Cancer worry at higher-risk sample of hereditary cancer in Spain

BACKGROUND

Few studies have examined the prevalence of cancer worry in the general and at-risk population. The objective of this study was to describe the prevalence of cancer worry in a sample of individuals at increased risk of developing hereditary cancer, determine differences in cancer worry by socio-demographic characteristics and assess the relationship between cancer worry and psychological distress.

METHODS

A cross-sectional study was designed with 895 patients. The Cancer Worry Scale (CWS), Hospital Anxiety and Depression Scale (HADS) for psychological distress and sociodemographic characteristics were examined. The multiple linear regression model was developed to explore what variables were predicted for cancer worry. To identify variables associated with higher cancer worry scores, a logistic model was fitted.

RESULTS

In the at-higher-risk sample of hereditary cancer, the mean of CWS was 10.20 (SD: 3.70). The significant predictors for cancer worry were gender, age, previous psychiatric treatment, patients affected by cancer and having children. In the sample, 38% of patients had higher scores on cancer worry, the variables associated were patients affected by cancer compared, women, widow/divorced participants, less than secondary school, patients with previous psychiatric treatment and patients less than 55 years old. Using the HADS cutoff score 29% of the sample showed significant psychological distress, more anxiety (35%) than depressive (22%) symptomatology. Psychological distress showed a higher variability (36%) on cancer worry.

CONCLUSION

Findings highlighted distinctive profiles in socio-demographic characteristics according to the degree of cancer worry; therefore, genetic counseling should continue to be provided to address cancer worry and relieve psychological distress.

Comparison of the accuracy of the 7-item HADS Depression subscale and 14-item total HADS for screening for major depression: A systematic review and individual participant data meta-analysis

The seven-item Hospital Anxiety and Depression Scale Depression subscale (HADS-D) and the total score of the 14-item HADS (HADS-T) are both used for major depression screening. Compared to the HADS-D, the HADS-T includes anxiety items and requires more time to complete. We compared the screening accuracy of the HADS-D and HADS-T for major depression detection. We conducted an individual participant data meta-analysis and fit bivariate random effects models to assess diagnostic accuracy among participants with both HADS-D and HADS-T scores. We identified optimal cutoffs, estimated sensitivity and specificity with 95% confidence intervals, and compared screening accuracy across paired cutoffs via two-stage and individual-level models. We used a 0.05 equivalence margin to assess equivalency in sensitivity and specificity. 20,700 participants (2,285 major depression cases) from 98 studies were included. Cutoffs of ≥7 for the HADS-D (sensitivity 0.79 [0.75, 0.83], specificity 0.78 [0.75, 0.80]) and ≥15 for the HADS-T (sensitivity 0.79 [0.76, 0.82], specificity 0.81 [0.78, 0.83]) minimized the distance to the top-left corner of the receiver operating characteristic curve. Across all sets of paired cutoffs evaluated, differences of sensitivity between HADS-T and HADS-D ranged from -0.05 to 0.01 (0.00 at paired optimal cutoffs), and differences of specificity were within 0.03 for all cutoffs (0.02-0.03). The pattern was similar among outpatients, although the HADS-T was slightly (not nonequivalently) more specific among inpatients. The accuracy of HADS-T was equivalent to the HADS-D for detecting major depression. In most settings, the shorter HADS-D would be preferred. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

[Adherence to treatment after kidney transplantation as quality indicator of the information received: Longitudinal study of 2 years follow-up]

INTRODUCTION

Transplantation is an optimal form of treatment for end-stage renal disease, but requires lifelong adherence to immunosuppressive therapy. The aim of this study was to longitudinally assess the adherence to treatment after kidney transplant, as well as to compare the amount of information about the treatment received at one month and 18 months post-transplantation, and its influence on adherence to treatment.

MATERIAL AND METHODS

The Self-Reported Measure of Medication Adherence was administered at month (T1), 6 months (T2), 12 months (T3), 18 months (T4), and 24 months (T5) post-transplantation. Survey about aspects of knowledge and attitudes about medication, was administered at one month and 18 months post-transplant. Measures of central tendency and non-parametric tests were used to compare the data.

RESULTS

The study included a total of 73 patients with a median age of 57 years. The percentage of patients non-adherent to medication was 9.6% (T1), 22.5% (T2), 29.2% (T3), 29.8% (T4), and 28.1% (T5). One month after transplantation "not consulting with the doctor on forgetting to take medication (P=.034) significantly influenced the non-adherence to treatment. At 18 months post- transplantation, none of the issues raised on medication knowledge had an influence on non-adherence to treatment.

CONCLUSIONS

Longer times since transplantation increased the non-adherence to treatment. Some issues regarding the information of treatment influenced the non-adherence in the immediate transplant period, but not in the follow-up.

Health-related behaviours after 1 year of renal transplantation

Health-related behaviours and psychological distress were examined after kidney transplantation. Patients were evaluated at 1 month, 6 months and 1 year after transplantation. Participants completed the Healthy Behaviours Questionnaire and the Hospital Anxiety and Depression Scale. No significant differences in Healthy Behaviours Questionnaire’s total score and psychological comorbidity were observed at three time points. However, there was an increase in drug-consumer habits ( p < 0.05) and a reduction in sedentary lifestyle ( p < 0.05) at 6 months and 1 year. Moreover, at 1 year, post-transplant had increased the harmful health habits ( p < 0.05). In regression analysis, anxiety symptoms were significant predictors of Healthy Behaviours Questionnaire change at a year post-transplantation.

[Health related quality of life and kidney transplantation: a comparison with population values at 6 months post-transplant]

BACKGROUND AND OBJECTIVE

Transplantation is an effective treatment for end stage renal failure. The aim of this study was to compare patient's perceived health related quality of life (HRQoL) with population values, at one moth and 6 moths of kidney post-transplantation.

PATIENTS AND METHOD

The Questionnaire of Quality of Life in Kidney Disease was administered during the first month and also at the 6 months following transplantation. A comparison with the general population was done with the generic part of the questionnaire. In the statistical analyses, typical standardized scores were used.

RESULTS

In this study 72 patients were included with a median age of 57 years. At the 6 month post-transplantation, the patient's HRQoL showed values that were similar to the general population. When we compared the HRQoL at the first month and at the 6 month post-transplantation, the differences of HRQoL were significant in all dimensions, except on the General health and Emotional role.

CONCLUSIONS

At 6 moths after transplantation, there was an improvement in the perceived HRQoL that was similar to the general population.

Perceived social support in Spanish cancer outpatients with psychiatric disorder

This study examines differences in perceived social support during oncology treatment of cancer patients, whilst taking into account the presence of psychiatric disorder. Of particular interest were cancer patients who received psychopharmacology treatment compared with those who did not. A total of 760 cancer outpatients were recruited from one hospital in Spain. Multivariate analysis of variance with the general linear model procedure was used. The Medical Outcomes Study Social Support Survey was used to assess social support perceived. The Diagnostic Interview Schedule using DSM-III-R criteria was utilized for the diagnosis of psychiatric disorders. There were significant differences between the patients diagnosed with a psychiatric disorder and those not diagnosed with psychiatric disorders in terms of perceived Emotional/Informational Support (F = 19.11, p < 0.01), Affectionate Support (F = 12.30, p < 0.01) and the Overall Support Index (F = 16.73, p < 0.01). In patients requiring psychopharmacology treatment, significant differences were presented with Structural Support (F = 4.32, p < 0.05), Emotional/Informational Support perceived (F = 7.87, p < 0.01), Instrumental Support (F = 4.17, p < 0.05) and Overall Support Index (F = 7.84, p < 0.01). Psychopharmacology treatment helped to increase the perception of social support received by the patient. Healthcare professionals could provide support that would normalize cancer patients' distress, taking into account the importance of perceived social support for the psychological well-being of patients.

Cognitive processing variables in breast cancer: worry and distress at the end of treatment

This study assessed the influence of cognitive processing variables on cancer worries and distress after breast cancer treatment. In multivariate analyses, while independent variables were intolerance of uncertainty and intrusive thoughts, constructs' variables were anxiety and depression symptoms and cancer-related worries. The intolerance to uncertainty had a tendency to influence on distress and concerns about cancer after the end of treatment (Wilks' λ = 0.687, p = 0.074). Whereas, thought intrusion had a significant influence on distress and cancer related worries (Wilks' λ = 0.228, p = 0.000). Cognitive variables could be addressed by the oncology nurse when considering the patients' concerns related to cancer and psychological distress.

Posttraumatic stress disorder symptoms in cancer: psychometric analysis of the Spanish Posttraumatic Stress Disorder Checklist-Civilian version

OBJECTIVE

The PTSD Checklist-Civilian version (PCL-C) was used as a screening tool to assess the presence of PTSD symptoms. The aim of this study was to explore the factorial structure of the Spanish version of the PCL-C and calculate the correlation of PTSD symptoms with distress and health-related quality of life.

METHOD

The sample included 494 cancer outpatients. In order to validate the PCL-C, a principal component analysis was applied. The association between variable was measured by Pearson correlation.

RESULTS

Findings evidenced three symptoms clusters on the PCL-C version, defined as Hyperarousal/Re-experiencing, Numbing and Avoidance. About 10% of the total sample met clinical PTSD symptoms. In addition, PTSD symptoms were related negatively to health-related quality of life and positively related with distress.

CONCLUSION

The conceptualization of PTSD symptoms for cancer patients is supported by the specific symptom clusters identified on PCL-C.