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Al Amri H, Al Qadire M, Abdelrahman H, Al Omari O, Damra J, Aljezawi M. Prevalence, Predictors, and the Role of Social Support in Posttraumatic Stress Disorder Among Cancer Patients in Oman. Cancer Nurs 2024:00002820-990000000-00229. [PMID: 38498793 DOI: 10.1097/ncc.0000000000001349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
BACKGROUND Cancer, regardless of type, presents a formidable life challenge affecting patients' psychological well-being. Many perceive cancer diagnosis and treatment as traumatic. OBJECTIVES This study aimed to estimate posttraumatic stress disorder (PTSD) prevalence in Omani adult cancer patients, identify predictors, and probe its correlation with social support. METHODS This cross-sectional study enrolled 343 adult cancer patients undergoing treatment from 3 hospitals in the Middle East country of Oman. Posttraumatic stress disorder was assessed via the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and perceived social support was measured using the Multidimensional Scale of Perceived Social Support. RESULTS The prevalence of PTSD among Omani adult cancer patients was 27.4%. Enhanced social support correlated with lower PTSD risk (odds ratio [OR], 0.95; 95% confidence interval [CI], 0.93-0.97; P < .001). Predictors included shorter time since diagnosis (OR, 0.98; 95% CI, 0.97-0.99; P = .017), no psychiatric referral (OR, 0.46; 95% CI, 0.23-0.96; P = .04), and insufficient social support (OR, 0.96; 95% CI, 0.94-0.98; P < .001). CONCLUSIONS Social support significantly mitigates PTSD risk. Routine assessment and psychiatric referrals, especially for recent diagnoses, can enhance patients' lives. Reevaluating the PTSD diagnostic cutoff score (33) merits consideration for improved clinical use. IMPLICATIONS FOR PRACTICE Early PTSD assessment, particularly for low-social support new-diagnosed patients, is crucial for timely intervention. Psychiatric referrals can guide specialized treatments. Stressing social support's role can guide healthcare providers, including oncology nurses, in supporting patients effectively.
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Affiliation(s)
- Hisham Al Amri
- Author Affiliations: College of Nursing, Sultan Qaboos University (Mr Al Amri and Drs Al Qadire, Abdelrahman, Al Omari, and Aljezawi), Muscat, Sultanate of Oman; Faculty of Nursing, Al Al-Bayt University (Drs Al Qadire and Aljezawi), Mafraq, Jordan; Faculty of Nursing, Suez Canal University (Dr Abdelrahman), Ismailia, Egypt; and Faculty of Educational Sciences, Hashemite University (Dr Damra), Zarqa, Jordan
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Capaldi JM, Shabanian J, Finster LB, Asher A, Wertheimer JC, Zebrack BJ, Shirazipour CH. Post-traumatic stress symptoms, post-traumatic stress disorder, and post-traumatic growth among cancer survivors: a systematic scoping review of interventions. Health Psychol Rev 2024; 18:41-74. [PMID: 36632776 DOI: 10.1080/17437199.2022.2162947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 12/21/2022] [Indexed: 01/13/2023]
Abstract
The detrimental effects of Post-Traumatic Stress Symptoms (PTSS) and Post-Traumatic Stress Disorder (PTSD) and the benefits of Post-Traumatic Growth (PTG) are well established for cancer survivors. Increased cancer survival rates necessitate an understanding of how these two paradoxical outcomes, PTSS/PTSD and PTG, are targeted through interventions. This systematic scoping review aims to (a) examine existing evidence on interventions targeting PTSS/PTSD and/or PTG among cancer survivors and (b) identify knowledge gaps to inform future research. Following the six steps of a scoping review, 76 articles met the inclusion criteria. Quantitative articles were examined using descriptive analysis. Frequency counts of the collated data were tabulated into summary tables. Qualitative articles were reviewed using meta-synthesis. Most articles were quantitative (n = 52) and targeted PTG (n = 68) through promising intervention approaches such as psychotherapy, mindfulness, physical activity, and psilocybin-assisted therapy. Three key implications for future research and practice were synthesized: (1) mechanistic considerations for intervention design that provide a roadmap for rigorous and theoretically-grounded research; (2) the need for improved representation of cancer survivors in trials; and (3) potential facilitators of intervention efficacy. Together, these findings can direct future research to optimize interventions to reduce PTSS/PTSD and promote PTG achievement among cancer survivors.
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Affiliation(s)
- Jessica M Capaldi
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Julia Shabanian
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Laurel B Finster
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Arash Asher
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | | | | | - Celina H Shirazipour
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
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Lin CC, Her YN. Demoralization in cancer survivors: an updated systematic review and meta-analysis for quantitative studies. Psychogeriatrics 2024; 24:35-45. [PMID: 37877340 DOI: 10.1111/psyg.13037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 09/18/2023] [Accepted: 10/09/2023] [Indexed: 10/26/2023]
Abstract
BACKGROUND Demoralization can cause impairments across all life aspects of cancer patients. Cancer patients are also vulnerable during their survivorship. The purpose of this review is to examine the risk of demoralization and associated risk factors among cancer survivors who have completed their primary anti-cancer treatment or time since diagnosis ≥5 years without recurrence. METHODS We searched databases of PubMed, Cochrane, Embase, PsycINFO and ClinicalTrial.gov to identify eligible studies which reported the demoralization level among cancer survivors. A random-effect meta-analysis model was used for calculating mean demoralization level. Heterogeneity was evaluated by I2 statistics. Funnel plots and Egger's regression tests were performed for checking publication bias. We used one-study-removed method for sensitivity analysis. Subgroup analysis was also done to examine the difference of demoralization level between cancer types. Meta-regression was performed to reveal risk factors of demoralization. RESULTS A meta-analysis of 12 articles involving 2902 cancer survivors was conducted. The mean demoralization score among cancer survivors was 25.98 (95% CI: 23.53-28.43). Higher demoralization level was seen in participants with older age, higher female ratio, higher married/living together status ratio and higher patient health questionnaire-9 score. The literature review revealed correlations between demoralization and suicide risk, anxiety and quality of life. No consistent correlation between demoralization and post-traumatic stress symptoms could be seen. CONCLUSIONS High demoralization level is noticed among cancer survivors. Risks for females, elder patients or breast cancer survivors are identified. More longitudinal or interventional studies for cancer survivors' demoralization are expected in the future.
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Affiliation(s)
- Cian-Cian Lin
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Yu-Ning Her
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
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Tan H. The mediating role of anxiety in disease uncertainty and acute stress in acute ischaemic stroke patients in the post-epidemic era. Front Psychiatry 2023; 14:1218390. [PMID: 37915800 PMCID: PMC10616834 DOI: 10.3389/fpsyt.2023.1218390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 09/01/2023] [Indexed: 11/03/2023] Open
Abstract
Objective To analyse the influencing factors of anxiety, disease uncertainty and acute stress response in patients with acute ischaemic stroke, and to verify the mediating role of anxiety in the post-epidemic era. Methods 240 patients with acute ischaemic stroke were selected from a tertiary hospital in Wuhan City and investigated by questionnaire and convenience sampling methods. Results The total anxiety score, disease uncertainty and acute stress reaction were at moderate levels. Anxiety was positively correlated with illness uncertainty, and anxiety and acute stress response were negatively correlated. Multiple linear regression analysis showed that Sickness uncertainty, acute stress response, age, and work status influenced anxiety. Anxiety mediated the prediction of Sickness uncertainty and acute stress response, with the mediating effect accounting for 35.6% of the total effect. Conclusion Disease uncertainty in patients with acute ischaemic stroke in the post-epidemic era directly affects the acute stress response and indirectly through anxiety.
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Affiliation(s)
- Hui Tan
- Quzhou TCM Hospital at the Junction of Four Provinces Affiliated to Zhejiang Chinese Medical University/Quzhou Hospital of Traditional Chinese Medicine, Quzhou, China
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Hardardottir H, Aspelund T, Fall K, Broström E, Sigurdsson BB, Cook E, Valdimarsdottir H, Fang F, Sloan EK, Lutgendorf SK, Jansson C, Valdimarsdottir UA. Psychobiological stress response to a lung cancer diagnosis: a prospective study of patients in Iceland and Sweden. Acta Oncol 2023; 62:1338-1347. [PMID: 37747345 DOI: 10.1080/0284186x.2023.2258445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 09/08/2023] [Indexed: 09/26/2023]
Abstract
BACKGROUND A diagnostic work-up leading to a lung cancer diagnosis is a severely stressful experience that may impact tumor progression. Yet, prospective data are scarce on psychological and biological components of stress at the time of lung cancer diagnosis. The aim of this study was to assess pre-to-post diagnosis change in psychological distress and urinary excretion of catecholamines in patients with suspected lung cancer. METHODS Participants were 167 patients within the LUCASS study, recruited at referral for suspected lung cancer to University Hospitals in Iceland and Sweden. Patients completed questionnaires on perceived distress (Hospital Anxiety and Depression Scale, HADS) before and after diagnosis of lung cancer or a non-malignant origin. A subpopulation of 85 patients also provided overnight urine for catecholamine analysis before and at a median of 24 days after diagnosis but before treatment. RESULTS A lung cancer diagnosis was confirmed in 123 (73.7%) patients, with a mean age of 70.1 years. Patients diagnosed with lung cancer experienced a post-diagnosis increase in psychological distress (p = 0.010), while patients with non-malignant lung pathology showed a reduction in distress (p = 0.070). Both urinary epinephrine (p = 0.001) and norepinephrine (p = 0.032) levels were higher before the diagnosis among patients eventually diagnosed with lung cancer compared to those with non-malignant lung pathology. We observed indications of associations between pre-to-post diagnosis changes in perceived distress and changes in urinary catecholamine levels. CONCLUSION Receiving a lung cancer diagnosis is associated with an increase in psychological distress, while elevated catecholamine levels are evident already before lung cancer diagnosis.
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Affiliation(s)
- Hronn Hardardottir
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
- Department of Respiratory Medicine, Landspitali University Hospital, Reykjavik, Iceland
| | - Thor Aspelund
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Katja Fall
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Erika Broström
- Department of Immunology, Genetics and Pathology, Clinical and Experimental Pathology, Uppsala University, Uppsala, Sweden
- Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Baldur B Sigurdsson
- Department of Clinical Chemistry, Landspitali University Hospital, Reykjavik, Iceland
| | - Elizabeth Cook
- Department of Clinical Chemistry, Landspitali University Hospital, Reykjavik, Iceland
| | - Heiddis Valdimarsdottir
- Department of Psychology, Reykjavik University, Reykjavik, Iceland
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Fang Fang
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Erica K Sloan
- Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia
| | - Susan K Lutgendorf
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, Iowa, USA
| | - Christer Jansson
- Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Unnur A Valdimarsdottir
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Lafuenti L, Dinapoli L, Mastrilli L, Savoia V, Linardos M, Masetti R, Tortora G, Valentini V, Scambia G, Chieffo DPR. Post-traumatic growth in oncological patients during the COVID-19 pandemic. Health Psychol Rep 2023; 12:142-153. [PMID: 38628280 PMCID: PMC11016944 DOI: 10.5114/hpr/169165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 05/31/2023] [Accepted: 07/03/2023] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Post-traumatic growth (PTG) is defined as "positive psychological change experienced as a result of the struggle with highly challenging life circumstances". Diagnosis of cancer leads to many psychological challenges. The recent pandemic forced oncological patients to face other multiple stressors. Resilience is a target of interest for PTG. The aim of this study is to analyze relationships between cancer trauma, COVID-19 pandemic stress, PTG and resilience over time. PARTICIPANTS AND PROCEDURE One hundred forty-six patients (124 females, 22 males) in active oncological treatment were enrolled from September 2020: 45.2% (n = 66) diagnosed with gynecological cancer, 23.3% (n = 34) with breast cancer, 15.1% (n = 22) with lung cancer, 16.5% (n = 24) with other cancers. We conducted a prospective longitudinal study on oncological patients evaluated at: diagnosis (T0), 6 (T1) and 12 months (T2) by means of the following self-administered tests: Distress Thermometer (DT), Hospital Anxiety and Depression Scale (HADS), Impact of Event Scale Revised (IES-R), Post-traumatic Growth Inventory (PTGI), Perceived Stress Scale (PSS), Connor-Davidson Resilience Scale (CD-RISC). RESULTS DT decreased over time (T0 vs. T2, p < .001). HADS decreased from T0 to T2 (p < .001). The PTG subscales regarding new possibilities and appreciating life improved comparing T0 vs. T2 (p = .029; p = .013), as well as the total index of PTG (p = .027). The IES avoidance subscale score decreased over time (T0 vs. T1, p = .035). CONCLUSIONS For some patients, the cancer experience is characterized not only by psychological distress but also by the presence and growth of positive aspects, such as the tendency to positively reconsider the value and importance of life, health and social relationships.
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Affiliation(s)
- Letizia Lafuenti
- UOS di Psicologia Clinica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Loredana Dinapoli
- UOS di Psicologia Clinica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Ludovica Mastrilli
- UOS di Psicologia Clinica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Vezio Savoia
- UOS di Psicologia Clinica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Marinella Linardos
- UOS di Psicologia Clinica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Riccardo Masetti
- UOS di Psicologia Clinica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giampaolo Tortora
- UOS di Psicologia Clinica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - Vincenzo Valentini
- UOS di Psicologia Clinica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giovanni Scambia
- UOS di Psicologia Clinica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - Daniela P. R. Chieffo
- UOS di Psicologia Clinica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
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Mazor M, Nelson A, Mathelier K, Wisnivesky JP, Goel M, Harris YT, Lin JJ. Racial and ethnic differences in post-traumatic stress trajectories in breast cancer survivors. J Psychosoc Oncol 2023; 42:1-15. [PMID: 37655715 PMCID: PMC10840938 DOI: 10.1080/07347332.2023.2253229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
PURPOSE To describe differences in post-traumatic stress (PTS) symptoms over time among racial and ethnic minoritized breast cancer survivors (BCS) with comorbid diabetes. DESIGN In a multisite longitudinal study, post-traumatic stress was evaluated at baseline, 6 and 12 months through self-reported questionnaires (Impact of Events Scale-Revised [IES-R]). PARTICIPANTS One hundred and seventy-eight post-treatment BCS with diabetes were recruited from three tertiary medical centers. FINDINGS Relative to non-Hispanic White women, minoritized women reported higher total IES-R scores at all time points. In the adjusted model, Latina women reported persistently higher IES-R total scores and Latina, and 'Other' women reported higher avoidance scores. CONCLUSIONS Minoritized BCS with comorbid diabetes report higher rates of cancer related PTS that persist over 12 months. IMPLICATIONS FOR PSYCHOSOCIAL PROVIDERS Post diagnosis PTS evaluation and support is important in survivorship and primary care practices. Linkage to socially and culturally sensitive community support may be warranted.
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Affiliation(s)
- Melissa Mazor
- Division of Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | | | - Krystina Mathelier
- Lienhard School of Nursing, College of Health Professions, Pace University, Pleasantville, New York, USA
| | - Juan P Wisnivesky
- Division of Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Mita Goel
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Yael Tobi Harris
- Division of Endocrinology, Diabetes & Metabolism, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Great Neck, New York, USA
| | - Jenny J Lin
- Division of Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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Özönder Ünal I, Ünal C, Duymaz T, Ordu C. The relationship between psychological flexibility, self-compassion, and posttraumatic growth in cancer patients in the COVID-19 pandemic. Support Care Cancer 2023; 31:428. [PMID: 37380871 DOI: 10.1007/s00520-023-07891-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 06/16/2023] [Indexed: 06/30/2023]
Abstract
PURPOSE The COVID-19 pandemic may have an important long-term emotional impact on patients with cancer diagnosis, as they are in the high-risk group. We aimed to evaluate the relationship between self-compassion, psychological flexibility, and posttraumatic growth, and to examine whether psychological flexibility may serve as a mediator between self-compassion and posttraumatic growth. METHODS Two hundred fifty-three patients with cancer were included in the study. Sociodemographic and Clinical Features Data Form, Self-Compassion Scale (SCS), Freiburg Mindfulness Inventory (FMI), Acceptance and Action Questionnaire-II (AAQ-II), Cognitive Fusion Questionnaire (CFQ), and Posttraumatic Growth Inventory (PTGI) were applied to all patients. RESULTS The multivariate analysis with independent variable SCS, FMI, AAQ-II, and CFQ scores explains 49% of the variance in PTGI (F(4,248) = 60,585, p < 0.001). SC and FMI scores were found to have a positive and AAQ-II and CFQ scores a negative predictive effect on PTGI scores. The partial mediational effect of psychological flexibility on the relationship between self-compassion and posttraumatic growth was found to be statistically significant. CONCLUSION In traumatic life events such as pandemics, the importance of self-compassion for posttraumatic growth and the mediator role of psychological flexibility in this relationship should be considered in order to manage the treatment process in cancer patients. These patients are more affected by the pandemic due to the nature of their malignancy and the strict protective measures they must follow as members of a high-risk group. The significance of therapies focused on psychological flexibility should be emphasized in comprehensive biopsychosocial approaches for the management of cancer patients.
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Affiliation(s)
- Ipek Özönder Ünal
- Department of Psychiatry, Tuzla State Hospital, Içmeler Mahallesi, Piri Reis Caddesi, No: 74 Tuzla, Istanbul, Turkey.
| | - Caglar Ünal
- Department of Medical Oncology, Istanbul Lutfi Kirdar City Hospital, Cevizli, D-100 Güney Yanyol, Cevizli Mevkii No: 47, 34865 Kartal, Istanbul, Turkey
| | - Tomris Duymaz
- Department of Physiotherapy & Rehabilitation, Istanbul Bilgi University, İnönü Cad. No: 72 Kuştepe 34387 Şişli, Istanbul, Turkey
| | - Cetin Ordu
- Department of Medical Oncology, Gayrettepe Florence Nightingale Hospital, Cemil Aslan Güder Sk. No: 8, 34349 Beşiktaş, Istanbul, Turkey
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Döring M, Dette AK, Werle D, Jendritza R, Malaval C, Thiel S, Michaelis S, Schlösser M, Lang P, Handgretinger R, Svaldi J, Cabanillas Stanchi KM. Screening for distress and quality of life in pediatric patients after allogeneic or autologous hematopoietic stem cell transplantation using a self-reporting instrument, blood stress biomarkers and an expert rating scale (PO-Bado). J Psychosom Res 2023; 170:111358. [PMID: 37196587 DOI: 10.1016/j.jpsychores.2023.111358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 04/07/2023] [Accepted: 05/04/2023] [Indexed: 05/19/2023]
Abstract
OBJECTIVE Hematopoietic stem cell transplantation (HSCT) is highly distressing and potentially traumatizing for pediatric and young adult patients (PYAP). At present, there is little evidence on their individual burdens. METHODS In this prospective cohort study, the course of the psychological and somatic distress was investigated on eight observation days (day -8/-12, -5, 0 (day of HSCT), +10, +20, and + 30 before/after HSCT), using the PO-Bado external rating scale and the EORTC-QLQ-C15-PAL self-assessment questionnaire. Stress-associated blood parameters were determined and correlated with the results of the questionnaires. RESULTS A total of 64 PYAP with a median age of 9.1 years (range 0-26 years) who underwent autologous (n = 20; 31%; autoHSCT) or allogeneic (n = 44; 69%; alloHSCT) HSCT were analyzed. Both were associated with a significant reduction in QOL. The reduction in self-assessed QOL correlated with somatic and psychological distress as assessed by medical staff. While somatic distress was similar in both groups with a maximum around day+10 (alloHSCT 8.9 ± 2.4 vs. autoHSCT 9.1 ± 2.6; p = 0.69), a significantly higher level of psychological distress was seen during alloHSCT (e.g. day0 alloHSCT 5.3 ± 2.6 vs. day0 autoHSCT 3.2 ± 1.0; p < 0.0001). CONCLUSIONS The maximum of psychological and somatic distress, as well as the lowest quality of life, ranges between day 0 and + 10 after both allogeneic and autologous pediatric HSCT. While somatic distress is similar during autologous and allogeneic HSCT, the allogeneic group seems to be affected by higher psychological distress. Larger prospective studies are needed to evaluate this observation.
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Affiliation(s)
- Michaela Döring
- University Children's Hospital Tübingen, General Pediatrics, Hematology and Oncology, Hoppe-Seyler-Str. 1, 72076 Tübingen, Germany.
| | - Anna Karina Dette
- University Children's Hospital Tübingen, General Pediatrics, Hematology and Oncology, Hoppe-Seyler-Str. 1, 72076 Tübingen, Germany.
| | - Dustin Werle
- Clinical Psychology and Psychotherapy, University of Tübingen, Schleichstr. 4, 72076 Tübingen, Germany.
| | - Ricarda Jendritza
- University Children's Hospital Tübingen, General Pediatrics, Hematology and Oncology, Hoppe-Seyler-Str. 1, 72076 Tübingen, Germany.
| | - Carmen Malaval
- University Children's Hospital Tübingen, General Pediatrics, Hematology and Oncology, Hoppe-Seyler-Str. 1, 72076 Tübingen, Germany.
| | - Stefanie Thiel
- University Children's Hospital Tübingen, General Pediatrics, Hematology and Oncology, Hoppe-Seyler-Str. 1, 72076 Tübingen, Germany
| | - Sebastian Michaelis
- University Children's Hospital Tübingen, General Pediatrics, Hematology and Oncology, Hoppe-Seyler-Str. 1, 72076 Tübingen, Germany.
| | - Manuel Schlösser
- University Children's Hospital Tübingen, Psychosocial-therapeutic service, Hoppe-Seyler-Str. 1, 72076 Tübingen, Germany
| | - Peter Lang
- University Children's Hospital Tübingen, General Pediatrics, Hematology and Oncology, Hoppe-Seyler-Str. 1, 72076 Tübingen, Germany.
| | - Rupert Handgretinger
- University Children's Hospital Tübingen, General Pediatrics, Hematology and Oncology, Hoppe-Seyler-Str. 1, 72076 Tübingen, Germany.
| | - Jennifer Svaldi
- Clinical Psychology and Psychotherapy, University of Tübingen, Schleichstr. 4, 72076 Tübingen, Germany.
| | - Karin Melanie Cabanillas Stanchi
- University Children's Hospital Tübingen, General Pediatrics, Hematology and Oncology, Hoppe-Seyler-Str. 1, 72076 Tübingen, Germany.
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Shams M, Pardini S, Del Bianco P, Calabrese C, De Salvo GL, Novara C. The predictive role of intolerance of uncertainty and trait of worry in breast cancer patients: A prospective, observational, single-center clinical study. Front Psychol 2023; 14:1092060. [PMID: 37138973 PMCID: PMC10149753 DOI: 10.3389/fpsyg.2023.1092060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 03/30/2023] [Indexed: 05/05/2023] Open
Abstract
Background Breast cancer diagnosis and treatment compromise well-being in a pervasive way, and negative consequences may remain after recovery. The psychological side of breast cancer has been extensively investigated; however, the role of intrusive thoughts and intolerance of uncertainty have been studied less systematically. Objectives The present study aimed to prospectively evaluate worry content, depression, anxiety, and post-traumatic stress symptoms and to define the role of the trait of worry and intolerance of uncertainty (IU) related to breast cancer. Methods Patients with their first breast cancer diagnosis were enrolled in a single-center, prospective observational trial. The trait of worry and IU were assessed using the Penn State Worry Questionnaire (PSWQ) and the Intolerance of Uncertainty Scale-Revised (IUS-R). The psychological aspects were evaluated using the Worry Domains Questionnaire (WDQ), the Beck Anxiety (BAI), Beck Depression Inventory-II (BDI-II), and the Impact of Event Scale-Revised (IES-R). Questionnaires were administered in a randomized sequence at diagnosis (T0), 3 months post-diagnosis (T1), and 12 months post-diagnosis (T2). Results One hundred and fifty eligible patients were enrolled in the study and provided the T0 assessment. Further compliance rates were 57% at T1 and 64% at T2. All patients showed a significant and continuous increase in the IES-R scale (p < 0.0001) from diagnosis to the end of the study, while no significant changes were observed for the WDQ, BAI, and BDI-II scales. The clinical PSWQ levels and/or high levels of the IUS-R score were the only variables that aided the distinction between patients who maintain high levels of depression, anxiety, and post-traumatic disorders and those who did not. Conclusion An early assessment of the components of the trait of worry and intolerance of uncertainty could be critical in identifying patients with a higher psychopathological risk. Furthermore, if future studies confirm the present findings, support and monitoring throughout the prognosis may present crucial benefits, and possibly affect the course of treatment.
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Affiliation(s)
| | - Susanna Pardini
- Department of General Psychology, University of Padova, Padua, Italy
- *Correspondence: Susanna Pardini,
| | | | | | | | - Caterina Novara
- Department of General Psychology, University of Padova, Padua, Italy
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11
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Zolfa R, Moradi A, Mahdavi M, Parhoon H, Parhoon K, Jobson L. Feasibility and acceptability of written exposure therapy in addressing posttraumatic stress disorder in Iranian patients with breast cancer. Psychooncology 2023; 32:68-76. [PMID: 36116086 DOI: 10.1002/pon.6037] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 07/18/2022] [Accepted: 07/26/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVE This study examined the feasibility and acceptability of written exposure therapy (WET) in reducing symptoms of posttraumatic stress disorder (PTSD) in Iranian women with breast cancer. Secondary aims included examining the influence of WET on quality of life (QoL), overgeneral memory and illness perceptions. METHOD Forty-six females with breast cancer and clinical symptoms of PTSD referred to the Razi Hospital in Rasht, Iran were randomly assigned to either WET (n = 23) or control (n = 23) groups. WET is a 5-session low-intensity exposure-based intervention for treating PTSD. The control group had no additional contact. Measures assessing PTSD, illness perceptions, overgeneral memory, and QoL were administered at baseline, post-intervention and 3-month follow-up. RESULTS Acceptability of WET was high; all participants completed all WET sessions. At post-intervention, 95.65% of the WET group met criteria for reliable change and 100% met criteria for minimal clinically important difference (MCID) and clinically significant change in PTSD symptom improvement. At follow-up, all WET participants met criteria for reliable change, MCID and clinically significant change in PTSD symptom improvement. No participants in the control group met reliable change, MCID or clinically significant change. The WET group had improved QoL and memory specificity and decreased threatening illness perceptions at post-intervention and follow-up when compared to controls. CONCLUSION WET may be a useful intervention for use with breast cancer patients with PTSD symptoms and may be an important adjunct to medical and pharmacological treatments, particularly in low- and middle-income countries. This study indicates further research in this area is warranted.
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Affiliation(s)
- Reihane Zolfa
- Department of Clinical Psychology, Kharazmi University, Tehran, Iran
| | - Alireza Moradi
- Kharazmi University and Institute for Cognitive Science Studies, Tehran, Iran
| | - Mohammad Mahdavi
- Kharazmi University and Institute for Cognitive Science Studies, Tehran, Iran
| | - Hadi Parhoon
- Department of Psychology, Razi University, Kermanshah, Iran
| | - Kamal Parhoon
- Postdoc Researcher in Cognitive Psychology, Kharazmi University, Tehran, Iran
| | - Laura Jobson
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
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12
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Kim Y. Mental health and quality of life according to sleep in cancer survivors. Perspect Psychiatr Care 2022; 58:2442-2448. [PMID: 35365854 DOI: 10.1111/ppc.13079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 12/07/2021] [Accepted: 03/23/2022] [Indexed: 11/29/2022] Open
Abstract
PURPOSE This study investigated the association of sleep duration with health-related quality of life (HRQoL) and mental health in cancer survivors. DESIGN AND METHODS This cross-sectional study included 846 cancer survivors aged 19 years and older from Korea. Associations between sleep duration, HRQoL, and mental health were analyzed using analysis of covariance and logistic regression. FINDINGS Survivors who slept 5 h or less had lower HRQoL and higher risk of suicidal ideation than survivors who slept 6-8 h. PRACTICE IMPLICATIONS Sleep improvement programs should be developed as sleep disorders may be a central concern among cancer survivors.
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Affiliation(s)
- Yoonjung Kim
- Faculty of Red Cross College of Nursing, Chung-Ang University, Seoul, Republic of Korea
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13
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Fioretti C, Vinciarelli V, Faggi D, Caligiani L, Tessitore F, Castelnuovo G, Cozzolino M. Investigating PTG in Cancer Patients: The Role of Time Dimension in the Experience of Personal Growth. IJERPH 2022; 19:ijerph19159619. [PMID: 35954972 PMCID: PMC9368546 DOI: 10.3390/ijerph19159619] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 07/30/2022] [Accepted: 08/01/2022] [Indexed: 02/04/2023]
Abstract
This study explored the experience of growth related to being a cancer patient by implementing a thematic analysis. An online questionnaire was completed by 69 patients narrating their growth experience related to cancer. Collected narratives were analyzed by running a deductive thematic analysis, starting from the five domains of the Post-Traumatic Growth Inventory (PTGI) and searching for the presence or absence of topics. Descriptive statistics and correlational analysis were performed. The five factors of the PTGI were identified in the narratives. The thematic analysis we performed defined a further theme that we labeled the “time dimension”, which saturated 37.7% of the entire sample. The presences of four sub-themes related to the “time dimension” were also found: “tracing a new temporal rhythm”, “the value of deserved time”, “facing the caducity of life” and “a view on the future”. Each sub-theme significantly correlated with the theme of the “time dimension”. This emergent theme does not correlate in our results with other domains of personal growth in cancer previously described in the scientific literature, emerging as an independent variable not significantly associated with other domains of post-traumatic growth. Our results suggest further investigation in the role of the time dimension in the practical and emotional experience of growth with regard to cancer.
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Affiliation(s)
- Chiara Fioretti
- Department of Human, Philosophical and Educational Sciences (DISUFF), University of Salerno, Via Giovanni Paolo II 132, 84084 Fisciano, Italy
- Correspondence:
| | - Viola Vinciarelli
- Psycho-Oncology Unit, USL Toscana Centro, Via Antella, 58, 50012 Bagno a Ripoli, Italy
| | - David Faggi
- Psycho-Oncology Unit, USL Toscana Centro, Via Antella, 58, 50012 Bagno a Ripoli, Italy
| | - Lucia Caligiani
- Psycho-Oncology Unit, USL Toscana Centro, Via Antella, 58, 50012 Bagno a Ripoli, Italy
| | - Francesca Tessitore
- Department of Human, Philosophical and Educational Sciences (DISUFF), University of Salerno, Via Giovanni Paolo II 132, 84084 Fisciano, Italy
| | - Gianluca Castelnuovo
- Department of Psychology, Catholic University of Milan, 20123 Milano, Italy
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, Largo Agostino Gemelli, 1, 20123 Milano, Italy
| | - Mauro Cozzolino
- Department of Human, Philosophical and Educational Sciences (DISUFF), University of Salerno, Via Giovanni Paolo II 132, 84084 Fisciano, Italy
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14
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Nik Jaafar NR, Abd Hamid N, Hamdan NA, Rajandram RK, Mahadevan R, Mohamad Yunus MR, Zakaria H, Mohd Shariff N, Hami R, Isa S, Shari NI, Leong Bin Abdullah MFI. Posttraumatic Growth, Positive Psychology, Perceived Spousal Support, and Psychological Complications in Head and Neck Cancer: Evaluating Their Association in a Longitudinal Study. Front Psychol 2022; 13:920691. [PMID: 35814154 PMCID: PMC9266623 DOI: 10.3389/fpsyg.2022.920691] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 06/03/2022] [Indexed: 11/13/2022] Open
Abstract
Despite head and neck cancer (HNC) association with various negative impacts, collective evidence is accumulating regarding the positive impacts of positive psychology on cancer survivors. However, data on how positive psychology is related to the psychological complications of HNC across time are lacking. This longitudinal study examined the trends of positive psychology (e.g., posttraumatic growth [PTG], hope, and optimism), perceived spousal support, and psychological complications (e.g., depression, anxiety, and posttraumatic stress symptoms) and determined the association between them, psychological complications, and PTG across two timelines among a cohort of HNC patients. A total of 175 HNC respondents exhibited an increasing trend of positive psychology and perceived spousal support while reporting a decreasing trend of psychological complications between baseline and follow-up assessments. A greater degree of hope and perceived spousal support contributed to a higher degree of PTG across time. Conversely, a higher severity of anxiety symptoms was associated with a lower degree of PTG over time. Female gender had a moderating effect on the association between severity of anxiety symptoms and PTG, but did not moderate the association between hope, perceived spousal support and PTG. This study indicates the pivotal role of incorporating psychosocial interventions into the treatment regimen to enhance the degree of hope and perceived spousal support and reduce the severity of anxiety symptoms, which, in turn, will facilitate the development of PTG in HNC patients.
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Affiliation(s)
- Nik Ruzyanei Nik Jaafar
- Department of Psychiatry, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Norhaliza Abd Hamid
- Department of Community Health, Advance Medical and Dental Institute, Universiti Sains Malaysia, Kepala Batas, Malaysia
| | - Nur Amirah Hamdan
- Department of Community Health, Advance Medical and Dental Institute, Universiti Sains Malaysia, Kepala Batas, Malaysia
| | - Rama Krsna Rajandram
- Department of Oral and Maxillofacial Surgery, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Raynuha Mahadevan
- Department of Psychiatry, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Mohd Razif Mohamad Yunus
- Department of Otorhinolaryngology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Hazli Zakaria
- Department of Psychiatry, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Noorsuzana Mohd Shariff
- Department of Community Health, Advance Medical and Dental Institute, Universiti Sains Malaysia, Kepala Batas, Malaysia
| | - Rohayu Hami
- Department of Community Health, Advance Medical and Dental Institute, Universiti Sains Malaysia, Kepala Batas, Malaysia
| | - Salbiah Isa
- Department of Community Health, Advance Medical and Dental Institute, Universiti Sains Malaysia, Kepala Batas, Malaysia
| | - Nurul Izzah Shari
- School of Human Resource Development and Psychology, Faculty of Social Sciences and Humanities, Universiti Teknologi Malaysia, Skudai, Malaysia
- *Correspondence: Nurul Izzah Shari
| | - Mohammad Farris Iman Leong Bin Abdullah
- Department of Community Health, Advance Medical and Dental Institute, Universiti Sains Malaysia, Kepala Batas, Malaysia
- Mohammad Farris Iman Leong Bin Abdullah
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15
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Abascal L, Vela A, Sugden S, Kohlenberg S, Hirschberg A, Young A, Lane K, Merlo G. Incorporating Mental Health Into Lifestyle Medicine. Am J Lifestyle Med 2022; 16:570-576. [DOI: 10.1177/15598276221084250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The evidence-based interconnection between mental health with lifestyle medicine practice is discussed. The extent to which physical health, and mental and behavioral health overlap are significant, and their interaction is seen in many ways. These bidirectional influences form a continuous thread through all lifestyle medicine pillars. The intersection of mental health and lifestyle should be considered and applied to provide optimal evidence-based lifestyle medicine for all patient populations who will benefit from the specific attention to diet, physical activity, relationships, stress, sleep, and substance use. Lifestyle medicine can be utilized to directly address and treat a range of mental health symptoms and disorders, and physical illnesses. In addition, behavior change skills and addressing the psychological factors contributing to barriers are crucial to helping patients reach their lifestyle medicine goals. Approaches to practice that attend to, and address, mental and behavioral health are relevant to and necessary for all types of providers who work within the lifestyle medicine framework.
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Affiliation(s)
- Liana Abascal
- California School of Professional Psychology - San Diego Campus
| | - Alyssa Vela
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Steve Sugden
- Huntsman Mental Health Institute, University of Utah, Salt Lake City, UT, USA
| | | | | | - Allison Young
- NYU Grossman School of Medicine, Palm Beach Gardens, FL, USA
| | - Karen Lane
- Life Ideals Private Practice, Windham, ME, USA
| | - Gia Merlo
- New York University, New York, NY, USA
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16
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Mirandola M, Andreis F, Abdel Kader S, Bianchetti M, Runcan M, Malighetti C, Meriggi F, Zaniboni A. Cancer and Covid-19: a preliminary study on the trauma aspects of Coronavirus in cancer patients. Psychooncology 2022; 31:1340-1346. [PMID: 35394096 PMCID: PMC9088541 DOI: 10.1002/pon.5936] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 03/24/2022] [Accepted: 03/27/2022] [Indexed: 11/07/2022]
Abstract
Objective Because of Covid 19, it has become necessary to revise the treatment of cancer patients (“how” and “when”). That has had important psychological repercussions. The purpose of this study is the evaluation of the impact of Covid19 in terms of Post‐Traumatic Stress Disorder and Depression and the potential association with coping strategies. Methods We conducted an exploratory study with 106 patients undergoing treatment, using following questionnaires: Screening Questionnaire for Disaster Mental Health and Mini‐Mental Adjustment to Cancer. Results Only 25.5% of our sample showed symptoms of posttraumatic stress disorder (PTSD) and 6.6% revealed a probable presence of depression. In addition, it came up a significant correlation between SQD_P and the coping styles “Hopelessness” (r = 0.41 p < 0.001) and “Anxious Preoccupation” (r = 0.45, p < 0.001). A strong correlation also emerged between non‐Covid 19 patients and PTSD (r = 0.29, p = 0.002). Conclusions Our preliminary data did not reveal a prevalence of PTSD, but the persistence of the health emergency requires to focus future research on protective and risk factors related to PTSD and psychological distress in cancer patients, in order to reduce the mental health burden of Covid19.
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Affiliation(s)
- Mara Mirandola
- Oncology Department, Istituto Ospedaliero Fondazione Poliambulanza, L. Bissolati 57, 25124, Brescia, Italy
| | - Federica Andreis
- Oncology Department, Istituto Ospedaliero Fondazione Poliambulanza, L. Bissolati 57, 25124, Brescia, Italy
| | - Sonia Abdel Kader
- Oncology Department, Istituto Ospedaliero Fondazione Poliambulanza, L. Bissolati 57, 25124, Brescia, Italy
| | - Margherita Bianchetti
- Oncology Department, Istituto Ospedaliero Fondazione Poliambulanza, L. Bissolati 57, 25124, Brescia, Italy
| | - Mariana Runcan
- Oncology Department, Istituto Ospedaliero Fondazione Poliambulanza, L. Bissolati 57, 25124, Brescia, Italy
| | - Clelia Malighetti
- Università Cattolica del Sacro Cuore, Largo A. Gemelli, 1, 20123, Milano, Italy
| | - Fausto Meriggi
- Oncology Department, Istituto Ospedaliero Fondazione Poliambulanza, L. Bissolati 57, 25124, Brescia, Italy
| | - Alberto Zaniboni
- Oncology Department, Istituto Ospedaliero Fondazione Poliambulanza, L. Bissolati 57, 25124, Brescia, Italy
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17
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Lin CC. Letter to the Editor: The possible role of lymphadenopathy after vaccination in posttraumatic stress disorder in cancer survivors during COVID-19. Support Care Cancer 2022; 30:7821-7822. [PMID: 35235041 PMCID: PMC8890009 DOI: 10.1007/s00520-022-06945-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 02/27/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Cian-Cian Lin
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
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18
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Fernández-Guerrero MJ, Palacios-Vicario B. Consecuencias psíquicas en supervivientes permanentes de cáncer de mama. Curadas, aunque no libres. Clínica Contemporánea 2021. [DOI: 10.5093/cc2021a17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Leong WC, Azmi NA, Wee LH, Rajah HDA, Chan CMH. Validation and reliability of the Bahasa Malaysia language version of the Acceptance of Illness Scale among Malaysian patients with cancer. PLoS One 2021; 16:e0256216. [PMID: 34587199 PMCID: PMC8480610 DOI: 10.1371/journal.pone.0256216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 08/02/2021] [Indexed: 11/18/2022] Open
Abstract
Cancer is a life-threatening disease, and the challenges in accepting the diagnosis can bring a devastating emotional impact on the patient's mental and psychological wellbeing. Issues related to illness acceptance among cancer patients are not well studied in Malaysia. To date, the Acceptance of Illness Scale has not been translated to the Malay language (Bahasa Malaysia) nor validated for use in the oncology setting. The objective of the study is to translate, validate and determine the reliability of the Bahasa Malaysia version of the Acceptance of Illness Scale among Malaysian patients with cancer. A total of 129 patients newly diagnosed with cancer were consecutively sampled and the scale was administered via face-to-face interviews. A pilot test (n = 30) was conducted and test-retest reliability was determined. The Bartlett Test of Sphericity was statistically significantly (p<0.001), while the Kaiser-Mayer-Olkin (KMO) measure of sampling adequacy was adequate at 0.84. Scale item mean scores ranged between 3.02 and 4.33, while the item-total correlation ranged between 0.50 to 0.66 (p<0.05). The internal reliability coefficient was 0.84. The test-retest reliability indicated a high correlation, r = 0.94 with p = 0.001. The Bahasa Malaysia version of the Acceptance of Illness Scale is a valid and reliable instrument that is appropriate for use in Malaysian patients with cancer. Use of this scale to assess illness acceptance among the Malay-speaking patients with cancer can act as a guide for delivery of psycho-oncological services to help patients have a better mental wellbeing and life adjustment in living with cancer.
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Affiliation(s)
- Wun Chin Leong
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Department of Radiotherapy and Oncology, National Cancer Institute, Putrajaya, Malaysia
| | - Nor Aniza Azmi
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Lei Hum Wee
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | | | - Caryn Mei Hsien Chan
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Abstract
BACKGROUND Individuals with cancer experience stress throughout the cancer trajectory. Allostatic load (AL), a cumulative multi-system measure, may have a greater value in stress assessment and the associated biological burden than individual biomarkers. A better understanding of the use of AL and its operationalization in cancer could aid in early detection and prevention or alleviation of AL in this population. PURPOSE To consolidate findings on the operationalization, antecedents, and outcomes of AL in cancer. METHODS Seven databases (CINAHL, Ovid MEDLINE, Web of Science, APA PsycInfo, Scopus, Embase, and Cochrane CENTRAL) were searched for articles published through April 2020. The NIH tools were used to assess study quality. RESULTS Twelve studies met inclusion criteria for this review. Although variability existed in the estimation of AL, biomarkers of cardiovascular, metabolic, and immune systems were mostly used. Associations of AL with cancer-specific variables were examined mostly utilizing population-databases. Significant associations of AL with variables such as cancer-related stress, positive cancer history, post traumatic growth, resilience, tumor pathology, and cancer-specific mortality were found. Mini meta-analysis found that a one-unit increase in AL was associated with a 9% increased risk of cancer-specific mortality. CONCLUSION This review reveals heterogeneity in operationalization of AL in cancer research and lack of clarity regarding causal direction between AL and cancer. Nevertheless, AL holds a significant promise in cancer research and practice. AL could be included as a screening tool for high-risk individuals or a health outcome in cancer. Optimal standardized approaches to measure AL would improve its clinical utility.
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Affiliation(s)
- Asha Mathew
- College of Nursing, University of Illinois, Chicago, IL, USA
- College of Nursing, Christian Medical College, Vellore, India
| | - Ardith Z. Doorenbos
- College of Nursing, University of Illinois, Chicago, IL, USA
- University of Illinois Cancer Center, Chicago, IL, USA
| | - Hongjin Li
- College of Nursing, University of Illinois, Chicago, IL, USA
- University of Illinois Cancer Center, Chicago, IL, USA
| | - Min Kyeong Jang
- College of Nursing, University of Illinois, Chicago, IL, USA
- University of Illinois Cancer Center, Chicago, IL, USA
| | - Chang Gi Park
- College of Nursing, University of Illinois, Chicago, IL, USA
- Department of Population Health Nursing Science, Office of Research Facilitation, Chicago, IL, USA
| | - Ulf G. Bronas
- College of Nursing, University of Illinois, Chicago, IL, USA
- Laboratory of Vascular and Cognitive Health, Chicago, IL, USA
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Farahimanesh S, Moradi A, Sadeghi M. Autobiographical memory bias in cancer-related post traumatic stress disorder and the effectiveness of competitive memory training. Curr Psychol 2021. [DOI: 10.1007/s12144-021-01648-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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22
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Rajah HDA, Chan CMH, Kong YC, Wong LP, Bustaman RS, Ho GF, Lai KMY, Yip CH, Bhoo-Pathy N. Insights on emotional distress following cancer, sources of support and the unmet needs in a setting with limited supportive care services for people living with cancer. Support Care Cancer 2021; 29:5811-5819. [PMID: 33742239 DOI: 10.1007/s00520-021-06148-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 03/08/2021] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Delivery of supportive cancer care is often deemed a low priority in resource-limited settings. We aimed to explore the sources of emotional distress, the related support and the unmet needs of cancer survivors in Malaysia, where cancer survivorship services are presently limited. METHOD Twenty focus group discussions were conducted with 102 cancer patients from diverse ethnic and socioeconomic backgrounds. Thematic analyses were performed. RESULTS Patient narratives suggested that emotional distress arose from direct and indirect stressors. Direct stressors comprised physical and cognitive side effects of cancer surgery and therapies, and fear of recurrence. Indirect stressors included worry over dependent family members, financial distress following cancer, working with cancer and lack of practical support at home. Distress from altered physical appearances, fear of recurrence and lack of practical support were mainly raised by women, implying that men and women may have disproportionate emotional needs. Emotional support largely came from informal sources including self, family, friends and religion. While formal emotional support from professional counsellors and cancer support groups was acknowledged as important, it appeared to be largely lacking. Unmet needs in coping with fear of recurrence, financial distress, workplace discrimination and household chores were particularly highlighted. CONCLUSION The unmet needs revealed in this study provide insights to initiate actionable changes to improve the emotional wellbeing of people living with cancer in settings where cancer survivorship services are still in its infancy.
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Affiliation(s)
- Harenthri Devy Alagir Rajah
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.,Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Caryn Mei Hsien Chan
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Yek-Ching Kong
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Li-Ping Wong
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Ros Suzanna Bustaman
- Department of Radiotherapy and Oncology, Kuala Lumpur Hospital, 50586, Kuala Lumpur, Malaysia
| | - Gwo-Fuang Ho
- Department of Clinical Oncology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | | | - Cheng-Har Yip
- Subang Jaya Medical Centre, 47500, Subang Jaya, Malaysia
| | - Nirmala Bhoo-Pathy
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
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Highfill-McRoy RM, Levine JA, Larson GE, Norman SJ, Schmied EA, Thomsen CJ. Predictors of Symptom Increase in Subsyndromal PTSD Among Previously Deployed Military Personnel. Mil Med 2021; 187:e711-e717. [PMID: 33580699 PMCID: PMC9071097 DOI: 10.1093/milmed/usab034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 01/11/2021] [Accepted: 01/24/2021] [Indexed: 11/16/2022] Open
Abstract
Introduction Subsyndromal PTSD (sub-PTSD) is associated with functional impairment and increased risk for full PTSD. This study examined factors associated with progression from sub-PTSD to full PTSD symptomatology among previously deployed military veterans. Materials and Methods Data were drawn from a longitudinal survey of Navy and Marine Corps personnel leaving military service between 2007 and 2010 administered immediately before separation (baseline) and ~1 year later (follow-up). Survey measures assessed PTSD symptoms at both times; the baseline survey also assessed potential predictors of symptom change over time. Logistic regression models were used to identify predictors of progression from sub-PTSD to full PTSD status. Results Compared to those with no or few PTSD symptoms at baseline, individuals with sub-PTSD were almost three times more likely to exhibit full PTSD symptomatology at follow-up. Risk factors for symptom increase among those with sub-PTSD included moderate or high levels of combat exposure and utilization of fewer positive coping behaviors. Use of prescribed psychotropic medication was protective against symptom increase. Conclusion This study identified several predictors of symptom increase in military veterans with sub-PTSD. Interventions targeting modifiable risk factors for symptom escalation, including behavioral and pharmacological treatments, may reduce rates of new-onset PTSD in this population.
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Affiliation(s)
- Robyn M Highfill-McRoy
- Leidos, San Diego, CA 92106-3521, USA.,Health and Behavioral Sciences Department, Naval Health Research Center, San Diego, CA 92106-3521, USA
| | - Jordan A Levine
- Leidos, San Diego, CA 92106-3521, USA.,Health and Behavioral Sciences Department, Naval Health Research Center, San Diego, CA 92106-3521, USA
| | - Gerald E Larson
- Health and Behavioral Sciences Department, Naval Health Research Center, San Diego, CA 92106-3521, USA
| | - Sonya J Norman
- National Center for PTSD, 215 North Main St., White River Junction, VT 05009, USA.,VA Center of Excellence for Stress and Mental Health, San Diego, CA 92161-0002, USA.,UCSD School of Medicine, La Jolla, CA 92093-0602, USA
| | | | - Cynthia J Thomsen
- Health and Behavioral Sciences Department, Naval Health Research Center, San Diego, CA 92106-3521, USA
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Zhang Y, Cui C, Wang L, Yu X, Wang Y, Wang X. The Mediating Role of Hope in the Relationship Between Perceived Stress and Post-Traumatic Stress Disorder Among Chinese Patients with Oral Cancer: A Cross-Sectional Study. Cancer Manag Res 2021; 13:393-401. [PMID: 33488121 PMCID: PMC7814276 DOI: 10.2147/cmar.s281886] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 12/31/2020] [Indexed: 12/29/2022] Open
Abstract
PURPOSE Cancer diagnosis and treatment are long-term traumatic stressors. Depression and anxiety are known to be prevalent in patients with cancer, but post-traumatic disorder (PTSD) has been overlooked frequently in this population. This study aimed to estimate the prevalence of PTSD and examined the mediating role of hope in the relationship between perceived stress and PTSD symptoms in Chinese patients with oral cancer. METHODS A total of 230 oral cancer patients were recruited to complete a questionnaire including the Posttraumatic Stress Checklist-Civilian Version (PCL-C), the Perceived Stress Scale-10 (PSS-10) and the Herth Hope Index (HHI). Analysis of variances (ANOVA)/t-test, Person's r and hierarchical linear regression analysis methods were conducted to assess the associations among perceived stress, hope and PTSD symptoms. Asymptotic and resampling strategies were used to explore the mediating role of hope. RESULTS The prevalence of PTSD symptoms was 6.05% in Chinese patients with oral cancer. Perceived stress was positively related to PTSD symptoms, explaining 39.9% of the variance. In addition, hope was negatively related to PTSD symptoms, explaining 5.9% of the variance. Besides, the proportion of mediation of hope was 30.06%. CONCLUSION Perceived stress was positively associated with PTSD symptoms, and hope was negatively associated with PTSD symptoms. Furthermore, hope played partial mediating role in the relationship between perceived stress and PTSD symptoms. Thus, more attention should be paid to patients' PTSD status, and take measures is to relieve stress and increase hope.
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Affiliation(s)
- Ying Zhang
- Department of Social Medicine, School of Public Health, China Medical University, Shenyang, Liaoning, People’s Republic of China
| | - Chunying Cui
- Department of Social Medicine, School of Public Health, China Medical University, Shenyang, Liaoning, People’s Republic of China
| | - Lie Wang
- Department of Social Medicine, School of Public Health, China Medical University, Shenyang, Liaoning, People’s Republic of China
| | - Xiaosong Yu
- Department of General Practice, The First Affiliated Hospital, China Medical University, Shenyang, Liaoning, People’s Republic of China
| | - Yu Wang
- Department of Social Medicine, School of Public Health, China Medical University, Shenyang, Liaoning, People’s Republic of China
| | - Xiaoxi Wang
- Medical Basic Experimental Teaching Center, China Medical University, Shenyang, Liaoning, People’s Republic of China
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Abstract
Background: Little research has been conducted on the quality of life (QoL), functional status, and traumatic symptoms related to the diagnosis and treatment of cancer in the Arab region, particularly in Palestine, where the psychological problems in patients with cancer are often neglected.Objective: The aim of the study was to assess QoL and post-traumatic stress disorder (PTSD) symptoms among adult female patients with cancer attending Beit-Jala Governmental Hospital in Bethlehem.Method: Participants were recruited from 4 April 2015 to the end of July 2015. The sample included 253 female patients with cancer attending Beit-Jala Governmental Hospital in Bethlehem. Data were collected using self-reported questionnaires, including a socio-demographic data sheet, the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30, and the post-traumatic stress disorder checklist for PTSD symptoms.Results: The current study showed poor global QoL (57.4%) and poor physical function (48.5%) for female patients with cancer. Insomnia, fatigue, and loss of appetite were the most troublesome symptoms that the participants complained about. The prevalence of PTSD symptoms was 3%. Regarding PTSD symptom severity, 2% reported severe symptoms, 23.3% reported moderate symptoms, and (68.8%) reported mild symptoms, based on a 1991 classification of PTSD symptom severity scores. Finally, Pearson's test revealed a strong, statistically significant, inverse relationship between QoL domains and PTSD.Conclusion: The study found that the overall QoL of female patients with cancer was low and strongly associated with PTSD symptoms, suggesting that early detection and treatment of these symptoms is critical.
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Affiliation(s)
| | - Muna Ahmead
- Faculty of Public Health, Al-Quds University, Jerusalem, Palestine
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Ismail NH, Liu N, Du M, He Z, Hu X. A deep learning approach for identifying cancer survivors living with post-traumatic stress disorder on Twitter. BMC Med Inform Decis Mak 2020; 20:254. [PMID: 33317508 PMCID: PMC7734710 DOI: 10.1186/s12911-020-01272-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 09/21/2020] [Indexed: 11/30/2022] Open
Abstract
Background Emotions after surviving cancer can be complicated. The survivors may have gained new strength to continue life, but some of them may begin to deal with complicated feelings and emotional stress due to trauma and fear of cancer recurrence. The widespread use of Twitter for socializing has been the alternative medium for data collection compared to traditional studies of mental health, which primarily depend on information taken from medical staff with their consent. These social media data, to a certain extent, reflect the users’ psychological state. However, Twitter also contains a mix of noisy and genuine tweets. The process of manually identifying genuine tweets is expensive and time-consuming. Methods We stream the data using cancer as a keyword to filter the tweets with cancer-free and use post-traumatic stress disorder (PTSD) related keywords to reduce the time spent on the annotation task. Convolutional Neural Network (CNN) learns the representations of the input to identify cancer survivors with PTSD. Results The results present that the proposed CNN can effectively identify cancer survivors with PTSD. The experiments on real-world datasets show that our model outperforms the baselines and correctly classifies the new tweets. Conclusions PTSD is one of the severe anxiety disorders that could affect individuals who are exposed to traumatic events, including cancer. Cancer survivors are at risk of short-term or long-term effects on physical and psycho-social well-being. Therefore, the evaluation and treatment of PTSD are essential parts of cancer survivorship care. It will act as an alarming system by detecting the PTSD presence based on users’ postings on Twitter.
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Affiliation(s)
- Nur Hafieza Ismail
- Department of Computer Science & Engineering, Texas A&M University, College Station, TX, USA.
| | - Ninghao Liu
- Department of Computer Science & Engineering, Texas A&M University, College Station, TX, USA
| | - Mengnan Du
- Department of Computer Science & Engineering, Texas A&M University, College Station, TX, USA
| | - Zhe He
- School of Information, Florida State University, Tallahassee, FL, USA
| | - Xia Hu
- Department of Computer Science & Engineering, Texas A&M University, College Station, TX, USA
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27
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Farahimanesh S, Moradi A, Sadeghi M, Jobson L. Comparing the Efficacy of Competitive Memory Training (COMET) and MEmory Specificity Training (MEST) on Posttraumatic Stress Disorder Among Newly Diagnosed Cancer Patients. Cogn Ther Res 2021; 45:918-28. [DOI: 10.1007/s10608-020-10175-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Fioretti C, Faggi D, Caligiani L. Exploring narratives on PTG in cancer patients in active vs remission phases of disease: what about a peritraumatic growth? Eur J Cancer Care (Engl) 2020; 30:e13338. [PMID: 33090534 DOI: 10.1111/ecc.13338] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 08/18/2020] [Accepted: 08/20/2020] [Indexed: 01/26/2023]
Abstract
OBJECTIVE The present study aims to explore post-traumatic growth in cancer patients comparing the active phase, when patients undergo different treatments, and the remission phase, characterised by periodic follow-ups and gradually return to lives outside the hospital world. METHODS 69 cancer patients (36 in active phase and 33 in remission phase) completed an online survey narrating their growth experience related to cancer disease. A modelling emergent theme analysis was implemented for narratives of both group by means of T-Lab software. RESULTS Four themes emerged for narratives of active phase group: 'the time of illness and the time of life (saturating the 46% of words)', 'the meaning-seeking' (21%), 'to find oneself in a battle (21%)' and 'to learn by battling' (12%). Remission phase group themes concerned 'the time of life' (40%), 'the seismic experience' (31%), 'to care for the Self and for others' (15%) and 'strength from vulnerability' (14%). CONCLUSIONS Remission group narratives are close to PTG as defined in scientific literature, while patients in the active phase of disease narrated PTG as the attempt of including illness in their life trajectory and learning from the battle against cancer. Author suggests the definition of peritraumatic growth as a transformation process parallel to treatment phase.
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Affiliation(s)
- Chiara Fioretti
- Department of Education, Languages, Intercultures, Literatures and Psychology, University of Florence, Firenze, Italy
| | - David Faggi
- Department of Education, Languages, Intercultures, Literatures and Psychology, University of Florence, Firenze, Italy
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Chu Q, Wu IHC, Tang M, Tsoh J, Lu Q. Temporal relationship of posttraumatic stress disorder symptom clusters during and after an expressive writing intervention for Chinese American breast cancer survivors. J Psychosom Res 2020; 135:110142. [PMID: 32485623 DOI: 10.1016/j.jpsychores.2020.110142] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 05/07/2020] [Accepted: 05/13/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Posttraumatic stress disorder (PTSD) is a significant condition and frequently observed among breast cancer survivors. Extant literature has demonstrated the effectiveness of expressive writing interventions in reducing PTSD among breast cancer survivors. However, little is known about how different PTSD symptom clusters influence each other over time during and after the expressive writing intervention among breast cancer survivors. We investigated how the three PTSD symptom clusters (reexperiencing, avoidance and hyperarousal) influence each other during and after an expressive writing intervention among Chinese American breast cancer survivors. METHODS Chinese American breast cancer survivors (n = 136) completed an expressive writing intervention. Their PTSD symptoms were assessed at baseline, 1-, 3-, and 6-month follow-ups. RESULTS Using cross-lagged panel analysis, the model with hyperarousal symptoms at each assessment wave predicting the subsequent severity of avoidance and reexperiencing symptoms indicated the best fit, χ2(52) = 65.422, p = .100; CFI = 0.990, RMSEA = 0.044, 95% CI [0.000, 0.074]. CONCLUSION The results suggest that hyperarousal symptoms predict the subsequent severity of reexperiencing and avoidance symptoms over time during and after the expressive writing intervention. The findings highlight the importance of early diagnosis, monitoring and treatment of hyperarousal symptoms in enhancing the efficacy of PTSD interventions and reducing the chronicity in PTSD among Chinese American breast cancer survivors. Clinical Trial Registration atClinicalTrials.gov: NCT02946619.
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Affiliation(s)
- Qiao Chu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Ivan Haw Chong Wu
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| | - Moni Tang
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| | - Janice Tsoh
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA.
| | - Qian Lu
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; Department of Psychology, University of Houston, Houston, TX, USA.
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Malam S, Lawrence B, Bradley C, McBride KM, Clement A, Conrad T, Noronha MC, Wong JK, Woo RA, Kassam Z. Integrating Survivorship Care Into a Radiation Medicine Program. Cureus 2020; 12:e8013. [PMID: 32528754 PMCID: PMC7279678 DOI: 10.7759/cureus.8013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Introduction An important but often overlooked component of caring for cancer patients is survivorship care, provided after the completion of active treatment in order to facilitate transition into the next surveillance phase. A survivorship program was developed to deliver a one-on-one education session on healthy lifestyle behaviours and available resources to help patients transition to their post-treatment life. This study reports the outcome of this pilot survivorship care program provided to breast cancer patients completing radiation therapy. Program delivery format and content were evaluated for effectiveness, applicability, and feasibility. Methods and materials Between March 2017 and August 2018, 124 breast cancer patients, nearing completion of their curative intent radiation treatments, participated in this centre-specific survivorship program. The survivorship program entailed a one on one education session delivered to breast cancer patients within the last two weeks of their radiation treatment. Participants were provided a Microsoft PowerPoint presentation, information pamphlet, and evaluation form to provide feedback on materials and presentation. Survivorship education sessions were delivered by study staff or staff scheduled in the Pre-Radiotherapy Patient Assessment role. Follow-up phone calls were conducted post-session delivery to determine the ongoing applicability of survivorship material. Staff was also given an evaluation form upon completion of the trial to measure the session feasibility. Results Of the 124 participants in the study, 69 (56%) provided feedback. Results showed that 98% of participants felt the information provided either confirmed what they were already doing (44%) or encouraged them to consider a lifestyle change (54%). Additionally, 70% reported feeling more confident after completing the session. Staff survey results reported that 87.5% agreed or strongly agreed that these sessions were beneficial and valuable to patients Conclusions Delivering one-on-one education sessions to individual participants focusing on healthy lifestyle measures garnered a positive response from participants, increasing their confidence and knowledge for making lifestyle changes. While staff survey results pointed strongly in favour of continuing with the survivorship sessions, it was shown that the methods of delivery trialed in this study were not feasible to be implemented on a larger scale. With some workflow modification, implementing a survivorship care program in our cancer centre is a possible and important aspect of a patient’s treatment journey.
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Affiliation(s)
- Shaziya Malam
- Radiation Oncology, Southlake Regional Health Centre, Newmarket, CAN
| | - Belinda Lawrence
- Radiation Oncology, Southlake Regional Health Centre, Newmarket, CAN
| | - Cari Bradley
- Radiation Oncology, Southlake Regional Health Centre, Newmarket, CAN
| | | | - Ashley Clement
- Radiation Oncology, Southlake Regional Health Centre, Newmarket, CAN
| | - Tatiana Conrad
- Radiation Oncology, Southlake Regional Health Centre, Newmarket, CAN
| | - M Cheryl Noronha
- Radiation Oncology, Southlake Regional Health Centre, Newmarket, CAN
| | - Jeanette K Wong
- Radiation Oncology, Southlake Regional Health Centre, Newmarket, CAN
| | - Rachel A Woo
- Radiation Oncology, Southlake Regional Health Centre, Newmarket, CAN
| | - Zahra Kassam
- Radiation Oncology, Southlake Regional Health Centre, Newmarket, CAN
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Brown LC, Murphy AR, Lalonde CS, Subhedar PD, Miller AH, Stevens JS. Posttraumatic stress disorder and breast cancer: Risk factors and the role of inflammation and endocrine function. Cancer 2020; 126:3181-3191. [PMID: 32374431 DOI: 10.1002/cncr.32934] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 03/10/2020] [Accepted: 03/23/2020] [Indexed: 12/20/2022]
Abstract
A breast cancer diagnosis can be a life-changing and stressful experience that can lead to chronic mental health conditions such as posttraumatic stress disorder (PTSD). Greater than one-third of patients initially diagnosed with PTSD after a diagnosis of breast cancer continue to have persistent or worsening PTSD symptoms after 4 years. An emerging body of literature has indicated several key environmental and biological risk factors for PTSD among survivors of breast cancer. Well-recognized risk factors include having a history of childhood trauma, being nonwhite, obesity, younger age at the time of diagnosis, diagnosis with a higher stage of breast cancer, and short time since treatment. Of the emerging risk factors related to fear circuitry in the brain, 2 pathways of particular importance are the stress-driven activation of inflammatory pathways and the long-term effect of antiendocrine therapies. These central and peripheral responses during and after stress exposure are important because increased fear and anxiety can lead to the maintenance of PTSD and worse patient outcomes. Given the poor outcomes associated with PTSD and the high prevalence of breast cancer in women, more research to identify those women at heightened risk of PTSD after breast cancer is warranted to reduce the number of diagnoses and lessen the negative impact of this chronic mental health condition.
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Affiliation(s)
- Lauren C Brown
- Emory University College of Arts and Sciences, Atlanta, Georgia, USA
| | - Amy R Murphy
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Chloe S Lalonde
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Preeti D Subhedar
- Glenn Family Breast Center, Winship Cancer Institute, Emory University, Atlanta, Georgia, USA.,Department of Surgery, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Andrew H Miller
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia, USA.,Glenn Family Breast Center, Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
| | - Jennifer S Stevens
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia, USA.,Glenn Family Breast Center, Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
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Sager ZS, Wachen JS, Naik AD, Moye J. Post-Traumatic Stress Disorder Symptoms from Multiple Stressors Predict Chronic Pain in Cancer Survivors. J Palliat Med 2020; 23:1191-1197. [PMID: 32228350 DOI: 10.1089/jpm.2019.0458] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Background: Despite the association between chronic pain and post-traumatic stress disorder (PTSD), little is known about the longitudinal course of pain and PTSD during cancer treatment. Objectives: We examined the prevalence of PTSD and chronic pain at three time periods in veterans with a diagnosis of cancer, and the relationship between the experience of pain and PTSD. Methods: Participants (N = 123) with oral-digestive cancers were recruited from the Veterans Healthcare System (age M = 65.31 and SD = 9.13; 98.4% male) and completed face to face interviews at 6, 12, and 18 months post-diagnosis. Measures included the Post-traumatic Stress Disorder Checklist-Stressor-Specific version (PCL-S), Primary care PTSD (PC-PTSD), and the Patient-Reported Outcomes Measurement Information System (PROMIS) Pain Impact Scale. Results: About one-third (26.8%) of the sample had chronic pain, defined as elevated pain at two time periods. About one-fifth (20.3%) endorsed symptoms of combat-related PTSD at 6 months, and 22.8% endorsed symptoms of cancer-related PTSD, exceeding a clinical cutoff for older adults (12 months = 21.1%, 18 months = 23.1%). Changes over time were observed for cancer-related PTSD symptom clusters of hyperarousal (F = 3.85 and p = 0.023) and emotional numbing (F = 4.06 and p = 0.018) with a statistically significant quadratic function increasing at 18 months. In logistic regression, individuals with both combat and cancer-related PTSD symptoms at six months had 8.49 times higher odds of experiencing chronic pain (χ2 = 25.91 and p < 0.001; R2 = 0.28). Conclusions: Persisting pain may be a concern in veterans with cancer. Individuals who have experienced traumatic events with persisting PTSD symptoms may be at elevated risk for chronic pain. Veterans with PTSD symptoms from both cancer and combat are at the highest risk to experience chronic pain.
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Affiliation(s)
- Zachary S Sager
- VA New England GRECC and Harvard Medical School, Boston, Massachusetts, USA
| | - Jennifer S Wachen
- Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System and Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Aanand D Naik
- Health Services Research and Development, Michael E. DeBakey VAMC and Baylor College of Medicine, Houston, Texas, USA
| | - Jennifer Moye
- VA New England GRECC and Harvard Medical School, Boston, Massachusetts, USA
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Chu Q, Wu IHC, Lu Q. Expressive writing intervention for posttraumatic stress disorder among Chinese American breast cancer survivors: the moderating role of social constraints. Qual Life Res 2020; 29:891-899. [PMID: 31900761 DOI: 10.1007/s11136-019-02385-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/04/2019] [Indexed: 11/30/2022]
Abstract
PURPOSE Posttraumatic stress disorder (PTSD) is a significant condition among breast cancer survivors (BCSs). However, few intervention studies for cancer-related PTSD were conducted among Asian cancer survivors. We evaluated a culturally sensitive expressive writing intervention, which combined cognitive reappraisal and emotional disclosure, in reducing PTSD among Chinese American BCSs. We also tested social constraints (defined as social conditions when individuals feel misunderstood or alienated when they desire to disclose their thoughts and feelings) as a moderator. METHODS Chinese American BCSs (n = 136) were randomly assigned to three groups with assigned writing topics for 3 weeks: a self-regulation group, which wrote about the deepest feelings related to cancer in week 1, cognitive reappraisal about stress and coping in week 2, and benefit finding in week 3; an enhanced self-regulation group, with the same instructions, except weeks 1 and 2 were reversed; and a cancer-fact group, which wrote about cancer experiences objectively for 3 weeks. PTSD symptoms were measured at baseline and 1-, 3-, and 6-month follow-ups. Social constraints were measured at baseline. RESULTS Both the self-regulation and enhanced self-regulation groups showed reduced PTSD symptoms compared to the cancer-fact group. For reexperiencing and hyperarousal symptoms, expressive writing was more effective for BCSs who experienced high vs. low levels of social constraints; the opposite was found for avoidance symptoms. CONCLUSION Findings demonstrated the effectiveness of expressive writing intervention in reducing PTSD for this minority population, and that the moderating role of survivors' social network varies among different PTSD symptom clusters. ClinicalTrials.gov Identifier: NCT02946619.
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Affiliation(s)
- Qiao Chu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ivan H C Wu
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., Houston, TX, 77030, USA
| | - Qian Lu
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., Houston, TX, 77030, USA.
- Department of Psychology, University of Houston, Houston, TX, USA.
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Camille C, Dimeglio C, Yrondi A, Compaci G, Delmas E, Gauché M, Laurent G, Birmes P. Posttraumatic Stress Disorder Symptoms in Lymphoma Patients: A Prospective Study. Front Psychiatry 2020; 11:201. [PMID: 32218748 PMCID: PMC7078238 DOI: 10.3389/fpsyt.2020.00201] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 03/02/2020] [Indexed: 11/23/2022] Open
Abstract
The cancer experience may be marked by repeat stressors and/or traumas. The aim of our study was to assess traumatic events in a group of patients diagnosed with lymphoma and to determine which of these contribute to the development of Post-Traumatic Stress Disorder/PTSD. Two weeks after receiving a diagnosis of lymphoma, patients were referred for an assessment of peritraumatic distress (using the Peritraumatic Distress Inventory/PDI) and peritraumatic dissociation (using the Peritraumatic Dissociative Experiences Questionnaire/PDEQ). Three months after the diagnosis, we recorded the following parameters: the patients' worst experiences, the presence of PTSD symptoms, using the PTSD CheckList/PCL, as it related to the diagnosis, and symptoms of anxiety using the Hospital Anxiety and Depression/HAD scale and of depression using the Beck Depression Inventory/BDI-II. The study recruited 129 patients, with a mean age of 46 years (SD = 17.3); 70 (54%) men, 87 (67.5%) with Non-Hodgkin's lymphoma, and 42 with Hodgkin's lymphoma. Two weeks after the diagnosis, 49% of patients reported peritraumatic distress, and 20% peritraumatic dissociation, during or immediately after being informed of the lymphoma diagnosis. Three months after the diagnosis, the severity of PTSD symptoms was evaluated. At this stage none of the patients suffered PTSD, but 29 (23%) individuals exhibited partial PTSD: 13.4% correlated it to receiving the lymphoma diagnosis, 8% to telling family members, and 1.6% to adverse effects. Peritraumatic distress and dissociation as a result of receiving a lymphoma diagnosis, as well as anxiety and a mucositis within the first 3 months post-diagnosis, were factors that were significantly associated with PTSD symptoms, accounting for 35.8% in PTSD symptom load. Our study reveals that clinicians should assess the impact of a number of stressors, which are risk factors for PTSD symptoms, starting from the time point of the initial lymphoma diagnosis.
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Affiliation(s)
- Claire Camille
- Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, Toulouse, France
| | - Chloé Dimeglio
- Faculté de Médecine de Toulouse, Biostatistique Informatique Médicale, Université Paul Sabatier, UMR 1027, Toulouse, France
| | - Antoine Yrondi
- Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, Toulouse, France
| | - Gisèle Compaci
- Departement d'Hématologie, Institut Universitaire du Cancer de Toulouse, Oncopôle, France
| | - Emmanuelle Delmas
- Departement d'Hématologie, Institut Universitaire du Cancer de Toulouse, Oncopôle, France
| | - Mélanie Gauché
- CERES (Culture, Ethique, Religion et Société), Institut Catholique de Toulouse, Toulouse, France
| | - Guy Laurent
- Departement d'Hématologie, Institut Universitaire du Cancer de Toulouse, Oncopôle, France
| | - Philippe Birmes
- Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, Toulouse, France
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Rim SH, Yabroff KR, Dasari S, Han X, Litzelman K, Ekwueme DU. Preventive care service use among cancer survivors with serious psychological distress: An analysis of the medical expenditure panel survey data. Prev Med 2019; 123:152-159. [PMID: 30890353 PMCID: PMC6637742 DOI: 10.1016/j.ypmed.2019.03.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 02/12/2019] [Accepted: 03/15/2019] [Indexed: 01/07/2023]
Abstract
Serious psychological distress (SPD) can adversely impact health and quality of life after cancer. The purpose of this study is to examine the association between SPD and the receipt of preventive care services and cancer screening among survivors and adults without a cancer history. A total of 12,564 cancer survivors and 160,023 adults without a cancer history as comparison group were identified from the population-based Medical Expenditure Panel Survey (2008-2015). SPD was assessed using the 6-item Kessler Psychological Distress Scale. We examined use of preventive care and cancer screening services in cancer survivors and comparison adults with/without SPD. Multivariable logistic regression models were conducted for each outcome: preventive service (i.e. blood pressure, cholesterol, influenza vaccination, routine and dental check-up) or cancer screening (i.e. mammography, Papanicolau test, colorectal cancer screening) adjusting for demographic, comorbidity, usual source of care covariates. Adjusted odds ratios and 95% confidence intervals were calculated. Prevalence of SPD was 9.8% in cancer survivors compared to 4.6% in comparison adults. Survivors with SPD were more frequent utilizers of medical care, reporting 10 or more visits to the doctor's office in the past 12 months (29.3% vs. 14.1% without SPD). Having SPD was associated with lower odds of being up-to-date with preventive service use and cancer screening among age- and gender-eligible individuals. The magnitude of the effect was greater in adults' age ≥65 years. Better coordination of care and patient-physician discussions are likely needed to improve delivery of recommended preventive services for persons with SPD.
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Affiliation(s)
- Sun Hee Rim
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, United States of America.
| | - K Robin Yabroff
- Surveillance and Health Services Research Program, American Cancer Society, Atlanta, GA, United States of America
| | - Sabitha Dasari
- Cyberdata Technologies, Inc., Atlanta, GA, United States of America
| | - Xuesong Han
- Surveillance and Health Services Research Program, American Cancer Society, Atlanta, GA, United States of America
| | - Kristin Litzelman
- University of Wisconsin-Madison, Madison, WI, United States of America
| | - Donatus U Ekwueme
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
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Pattison N, O'gara G, Lucas C, Gull K, Thomas K, Dolan S. Filling the gaps: A mixed-methods study exploring the use of patient diaries in the critical care unit. Intensive Crit Care Nurs 2019; 51:27-34. [DOI: 10.1016/j.iccn.2018.10.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 05/02/2018] [Accepted: 10/29/2018] [Indexed: 11/18/2022]
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Oliveri S, Arnaboldi P, Pizzoli SFM, Faccio F, Giudice AV, Sangalli C, Luini A, Pravettoni G. PTSD symptom clusters associated with short- and long-term adjustment in early diagnosed breast cancer patients. Ecancermedicalscience 2019; 13:917. [PMID: 31123500 PMCID: PMC6467457 DOI: 10.3332/ecancer.2019.917] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Indexed: 12/28/2022] Open
Abstract
Objectives We performed an observational prospective cohort study to investigate post-traumatic stress symptoms, emerging after cancer diagnosis, which could influence patients’ short- and long-term adjustment to illness, in order to foster screening measures and management of psychological factors in daily clinical pathways. Methods Patients’ post-traumatic stress symptoms, psychological well-being and perceived quality of life were assessed through standardised questionnaires. The Profile of Mood States questionnaire was administered at pre-operative assessment (T0), surgical admission (T1) and discharge from hospital (T2). The Impact of Event Scale and the State-Trait Anxiety Inventory were administered at T0, T1, T2 and 2 years after discharge (T3). At 2-year follow-up, women were also asked to rate their perceived quality of life on a 0–10 visual analogue scale. Results Between January 2014 and April 2015, 150 women were enrolled. Results showed that more than 90% of patients experienced post-traumatic stress symptoms after cancer diagnosis (14% with severe symptoms and 76.7% with moderate symptoms) and post-traumatic stress disorder (PTSD) symptoms that persisted up to the 2-year from discharge follow-up, with significant improvement only 2 years after hospital discharge. In particular, mediation models showed that intrusive thoughts impede mood adjustment to the disease during the pre-surgical phase, with anxiety amplifying the negative effect, while symptoms of avoidance are more detrimental in the long term for patients’ quality of life. Conclusion PTSD symptom clusters have different influence on short- and long-term reaction to illness. Based on this evidence, appropriate interventions to manage PTSDs in the context of oncology should be developed.
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Affiliation(s)
- Serena Oliveri
- Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, 20122 Milan, Italy.,Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, 20141, Milan, Italy
| | - Paola Arnaboldi
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, 20141, Milan, Italy
| | - Silvia Francesca Maria Pizzoli
- Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, 20122 Milan, Italy.,Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, 20141, Milan, Italy
| | - Flavia Faccio
- Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, 20122 Milan, Italy.,Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, 20141, Milan, Italy
| | - Alice V Giudice
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, 20141, Milan, Italy
| | - Claudia Sangalli
- Data management, European Institute of Oncology, 20141, Milan, Italy
| | - Alberto Luini
- Division of Senology, European Institute of Oncology, 20141, Milan, Italy
| | - Gabriella Pravettoni
- Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, 20122 Milan, Italy.,Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, 20141, Milan, Italy
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Yahya N, Sukiman NK, Suhaimi NA, Azmi NA, Manan HA. How many roads must a Malaysian walk down? Mapping the accessibility of radiotherapy facilities in Malaysia. PLoS One 2019; 14:e0213583. [PMID: 30897166 PMCID: PMC6428267 DOI: 10.1371/journal.pone.0213583] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 02/25/2019] [Indexed: 12/18/2022] Open
Abstract
Background The accessibility to radiotherapy facilities may affect the willingness to undergo treatment. We sought to quantify the distance and travel time of Malaysian population to the closest radiotherapy centre and to estimate the megavoltage unit (MV)/million population based on the regions. Materials & methods Data for subdistricts in Malaysia and radiotherapy services were extracted from Department of Statistics Malaysia and Directory of Radiotherapy Centres (DIRAC). Data from DIRAC were validated by direct communication with centres. Locations of radiotherapy centres, distance and travel time to the nearest radiotherapy were estimated using web mapping service, Google Map. Results The average distance and travel time from Malaysian population to the closest radiotherapy centre were 82.5km and 83.4mins, respectively. The average distance and travel were not homogenous; East Malaysia (228.1km, 236.1mins), Central (14.4km, 20.1mins), East Coast (124.2km, 108.8mins), Northern (42.9km, 42.8mins) and Southern (36.0km, 39.8mins). The MV/million population for the country is 2.47, East Malaysia (1.76), Central (4.19), East Coast (0.54), Northern (2.40), Southern (2.36). About 25% of the population needs to travel >100 km to get to the closest radiotherapy facility. Conclusion On average, Malaysians need to travel far and long to reach radiotherapy facilities. The accessibility to radiotherapy facilities is not equitable. The disparity may be reduced by adding centres in East Malaysia and the East Coast.
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Affiliation(s)
- Noorazrul Yahya
- Diagnostic Imaging & Radiotherapy Programme, Faculty of Health Sciences, National University of Malaysia, Kuala Lumpur, Malaysia
- * E-mail:
| | - Nur Khalis Sukiman
- Diagnostic Imaging & Radiotherapy Programme, Faculty of Health Sciences, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Nani Adilah Suhaimi
- Diagnostic Imaging & Radiotherapy Programme, Faculty of Health Sciences, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Nor Aniza Azmi
- Diagnostic Imaging & Radiotherapy Programme, Faculty of Health Sciences, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Hanani A. Manan
- Department of Radiology, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
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Zhou TH, Hu GL, Wang L. Psychological Disorder Identifying Method Based on Emotion Perception over Social Networks. Int J Environ Res Public Health 2019; 16:E953. [PMID: 30884824 DOI: 10.3390/ijerph16060953] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 03/05/2019] [Accepted: 03/13/2019] [Indexed: 01/15/2023]
Abstract
The Institute for Health Metrics and Evaluation (IHME) has stated that over 1.1 billion people suffered from mental disorders globally in 2016, and the burden of mental disorders has continued to grow with impacts on social development. Despite the implementation of strategies for promotion and prevention in mental health WHO's Comprehensive Mental Health Action Plan 2013⁻2020, the difficulty of diagnosis of mental disorders makes the objective "To provide comprehensive, integrated, and responsive mental health and social care services in community-based settings" hard to carry out. This paper presents a mental-disorder-aided diagnosis model (MDAD) to quantify the multipolarity sentiment affect intensity of users' short texts in social networks in order to analyze the 11-dimensional sentiment distribution. We searched the five mental disorder topics and collected data based on Twitter hashtag. Through sentiment distribution similarity calculations and Stochastic Gradient Descent (SGD), people with a high probability of suffering from mental disorder can be detected in real time. In particular, mental health warnings can be made in time for users with an obvious emotional tendency in their tweets. In the experiments, we make a comprehensive evaluation of MDAD by five common adult mental disorders: depressive disorder, anxiety disorder, obsessive-compulsive disorder (OCD), bipolar disorder, and panic disorder. Our proposed model can effectively diagnose common mental disorders by sentiment multipolarity analysis, providing strong support for the prevention and diagnosis of mental disorders.
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Abstract
Background: Being diagnosed with cancer and undergoing its treatment are associated with substantial distress that can cause long-lasting negative psychological outcomes. Resilience is an individual's ability to maintain or restore relatively stable psychological and physical functioning when confronted with stressful life events and adversities. Posttraumatic growth (PTG) can be defined as positive life changes that result from major life crises or stressful events. Objectives: The aims of this study were to 1) investigate which factors can strengthen or weaken resilience and PTG in cancer patients and survivors; 2) explore the relationship between resilience and PTG, and mental health outcomes; and 3) discuss the impact and clinical implications of resilience and PTG on the process of recovery from cancer. Methods: A literature search was conducted, restricted to PubMed from inception until May 2018, utilizing the following key words: cancer, cancer patients, cancer survivors, resilience, posttraumatic growth, coping, social support, and distress. Results: Biological, personal, and most importantly social factors contribute to cancer patients' resilience and, consequently, to favorable psychological and treatment-related outcomes. PTG is an important phenomenon in the adjustment to cancer. From the literature included in this review, a model of resilience and PTG in cancer patients and survivors was developed. Conclusions: The cancer experience is associated with positive and negative life changes. Resilience and PTG are quantifiable and can be modified through psychological and pharmacological interventions. Promoting resilience and PTG should be a critical component of cancer care.
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Affiliation(s)
- Annina Seiler
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Josef Jenewein
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Zurich, Switzerland.,Clinic Zugersee, Center for Psychiatry and Psychotherapy, Oberwil-Zug, Switzerland
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Abstract
The purpose of this pre-experimental case study was to explore the efficacy and safety of the Eye Movement Desensitization and Reprocessing (EMDR) Group Traumatic Episode Protocol (G-TEP) in the psychological treatment of cancer survivors and its potential effects on posttraumatic stress, anxiety, and depressive symptoms. Participants (N = 35) were patients with various types of cancer, in different stages, initial or recurring, with diagnosis or oncology treatment received within the past year. Following an individual psychoeducational intake session, participants received two 90-minute EMDR G-TEP sessions, administered on consecutive days. They were randomly assigned to a treatment group or a delayed treatment group. Assessments were administered at pre, post, and follow-up using the Short PostTraumatic Stress Disorder Interview (SPRINT), State-Trait Anxiety Inventory (STAI), and Beck Depression Inventory (BDI-II). Repeated measures comparisons of PTSD symptoms, anxiety, and depression revealed significant differences between pretest and posttest, with most results maintained at follow-up. Pre-follow-up effect sizes showed medium effects. These promising results suggest the value in providing a lengthier course of treatment. They support the need for research with large sample, randomized clinical trials to examine the viability of providing EMDR G-TEP in the psychological treatment of cancer survivors. No serious adverse effects were reported and we conclude that the EMDR G-TEP may be effective and safe in the psychological treatment of an oncology population.
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Nipp RD, El-Jawahri A, D'Arpino SM, Chan A, Fuh CX, Johnson PC, Lage DE, Wong RL, Pirl WF, Traeger L, Cashavelly BJ, Jackson VA, Ryan DP, Hochberg EP, Temel JS, Greer JA. Symptoms of posttraumatic stress disorder among hospitalized patients with cancer. Cancer 2018; 124:3445-3453. [PMID: 29905935 DOI: 10.1002/cncr.31576] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Revised: 05/01/2018] [Accepted: 05/07/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND Patients with cancer experience many stressors placing them at risk for posttraumatic stress disorder (PTSD) symptoms, yet little is known about factors associated with PTSD symptoms in this population. This study explored relationships among patients' PTSD symptoms, physical and psychological symptom burden, and risk for hospital readmissions. METHODS We prospectively enrolled patients with cancer admitted for an unplanned hospitalization from August 2015-April 2017. Upon admission, we assessed patients' PTSD symptoms (Primary Care PTSD Screen), as well as physical (Edmonton Symptom Assessment System [ESAS]) and psychological (Patient Health Questionnaire 4 [PHQ-4]) symptoms. We examined associations between PTSD symptoms and patients' physical and psychological symptom burden using linear regression. We evaluated relationships between PTSD symptoms and unplanned hospital readmissions within 90-days using Cox regression. RESULTS We enrolled 954 of 1,087 (87.8%) patients approached, and 127 (13.3%) screened positive for PTSD symptoms. The 90-day hospital readmission rate was 38.9%. Younger age, female sex, greater comorbidities, and genitourinary cancer type were associated with higher PTSD scores. Patients' PTSD symptoms were associated with physical symptoms (ESAS physical: B = 3.41; P < .001), the total symptom burden (ESAS total: B = 5.97; P < .001), depression (PHQ-4 depression: B = 0.67; P < .001), and anxiety symptoms (PHQ-4 anxiety: B = 0.71; P < .001). Patients' PTSD symptoms were associated with a lower risk of hospital readmissions (hazard ratio, 0.81; P = .001). CONCLUSIONS A high proportion of hospitalized patients with cancer experience PTSD symptoms, which are associated with a greater physical and psychological symptom burden and a lower risk of hospital readmissions. Interventions to address patients' PTSD symptoms are needed and should account for their physical and psychological symptom burden. Cancer 2018. © 2018 American Cancer Society.
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Affiliation(s)
- Ryan D Nipp
- Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital Cancer Center and Harvard Medical School, Boston, Massachusetts
| | - Areej El-Jawahri
- Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital Cancer Center and Harvard Medical School, Boston, Massachusetts
| | - Sara M D'Arpino
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Andy Chan
- Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital Cancer Center and Harvard Medical School, Boston, Massachusetts
| | - Charn-Xin Fuh
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - P Connor Johnson
- Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital Cancer Center and Harvard Medical School, Boston, Massachusetts
| | - Daniel E Lage
- Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital Cancer Center and Harvard Medical School, Boston, Massachusetts
| | - Risa L Wong
- Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital Cancer Center and Harvard Medical School, Boston, Massachusetts
| | - William F Pirl
- Department of Psychiatry, Sylvester Comprehensive Cancer Center and University of Miami, Miami, Florida
| | - Lara Traeger
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Barbara J Cashavelly
- Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital Cancer Center and Harvard Medical School, Boston, Massachusetts
| | - Vicki A Jackson
- Division of Palliative Care, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - David P Ryan
- Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital Cancer Center and Harvard Medical School, Boston, Massachusetts
| | - Ephraim P Hochberg
- Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital Cancer Center and Harvard Medical School, Boston, Massachusetts
| | - Jennifer S Temel
- Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital Cancer Center and Harvard Medical School, Boston, Massachusetts
| | - Joseph A Greer
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
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Safiri S. Course and predictors of posttraumatic stress disorder in a cohort of psychologically distressed patients with cancer: A 4-year follow-up study-methodological and statistical issues. Cancer 2018; 124:2456. [PMID: 29645078 DOI: 10.1002/cncr.31366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 03/07/2018] [Indexed: 11/07/2022]
Affiliation(s)
- Saeid Safiri
- Managerial Epidemiology Research Center Department of Public Health, School of Nursing and Midwifery, Maragheh University of Medical Sciences, Maragheh, Iran
- Department of Epidemiology and Biostatistics School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Chan CMH, Ng CG, Taib A, Wee LH, Krupat E, Meyer F. Reply to Course and predictors of posttraumatic stress disorder in a cohort of psychologically distressed patients with cancer: A 4-year follow-up study-methodological and statistical issues. Cancer 2018; 124:2457. [PMID: 29645084 DOI: 10.1002/cncr.31365] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 03/07/2018] [Indexed: 11/11/2022]
Affiliation(s)
- Caryn Mei Hsien Chan
- Faculty of Health Sciences, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Chong Guan Ng
- University Malaya Medical Center, Kuala Lumpur, Malaysia
| | - Aishah Taib
- University Malaya Medical Center, Kuala Lumpur, Malaysia
| | - Lei Hum Wee
- Faculty of Health Sciences, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Edward Krupat
- Center for Evaluation, Harvard Medical School, Boston, Massachusetts
| | - Fremonta Meyer
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts
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Turner C, Hancock J. Do 1 in 5 cancer patients develop post-traumatic stress disorder? Cancer 2018; 124:1839. [DOI: 10.1002/cncr.31282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Accepted: 01/08/2018] [Indexed: 11/09/2022]
Affiliation(s)
| | - Jason Hancock
- Psychiatry Southway Clinic Plymouth, United Kingdom; University of Exeter Medical School; Exeter United Kingdom
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Affiliation(s)
| | - You-Jeong Kim
- College of Nursing, Graduate School of Keimyung University, Daegu, Korea
| | - Young-Seun Ryu
- College of Nursing, Graduate School of Keimyung University, Daegu, Korea
| | - Mi-Hyang Park
- Department of Nursing, Suseong University, Daegu, Korea
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