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Hirayama T, Kojima R, Udagawa R, Mashiko Y, Matsumoto K, Ogata K, Shindo A, Mizuta T, Ogawa Y, Kayano A, Yanai Y, Ishiki H, Satomi E. Preliminary Effectiveness of an In-Hospital Peer Support Program, Adolescent and Young Adult Hiroba, on Anxiety in Adolescent and Young Adult Patients with Cancer. J Adolesc Young Adult Oncol 2024; 13:224-232. [PMID: 37579263 PMCID: PMC10877384 DOI: 10.1089/jayao.2023.0065] [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] [Indexed: 08/16/2023] Open
Abstract
Purpose: Adolescent and young adult (AYA) patients with cancer have few opportunities to connect with patients of the same generation while hospitalized. Although anxiety is frequently reported by them, there are no reports on the psychological effectiveness of an in-hospital patient support program based on peer support. This study aimed to evaluate the effectiveness of a program, termed Adolescent and Young Adult Hiroba (AYA Hiroba), for anxiety in AYA patients with cancer. Methods: This single-center, prospective, observational study in 24 AYA patients with cancer was conducted at the National Cancer Center Hospital in Japan. The Hospital Anxiety and Depression Scale-Anxiety (HADS-A) was used to evaluate the primary outcome, anxiety. The Distress Thermometer (DT) was used to evaluate the secondary outcome, distress. The two outcomes were assessed before and after participation in AYA Hiroba. The Net Promoter Score (NPS) was used to evaluate satisfaction after participation in AYA Hiroba. Participants' free-text descriptions of the program were categorized according to similarities and differences. Results: The HADS-A and DT scores were significantly lower after the program than before (p < 0.001), as was the percentage of AYA patients with cancer with high distress (p = 0.04). The NPS was 27, which was lower than the value of 52 obtained in our previous study. Requests and suggestions to improve the program were grouped into three categories: content, facilitation, and online connection environment. Conclusion: This study suggests the preliminary effectiveness of the in-hospital peer support program for anxiety in AYA patients with cancer. The Clinical Trial Registration number: UMIN000045779.
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Affiliation(s)
- Takatoshi Hirayama
- Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Rebekah Kojima
- Department of Palliative Medicine, and National Cancer Center Hospital, Tokyo, Japan
| | - Ryoko Udagawa
- Department of Pharmacy, National Cancer Center Hospital, Tokyo, Japan
| | - Yuki Mashiko
- Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Kazuko Matsumoto
- Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Kyoka Ogata
- Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Akie Shindo
- Department of Palliative Care, National Center for Global Health and Medicine, Tokyo, Japan
| | - Tomoko Mizuta
- Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Yuko Ogawa
- Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Ayako Kayano
- Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Yuko Yanai
- Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Hiroto Ishiki
- Department of Palliative Medicine, and National Cancer Center Hospital, Tokyo, Japan
| | - Eriko Satomi
- Department of Palliative Medicine, and National Cancer Center Hospital, Tokyo, Japan
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Deodhar JK, Goswami SS, Sonkusare LN. Validation of the hospital anxiety depression scale - Marathi version in detecting anxiety and depression in cancer patients and caregivers. Indian J Cancer 2023; 60:345-352. [PMID: 36861691 DOI: 10.4103/ijc.ijc_1321_20] [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] [Indexed: 03/03/2023]
Abstract
Background ">The Hospital and Anxiety Depression Scale (HADS) is useful for screening depression and anxiety in cancer. It has not been validated in the Marathi language, which is the third most common language in India. We aimed to examine the reliability and validity of the Marathi-translated version of HADS in cancer patients and their caregivers. Methods In a cross-sectional study design, we administered the Hospital and Anxiety Depression Scale-Marathi version (HADS-Marathi) to 100 participants (50 patients and 50 caregivers) after obtaining their informed consent. The team Psychiatrist, who was blind to the HADS-Marathi scores, interviewed all participants and identified the presence of anxiety and depressive disorders using the diagnostic criteria of the International Classification of Diseases - 10th edition. We measured internal consistency using Cronbach's alpha, receiver operating characteristics, and factor structure. The study was registered with the Clinical Trials Registry-India (CTRI). Results The internal consistency of HADS-Marathi was good with 0.815, 0.797, and 0.887 for anxiety and depression subscales and total scale, respectively. The area under curve figures were 0.836 (95% Confidence Interval [CI]: 0.756 - 0.915), 0.835 (95% [CI]: 0.749-0.921), and 0.879 (95% [CI] 0.806-0.951) for anxiety and depression subscales, and total scale, respectively. The best cutoffs identified were 8 (anxiety), 7 (depression), and 15 (total). The scale displayed a three-factor structure, with two depression subscale and one anxiety subscales items loading on to the third factor. Conclusion We found that the HADS-Marathi version is a reliable and valid instrument for use in cancer patients. However, we found a three-factor structure, possibly reflecting a cross-cultural effect.
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Affiliation(s)
- Jayita K Deodhar
- Department of Palliative Medicine; Psycho-oncology Unit, Tata Memorial Hospital; Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Savita S Goswami
- Psycho-oncology Unit, Tata Memorial Hospital, Mumbai, Maharashtra, India
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Abu-Odah H, Molassiotis A, Liu JYW. A distress thermometer with a cutoff score of ≥ 6 is the optimal point to identify highly distressed patients with advanced cancer stages in resource-limited countries without palliative care services. Front Oncol 2023; 13:970164. [PMID: 37007106 PMCID: PMC10050695 DOI: 10.3389/fonc.2023.970164] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 02/28/2023] [Indexed: 03/17/2023] Open
Abstract
PurposeAlthough the distress thermometer (DT) scale has been widely validated and used in different cancer types and settings, an optimal cutoff score of DT is not defined to screen advanced cancer patients. The study aimed to define the optimal DT’s cutoff score among advanced cancer patients in resource-limited countries without palliative care services and to assess the prevalence and factors associated with psychological distress among this population.MethodsA secondary analysis was performed. Three hundred seventy-nine patients were recruited from Palestine. Participants completed the DT and the Hospital Anxiety and Depression Scale (HADS). Receiver operating characteristic analysis (ROC) was used to define the optimal cutoff score for the DT against HADS-Total ≥15. Multiple logistic regression was utilized for identifying the factors associated with psychological distress of the DT.ResultsA DT cutoff score ≥ 6 correctly identified 74% of HADS distress cases and 77% of HADS non-distress cases, with a positive predictive value (PPV) and negative predictive value (NPV) of 97% and 18%, respectively. The prevalence of distress was found to be 70.7%, and the major sources of distress were related to physical (n = 373; 98.4%) and emotional problems (n = 359; 94.7%). Patients with colon (OR = 0.44, 95% CI: 0.31 – 0.62) and lymphoid cancers (OR = 0.41, 95% CI: 0.26 – 0.64) were less likely to have psychological distress than patients with other types of cancer, whereas patients with lung (OR = 1.80, 95% CI: 1.20 – 2.70) and bone cancers (OR = 1.75, 95% CI: 1.14 – 2.68) were more likely to experience it.ConclusionA cutoff DT score of 6 appeared acceptable and effective for screening distress in patients with advanced cancer stages. Palestinian patients exhibited a high level of distress, and the high prevalence supports the argument of using a DT within the standard delivery of cancer care to identify highly distressed patients. These highly distressed patients should then be involved in a psychological intervention programme.
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Affiliation(s)
- Hammoda Abu-Odah
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, Hong Kong SAR, China
- Nursing and Health Sciences Department, University College of Applied Sciences (UCAS), Gaza, Palestine
- *Correspondence: Hammoda Abu-Odah, ;
| | - Alex Molassiotis
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, Hong Kong SAR, China
- College of Arts, Humanities and Education, University of Derby, Derby, United Kingdom
| | - Justina Yat Wa Liu
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, Hong Kong SAR, China
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Routine patient assessment and the use of patient-reported outcomes in specialized palliative care in Japan. J Patient Rep Outcomes 2023; 7:25. [PMID: 36894802 PMCID: PMC9998740 DOI: 10.1186/s41687-023-00565-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 02/21/2023] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND Discrepancies in symptom assessment between providers and patients are reported in cancer care, and the use of patient-reported outcome measures (PROMs) has been recommended for patients receiving palliative care. However, the status of the routine use of PROMs in palliative care in Japan is presently unclear. Therefore, this study aimed to clarify this complex question. To this end, we administered a questionnaire survey either online or via telephone interviews (questionnaire: sent to 427 designated cancer hospitals, 423 palliative care units [PCUs], and 197 home hospices; interviews: conducted at 13 designated cancer hospitals, nine PCUs, and two home hospices). RESULTS Questionnaires were returned from 458 institutions (44% response rate). We found that 35 palliative care teams (PCTs, 15%), 66 outpatient palliative care services (29%), 24 PCUs (11%) and one (5%) home hospice routinely used PROMs. The most frequently implemented instrument was the Comprehensive Care Needs Survey questionnaire. Moreover, 99 institutions (92%) that routinely used PROMs responded these instruments as useful in relieving patients' symptoms; and moreover, the response rate in regard to usefulness in symptom management was higher than that of institutions that did not routinely use PROMs (p = 0.002); > 50% of the institutions that routinely used PROMs stated that use of these instruments was influenced by disease progression and patients' cognitive function. Moreover, 24 institutions agreed to be interviewed, and interviews demonstrated the benefits of and the barriers to the implementation of PROMs. Effective methods used in the implementation of PROMs were introduced as efforts to reduce the burden placed on patients and to promote healthcare providers' education in the use of PROMs. CONCLUSIONS This survey quantified the status of the routine use of PROMs within specialized palliative care in Japan, revealed barriers to wider PROM use, and identified needed innovations. Only 108 institutions (24%) routinely used PROMs within specialized palliative care. Based on the results of the study, it is necessary to carefully consider the usefulness of PROs in clinical palliative care, perform careful selection of PROMs according to the patient's condition, and evaluate how specifically to introduce and operate PROMs.
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Brauer ER, Lazaro S, Williams CL, Rapkin DA, Madnick AB, Dafter R, Cheng G, Porter A, Abemayor E, Chai-Ho W, Morasso E, Erman A, Chhetri D, John MS, Wong DJ. Implementing a Tailored Psychosocial Distress Screening Protocol in a Head and Neck Cancer Program. Laryngoscope 2022; 132:1600-1608. [PMID: 34953151 PMCID: PMC9875715 DOI: 10.1002/lary.30000] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 12/03/2021] [Accepted: 12/14/2021] [Indexed: 01/27/2023]
Abstract
OBJECTIVES/HYPOTHESIS Psychosocial distress is common among patients with head and neck cancer (HNC) and is associated with poorer quality of life and clinical outcomes. Despite these risks, distress screening is not widely implemented in HNC care. In this study, we investigated the prevalence of psychosocial distress and its related factors in routine care of patients with HNC. METHODS Data from medical records between September 2017 and March 2020 were analyzed. Psychosocial distress was measured by the National Comprehensive Cancer Network's Distress Thermometer (DT), and a modified HNC-specific problem list; depression and anxiety were assessed using the Patient Health Questionnaire-4. Descriptive statistics and logistic regression were conducted to report prevalence of distress, depression and anxiety, and factors associated with clinical distress. Implementation outcomes, including rates of referrals and follow-up for distressed patients, are also reported. RESULTS Two hundred and eighty seven HNC patients completed the questionnaire (age 64.3 ± 14.9 years), with a mean distress score of 4.51 ± 3.35. Of those, 57% (n = 163) reported clinical distress (DT ≥ 4). Pain (odds ratio [OR] = 3.31, 95% CI = 1.75-6.26), fatigue (OR = 2.43, 95% CI = 1.1.7-5.05), anxiety (OR = 1.63, 95% CI = 1.30-2.05), and depression (OR = 1.51, 95% CI = 1.04-2.18) were significantly associated with clinical distress (P < .05). Of patients identified as distressed, 79% received same-day psychosocial evaluation. CONCLUSIONS Clinical distress was identified in 57% of patients who completed the questionnaire, suggesting that an ultra-brief psychosocial screening protocol can be implemented in routine ambulatory oncology care, and identifies patients whose distress might otherwise go unrecognized. LEVEL OF EVIDENCE 4 Laryngoscope, 132:1600-1608, 2022.
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Affiliation(s)
- Eden R Brauer
- Department of Nursing, UCLA School of Nursing, Los Angeles, CA
| | - Stephanie Lazaro
- Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Charlene L Williams
- Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - David A Rapkin
- Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Amy B Madnick
- Department of Care Coordination & Clinical Social Work, Ronald Reagan-UCLA Medical Center
| | - Roger Dafter
- Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Guo Cheng
- Department of Physiology, David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Ashleigh Porter
- Department of Hematology Oncology, David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Elliot Abemayor
- Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Wanxing Chai-Ho
- Department of Hematology Oncology, David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Elizabeth Morasso
- Department of Radiation Oncology, David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Andrew Erman
- Department of Audiology and Speech Pathology, Ronald Reagan-UCLA Medical Center, Los Angeles, CA
| | - Dinesh Chhetri
- Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Maie St. John
- Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Deborah J. Wong
- Department of Hematology Oncology, David Geffen School of Medicine at UCLA, Los Angeles, CA
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McElroy JA, Waindim F, Weston K, Wilson G. A systematic review of the translation and validation methods used for the national comprehensive cancer network distress thermometer in non-English speaking countries. Psychooncology 2022; 31:1267-1274. [PMID: 35757974 DOI: 10.1002/pon.5989] [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: 01/10/2022] [Revised: 06/10/2022] [Accepted: 06/20/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The National Comprehensive Cancer Network (NCCN) distress thermometer (DT) was developed as a brief screening tool for detecting distress in cancer patients. Conceptually, distress was considered a more acceptable and inclusive term than other psychological terms such as depression or anxiety. It is used extensively in the United States and other English-speaking countries. We aim to describe the translation and validation methods of the DT and describe the recommended cutoff scores used to identify cancer patients experiencing clinically significant distress. METHODS Nine bibliographic databases were searched using keywords to identify original research studies for non-English speaking countries' cancer patients. Full articles were independently assessed for inclusion and data extraction by two authors. RESULTS The review of 4442 articles yielded 39 articles that validated the DT. We identified 20 languages in 25 countries. In all but one country, investigators were able to agree upon a word or phrase that meant distress in their native language that was subsequently validated against standardized instruments. Asian, Middle Eastern and European counties recommended cutoff score of 4 or 5 to identify clinically significant distress; however, European Union countries had a range of 2 to 7. CONCLUSIONS Use of the translated DT with non-English speaking cancer patients provides a simple and quick tool to identify high distress. Similar to NCCN, the cutoff score of 4 or 5 was suggested by 78% of the studies; however, more studies of different types of cancer and within and among more countries will strengthen a recommended global DT cutoff score.
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Affiliation(s)
- Jane A McElroy
- Department of Family and Community Medicine, University of Missouri, Columbia, Missouri, USA
| | - Flevis Waindim
- School of Medicine, University of Missouri, Columbia, Missouri, USA
| | - Karry Weston
- Department of Family and Community Medicine, University of Missouri, Columbia, Missouri, USA.,School of Nursing, University of Missouri, Columbia, Missouri, USA
| | - Gwendolyn Wilson
- Department of Family and Community Medicine, University of Missouri, Columbia, Missouri, USA
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Trajectories of adjustment disorder symptoms in post-treatment breast cancer survivors. Support Care Cancer 2022; 30:3521-3530. [PMID: 35020075 PMCID: PMC8857158 DOI: 10.1007/s00520-022-06806-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 12/31/2021] [Indexed: 11/06/2022]
Abstract
Objective Breast cancer survivors (BCS) may experience problems to adjust to their situation after cancer treatment completion. In case of severe distress, an adjustment disorder (AD) might develop. This study investigates the course of AD symptoms during 1 year and its predictors in BCS up to 5 years post-treatment. Methods BCS completed the Hospital Anxiety and Depression Scale (HADS) at baseline, 3, 6, and 12 months. HADS total scores were defined as no mental disorder (MD) symptoms (≤ 10), AD symptoms (11–14), and any other MD symptoms (≥ 15). Over the course of four assessments, symptom trajectories were a priori defined as no MD symptoms, AD symptoms, fluctuating AD symptoms below and above cut-offs, or any other MD symptoms. Complementary, latent class growth analysis (LCGA) was used to identify data-driven trajectories. Results Among 293 BCS with complete data, the majority was classified as no MD symptoms (54.4%), followed by 37.5% in the fluctuating AD symptoms trajectory. Only 1.4% had AD symptoms, and 6.8% had any other MD symptoms. With LCGA (N = 459), three trajectories were found: stable no MD symptoms (58.6%), stable AD symptoms (32.9%), and high increasing any other MD symptoms (8.5%). Compared to BCS with no MD symptoms, BCS with fluctuating AD symptoms or any other MD symptoms were younger, less able to handle daily activities, and showed more social support discrepancy, neuroticism, and less optimism. Conclusions Results of our study showed that AD symptoms in BCS up to 5 years post-treatment fluctuate over 1 year. It is thus important to appropriately assess AD over the course of 5 years post-treatment as AD symptoms can fluctuate.
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Han XB, Fang YQ, Liu SX, Tan Y, Hou JJ, Zhao LJ, Li F. Efficacy of combined naikan and morita therapies on psychological distress and posttraumatic growth in Chinese patients with advanced cancer: A randomized controlled trial. Medicine (Baltimore) 2021; 100:e26701. [PMID: 34397698 PMCID: PMC8322545 DOI: 10.1097/md.0000000000026701] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 06/19/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Advanced cancer (AC) patients experience serious physical and psychological problems with the disease progression. When approaching the end of life, these patients have to cope with not only the bodily illness, but also the spiritual crisis. Conventional psychological treatments reduce distress to a certain extent, but for patients with AC, especially when they face progressive illness and are approaching death, their psychological problems are complex, and no simple solutions are in sight. Therefore, we designed this study to evaluate the efficacy of the combined Naikan therapy (NT) and Morita therapy (MT) on psychological distress and posttraumatic growth in patients with AC. METHOD One hundred thirty patients newly diagnosed with AC were allocated randomly into treatment (n = 65) and control (n = 65) groups. Patients in the treatment group received combined NT and MT for 7 consecutive weeks, while the control group received normal medical treatments without NT and MT. Patients were assessed before and after the therapies. The primary outcome measures include distress thermometer (DT) and posttraumatic growth, and the secondary outcome measure contains the list of distress problems. RESULTS At the post-treatment stage, the treatment group displayed a decreased score of psychological distress as compared to that in the control group, which accompanied by a higher post-traumatic growth total score and subscale scores in relationship to others, new possibilities, personal strength, spiritual changes, and appreciation of life. A significant decrease in fear, sleeping difficulty/insomnia, nervousness/anxiety, and loss of appetite was also observed in the treatment group. CONCLUSION The results proved that the combined Naikan and Morita therapies decreased the psychological distress and improved the posttraumatic growth of the patients with AC. TRIAL REGISTRATION ChiCTR1900026691.
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Affiliation(s)
- Xiang-Bei Han
- Jilin University School of Nursing, Changchun City, Jilin, P.R. China
- Jilin Province People's Hospital, Changchun City, Jilin, P.R. China
| | - Yan-Qiu Fang
- Jilin Province People's Hospital, Changchun City, Jilin, P.R. China
| | - Shu-Xiang Liu
- Jilin University School of Nursing, Changchun City, Jilin, P.R. China
| | - Yan Tan
- Jilin Province People's Hospital, Changchun City, Jilin, P.R. China
| | - Jun-Jie Hou
- Jilin Province People's Hospital, Changchun City, Jilin, P.R. China
| | - Li-Jing Zhao
- Jilin University School of Nursing, Changchun City, Jilin, P.R. China
| | - Feng Li
- Jilin University School of Nursing, Changchun City, Jilin, P.R. China
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Predictors and moderators of outcomes in mindfulness-based cognitive therapy intervention for early breast cancer patients. Palliat Support Care 2021; 20:159-166. [PMID: 34158140 DOI: 10.1017/s147895152100078x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES To deliver mindfulness-based cognitive therapy (MBCT) efficiently, the present study aimed (1) to identify predictors and moderators of patients who benefit from MBCT for psychological distress and (2) to explore the initial treatment reaction to identify the optimal number of sessions that produce a significant clinical effect. METHODS This is the secondary analysis of a randomized controlled trial of MBCT for breast cancer patients (N = 74). We classified the participants into remitters vs. non-remitters, and responder vs. non-responders, according to the total score of the Hospital Anxiety and Depression Scale at the end of the intervention. We conducted multivariate analyses to explore for predictors of response and remission. We adopted generalized estimating equations to explore the optimal number of sessions. RESULTS Sociodemographic and clinical backgrounds did not have significant influence on the treatment outcomes of the MBCT. Better program adherence, which was represented as the participants' better attendance to the MBCT program, was a significant predictor of both remission and response [odds ratio (OR) = 1.90, 95% confidence interval (CI) 1.25-2.89, p = 0.003, and OR = 1.72, 95% CI 1.12-2.65, p = 0.013, respectively]. It was not until seventh session that the remission rate exceeded 50% and the response rate showed significance. SIGNIFICANCE OF RESULTS Sociodemographic and clinical characteristics did not significantly influence the treatment outcomes, while homework minutes and class attendance had significant effects on treatment outcomes. This implies that MBCT is recommended to any cancer patient, if he/she is motivated to the program, regardless of their sociodemographic and clinical characteristics. Patients are encouraged to attend a standard MBCT program (eight sessions) and do the assigned homework as intensely as possible. Further studies with larger sample and objective measurements are desired.
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Salari N, Rezaie L, Khazaie H, Bokaee S, Ghasemi H, Mohammadi M, Khaledi-Paveh B. The effect of acceptance and commitment therapy on anxiety and depression in patients with cancer: A systematic review. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01934-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Tian X, Jin Y, Chen H, Tang L, Jiménez‐Herrera MF. The positive effect of social support on psychological distress among Chinese lung cancer patients: The mediating role of self-esteem. Nurs Open 2021; 8:1642-1651. [PMID: 33599393 PMCID: PMC8186711 DOI: 10.1002/nop2.793] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 12/10/2020] [Accepted: 01/29/2021] [Indexed: 12/25/2022] Open
Abstract
AIM To investigate the effect of social support on psychological distress among Chinese lung cancer patients and clarify the mediating role of self-esteem. DESIGN A cross-sectional descriptive correlational survey of 441 Chinese lung cancer patients was designed. METHODS Self-esteem was supposed to play a mediating role in the association between social support and psychological distress. We collected demographic information, the Distress Thermometer, Multidimensional Scale of Perceived Social Support and Rosenberg Self-Esteem Scale. RESULTS Our revised model demonstrated an acceptable fit to the data (χ2 = 37.489, comparative fit index (CFI) = 0.965, Tucker-Lewis index (TLI) = 0.926, root mean square error of approximation [RMSEA] = 0.099). Social support had a direct effect on self-esteem and psychological distress, and self-esteem had also a direct effect on psychological distress. Meanwhile, self-esteem also partially mediated the relationship between social support and psychological distress among Chinese lung cancer patients.
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Affiliation(s)
- Xu Tian
- Nursing DepartmentUniversitat Rovira i VirgiliTarragonaSpain
- Department of GastroenterologyChongqing University Cancer HospitalSchool of MedicineChongqing UniversityChongqingChina
| | - Yanfei Jin
- Nursing DepartmentUniversitat Rovira i VirgiliTarragonaSpain
| | - Hui Chen
- Department of GastroenterologyChongqing University Cancer HospitalSchool of MedicineChongqing UniversityChongqingChina
| | - Ling Tang
- Department of NursingChongqing University Cancer HospitalSchool of MedicineChongqing UniversityChongqingChina
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Tian X, Jin Y, Chen H, Tang L, Jiménez-Herrera MF. Relationships among Social Support, Coping Style, Perceived Stress, and Psychological Distress in Chinese Lung Cancer Patients. Asia Pac J Oncol Nurs 2021; 8:172-179. [PMID: 33688566 PMCID: PMC7934593 DOI: 10.4103/apjon.apjon_59_20] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Accepted: 09/29/2020] [Indexed: 12/24/2022] Open
Abstract
Objective: Social support is associated with improved psychological distress in cancer patients. This study investigates the impact of social support on Chinese lung cancer patients' psychological distress and further clarifies the mediating role of perceived stress and coping style. Methods: A cross-sectional survey study examined social support and psychological distress in 441 patients diagnosed with lung cancer from seven hospitals in Chongqing, China, between September 2018 and August 2019. Coping style and perceived stress were considered to be potential mediators of adjustment outcomes. Results: We found a detection rate of 17.7% for psychological distress among Chinese lung cancer patients. Social support was in significantly negative association with psychological distress, which was partially mediated by confrontation coping and perceived stress. Conclusions: Social support appears to contribute to ameliorate psychological distress by enhancing confrontation coping with cancer and enhancing perceived stress. There is a need for the development and evaluation of psychological intervention program to enhance the buffering effects of social support in lung cancer patients.
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Affiliation(s)
- Xu Tian
- Department of Nursing, Faculty of Nursing, Rovira I Virgili University, Tarragona, Spain.,Department of Gastroenterology, Chongqing University Cancer Hospital, School of Medicine, Chongqing, China
| | - Yanfei Jin
- Department of Nursing, Faculty of Nursing, Rovira I Virgili University, Tarragona, Spain
| | - Hui Chen
- Department of Gastroenterology, Chongqing University Cancer Hospital, School of Medicine, Chongqing, China
| | - Ling Tang
- Department of Nursing, Chongqing University Cancer Hospital, School of Medicine, Chongqing, China
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Validation of the Greek version of the distress thermometer compared to the clinical interview for depression. BMC Psychiatry 2020; 20:527. [PMID: 33158431 PMCID: PMC7648283 DOI: 10.1186/s12888-020-02926-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 10/22/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The Distress Thermometer (DT) is worldwide the most commonly used instrument for quick screening of emotional burden in patients with cancer. In order to validate the Greek version of the DT in the Greek population we aimed to explore the capacity of the DT to identify patients with comorbid depressive diagnosis. METHODS We analyzed the routinely collected clinical data from 152 patients with cancer who had been evaluated by the consultation-liaison psychiatric service and had received a diagnosis of either depressive disorder or no psychiatric diagnosis. The score of the DT accompanied by the list of problems in the Problem List, the depression status, and the clinical and demographic characteristics entered the data sheet. RESULTS The ROC analysis revealed that the DT achieved a significant discrimination with an area under the curve of 0.79. At a cut-off point of 4, the DT identified 85% of the patients with an ICD-10 depressive diagnosis (sensitivity) and 60% of the patients without a psychiatric diagnosis (specificity). The positive predictive value was 44%, the negative predictive value 92% and the diagnostic odd ratio 8.88. Fatigue and emotional difficulties were the most commonly reported problems by the patients. CONCLUSION The Greek version of the DT has a sufficient overall accuracy in classifying patients regarding the existence of depressive disorders, in the oncology setting. Therefore, it can be considered as a valid initial screening tool for depression in patients with cancer; patients scoring ≥4 should be assessed by a more thorough mental evaluation.
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14
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Abd El-Aziz N, Khallaf S, Abozaid W, Elgohary G, Abd El-Fattah O, Alhawari M, Khaled S, AbdelHaffez A, Kamel E, Mohamed S. Is it the time to implement the routine use of distress thermometer among Egyptian patients with newly diagnosed cancer? BMC Cancer 2020; 20:1033. [PMID: 33109093 PMCID: PMC7592584 DOI: 10.1186/s12885-020-07451-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 09/22/2020] [Indexed: 01/30/2023] Open
Abstract
Background The distress thermometer (DT) is an effective tool for identifying distress among cancer patients worldwide. However, DT has not been studied in Egyptian patients. We aimed to study the prevalence of distress among Egyptian patients with different types of cancers using DT. Methods A total of 550 patients with newly diagnosed hematological and solid cancers who were followed up at 3 Oncology Centers in Egypt were enrolled. They completed a sociodemographic and clinical status questionnaire, the DT and the Problem List (PL) scale. Results At a DT cut-off score of ≥4, 46% of patients had significant distress, which was related to the tumor site and stage. The most frequent problems reported were treatment decision (64.4%), worry (47%), and fears (44.5%). In univariate logistic regression analysis, participants who had significant distress described 23 out of 36 problems in the practical, family, emotional, and physical areas. After adjustment to sociodemographic and clinical characteristics, multivariable analysis confirmed that insurance, depression, fear, sadness, worry, loss of interest in usual activity, and sleep were independent factors associated with significant distress in cancer patients. Conclusions Almost half of Egyptian patients newly diagnosed with cancer reported significant distress. Those who had significant distress described extra problems in the practical, family, emotional, and physical areas. We recommend the routine use of DT for screening Egyptian patients with cancer, as well as the involvement of the psycho-oncology and social services, at the time of their initial diagnosis.
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Affiliation(s)
- Nashwa Abd El-Aziz
- Department of Medical Oncology, South Egypt Cancer Institute, Assiut University, Assiut, Egypt.,Hematology-Oncology Department, King Khaled University hospital, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Salah Khallaf
- Department of Medical Oncology, South Egypt Cancer Institute, Assiut University, Assiut, Egypt
| | - Waleed Abozaid
- Department of Clinical Oncology, Faculty of Medicine, Mansura University, Mansura, Egypt
| | - Ghada Elgohary
- Hematology-Oncology Department, King Khaled University hospital, King Saud University, Riyadh, Kingdom of Saudi Arabia.,Department of Adult Hematology/Internal Medicine, Ain Shams University, College of Medicine, Cairo, Egypt
| | - Ola Abd El-Fattah
- Department of Adult Hematology/Internal Medicine, Ain Shams University, College of Medicine, Cairo, Egypt.,Department of Clinical Oncology, Faculty of medicine, Assiut University, Assiut, Egypt
| | - Mai Alhawari
- Hematology-Oncology Department, King Khaled University hospital, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Safaa Khaled
- Department of Internal Medicine, Clinical Hematology Unit/Unit of Bone Marrow Transplantation, South Egypt Cancer Institute, Assiut University, Assiut, Egypt
| | - Azza AbdelHaffez
- Department of Medical Physiology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Ehab Kamel
- Department of Pyschiatry, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Sherif Mohamed
- Department of Chest Diseases and Tuberculosis, Faculty of Medicine, Assiut University, Assiut, Egypt.
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15
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Park S, Sato Y, Takita Y, Tamura N, Ninomiya A, Kosugi T, Sado M, Nakagawa A, Takahashi M, Hayashida T, Fujisawa D. Mindfulness-Based Cognitive Therapy for Psychological Distress, Fear of Cancer Recurrence, Fatigue, Spiritual Well-Being, and Quality of Life in Patients With Breast Cancer-A Randomized Controlled Trial. J Pain Symptom Manage 2020; 60:381-389. [PMID: 32105790 DOI: 10.1016/j.jpainsymman.2020.02.017] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 02/14/2020] [Accepted: 02/14/2020] [Indexed: 01/04/2023]
Abstract
CONTEXT Mindfulness-based interventions have been receiving growing attention in cancer care. OBJECTIVES The purpose of this randomized controlled trial is to examine the effectiveness of mindfulness-based cognitive therapy (MBCT) for psychological distress (anxiety and depression), fear of cancer recurrence (FCR), fatigue, spiritual well-being, and quality of life (QOL) in Japanese ambulatory patients with Stage I-III breast cancer. METHODS A total of 74 patients were randomly assigned to either an eight-week MBCT intervention group (n = 38) or a wait-list control group (n = 36). The primary outcome was psychological distress, measured on Hospital Anxiety and Depression Scale. The secondary outcomes were FCR (Concerns About Recurrence Scale-overall anxiety subscale), fatigue (Brief Fatigue Inventory), spiritual well-being (Functional Assessment of Chronic Illness Therapy-Spiritual), QOL (Functional Assessment of Cancer Therapy-General), and mindfulness skills (Five Facet Mindfulness Questionnaire). The participants were assessed at baseline (T0), Week 8 (T1), and Week 12 (T2). The results were analyzed using a intention-to-treat linear mixed model. RESULTS The participants in the MBCT group experienced significantly better outcomes in their psychological distress (Cohen's d = 1.17; P < 0.001), FCR (d = 0.43; P < 0.05), fatigue (d = 0.66; P < 0.01), spiritual well-being (d = 0.98; P < 0.001), and QOL (d = 0.79; P < 0.001) compared with the control group. The difference remained significant at T2 (four weeks after completion of the intervention). CONCLUSION MBCT was demonstrated to improve well-being that encompasses psychological, physical, and spiritual domains in Japanese patients with nonmetastatic breast cancer. The favorable effect was maintained up to four weeks after the completion of the intervention.
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Affiliation(s)
- Sunre Park
- Faculty of Nursing and Medical Care, Keio University, Shinjuku-ku, Tokyo, Japan.
| | - Yasuko Sato
- Department of Nursing, National Hospital Organization Tokyo Medical Center, Meguro-ku, Tokyo, Japan
| | - Yuka Takita
- Faculty of Nursing and Medical Care, Keio University, Shinjuku-ku, Tokyo, Japan; Department of Nursing, Faculty of Health Sciences, Tokyo Kasei University, Itabashi-ku, Tokyo, Japan
| | - Noriko Tamura
- Department of Neuropsychiatry, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Akira Ninomiya
- Department of Neuropsychiatry, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Teppei Kosugi
- Department of Neuropsychiatry, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Mitsuhiro Sado
- Department of Neuropsychiatry, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Atsuo Nakagawa
- Department of Neuropsychiatry, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan; Clinical and Translational Research Center, Keio University Hospital, Shinjuku-ku, Tokyo, Japan
| | - Maiko Takahashi
- Department of Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Tetsu Hayashida
- Department of Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Daisuke Fujisawa
- Department of Neuropsychiatry, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan; Division of Patient Safety, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
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16
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Fu YQ. Mediating effect of hope level between psychological pain and quality of life in patients on chemotherapy for esophageal cancer. Shijie Huaren Xiaohua Zazhi 2020; 28:650-654. [DOI: 10.11569/wcjd.v28.i14.650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Esophageal cancer (EC) seriously endangers the life and health of patients, and the physical and psychological pain due to gastrointestinal and other adverse reactions caused by chemotherapy rarely attracts the attention of medical staff and family members. Hope is a kind of dynamic psychological energy, which can effectively alleviate the influence of risk factors on mental health, and is an important psychological resource for individuals to cope with stress. Therefore, this study investigated the relationship between psychological pain, hope level, and quality of life in patients on chemotherapy for EC, in order to provide an objective basis for appropriate clinical psychological intervention.
AIM To explore the mediating effect of hope level between psychological pain and quality of life in patients with EC on chemotherapy, so as to provide a basis for psychological management of patients with EC.
METHODS The psychological pain thermometer, Herth hope scale, and quality of life scale were used to investigate the psychological pain, hope level, and quality of life in 80 patients with EC on chemotherapy by convenient sampling method.
RESULTS The psychological pain score of the 80 patients was 2.98 ± 0.65, among which no psychological pain accounted for 20.0% (16/80), mild psychological pain accounted for 40.0% (32/80), and significant psychological pain accounted for 40.0% (32/80). The score of hope level was 34.98 ± 4.65, and the score of quality of life was 103.56 ± 18.47. Pearson analysis showed that the patient's hope level was negatively correlated with the degree of psychological pain (P < 0.01) and positively correlated with the quality of life (P < 0.01), while psychological pain was negatively correlated with the quality of life (P < 0.01). Mediating effect variance analysis showed that the hope level had a partial mediating effect between psychological pain and overall quality of life, emotional state, and functional state (P < 0.05).
CONCLUSION Psychological distress and hope level both affect the quality of life in patients with EC on chemotherapy, and hope level in patients with EC on chemotherapy plays an intermediary role between psychological distress and quality of life. Psychological pain and hope level assessment should be enhanced in clinical work, and measures should be taken to improve the level of hope, reduce psychological distress, and thus improve patients' quality of life.
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Affiliation(s)
- Yun-Qing Fu
- Yiwu Central Hospital, Yiwu 322000, Zhejiang Province, China
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17
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A Systematic Review and Meta-analysis of the Distress Thermometer for Screening Distress in Asian Patients with Cancer. J Clin Psychol Med Settings 2020; 28:212-220. [DOI: 10.1007/s10880-020-09705-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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18
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van Beek FE, Wijnhoven LMA, Jansen F, Custers JAE, Aukema EJ, Coupé VMH, Cuijpers P, van der Lee ML, Lissenberg-Witte BI, Wijnen B, Prins JB, Verdonck-de Leeuw IM. Prevalence of adjustment disorder among cancer patients, and the reach, effectiveness, cost-utility and budget impact of tailored psychological treatment: study protocol of a randomized controlled trial. BMC Psychol 2019; 7:89. [PMID: 31870421 PMCID: PMC6929410 DOI: 10.1186/s40359-019-0368-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 12/15/2019] [Indexed: 01/01/2023] Open
Abstract
Background Information on the prevalence of adjustment disorders among cancer patients and the value of psychological interventions in this group of patients is limited. This study investigates the prevalence of adjustment disorders among cancer patients as well as the reach, effectiveness, cost-utility and budget impact of a tailored psychological intervention. Method This study consists of two parts. Part 1 is an observational study among a representative group of mixed cancer patients after cancer treatment on the prevalence of adjustment disorder as well as the uptake (i.e. reach) of psychological treatment. In Part 2, patients diagnosed with an adjustment disorder are invited to participate in a randomized controlled trial. Patients will be randomized to the intervention (access to the tailored psychological intervention) or control group (waitlist period of 6 months). The psychological intervention consists of three modules: one module containing psycho-education (3 sessions, all patients) and two additional modules (maximum of 6 sessions per module) provided as continuum, in case needed. Module 2 and 3 can consist of several evidence-based interventions (e.g. group interventions, mindfulness, eHealth) The primary outcome is psychological distress (HADS). Secondary outcomes are mental adjustment to cancer (MAC) and health-related quality of life (EORTC QLQ-C30). To assess the cost-utility and budget impact, quality of life (EQ-5D-5 L) and costs (iMCQ and iPCQ) will be measured. Measures will be completed at baseline and 3 and 6-months after randomization. Discussion This study will provide data of the prevalence of adjustment disorders and the reach, effectiveness, cost-utility and budget impact of a tailored psychological intervention. Trial registration Netherlands Trial Register identifier: NL7763. Registered on 3 June 2019.
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Affiliation(s)
- Florie E van Beek
- Department of Clinical, Neuro & Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Lonneke M A Wijnhoven
- Department of Medical Psychology, Radboudumc Nijmegen, Radboud Institute of Health Sciences, Nijmegen, The Netherlands
| | - Femke Jansen
- Department of Clinical, Neuro & Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - José A E Custers
- Department of Medical Psychology, Radboudumc Nijmegen, Radboud Institute of Health Sciences, Nijmegen, The Netherlands
| | - Eline J Aukema
- Ingeborg Douwes Centrum, Centre for Psycho-Oncology, Amsterdam, The Netherlands
| | - Veerle M H Coupé
- Department of Epidemiology and Biostatistics, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Pim Cuijpers
- Department of Clinical, Neuro & Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | | - Birgit I Lissenberg-Witte
- Department of Epidemiology and Biostatistics, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ben Wijnen
- Trimbos Institute, Utrecht, The Netherlands
| | - Judith B Prins
- Department of Medical Psychology, Radboudumc Nijmegen, Radboud Institute of Health Sciences, Nijmegen, The Netherlands
| | - Irma M Verdonck-de Leeuw
- Department of Clinical, Neuro & Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands. .,Department of Otolaryngology-Head and Neck Surgery, Amsterdam UMC, VUmc, Cancer Center Amsterdam, Amsterdam, The Netherlands.
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19
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Livingston PM, Heckel L, Orellana L, Ashley D, Ugalde A, Botti M, Pitson G, Woollett A, Chambers SK, Parente P, Chirgwin J, Mihalopoulos C, Lavelle B, Sutton J, Phipps-Nelson J, Krishnasamy M, Simons K, Heynsbergh N, Wickramasinghe N, White V. Outcomes of a randomized controlled trial assessing a smartphone Application to reduce unmet needs among people diagnosed with CancEr (ACE). Cancer Med 2019; 9:507-516. [PMID: 31769226 PMCID: PMC6970035 DOI: 10.1002/cam4.2718] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 10/22/2019] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Smartphone technology represents an opportunity to deliver practical solutions for people affected by cancer at a scale that was previously unimaginable, such as information, appointment monitoring, and improved access to cancer support services. This study aimed to determine whether a smartphone application (app) reduced the unmet needs among people newly diagnosed with cancer. METHODS A single blind, multisite randomized controlled trial to determine the impact of an app-based, 4-month intervention. Newly diagnosed cancer patients were approached at three health service treatment clinics. RESULTS Eighty-two people were randomized (intervention; n = 43 and control; n = 39), average age was 59.5 years (SD: 12.9); 71% female; 67% married or in a de facto relationship. At baseline, there were no differences in participants' characteristics between the groups. No significant effects, in reducing unmet needs, were demonstrated at the end of intervention (4-month) or 12-month follow-up. Overall, 94% used the app in weeks 1-4, which decreased to 41% in weeks 13-16. Mean app use time per participant: Cancer Information, 6.9 (SD: 18.9) minutes; Appointment Schedule, 5.1 (SD: 9.6) minutes; Cancer Services 1.5 minutes (SD: 6.8); Hospital Navigation, 1.4 (SD: 2.8) minutes. CONCLUSIONS Despite consumer involvement in the design of this smartphone technology, the app did not reduce unmet needs. This may have been due to the study being underpowered. To contribute to a meaningful understanding and improved implementation of smartphone technology to support people affected by cancer, practical considerations, such as recruitment issues and access to, and confidence with, apps, need to be considered. Australian New Zealand Clinical Trials Registration (ACTRN) Trial Registration: 12616001251415; WEF 7/9/2016.
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Affiliation(s)
- Patricia M Livingston
- Faculty of Health, Deakin University, Geelong, Vic., Australia.,School of Nursing and Midwifery, Faculty of Health, Deakin University, Geelong, Vic., Australia
| | - Leila Heckel
- School of Nursing and Midwifery, Faculty of Health, Deakin University, Geelong, Vic., Australia
| | - Liliana Orellana
- Biostatistics Unit, Faculty of Health, Deakin University, Geelong, Vic., Australia
| | - David Ashley
- Duke University School of Medicine, Durham, NC, USA
| | - Anna Ugalde
- School of Nursing and Midwifery, Faculty of Health, Deakin University, Geelong, Vic., Australia
| | - Mari Botti
- School of Nursing and Midwifery, Faculty of Health, Deakin University, Geelong, Vic., Australia.,Epworth HealthCare, Richmond, Vic., Australia
| | - Graham Pitson
- Andrew Love Cancer Centre, Barwon Health, University Hospital, Geelong, Vic., Australia
| | - Anne Woollett
- The University of Melbourne, Medicine, Dentistry and Health Sciences, Melbourne, Vic., Australia
| | - Suzanne K Chambers
- Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Phillip Parente
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Vic., Australia.,Eastern Health, Department of Oncology, Box Hill, Vic., Australia
| | | | - Cathrine Mihalopoulos
- Faculty of Health, School of Health and Social Development, Deakin University, Geelong, Vic., Australia
| | - Barbara Lavelle
- Faculty of Health, Deakin University, Geelong, Vic., Australia
| | | | | | - Mei Krishnasamy
- The University of Melbourne, Medicine, Dentistry and Health Sciences, Melbourne, Vic., Australia
| | - Katherine Simons
- North Eastern Melbourne Integrated Cancer Service, Heidelberg, Vic., Australia
| | - Natalie Heynsbergh
- School of Nursing and Midwifery, Faculty of Health, Deakin University, Geelong, Vic., Australia
| | - Nilmini Wickramasinghe
- Iverson Health Innovation Research Institute, Swinburne University, Hawthorn, Vic., Australia
| | - Vicki White
- Faculty of Health, School of Psychology, Deakin University, Geelong, Vic., Australia
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20
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Risk factors for early postoperative psychological problems in breast cancer patients after axillary lymph node dissection. Breast Cancer 2019; 27:284-290. [PMID: 31679113 DOI: 10.1007/s12282-019-01020-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 10/26/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND The purpose of this study was to investigate the factors related to early postoperative psychological conditions in breast cancer patients with axillary lymph node dissection 3 months after the surgery. METHODS The subjects of this study were 200 consecutive patients who underwent axillary lymph node dissection for breast cancer at our hospital. Age, body mass index, surgical side, work, marriage, presence of children, presence of co-resident household members, resection of the pectoralis minor muscle, preoperative chemotherapy, postoperative chemotherapy, postoperative hormonal therapy, postoperative radiotherapy, shoulder range of motion, upper limb function (Disabilities of the Arm, Shoulder and Hand; DASH), and psychological conditions were evaluated. In this study, a Distress and Impact Thermometer was used to classify patients with adjustment disorders, depression, or major depression and suicidal ideation into a group with psychological problems and the remaining patients into a group with no psychological problems. RESULTS Logistic regression analysis showed that only DASH was statistically significantly associated with psychological conditions (p < 0.05). Using receiver operating characteristic curve analysis, a DASH score of 18 or greater was found to be very specific for predicting psychological conditions. CONCLUSIONS The observation that somatic symptoms and disability of upper limb function are related to psychological conditions may indicate the importance of postoperative rehabilitation in breast cancer patients with axillary lymph node dissection.
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21
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A new way of rapidly screening for depression in multiple sclerosis using Emotional Thermometers. Acta Neuropsychiatr 2019; 31:151-158. [PMID: 30914071 DOI: 10.1017/neu.2019.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Depression is a common, serious, but under-recognised problem in multiple sclerosis (MS). The primary objective of this study was to assess whether a rapid visual analogue screening tool for depression could operate as a quick and reliable screening method for depression, in patients with MS. METHOD Patients attending a regional MS outpatient clinic completed the Emotional Thermometer 7 tool (ET7), the Hospital Anxiety and Depression Scale - Depression Subscale (HADS-D) and the Major Depression Inventory (MDI) to establish a Diagnostic and Statistical Manual, 4th edition (DSM-IV) diagnosis of Major Depression. Full ET7, briefer subset ET4 version and depression and distress thermometers alone were compared with HADS-D and MDI. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and receiver operating characteristic (ROC) curve were calculated to compare the performance of all the screening tools. RESULTS In total, 190 patients were included. ET4 performed well as a 'rule-out' screening step (sensitivity 0.91, specificity 0.72, NPV 0.98, PPV 0.32). ET4 performance was comparable to HADS-D (sensitivity 0.96, specificity 0.77, NPV 0.99, PPV 0.37) without need for clinician scoring. The briefer ET4 performed as well as the full ET7. CONCLUSION ET are quick, sensitive and useful screening tools for depression in this MS population, to be complemented by further questioning or more detailed psychiatric assessment where indicated. Given that ET4 and ET7 perform equally well, we recommend the use of ET4 as it is briefer. It has the potential to be widely implemented across busy neurology clinics to assist in depression screening in this under diagnosed group.
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22
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Ehlers SL, Davis K, Bluethmann SM, Quintiliani LM, Kendall J, Ratwani RM, Diefenbach MA, Graves KD. Screening for psychosocial distress among patients with cancer: implications for clinical practice, healthcare policy, and dissemination to enhance cancer survivorship. Transl Behav Med 2019; 9:282-291. [PMID: 30566662 PMCID: PMC6610173 DOI: 10.1093/tbm/iby123] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Accreditation standards are at the forefront of evolving healthcare systems, setting metrics for high-quality care. Healthcare outcomes (health, experience, cost, provider satisfaction/burn out) are becoming mutual goals of the patient, provider, payer, and healthcare system. Achieving high-quality outcomes in cancer care necessitates collaboration among interdisciplinary teams of clinical providers, administrators, patient advocates, caregivers, and researchers. Dissemination and implementation science provides necessary frameworks to organize the efforts of these implementation teams, inclusive of identifying facilitators and barriers to implementation of accreditation standards. Since 2015, cancer distress screening has been mandated for continued cancer center accreditation by the American College of Surgeon's Commission on Cancer. Cancer centers have thus become real world implementation laboratories. We present the current context of distress screening, highlighting prior research and key areas of future research. We consider multiple levels of cancer care delivery and the use of interdisciplinary teams to help cancer center teams adopt, implement, and maintain efficient distress screening programs. Finally, we present a case study to identify methods for successful implementation of distress screening at one cancer center and then describe efficiencies that can be introduced using elements from human factors engineering, e- and m-health screening platforms, and community partnerships.
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Affiliation(s)
- Shawna L Ehlers
- Department of Psychiatry and Psychology, Mayo College of Medicine and Science, Rochester, MN, USA
| | - Kimberly Davis
- Departments of Oncology and Psychiatry, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA
| | - Shirley M Bluethmann
- Department of Public Health Sciences, College of Medicine, The Pennsylvania State University, Hershey, PA, USA
| | - Lisa M Quintiliani
- Section of General Internal Medicine, School of Medicine, Boston University, MA, USA
| | - Jeffrey Kendall
- Oncology Service Line, University of Minnesota Cancer Care, Minneapolis, MN, USA
| | - Raj M Ratwani
- National Center for Human Factors in Healthcare, MedStar Health, Washington, DC, USA
| | - Michael A Diefenbach
- Feinstein Institute for Medical Research, Center for Health Innovation and Outcomes Research, Manhasset, NY, USA
| | - Kristi D Graves
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA
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23
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Wong EC, Kaplan CP, Dreher N, Hwang J, Van't Veer L, Melisko ME. Integration of Health Questionnaire Systems to Facilitate Supportive Care Services for Patients at an Academic Breast Care Center. JCO Clin Cancer Inform 2019; 2:1-13. [PMID: 30652601 DOI: 10.1200/cci.18.00018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE This study evaluated the use of an electronic Health Questionnaire System (HQS) within the University of California San Francisco Breast Care Center as a screening and triage tool to proactively recognize patients' supportive care needs during new patient consultations and identify demographic characteristics associated with referrals to three supportive care services. PATIENTS AND METHODS A total of 428 patients with and without breast cancer between the ages of 18 and 84 years completed HQS intake forms before appointments at the University of California San Francisco Breast Care Center between November 2014 and May 2015 and agreed to participate in this study. Patient HQS responses triggered referrals to supportive care services, and a review of electronic health records was conducted to determine the outcomes of these referrals. RESULTS A total of 242 patients (56.5%) met criteria for at least one supportive care referral. Women with invasive breast cancer or ductal carcinoma in situ met criteria for supportive services more frequently than women without breast cancer diagnoses (76.9% v 23.8%; P < .001) and were most likely to receive referrals for genetic counseling (67.0%), psychological services (32.2%), and social services (12.1%). Multivariable logistic regression analysis showed that being married was associated with fewer referrals to social work (OR, 0.42; 95% CI, 0.21 to 0.81) and that those between 45 and 54 years of age were less likely to receive referrals to genetic counseling than those ≥ 55 years of age (OR, 0.41; 95% CI, 0.23 to 0.73). Among all referrals (n = 369), 26.8% resulted in completed appointments. CONCLUSION Using an automated intake form is an efficient way to identify and triage individuals in need of supportive care services and can provide insight into the populations with supportive care needs for targeted outreach.
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Affiliation(s)
- Emily C Wong
- All authors: University of California San Francisco, San Francisco, California
| | - Celia P Kaplan
- All authors: University of California San Francisco, San Francisco, California
| | - Nickolas Dreher
- All authors: University of California San Francisco, San Francisco, California
| | - Jimmy Hwang
- All authors: University of California San Francisco, San Francisco, California
| | - Laura Van't Veer
- All authors: University of California San Francisco, San Francisco, California
| | - Michelle E Melisko
- All authors: University of California San Francisco, San Francisco, California
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Alosaimi FD, Abdel-Aziz N, Alsaleh K, AlSheikh R, AlSheikh R, Abdel-Warith A. Validity and feasibility of the Arabic version of distress thermometer for Saudi cancer patients. PLoS One 2018; 13:e0207364. [PMID: 30427918 PMCID: PMC6241127 DOI: 10.1371/journal.pone.0207364] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 10/30/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The distress thermometer (DT) has been studied and validated as an effective screening instrument for identifying distress among cancer patients worldwide. This study aims to evaluate the validity of the Arabic version of the DT in Saudi cancer patients, to define the optimal cutoff point of the Arabic DT for detecting clinically significant distress and to determine whether there is any correlation between clinically significant distress and other demographic and Problem List variables. METHODS The original form of the DT was translated to Arabic using a forward and backward translation method. Then, a group of 247 cancer patients who were followed up at the Outpatient Oncology Clinic at King Saud Medical City in Riyadh, Saudi Arabia, completed a socio-demographic and clinical status questionnaire, the DT and the Problem List scale, and the Hospital Anxiety and Depression Scale (HADS). RESULTS Receiver operating characteristic (ROC) curve analyses picked out an area under the curve of 0.76 when compared with a HADS cutoff score of 15. The DT had the best sensitivity (0.70) and specificity (0.63) with cutoff score of 4. A DT score of 4 or more was found to have a statistically significant correlation with female gender, advanced cancer stages and most of the Problem List items, including child care, work or school, treatment decision, dealing with children and partners, depression, fears, nervousness, sadness, loss of interest in usual activity, religious concerns, appearance, bathing/dressing, breathing, diarrhea, fatigue, feeling swollen, fever, getting around, indigestion, memory and concentration, nausea, dry nose, pain, and sexual problems. In contrast, a multivariate regression analysis confirmed only advanced cancer stages, treatment decision, depression, fear, sadness, worry, breathing, feeling swollen, fever, indigestion, memory and concentration, dry nose and congestion, pain and sleep as independent factors associated with distress in cancer patients. CONCLUSIONS We found the Arabic version of the DT to be a valid instrument for screening distress in Saudi patients with cancer. Our study proposes using a cutoff score of 4 as an indicator of clinically significant distress in this population.
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Affiliation(s)
| | - Nashwa Abdel-Aziz
- Hematology Oncology center, King Saud University, Riyadh, Saudi Arabia
- Department of Medical Oncology, South Egypt Cancer Institute, Assiut University, Assiut, Egypt
| | - Khalid Alsaleh
- Hematology Oncology center, King Saud University, Riyadh, Saudi Arabia
| | - Rawan AlSheikh
- Department of Pediatrics, King Saud University, Riyadh, Saudi Arabia
| | - Rana AlSheikh
- Department of Pediatrics, King Saud University, Riyadh, Saudi Arabia
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Akechi T, Yamaguchi T, Uchida M, Imai F, Momino K, Katsuki F, Sakurai N, Miyaji T, Horikoshi M, Furukawa TA, Iwata H, Uchitomi Y. Smartphone problem-solving and behavioural activation therapy to reduce fear of recurrence among patients with breast cancer (SMartphone Intervention to LEssen fear of cancer recurrence: SMILE project): protocol for a randomised controlled trial. BMJ Open 2018; 8:e024794. [PMID: 30413519 PMCID: PMC6231603 DOI: 10.1136/bmjopen-2018-024794] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION One of the most common distressing conditions experienced by breast cancer survivors is fear of cancer recurrence (FCR). There is, however, no standard intervention for ameliorating FCR. Our clinical experience and previous studies have suggested the potential benefits of problem-solving therapy (PST) and behavioural activation (BA). Given the huge number of cancer survivors and limited number of therapists to competently conduct PST and BA, we have developed PST and BA smartphone applications. This study aimed to evaluate the efficacy of the smartphone-based PST (Kaiketsu-App) and BA (Genki-App) apps in reducing FCR in patients with breast cancer. METHODS AND ANALYSIS The SMartphone Intervention to LEssen fear of cancer recurrence project is an open-label, individually randomised, parallel-group trial. Allocation will be managed by a central server using a computer-generated random allocation sequence provided by an independent data centre. Participants will be randomised to smartphone-based intervention plus treatment as usual (TAU) or waitlist control with TAU alone. The primary endpoint of the study is the Japanese version of the Concerns About Recurrence Scale, which will be administered as an electronic patient-reported outcome on the patients' smartphone after 8 weeks. ETHICS AND DISSEMINATION The present study is subject to the ethical guidelines for clinical studies published by Japan's Ministry of Education, Science and Technology and Ministry of Health, Labour and Welfare and the modified Act on the Protection of Personal Information as well as the ethical principles established for research on humans stipulated in the Declaration of Helsinki and further amendments thereto. The protocol was approved by the Institutional Review Board of Nagoya City University on 15 January 2018 (ID: 60-00-1171). TRIAL STATUS The randomised trial, which commenced on 2 April 2018, currently enrols participants. The estimated end date for this study is in March 2020. TRIAL REGISTRATION NUMBER UMIN000031140; Pre-results.
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Affiliation(s)
- Tatsuo Akechi
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
- Division of Palliative Care and Psycho-oncology, Nagoya City University Hospital, Nagoya, Japan
| | - Takuhiro Yamaguchi
- Division of Biostatistics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Megumi Uchida
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
- Division of Palliative Care and Psycho-oncology, Nagoya City University Hospital, Nagoya, Japan
| | - Fuminobu Imai
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
- Division of Palliative Care and Psycho-oncology, Nagoya City University Hospital, Nagoya, Japan
| | - Kanae Momino
- Department of Nursing Administration and Management, Nagoya City University School of Nursing, Nagoya, Japan
| | - Fujika Katsuki
- Department of Psychiatric and Mental Health Nursing, Nagoya City University School of Nursing, Nagoya, Japan
| | | | - Tempei Miyaji
- Department of Clinical Trial Data Management, Tokyo University Graduate School of Medicine, Tokyo, Japan
| | - Masaru Horikoshi
- National Center for Cognitive Behavior Therapy and Research, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Toshi A Furukawa
- Department of Health Promotion of Human Behavior, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan
| | - Hiroji Iwata
- Department of Breast Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Yosuke Uchitomi
- Behavioral and Survivorship Research Group, Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
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Association Between Androgen Deprivation Therapy and Patient-reported Depression in Men With Recurrent Prostate Cancer. Clin Genitourin Cancer 2018; 16:313-317. [DOI: 10.1016/j.clgc.2018.05.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 05/03/2018] [Accepted: 05/07/2018] [Indexed: 11/21/2022]
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Mackenzie L, Carey M, Suzuki E, Yoshimura M, Toi M, D'Este C, Sanson-Fisher R. A cross-sectional study of agreement between the Hospital Anxiety and Depression Scale and patient- and radiation oncologist-reported single-item assessment of depression and anxiety. Psychooncology 2018; 27:1840-1846. [DOI: 10.1002/pon.4736] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 04/05/2018] [Accepted: 04/06/2018] [Indexed: 02/06/2023]
Affiliation(s)
- Lisa Mackenzie
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine; University of Newcastle; Callaghan NSW Australia
- Priority Research Centre for Health Behaviour; University of Newcastle; Callaghan NSW Australia
- Hunter Medical Research Institute; Newcastle NSW Australia
- Graduate School of Medicine; Kyoto University; Kyoto Japan
| | - Mariko Carey
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine; University of Newcastle; Callaghan NSW Australia
- Priority Research Centre for Health Behaviour; University of Newcastle; Callaghan NSW Australia
- Hunter Medical Research Institute; Newcastle NSW Australia
| | - Eiji Suzuki
- Breast Surgery; Kyoto University Hospital; Kyoto Japan
| | - Michio Yoshimura
- Department of Radiation Oncology and Image-Applied Therapy; Kyoto University Hospital; Kyoto Japan
| | - Masakazu Toi
- Breast Surgery; Kyoto University Hospital; Kyoto Japan
| | - Catherine D'Este
- National Centre for Epidemiology and Population Health, Research School of Population Health; Australian National University; Canberra ACT Australia
| | - Rob Sanson-Fisher
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine; University of Newcastle; Callaghan NSW Australia
- Priority Research Centre for Health Behaviour; University of Newcastle; Callaghan NSW Australia
- Hunter Medical Research Institute; Newcastle NSW Australia
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Heckel L, Fennell KM, Orellana L, Boltong A, Byrnes M, Livingston PM. A telephone outcall program to support caregivers of people diagnosed with cancer: utility, changes in levels of distress, and unmet needs. Support Care Cancer 2018; 26:3789-3799. [PMID: 29766259 DOI: 10.1007/s00520-018-4246-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 05/06/2018] [Indexed: 12/17/2022]
Abstract
PURPOSE To evaluate the utility of a telephone outcall program for cancer caregivers and to examine longitudinal changes in their distress levels and supportive care needs. METHODS As part of the PROTECT trial, caregivers assigned to the intervention arm (N = 108) received three telephone outcalls from a Cancer Council 13 11 20 nurse at three time points (7-10 days post-randomization, 1 and 4 months later). During each call, caregivers were screened for distress using the Distress Thermometer (range: 0-10) then six supportive care issues were raised for discussion. Participants completed a utility survey 1 month post-intervention. RESULTS The outcall program was highly acceptable and perceived as beneficial by caregivers. Overall, 95% reported it was worth their time to take part in the outcall program and 82% stated that the program was very relevant to them. Level of distress and impact of distress decreased over time (p = 0.0031, p < 0.0001, respectively). Average call duration decreased over time (p < 0.0001) and was longer for female than male caregivers (p = 0.0009). The frequency of caregivers discussing issues related to psychological distress (p = 0.0003), health literacy (p < 0.0001), financial (p = 0.0014), and practical concerns (p = 0.0121) decreased over time. Psychological distress was more often discussed by female than male caregivers (p = 0.0153), and family issues more often by younger (< 55 years) than older caregivers (p = 0.0071). CONCLUSIONS Utility of this outcall program was high. Caregivers' level of distress and unmet needs decreased over time. Gender and age differences emerged, which warrants the need for tailored support. Further research is necessary to identify the best method of improving access to 13 11 20 services for caregivers.
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Affiliation(s)
- Leila Heckel
- Faculty of Health, School of Nursing and Midwifery, Deakin University, Geelong, VIC, 3220, Australia.
| | - Kate M Fennell
- Cancer Council SA, 202 Greenhill Road, Eastwood, South Australia, 5063, Australia.,Flinders Centre for Innovation in Cancer, School of Medicine, Flinders University, Sturt Road, Bedford Park, South Australia, 5042, Australia.,Sansom Institute for Health Research, University of South Australia, City East Campus, North Terrace, Adelaide, South Australia, 5000, Australia
| | - Liliana Orellana
- Faculty of Health, Biostatistics Unit, Deakin University, Geelong, VIC, 3220, Australia
| | - Anna Boltong
- Cancer Council Victoria, 615 St Kilda Road, Melbourne, VIC, 3004, Australia.,Melbourne School of Health Sciences, The University of Melbourne, Grattan Street, Parkville, VIC, 3010, Australia
| | - Monica Byrnes
- Cancer Council SA, 202 Greenhill Road, Eastwood, South Australia, 5063, Australia
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Grassi L, Caruso R, Mitchell AJ, Sabato S, Nanni MG. Screening for emotional disorders in patients with cancer using the Brief Symptom Inventory (BSI) and the BSI-18 versus a standardized psychiatric interview (the World Health Organization Composite International Diagnostic Interview). Cancer 2018; 124:2415-2426. [PMID: 29660109 DOI: 10.1002/cncr.31340] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2017] [Revised: 01/24/2018] [Accepted: 01/26/2018] [Indexed: 12/25/2022]
Abstract
BACKGROUND Given the adverse consequences of psychiatric and psychosocial morbidity on the quality of life for patients with cancer, prompt detection of psychological symptoms is mandatory. The authors examined the properties and accuracy of the Brief Symptom Inventory (the 53-item version [BSI] and the 18-item version [BSI-18]) for the detection of psychiatric morbidity compared with the World Health Organization Composite International Diagnostic Interview (CIDI) for International Classification of Diseases-10th Revision psychiatric diagnoses. METHODS A convenience sample of 498 patients with newly diagnosed cancer who were recruited in cancer outpatient services participated in the CIDI interview and in BSI and BSI-18 assessments. RESULTS The prevalence of psychiatric morbidity was 39.75%. When participants were classified as cases using the BSI standard case rule, agreement with the CIDI was potentially acceptable (sensitivity, 72.7%; specificity, 88.7%). In contrast, the accuracy of the BSI-18 in identifying cases was poor according to the standard case rule, with very low sensitivity (29.3%) (misclassification rate, 28.7%). By using a first alternative case-rule system (a BSI-18 global severity index [GSI] T-score ≥57), sensitivity marginally improved (45%), whereas a second alternative case-rule system (a GSI T-score ≥50) significantly increased sensitivity (77.3%). In receiver operating characteristic curve analysis, a further cutoff GSI T-score ≥48 exhibited good discrimination levels (sensitivity, 82.3%; specificity, 72.4%). There were some differences in GSI cutoff T-scores according to the International Classification of Diseases-10th Revision diagnosis and sex. CONCLUSIONS The BSI appeared to have acceptable diagnostic accuracy compared with a standardized psychiatric interview. For the BSI-18, it is mandatory to use alternative case-rule systems, to identify patients with psychiatric morbidity. Cancer 2018;124:2415-26. © 2018 American Cancer Society.
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Affiliation(s)
- Luigi Grassi
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy.,University Unit of Hospital Psychiatry, S. Anna Hospital and Health Authorities, Ferrara, Italy
| | - Rosangela Caruso
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy.,University Unit of Hospital Psychiatry, S. Anna Hospital and Health Authorities, Ferrara, Italy
| | - Alex J Mitchell
- Department of Psycho-Oncology, Cancer, and Molecular Medicine, University of Leicester, Leicester, United Kingdom
| | - Silvana Sabato
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy
| | - Maria Giulia Nanni
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy.,University Unit of Hospital Psychiatry, S. Anna Hospital and Health Authorities, Ferrara, Italy
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Stonelake-French H, Moos BE, Brueggen CM, Gravemann EL, Hansen AL, Voll JM, Dose AM. Understanding Distress in the Hospital: A Qualitative Study Examining Adults With Cancer. Oncol Nurs Forum 2018; 45:206-216. [PMID: 29466351 DOI: 10.1188/18.onf.206-216] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To measure the distress of hospitalized adults with cancer and identify strategies and behaviors to manage distress.
. PARTICIPANTS & SETTING 185 adults with cancer hospitalized in a large tertiary hospital in the Midwest.
. METHODOLOGIC APPROACH This study involved a one-time assessment using the National Comprehensive Cancer Network's (NCCN's) Distress Thermometer and two open-ended questions. Demographic data were reviewed, and responses to open-ended questions were analyzed by content analysis. A team approach was used to develop and validate themes.
. FINDINGS Strategies used by patients to manage distress were categorized as taking charge and embracing help. Helpful strategies were related to quality of life and relationship with care teams.
. IMPLICATIONS FOR NURSING Understanding of distress in hospitalized adults with cancer is limited, which warrants the attention of healthcare professionals. Study results have implications to enhance patient care and to address nationally established psychosocial care objectives and NCCN distress screening standards.
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Naito AS, Sakuma Y, Kinoshita H, Ito T, Mimatsu S, Tarumi A, Kiyohara E, Morita T. Screening using the fifth vital sign in the electronic medical recording system. Jpn J Clin Oncol 2017; 47:430-433. [PMID: 28201540 DOI: 10.1093/jjco/hyx020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Accepted: 01/31/2017] [Indexed: 01/30/2023] Open
Abstract
Purpose To investigate the usefulness of screening for patient symptoms as the fifth vital sign using an electronic medical recording system. Patients and methods In the electronic medical recording system, all admitted patients received routine nurse-based assessment of discomfort (defined as any physical symptom) at every vital sign check regarding item 2 of the Support Team Assessment Schedule Japanese version (STAS-J). All cancer patients admitted to oncology units were screened at 1-week intervals. Screening-positive was defined when patients had a STAS-J score of 2 or more at least two times in a week. For all screening-positive patients, the palliative care team reviewed each patient's medical records, and provided written recommendations as needed. The primary outcomes were the proportion of screening-positive patient, and the proportion of patients deemed to need additional palliative treatment in the screening-positive patients. Results Of 2427 patients screened, 223 (9.1%; 95% confidence interval, 8-10%) met the screening-positive criterion. A total of 12 (5.4%; 95% confidence interval, 3-9%) of them were deemed to need additional palliative care, including six patients referred to the PCT within 1 week. In the remaining 211 screening-positive patients, 100 had received adequate palliative care, 68 had already been referred to the palliative care team and 43 had self-limiting transient discomfort. Conclusion This screening system was feasible but the majority of screening-positive patients did not require additional palliative care interventions.
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Affiliation(s)
- Akemi Shirado Naito
- Department of Palliative and Supportive Care, Palliative Care Team, Seirei Mikatahara Hospital
| | - Yumi Sakuma
- Palliative Care Team, Seirei Mikatahara Hospital
| | | | - Tomoko Ito
- Palliative Care Team, Seirei Mikatahara Hospital
| | - Saki Mimatsu
- Palliative Care Team, Seirei Mikatahara Hospital
| | - Akiko Tarumi
- Palliative Care Team, Seirei Mikatahara Hospital
| | - Emi Kiyohara
- Nursing Department of Oncology Center, Seirei Mikatahara Hospital, Japan
| | - Tatsuya Morita
- Department of Palliative and Supportive Care, Palliative Care Team, Seirei Mikatahara Hospital
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Cutillo A, O’Hea E, Person S, Lessard D, Harralson T, Boudreaux E. The Distress Thermometer: Cutoff Points and Clinical Use. Oncol Nurs Forum 2017; 44:329-336. [PMID: 29493167 PMCID: PMC5839660 DOI: 10.1188/17.onf.329-336] [Citation(s) in RCA: 118] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose/Objectives To establish an optimal cutoff point for the National Comprehensive Cancer Network’s Distress Thermometer (DT) as a screening measure to identify and address psychological distress in individuals with cancer, and to examine whether distress as measured by the DT significantly changes across the treatment trajectory. Design Secondary analyses of baseline data from a longitudinal parent study examining a computerized psychosocial assessment. Setting Three diverse comprehensive cancer centers across the United States. Sample 836 patients with a current or past diagnosis of cancer. Methods Study participants were selected from a randomized clinical trial. Patients during any stage of the cancer treatment trajectory were recruited during a chemotherapy infusion or routine oncology appointment. Main Research Variables The Behavioral Health Status Index and the DT were administered and compared using receiver operating characteristic analyses. Findings Results support a cutoff score of 3 on the DT to indicate patients with clinically elevated levels of distress. In addition, patients who received a diagnosis within the 1–4 weeks prior to the assessment indicated the highest levels of distress. Conclusions Providers may wish to use a cutoff point of 3 to most efficiently identify distress in a large, diverse population of patients with cancer. In addition, results indicate that patients may experience a heightened state of distress within 1–4 weeks postdiagnosis compared to other stages of coping with cancer. Implications for Nursing Using a brief measure of distress can help streamline the process of screening for psychosocial distress.
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Affiliation(s)
- Alexandra Cutillo
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Erin O’Hea
- Department of Psychology, Stonehill College, Easton, MA, United States
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, United States
| | - Sharina Person
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
| | - Darleen Lessard
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
| | | | - Edwin Boudreaux
- Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, MA, United States
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
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Shinn EH, Valentine A, Baum G, Carmack C, Kilgore K, Bodurka D, Basen-Engquist K. Comparison of four brief depression screening instruments in ovarian cancer patients: Diagnostic accuracy using traditional versus alternative cutpoints. Gynecol Oncol 2017; 145:562-568. [PMID: 28400146 DOI: 10.1016/j.ygyno.2017.03.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 03/27/2017] [Accepted: 03/28/2017] [Indexed: 11/17/2022]
Abstract
OBJECTIVES We compared the diagnostic accuracy of 4 depression screening scales, using traditional and alternative scoring methods, to the gold standard Structured Clinical Interview-DSM IV major depressive episode (MDE) in ovarian cancer patients on active treatment. METHODS At the beginning of a new chemotherapy regimen, ovarian cancer patients completed the following surveys on the same day: the Center for Epidemiological Studies Depression Scale (CES-D), the Beck Depression Inventory Fast-Screen for Primary Care (BDI-FastScreen), the Patient Health Questionnaire-9 (PHQ-9), and a 1-item screener ("Are you depressed?"). Each instrument's sensitivity, specificity, positive predictive value (PPV) and negative predictive value were calculated with respect to major depression. To control for antidepressant use, the analyses were re-run for a subsample of patients who were not on antidepressants. RESULTS One hundred fifty-three ovarian cancer patients were enrolled into the study. Only fourteen participants met SCID criteria for current MDE (9%). When evaluating all patients regardless of whether they were already being treated with antidepressants, the two-phase scoring approach with an alternate cutpoint of 6 on the PHQ-9 had the best positive predictive value (PPV=32%). Using a traditional cutpoint of 16 on the CES-D resulted in the lowest PPV (5%); using a more stringent cutpoint of 22 resulted in a slightly improved but still poor PPV, 7%. CONCLUSIONS Screening with a two-phase PHQ-9 proved best overall, and its accuracy was improved when used with patients who were not already being treated with antidepressants.
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Affiliation(s)
- Eileen H Shinn
- Department of Behavioral Science, The University of Texas M. D. Anderson Cancer Center: Cancer Prevention Building - Unit 1330, 1155 Pressler St., Houston, TX 77030, USA.
| | - Alan Valentine
- Department of Psychiatry, The University of Texas MD Anderson Cancer Center: T. Boone Pickens Academic Tower - Unit 1454, 1515 Holcombe Blvd., Houston, TX 77030, USA.
| | - George Baum
- Department of Behavioral Science, The University of Texas M. D. Anderson Cancer Center: Cancer Prevention Building - Unit 1330, 1155 Pressler St., Houston, TX 77030, USA.
| | - Cindy Carmack
- Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center: T. Boone Pickens Academic Tower - Unit 1414, 1515 Holcombe Blvd., Houston, TX 77030, USA.
| | - Kelly Kilgore
- Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center: T. Boone Pickens Academic Tower - Unit 1414, 1515 Holcombe Blvd., Houston, TX 77030, USA.
| | - Diane Bodurka
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas M. D. Anderson Cancer Center: Mid Campus Building 1 - Unit 1727, 1515 Holcombe Blvd., Houston, TX 77030, USA.
| | - Karen Basen-Engquist
- Department of Behavioral Science, The University of Texas M. D. Anderson Cancer Center: Cancer Prevention Building - Unit 1330, 1155 Pressler St., Houston, TX 77030, USA.
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Camilleri S, Chong S, Tangvoraphonkchai K, Yoowannakul S, Davenport A. Effect of Self-Reported Distress Thermometer Score on the Maximal Handgrip and Pinch Strength Measurements in Hemodialysis Patients. Nutr Clin Pract 2017; 32:682-686. [DOI: 10.1177/0884533617697936] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Affiliation(s)
- Stephanie Camilleri
- UCL Centre for Nephrology, Royal Free Hospital, University College London, London, UK
| | - Stephanie Chong
- UCL Centre for Nephrology, Royal Free Hospital, University College London, London, UK
| | | | - Suree Yoowannakul
- UCL Centre for Nephrology, Royal Free Hospital, University College London, London, UK
| | - Andrew Davenport
- UCL Centre for Nephrology, Royal Free Hospital, University College London, London, UK
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The role of social media use in improving cancer survivors’ emotional well-being: a moderated mediation study. J Cancer Surviv 2017; 11:386-392. [DOI: 10.1007/s11764-017-0595-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2016] [Accepted: 01/03/2017] [Indexed: 10/20/2022]
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Botella C, Baños RM, Etchemendy E, García-Palacios A, Alcañiz M. Psychological countermeasures in manned space missions: “EARTH” system for the Mars-500 project. COMPUTERS IN HUMAN BEHAVIOR 2016. [DOI: 10.1016/j.chb.2015.10.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Shaw JM, Price MA, Clayton JM, Grimison P, Shaw T, Rankin N, Butow PN. Developing a clinical pathway for the identification and management of anxiety and depression in adult cancer patients: an online Delphi consensus process. Support Care Cancer 2015; 24:33-41. [PMID: 25903929 DOI: 10.1007/s00520-015-2742-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Accepted: 04/13/2015] [Indexed: 12/11/2022]
Abstract
PURPOSE People with cancer and their families experience high levels of psychological morbidity. However, many cancer services do not routinely screen patients for anxiety and depression, and there are no standardized clinical referral pathways. This study aimed to establish consensus on elements of a draft clinical pathway tailored to the Australian context. METHODS A two-round Delphi study was conducted to gain consensus among Australian oncology and psycho-oncology clinicians about the validity of 39 items that form the basis of a clinical pathway that includes screening, assessment, referral and stepped care management of anxiety and depression in the context of cancer. The expert panel comprised 87 multidisciplinary clinician members of the Australian Psycho-oncology Co-operative Research Group (PoCoG). Respondents rated their level of agreement with each statement on a 5-point Likert scale. Consensus was defined as >80% of respondents scoring within 2 points on the Likert scale. RESULTS Consensus was reached for 21 of 39 items, and a further 15 items approached consensus except for specific contextual factors, after two Delphi rounds. Formal screening for anxiety and depression, a stepped care model of management and recommendations for inclusion of length of treatment and time to review were endorsed. Consensus was not reached on items related to roles and responsibilities, particularly those not applicable across cancer settings. CONCLUSIONS This study identified a core set of evidence- and consensus-based principles considered essential to a stepped care model of care incorporating identification, referral and management of anxiety and depression in adult cancer patients.
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Affiliation(s)
- Joanne M Shaw
- Psycho-oncology Co-operative Research Group, School of Psychology, The University of Sydney, Level 6 North, Chris O'Brien Lifehouse (C39Z), Sydney, NSW, 2006, Australia.
| | - Melanie A Price
- Psycho-oncology Co-operative Research Group, School of Psychology, The University of Sydney, Level 6 North, Chris O'Brien Lifehouse (C39Z), Sydney, NSW, 2006, Australia.,Centre for Medical Psychology and Evidence-based Decision-making, School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - Josephine M Clayton
- HammondCare Palliative & Supportive Care Service, Greenwich Hospital, Greenwich, NSW, Australia.,Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Peter Grimison
- Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.,The Chris O'Brien Lifehouse, Camperdown, NSW, Australia
| | - Tim Shaw
- Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Nicole Rankin
- Sydney Catalyst, The University of Sydney, Sydney, NSW, Australia
| | - Phyllis N Butow
- Psycho-oncology Co-operative Research Group, School of Psychology, The University of Sydney, Level 6 North, Chris O'Brien Lifehouse (C39Z), Sydney, NSW, 2006, Australia.,Centre for Medical Psychology and Evidence-based Decision-making, School of Psychology, The University of Sydney, Sydney, NSW, Australia
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Grube M, Weigand-Tomiuk H. [Psychiatric psychotherapeutic interventions in breast cancer inpatients: a contribution to liaison-consultation psychiatry]. DER NERVENARZT 2014; 85:1390-1401. [PMID: 24796707 DOI: 10.1007/s00115-013-3940-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND Psychosocial stress and psychopathological abnormalities are expected in cancer patients at a frequency of 30-60%. Apart from decreased quality of life psychological factors may cause a negative impact on treatment compliance and on the subsequent biological course of tumor development. MATERIALS AND METHODS This study examined the association of different psychiatric and psychotherapeutic interventions in liaison-consultation psychiatry with the four psychopathological dimensions derived by factor analysis based on the items of psycho-oncological basic documentation in a group of 141 breast cancer patients without pre-existing mental disorders who were inpatients of a gynecologic cancer centre. In addition information concerning subjective stress experience was collected with the distress thermometer. RESULTS The plausible fit of the various psychiatric and psychotherapeutic interventions due to the psychopathological dimensions and due to the subjective experience of stress could be demonstrated. Those intervention variables that were associated with an improvement of the psychological state could be described as well. The findings showed that improvement or at least stability of the psychological state was regularly associated with completion of oncological treatment in the relevant index inpatient stay. In addition it was found that the interventions offered could contribute to improved psychological well-being in the subgroup of patients without mental disorders particularly in normal grief reactions. CONCLUSION Despite methodological limitations this investigation contributes to describing relevant psychopathological syndromes in a group of breast cancer patients without pre-existing mental disorders and the goodness of fit of the different psychiatric and psychotherapeutic interventions. Finally the study confirmed the assumption that stabilization of the mental state may help to avoid treatment interruptions in an oncological inpatient setting and therefore decrease the likelihood that reduced psychological well-being can negatively impact the biological course of tumor development.
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Affiliation(s)
- M Grube
- Klinik für Psychiatrie und Psychotherapie - Psychosomatik, Klinikum Frankfurt Höchst, 65929, Frankfurt am Main, Deutschland,
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Marten-Mittag B, Book K, Buchhold B, Dinkel A, Gründobler B, Henrich G, Huber B, Pirker C, Regenberg A, Schickel S, Senf B, Wünsch A, Herschbach P. The Basic Documentation for Psycho-Oncology Short Form (PO-Bado SF)--an expert rating scale for distress screening: development and psychometric properties. Psychooncology 2014; 24:653-60. [PMID: 25346529 DOI: 10.1002/pon.3708] [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: 12/11/2013] [Revised: 09/17/2014] [Accepted: 09/17/2014] [Indexed: 11/12/2022]
Abstract
BACKGROUND The aim of this study is to validate the Basic Documentation for Psycho-Oncology Short Form (PO-Bado SF), a six item interview-based expert rating scale for distress screening in cancer patients. METHODS Using a heterogeneous multicenter study sample (n = 1551), we examined validity, reliability, and dimensionality of the PO-Bado SF. The Hospital Anxiety and Depression Scale (HADS), the Distress Thermometer, the Questionnaire on Stress in Cancer, and the Patient Health Questionnaire were used to investigate convergent validity. Confirmatory factor analysis was applied to address unidimensionality. An optimal cutoff point was determined by ROC analysis and the maximum of Youden's index. An additional study with n = 41 audio recorded PO-Bado SF interviews was carried out to assess inter-rater reliability. RESULTS Mean age of the study sample was 64.0 (SD = 12.0), 42% were women. About 24% of the patients suffered from metastases. The one-factor solution was confirmed; internal consistency of the PO-Bado SF was high (α = 0.84). The PO-Bado SF total score correlated significantly with all psychosocial measures, the highest correlation was with the HADS total score (r = 0.64). Patients with severe disease conditions (metastases, psychological/psychiatric treatment in the past, low performance status) received higher distress ratings (p < 0.001). Using HADS total score (>13) as external criterion, an optimal PO-Bado SF cutoff score of >9 emerged (sensitivity 0.75; specificity 0.82). Inter-rater reliability was satisfactory for each of the six items (intra class correlation of 0.75 to 0.85). CONCLUSIONS The PO-Bado SF is a short, reliable and valid expert rating scale to identify distressed cancer patients.
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Affiliation(s)
- Birgitt Marten-Mittag
- Division of Psychosocial Oncology, Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Katrin Book
- Division of Psychosocial Oncology, Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.,Roman-Herzog Comprehensive Cancer Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Britta Buchhold
- Institute for Medical Psychology, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Andreas Dinkel
- Division of Psychosocial Oncology, Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Bärbel Gründobler
- Division of Psychosocial Oncology, Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Gerhard Henrich
- Division of Psychosocial Oncology, Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | | | - Celia Pirker
- Division of Psychosocial Oncology, Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | | | - Simone Schickel
- Division of Psychosocial Oncology, Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Bianca Senf
- Universitäres Centrum für Tumorerkrankungen, Universitätsklinikum Frankfurt am Main, Frankfurt am Main, Germany
| | - Alexander Wünsch
- Division of Psychosocial Oncology, Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Peter Herschbach
- Division of Psychosocial Oncology, Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.,Roman-Herzog Comprehensive Cancer Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
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Abstract
Seasonal affective disorder is a subtype of other affective disorders. The most studied treatment is light therapy, although second-generation antidepressants are also an option. Grief reactions are normal for patients experiencing loss, and primary care providers (PCPs) should be aware of both the expected course of grief and the more severe symptoms that indicate complex grief. Adjustment disorder is a time-limited abnormal response to a stressor. PCPs can manage patients with adjustment disorder by arranging counseling, screening for suicidality, assessing for substance abuse, and ruling out other psychiatric diagnoses. At present there are no reliable data to suggest medication management.
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Affiliation(s)
- Justin Osborn
- Department of Family Medicine, University of Washington, 331 Northeast Thornton Place, Box 358732, Seattle, WA 98125, USA.
| | - Jacqueline Raetz
- Department of Family Medicine, University of Washington, 331 Northeast Thornton Place, Box 358732, Seattle, WA 98125, USA
| | - Amanda Kost
- Department of Family Medicine, University of Washington, Box 356390, Seattle, WA 98195, USA.
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Morita T, Kuriya M, Miyashita M, Sato K, Eguchi K, Akechi T. Symptom Burden and Achievement of Good Death of Elderly Cancer Patients. J Palliat Med 2014; 17:887-93. [DOI: 10.1089/jpm.2013.0625] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Tatsuya Morita
- Department of Palliative Care and Supportive Care, Seirei Mikatahara General Hospital, Hamamatsu, Japan
| | - Meiko Kuriya
- Department of Palliative Medicine, Teikyo University School of Medicine, Tokyo, Japan
| | - Mitsunori Miyashita
- Department of Palliative Nursing, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kazuki Sato
- Department of Palliative Nursing, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kenji Eguchi
- Department of Internal Medicine and Medical Oncology, Teikyo University School of Medicine, Tokyo, Japan
| | - Tatsuo Akechi
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
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Rubes M, Podolsky AH, Caso N, Ambrose MA, Sicherer SH, Shemesh E, Annunziato RA. Utilizing physician screening questions for detecting anxiety among food-allergic pediatric patients. Clin Pediatr (Phila) 2014; 53:764-70. [PMID: 24691077 DOI: 10.1177/0009922814529016] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To explore the utility of clinician screening for anxiety in pediatric food-allergic patients. STUDY DESIGN In Phase I, 39 patients completed an anxiety questionnaire while their allergists completed a companion questionnaire estimating their patient's responses. Allergists then attended an educational workshop to improve their anxiety detection. In Phase II, following the workshop, questionnaires were completed by an additional 39 patients and their allergists. RESULTS The percentage of clinician questionnaires with a "do not know" response decreased from 70% to 5% after the workshop. Correlation between allergists' and children's responses remained nonsignificant (r = .314, P = .321) before the workshop and after (r = .303, P = .068) and only 25% of patients who reported elevated anxiety were identified. Additionally, clinicians expressed poor acceptability of the screening. CONCLUSIONS After the workshop, clinicians did not more accurately detect anxiety and found the process intrusive. Alternative methods for uncovering anxiety among high-risk patients are needed.
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Affiliation(s)
- Melissa Rubes
- Fordham University, Bronx NY, USA Kravis Children's Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Anna H Podolsky
- Kravis Children's Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Michael A Ambrose
- Kravis Children's Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Scott H Sicherer
- Kravis Children's Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Eyal Shemesh
- Kravis Children's Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Rachel A Annunziato
- Fordham University, Bronx NY, USA Kravis Children's Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Özalp E, Karslıoğlu EH, Aydemir Ö, Soygür H, Erkek BM, Peker SE, Kaymak SU. Validating the Sexual Adjustment and Body Image Scale (Sabis) with Breast Cancer Patients. SEXUALITY AND DISABILITY 2014. [DOI: 10.1007/s11195-014-9367-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Lim HA, Mahendran R, Chua J, Peh CX, Lim SE, Kua EH. The Distress Thermometer as an ultra-short screening tool: a first validation study for mixed-cancer outpatients in Singapore. Compr Psychiatry 2014; 55:1055-62. [PMID: 24556515 DOI: 10.1016/j.comppsych.2014.01.008] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Revised: 01/01/2014] [Accepted: 01/13/2014] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Research has shown that single-item tools, like the Distress Thermometer (DT), are comparable to longer ones, like the Hospital Anxiety and Depression Scale (HADS). In this study, we tested the validity of the DT in a population of Singapore cancer outpatients, and determined the cut-off scores on the DT for clinically relevant distress and an impaired quality of life (QOL). We also documented the prevalence of anxiety, depression, and QOL impairments in this population. METHODS One hundred and five patients (Mdn age=51-60years, 64% female, and 71% Chinese) diagnosed with various cancers participated in this study. They completed a standard socio-demographic form, the DT and the Problem List, the HADS, and the EuroQOL Quality of Life Scale (EQ-5D). RESULTS Almost a third of patients had clinically significant emotional distress, with 15%-16% having probable levels of anxiety and depression. Almost half (41%-55%) had an impaired QOL compared to Singapore population norms. Receiver operating characteristic curve analyses identified an area under the curve of 0.89 (SE=0.36, 95% CI [0.82, 0.96], p<.001) when compared to the HADS cut-off score of 15. A cut-off score of 5 on the DT had the best sensitivity (0.88) and specificity (0.81). Participants above the DT cut-off score of 5 reported significantly more emotional problems (worry, nervousness, depression, sadness), insurance/finance-related problems, and sleep problems. They also scored significantly lower on EQ-5D, with more QOL impairments in the domains of carrying out their usual activities and anxiety/depression. CONCLUSION Levels of distress, anxiety, depression, and QOL impairments are high in this population. The DT was found to be a valid tool for distress screening in the Singapore cancer population, with a recommended cut-off score of 5.
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Affiliation(s)
- Haikel A Lim
- Department of Psychological Medicine, National University of Singapore, NUHS Tower Block, Level 9, 1E Kent Ridge Road, 119228 Singapore
| | - Rathi Mahendran
- Department of Psychological Medicine, National University of Singapore, NUHS Tower Block, Level 9, 1E Kent Ridge Road, 119228 Singapore; Department of Psychological Medicine, National University Hospital, NUHS Tower Block, Level 9, 1E Kent Ridge Road, 119228 Singapore.
| | - Joanne Chua
- Department of Psychological Medicine, National University Hospital, NUHS Tower Block, Level 9, 1E Kent Ridge Road, 119228 Singapore
| | - Chao-Xu Peh
- Department of Psychological Medicine, National University of Singapore, NUHS Tower Block, Level 9, 1E Kent Ridge Road, 119228 Singapore
| | - Siew-Eng Lim
- National University Cancer Institute, Singapore, National University Health System, NUHS Tower Block, Level 7, 1E Kent Ridge Road, 119228, Singapore
| | - Ee-Heok Kua
- Department of Psychological Medicine, National University of Singapore, NUHS Tower Block, Level 9, 1E Kent Ridge Road, 119228 Singapore; Department of Psychological Medicine, National University Hospital, NUHS Tower Block, Level 9, 1E Kent Ridge Road, 119228 Singapore
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Beck KR, Tan SM, Lum SS, Lim LEC, Krishna LKR. Validation of the emotion thermometers and hospital anxiety and depression scales in Singapore: Screening cancer patients for distress, anxiety and depression. Asia Pac J Clin Oncol 2014; 12:e241-9. [DOI: 10.1111/ajco.12180] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Kevin R Beck
- Department of Psychiatry; Singapore General Hospital; Singapore
| | - Shian M Tan
- Department of Psychiatry; Singapore General Hospital; Singapore
| | - Shin S Lum
- Psychological Care Centre; Military Medicine Institute; Singapore
| | - Leslie EC Lim
- Department of Psychiatry; Singapore General Hospital; Singapore
| | - Lalit KR Krishna
- Department of Palliative Medicine; National Cancer Centre; Singapore
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Ma X, Zhang J, Zhong W, Shu C, Wang F, Wen J, Zhou M, Sang Y, Jiang Y, Liu L. The diagnostic role of a short screening tool—the distress thermometer: a meta-analysis. Support Care Cancer 2014; 22:1741-55. [DOI: 10.1007/s00520-014-2143-1] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2013] [Accepted: 01/22/2014] [Indexed: 10/25/2022]
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Livingston PM, Osborne RH, Botti M, Mihalopoulos C, McGuigan S, Heckel L, Gunn K, Chirgwin J, Ashley DM, Williams M. Efficacy and cost-effectiveness of an outcall program to reduce carer burden and depression among carers of cancer patients [PROTECT]: rationale and design of a randomized controlled trial. BMC Health Serv Res 2014; 14:5. [PMID: 24393305 PMCID: PMC3893402 DOI: 10.1186/1472-6963-14-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Accepted: 12/27/2013] [Indexed: 11/23/2022] Open
Abstract
Background Carers provide extended and often unrecognized support to people with cancer. The aim of this study is to test the hypothesis that excessive carer burden is modifiable through a telephone outcall intervention that includes supportive care, information and referral to appropriate psycho-social services. Secondary aims include estimation of changes in psychological health and quality of life. The study will determine whether the intervention reduces unmet needs among patient dyads. A formal economic program will also be conducted. Methods/Design This study is a single-blind, multi-centre, randomized controlled trial to determine the efficacy and cost-efficacy of a telephone outcall program among carers of newly diagnosed cancer patients. A total of 230 carer/patient dyads will be recruited into the study; following written consent, carers will be randomly allocated to either the outcall intervention program (n = 115) or to a minimal outcall / attention control service (n = 115). Carer assessments will occur at baseline, at one and six months post-intervention. The primary outcome is change in carer burden; the secondary outcomes are change in carer depression, quality of life, health literacy and unmet needs. The trial patients will be assessed at baseline and one month post-intervention to determine depression levels and unmet needs. The economic analysis will include perspectives of both the health care sector and broader society and comprise a cost-consequences analysis where all outcomes will be compared to costs. Discussion This study will contribute to our understanding on the potential impact of a telephone outcall program on carer burden and provide new evidence on an approach for improving the wellbeing of carers. Trial registration Australian New Zealand Clinical Trials Registry ACTRN: 12613000731796.
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Affiliation(s)
- Patricia M Livingston
- Faculty of Health, Deakin University, 221 Burwood Highway, Burwood, Victoria 3125, Australia.
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Campbell A, Steginga SK, Ferguson M, Beeden A, Walls M, Cairns W, Dunn J. Measuring distress in cancer patients: the Distress Thermometer in an Australian sample. PROGRESS IN PALLIATIVE CARE 2013. [DOI: 10.1179/096992609x392259] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Lou Y, Yates P, McCarthy A, Wang H. Fatigue self-management: a survey of Chinese cancer patients undergoing chemotherapy. J Clin Nurs 2013; 22:1053-65. [PMID: 23480501 DOI: 10.1111/jocn.12174] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2012] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To examine Chinese cancer patients' fatigue self-management, including the types of self-management behaviours used, their confidence in using these behaviours, the degree of relief obtained and the factors associated with patients' use of fatigue self-management behaviours. BACKGROUND Fatigue places significant burden on patients with cancer undergoing chemotherapy. While some studies have explored fatigue self-management in Western settings, very few studies have explored self-management behaviours in China. DESIGN Cross-sectional self- and/or interviewer-administered survey. METHODS A total of 271 participants with self-reported fatigue in the past week were recruited from a specialist cancer hospital in south-east China. Participants completed measures assessing the use of fatigue self-management behaviours, corresponding self-efficacy, perceived relief levels plus items assessing demographic characteristics, fatigue experiences, distress and social support. RESULTS A mean of 4.94 (± 2.07; range 1-10) fatigue self-management behaviours was reported. Most behaviours were rated as providing moderate relief and were implemented with moderate self-efficacy. Regression analyses identified that having more support from one's neighbourhood and better functional status predicted the use of a greater number of self-management behaviours. Separate regression analyses identified that greater neighbourhood support predicted greater relief from 'activity enhancement behaviours' and that better functional status predicted greater relief from 'rest and sleep behaviours'. Higher self-efficacy scores predicted greater relief from corresponding behaviours. CONCLUSIONS A range of fatigue self-management behaviours were initiated by Chinese patients with cancer. Individual, condition and environmental factors were found to influence engagement in and relief from fatigue self-management behaviours. RELEVANCE TO CLINICAL PRACTICE Findings highlight the need for nurses to explore patients' use of fatigue self-management behaviours and the effectiveness of these behaviours in reducing fatigue. Interventions that improve patients' self-efficacy and neighbourhood supports have the potential to improve outcomes from fatigue self-management behaviours.
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Affiliation(s)
- Yan Lou
- School of Nursing, Hangzhou Normal University, Hangzhou, China.
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