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Siefert E, Delva F, Paris C, Pairon JC, Thaon I. Quality of life in retired workers with past exposure to asbestos. Am J Ind Med 2024; 67:610-623. [PMID: 38734874 DOI: 10.1002/ajim.23592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 03/31/2024] [Accepted: 04/25/2024] [Indexed: 05/13/2024]
Abstract
BACKGROUND Asbestos causes cancer and non-cancerous lung and pleural diseases and can also have a negative psychological impact but little is known about its effect on health-related quality of life. OBJECTIVES The aim of this study is to describe the health-related quality of life (HRQoL) of retired men with a history of occupational exposure to asbestos and examine factors linked with low HRQoL. METHODS Retired male workers of the French Asbestos-Related Disease Cohort (ARDCO) completed self-questionnaires that included SF-36v2 and HAD scales, questions about their perception of asbestos (perceived dangers and level of exposure, expectations to fall ill, or knowing someone who is) and their respiratory symptoms. Asbestos exposure was assessed by industrial hygienists. A perceived risk score was created using factorial analysis. Multivariable regressions were performed for all SF-36 subscales. RESULTS A total of 1266 of 2075 questionnaires (61%) were returned complete and included in analysis. After adjustment for potential confounders, an increase in perceived risk score resulted in a decrease in physical component summary score (PCS), up to 10.7 points (p = 0.048) and in mental component summary score (MCS) (p = 0.044). Presence of respiratory symptoms was also associated with significantly decreased PCS and MCS (p < 0.001). Poor HRQoL was linked to higher perceived risk score with p ≤ 0.01 for all SF-36 dimensions. Asbestos exposure assessed by an expert was not associated with any outcome. CONCLUSIONS All dimensions of HRQoL appear to be affected by the perceived risk of incurring asbestos-related disease and respiratory symptoms.
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Affiliation(s)
- Emmanuelle Siefert
- INSPIIRE, Université de Lorraine, Inserm, Nancy, France
- Centre de consultations de pathologies professionnelles, CHRU-Nancy, Nancy, France
| | - Fleur Delva
- Epicene Team, I, INSERM U1219 - Bordeaux Population Health Research Center, Bordeaux, France
- Service Santé Travail Environnement, CHU Bordeaux, Bordeaux, France
| | - Christophe Paris
- Service de Santé au Travail et Pathologie Professionnelle, CHU Rennes, Rennes, France
- Equipe ESTER, Institut de Recherche en Santé, Environnement et Travail, Rennes, France
| | - Jean-Claude Pairon
- GEIC20 Team, INSERM U955, F-94000, Créteil, France
- Service de Pathologies Professionnelles et de l'Environnement, Centre Hospitalier Intercommunal Créteil, Institut Santé-Travail Paris-Est, Créteil, France
| | - Isabelle Thaon
- INSPIIRE, Université de Lorraine, Inserm, Nancy, France
- Centre de consultations de pathologies professionnelles, CHRU-Nancy, Nancy, France
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Sherborne V, Ejegi-Memeh S, Tod AM, Taylor B, Hargreaves S, Gardiner C. Living with mesothelioma: a systematic review of mental health and well-being impacts and interventions for patients and their informal carers. BMJ Open 2024; 14:e075071. [PMID: 38951010 PMCID: PMC11218022 DOI: 10.1136/bmjopen-2023-075071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 06/12/2024] [Indexed: 07/03/2024] Open
Abstract
OBJECTIVES Mesothelioma is an aggressive cancer predominantly affecting the lung and abdominal linings. It can have a unique impact on mental health and well-being (MHWB) due to its incurability, poor prognosis and asbestos-exposure causation. This review's aims were to identify/synthesise international evidence on mesothelioma's MHWB impacts; explore MHWB interventions used by patients and carers; and identify evidence of their effectiveness. DESIGN Systematic review. DATA SOURCES Databases, searched March 2022 and March 2024, were MEDLINE; CINAHL; PsycINFO; Cochrane Library; ASSIA. ELIGIBILITY CRITERIA We included study designs focusing on psychological impacts of living with mesothelioma and MHWB interventions used by patients and informal carers, published in English since January 2002. DATA EXTRACTION AND SYNTHESIS A team of reviewers screened included studies using standardised methods. Quality was assessed using validated tools: Mixed-Methods Appraisal tool for primary research and Joanna Briggs Institute Critical Appraisal Checklist for Systematic Reviews. RESULTS Forty-eight studies met the inclusion criteria: 20 qualitative, 16 quantitative, nine reviews, two mixed-methods, one combined systematic review/qualitative study. UK studies predominated. Many MHWB impacts were reported, including traumatic stress, depression, anxiety and guilt. These were influenced by mesothelioma's causation, communication issues and carer-patient relational interactions. Participants used wide-ranging MHWB interventions, including religious/spiritual practice; talking to mental-health professionals; meaning-making. Some strategies were presented as unhelpful, for example, denial. Participants reported lack of access to support. CONCLUSIONS Most qualitative studies were rated high quality. The quality of the quantitative studies and reviews varied. The sparse literature regarding MHWB in mesothelioma means more research is needed into impacts on patients and carers, including trauma. To enable access to evidence-based support, research is recommended concerning MHWB interventions' effectiveness in mesothelioma. PROSPERO REGISTRATION NUMBER CRD42022302187.
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Affiliation(s)
- Virginia Sherborne
- Mesothelioma UK Research Centre, Division of Nursing and Midwifery, The University of Sheffield, Sheffield, UK
| | - Stephanie Ejegi-Memeh
- Mesothelioma UK Research Centre, Division of Nursing and Midwifery, The University of Sheffield, Sheffield, UK
| | - Angela Mary Tod
- Mesothelioma UK Research Centre, Division of Nursing and Midwifery, The University of Sheffield, Sheffield, UK
| | - Bethany Taylor
- Mesothelioma UK Research Centre, Division of Nursing and Midwifery, The University of Sheffield, Sheffield, UK
| | - Sarah Hargreaves
- Mesothelioma UK Research Centre, Division of Nursing and Midwifery, The University of Sheffield, Sheffield, UK
| | - Clare Gardiner
- Mesothelioma UK Research Centre, Division of Nursing and Midwifery, The University of Sheffield, Sheffield, UK
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Bonafede M, Franzoi IG, Sauta MD, Marinaccio A, Mensi C, Rugarli S, Migliore E, Cozzi I, Cavone D, Vimercati L, Grosso F, Bertolotti M, Raimondi G, Innamorati M, Granieri A. Confirmatory validation of the Mesothelioma Psychological Distress Tool-Patients: A brief patient-reported outcome measure assessing psychological distress in malignant mesothelioma patients. Psychooncology 2024; 33:e6371. [PMID: 38942736 DOI: 10.1002/pon.6371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 06/14/2024] [Accepted: 06/20/2024] [Indexed: 06/30/2024]
Abstract
OBJECTIVE Psychological suffering in patients with Malignant Mesothelioma (MM) is different from the one experienced by patients with other cancers due to its occupational or environmental etiology and its peculiar symptomatology and prognosis (i.e., poor prognosis, reduced effectiveness of the therapies, poor quality of residual life, and advanced age at the time of diagnosis). Therefore, the Mesothelioma Psychological Distress Tool-Patients (MPDT-P) has been developed to evaluate the specific profile of psychological suffering in this population. This paper describes the item selection, factor analysis, and psychometric evaluation of the revised MPDT-P. METHODS The analyses of the current work aimed to confirm the factorial structure found in the first version of the MPDT-P. In the case of nonfit, it aimed to find an alternative structure and causes of nonfit in the model. The search for the fit of the factorial model was conducted using a Bayesian approach. RESULTS The two-factor model reported in the first version of the instrument did not fit the data. Confirmatory Bayesian analyses showed adequate fit for the three-factor solution. Based on the content of the items, we labeled the factors as dysfunctional emotions, claims for justice, and anxieties about the future. CONCLUSIONS Integrating the MPDT-P into clinical practice could help clinicians gain insight into the specific suffering related to MM and investigate potential differences related to different occupational and environmental exposure contexts.
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Affiliation(s)
- Michela Bonafede
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers' Compensation Authority (INAIL), Rome, Italy
| | | | | | - Alessandro Marinaccio
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers' Compensation Authority (INAIL), Rome, Italy
| | - Carolina Mensi
- COR Lombardy, Occupational Health Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico of Milan, Milan, Italy
| | - Sabrina Rugarli
- COR Lombardy, Occupational Health Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico of Milan, Milan, Italy
| | - Enrica Migliore
- COR Piedmont, Unit of Cancer Epidemiology, AOU Città della Salute e della Scienza di Torino, CPO Piedmont and University of Turin, Turin, Italy
| | - Ilaria Cozzi
- Department of Epidemiology, COR Lazio, Lazio Regional Health Service, Local Health Unit 1, Rome, Italy
| | - Domenica Cavone
- Department of Interdisciplinary Medicine, Section of Occupational Medicine "B. Ramazzini", Regional Operating Center of Puglia (COR Puglia), University of Bari, Bari, Italy
| | - Luigi Vimercati
- Department of Interdisciplinary Medicine, Section of Occupational Medicine "B. Ramazzini", Regional Operating Center of Puglia (COR Puglia), University of Bari, Bari, Italy
| | - Federica Grosso
- Mesothelioma and Rare Cancers Unit, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Marinella Bertolotti
- Research Training Innovation Infrastructure, Research and Innovation Department (DAIRI), AO SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Giulia Raimondi
- Department of Psychology, University of Turin, Turin, Italy
- Clinical Epidemiology Unit, Istituto Dermopatico dell'Immacolata, IDI-IRCCS, Rome, Italy
| | - Marco Innamorati
- Department of Human Sciences, European University of Rome, Roma, Italy
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Ejegi-Memeh S, Sherborne V, Mayland C, Tod A, Taylor BH. Mental health and wellbeing in mesothelioma: A qualitative study exploring what helps the wellbeing of those living with this illness and their informal carers. Eur J Oncol Nurs 2024; 70:102572. [PMID: 38640636 DOI: 10.1016/j.ejon.2024.102572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 03/11/2024] [Accepted: 03/18/2024] [Indexed: 04/21/2024]
Abstract
PURPOSE Mesothelioma is an incurable, asbestos related cancer with a poor prognosis. Little is known about how patients and carers living with the condition manage their mental health and wellbeing needs. This paper reports findings on interventions being used by patients and informal carers living with mesothelioma and those which they find most helpful. METHODS In-depth interviews with patients (n = 10) and (informal) carers (n = 11) living with mesothelioma in the UK. We analysed our data inductively using a reflexive thematic analysis approach. RESULTS Participants described the importance of both smaller and larger actions and strategies which helped with their mental health. This included spending more time with family and friends and going on holidays. Professionals who participants said supported their mental health journey included not only specialist nurses and mental health professionals but also legal and Asbestos Support Group professionals. The latter demonstrates the unique needs and support required for this population. Exposure to asbestos as the cause of mesothelioma, has led to a social justice aspect of the experience of living with this cancer. Participants reported the importance of collective action to their mental health and wellbeing. The data indicate that patients and carers may have distinct mental health and wellbeing requirements and need to manage these in different ways at different times. CONCLUSIONS Findings have implications for nurses and other key professionals working in healthcare, community and legal settings supporting this client group, and for those living with mesothelioma who want to understand ways to enhance their own wellbeing.
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Affiliation(s)
- Stephanie Ejegi-Memeh
- Mesothelioma UK Research Centre, School of Allied Health Professions, Nursing and Midwifery, University of Sheffield, UK.
| | - Virginia Sherborne
- Mesothelioma UK Research Centre, School of Allied Health Professions, Nursing and Midwifery, University of Sheffield, UK
| | - Catriona Mayland
- Division of Clinical Medicine, School of Medicine & Population Health, UK
| | - Angela Tod
- Mesothelioma UK Research Centre, School of Allied Health Professions, Nursing and Midwifery, University of Sheffield, UK
| | - Bethany H Taylor
- Mesothelioma UK Research Centre, School of Allied Health Professions, Nursing and Midwifery, University of Sheffield, UK
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5
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Marcu A, McGregor F, Egan B, Hill K, Cook T, Arber A. Developing sustainable patient and public involvement in mesothelioma research: multi-method exploration with researchers, patients, carers, and patient organisations. RESEARCH INVOLVEMENT AND ENGAGEMENT 2023; 9:15. [PMID: 36966347 PMCID: PMC10039679 DOI: 10.1186/s40900-023-00426-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 03/14/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Rare diseases where prognosis is poor provide limited scope for patient and public involvement (PPI). One such disease is mesothelioma, a cancer of the lung pleura or of the peritoneum caused by exposure to asbestos, where PPI is poorly documented. We undertook to explore how PPI could be facilitated in mesothelioma research. METHODS An online survey with mesothelioma researchers (n = 23) assessed the perceived benefits and challenges of PPI in mesothelioma. Six online workshops and thirteen in-depth interviews with patients and the public explored their views on how PPI could be increased in mesothelioma and their motivations to become PPI representatives in the future. The survey data were analysed using descriptive statistics and the interviews, using Thematic Analysis. RESULTS In the survey, 26% (n = 6) of the researchers did not include PPI in their research, while 74% (n = 17) did, finding it most beneficial at the stages of applying for funding and dissemination. The main perceived benefits of PPI were clarifying the research question and outcome measures, making research more credible and relevant to patients' needs, and increasing its impact. The main perceived challenges to PPI were the general poor prognosis in mesothelioma, and funding timescales which hindered timely recruitment of PPI representatives. The analysis of the interviews with the patients and public revealed three main themes: "Motivations to become a PPI representative in the future", "Understanding the nature of PPI during the project", and "Perceived challenges to PPI in mesothelioma". Altruism and the need for hope were the main reasons to wish to become involved in PPI in the future. For many participants, the project proved to be a journey of understanding the nature of PPI, a concept that was not easy to grasp from the start. The participants perceived certain barriers to PPI such as high symptom burden in mesothelioma, the abstract concept of PPI, and the use of scientific language. CONCLUSIONS The present research provides a detailed picture of the benefits and challenges of PPI in mesothelioma. We recommend long-term engagement with mesothelioma support groups so that researchers achieve meaningful and sustainable PPI in mesothelioma research.
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Affiliation(s)
- Afrodita Marcu
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, GU2 7YH, UK.
| | - Fiona McGregor
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, GU2 7YH, UK
| | - Bernadette Egan
- School of Biosciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Kate Hill
- School of Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | | | - Anne Arber
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, GU2 7YH, UK
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Taylor B, Tod A, Gardiner C, Ejegi-Memeh S, Harrison M, Sherborne V, Couchman E, Senek M, Bachas Brook H, Ross J, Zhang X. Mesothelioma patient and carer experience research: A research prioritisation exercise. Eur J Oncol Nurs 2023; 63:102281. [PMID: 36905742 DOI: 10.1016/j.ejon.2023.102281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 01/27/2023] [Accepted: 02/09/2023] [Indexed: 02/12/2023]
Abstract
OBJECTIVES Incidence of mesothelioma worldwide is growing and the UK reports the highest global incidence. Mesothelioma is an incurable cancer with a high symptom burden. However, it is under researched when compared to other cancers. The aim of this exercise was to identify unanswered questions about the mesothelioma patient and carer experience in the UK and to prioritise research areas of most importance through consultation with patients, carers and professionals. MATERIALS AND METHODS A virtual Research Prioritisation Exercise was conducted. This involved a review of mesothelioma patient and carer experience literature to identify research gaps and a national online survey to identify and rank research gaps. Following this, a modified consensus method with mesothelioma experts (patients, carers and professionals from healthcare, legal, academic and volunteer organisations) was undertaken to reach a consensus regarding mesothelioma patient and carer experience research priorities. RESULTS Survey responses were received from 150 patients, carers and professionals and 29 research priorities were identified. During consensus meetings, 16 experts refined these into a list of 11 key priorities. The five most urgent priorities were symptom management, receiving a mesothelioma diagnosis, palliative and end of life care, treatment experiences, barriers and facilitators to joined up service provision. CONCLUSION This novel priority setting exercise will shape the national research agenda, contribute knowledge to inform nursing and wider clinical practice and ultimately improve the experiences of mesothelioma patients and carers.
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Affiliation(s)
- Bethany Taylor
- Mesothelioma UK Research Centre, University of Sheffield, UK.
| | - Angela Tod
- Mesothelioma UK Research Centre, University of Sheffield, UK
| | - Clare Gardiner
- Mesothelioma UK Research Centre, University of Sheffield, UK
| | | | | | | | - Emilie Couchman
- Mesothelioma UK Research Centre, University of Sheffield, UK
| | - Michaela Senek
- Mesothelioma UK Research Centre, University of Sheffield, UK
| | | | - Jennifer Ross
- Mesothelioma UK Research Centre, University of Sheffield, UK
| | - Xueming Zhang
- Mesothelioma UK Research Centre, University of Sheffield, UK
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Magnani C, Mensi C, Binazzi A, Marsili D, Grosso F, Ramos-Bonilla JP, Ferrante D, Migliore E, Mirabelli D, Terracini B, Consonni D, Degiovanni D, Lia M, Cely-García MF, Giraldo M, Lysaniuk B, Comba P, Marinaccio A. The Italian Experience in the Development of Mesothelioma Registries: A Pathway for Other Countries to Address the Negative Legacy of Asbestos. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20020936. [PMID: 36673690 PMCID: PMC9858856 DOI: 10.3390/ijerph20020936] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 12/30/2022] [Accepted: 01/01/2023] [Indexed: 06/12/2023]
Abstract
Asbestos (all forms, including chrysotile, crocidolite, amosite, tremolite, actinolite, and anthophyllite) is carcinogenic to humans and causally associated with mesothelioma and cancer of the lung, larynx, and ovary. It is one of the carcinogens most diffuse in the world, in workplaces, but also in the environment and is responsible for a very high global cancer burden. A large number of countries, mostly with high-income economies, has banned the use of asbestos which, however, is still widespread in low- and middle-income countries. It remains, thus, one of the most common occupational and environmental carcinogens worldwide. Italy issued an asbestos ban in 1992, following the dramatic observation of a large increase in mortality from mesothelioma and other asbestos-related diseases in exposed workers and also in subjects with non-occupational exposure. A mesothelioma registry was also organized and still monitors the occurrence of mesothelioma cases, conducting a case-by-case evaluation of asbestos exposure. In this report, we describe two Italian communities, Casale Monferrato and Broni, that faced an epidemic of mesothelioma resulting from the production of asbestos cement and the diffuse environmental exposure; we present the activity and results of the Italian mesothelioma registry (ReNaM), describe the risk-communication activities at the local and national level with a focus on international cooperation and also describe the interaction between mesothelioma registration and medical services specialized in mesothelioma diagnosis and treatment in an area at high risk of mesothelioma. Finally, we assess the potential application of the solutions and methods already developed in Italy in a city in Colombia with high mesothelioma incidence associated with the production of asbestos-cement materials and the presence of diffuse environmental asbestos pollution.
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Affiliation(s)
- Corrado Magnani
- Department of Translational Medicine, University of Eastern Piedmont, 28100 Novara, Italy
- Collegium Ramazzini, Bentivoglio, 40010 Modena, Italy
| | - Carolina Mensi
- Occupational Health Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Alessandra Binazzi
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers’ Compensation Authority, 00143 Rome, Italy
| | - Daniela Marsili
- Department of Environment and Health, Istituto Superiore di Sanità, ISS (Italian National Institute of Health), 00161 Rome, Italy
| | - Federica Grosso
- Mesothelioma Unit, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
| | - Juan Pablo Ramos-Bonilla
- Collegium Ramazzini, Bentivoglio, 40010 Modena, Italy
- Departamento de Ingeniería Civil y Ambiental, Universidad de Los Andes, Bogotá 111711, Colombia
| | - Daniela Ferrante
- Department of Translational Medicine, University of Eastern Piedmont, 28100 Novara, Italy
| | - Enrica Migliore
- Unit of Cancer Epidemiology, Regional Operating Center of Piemonte (COR Piemonte), University of Torino and CPO-Piemonte, 10126 Torin, Italy
| | - Dario Mirabelli
- Unit of Cancer Epidemiology, Regional Operating Center of Piemonte (COR Piemonte), University of Torino and CPO-Piemonte, 10126 Torin, Italy
| | - Benedetto Terracini
- Collegium Ramazzini, Bentivoglio, 40010 Modena, Italy
- Unit of Cancer Epidemiology, Regional Operating Center of Piemonte (COR Piemonte), University of Torino and CPO-Piemonte, 10126 Torin, Italy
| | - Dario Consonni
- Occupational Health Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | | | - Michela Lia
- Mesothelioma Unit, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
| | | | - Margarita Giraldo
- Departamento de Ingeniería Civil y Ambiental, Universidad de Los Andes, Bogotá 111711, Colombia
| | | | - Pietro Comba
- Collegium Ramazzini, Bentivoglio, 40010 Modena, Italy
| | - Alessandro Marinaccio
- Collegium Ramazzini, Bentivoglio, 40010 Modena, Italy
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers’ Compensation Authority, 00143 Rome, Italy
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Guglielmucci F, Bonafede M, Azzolina D, Marinaccio A, Franzoi IG, Migliore E, Mensi C, Chellini E, Romeo E, Grosso F, Granieri A. Preliminary validation of a brief PROM assessing psychological distress in patients with malignant mesothelioma: The mesothelioma psychological distress tool-Patients. Front Psychol 2022; 13:974982. [PMID: 36506969 PMCID: PMC9732528 DOI: 10.3389/fpsyg.2022.974982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 11/09/2022] [Indexed: 11/27/2022] Open
Abstract
Objective Psychological suffering in malignant mesothelioma (MM) differs from that in other cancers because of its occupational etiology, and we aimed to develop specific patient-reported outcome measures to assess it. Methods We used a multi-method prospective observational multicentric study (N = 149), and a preliminary questionnaire validation was performed through a Bayesian approach. Results Item analysis showed a good internal consistency and reliability (Cronbach alpha = 0.79 [95% CI = 0.74-0.93]. Twenty of the 41 initial items were selected as posterior 95% highest density interval factor loading standardized effect size fell outside of the region of practical equivalence. Bayesian exploratory factor analysis showed a two-factor structure: (1) Trauma-related reactions (TR, 13 items) and (2) Claim for justice (CJ, 7 items), confirmed by the Bayesian confirmatory factor analysis. Latent factors were poorly correlated (Posterior median: 0.13; 95% CI = -0.079 to 0.323). The 90% root mean square error of approximation posterior median was 0.04 [90% CI = 0.03-0.58]; the 90% chi-square posterior median was 242 [90% CI = 209-287]. Conclusion Psychological suffering in MM patients implies negative cognitive, emotional, and somatic reactions related to the traumatic impact of the disease and the need to obtain justice through economic compensation. Our findings provide preliminary evidence that the Mesothelioma Psychological Distress Tool-Patients could be a promising and reliable instrument to assess MM patients' psychological distress.
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Affiliation(s)
- Fanny Guglielmucci
- Department of Philosophy, Communication and Performing Arts, University of Roma Tre, Rome, Italy
| | - Michela Bonafede
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers’ Compensation Authority (INAIL), Rome, Italy,*Correspondence: Michela Bonafede,
| | - Danila Azzolina
- Department of Environmental and Preventive Sciences, University of Ferrara, Ferrara, Italy
| | - Alessandro Marinaccio
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers’ Compensation Authority (INAIL), Rome, Italy
| | | | - Enrica Migliore
- COR Piedmont, Unit of Cancer Epidemiology, University of Turin and CPO-Piedmont, Turin, Italy
| | - Carolina Mensi
- COR Lombardy, Epidemiology Unit, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico and University of Milan, Milan, Italy
| | - Elisabetta Chellini
- COR Tuscany, Cancer Prevention and Research Institute, Unit of Environmental and Occupational Epidemiology, Florence, Italy
| | - Elisa Romeo
- COR Lazio, Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - Federica Grosso
- Mesothelioma Unit, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
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9
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Breen LJ, Huseini T, Same A, Peddle-McIntyre CJ, Lee YCG. Living with mesothelioma: A systematic review of patient and caregiver psychosocial support needs. PATIENT EDUCATION AND COUNSELING 2022; 105:1904-1916. [PMID: 35260259 DOI: 10.1016/j.pec.2022.02.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 02/24/2022] [Accepted: 02/26/2022] [Indexed: 05/10/2023]
Abstract
OBJECTIVE Practice guidelines emphasize the importance of investigating psychosocial distress in mesothelioma patients and family caregivers. We aimed to synthesize research on the psychosocial support needs of mesothelioma patients and their family caregivers. METHODS We conducted a systematic review with a narrative synthesis and quality assessment. The review process adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS MEDLINE, EMBASE, Scopus, PsychArticles, and PsycINFO were searched until December 2020 and 37 studies in English met inclusion criteria. Most (n = 24) included mesothelioma patients as a very small proportion of their cancer samples. A narrative synthesis was conducted on the 13 studies including only mesothelioma patients (n = 297) and/or caregivers (n = 82). Patients and caregivers want improvements in the diagnosis delivery and access to palliative care. Patients want emotional support, patient-centered treatment, improved information about illness progression and death, and to meet others with mesothelioma. Caregivers want one-on-one practical and emotional support. Study quality varied. CONCLUSIONS Few studies focus on the psychosocial support needs relevant to mesothelioma. Mesothelioma patients and family caregivers highlight targeted psychosocial care as an unmet need. PRACTICE IMPLICATIONS Efforts are required to design and test psychosocial interventions for this vulnerable and overlooked group. PROTOCOL REGISTRATION PROSPERO (registration number CRD42020167852).
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Affiliation(s)
- Lauren J Breen
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia; Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia.
| | - Taha Huseini
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia; Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Anne Same
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Carolyn J Peddle-McIntyre
- Exercise Medicine Research Institute, Edith Cowan University, Perth, Western Australia, Australia; School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
| | - Y C Gary Lee
- Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia; Centre for Respiratory Health, University of Western Australia, Perth, Western Australia, Australia
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10
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Ejegi-Memeh S, Sherborne V, Harrison M, Taylor B, Senek M, Tod A, Gardiner C. Patients' and informal carers' experience of living with mesothelioma: A systematic rapid review and synthesis of the literature. Eur J Oncol Nurs 2022; 58:102122. [PMID: 35339776 DOI: 10.1016/j.ejon.2022.102122] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 03/08/2022] [Accepted: 03/12/2022] [Indexed: 12/21/2022]
Abstract
PURPOSE Mesothelioma is a rare and incurable cancer linked to asbestos exposure. It primarily affects the pleura. This systematic rapid review aimed to identify what is known about the experience of living with mesothelioma, from the perspective of patients and their informal carers. METHODS Medline, PsycInfo, Scopus and the Cumulative Index to Nursing and Allied Health Literature were searched for empirical studies published between December 2008 and October 2020. Google Scholar was searched. The inclusion criteria stated that studies were peer-reviewed, reported the experience of living with mesothelioma from the perspective of patients and carers and written in English. The Mixed-Methods Appraisal Tool was used to assess quality. The review protocol is registered on PROSPERO: CRD42020204726. RESULTS Twenty-five studies met the inclusion criteria. Following data extraction, a narrative synthesis identified three themes: the impact on the individual; the impact on informal carers and relationships; and interactions with professionals and systems. The physical and psychological symptom burden of mesothelioma on patients' lives was reported as high. Both the qualitative and quantitative literature highlighted that patients and carers may have different needs throughout the mesothelioma journey. Differences included psychological experiences and preferences regarding the timing of information and support provision. Patients and carers expected their health care professionals to be knowledgeable about mesothelioma or refer to those who were. Health care professionals that were compassionate, honest and supportive also positively influenced the experience of patients and carers living with mesothelioma. A lack of communication or misinformation was damaging to the patient-healthcare professional relationship. Continuity of care, coordinated care and good communication between treatment centres were widely reported as important in the literature. Fragmented care was identified as detrimental to the patient experience, increasing anxiety in patients. However, relationships with professionals were not only important in terms of co-ordinating care. There was also evidence that good relationships with healthcare professionals were beneficial to coping with the mesothelioma diagnosis. CONCLUSION The volume of mesothelioma experience research has grown over the past decade. This has led to our growing understanding of the complex needs and experiences of mesothelioma patients and carers. However, this review identified several evidence gaps.
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Affiliation(s)
- Stephanie Ejegi-Memeh
- University of Sheffield, Division of Nursing and Midwifery, Health Sciences School, Barber House, 3 Clarkehouse Road, Sheffield, S10 2LA, United Kingdom.
| | - Virginia Sherborne
- University of Sheffield, Division of Nursing and Midwifery, Health Sciences School, Barber House, 3 Clarkehouse Road, Sheffield, S10 2LA, United Kingdom.
| | - Madeleine Harrison
- University of Sheffield, Division of Nursing and Midwifery, Health Sciences School, Barber House, 3 Clarkehouse Road, Sheffield, S10 2LA, United Kingdom.
| | - Bethany Taylor
- University of Sheffield, Division of Nursing and Midwifery, Health Sciences School, Barber House, 3 Clarkehouse Road, Sheffield, S10 2LA, United Kingdom.
| | - Michaela Senek
- University of Sheffield, Division of Nursing and Midwifery, Health Sciences School, Barber House, 3 Clarkehouse Road, Sheffield, S10 2LA, United Kingdom.
| | - Angela Tod
- University of Sheffield, Division of Nursing and Midwifery, Health Sciences School, Barber House, 3 Clarkehouse Road, Sheffield, S10 2LA, United Kingdom.
| | - Clare Gardiner
- University of Sheffield, Division of Nursing and Midwifery, Health Sciences School, Barber House, 3 Clarkehouse Road, Sheffield, S10 2LA, United Kingdom.
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11
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Mangone L, Mancuso P, Bisceglia I, Giorgi Rossi P, Chellini E, Negro C, Benfatto L, Migliore E, Casotto V, Mensi C, Romanelli A, Tumino R, Grappasonni I, Cavone D, Mazzoleni G, Tallarigo F, Marinaccio A. The impact of COVID-19 on new mesothelioma diagnoses in Italy. Thorac Cancer 2022; 13:702-707. [PMID: 35076994 PMCID: PMC8888152 DOI: 10.1111/1759-7714.14296] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 12/09/2021] [Accepted: 12/11/2021] [Indexed: 12/02/2022] Open
Abstract
Background The aim of this work was to evaluate the impact of the restrictions put in place to control the COVID‐19 pandemic on new diagnoses of malignant mesothelioma (MM) in Italy. Methods Twelve of the 21 Italian malignant mesothelioma CORs (regional operating centres) participated. The study included all cases of MM with microscopic confirmation; cases without microscopic confirmation and death certificate only (DCO) were excluded. For each case, information on sex, date of birth, tumor site, morphology, and date of diagnosis was retrieved. We compared the number of incident cases in 2020 with 2019, looking at the overall picture and for four periods: pre‐pandemic (January–February), first wave (March–May), low incidence (June–September), and second wave (October–December). Results A total of 604 cases were registered: 307 in 2019 and 297 in 2020. In the 2020 pre‐pandemic period, the incidence was higher than in the same months in 2019 (+45%); there was no significant change during the first wave (+1%) or in the low‐incidence period (−3%), while a decrease was observed during the second wave (−32%). However, the data were not homogeneous across the country: the increase in the pre‐pandemic period concerned mostly the regions of northern (+61.5%) and central Italy (+43.5%); during the first wave, MM diagnoses increased in the northern (+38.5%) and central (+11.4%) regions but decreased in the southern regions (−52.9%). All these differences are compatible with random fluctuations. Conclusion The COVID‐19 pandemic had little or no impact on new MM diagnoses, and variations were not homogeneous throughout the country.
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Affiliation(s)
- Lucia Mangone
- Reggio Emilia Cancer Registry, Epidemiology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy.,COR Emilia-Romagna, Epidemiology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Pamela Mancuso
- Reggio Emilia Cancer Registry, Epidemiology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Isabella Bisceglia
- Reggio Emilia Cancer Registry, Epidemiology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Paolo Giorgi Rossi
- Reggio Emilia Cancer Registry, Epidemiology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Elisabetta Chellini
- COR Toscana, Unit of Occupational & Environmental Epidemiology, Institute for Cancer Research, Prevention and Clinical Network, Firenze, Italy
| | - Corrado Negro
- COR Friuli Venezia Giulia, Azienda Ospedaliero-Universitaria "Ospedali Riuniti di Trieste" Struttura Complessa Medicina del Lavoro, Trieste, Italy
| | - Lucia Benfatto
- COR Liguria, Epidemiologia Clinica, Istituto Nazionale per la Ricerca sul Cancro (IST-Nord), Dipartimento Terapie Oncologiche Integrate e IRCCS Azienda Ospedaliera Universitaria San Martino, Genoa, Italy
| | - Enrica Migliore
- COR Piemonte, Unità di Epidemiologia dei Tumori Città della salute e della scienza di Torino, Torino, Italy
| | - Veronica Casotto
- COR Veneto, Epidemiological Department, Azienda Zero, Veneto Region, Padova, Italy
| | - Carolina Mensi
- COR Lombardia, Occupational Health Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Antonio Romanelli
- COR Emilia-Romagna, Epidemiology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Rosario Tumino
- COR Sicilia, Cancer Registry and Histopathology Department, Provincial Health Authority (ASP 7), Ragusa, Italy
| | - Iolanda Grappasonni
- COR Marche, School of Medicinal and Health Products Sciences, University of Camerino, Camerino, Italy
| | - Domenica Cavone
- COR Puglia, Interdisciplinary Department of Medicine, Section Occupational Medicine B. Ramazzini, School of Medicine, University Aldo Moro Bari, Bari, Italy
| | - Guido Mazzoleni
- COR Alto-Adige, Health Trust South Tyrol, South Tyrol, Italy
| | - Federico Tallarigo
- COR Calabria, c/o UOC Anatomia Patologica PO San Giovanni di Dio, ASP, Crotone, Italy
| | - Alessandro Marinaccio
- RENAM, INAIL (Italian Workers' Compensation Authority), Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Occupational and Environmental Epidemiology Unit, Rome, Italy
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12
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Binazzi A, Di Marzio D, Verardo M, Migliore E, Benfatto L, Malacarne D, Mensi C, Consonni D, Eccher S, Mazzoleni G, Comiati V, Negro C, Romanelli A, Chellini E, Angelini A, Grappasonni I, Madeo G, Romeo E, Di Giammarco A, Carrozza F, Angelillo IF, Cavone D, Vimercati L, Labianca M, Tallarigo F, Tumino R, Melis M, Bonafede M, Scarselli A, Marinaccio A. Asbestos Exposure and Malignant Mesothelioma in Construction Workers-Epidemiological Remarks by the Italian National Mesothelioma Registry (ReNaM). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:ijerph19010235. [PMID: 35010496 PMCID: PMC8744912 DOI: 10.3390/ijerph19010235] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 12/14/2021] [Accepted: 12/21/2021] [Indexed: 12/20/2022]
Abstract
Notwithstanding the ban in 1992, asbestos exposure for workers in the construction sector in Italy remains a concern. The purpose of this study is to describe the characteristics of malignant mesothelioma (MM) cases recorded by the Italian registry (ReNaM) among construction workers. Incident mesothelioma cases with a definite asbestos exposure have been analyzed. Characteristics of cases and territorial clusters of crude rates of MM in construction workers have been described, as well as the relation between asbestos use before the ban and the historical trend of workforce in the construction sector in Italy. ReNaM has collected 31,572 incident MM cases in the period from 1993 to 2018 and asbestos exposure has been assessed for 24,864 (78.2%) cases. An occupational exposure has been reported for 17,191 MM cases (69.1% of subjects with a definite asbestos exposure). Among them, 3574 had worked in the construction sector, with an increasing trend from 15.8% in the 1993–98 period to 23.9% in 2014–2018 and a ubiquitous territorial distribution. The large use of asbestos in construction sector before the ban makes probability of exposure for workers a real concern still today, particularly for those working in maintenance and removal of old buildings. There is a clear need to assess, inform, and prevent asbestos exposure in this sector.
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Affiliation(s)
- Alessandra Binazzi
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Istituto Nazionale per l’Assicurazione Contro gli Infortuni sul Lavoro, 00143 Roma, Italy; (A.B.); (D.D.M.); (M.B.); (A.S.)
| | - Davide Di Marzio
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Istituto Nazionale per l’Assicurazione Contro gli Infortuni sul Lavoro, 00143 Roma, Italy; (A.B.); (D.D.M.); (M.B.); (A.S.)
| | - Marina Verardo
- Valle d’Aosta Health Local Unit, Regional Operating Center of Valle d’Aosta (COR Valle d’Aosta), 11100 Aosta, Italy;
| | - Enrica Migliore
- Unit of Cancer Epidemiology, Regional Operating Center of Piemonte (COR Piemonte), University of Torino and CPO-Piemonte, 10124 Torino, Italy;
| | - Lucia Benfatto
- Regional Operating Center of Liguria (COR Liguria), UO Clinical Epidemiology, IRCCS AOU Policlinico San Martino, 16132 Genova, Italy; (L.B.); (D.M.)
| | - Davide Malacarne
- Regional Operating Center of Liguria (COR Liguria), UO Clinical Epidemiology, IRCCS AOU Policlinico San Martino, 16132 Genova, Italy; (L.B.); (D.M.)
| | - Carolina Mensi
- Epidemiology Unit, Regional Operating Center of Lombardia (COR Lombardia), Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy; (C.M.); (D.C.)
| | - Dario Consonni
- Epidemiology Unit, Regional Operating Center of Lombardia (COR Lombardia), Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy; (C.M.); (D.C.)
| | - Silvia Eccher
- Hygiene and Occupational Medicine, Provincial Unit of Health, Regional Operating Center of Autonomous Province of Trento (COR A.P. of Trento), 38100 Trento, Italy;
| | - Guido Mazzoleni
- Occupational Medicine Unit, Alto Adige Health Authority, Regional Operating Center of Autonomous Province of Bolzano (COR A.P. of Bolzano), 39100 Bolzano, Italy;
| | - Vera Comiati
- Azienda Zero, Epidemiological Department, Regional Operating Center of Veneto (COR Veneto), Veneto Region, 35131 Padova, Italy;
| | - Corrado Negro
- Clinical Unit of Occupational Medicine, Regional Operating Center of Friuli-Venezia Giulia (COR Friuli-Venezia Giulia), University of Trieste-Trieste General Hospitals, 34123 Trieste, Italy;
| | - Antonio Romanelli
- Health Local Unit, Public Health Department, Regional Operating Center of Emilia-Romagna (COR Emilia-Romagna), 42020 Reggio Emilia, Italy;
| | - Elisabetta Chellini
- Prevention and Clinical Network, Institute for Cancer Research, Regional Operating Center of Toscana (COR Toscana), 50139 Firenze, Italy; (E.C.); (A.A.)
| | - Alessia Angelini
- Prevention and Clinical Network, Institute for Cancer Research, Regional Operating Center of Toscana (COR Toscana), 50139 Firenze, Italy; (E.C.); (A.A.)
| | - Iolanda Grappasonni
- Regional Operating Center of Marche (COR Marche), School of Medicinal and Health Products Sciences, University of Camerino, 62032 Camerino, Italy;
| | - Gabriella Madeo
- Regional Operating Center of Umbria (COR Umbria), Servizio Prevenzione, Sanità Veterinaria e Sicurezza Alimentare-Regione Umbria, 06126 Perugia, Italy;
| | - Elisa Romeo
- Regional Operating Center of Lazio (COR Lazio), Department of Epidemiology, Lazio Region, 00143 Roma, Italy;
| | - Annamaria Di Giammarco
- Occupational Medicine Unit, Health Local Unit, Regional Operating Center of Abruzzo (COR Abruzzo), 65121 Pescara, Italy; or
| | - Francesco Carrozza
- Oncology Unit, Cardarelli Hospital, Regional Operating Center of Molise (COR Molise), 86100 Campobasso, Italy;
| | - Italo F. Angelillo
- Department of Experimental Medicine, “Luigi Vanvitelli” University, Regional Operating Center of Campania (COR Campania), 80138 Napoli, Italy; or
| | - Domenica Cavone
- Section of Occupational Medicine ‘‘B.Ramazzini’’, Department of Interdisciplinary Medicine, Regional Operating Center of Puglia (COR Puglia), University of Bari, 70125 Bari, Italy; (D.C.); (L.V.)
| | - Luigi Vimercati
- Section of Occupational Medicine ‘‘B.Ramazzini’’, Department of Interdisciplinary Medicine, Regional Operating Center of Puglia (COR Puglia), University of Bari, 70125 Bari, Italy; (D.C.); (L.V.)
| | - Michele Labianca
- Epidemiologic Regional Center, Regional Operating Center of Basilicata (COR Basilicata), 85100 Potenza, Italy;
| | - Federico Tallarigo
- Public Health Unit, Regional Operating Center of Calabria (COR Calabria), 88900 Crotone, Italy;
| | - Rosario Tumino
- Cancer Registry ASP Ragusa and Sicilia Regional Epidemiological Observatory, Regional Operating Center of Sicilia (COR Sicilia), 97100 Ragusa, Italy;
| | - Massimo Melis
- Regional Epidemiological Center, Regional Operating Center of Sardegna (COR Sardegna), 09125 Cagliari, Italy;
| | - Michela Bonafede
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Istituto Nazionale per l’Assicurazione Contro gli Infortuni sul Lavoro, 00143 Roma, Italy; (A.B.); (D.D.M.); (M.B.); (A.S.)
| | - Alberto Scarselli
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Istituto Nazionale per l’Assicurazione Contro gli Infortuni sul Lavoro, 00143 Roma, Italy; (A.B.); (D.D.M.); (M.B.); (A.S.)
| | - Alessandro Marinaccio
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Istituto Nazionale per l’Assicurazione Contro gli Infortuni sul Lavoro, 00143 Roma, Italy; (A.B.); (D.D.M.); (M.B.); (A.S.)
- Correspondence: ; Tel.: +39-0654872621
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13
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Bonafede M, Chiorri C, Azzolina D, Marinaccio A, Migliore E, Mensi C, Chellini E, Romeo E, Grosso F, Franzoi IG, Granieri A, Guglielmucci F. Preliminary validation of a questionnaire assessing psychological distress in caregivers of patients with malignant mesothelioma: Mesothelioma Psychological Distress Tool-Caregivers. Psychooncology 2021; 31:122-129. [PMID: 34406682 DOI: 10.1002/pon.5789] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 08/04/2021] [Accepted: 08/11/2021] [Indexed: 01/12/2023]
Abstract
OBJECTIVE To develop a short, flexible, and comprehensive tool to measure psychological distress in caregivers of malignant mesothelioma (MM) patients: the Mesothelioma Psychological Distress Tool-Caregivers version (MPDT-C). METHODS Based on a systematic review of the relevant literature, aspects associated with caregiver distress were derived. Expert researchers/clinicians developed a pool of items for each identified aspect. Content validity was assessed through a multiple mixed-methods approach. A multicenter study was conducted to explore the factorial structure of the 47-item MPDT-C through Bayesian factor analysis. RESULTS The Bayesian exploratory factor analysis revealed an underlying three-factor structure. Factors were labeled Secondary Traumatic Stress, Engagement in Caring, and Meaningful Cognitive Restructuring. All scales showed sufficient reliability and corrected item-total correlations. Females scored higher than males for Engagement in Caring. CONCLUSIONS Taking care of malignant mesothelioma patients is a stressful process that influences the caregiver's physical, emotional, and social wellbeing. Our study offers preliminary evidence in support of the adequate psychometric properties of the MPDT-C, and these should now be replicated. Results suggest that the MPDT-C is a reliable tool with which to detect the psychological distress of this traumatized population.
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Affiliation(s)
- Michela Bonafede
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers' Compensation Authority (INAIL), Rome, Italy
| | - Carlo Chiorri
- Department of Educational Sciences, University of Genoa, Genova, Italy
| | - Danila Azzolina
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Alessandro Marinaccio
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers' Compensation Authority (INAIL), Rome, Italy
| | - Enrica Migliore
- COR Piedmont, Unit of Cancer Epidemiology, CPO Piedmont, University of Turin, Turin, Italy
| | - Carolina Mensi
- COR Lombardy, Epidemiology Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico and University of Milan, Milano, Italy
| | - Elisabetta Chellini
- COR Tuscany, Cancer Prevention and Research Institute, Unit of Environmental and Occupational Epidemiology, Firenze, Italy
| | - Elisa Romeo
- COR Lazio, Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - Federica Grosso
- Mesothelioma Unit, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
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14
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Prusak A, van der Zwan JM, Aarts MJ, Arber A, Cornelissen R, Burgers S, Duijts SFA. The psychosocial impact of living with mesothelioma: Experiences and needs of patients and their carers regarding supportive care. Eur J Cancer Care (Engl) 2021; 30:e13498. [PMID: 34339095 DOI: 10.1111/ecc.13498] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 06/30/2021] [Accepted: 07/13/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Mesothelioma is a rare cancer with a poor prognosis caused by exposure to asbestos. Psychosocial support and care for mesothelioma patients and their carers is limited and not tailored to their specific needs. The aim of this study was to explore patients' and carers' needs and experiences regarding psychosocial support and their coping mechanisms dealing with psychosocial problems. METHODS A qualitative study was performed using semi-structured interviews with both mesothelioma patients and their carers. Participants were recruited through two specialised hospitals and two patient organisations. All interviews were transcribed verbatim and thematically analysed. RESULTS Ten patients (70% male, mean age 67.7) and five carers (20% male, mean age 65) participated in the study. The main themes identified for patients were active coping, limited needs and limited knowledge and awareness about psychosocial support. The main themes for carers were passive coping and 'it's all about the patient'. CONCLUSION Mesothelioma patients do not seem to have high needs for psychosocial support, whereas carers do. However, knowledge about and awareness of psychosocial support is low among mesothelioma patients. The findings from this study should be used to adjust guidelines for psychosocial support in mesothelioma patients and their carers.
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Affiliation(s)
- Agata Prusak
- Department of Research & Development, Netherlands Comprehensive Cancer Organization (Integraal Kankercentrum Nederland, IKNL), Utrecht, The Netherlands
| | - Jan Maarten van der Zwan
- Department of Research & Development, Netherlands Comprehensive Cancer Organization (Integraal Kankercentrum Nederland, IKNL), Utrecht, The Netherlands
| | - Mieke J Aarts
- Department of Research & Development, Netherlands Comprehensive Cancer Organization (Integraal Kankercentrum Nederland, IKNL), Utrecht, The Netherlands
| | - Anne Arber
- School of Health and Social Care, University of Surrey, Guildford, UK
| | - Robin Cornelissen
- Department of Pulmonary Medicine, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Sjaak Burgers
- Department of Thoracic Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Saskia F A Duijts
- Department of Research & Development, Netherlands Comprehensive Cancer Organization (Integraal Kankercentrum Nederland, IKNL), Utrecht, The Netherlands.,Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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15
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Ejegi-Memeh S, Robertson S, Taylor B, Darlison L, Tod A. Gender and the experiences of living with mesothelioma: A thematic analysis. Eur J Oncol Nurs 2021; 52:101966. [PMID: 33945895 DOI: 10.1016/j.ejon.2021.101966] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 03/31/2021] [Accepted: 04/14/2021] [Indexed: 01/10/2023]
Abstract
PURPOSE Mesothelioma is a terminal cancer caused by exposure to asbestos. As a cancer with a higher rate in men than women, women's experiences of living with mesothelioma are often underexplored. Furthermore, men's experiences are often taken for granted and therefore have remained underexplored. This paper considers men's and women's experiences across the mesothelioma pathway. METHODS This qualitative study incorporated semi-structured interviews with 13 men and 11 women living with mesothelioma. Telephone interviews took place between July and December 2019, and were audio recorded, transcribed and anonymised. Thematic analysis was used to analyse the data. RESULTS Three themes were developed in relation to the gendered experience of mesothelioma: familial responsibility and social perceptions; support preferences; and treatment and trials. Analysis suggests that men and women's sense of familial responsibility varied. Differences in priorities and motivations influenced approaches to seeking support, compensation and, making decisions around treatments and clinical trials. CONCLUSIONS The current study reports on how gender can influence the experience of living with mesothelioma. The findings indicate how the patients' role in their families and society can more broadly influence their experiences, choices and preferences. Nurses caring for mesothelioma patients need high quality research on which to base their practice. Recognition and an understanding of the underlyingfactors influencing patients' decision-making will enable nurses and other professionals to support their patients better.
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Affiliation(s)
- Stephanie Ejegi-Memeh
- Division of Nursing and Midwifery, Health Sciences School, University of Sheffield, Sheffield, United Kingdom.
| | - Steve Robertson
- Division of Nursing and Midwifery, Health Sciences School, University of Sheffield, Sheffield, United Kingdom
| | - Bethany Taylor
- Division of Nursing and Midwifery, Health Sciences School, University of Sheffield, Sheffield, United Kingdom
| | - Liz Darlison
- University Hospitals of Leicester, The Glenfield Hospital, Leicester, United Kingdom
| | - Angela Tod
- Division of Nursing and Midwifery, Health Sciences School, University of Sheffield, Sheffield, United Kingdom
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16
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Granieri A, Bonafede M, Marinaccio A, Iavarone I, Marsili D, Franzoi IG. SARS-CoV-2 and Asbestos Exposure: Can Our Experience With Mesothelioma Patients Help Us Understand the Psychological Consequences of COVID-19 and Develop Interventions? Front Psychol 2020; 11:584320. [PMID: 33414743 PMCID: PMC7782241 DOI: 10.3389/fpsyg.2020.584320] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 11/20/2020] [Indexed: 12/11/2022] Open
Abstract
Since its emergence, the novel coronavirus disease of 2019 (COVID-19) has had enormous physical, social, and psychological impacts worldwide. The aim of this article was to identify elements of our knowledge on asbestos exposure and malignant mesothelioma (MM) that can provide insight into the psychological impact of the COVID-19 pandemic and be used to develop adequate interventions. Although the etiology of Covid-19 and MM differs, their psychological impacts have common characteristics: in both diseases, there is a feeling of being exposed through aerial contagion to an "invisible killer" without boundaries that can strike even the strongest individuals. In both cases, affected persons can experience personality dysfunction, anxiety, depression, and posttraumatic symptoms; helplessness, hopelessness, and projection of destructive thoughts onto external forces often emerge, while defense mechanisms such as denial, splitting, repression, and reduced emotional expression are used by individuals to contain their overwhelming anxieties. We believe that in both diseases, an integrated multidimensional intervention offered by hospitals and other public health services is the most effective approach to alleviating patients' and caregivers' psychological distress. In particular, we emphasize that in the context of both MM and COVID-19, Brief Psychoanalytic Group therapy can help patients and caregivers attribute meaning to the significant changes in their lives related to the experience of the disease and identify adaptive strategies and more realistic relational modalities to deal with what has happened to them. We also highlight the importance of developing a surveillance system that includes individual anamnestic evaluation of occupational risk factors for COVID-19 disease.
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Affiliation(s)
| | - Michela Bonafede
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers’ Compensation Authority (INAIL), Rome, Italy
| | - Alessandro Marinaccio
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers’ Compensation Authority (INAIL), Rome, Italy
| | - Ivano Iavarone
- Environmental and Social Epidemiology Unit, Department of Environment and Health, Istituto Superiore di Sanità, Rome, Italy
- WHO Collaborating Centre for Environmental Health in Contaminated Sites, Rome, Italy
| | - Daniela Marsili
- Environmental and Social Epidemiology Unit, Department of Environment and Health, Istituto Superiore di Sanità, Rome, Italy
- WHO Collaborating Centre for Environmental Health in Contaminated Sites, Rome, Italy
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Predictors of filing claims and receiving compensation in malignant mesothelioma patients. Health Policy 2020; 124:1032-1040. [DOI: 10.1016/j.healthpol.2020.06.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 04/11/2020] [Accepted: 06/04/2020] [Indexed: 11/21/2022]
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Sherborne V, Seymour J, Taylor B, Tod A. What are the psychological effects of mesothelioma on patients and their carers? A scoping review. Psychooncology 2020; 29:1464-1473. [PMID: 32596966 DOI: 10.1002/pon.5454] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 06/05/2020] [Accepted: 06/21/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Despite recent advances in research, malignant mesothelioma remains an incurable and devastating disease, typically bringing shock and emotional distress to patients and carers. Little research has addressed the psychological impact on either group. This scoping review examines the current state of evidence on the psychological effects of mesothelioma on patients and carers, and identifies areas for further research. METHODS We searched PubMed, PsychINFO, CINAHL, the Cochrane Library and Web of Science for English-language peer-reviewed research articles published 1981 to 2019 reporting studies focussing on the psychological effects of mesothelioma on patients and carers. Following data extraction and quality appraisal, reflexive thematic analysis was used to identify themes. RESULTS Seventeen articles met the inclusion criteria. Carers' experiences were generally amalgamated with patients'. Three themes were developed. The Passing of Time included the importance of timing of interventions; delays in the medical journey; awareness of different time-phases in mesothelioma; and uncertainty/certainty. Dealing with Difficult Feelings reflected ubiquitous negative emotions, feelings about identity and states of being and associated coping strategies. Craving Good Communication covered issues related to sharing of information and to positive/negative aspects of communication. CONCLUSIONS Though limited, the evidence indicates that mesothelioma, with its high symptom-burden, incurability, rarity and asbestos-related causation, leads to complex and inter-relating psychological effects on patients and carers. These effects are both negative and positive. The sparse literature gives a partial picture and demonstrates an urgent need for more nuanced research. Studies exploring the experiences of specific groups are recommended, with particular attention required to carers.
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Affiliation(s)
- Virginia Sherborne
- Division of Nursing and Midwifery, The University of Sheffield, Sheffield, UK
| | - Jane Seymour
- Division of Nursing and Midwifery, The University of Sheffield, Sheffield, UK
| | - Bethany Taylor
- Division of Nursing and Midwifery, The University of Sheffield, Sheffield, UK
| | - Angela Tod
- Division of Nursing and Midwifery, The University of Sheffield, Sheffield, UK
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Psychological Distress after a Diagnosis of Malignant Mesothelioma in a Group of Patients and Caregivers at the National Priority Contaminated Site of Casale Monferrato. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17124353. [PMID: 32560553 PMCID: PMC7345082 DOI: 10.3390/ijerph17124353] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 06/12/2020] [Accepted: 06/15/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND Patients of malignant mesothelioma (MM) and their caregivers face significant physical and psychological challenges. The purpose of the present study is to examine the emotional impact after the diagnosis of MM in a group of patients and familial caregivers in a National Priority Contaminated Site (NPCS). METHODS A sample of 108 patients and 94 caregivers received a sociodemographic/clinical questionnaire, the Beck Depression Inventory II, the Davidson Trauma Scale, the Coping Orientation to the Problems Experienced-New Italian Version, and the Defense style questionnaire. The risk of depressive and post-traumatic stress disorder (PTSD) symptoms in relation to the strategies of coping and defense mechanisms was estimated in patients and caregivers separately by logistic regression models. RESULTS For patients, a high risk of depression was associated with high usage of Defense Style Questionnaire (DSQ) Isolation (OR: 53.33; 95% CI: 3.22-882.30; p = 0.01) and DSQ Somatization (OR: 16.97; 95% CI: 1.04-275.90; p = 0.05). Other significant risks emerged for some coping strategies and some defenses regarding both depression and trauma in patients and caregivers. CONCLUSIONS This research suggests that for both patients and caregivers unconscious adaptive processes have a central role in dealing with overwhelming feelings related to the disease.
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Cortés-Guiral D, Mohamed F, Glehen O, Passot G. Prehabilitation of patients undergoing cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) for peritoneal malignancy. Eur J Surg Oncol 2020; 47:60-64. [PMID: 32063398 DOI: 10.1016/j.ejso.2020.01.032] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 01/14/2020] [Accepted: 01/27/2020] [Indexed: 12/15/2022] Open
Abstract
Treatment of peritoneal malignancy with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) is often undertaken in patients who have nutritional, physical and psychological challenges as a result of advanced disease. Prehabilitation is a multimodal approach that helps optimize postoperative recovery and reduce morbidity and may be of benefit in this group of patients. It begins once the decision to operate is made and continues until recovery to baseline health. Here we present recommendations on Prehabilitation for patients undergoing cytoreductive surgery and HIPEC following discussion at the 10th Peritoneal Malignancy Workshop in Paris September 2018.
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Affiliation(s)
- Delia Cortés-Guiral
- Department of Surgical Oncology, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, GECOP Grupo Español de Cirugía Oncológica Peritoneal, Madrid, Spain.
| | - Faheez Mohamed
- Peritoneal Malignancy Department, Basingstoke and North Hampshire Hospitals, Basingstoke, UK
| | - Olivier Glehen
- Department of Surgical Oncology, CHU Lyon Sud, Hospices Civils de Lyon, University of Lyon, France
| | - Guillaume Passot
- Department of Surgical Oncology, CHU Lyon Sud, Hospices Civils de Lyon, University of Lyon, France
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Lang J, Felten MK, Kraus T. Are the knowledge of non-malignant asbestos-related diseases and lung function impairment differentially associated with psychological well-being? A cross-sectional study in formerly asbestos-exposed workers in Germany. BMJ Open 2019; 9:e030094. [PMID: 31662369 PMCID: PMC6830594 DOI: 10.1136/bmjopen-2019-030094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES The knowledge of past asbestos exposure may lead to chronic psychological strain. In addition, the information about an increased cancer risk can place a psychological burden on individuals triggering mental health symptoms of depression or anxiety. This applies in particular to individuals with non-malignant asbestos-related disease (ARD) such as lung fibrosis and pleural thickening with or without lung function impairment. ARDs with or without lung function impairment may develop even years after exposure cessation. Therefore, the aim of the present study was to test for our cohort whether non-malignant ARD and lung function impairment have differential effects on mental health and psychological strain. DESIGN Cross-sectional study. PARTICIPANTS AND SETTING Overall, 612 male participants (mean age=66.2 years, SD=9.5) attending a surveillance programme for ARDs received routine examinations including lung function testing (24% refused to fill in the psychological questionnaire) at a German university hospital study centre from August 2008 to August 2013. OUTCOME MEASURES Using multiple hierarchical regression analysis, ARD diagnosis and lung function impairment were used to predict psychological health as measured with validated questionnaires for depression and anxiety. Psychological strain was operationalised by intrusive thoughts and specific fear of cancer. RESULTS The strongest predictor for mental health was obstructive functional impairment (eg, anxiety: β=0.22, p<0.001). Psychological strain was predicted by the presence of a non-malignant ARD (eg, intrusive thoughts: β=0.17, p=0.003). CONCLUSIONS The presence of mental health symptoms is associated with ventilation disturbances, whereas the knowledge of an already initiated morphological change-caused by asbestos exposure-is primarily associated with psychological strain. Specifically, the affected individuals are more prone to intrusive thoughts and specific fear of asbestos-related cancer. As an implication, physicians should be sensitised about possible consequences of risk communication and functional impairment to counteract excessive fear or anxiety.
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Affiliation(s)
- Jessica Lang
- Institute of Occupational, Social and Environmental Medicine, RWTH Aachen University, Aachen, Germany
| | - Michael K Felten
- Institute of Occupational, Social and Environmental Medicine, RWTH Aachen University, Aachen, Germany
| | - Thomas Kraus
- Institute of Occupational, Social and Environmental Medicine, RWTH Aachen University, Aachen, Germany
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