Connie M Ulrich
- New Courtland Center for Transitions and Health, University of Pennsylvania in Philadelphia
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Rajmohan V, Kumar SK. Psychiatric morbidity, pain perception, and functional status of chronic pain patients in palliative care. Indian J Palliat Care 2013; 19:146-51. [PMID: 24347904 PMCID: PMC3853392 DOI: 10.4103/0973-1075.121527] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Context: Psychological factors, such as that exist when we experience pain, can profoundly alter the strength of pain perception. Aim: The study aims to estimate the prevalence of psychiatric disorders, and its association with perception of pain and functional status in chronic patients in palliative care. Materials and Methods: The sample was selected via simple randomisation and post consent were assessed using (1) a semi- structured questionnaire to elicit socio-demographic information and medical data (2) Brief Pain Inventory (3) ICD-10 Symptom Checklist (4) ICD-10-Diagnostic Criteria for Research (DCR) (5) Montgomery Asberg Depression Rating Scale (MADRS) (6) Covi Anxiety Rating Scale (7) Karnofsky Performance Status Scale. Data was analysed using independent sample t test and chi square test. Results: The psychiatric morbidity was 67% with depression and adjustment disorders being the major diagnosis. There was a significant association between psychiatric morbidity pain variables (P = 0.000). Psychiatric morbidity significantly impaired activity, mood, working, walk, sleep, relationship, and enjoyment. There was no association between aetiology of pain, type of cancer, treatment for primary condition and treatment for pain and psychiatric morbidity. The functional status of cancer patients was also poorer in patients with psychiatric morbidity (P = 0.008). Conclusion: There is a high prevalence of psychiatric illness in chronic pain patients of any aetiology. Psychiatric morbidity is associated with increased pain perception, impairment in activity and poor functional status.
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Affiliation(s)
- V Rajmohan
- Muslim Educational Society Medical College, Perintalmanna, India
| | - Suresh K Kumar
- Institute of Palliative Medicine, Kozhikode, Kerala, India
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Hong JS, Tian J. Sensitivity and specificity of the Distress Thermometer in screening for distress in long-term nasopharyngeal cancer survivors. ACTA ACUST UNITED AC 2013; 20:e570-6. [PMID: 24311958 DOI: 10.3747/co.20.1617] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The Distress Thermometer (dt) is a screening tool recommended to quickly identify cancer patients with distress. Our study aimed to examine the sensitivity and specificity of the dt in detecting psychological distress in long-term Chinese nasopharyngeal cancer (npc) survivors. METHODS Data for the 442 participating npc survivors were collected through a self-administered questionnaire based on the dt and the Hospital Anxiety and Depression Scale (hads). The hads was used to define cases of psychological distress. Positive and negative groups were defined based on 4 hads criteria (Anxiety, Depression, Anxiety or Depression, and overall score). Receiver operating characteristic (roc) curves were used to examine the ability of all possible cut-off values of the dt to detect positive and negative cases. For each roc curve, the area under the curve (auc) was used as an indicator of the overall accuracy of the dt to identify positive cases of distress. RESULTS The positive auc values [with 95% confidence intervals (ci)] for the 4 hads criteria were 0.715 (95% ci: 0.667 to 0.764), 0.714 (95% ci: 0.661 to 0.768), 0.724 (95% ci: 0.677 to 0.771), and 0.724 (95% ci: 0.664 to 0.775) respectively. At a cut-off score of 4, the sensitivity of the dt to the four hads criteria was, respectively, 0.366 (95% ci: 0.296 to 0.436), 0.448 (95% ci: 0.364 to 0.532), 0.362 (95% ci: 0.299 to 0.425), and 0.421 (95% ci: 0.339 to 0.502), and the specificity of the dt to the 4 hads criteria was, respectively, 0.860 (95% ci: 0.818 to 0.902), 0.860 (95% ci: 0.821 to 0.899), 0.854 (95% ci: 0.814 to 0.894), and 0.854 (95% ci: 0.814 to 0.894). At a cut-off score of 5, the corresponding sensitivities were lower than those at the cut-off score of 4. All potential cut-off scores showed poor sensitivity (<0.90). CONCLUSIONS The roc analysis showed poor discrimination. No potential dt cut-off score had an acceptable sensitivity. The dt showed poor sensitivity in npc survivors. Thus, the dt might not be a valid scale for psychological distress screening in long-term Chinese npc survivors.
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Affiliation(s)
- J S Hong
- Department of Radiation Oncology, Department of Radiation Biology, First Affiliated Hospital of Fujian Medical University, Fuzhou, PR China
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Mahendran R, Chua J, Wuan E, Ang ENK, Lim SE, Kua EH. Psychosocial Care for Cancer Patients—Too Little, Too Late? ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2013. [DOI: 10.47102/annals-acadmedsg.v42n10p535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Assessment of psychosocial and psychiatric needs is an increasingly important component of cancer care. Clinical experience with patients indicate that distress, anxiety and depression are prevalent from early stages of the illness. Strategies to enhance psychosocial care are presented and these include early identification through screening, training for healthcare staff working with cancer patients and support not only for patients but their caregivers as well.
Key words: Distress, Emotional Needs, Social Needs
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Affiliation(s)
| | | | - Eugene Wuan
- Institute of Mental Health/Woodbridge Hospital, Singapore
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Vissers KCP, van den Brand MWM, Jacobs J, Groot M, Veldhoven C, Verhagen C, Hasselaar J, Engels Y. Palliative Medicine Update: A Multidisciplinary Approach. Pain Pract 2012; 13:576-88. [DOI: 10.1111/papr.12025] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2012] [Accepted: 11/06/2012] [Indexed: 11/29/2022]
Affiliation(s)
- Kris C. P. Vissers
- Department of Anesthesiology, Pain and Palliative Medicine; Radboud University Nijmegen Medical Centre; Nijmegen; The Netherlands
| | - Maria W. M. van den Brand
- Department of Anesthesiology, Pain and Palliative Medicine; Radboud University Nijmegen Medical Centre; Nijmegen; The Netherlands
| | - Jose Jacobs
- Department of Anesthesiology, Pain and Palliative Medicine; Radboud University Nijmegen Medical Centre; Nijmegen; The Netherlands
| | - Marieke Groot
- Department of Anesthesiology, Pain and Palliative Medicine; Radboud University Nijmegen Medical Centre; Nijmegen; The Netherlands
| | - Carel Veldhoven
- Department of Anesthesiology, Pain and Palliative Medicine; Radboud University Nijmegen Medical Centre; Nijmegen; The Netherlands
| | | | - Jeroen Hasselaar
- Department of Anesthesiology, Pain and Palliative Medicine; Radboud University Nijmegen Medical Centre; Nijmegen; The Netherlands
| | - Yvonne Engels
- Department of Anesthesiology, Pain and Palliative Medicine; Radboud University Nijmegen Medical Centre; Nijmegen; The Netherlands
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Abstract
Given that such a substantial proportion of oncology patients have advanced and/or incurable cancer oncologists invariably face enormous challenges in maintaining or improving the quality of life of this cohort of their practice. The provision of supportive and palliative care for these patients is a core element of quality cancer care. As the primary professional health care provider to the cancer patient, the oncologist has a special, significant, and challenging role in the care of these patients and their families. This article addresses the scope of these responsibilities and challenges and provides some introductory insights relating to practice that will be elaborated upon in the other contributions in this special issue of the Cancer Journal.
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Abstract
Palliative care, which seeks to alleviate suffering and optimize quality of life, is an increasingly recognized and valued medical subspecialty. With its focus on identifying and managing symptoms and problems encountered in expected functional decline, the domain of palliative care overlaps significantly with that of oncology, where patients typically experience a host of disease- and treatment-related effects. Assessment instruments have been developed and validated in the context of both disciplines, but oncology may benefit from the inclusion of palliative care screening instruments specifically developed for patients with advanced, life-limiting illnesses. New methods of screening, particularly technology-based ones such as electronic data capture, allow greater flexibility across care settings and longitudinal data capture for ongoing evaluation. This article reviews frequently used and available screening instruments for common palliative needs in cancer patients and provides an example of a novel technology-based screening approach to quickly identify and address a critical patient concern.
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Hallac S, Oz F. Existential Anxiety in Diagnostic Process of Genital Cancer. PSIKIYATRIDE GUNCEL YAKLASIMLAR 2011. [DOI: 10.5455/cap.20110326] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Psychosociale zorg voor de kankerpatiënt. ONCOLOGIE 2011. [DOI: 10.1007/978-90-313-8476-1_34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Uchida M, Akechi T, Okuyama T, Sagawa R, Nakaguchi T, Endo C, Yamashita H, Toyama T, Furukawa TA. Patients' Supportive Care Needs and Psychological Distress in Advanced Breast Cancer Patients in Japan. Jpn J Clin Oncol 2010; 41:530-6. [DOI: 10.1093/jjco/hyq230] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
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Mergenthaler U, Heymanns J, Köppler H, Thomalla J, van Roye C, Schenk J, Weide R. Evaluation of psychosocial distress in patients treated in a community-based oncology group practice in Germany. Ann Oncol 2010; 22:931-938. [PMID: 20926545 PMCID: PMC3065878 DOI: 10.1093/annonc/mdq455] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background: Systematic evaluation of psychosocial distress in oncology outpatients is an important issue. We assessed feasibility and benefit of standardized routine screening using the Distress Thermometer (DT) and Problem List (PL) in all patients of our community-based hematooncology group practice. Patients and methods: One thousand four hundred forty-six patients were screened between July 2008 and September 2008. Five hundred randomly selected patients were sent a feedback form. Results: The average distress level was 4.7, with 37% indicating a distress level >5. Patients with nonmalignant diseases (81% autoimmune diseases or hereditary hemochromatosis) showed the highest distress level of 5.2. Most distressed were patients who just learned about relapse or metastases (6.4), patients receiving best supportive care (5.4) and patients receiving adjuvant antihormonal therapy (5.4). Ninety-seven percent of patients appreciated to speak to their doctor about their distress. Fifty-six percent felt better than usual after this consultation. Conclusion: DT and PL are feasible instruments to measure distress in hematooncology outpatients receiving routine care. DT and PL are able to improve doctor–patient communication and thus should be implemented in routine patient care. The study shows that distress is distributed differently between individuals, disease groups and treatment phases.
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Affiliation(s)
| | | | | | | | | | - J Schenk
- Radiology Group Practice, Mammography Screening Unit Mittelrhein, Koblenz, Germany
| | - R Weide
- Hematology/Oncology Group Practice.
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Deshields TL, Nanna SK. Providing Care for the “Whole Patient” in the Cancer Setting: The Psycho-Oncology Consultation Model of Patient Care. J Clin Psychol Med Settings 2010; 17:249-57. [DOI: 10.1007/s10880-010-9208-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Age and depression in patients with metastatic cancer: the protective effects of attachment security and spiritual wellbeing. AGEING & SOCIETY 2009. [DOI: 10.1017/s0144686x09990201] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
ABSTRACTPsychological distress in cancer patients is inversely related to age, although the reasons are unclear. The adult development literature suggests that ageing may be associated with the development of adaptive capacities, specifically greater attachment security (the sense that others will be available and supportive when needed) and spirituality (the capacity to view one's life as having meaning, purpose and value), that enable older people to cope better with disease. We examined whether age-related patterns in attachment security and spiritual wellbeing account for the protective effect of age against distress. Measures of depression, attachment security, spiritual wellbeing and disease burden were collected from 342 patients aged from 21 to 88 years with advanced, metastatic cancer. Attachment security and spiritual wellbeing were tested as mediators of the effect of age on depression, controlling for disease burden. It was found that age was associated inversely with depression and positively with spiritual wellbeing and attachment security. Depression was inversely related to attachment security and spiritual wellbeing, and the effect of age on depression was fully mediated by attachment security and spiritual wellbeing. The relative protection from psychological distress among older cancer patients may be the result of age-related developmental accomplishments and/or differences in the response to adverse life-events.
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Neumann M, Galushko M, Karbach U, Goldblatt H, Visser A, Wirtz M, Ernstmann N, Ommen O, Pfaff H. Barriers to using psycho-oncology services: a qualitative research into the perspectives of users, their relatives, non-users, physicians, and nurses. Support Care Cancer 2009; 18:1147-56. [DOI: 10.1007/s00520-009-0731-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2009] [Accepted: 08/13/2009] [Indexed: 11/28/2022]
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Ledesma D, Kumano H. Mindfulness-based stress reduction and cancer: a meta-analysis. Psychooncology 2009; 18:571-9. [PMID: 19023879 DOI: 10.1002/pon.1400] [Citation(s) in RCA: 247] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE This meta-analysis was conducted to investigate the effects of mindfulness-based stress reduction (MBSR) on the mental and physical health status of various cancer patients. METHODS Ten studies (randomized-controlled trials and observational studies) were found to be eligible for meta-analysis. Individual study results were categorized into mental and physical variables and Cohen's effect size d was computed for each category. RESULTS MBSR may indeed be helpful for the mental health of cancer patients (Cohen's effect size d=0.48); however, more research is needed to show convincing evidence of the effect on physical health (Cohen's effect size d=0.18). CONCLUSION The results suggest that MBSR may improve cancer patients' psychosocial adjustment to their disease.
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Affiliation(s)
- Dianne Ledesma
- Department of Stress Science and Psychosomatic Medicine, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
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Addressing the information needs of patients with prostate cancer: A literature review. JOURNAL OF RADIOTHERAPY IN PRACTICE 2009. [DOI: 10.1017/s1460396908006511] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractPsychosocial support is a cornerstone in the holistic care of cancer patients. The provision of information is a key tool in the psychosocial management of the cancer patient, and it is important that the therapy radiographer is cognizant of the patient's need for information.This article reviews the importance of information to the psychosocial well-being of cancer patients in general, with specific emphasis on patients with prostate cancer. The information services at a large Canadian cancer facility are also reviewed to gain some insight into how the needs of patients with prostate cancer are addressed at the author's workplace.Most patients with prostate cancer have an expressed need for considerable amounts of information at various stages of their cancer journey. The provision of information has a range of benefits to the prostate patient such as helping the patient deal with their diagnosis, assisting with the decision-making process and reducing anxiety.Interpersonal sources of information such as face-to-face communication with the oncologist or radiation therapist are preferred by many patients, including patients with prostate cancer. Other sources that include the internet and written hospital material are also used with varying degrees of effectiveness to deliver information.The provision of quality information in a timely and effective manner cannot be taken for granted. Access to appropriate information resources can be impeded because of poorly designed information material, inadequate communication, ineffective signposting, resource constraints and lack of knowledge/comprehension on the part of frontline health-care workers dealing with the patient. Radiation therapists are encouraged to be advocates for their patients’ information needs and to be involved in initiatives that will improve the quality, dissemination and efficacy of information.
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RN HRJ, Dassen T, Widdershoven G, Halfens R. Evaluating Palliative Care—A Review of the Literature. Palliat Care 2009. [DOI: 10.4137/pcrt.s2178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The purpose of this article was to investigate the outcome measures developed and used in palliative care. The paper involved a literature review of published research. Many of the reviewed papers concluded similarly that there was lack of good quality evidence on which to base conclusions. More high quality evidence is needed to compare the relative merits of the differences in models of palliative care services, so that we can learn from other appropriate systems of care at end of life. It follows that quality of life is the main outcome of palliative care, in which the patient instead of the disease represents the target of the clinical approach. Patients struggling with serious illness have other concerns, including managing pain and other symptoms, coordinating care among multiple providers and settings, ensuring that treatments reflect preferences and balance benefits and harms as well as clinical appropriateness, achieving empathic communication and care, fostering well-being, maintaining function and practically supporting family and caregivers through illness and bereavement.
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Bulli F, Miccinesi G, Maruelli A, Katz M, Paci E. The measure of psychological distress in cancer patients: the use of Distress Thermometer in the Oncological Rehabilitation Center of Florence. Support Care Cancer 2008; 17:771-9. [PMID: 19050940 DOI: 10.1007/s00520-008-0543-9] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2008] [Accepted: 11/17/2008] [Indexed: 10/21/2022]
Abstract
GOALS OF WORK Distress in cancer patients is common. In the last years, several studies have used the single-item Distress Thermometer (DT) as a screening tool for psychological distress in cancer patients. The primary objective of this study was to determine the optimal cutoff score on the DT for detecting psychological distress in cancer patients attending a rehabilitation center, by comparing the DT's scores with those of the Psychological Distress Inventory (PDI). The second aim was to explore the effectiveness of the DT as a screening tool for psychological distress in rehabilitative oncological setting. PATIENTS AND METHODS The sample study totaled 290 patients who were recruited from patients attending the Oncological Rehabilitation Center of Florence for the first time between January and December 2007. Patients were administered the DT along with the Problem List (PL) and the PDI as the gold standard against which the DT was compared. MAIN RESULTS The area under the receiver operating characteristics curve was 0.84 [95%CI 0.80-0.89]. The optimal DT cutoff score for identifying distressed cancer patients would be at or above 7 (sensitivity = 0.73; specificity = 0.82). Patients whose DT score was 7 or above were more likely to report problems in all issues on the PL. CONCLUSIONS The combination of DT and PL could be a practicable screening instrument for assessing the extent and the kind of distress also in rehabilitative oncological patients. On the other hand, the choice of the DT should be evaluated by clinicians.
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Affiliation(s)
- Francesco Bulli
- Clinical and Descriptive Epidemiology Unit ISPO, Cancer Prevention and Research Institute, Epidemiologia Clinica e Descrittiva, ISPO, Istituto Scientifico della Regione Toscana, Via S. Salvi 12, 50135, Florence, Italy.
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48
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Barros GCD, Labate RC. Psychological repercussions related to brachytherapy treatment in women with gynecological cancer: analysis of production from 1987 to 2007. Rev Lat Am Enfermagem 2008; 16:1049-53. [DOI: 10.1590/s0104-11692008000600018] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2007] [Accepted: 07/02/2008] [Indexed: 11/22/2022] Open
Abstract
One of the radiotherapeutic modalities for gynecological cancer treatment is brachytherapy, characterized by the placement of radioactive materials near the tumor. This treatment can bring side effects for patients. Due to the emotional issues involved, the objective of this research was to apprehend studies about psychological repercussions related to brachytherapy treatment in women with gynecological cancer, through a literature review. The results revealed an embryionic production, with only one study produced in Brazil. A higher concentration of studies was found in the Nursing area. Research focused on psychosocial repercussions, attempting to understand the patients' experiences before, during and after treatment, evidencing physical and psychological consequences that affect their quality of life. It is important to consider the expansion of this production through psychological research that furthers the comprehension about the experience of women submitted to brachytherapy.
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Affiliation(s)
- Gisele Curi de Barros
- University of Sao Paulo at Ribeirao Preto; WHO Collaborating Centre for Nursing Research Development, Brazil
| | - Renata Curi Labate
- University of Sao Paulo at Ribeirao Preto; WHO Collaborating Centre for Nursing Research Development, Brazil
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49
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Survivorship Research: Past, Present, and Future. Oncology 2007. [DOI: 10.1007/0-387-31056-8_100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Kenne Sarenmalm E, Ohlén J, Jonsson T, Gaston-Johansson F. Coping with recurrent breast cancer: predictors of distressing symptoms and health-related quality of life. J Pain Symptom Manage 2007; 34:24-39. [PMID: 17544244 DOI: 10.1016/j.jpainsymman.2006.10.017] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2006] [Revised: 10/04/2006] [Accepted: 10/05/2006] [Indexed: 11/29/2022]
Abstract
Little is known about how postmenopausal women with recurrent breast cancer cope with distressing symptoms and which factors predict health-related quality of life (HRQOL). In the present study, 56 consecutively enrolled patients completed questionnaires measuring symptom occurrence, coping capacity, coping efforts, and HRQOL at the time of recurrence. Results from this study illustrate that women with recurrent breast cancer suffer from multiple, concurrent, and interrelated symptoms of illness, anxiety, depression, and fatigue. Highly prevalent symptoms are lack of energy, difficulty sleeping, pain, worrying, problems with sexual interest, feeling sad, and dry mouth. The most frequently occurring symptom is problem with sexual interest, and the most severe symptom is worrying. The most distressing symptom experienced is pain. The majority of the women report 10-23 symptoms. Women who experience multiple symptoms also report higher levels of symptom distress. The experience of distressing symptoms is predicted by coping capacity, and the coping efforts experienced predict HRQOL. Patients with lower coping capacity report higher prevalence of symptoms, experience higher levels of distress, and experience worse perceived health, which in turn may decrease their HRQOL. To help women manage recurrent breast cancer, it is important to use multidimensional measurement to identify, evaluate, and treat distressing symptoms, and not assess single symptoms only. Care must be based upon the awareness of critical factors that exacerbate vulnerability to distress, as well as the ability to adapt to a recurrent breast cancer disease.
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