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Morgan S, Cooper B, Paul S, Hammer MJ, Conley YP, Levine JD, Miaskowski C, Dunn LB. Association of Personality Profiles with Depressive, Anxiety, and Cancer-related Symptoms in Patients Undergoing Chemotherapy. PERSONALITY AND INDIVIDUAL DIFFERENCES 2017; 117:130-138. [PMID: 29479128 PMCID: PMC5822738 DOI: 10.1016/j.paid.2017.05.039] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Background This study identified latent classes of cancer patients based on Big Five personality dimensions and evaluated for differences in demographic and clinical characteristics, depression, anxiety, and cancer-related symptoms. Methods Patients (n=1248) with breast, gastrointestinal, gynecological, or lung cancer completed the Center for Epidemiological Studies-Depression scale, Spielberger State-Trait Anxiety Inventories, NEO-Five Factor Inventory (NEO-FFI), and Memorial Symptom Assessment Scale (MSAS). Latent class profile analysis of NEO-FFI scores was used to identify patient subgroups. Results Three latent classes were identified. The "Distressed" class (14.3%) scored highest on neuroticism and lowest on extraversion, agreeableness, and conscientiousness. The "Resilient" class (31.9%) scored lowest on neuroticism and highest on extraversion, agreeableness, and conscientiousness. The "Normative" class (53.8%) was intermediate on all dimensions except openness. Compared to the Resilient class, patients in the Distressed class were younger, less educated, more likely to care for another adult, had more comorbidities, and exercised less. The three classes differed by performance status, marital and employment status, and income, but not by gender, time since diagnosis, or type of prior cancer treatment. The classes differed (Distressed > Normative > Resilient) in depression, anxiety, and cancer symptoms. Conclusions Personality is associated with psychological and physical symptoms in cancer patients.
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Affiliation(s)
- Stefana Morgan
- Department of Psychiatry, University of California, San Francisco
| | - Bruce Cooper
- School of Nursing, University of California, San Francisco
| | - Steven Paul
- School of Nursing, University of California, San Francisco
| | | | | | - Jon D. Levine
- School of Dentistry, University of California, San Francisco
| | | | - Laura B. Dunn
- Department of Psychiatry and Behavioral Sciences, Stanford University
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Young-McCaughan S, Bingham MO, Vriend CA, Inman AW, Gaylord KM, Miaskowski C. The impact of symptom burden on the health status of service members with extremity trauma. Nurs Outlook 2017; 65:S61-S70. [DOI: 10.1016/j.outlook.2017.06.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 06/28/2017] [Indexed: 10/19/2022]
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Park JW, Gong HS, Rhee SH, Kim J, Lee YH, Baek GH. The Effect of Psychological Factors on the Outcomes of Carpal Tunnel Release: A Systematic Review. J Hand Surg Asian Pac Vol 2017; 22:131-137. [DOI: 10.1142/s0218810417300029] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Background: Several studies report that psychological factors are associated with outcomes of carpal tunnel release. However, interpretation of the association is difficult as there are diverse outcome parameters and patient expectations are different. We performed a systematic review to assess the relationships between psychological factors and the various outcome parameters. Methods: We identified 611 papers and selected 8 papers that fit the inclusion criteria. Psychological factors assessed were anxiety, depression, pain catastrophizing, coping, and mental health status. Outcomes of interest included satisfaction and measures of perceived level of function, pain, and physical measures of recovery. Results: For satisfaction and perceived level of function as the outcome, three studies reported a significant association, one study found an association approaching a value of significance, and one study reported no association. For pain as the outcome, two studies reported a significant association. For physical measures, one study reported no association. Conclusions: This systematic review found that depression correlates with postoperative pain, but that the association is less clear between psychological factors and outcomes such as satisfaction, perceived level of symptom and function, and physical measures of recovery. As pain may not be a primary symptom or outcome of CTS, we consider that the current literature does not strongly support the association between psychological factors and outcomes of CTR. This review could be of benefit during preoperative counseling in patients with psychological disturbances.
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Affiliation(s)
- Jin Woo Park
- Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hyun Sik Gong
- Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Seung Hwan Rhee
- Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jihyeung Kim
- Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Young Ho Lee
- Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Goo Hyun Baek
- Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
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Abid H, Kober KM, Smoot B, Paul SM, Hammer M, Levine JD, Lee K, Wright F, Cooper BA, Conley YP, Miaskowski C. Common and Distinct Characteristics Associated With Trajectories of Morning and Evening Energy in Oncology Patients Receiving Chemotherapy. J Pain Symptom Manage 2017; 53:887-900.e2. [PMID: 28063861 PMCID: PMC5410179 DOI: 10.1016/j.jpainsymman.2016.12.339] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 12/11/2016] [Accepted: 12/27/2016] [Indexed: 12/11/2022]
Abstract
CONTEXT Although energy conservation strategies are recommended in clinical practice guidelines, little is known about changes in energy levels in oncology patients undergoing cancer treatment. OBJECTIVES The objective of this study was to identify variations in the trajectories of morning and evening energy levels and determine which characteristics predicted initial levels and the trajectories of morning and evening energy. METHODS Outpatients receiving chemotherapy (CTX) completed demographic and symptom questionnaires six times over two CTX cycles. Energy was assessed using the Lee Fatigue Scale. Hierarchical linear modeling was used to analyze the data. RESULTS A large amount of interindividual variability was found in the morning and evening energy trajectories. Patients who lived alone, had childcare responsibilities, had a lower functional status, did not exercise on a regular basis, had lower hemoglobin levels, had lower attentional function, higher trait anxiety, and higher sleep disturbance reported lower morning energy levels at enrollment. Variations in the trajectories of morning energy were associated with a higher body mass index and higher levels of morning energy and higher sleep disturbance scores. For evening energy, patients who were female, white, had lower functional status, and had lower attentional function and higher sleep disturbance reported lower evening energy levels at enrollment. Evening energy levels at enrollment were associated with changes in evening energy over time. CONCLUSION Patients undergoing CTX experience decrements in both morning and evening energy. The modifiable characteristics associated with these decrements can be used to design intervention studies to increase energy levels in these patients.
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Affiliation(s)
- Hamza Abid
- School of Nursing, University of California, San Francisco, California, USA
| | - Kord M Kober
- School of Nursing, University of California, San Francisco, California, USA
| | - Betty Smoot
- School of Medicine, University of California, San Francisco, California, USA
| | - Steven M Paul
- School of Nursing, University of California, San Francisco, California, USA
| | - Marilyn Hammer
- Department of Nursing, Mount Sinai Medical Center, New York, New York, USA
| | - Jon D Levine
- School of Medicine, University of California, San Francisco, California, USA
| | - Kathryn Lee
- School of Nursing, University of California, San Francisco, California, USA
| | - Fay Wright
- School of Nursing, Yale University, New Haven, Connecticut, USA
| | - Bruce A Cooper
- School of Nursing, University of California, San Francisco, California, USA
| | - Yvette P Conley
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Vance D, Fazeli P, Shacka J, Nicholson W, McKie P, Raper J, Azuero A, Wadley V, Ball K. Testing a Computerized Cognitive Training Protocol in Adults Aging With HIV-Associated Neurocognitive Disorders: Randomized Controlled Trial Rationale and Protocol. JMIR Res Protoc 2017; 6:e68. [PMID: 28446421 PMCID: PMC5422019 DOI: 10.2196/resprot.6625] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 10/20/2016] [Accepted: 10/22/2016] [Indexed: 12/26/2022] Open
Abstract
Background HIV-associated neurocognitive disorders occur in nearly 50% of adults with HIV. Such disorders can interfere with everyday functioning such as driving and medication adherence. Therefore, cognitive interventions are needed to address such neurocognitive disorders as well as improve everyday functioning, especially as people age with HIV. Objective This article reports and discusses the overall rationale and development of speed of processing training, a computerized Internet cognitive training program, to improve this specific neurocognitive ability as well as everyday functioning and quality of life in adults aging with HIV. Although this protocol has been shown to improve speed of processing, everyday functioning, and quality of life in healthy, community-dwelling older adults in the advanced cognitive training in vital elderly (ACTIVE) study, its efficacy in adults aging with HIV has not been established. Nevertheless, such a cognitive intervention is particularly germane as 52%-59% of adults with HIV experience HIV-associated neurocognitive disorders (HAND), and both the frequency and severity of such disorders may increase with advancing age. Methods The description of this longitudinal randomized controlled trial covers the following: (1) rationale for speed of processing training in this clinical population, (2) overview of overall study design, (3) eligibility criteria and HAND, (4) intervention dosage, (5) assessment battery, and (6) examination of biomarkers. Results The project was funded in April 2016 and enrolment is on-going. The first results are expected to be submitted for publication in 2020. Conclusions Similar novel cognitive intervention approaches are suggested as they may be of value to those with HAND and may utilize similar features of this current randomized controlled trial (RCT) protocol to examine their therapeutic efficacy. Trial Registration ClinicalTrials.gov NCT02758093; https://clinicaltrials.gov/ct2/show/NCT02758093 (Archived by Webcite at http://www.webcitation.org/6p8C5fBCX)
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Affiliation(s)
- David Vance
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Pariya Fazeli
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, United States
| | - John Shacka
- Department of Pharmacology & Toxicology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - William Nicholson
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Peggy McKie
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, United States
| | - James Raper
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Andres Azuero
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Virginia Wadley
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Karlene Ball
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, United States
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Zlotnick C, Lawental M, Pud D. Double whammy: Adverse childhood events and pain reflect symptomology and quality of life in women in substance abuse treatment. SOCIAL WORK IN HEALTH CARE 2017; 56:189-201. [PMID: 28103148 DOI: 10.1080/00981389.2016.1265629] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND This study examined the profiles of symptoms and health-related quality of life (QOL) of women in substance abuse treatment, comparing those with higher versus lower histories of adverse childhood events (ACE), and those with versus without current pain. METHODS Adult women in outpatient substance abuse treatment (n = 30) completed questionnaires (cross-sectional study) on topics including drug use, adverse childhood events (ACE), QOL, functional ability, current pain, and depression. RESULTS Women with pain indicated significant differences in emotional (p < 0.05), and functional ability (p < 0.01); but no significant differences were found between women with high versus low levels of ACE. Yet, radar plots of women with both current pain and high levels of ACE, versus those without, portrayed a distinctive profile indicating high levels of anxiety and depression. CONCLUSIONS Rather than a checklist, visual composites of symptoms experienced by women in substance abuse treatment illustrates areas of concern in the overall status of women in substance abuse treatment.
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Affiliation(s)
- Cheryl Zlotnick
- a Cheryl Spencer Department of Nursing, Faculty of Health and Welfare Sciences , University of Haifa , Mt. Carmel , Haifa , Israel
| | - Maayan Lawental
- b School of Social Work, Faculty of Health and Welfare Sciences , University of Haifa , Mt. Carmel , Haifa , Israel
| | - Dorit Pud
- a Cheryl Spencer Department of Nursing, Faculty of Health and Welfare Sciences , University of Haifa , Mt. Carmel , Haifa , Israel
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Differences in demographic, clinical, and symptom characteristics and quality of life outcomes among oncology patients with different types of pain. Pain 2017; 157:892-900. [PMID: 26683234 DOI: 10.1097/j.pain.0000000000000456] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The purposes of this study, in oncology outpatients receiving chemotherapy (n = 926), were to: describe the occurrence of different types of pain (ie, no pain, only noncancer pain [NCP], only cancer pain [CP], or both CP and NCP) and evaluate for differences in demographic, clinical, and symptom characteristics, and quality of life (QOL) among the 4 groups. Patients completed self-report questionnaires on demographic and symptom characteristics and QOL. Patients who had pain were asked to indicate if it was or was not related to their cancer or its treatment. Medical records were reviewed for information on cancer and its treatments. In this study, 72.5% of the patients reported pain. Of the 671 who reported pain, 21.5% reported only NCP, 37.0% only CP, and 41.5% both CP and NCP. Across the 3 pain groups, worst pain scores were in the moderate to severe range. Compared with the no pain group, patients with both CP and NCP were significantly younger, more likely to be female, have a higher level of comorbidity, and a poorer functional status. In addition, these patients reported: higher levels of depression, anxiety, fatigue, and sleep disturbance; lower levels of energy and attentional function; and poorer QOL. Patients with only NCP were significantly older than the other 3 groups. The most common comorbidities in the NCP group were back pain, hypertension, osteoarthritis, and depression. Unrelieved CP and NCP continue to be significant problems. Oncology outpatients need to be assessed for both CP and NCP conditions.
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Tatar A, Saltukoglu G. The Adaptation of the CES-Depression Scale into Turkish through the use of Confirmatory Factor Analysis and Item Response Theory and the Examination of Psychometric Characteristics. ACTA ACUST UNITED AC 2016. [DOI: 10.1080/10177833.2010.11790662] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Arkun Tatar
- Haliç Üniversitesi Fen Edebiyat Fakültesi Psikoloji Bölümü öğretim üyesi, Istanbul-Turkey
| | - Gaye Saltukoglu
- Haliç Üniversitesi Fen Edebiyat Fakültesi Psikoloji Bölümü öğretim üyesi, Istanbul-Turkey
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Nair VA, Beniwal-Patel P, Mbah I, Young BM, Prabhakaran V, Saha S. Structural Imaging Changes and Behavioral Correlates in Patients with Crohn's Disease in Remission. Front Hum Neurosci 2016; 10:460. [PMID: 27695405 PMCID: PMC5025433 DOI: 10.3389/fnhum.2016.00460] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 08/31/2016] [Indexed: 11/27/2022] Open
Abstract
Background: Crohn’s disease (CD) is a subtype of inflammatory bowel disease caused by immune-mediated inflammation in the gastrointestinal tract. The extent of morphologic brain alterations and their associated cognitive and affective impairments remain poorly characterized. Aims: We used magnetic resonance imaging to identify structural brain differences between patients with Crohn’s disease in remission compared to age-matched healthy controls and evaluated for structural-behavioral correlates. Methods: Nineteen patients and 20 healthy, age-matched controls were recruited in the study. Group differences in brain morphometric measures and correlations between brain measures and performance on a cognitive task, the verbal fluency (VF) task, were examined. Correlations between brain measures and cognitive measures as well as self-reported measures of depression, personality, and affective scales were examined. Results: Patients showed significant cortical thickening in the left superior frontal region compared to controls. Significant group differences were observed in sub-cortical volume measures in both hemispheres. Investigation of brain-behavior correlations revealed significant group differences in the correlation between cortical surface area and VF performance, although behavioral performance was equivalent between the two groups. The left middle temporal surface area was a significant predictor of VF performance with controls showing a significant positive correlation between these measures, and patients showing the opposite effect. Conclusion: Our results indicate key differences in structural brain measures in patients with CD compared to controls. Additionally, correlation between brain measures and behavioral responses suggest there may be a neural basis to the alterations in patients’ cognitive and affective responses.
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Affiliation(s)
- Veena A Nair
- Department of Radiology, School of Medicine and Public Health, University of Wisconsin - Madison, Madison WI, USA
| | - Poonam Beniwal-Patel
- Division of Gastroenterology and Hepatology, University of Wisconsin - Madison, Madison WI, USA
| | - Ifeanyi Mbah
- Department of Radiology, School of Medicine and Public Health, University of Wisconsin - Madison, MadisonWI, USA; Division of Gastroenterology and Hepatology, University of Wisconsin - Madison, MadisonWI, USA
| | - Brittany M Young
- Department of Radiology, School of Medicine and Public Health, University of Wisconsin - Madison, MadisonWI, USA; Medical Scientist Training Program, University of Wisconsin - Madison, MadisonWI, USA; Neuroscience Training Program, University of Wisconsin - Madison, MadisonWI, USA
| | - Vivek Prabhakaran
- Department of Radiology, School of Medicine and Public Health, University of Wisconsin - Madison, MadisonWI, USA; Medical Scientist Training Program, University of Wisconsin - Madison, MadisonWI, USA; Neuroscience Training Program, University of Wisconsin - Madison, MadisonWI, USA; Department of Neurology, University of Wisconsin - Madison, MadisonWI, USA; Department of Psychology and Department of Psychiatry, University of Wisconsin - Madison, MadisonWI, USA
| | - Sumona Saha
- Division of Gastroenterology and Hepatology, University of Wisconsin - Madison, Madison WI, USA
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Yamasaki K, Uchida K. Relation of Positive Affect with Emotion-Focused Coping in Japanese Undergraduates. Psychol Rep 2016; 98:611-20. [PMID: 16933654 DOI: 10.2466/pr0.98.3.611-620] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study examined the relationships between coping and positive affect and sex differences in those relationships, focusing on emotional expression as an emotion-focused coping strategy. Undergraduates (193 men and 225 women) completed the Center for Epidemiologic Studies-Depression to assess positive affect by using the Positive Affect subscale and the General Coping Questionnaire for measurement of coping. Analysis showed a positive relationship between positive affect and both problem-solving and cognitive reinterpretation, but only for men, while a positive relation between positive affect and emotional expression was found only for women. Also there were no interactions of emotional expression and other coping strategies, such as problem-solving, cognitive reinterpretation, and emotional support-seeking, on positive affect. These findings provide evidence to suggest that the relationship between positive affect and coping should be examined by sex.
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Affiliation(s)
- Katsuyuki Yamasaki
- Department of Human Development, Naruto University of Education, 748 Nakashima, Takashima, Naruto-cho, Naruto-shi, Tokushima 772-8502 Japan.
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A randomized, controlled study of an online intervention to promote job satisfaction and well-being among physicians. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.burn.2016.06.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Qiu P, Caine ED, Hou F, Cerulli C, Wittink MN, Li J. The Prevalence of Distress and Depression among Women in Rural Sichuan Province. PLoS One 2016; 11:e0161097. [PMID: 27526182 PMCID: PMC4985145 DOI: 10.1371/journal.pone.0161097] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Accepted: 07/31/2016] [Indexed: 02/05/2023] Open
Abstract
Background In this paper, we report findings regarding the prevalence of expressed distress and depressive conditions among women living in a rural region of Sichuan Province. As well, we know of no data among women in rural China that examine whether “depression,” as categorically defined in classifications such as the DSM, adequately captures the expressed distress and symptomatic complaints of women in rural China. Methods A multistage sampling method was employed to recruit the target population. The Center for Epidemiologic Studies Depression Scale (CES-D) was used to measure distress symptoms, and MINI International Neuropsychiatric Interview (MINI) was employed to determine the prevalence of diagnosable depression and other disorders. Results Among 1898 rural women, 12.4% (236) scored ≥16 on the CES-D, indicative of distress, and a subset of 7.7% (146) had scores ≥21, highly suggestive of a clinically significant disorder. We found that 49.8% women with ≥16 CES-D score were identified as showing features consistent with a current major depressive episode (MDE) vs. 1.9% in a sample of randomly selected women with <16 CES-D score. Among respondents, 30 of 84 (35.7%) scoring 16–20 and 83 of 143 (58.0%) scoring ≥21 reported symptoms consistent with MDE. 25.1% of women with a positive CES-D score did not describe symptoms consistent with any DSM-IV disorder. Conclusions We found a higher portion of women reporting significant distress than previously described. Among them, there was a clear gradient, such that 41.7% of women with moderate distress did not have a psychiatric diagnosis, and even among those with more severe symptoms, 15.4% did not manifest a DSM-specific psychiatric condition.
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Affiliation(s)
- Peiyuan Qiu
- West China School of Public Health, Sichuan University, Chengdu, China
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, United States of America
- * E-mail:
| | - Eric D. Caine
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, United States of America
| | - Fengsu Hou
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, United States of America
- School of Public Health, Sun Yat-sen University, Guangzhou, China
- Sun Yat-sen Global Health Institute, Institute of State Governance, Sun Yat-sen University, Guangzhou, China
| | - Catherine Cerulli
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, United States of America
| | - Marsha N. Wittink
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, United States of America
| | - Jin Li
- Department of Psychiatry, West China Hospital, Sichuan University, Chengdu, China
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Kvillemo P, Brandberg Y, Bränström R. Feasibility and Outcomes of an Internet-Based Mindfulness Training Program: A Pilot Randomized Controlled Trial. JMIR Ment Health 2016; 3:e33. [PMID: 27450466 PMCID: PMC4975795 DOI: 10.2196/mental.5457] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 05/11/2016] [Accepted: 06/10/2016] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Interventions based on meditation and mindfulness techniques have been shown to reduce stress and increase psychological well-being in a wide variety of populations. Self-administrated Internet-based mindfulness training programs have the potential to be a convenient, cost-effective, easily disseminated, and accessible alternative to group-based programs. OBJECTIVE This randomized controlled pilot trial with 90 university students in Stockholm, Sweden, explored the feasibility, usability, acceptability, and outcomes of an 8-week Internet-based mindfulness training program. METHODS Participants were randomly assigned to either an intervention (n=46) or an active control condition (n=44). Intervention participants were invited to an Internet-based 8-week mindfulness program, and control participants were invited to an Internet-based 4-week expressive writing program. The programs were automated apart from weekly reminders via email. Main outcomes in pre- and postassessments were psychological well-being and depression symptoms. To assess the participant's experiences, those completing the full programs were asked to fill out an assessment questionnaire and 8 of the participants were interviewed using a semistructured interview guide. Descriptive and inferential statistics, as well as content analysis, were performed. RESULTS In the mindfulness program, 28 out of 46 students (60%) completed the first week and 18 out of 46 (39%) completed the full program. In the expressive writing program, 35 out of 44 students (80%) completed the first week and 31 out of 44 (70%) completed the full program. There was no statistically significantly stronger intervention effect for the mindfulness intervention compared to the active control intervention. Those completing the mindfulness group reported high satisfaction with the program. Most of those interviewed were satisfied with the layout and technique and with the support provided by the study coordinators. More frequent contact with study coordinators was suggested as a way to improve program adherence and completion. Most participants considered the program to be meaningful and helpful but also challenging. The flexibility in performing the exercises at a suitable time and place was appreciated. A major difficulty was, however, finding enough time to practice. CONCLUSIONS The program was usable, acceptable, and showed potential for increasing psychological well-being for those completing it. However, additional modification of the program might be needed to increase retention and compliance. CLINICALTRIAL ClinicalTrials.gov NCT02062762; https://clinicaltrials.gov/ct2/show/NCT0206276 (Archived by WebCite at http://www.webcitation.org/6j9I5SGJ4).
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Affiliation(s)
- Pia Kvillemo
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
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Korean American Adolescents’ Depression and Religiousness/Spirituality: Are There Gender Differences? CURRENT PSYCHOLOGY 2016. [DOI: 10.1007/s12144-016-9471-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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West C, Paul SM, Dunn L, Dhruva A, Merriman J, Miaskowski C. Gender Differences in Predictors of Quality of Life at the Initiation of Radiation Therapy. Oncol Nurs Forum 2016; 42:507-16. [PMID: 26302279 DOI: 10.1188/15.onf.507-516] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
PURPOSE/OBJECTIVES To evaluate gender differences in quality of life (QOL), demographic, clinical, and symptom characteristics.
DESIGN Prospective, observational.
SETTING Two radiation oncology departments in northern California.
SAMPLE 185 patients before initiation of radiation therapy (RT).
METHODS At their RT simulation visit, patients completed a demographic questionnaire, a measure of QOL, and symptom-specific scales. Backward elimination regression analyses were conducted to determine the significant predictors of QOL
. MAIN RESEARCH VARIABLES QOL, gender, and 20 potential predictors
. FINDINGS In women, depressive symptoms, functional status, age, and having children at home explained 64% of the variance in QOL. In men, depressive symptoms, state anxiety, number of comorbidities, being a member of a racial or ethnic minority, and age explained 70% of the variance in QOL
. CONCLUSIONS Predictors of QOL differed by gender. Depressive symptom score was the greatest contributor to QOL in both genders.
. IMPLICATIONS FOR NURSING Nurses need to assess for QOL and depression at the initiation of RT. Knowledge of the different predictors of QOL may be useful in the design of gender-specific interventions to improve QOL.
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Ouyang P, Wenger NK, Taylor D, Rich-Edwards JW, Steiner M, Shaw LJ, Berga SL, Miller VM, Merz NB. Strategies and methods to study female-specific cardiovascular health and disease: a guide for clinical scientists. Biol Sex Differ 2016; 7:19. [PMID: 27034774 PMCID: PMC4815158 DOI: 10.1186/s13293-016-0073-y] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 03/21/2016] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND In 2001, the Institute of Medicine's (IOM) report, "Exploring the Biological Contributions to Human Health: Does Sex Matter?" advocated for better understanding of the differences in human diseases between the sexes, with translation of these differences into clinical practice. Sex differences are well documented in the prevalence of cardiovascular (CV) risk factors, the clinical manifestation and incidence of cardiovascular disease (CVD), and the impact of risk factors on outcomes. There are also physiologic and psychosocial factors unique to women that may affect CVD risk, such as issues related to reproduction. METHODS The Society for Women's Health Research (SWHR) CV Network compiled an inventory of sex-specific strategies and methods for the study of women and CV health and disease across the lifespan. References for methods and strategy details are provided to gather and evaluate this information. Some items comprise robust measures; others are in development. RESULTS To address female-specific CV health and disease in population, physiology, and clinical trial research, data should be collected on reproductive history, psychosocial variables, and other factors that disproportionately affect CVD in women. Variables related to reproductive health include the following: age of menarche, menstrual cycle regularity, hormone levels, oral contraceptive use, pregnancy history/complications, polycystic ovary syndrome (PCOS) components, menopause age, and use and type of menopausal hormone therapy. Other factors that differentially affect women's CV risk include diabetes mellitus, autoimmune inflammatory disease, and autonomic vasomotor control. Sex differences in aging as well as psychosocial variables such as depression and stress should also be considered. Women are frequently not included/enrolled in mixed-sex CVD studies; when they are included, information on these variables is generally not collected. These omissions limit the ability to determine the role of sex-specific contributors to CV health and disease. Lack of sex-specific knowledge contributes to the CVD health disparities that women face. CONCLUSIONS The purpose of this review is to encourage investigators to consider ways to increase the usefulness of physiological and psychosocial data obtained from clinical populations, in an effort to improve the understanding of sex differences in clinical CVD research and health-care delivery for women and men.
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Affiliation(s)
- Pamela Ouyang
- />Johns Hopkins University, Baltimore, MD USA
- />Division of Cardiology, Johns Hopkins Bayview Medical Center, 301 Building, Suite 2400, 4940 Eastern Ave, Baltimore, MD 21224 USA
| | | | | | | | | | | | | | | | - Noel Bairey Merz
- />Barbra Streisand Women’s Heart Center, Cedars-Sinai Heart Institute, Los Angeles, CA USA
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Predictors of initial levels and trajectories of anxiety in women before and for 6 months after breast cancer surgery. Cancer Nurs 2016; 37:406-17. [PMID: 24633334 DOI: 10.1097/ncc.0000000000000131] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The diagnosis of breast cancer, in combination with the anticipation of surgery, evokes fear, uncertainty, and anxiety in most women. OBJECTIVE Study purposes were to examine in patients who underwent breast cancer surgery how ratings of state anxiety changed from the time of the preoperative assessment to 6 months after surgery and to investigate whether specific demographic, clinical, symptom, and psychosocial adjustment characteristics predicted the preoperative levels of state anxiety and/or characteristics of the trajectories of state anxiety. INTERVENTIONS/METHODS Patients (n = 396) were enrolled preoperatively and completed the Spielberger State Anxiety inventory monthly for 6 months. Using hierarchical linear modeling, demographic, clinical, symptom, and psychosocial adjustment characteristics were evaluated as predictors of initial levels and trajectories of state anxiety. RESULTS Patients experienced moderate levels of anxiety before surgery. Higher levels of depressive symptoms and uncertainty about the future, as well as lower levels of life satisfaction, less sense of control, and greater difficulty coping, predicted higher preoperative levels of state anxiety. Higher preoperative state anxiety, poorer physical health, decreased sense of control, and more feelings of isolation predicted higher state anxiety scores over time. CONCLUSIONS Moderate levels of anxiety persist in women for 6 months after breast cancer surgery. IMPLICATIONS FOR PRACTICE Clinicians need to implement systematic assessments of anxiety to identify high-risk women who warrant more targeted interventions. In addition, ongoing follow-up is needed to prevent adverse postoperative outcomes and to support women to return to their preoperative levels of function.
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Gold M, Dunn LB, Phoenix B, Paul SM, Hamolsky D, Levine JD, Miaskowski C. Co-occurrence of anxiety and depressive symptoms following breast cancer surgery and its impact on quality of life. Eur J Oncol Nurs 2016; 20:97-105. [PMID: 26187660 PMCID: PMC4706814 DOI: 10.1016/j.ejon.2015.06.003] [Citation(s) in RCA: 85] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Revised: 06/08/2015] [Accepted: 06/10/2015] [Indexed: 12/11/2022]
Abstract
PURPOSE Little is known about the prevalence of combined anxiety and depressive symptoms (CADS) in breast cancer patients. Purpose was to evaluate for differences in demographic and clinical characteristics and quality of life (QOL) prior to breast cancer surgery among women classified into one of four distinct anxiety and/or depressive symptom groups. METHODS A total of 335 patients completed measures of anxiety and depressive symptoms and QOL prior to and for 6 months following breast cancer surgery. Growth Mixture Modelling (GMM) was used to identify subgroups of women with distinct trajectories of anxiety and depressive symptoms. These results were used to create four distinct anxiety and/or depressive symptom groups. Differences in demographic, clinical, and symptom characteristics, among these groups were evaluated using analyses of variance and Chi square analyses. RESULTS A total of 44.5% of patients were categorized with CADS. Women with CADS were younger, non-white, had lower performance status, received neoadjuvant or adjuvant chemotherapy, had greater difficulty dealing with their disease and treatment, and reported less support from others to meet their needs. These women had lower physical, psychological, social well-being, and total QOL scores. Higher levels of anxiety with or without subsyndromal depressive symptoms were associated with increased fears of recurrence, hopelessness, uncertainty, loss of control, and a decrease in life satisfaction. CONCLUSIONS Findings suggest that CADS occurs in a high percentage of women following breast cancer surgery and results in a poorer QOL. Assessments of anxiety and depressive symptoms are warranted prior to surgery for breast cancer.
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Affiliation(s)
- Marshall Gold
- Schools of Nursing, University of California, San Francisco, CA, USA
| | - Laura B Dunn
- Schools of Medicine, University of California, San Francisco, CA, USA
| | - Bethany Phoenix
- Schools of Nursing, University of California, San Francisco, CA, USA
| | - Steven M Paul
- Schools of Nursing, University of California, San Francisco, CA, USA
| | - Deborah Hamolsky
- Schools of Nursing, University of California, San Francisco, CA, USA
| | - Jon D Levine
- Schools of Medicine, University of California, San Francisco, CA, USA
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The Factor Structure, Predictors, and Percentile Norms of the Center for Epidemiologic Studies Depression (CES-D) Scale in the Dutch-speaking Adult Population of Belgium. Psychol Belg 2016; 56:1-12. [PMID: 30479426 PMCID: PMC5854088 DOI: 10.5334/pb.261] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The Center of Epidemiologic Studies Depression Scale (CES-D) is a commonly used self-report scale to measure depressive symptoms in the general population. In the present study, the Dutch version of the CES-D was administered to a sample of 837 Dutch-speaking adults of Belgium to examine the factor structure of the scale. Using confirmatory factory analysis (CFA), four first-order models and two second-order models were tested, and the second-order factor model with three pairs of correlated error terms provided the best fit to the data. Second, five socio-demographic variables (age, gender, education level, relation status, and family history of depression) were included as covariates to the second-order factor model to explore the associations between background characteristics and the latent factor depression using a multiple indicators and multiple causes (MIMIC) approach. Age had a significantly negative effect on depression, but the effect was not substantial. Female gender, lower education level, being single or widowed, and having a family history of depression were found to be significant predictors of higher levels of depression symptomatology. Finally, percentile norms on the CES-D raw scores were provided for subgroups of gender by education level for the general Dutch-speaking adult population of Belgium.
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Psychometric Limitations of the Center for Epidemiologic Studies-Depression Scale for Assessing Depressive Symptoms among Adults with HIV/AIDS: A Rasch Analysis. DEPRESSION RESEARCH AND TREATMENT 2016; 2016:2824595. [PMID: 27042347 PMCID: PMC4794594 DOI: 10.1155/2016/2824595] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 02/03/2016] [Accepted: 02/14/2016] [Indexed: 11/20/2022]
Abstract
The Center for Epidemiological Studies-Depression (CES-D) scale is a widely used measure of depressive symptoms, but its psychometric properties have not been adequately evaluated among adults with HIV/AIDS. This study used an item response theory approach (Rasch analysis) to evaluate the CES-D's validity and reliability in relation to key demographic and clinical variables in adults with HIV/AIDS. A convenience sample of 347 adults with HIV/AIDS (231 males, 93 females, and 23 transgenders; age range 22-77 years) completed the CES-D. A Rasch model application was used to analyze the CES-D's rating scale functioning, internal scale validity, person-response validity, person-separation validity, internal consistency, differential item functioning (DIF), and differential test functioning. CES-D scores were generally high and associated with several demographic and clinical variables. The CES-D distinguished 3 distinct levels of depression and had acceptable internal consistency but lacked unidimensionality, five items demonstrated poor fit to the model, 15% of the respondents demonstrated poor fit, and eight items demonstrated DIF related to gender, race, or AIDS diagnosis. Removal of misfitting items resulted in minimal improvement in the CES-D's substantive and structural validity. CES-D scores should be interpreted with caution in adults with HIV/AIDS, particularly when comparing scores across gender and racial groups.
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Caraballo JN, Pérez-Pedrogo C, Albizu-García CE. Assessing post-traumatic stress symptoms in a Latino prison population. Int J Prison Health 2015; 9:196-207. [PMID: 25763455 DOI: 10.1108/ijph-02-2013-0004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE The purpose of this paper is to assess the reliability and validity of the Spanish version of the Davidson trauma scale (DTS-S) and to determine the prevalence and correlates of post-traumatic stress disorder (PTSD) symptoms in a non-clinical random sample of prison inmates. DESIGN/METHODOLOGY/APPROACH Probabilistic samples of 1,179 inmates from 26 penal institutions in Puerto Rico were selected using a multistage sampling design. Population estimates and correlations were obtained for PTSD, generalized anxiety and depression. The reliability, factor structure, and convergent validity of the DTS-S were assessed. Cross-validation was employed to confirm the results of the factor analyses. FINDINGS Using the cut-offs adopted by the scale's author, 136 (13.4 percent) of the inmates are likely to have current PTSD and 117 (11.6 percent) reach the cut-off for sub-threshold PTSD. Confirmatory factor analysis generated two factors explaining 53 percent of the variance. High reliabilities were obtained for the total scale (α=0.95) and for the frequency and severity scales (α=0.90 and 0.91). Significantly higher DTS-S scores were found for females (t=2.26, p<0.025), for inmates diagnosed with depression or anxiety (t=2.02, p<0.05), and those reporting suicide attempts (t=4.47, p<0.0001). ORIGINALITY/VALUE Findings support that the DTS-S is a reliable and valid measure to assess PTSD symptoms in Latino inmate populations and to identify individuals at risk for the disorder that require confirmatory diagnosis and clinical interventions.
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Affiliation(s)
- José N Caraballo
- Professor, based at Department of Mathematics-Physics, University of Puerto Rico, Cayey, Puerto Rico
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Aouizerat BE, Dhruva A, Paul SM, Cooper BA, Kober KM, Miaskowski C. Phenotypic and Molecular Evidence Suggests That Decrements in Morning and Evening Energy Are Distinct but Related Symptoms. J Pain Symptom Manage 2015; 50:599-614.e3. [PMID: 26031709 PMCID: PMC4624028 DOI: 10.1016/j.jpainsymman.2015.05.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Revised: 05/11/2015] [Accepted: 05/19/2015] [Indexed: 10/25/2022]
Abstract
CONTEXT Little is known about energy levels in oncology patients and their family caregivers. OBJECTIVES This study sought to identify latent classes of participants, based on self-reported energy levels and evaluate for differences in phenotypic and genotypic characteristics between these classes. METHODS Energy subscale scores from the Lee Fatigue Scale were used to determine latent class membership. Morning and evening energy scores were obtained just before, during, and for four months after the completion of radiation therapy. Genetic associations were evaluated for 15 proinflammatory and anti-inflammatory cytokine genes. RESULTS Two latent classes with distinct morning energy trajectories were identified. Participants who were younger, female, not married/partnered, black, and had more comorbidities, and a lower functional status were more likely to be in the low morning energy class. Two polymorphisms (IL2 rs1479923 and NFKB1 rs4648110) were associated with morning energy latent class membership. Two latent classes with distinct evening energy trajectories were identified. Participants who were younger and male and who had more comorbidities, decreased body weight, and a lower functional status were more likely to be in the moderate evening energy class. Five different polymorphisms (IL1R2 rs4141134, IL6 rs4719714, IL17A rs8193036, NFKB2 rs1056890, and TNFA rs1800683) were associated with evening energy latent class membership. CONCLUSION This study provides preliminary evidence that decrements in morning and evening energy are associated with different phenotypic risk factors and cytokine gene variations.
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Affiliation(s)
- Bradley E Aouizerat
- School of Nursing, University of California, San Francisco, California, USA; Institute for Human Genetics, University of California, San Francisco, California, USA
| | - Anand Dhruva
- School of Medicine, University of California, San Francisco, California, USA
| | - Steven M Paul
- School of Nursing, University of California, San Francisco, California, USA
| | - Bruce A Cooper
- School of Nursing, University of California, San Francisco, California, USA
| | - Kord M Kober
- School of Nursing, University of California, San Francisco, California, USA
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Hammer M, Aouizerat B, Schmidt B, Cartwright F, Wright F, Miaskowski C. Glycosylated Hemoglobin A1c and Lack of Association With Symptom Severity in Patients Undergoing Chemotherapy for Solid Tumors. Oncol Nurs Forum 2015; 42:581-90. [DOI: 10.1188/15.onf.581-590] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Bayer JL, Spitz DR, Christensen D, McCormick ML, Farley D, DeGeest K, Damoush L, Aust S, Sood AK, Lutgendorf SK. Biobehavioral and neuroendocrine correlates of antioxidant enzyme activity in ovarian carcinoma. Brain Behav Immun 2015; 50:58-62. [PMID: 25989110 PMCID: PMC4631681 DOI: 10.1016/j.bbi.2015.04.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2015] [Revised: 04/01/2015] [Accepted: 04/10/2015] [Indexed: 12/22/2022] Open
Abstract
Increased levels of reactive oxygen species (ROS) such as superoxide anions and hydrogen peroxide have been reported in many cancer cells and they have been implicated in carcinogenesis and tumor progression. Antioxidant enzymes, such as Manganese Superoxide Dismutase (MnSOD or SOD2) and Glutathione Peroxidase-1 (GPx1), act coordinately to neutralize ROS. These enzymes are also thought to contribute to cancer cell resistance to conventional radio-chemo-therapies. Although some relationships have been reported between psychosocial factors and the regulation of antioxidant enzymes, little is known about these relationships in the context of cancer progression. The current study investigated the levels of MnSOD and GPx1in confirmed serous, high-grade tumor tissue from 60 ovarian cancer patients, and explored the relationship between the activity of these enzymes, the levels of tumor norepinephrine (NE), and patient mood as determined via pre-operative questionnaires. MnSOD activity was positively related to depressed mood (p=0.025) and tumor NE (p=0.023). In contrast, GPx1 activity was inversely related to fatigue (p=0.015) and tumor NE (p=0.009), and was positively associated with vigor (p=0.024). These findings suggest that psychological state and adrenergic signaling are linked with antioxidant enzyme activity in ovarian cancer and may have implications for patient treatments and outcomes.
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Affiliation(s)
| | - Douglas R Spitz
- Free Radical and Radiation Biology Program, Department of Radiation Oncology, University of Iowa, United States; Holden Comprehensive Cancer Center, University of Iowa, United States
| | | | - Michael L McCormick
- Free Radical and Radiation Biology Program, Department of Radiation Oncology, University of Iowa, United States; Holden Comprehensive Cancer Center, University of Iowa, United States
| | - Donna Farley
- Department of Pharmacology, University of Iowa, United States
| | - Koen DeGeest
- Oregon Health and Sciences University, United States
| | - Laila Damoush
- Department of Pathology, University of Iowa, United States
| | - Samantha Aust
- Department of Psychology, University of Iowa, United States
| | - Anil K Sood
- Departments of Gynecologic Oncology, Cancer Biology, and Center for RNA Interference and Noncoding RNA, University of Texas, M.D. Anderson Cancer Center, United States
| | - Susan K Lutgendorf
- Department of Psychology, University of Iowa, United States; Holden Comprehensive Cancer Center, University of Iowa, United States; Department of Obstetrics and Gynecology, University of Iowa, United States; Department of Urology, University of Iowa, United States.
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Wright F, D'Eramo Melkus G, Hammer M, Schmidt BL, Knobf MT, Paul SM, Cartwright F, Mastick J, Cooper BA, Chen LM, Melisko M, Levine JD, Kober K, Aouizerat BE, Miaskowski C. Predictors and Trajectories of Morning Fatigue Are Distinct From Evening Fatigue. J Pain Symptom Manage 2015; 50:176-89. [PMID: 25828559 PMCID: PMC4526314 DOI: 10.1016/j.jpainsymman.2015.02.016] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Revised: 02/06/2015] [Accepted: 02/18/2015] [Indexed: 11/25/2022]
Abstract
CONTEXT Fatigue is the most common symptom in oncology patients during chemotherapy. Little is known about the predictors of interindividual variability in initial levels and trajectories of morning fatigue severity in these patients. OBJECTIVES An evaluation was done to determine which demographic, clinical, and symptom characteristics were associated with initial levels as well as the trajectories of morning fatigue and to compare findings with our companion paper on evening fatigue. METHODS A sample of outpatients with breast, gastrointestinal, gynecological, and lung cancer (n = 586) completed demographic and symptom questionnaires a total of six times over two cycles of chemotherapy. Fatigue severity was evaluated using the Lee Fatigue Scale. Hierarchical linear modeling was used to answer the study objectives. RESULTS A large amount of interindividual variability was found in the morning fatigue trajectories. A piecewise model fit the data best. Patients with higher body mass index, who did not exercise regularly, with a lower functional status, and who had higher levels of state anxiety, sleep disturbance, and depressive symptoms reported higher levels of morning fatigue at enrollment. Variations in the trajectories of morning fatigue were predicted by the patients' ethnicity and younger age. CONCLUSION The modifiable risk factors that were associated with only morning fatigue were body mass index, exercise, and state anxiety. Modifiable risk factors that were associated with both morning and evening fatigue included functional status, depressive symptoms, and sleep disturbance. Using this information, clinicians can identify patients at higher risk for more severe morning fatigue and evening fatigue, provide individualized patient education, and tailor interventions to address the modifiable risk factors.
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Affiliation(s)
- Fay Wright
- Florence S. Downs PhD Program in Nursing Research and Theory Development, College of Nursing, New York University, New York, New York, USA
| | - Gail D'Eramo Melkus
- Florence S. Downs PhD Program in Nursing Research and Theory Development, College of Nursing, New York University, New York, New York, USA
| | - Marilyn Hammer
- Florence S. Downs PhD Program in Nursing Research and Theory Development, College of Nursing, New York University, New York, New York, USA
| | - Brian L Schmidt
- Department of Oral and Maxillofacial Surgery, School of Dentistry, New York University, New York, New York, USA
| | - M Tish Knobf
- Division of Acute Care/Health Systems, Yale School of Nursing, New Haven, Connecticut, USA
| | - Steven M Paul
- Department of Physiologic Nursing, School of Nursing, University of California at San Francisco, San Francisco, California, USA
| | | | - Judy Mastick
- Department of Physiologic Nursing, School of Nursing, University of California at San Francisco, San Francisco, California, USA
| | - Bruce A Cooper
- Department of Physiologic Nursing, School of Nursing, University of California at San Francisco, San Francisco, California, USA
| | - Lee-May Chen
- Department of Obstetrics and Gynecology, University of California at San Francisco, San Francisco, California, USA
| | - Michelle Melisko
- Department of Medicine, School of Medicine, University of California at San Francisco, San Francisco, California, USA
| | - Jon D Levine
- Department of Oral and Maxillofacial Surgery, School of Dentistry, University of California at San Francisco, San Francisco, California, USA
| | - Kord Kober
- Department of Physiologic Nursing, School of Nursing, University of California at San Francisco, San Francisco, California, USA
| | - Bradley E Aouizerat
- Department of Physiologic Nursing, School of Nursing, University of California at San Francisco, San Francisco, California, USA; The Institute for Human Genetics, University of California at San Francisco, San Francisco, California, USA
| | - Christine Miaskowski
- Department of Physiologic Nursing, School of Nursing, University of California at San Francisco, San Francisco, California, USA.
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Wright F, D'Eramo Melkus G, Hammer M, Schmidt BL, Knobf MT, Paul SM, Cartwright F, Mastick J, Cooper BA, Chen LM, Melisko M, Levine JD, Kober K, Aouizerat BE, Miaskowski C. Trajectories of Evening Fatigue in Oncology Outpatients Receiving Chemotherapy. J Pain Symptom Manage 2015; 50:163-75. [PMID: 25828560 PMCID: PMC4526403 DOI: 10.1016/j.jpainsymman.2015.02.015] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Revised: 02/06/2015] [Accepted: 02/18/2015] [Indexed: 11/28/2022]
Abstract
CONTEXT Fatigue is a distressing persistent sense of physical tiredness that is not proportional to a person's recent activity. Fatigue impacts patients' treatment decisions and can limit their self-care activities. Although significant interindividual variability in fatigue severity has been noted, little is known about predictors of interindividual variability in initial levels and trajectories of evening fatigue severity in oncology patients receiving chemotherapy. OBJECTIVES To determine whether demographic, clinical, and symptom characteristics were associated with initial levels and the trajectories of evening fatigue. METHODS A sample of outpatients with breast, gastrointestinal, gynecological, and lung cancer (N = 586) completed demographic and symptom questionnaires a total of six times over two cycles of chemotherapy. Fatigue severity was evaluated using the Lee Fatigue Scale. Hierarchical linear modeling was used to answer the study objectives. RESULTS A large amount of interindividual variability was found in the evening fatigue trajectories. A piecewise model fit the data best. Patients who were white, diagnosed with breast, gynecological, or lung cancer, and who had more years of education, childcare responsibilities, lower functional status, and higher levels of sleep disturbance and depression reported higher levels of evening fatigue at enrollment. CONCLUSION This study identified both nonmodifiable (e.g., ethnicity) and modifiable (e.g., childcare responsibilities, depressive symptoms, sleep disturbance) risk factors for more severe evening fatigue. Using this information, clinicians can identify patients at higher risk for more severe evening fatigue, provide individualized patient education, and tailor interventions to address the modifiable risk factors.
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Affiliation(s)
- Fay Wright
- Florence S. Downs PhD Program in Nursing Research and Theory Development, College of Nursing, New York University, New York, New York, USA
| | - Gail D'Eramo Melkus
- Florence S. Downs PhD Program in Nursing Research and Theory Development, College of Nursing, New York University, New York, New York, USA
| | - Marilyn Hammer
- Florence S. Downs PhD Program in Nursing Research and Theory Development, College of Nursing, New York University, New York, New York, USA
| | - Brian L Schmidt
- Department of Oral and Maxillofacial Surgery, School of Dentistry, New York University, New York, New York, USA
| | - M Tish Knobf
- Division of Acute Care/Health Systems, Yale School of Nursing, New Haven, Connecticut, USA
| | - Steven M Paul
- Department of Physiologic Nursing, School of Nursing, University of California at San Francisco, San Francisco, California, USA
| | | | - Judy Mastick
- Department of Physiologic Nursing, School of Nursing, University of California at San Francisco, San Francisco, California, USA
| | - Bruce A Cooper
- Department of Physiologic Nursing, School of Nursing, University of California at San Francisco, San Francisco, California, USA
| | - Lee-May Chen
- Department of Obstetrics and Gynecology, University of California at San Francisco, San Francisco, California, USA
| | - Michelle Melisko
- Department of Medicine, School of Medicine, University of California at San Francisco, San Francisco, California, USA
| | - Jon D Levine
- Department of Oral and Maxillofacial Surgery, School of Dentistry, University of California at San Francisco, San Francisco, California, USA
| | - Kord Kober
- Department of Physiologic Nursing, School of Nursing, University of California at San Francisco, San Francisco, California, USA
| | - Bradley E Aouizerat
- Department of Physiologic Nursing, School of Nursing, University of California at San Francisco, San Francisco, California, USA; The Institute for Human Genetics, University of California at San Francisco, San Francisco, California, USA
| | - Christine Miaskowski
- Department of Physiologic Nursing, School of Nursing, University of California at San Francisco, San Francisco, California, USA.
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Langford DJ, Paul SM, Cooper B, Kober KM, Mastick J, Melisko M, Levine JD, Wright F, Hammer MJ, Cartwright F, Lee KA, Aouizerat BE, Miaskowski C. Comparison of subgroups of breast cancer patients on pain and co-occurring symptoms following chemotherapy. Support Care Cancer 2015; 24:605-614. [DOI: 10.1007/s00520-015-2819-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Accepted: 06/15/2015] [Indexed: 01/17/2023]
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Dunn LB, Langford DJ, Paul SM, Berman MB, Shumay DM, Kober K, Merriman JD, West C, Neuhaus JM, Miaskowski C. Trajectories of fear of recurrence in women with breast cancer. Support Care Cancer 2015; 23:2033-43. [PMID: 25524004 PMCID: PMC5469210 DOI: 10.1007/s00520-014-2513-8] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2014] [Accepted: 11/10/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE Although fear of recurrence (FCR) is common among cancer survivors, it remains unclear what factors predict initial levels (e.g., prior to surgery) or changes in FCR in the post-treatment period. Among women treated for breast cancer, this study evaluated the effects of demographic, clinical, symptom, and psychosocial adjustment characteristics on the initial (preoperative) levels of FCR and trajectories of FCR over 6 months following surgery. METHODS Prior to and for 6 months following breast cancer surgery, 396 women were assessed for demographic and clinical (disease and treatment) characteristics, symptoms, psychological adjustment characteristics, and quality of life (QOL). FCR was assessed using a four-item subscale from the QOL instrument. Hierarchical linear modeling was used to examine changes in FCR scores and to identify predictors of inter-individual differences in preoperative FCR levels and trajectories over 6 months. RESULTS From before surgery to 6 months post-operatively, women with breast cancer showed a high degree of inter-individual variability in FCR. Preoperatively, women who lived with someone, experienced greater changes in spiritual life, had higher state anxiety, had more difficulty coping, or experienced more distress due to diagnosis or distress to family members reported higher FCR scores. Patients who reported better overall physical health and higher FCR scores at enrollment demonstrated a steeper decrease in FCR scores over time. CONCLUSIONS These findings highlight inter-individual heterogeneity in initial levels and changes in FCR over time among women undergoing breast cancer surgery. Further work is needed to identify and provide interventions for women experiencing FCR during and after breast cancer treatment.
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Affiliation(s)
- Laura B Dunn
- School of Medicine, University of California, San Francisco, CA, USA,
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Davis LZ, Slavich GM, Thaker PH, Goodheart MJ, Bender DP, Dahmoush L, Farley DM, Markon KE, Penedo FJ, Lubaroff DM, Cole SW, Sood AK, Lutgendorf SK. Eudaimonic well-being and tumor norepinephrine in patients with epithelial ovarian cancer. Cancer 2015; 121:3543-50. [PMID: 26096769 DOI: 10.1002/cncr.29516] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 05/01/2015] [Accepted: 05/18/2015] [Indexed: 12/29/2022]
Abstract
BACKGROUND The impact of psychological well-being on the physiologic processes involved in cancer progression remains unclear. Prior research has implicated adrenergic signaling in tumor growth and metastasis. Given that adrenergic signaling is influenced by both positive and negative factors, the authors examined how 2 different aspects of well-being (eudaimonic and positive affect) and psychological distress were associated with tumor norepinephrine (NE) in patients with ovarian cancer. METHODS A total of 365 women with suspected ovarian cancer completed psychosocial assessments before surgery and clinical information was obtained from medical records. Study inclusion was confirmed after histological diagnosis. Tumor NE was measured in frozen tissue samples using high-performance liquid chromatography with electrochemical detection. Confirmatory factor analysis was used to model eudaimonic well-being, positive affect, and psychological distress, and structural equation modeling was used to examine associations between these factors and tumor NE. RESULTS Eudaimonic well-being, positive affect, and psychological distress, modeled as distinct but correlated constructs, best fit the data (ie, compared with unitary or 2-factor models) (root mean square error of approximation, 0.048; comparative fit index, 0.982; and standardized root-mean-squared residual, 0.035). Structural equation modeling analysis that included physical well-being, stage of disease, histology, psychological treatment history, beta-blocker use, and caffeine use as covariates was found to have good model fit (root mean square error of approximation, 0.052; comparative fit index, 0.955; and standardized root-mean-squared residual, 0.036) and demonstrated that eudaimonic well-being was related to lower tumor NE (β = -.24 [P = .045]). In contrast, no effects were found for positive affect or psychological distress. CONCLUSIONS Eudaimonic well-being was found to be associated with lower tumor NE, independent of positive affect and psychological distress. Because adrenergic signaling is implicated in tumor progression, increasing eudaimonic well-being may improve both psychological and physiologic resilience in patients with ovarian cancer.
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Affiliation(s)
- Lauren Z Davis
- Department of Psychology, University of Iowa, Iowa City, Iowa
| | - George M Slavich
- Cousins Center for Psychoneuroimmunology, Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, California
| | - Premal H Thaker
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri
| | - Michael J Goodheart
- Department of Obstetrics and Gynecology, University of Iowa, Iowa City, Iowa
| | - David P Bender
- Department of Obstetrics and Gynecology, University of Iowa, Iowa City, Iowa
| | - Laila Dahmoush
- Department of Pathology, University of Iowa, Iowa City, Iowa
| | - Donna M Farley
- College of Pharmacy, University of Iowa, Iowa City, Iowa
| | | | - Frank J Penedo
- Department of Medical and Social Sciences, Northwestern University, Evanston, Illinois.,Department of Psychology, Northwestern University, Evanston, Illinois.,Department of Psychiatry and Behavioral Sciences, Northwestern University, Evanston, Illinois
| | - David M Lubaroff
- Department of Urology, University of Iowa, Iowa City, Iowa.,Holden Comprehensive Cancer Center, University of Iowa, Iowa City, Iowa.,Department of Microbiology, University of Iowa, Iowa City, Iowa
| | - Steve W Cole
- Cousins Center for Psychoneuroimmunology, Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, California.,Division of Hematology/Oncology, Jonsson Comprehensive Cancer Center, University of California at Los Angeles School of Medicine, Los Angeles, California.,University of California at Los Angeles Molecular Biology Institute, Los Angeles, California
| | - Anil K Sood
- Department of Gynecologic Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.,Department of Cancer Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Susan K Lutgendorf
- Department of Psychology, University of Iowa, Iowa City, Iowa.,Department of Obstetrics and Gynecology, University of Iowa, Iowa City, Iowa.,Department of Urology, University of Iowa, Iowa City, Iowa.,Holden Comprehensive Cancer Center, University of Iowa, Iowa City, Iowa
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80
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Alker HJ, Wang ML, Pbert L, Thorsen N, Lemon SC. Impact of school staff health on work productivity in secondary schools in Massachusetts. THE JOURNAL OF SCHOOL HEALTH 2015; 85:398-404. [PMID: 25877437 DOI: 10.1111/josh.12266] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Revised: 11/07/2014] [Accepted: 01/12/2015] [Indexed: 06/04/2023]
Abstract
BACKGROUND Healthy, productive employees are an integral part of school health programs. There have been few assessments of work productivity among secondary school staff. This study describes the frequency of 3 common health risk factors--obesity, depressive symptoms, and smoking--and their impact on work productivity in secondary school employees. METHODS Employees of secondary schools in Massachusetts (N = 630) participated in a longitudinal weight gain prevention intervention study. Assessment completed at baseline, 1-year and 2-year follow-up included survey assessments of health risk factors as well as measurements for height, weight, and body mass index (BMI). The survey also included a depression inventory and Work Limitations Questionnaire. Data analysis included multivariate mixed effect models to identify productivity differences in relation to BMI, depressive symptoms, and smoking in this population stratified by position type (teacher and other school staff). RESULTS The sample included 361 teachers and 269 other school staff. Obesity, depressive symptoms, and smoking were significantly associated with work productivity, including workdays missed because of health concerns (absenteeism) and decreases in on-the-job productivity because of health concerns (presenteeism). CONCLUSIONS Three common health conditions, namely obesity, depressive symptoms, and smoking, adversely affect the productivity of high school employees.
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Affiliation(s)
- Heather J Alker
- Department of Family Medicine and Community Health, University Massachusetts Medical School, 55 N Lake Avenue, Worcester, MA 01655.
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81
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Langford DJ, Schmidt B, Levine JD, Abrams G, Elboim C, Esserman L, Hamolsky D, Mastick J, Paul SM, Cooper B, Kober K, Dodd M, Dunn L, Aouizerat B, Miaskowski C. Preoperative Breast Pain Predicts Persistent Breast Pain and Disability After Breast Cancer Surgery. J Pain Symptom Manage 2015; 49:981-94. [PMID: 25527442 PMCID: PMC4470873 DOI: 10.1016/j.jpainsymman.2014.11.292] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Revised: 11/04/2014] [Accepted: 11/13/2014] [Indexed: 12/31/2022]
Abstract
CONTEXT Approximately 30% of the women report pain in the affected breast before breast cancer surgery. OBJECTIVES The purpose of this secondary analysis of our prospective study was to determine how women who experienced both preoperative and persistent postsurgical breast pain (n=107) differed from women who did not report preoperative breast pain and did (n=158) or did not (n=122) experience persistent postsurgical breast pain. METHODS Differences in demographic and clinical characteristics were evaluated. Linear mixed effects (LME) modeling was used to evaluate for group differences in symptom severity, function, sensation, and quality of life (QOL) over time. RESULTS Between-group differences in demographic and clinical characteristics as well as trajectories of shoulder function and QOL were identified. Women with both preoperative and persistent postsurgical breast pain were younger; were more likely to report swelling, strange sensations, hardness, and numbness in the affected breast before surgery; and were more likely to have reconstruction at the time of surgery. Women with both preoperative and persistent postsurgical breast pain had more biopsies in the prior year, more lymph nodes removed, and reported more severe acute postsurgical pain than women without preoperative breast pain. The LME modeling revealed significant group effects for most outcomes evaluated. Over the six months of the study, women with both preoperative and persistent postsurgical pain had persistently poorer shoulder flexion and physical well-being than women without preoperative breast pain. CONCLUSION Investigations of the etiology and molecular mechanisms of preoperative breast pain, as well as interventions for this high-risk group, are needed.
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Affiliation(s)
- Dale J Langford
- School of Nursing, University of California at San Francisco, San Francisco, California, USA
| | - Brian Schmidt
- School of Dentistry, New York University, New York, New York, USA
| | - Jon D Levine
- School of Medicine, University of California at San Francisco, San Francisco, California, USA
| | - Gary Abrams
- School of Medicine, University of California at San Francisco, San Francisco, California, USA
| | - Charles Elboim
- Redwood Regional Medical Group, Santa Rosa, California, USA
| | - Laura Esserman
- School of Medicine, University of California at San Francisco, San Francisco, California, USA
| | - Deborah Hamolsky
- School of Nursing, University of California at San Francisco, San Francisco, California, USA
| | - Judy Mastick
- School of Nursing, University of California at San Francisco, San Francisco, California, USA
| | - Steven M Paul
- School of Nursing, University of California at San Francisco, San Francisco, California, USA
| | - Bruce Cooper
- School of Nursing, University of California at San Francisco, San Francisco, California, USA
| | - Kord Kober
- School of Nursing, University of California at San Francisco, San Francisco, California, USA
| | - Marylin Dodd
- School of Nursing, University of California at San Francisco, San Francisco, California, USA
| | - Laura Dunn
- School of Medicine, University of California at San Francisco, San Francisco, California, USA
| | - Bradley Aouizerat
- School of Nursing, University of California at San Francisco, San Francisco, California, USA; Institute for Human Genetics, University of California at San Francisco, San Francisco, California, USA
| | - Christine Miaskowski
- School of Nursing, University of California at San Francisco, San Francisco, California, USA.
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82
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Lusa AL, Amigues I, Kramer HR, Dam TT, Giles JT. Indicators of walking speed in rheumatoid arthritis: relative influence of articular, psychosocial, and body composition characteristics. Arthritis Care Res (Hoboken) 2015; 67:21-31. [PMID: 25155859 DOI: 10.1002/acr.22433] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Accepted: 08/05/2014] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To explore the contributions from and interactions between articular swelling and damage, psychosocial factors, and body composition characteristics on walking speed in rheumatoid arthritis (RA). METHODS RA patients underwent the timed 400-meter long-corridor walk. Demographics, self-reported levels of depressive symptoms and fatigue, RA characteristics, and body composition (using whole-body dual X-ray absorptiometry, and abdominal and thigh computed tomography) were assessed and their associations with walking speed explored. RESULTS A total of 132 RA patients had data for the 400-meter walk, among whom 107 (81%) completed the full 400 meters. Significant multivariable indicators of slower walking speed were older age, higher depression scores, higher reported pain and fatigue, higher swollen and replaced joint counts, higher cumulative prednisone exposure, nontreatment with disease-modifying antirheumatic drugs, and worse body composition. These features accounted for 60% of the modeled variability in walking speed. Among specific articular features, slower walking speed was primarily correlated with large/medium lower-extremity joint involvement. However, these articular features accounted for only 21% of the explainable variability in walking speed. Having any relevant articular characteristic was associated with a 20% lower walking speed among those with worse body composition (P < 0.001), compared with only a 6% lower speed among those with better body composition (P = 0.010 for interaction). CONCLUSION Psychosocial factors and body composition are potentially reversible contributors to walking speed in RA. Relative to articular disease activity and damage, nonarticular indicators were collectively more potent indicators of an individual's mobility limitations.
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Affiliation(s)
- Amanda L Lusa
- Columbia University, College of Physicians and Surgeons, New York, New York
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83
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Pud D. The psychometric properties of the Hebrew version of the Memorial Symptom Assessment scale (MSAS-Heb) in patients with breast cancer. J Pain Symptom Manage 2015; 49:790-5. [PMID: 25261638 DOI: 10.1016/j.jpainsymman.2014.08.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Revised: 08/27/2014] [Accepted: 09/08/2014] [Indexed: 11/21/2022]
Abstract
CONTEXT To date, no report of the psychometric properties of the Hebrew version of the Memorial Symptom Assessment Scale (MSAS-Heb) has been available, which may be a barrier to comprehensively assessing symptom frequency, severity, and distress in Israeli patients with cancer. OBJECTIVES This study aimed to translate the MSAS into Hebrew and to evaluate the psychometric properties in Israeli patients with cancer. METHODS The original 32-item MSAS was translated into Hebrew using the forward and backward procedure, and administered to female patients with early stage breast cancer (stages I-IIIA) who had received adjuvant chemotherapy. In addition, patients completed a demographic questionnaire, the Lee Fatigue Scale, the Center for Epidemiological Studies-Depression Scale, the General Sleep Disturbance Scale, a numeric rating scale for pain intensity, the Multidimensional Quality of Life Scale-Cancer and the Karnofsky Performance Status Scale. RESULTS A sample of 110 patients was recruited (mean age 45.5 ± 10.1 years). The most frequent symptoms were hair loss (96.4%), lack of energy (88.2%) and "I do not look like myself" (80.9%), and the most infrequent were vomiting (7.3%), problems with urination (10.9%), and shortness of breath (20.9%). Cronbach alpha coefficients for the MSAS-Heb subscales (i.e., physical, psychological and global distress index) ranged from 0.78 to 0.90. All MSAS-Heb subscales and all the other questionnaires used in this study were significantly correlated (P < 0.0001), with expected directions. CONCLUSION The MSAS-Heb is a valid and a reliable measure and should be a useful tool in the clinical arena and in future studies for evaluation of multiple symptoms in Israeli patients with cancer.
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Affiliation(s)
- Dorit Pud
- Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.
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84
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Transitions in Symptom Cluster Subgroups Among Men Undergoing Prostate Cancer Radiation Therapy. Cancer Nurs 2015; 39:3-11. [PMID: 25730597 DOI: 10.1097/ncc.0000000000000236] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Prostate cancer is a common type of cancer worldwide and in the United States. However, little information has been reported on the symptoms of men over time who receive radiation therapy. OBJECTIVE The objectives of this study were to identify subgroups of men at pre- and post-radiation therapy on general and treatment-related symptoms and to determine transitions in subgroup membership over time. METHODS Men (n = 84) receiving radiation therapy completed questionnaires on fatigue, insomnia, pain, depression, anxiety, and sexual, urinary, and bowel problems at pretreatment and posttreatment. Latent class analysis identified subgroups. One-way analyses of variance determined subgroups differed on symptoms, participant characteristics, and quality of life. Latent transition analysis examined subgroup transitions over time. RESULTS At pretreatment, 4 subgroups were identified: resilient group, with little to no symptom reporting; adjusted group, with moderately high treatment-related symptoms, low insomnia, depression, and anxiety; distressed group, consistently high on most symptoms; and emerging group, with moderately high fatigue, depression, and anxiety with few treatment-related symptoms. At posttreatment, similar results were seen in groups to those at pretreatment: resilient, adjusted. and distressed groups with an impacted group having high pain, insomnia, depression, and urinary and bowel symptoms. Quality of life and participant characteristics further distinguished groups at pretreatment and posttreatment. Income level predicted a transition in group membership. CONCLUSIONS Men can be classified into distinctly different subgroups over time. IMPLICATIONS FOR PRACTICE Assessment and intervention with men in subgroups such as distressed and emerging before and during treatment may lessen potential for remaining distressed or moving into impacted group where symptom severity is high at posttreatment. Interventions to reduce multiple symptoms are vitally needed.
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85
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Mair C, Diez Roux AV, Golden SH, Rapp S, Seeman T, Shea S. Change in neighborhood environments and depressive symptoms in New York City: the Multi-Ethnic Study of Atherosclerosis. Health Place 2015; 32:93-8. [PMID: 25665936 DOI: 10.1016/j.healthplace.2015.01.003] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Revised: 11/07/2014] [Accepted: 01/11/2015] [Indexed: 10/24/2022]
Abstract
Physical and social features of neighborhoods, such as esthetic environments and social cohesion, change over time. The extent to which changes in neighborhood conditions are associated with changes in mental health outcomes has not been well-established. Using data from the MultiEthnic Study of Atherosclerosis, this study investigated the degree to which neighborhood social cohesion, stress, violence, safety and/or the esthetic environment changed between 2002 and 2007 in 103 New York City Census tracts and the associations of these changes with changes in depressive symptoms. Neighborhoods became less stressful, more socially cohesive, safer, and less violent. White, wealthy, highly educated individuals tended to live in neighborhoods with greater decreasing violence and stress and increasing social cohesion. Individuals living in neighborhoods with adverse changes were more likely to have increased CES-D scores, although due to limited sample size associations were imprecisely estimated (P>0.05). Changes in specific features of the neighborhood environment may be associated with changes in level of depressive symptoms among residents.
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Affiliation(s)
- C Mair
- Prevention Research Center, Pacific Institute for Research and Evaluation, 180 Grand Ave, Suite 1200, Oakland, CA 94612, USA.
| | - A V Diez Roux
- Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, USA.
| | - S H Golden
- Departments of Medicine and Epidemiology, Johns Hopkins University School of Medicine and Bloomberg School of Public Health, 2024 E. Monument Street, Suite 2-600, Baltimore, MD 21205, USA.
| | - S Rapp
- Department of Psychiatry and Behavioral Medicine, Wake Forest University School of Medicine, 791 Jonestown Road, Winston-Salem, NC 27103, USA.
| | - T Seeman
- Department of Medicine, Division of Geriatrics, David Geffen School of Medicine at UCLA, 1095 Le Conte Ave, Suite 2339, Los Angeles, CA 90095, USA.
| | - S Shea
- Departments of Medicine and Epidemiology, Columbia University, 630 W. 168th Street PH9E, New York, NY 10032, USA.
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Prinsloo S, Wei Q, Scott SM, Tannir N, Jonasc E, Pisters L, Cohen L. Psychological states, serum markers and survival: associations and predictors of survival in patients with renal cell carcinoma. J Behav Med 2015; 38:48-56. [PMID: 24935017 PMCID: PMC4824635 DOI: 10.1007/s10865-014-9578-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2013] [Accepted: 05/31/2014] [Indexed: 11/26/2022]
Abstract
This study sought to determine if there was an association between prognostic-based serum biomarkers, survival, and psychosocial factors in patients with metastatic renal cell carcinoma. Associations were found between psychosocial factors and biomarker levels (hemoglobin with depressive symptoms (r = -0.29), positive affect (r = 0.30), social support (r = 0.19), and perceived stress (r = -0.27); albumin with depressive symptoms (r = -0.19), positive affect (r = 0.22), and social support (r = 0.20); alkaline phosphatase with depressive symptoms (r = 0.21), all p values <0.05. After adjustment for disease-related risk factors, only the associations between positive affect and perceived stress with hemoglobin remained significant (p's < 0.05). Positive affect (HR = 0.90; 95% CI = 0.83, 0.97; p = 0.009) and depressive symptom total scores (HR = 1.03; 95% CI = 1.01, 1.06; p = 0.013), and alkaline phosphatase (HR 2.72; 95% CI = 1.41, 5.24; p = 0.003) were associated with survival. This study suggests that measures of positive and negative psychological outlook may contribute differently to health, well-being, and survival.
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Affiliation(s)
- Sarah Prinsloo
- Unit 410, Department of General Oncology and the Integrative Medicine Program, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77230, USA
| | - Qi Wei
- Unit 410, Department of General Oncology and the Integrative Medicine Program, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77230, USA
| | - Shellie M. Scott
- Department of Urology, University of Texas MD Anderson, Cancer Center, Houston, TX, USA
| | - Nizar Tannir
- Department of Genitourinary Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Eric Jonasc
- Department of Genitourinary Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Louis Pisters
- Department of Urology, University of Texas MD Anderson, Cancer Center, Houston, TX, USA
| | - Lorenzo Cohen
- Unit 410, Department of General Oncology and the Integrative Medicine Program, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77230, USA
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Mogos MF, Beckstead JW, Kip KE, Evans ME, Boothroyd RA, Aiyer AN, Reis SE. Assessing Longitudinal Invariance of the Center for Epidemiologic Studies-Depression Scale Among Middle-Aged and Older Adults. J Nurs Meas 2015; 23:302-14. [DOI: 10.1891/1061-3749.23.2.302] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background and Purpose: The longitudinal invariance of the Center for Epidemiologic Studies-Depression (CES-D) scale among middle-aged and older adults is unknown. This study examined the factorial invariance of the CES-D scale in a large cohort of community-based adults longitudinally. Methods: 1,204 participants completed the 20-item CES-D scale at 4 time points 1 year apart. Structural equation modeling was used to identify best fitting model using longitudinal data at baseline and at 1-, 2-, and 3-year follow-up. Results: The 4-factor model showed partial invariance over 3 years. Two of the 6 noninvariant items were consistently noninvariant at the 3 follow-up points. Conclusion: Special consideration should be given to these 2 items when using the CES-D scale in healthy adults (45–75 years old).
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Miaskowski C, Elboim C, Paul SM, Mastick J, Cooper BA, Levine JD, Aouizerat BE. Polymorphisms in Tumor Necrosis Factor-α Are Associated With Higher Anxiety Levels in Women After Breast Cancer Surgery. Clin Breast Cancer 2014; 16:63-71.e3. [PMID: 25813148 DOI: 10.1016/j.clbc.2014.12.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Revised: 12/09/2014] [Accepted: 12/16/2014] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Before and after breast cancer surgery, women have reported varying anxiety levels. Recent evidence has suggested that anxiety has a genetic basis and is associated with inflammation. The purposes of the present study were to identify the subgroups of women with distinct anxiety trajectories; to evaluate for differences in the phenotypic characteristics between these subgroups; and to evaluate for associations between polymorphisms in cytokine genes and subgroup membership. PATIENTS AND METHODS Patients with breast cancer (n = 398) were recruited before surgery and followed up for 6 months. The patients completed the Spielberger State Anxiety Inventory and provided a blood sample for genomic analyses. Growth mixture modeling was used to identify the subgroups of patients with distinct anxiety trajectories. RESULTS Two distinct anxiety subgroups were identified. The women in the higher anxiety subgroup were younger and had a lower functional status score. Two single nucleotide polymorphisms in tumor necrosis factor-α (rs1799964, rs3093662) were associated with the higher anxiety subgroup. CONCLUSION The results of the present exploratory study suggest that polymorphisms in cytokine genes could partially explain the interindividual variability in anxiety. The determination of phenotypic and molecular markers associated with greater levels of anxiety can assist clinicians to identify high-risk patients and initiate appropriate interventions.
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Affiliation(s)
| | | | - Steven M Paul
- School of Nursing, University of California, San Francisco, San Francisco, CA
| | - Judy Mastick
- School of Nursing, University of California, San Francisco, San Francisco, CA
| | - Bruce A Cooper
- School of Nursing, University of California, San Francisco, San Francisco, CA
| | - Jon D Levine
- School of Medicine, University of California, San Francisco, San Francisco, CA
| | - Bradley E Aouizerat
- School of Nursing, University of California, San Francisco, San Francisco, CA; Institute for Human Genetics, University of California, San Francisco, San Francisco, CA
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Miaskowski C, Cataldo JK, Baggott CR, West C, Dunn LB, Dhruva A, Merriman JD, Langford DJ, Kober KM, Paul SM, Cooper BA, Aouizerat BE. Cytokine gene variations associated with trait and state anxiety in oncology patients and their family caregivers. Support Care Cancer 2014; 23:953-65. [PMID: 25249351 DOI: 10.1007/s00520-014-2443-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2014] [Accepted: 09/14/2014] [Indexed: 01/01/2023]
Abstract
PURPOSE Anxiety is common among cancer patients and their family caregivers (FCs) and is associated with poorer outcomes. Recently, associations between inflammation and anxiety were identified. However, the relationship between variations in cytokine genes and anxiety warrants investigation. Therefore, phenotypic and genotypic characteristics associated with trait and state anxiety were evaluated in a sample of 167 oncology patients with breast, prostate, lung, or brain cancer and 85 of their FCs. METHODS Using multiple regression analyses, the associations between participants' demographic and clinical characteristics as well as variations in cytokine genes and trait and state anxiety were evaluated. RESULTS In the bivariate analyses, a number of phenotypic characteristics were associated with both trait and state anxiety (e.g., age, functional status). However, some associations were specific only to trait anxiety (e.g., number of comorbid conditions) or state anxiety (e.g., participation with a FC). Variations in three cytokine genes (i.e., interleukin (IL) 1 beta, IL1 receptor 2 (IL1R2), nuclear factor kappa beta 2 (NFKB2)) were associated with trait anxiety, and variations in two genes (i.e., IL1R2, tumor necrosis factor alpha (TNFA)) were associated with state anxiety. CONCLUSIONS These findings suggest that both trait and state anxiety need to be assessed in oncology patients and their FCs. Furthermore, variations in cytokine genes may contribute to higher levels of anxiety in oncology patients and their FCs.
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90
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Gomez R, McLaren S, Sharp M, Smith C, Hearn K, Turner L. Evaluation of the Bifactor Structure of the Dispositional Hope Scale. J Pers Assess 2014; 97:191-9. [DOI: 10.1080/00223891.2014.938158] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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91
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Gomez R, McLaren S. The center for epidemiologic studies depression scale: support for a bifactor model with a dominant general factor and a specific factor for positive affect. Assessment 2014; 22:351-60. [PMID: 25085880 DOI: 10.1177/1073191114545357] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES For the Center for Epidemiologic Studies Depression Scale (CES-D) ratings, the study examined support for a bifactor model, and also the internal consistency reliability and external validity of the factors in this model. METHOD Participants (N = 1,178) were older adults from the general community who completed the CES-D. RESULTS Confirmatory factor analysis of their ratings indicated support for the bifactor model. For this model, the general factor explained most of the covariance in the scores of the CES-D items for Depressed Affect, Somatic Symptoms and Retarded Activity, and Interpersonal Difficulties items. Most of the covariance in the scores of the Positive Affect (PA) scale was explained by its own specific factor. Additional analyses showed support for internal consistencies and external validities of general factors based on all the CES-D items, and when PA items were excluded, and also the PA-specific factor. DISCUSSION The findings support the use of a total CES-D score without the PA items and also the concurrent use of the PA scale score.
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Affiliation(s)
- Rapson Gomez
- Federation University Australia, Ballarat, Victoria, Australia
| | - Suzanne McLaren
- Federation University Australia, Ballarat, Victoria, Australia
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92
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Montagnier D, Dartigues JF, Rouillon F, Pérès K, Falissard B, Onen F. Ageing and trajectories of depressive symptoms in community-dwelling men and women. Int J Geriatr Psychiatry 2014; 29:720-9. [PMID: 24311371 DOI: 10.1002/gps.4054] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Accepted: 10/29/2013] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The aim of this study was to investigate age-related patterns of depressive symptoms in older men and women and to identify their determinants. METHODS The Center for Epidemiological Studies Depression Scale was used to prospectively assess depressive symptoms in 1059 men and 1531 women, enrolled in a French representative population-based cohort (PAQUID study) and followed over a period of 20 years. Using a group-based trajectory method with an accelerated longitudinal design, we modelled the course of depressive symptoms between 65 and 104 years of age and examined associations between trajectory patterns and baseline socio-demographic and health variables. RESULTS In men, we identified three rising trajectories: 'never depressed' including 65% of the sample, 'emerging depression' (28%) and 'increasing depression' (7%). Compared with the membership of the never-depressed trajectory, that of the two higher trajectories was significantly associated with a history of depression and dyspnoea. In women, we identified two slightly rising trajectories (never depressed, 56%, and 'rising subclinical', 33%) and one stable high trajectory ('persistent depression', 11%). Membership of the two higher trajectories was significantly associated with the use of benzodiazepine, polymedication and dyspnoea. A history of nondepressive psychiatric disorder was a risk factor for membership of the persistent-depression group, whereas being widowed seemed to be a protective factor for membership of this group. CONCLUSION High-risk groups for later-life depression should be targeted differently in older men and women in order to implement appropriate interventions to prevent chronicity and disability.
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Affiliation(s)
- Delphine Montagnier
- INSERM U669. Université Paris-Sud and Université Paris Descartes, UMR-S0669, Paris, France
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93
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Kyranou M, Puntillo K, Aouizerat BE, Dunn LB, Paul SM, Cooper BA, West C, Dodd M, Elboim C, Miaskowski C. Trajectories of Depressive Symptoms in Women Prior to and for Six Months After Breast Cancer Surgery. ACTA ACUST UNITED AC 2014; 19:79-105. [PMID: 25382962 DOI: 10.1111/jabr.12017] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Depressive symptoms are common in women with breast cancer. This study evaluated how ratings of depressive symptoms changed from the time of the preoperative assessment to 6 months after surgery and investigated whether specific demographic, clinical, and symptom characteristics predicted preoperative levels of and/or characteristics of the trajectories of depressive symptoms. Characteristics that predicted higher preoperative levels of depressive symptoms included being married/partnered; receipt of adjuvant chemotherapy; more fear of metastasis; higher levels of trait anxiety, state anxiety, sleep disturbance, problems with changes in appetite; more hours per day in pain; and lower levels of attentional function. Future studies need to evaluate associations between anxiety, fears of recurrence, and uncertainty, as well as personality characteristics and depressive symptoms.
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Affiliation(s)
| | | | - Bradley E Aouizerat
- School of Nursing, University of California, San Francisco, CA ; Institute for Human Genetics, University of California, San Francisco, CA
| | - Laura B Dunn
- School of Medicine, University of California, San Francisco, CA
| | - Steven M Paul
- School of Nursing, University of California, San Francisco, CA
| | - Bruce A Cooper
- School of Nursing, University of California, San Francisco, CA
| | - Claudia West
- School of Nursing, University of California, San Francisco, CA
| | - Marylin Dodd
- School of Nursing, University of California, San Francisco, CA
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94
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Miaskowski C, Paul SM, Cooper B, West C, Levine JD, Elboim C, Hamolsky D, Abrams G, Luce J, Dhruva A, Langford DJ, Merriman JD, Kober K, Baggott C, Leutwyler H, Aouizerat BE. Identification of patient subgroups and risk factors for persistent arm/shoulder pain following breast cancer surgery. Eur J Oncol Nurs 2014; 18:242-53. [PMID: 24485012 PMCID: PMC4013216 DOI: 10.1016/j.ejon.2013.12.002] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2013] [Revised: 12/10/2013] [Accepted: 12/12/2013] [Indexed: 01/07/2023]
Abstract
PURPOSE In this prospective, longitudinal study, we extend our findings on persistent breast pain in patients (n = 398) following breast cancer surgery and evaluate the prevalence and characteristics of persistent pain in the arm/shoulder. In addition, differences in the severity of common symptoms and quality of life outcomes measured prior to surgery, among the arm pain classes, were evaluated. METHODS AND SAMPLE Patients were recruited from Breast Care Centers located in a Comprehensive Cancer Center, two public hospitals, and four community practices. Patients were assessed prior to and monthly for six months following breast cancer surgery. RESULTS Using growth mixture modeling, patients were classified into no (41.6%), mild (23.6%), and moderate (34.8%) arm pain classes based on ratings of worst arm/shoulder pain. Compared to the no pain class, patients in the moderate pain class were significantly younger, had a higher body mass index, and were more likely to report preoperative breast pain and swelling in the affected breast. In addition, patients in the moderate pain class reported higher levels of depression, anxiety, and sleep disturbance than the no pain class. CONCLUSIONS Findings suggest that approximately 35% of women experience persistent levels of moderate arm/shoulder pain in the first six months following breast cancer surgery. Moderate arm/shoulder pain is associated with clinically meaningful decrements in functional status and quality of life.
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Affiliation(s)
| | - Steven M Paul
- School of Nursing, University of California, San Francisco, CA, USA
| | - Bruce Cooper
- School of Nursing, University of California, San Francisco, CA, USA
| | - Claudia West
- School of Nursing, University of California, San Francisco, CA, USA
| | - Jon D Levine
- School of Medicine, University of California, San Francisco, CA, USA
| | | | - Deborah Hamolsky
- School of Nursing, University of California, San Francisco, CA, USA
| | - Gary Abrams
- School of Medicine, University of California, San Francisco, CA, USA
| | - Judith Luce
- School of Medicine, University of California, San Francisco, CA, USA
| | - Anand Dhruva
- School of Medicine, University of California, San Francisco, CA, USA
| | - Dale J Langford
- School of Nursing, University of California, San Francisco, CA, USA
| | - John D Merriman
- School of Nursing, University of California, San Francisco, CA, USA
| | - Kord Kober
- School of Nursing, University of California, San Francisco, CA, USA
| | | | | | - Bradley E Aouizerat
- School of Nursing, University of California, San Francisco, CA, USA; Institute for Human Genetics, University of California, San Francisco, CA, USA
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95
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Sacco SJ, Park CL, Suresh DP, Bliss D. Living with heart failure: psychosocial resources, meaning, gratitude and well-being. Heart Lung 2014; 43:213-8. [PMID: 24661743 DOI: 10.1016/j.hrtlng.2014.01.012] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2012] [Revised: 01/24/2014] [Accepted: 01/27/2014] [Indexed: 01/20/2023]
Abstract
OBJECTIVES The present study explored the experiences of people living with advanced heart failure (HF) to determine the extent to which (1) psychosocial resources relevant to HF patients were qualitatively reported, and (2) to determine the extent to which psychosocial resources were correlates of subsequent well-being as assessed by validated quantitative measures. BACKGROUND HF is a serious life-limiting illness that involves impaired heart functionality. Patients commonly face severe physical fatigue and frequently endure disabling depression. Individuals with HF often report the use of social support and religion/spirituality (R/S) as helpful, but little work has systematically linked their reliance on these resources and well-being. METHODS 111 participants completed four open-ended questions to assess aspects of living with HF. Open-ended questions were coded to identify psychosocial resources: positive meaning, gratitude, R/S, social support, and medical resources. Data were collected once and then again 3 months later. Participants also completed measures of well-being, including religious meaning, life meaning, satisfaction with life, depressive symptoms, death anxiety, and health-related quality of life. Bivariate correlations were used to relate psychosocial resources and well-being. RESULTS Patients reported many psychosocial resources, particularly positive meaning, R/S, social support, and medical resources. Positive meaning and R/S were inversely linked with depressive symptoms. R/S was also related to less death anxiety, while social support was related to higher anxiety about death three months later. CONCLUSIONS Findings advance our understanding of the struggles HF patients experience and the roles of psychosocial resources such as meaning and gratitude in alleviating these struggles. Results may help explain how resources like R/S and social support may influence well-being.
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Affiliation(s)
- Shane J Sacco
- Department of Psychology, University of Connecticut, Storrs, CT 06269, USA
| | - Crystal L Park
- Department of Psychology, University of Connecticut, Storrs, CT 06269, USA.
| | - D P Suresh
- St. Elizabeth's Healthcare, Covington, KY, USA
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96
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Oyama H, Sakashita T. Differences in specific depressive symptoms among community-dwelling middle-aged Japanese adults before and after a universal screening intervention. Soc Psychiatry Psychiatr Epidemiol 2014; 49:251-8. [PMID: 23824236 DOI: 10.1007/s00127-013-0735-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Accepted: 06/24/2013] [Indexed: 11/26/2022]
Abstract
PURPOSE This study investigated changes in depressive symptoms after the implementation of a universal screening for depression and subsequent care support. METHODS A cluster-randomized study design used 10 subdistricts (2,400 inhabitants aged 40-64 years) in northern Japan randomly assigned in a 2:3 ratio to intervention and control conditions. All 900 residents aged 40-64 in the intervention districts were invited to participate in a 2-year depressive screening program, with a participation rate of 49.2%. A 4-year ongoing education program occurred in both intervention and control districts. The Center for Epidemiologic Studies Depression Scale (CES-D) was used to assess depressive symptomatology. Repeated cross-sectional samples were surveyed before (n = 1,516, response rate 63.6%) and after (n = 1,596, 66.4%) intervention, and the data, clustered according to district, were analyzed at the individual level using a mixed-effects model. RESULTS Significant changes in mean scores between baseline and 5-year follow-up in the intervention group were observed in the Depressive Affect, Somatic Symptoms, and Interpersonal Problems subscales. The difference between the changes over time in the two groups was significant for the three subscales and marginally for the CES-D total scale, but not for the Positive Affect subscale. CONCLUSIONS Universal depression screening and subsequent support can be effective in preventing general depressive symptoms, but may not influence psychological well-being, among middle-aged adults in a community setting.
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Affiliation(s)
- Hirofumi Oyama
- Department of Social Welfare, Faculty of Health Sciences, Aomori University of Health and Welfare, 58-1 Mase Hamadate, Aomori, 030-8505, Japan,
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97
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Stenberg U, Cvancarova M, Ekstedt M, Olsson M, Ruland C. Family caregivers of cancer patients: perceived burden and symptoms during the early phases of cancer treatment. SOCIAL WORK IN HEALTH CARE 2014; 53:289-309. [PMID: 24628120 DOI: 10.1080/00981389.2013.873518] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This study investigated levels of symptoms, caregiver burden, and changes over time in 278 family caregivers (FC) of cancer patients. FCs experienced high levels of depressive symptoms and sleep disturbance, low levels of fatigue, and low to moderate levels of caregiver burden, yet these symptoms remained relatively stable over time. Being female and not being employed were factors associated with an increased risk of symptoms and caregiver burden. The understanding evolving from this study can enhance social- and health care professionals' awareness of FCs' challenging situation and the potential impact this has on the FCs' ability to provide care to the patient.
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Affiliation(s)
- Una Stenberg
- a Center for Shared Decision Making and Collaborative Care Research, and Section for Social Medicine, Department of Clinical Service, Division of Cancer Medicine, Surgery and Transplantation , Oslo University Hospital , Oslo , Norway
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98
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Confirmation des dimensions de la version française de l’échelle d’auto-évaluation Center for Epidemiological Studies Depression (CES-D). Encephale 2013; 39:452-3. [DOI: 10.1016/j.encep.2012.01.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2012] [Indexed: 11/23/2022]
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99
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Dhruva A, Aouizerat BE, Cooper B, Paul SM, Dodd M, West C, Wara W, Lee K, Dunn LB, Langford DJ, Merriman JD, Baggott C, Cataldo J, Ritchie C, Kober K, Leutwyler H, Miaskowski C. Differences in morning and evening fatigue in oncology patients and their family caregivers. Eur J Oncol Nurs 2013; 17:841-8. [PMID: 24012189 PMCID: PMC3867806 DOI: 10.1016/j.ejon.2013.06.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Revised: 06/10/2013] [Accepted: 06/21/2013] [Indexed: 01/13/2023]
Abstract
PURPOSE OF THE RESEARCH To identify distinct latent classes of individuals based on ratings of morning and evening fatigue; evaluate for differences in phenotypic characteristics, as well as symptom and quality of life scores, among these latent classes; and evaluate for an overlap in morning and evening fatigue class membership. PATIENTS AND METHODS In a sample of 167 oncology outpatients and 85 of their FCs, growth mixture modeling was used to identify distinct latent classes based on ratings of morning and evening fatigue obtained before, during, and after radiation therapy. Analyses of variance and Chi Square analyses were used to evaluate for differences among the morning and evening fatigue latent classes. RESULTS Three distinct latent classes for morning fatigue were identified. Participants in the High Morning Fatigue class (47%) were younger and had lower functional status. Three distinct latent classes for evening fatigue were identified. Participants in the High Evening Fatigue class (61%) were younger, more likely to be female, more likely to have children at home, and more likely to be a FC. Only 10.3% of participants were classified in both the Very Low Morning and Low Evening Fatigue classes and 41.3% were classified in both the High Morning and High Evening Fatigue classes. CONCLUSIONS Different characteristics were associated with morning and evening fatigue, which suggests that morning and evening fatigue may be distinct but related symptoms. Additional research is needed to elucidate the mechanisms that may underlie diurnal variability in fatigue.
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Affiliation(s)
- Anand Dhruva
- School of Medicine, University of California, San Francisco, CA, USA
| | - Bradley E. Aouizerat
- School of Nursing, University of California, San Francisco, CA, USA
- Institute for Human Genetics, University of California, San Francisco, CA, USA
| | - Bruce Cooper
- School of Nursing, University of California, San Francisco, CA, USA
| | - Steven M. Paul
- School of Nursing, University of California, San Francisco, CA, USA
| | - Marylin Dodd
- School of Nursing, University of California, San Francisco, CA, USA
| | - Claudia West
- School of Nursing, University of California, San Francisco, CA, USA
| | - William Wara
- California and Kaiser Permanente, San Francisco, CA, USA
| | - Kathryn Lee
- School of Nursing, University of California, San Francisco, CA, USA
| | - Laura B. Dunn
- School of Medicine, University of California, San Francisco, CA, USA
| | - Dale J. Langford
- School of Nursing, University of California, San Francisco, CA, USA
| | - John D. Merriman
- School of Nursing, University of California, San Francisco, CA, USA
| | | | - Janine Cataldo
- School of Nursing, University of California, San Francisco, CA, USA
| | - Christine Ritchie
- School of Medicine, University of California, San Francisco, CA, USA
| | - Kord Kober
- School of Nursing, University of California, San Francisco, CA, USA
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100
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Cardon MS, Patel PC. Is Stress Worth it? Stress-Related Health and Wealth Trade-Offs for Entrepreneurs. APPLIED PSYCHOLOGY-AN INTERNATIONAL REVIEW-PSYCHOLOGIE APPLIQUEE-REVUE INTERNATIONALE 2013. [DOI: 10.1111/apps.12021] [Citation(s) in RCA: 116] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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