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Kuczmarski TM, Roemer L, Odejide OO. Depression in patients with hematologic malignancies: The current landscape and future directions. Blood Rev 2024; 65:101182. [PMID: 38402023 DOI: 10.1016/j.blre.2024.101182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 02/08/2024] [Accepted: 02/12/2024] [Indexed: 02/26/2024]
Abstract
Patients with hematologic malignancies experience high rates of depression. These patients are vulnerable to depression throughout the disease trajectory, from diagnosis to survivorship, and at the end of life. In addition to the distressing nature of depression, it has substantial downstream effects including poor quality of life, increased risk of treatment complications, and worse survival. Therefore, systematic screening for depression and integration of robust psychological interventions for affected patients is crucial. Although depression has been historically studied mostly in patients with solid malignancies, research focusing on patients with hematologic malignancies is growing. In this article, we describe what is known about depression in patients with hematologic malignancies, including its assessment, prevalence, risk factors, and implications. We also describe interventions to ameliorate depression in this population. Future research is needed to test effective and scalable interventions to reduce the burden of depression among patients with blood cancers.
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Affiliation(s)
| | - Lizabeth Roemer
- Department of Psychology, University of Massachusetts Boston, USA
| | - Oreofe O Odejide
- Division of Population Sciences, Dana-Farber Cancer Institute, Boston, USA; Division of Hematologic Malignancies, Dana-Farber Cancer Institute, Boston, USA.
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Skaali T, Blomhoff R, Lindemann K, Smeland S, Bruheim K, Seland M, Thorsen L. Self-reported distress and problems after treatment for gynecological cancer - Correlation between a short screening tool and longer measures of anxiety/depression and health-related quality of life. Acta Obstet Gynecol Scand 2024; 103:387-395. [PMID: 37991142 PMCID: PMC10823398 DOI: 10.1111/aogs.14709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 09/16/2023] [Accepted: 10/13/2023] [Indexed: 11/23/2023]
Abstract
INTRODUCTION The National Comprehensive Cancer Network (NCCN) distress thermometer and problem list (DTPL) is a brief self-report screening measure for use in follow-up cancer care. The aims of this study were to explore the correlations between scores on the DTPL and scores on longer measures of anxiety/depression and health-related quality of life among women treated for gynecological cancer, and to define a cutoff score on the DT representing high levels of psychological distress in this patient group. MATERIAL AND METHODS During outpatient visits, 144 women filled in the DTPL, the Hospital Anxiety and Depression Scale (HADS) and the RAND-36-Item Short Form Health Survey (RAND-36) between October 2019 and March 2020. We assessed the agreement between the DT-scores and the HADS scores, explored variables associated with high levels of distress on the DT, and studied the associations between DTPL-scores and scores of health-related quality of life (HRQoL) from RAND-36. RESULTS In receiver operating characteristic curve analysis between the distress score from the DT and a HADS total score ≥15 (defining high levels of anxiety/depression symptoms), the area under the curve was 0.81 (95% CI: 0.74-0.89). Using a cutoff of ≥5 on the DT (scale 0-10), we found a balanced level of sensitivity (81%) and specificity (71%) towards a HADS total score of ≥15. The scores of distress and problems reported on the DTPL correlated significantly with the majority of HRQoL function scales from RAND-36. CONCLUSIONS The NCCN DTPL can be used as a screening measure for self-reported distress and problems after treatment for gynecological cancer. A score of ≥5 on DT may indicate high level of anxiety/depression as measured by HADS. The tool may help identify patients in need of referral to supportive care and rehabilitation facilities.
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Affiliation(s)
- Tone Skaali
- Department of Clinical Service, Division of Cancer MedicineOslo University HospitalOsloNorway
- Department of Behavioral Medicine, Institute of Basic Medical Sciences, Faculty of MedicineUniversity of OsloOsloNorway
| | - Rune Blomhoff
- Department of Clinical Service, Division of Cancer MedicineOslo University HospitalOsloNorway
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of MedicineUniversity of OsloOsloNorway
| | - Kristina Lindemann
- Department of Gynecologic Cancer, Division of Cancer MedicineOslo University HospitalOsloNorway
- Institute of Clinical Medicine, Faculty of MedicineUniversity of OsloOsloNorway
| | - Sigbjørn Smeland
- Institute of Clinical Medicine, Faculty of MedicineUniversity of OsloOsloNorway
- Division of Cancer MedicineOslo University HospitalOsloNorway
| | - Kjersti Bruheim
- Department of Oncology, Division of Cancer MedicineOslo University HospitalOsloNorway
| | - Mette Seland
- Department of Clinical Service, Division of Cancer MedicineOslo University HospitalOsloNorway
| | - Lene Thorsen
- Department of Clinical Service, Division of Cancer MedicineOslo University HospitalOsloNorway
- Department of Oncology, Division of Cancer Medicine, National Advisory Unit on Late Effects after Cancer TreatmentOslo University HospitalOsloNorway
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Gong IY, Cheung MC, Chan KKW, Arya S, Faught N, Calzavara A, Liu N, Odejide OO, Abel G, Kurdyak P, Raphael MJ, Kuczmarski T, Prica A, Mozessohn L. Mortality among patients with diffuse large B-cell lymphoma and mental disorders: a population-based study. J Natl Cancer Inst 2023; 115:1194-1203. [PMID: 37531271 DOI: 10.1093/jnci/djad149] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 07/04/2023] [Accepted: 07/28/2023] [Indexed: 08/04/2023] Open
Abstract
BACKGROUND Mental disorders have been reported in patients with diffuse large B-cell lymphoma (DLBCL), but studies examining their association with mortality are lacking. METHODS We conducted a population-based study using linked administrative health-care databases from Ontario, Canada. All patients with DLBCL 18 years of age or older treated with rituximab-based therapy between January 1, 2005, and December 31, 2017, were identified and followed until March 1, 2020. Mental disorders were defined as either preexisting or postdiagnosis (after lymphoma treatment initiation). Cox proportional hazards models were used to estimate the adjusted hazard ratio (HR) between mental disorders and 1-year and all-cause mortality while controlling for covariates. RESULTS We identified 10 299 patients with DLBCL. The median age of the cohort was 67 years; 46% of patients were female, and 28% had a preexisting mental disorder. At 1-year follow-up, 892 (9%) had a postdiagnosis mental disorder, and a total of 2008 (20%) patients died. Preexisting mental disorders were not associated with 1-year mortality (adjusted HR = 1.06, 95% confidence interval [CI] = 0.96 to 1.17, P = .25), but postdiagnosis disorders were (adjusted HR = 1.51, 95% CI = 1.26 to 1.82, P = .0001). During a median follow-up of 5.2 years, 2111 (22%) patients had a postdiagnosis mental disorder, and 4084 (40%) patients died. Both preexisting and postdiagnosis mental disorders were associated with worse all-cause mortality (preexisting adjusted HR = 1.12, 95% CI = 1.04 to 1.20, P = .0024; postdiagnosis adjusted HR = 1.63, 95% CI = 1.49 to 1.79, P < .0001). CONCLUSIONS Patients with DLBCL and mental disorders had worse short-term and long-term mortality, particularly those with postdiagnosis mental disorders. Further studies are needed to examine mental health service utilization and factors mediating the relationship between mental disorders and inferior mortality.
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Affiliation(s)
- Inna Y Gong
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Matthew C Cheung
- Department of Medicine, University of Toronto, Toronto, ON, Canada
- Sunnybrook Odette Cancer Centre, Toronto, ON, Canada
- Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
| | - Kelvin K W Chan
- Department of Medicine, University of Toronto, Toronto, ON, Canada
- Sunnybrook Odette Cancer Centre, Toronto, ON, Canada
- Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
- Canadian Centre for Applied Research in Cancer Control, Vancouver, BC, Canada
| | - Sumedha Arya
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Neil Faught
- Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
| | | | - Ning Liu
- Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | | | | | - Paul Kurdyak
- Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
- Centre for Addition and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Michael J Raphael
- Department of Medicine, University of Toronto, Toronto, ON, Canada
- Sunnybrook Odette Cancer Centre, Toronto, ON, Canada
| | - Thomas Kuczmarski
- University of Washington Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Anca Prica
- Department of Medicine, University of Toronto, Toronto, ON, Canada
- Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Lee Mozessohn
- Department of Medicine, University of Toronto, Toronto, ON, Canada
- Sunnybrook Odette Cancer Centre, Toronto, ON, Canada
- Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
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Zhang Q, Tang L, Chen H, Chen S, Luo M, He Y, Liu M. Psychological outcomes of the systematic interventions based on the stress-induced situation, affective, bodily, and cognitive reactions framework for patients with lung cancer: A randomized clinical trial. Int J Nurs Stud 2023; 146:104566. [PMID: 37544148 DOI: 10.1016/j.ijnurstu.2023.104566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 07/09/2023] [Accepted: 07/17/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND Psychological distress is a multi-factorial unpleasant experience of a psychological, social, spiritual, and/or physical nature that may interfere with one's ability to cope effectively with cancer, physical symptoms and treatment. Psychological distress is common and affects the prognosis of cancer patients. Lung cancer accounted for 11.4 % of all new cancer cases and 18 % of all cancer mortality for 36 cancers in 185 countries. The prevalence of distress among Chinese lung cancer patients ranged from 10.1 % to 61.29 %. However, the existing intervention studies on the psychological distress in lung cancer patients are limited and intervention results may be different. OBJECTIVES To explore the psychological outcomes of a nurse-led systematic intervention program based on the stress-induced situation, affective, bodily, and cognitive reactions framework for patients with lung cancer undergoing operation at anxiety and depression. DESIGN A randomized clinical trial. SETTING Thoracic surgery ward in a tertiary hospital in China. PARTICIPANTS Lung cancer patients undergoing surgery. METHODS This is a 12-month longitudinal randomized controlled study in a tertiary hospital in China. A total of 240 lung cancer patients were randomly divided into either the control group or the intervention group. The nurse-led systematic intervention contents include psychological education, intervention measures based on the stress-induced situation, affective, bodily, and cognitive reactions framework, issuance of daily lifestyle cards, and regular follow-ups. The Hospital Anxiety and Depression Scale, Functional Assessment of Chronic Illness Therapy-Fatigue Scale, and Satisfaction with Life Scale were used for the baseline assessment within 48 h upon admission. The same assessment was performed respectively at 1, 3, 6 and 12 months after the intervention started. The effects of the systematic interventions on depression, anxiety, fatigue, and life satisfaction were tested by a linear mixed effects model. RESULTS Overall time-by-group interaction effects were significantly different with regard to anxiety, depression, and fatigue after controlling for the covariates, while a significant time-by-group interaction effect was not found for life satisfaction. Changes for anxiety and depression scores at 6 and 12 months after initiation of the intervention were significantly greater in the intervention group compared with those in the control group (t = 3.046, p = 0.002, t = 3.190, p = 0.001; t = 3.735, p = 0.000, t = 2.979, p = 0.002), whereas scores for fatigue were significantly higher in the intervention group at 6 and 12 months (t = -3.096, p = 0.002, t = -2.784, p = 0.005). CONCLUSION The systematic intervention program based on the stress-induced situation, affective, bodily, and cognitive reactions framework may effectively relieve anxiety, depression, and fatigue in lung cancer patients undergoing surgery. REGISTRATION This study was registered on December 22, 2019 with the registration number ChiCTR1900028487, and the date of first recruitment was Jan 5, 2020.
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Affiliation(s)
- Qingling Zhang
- Department of Medical Psychology, The Second Affiliated Hospital of Army Medical University, Chongqing 400037, China
| | - Lili Tang
- Department of Thoracic Surgery, The Second Affiliated Hospital of Army Medical University, Chongqing 400037, China
| | - Hui Chen
- Digestive Department, The Second Affiliated Hospital of Army Medical University, Chongqing 400037, China
| | - Shuanghong Chen
- Department of Medical Psychology, The Second Affiliated Hospital of Army Medical University, Chongqing 400037, China
| | - Maoyu Luo
- Department of Thoracic Surgery, The Second Affiliated Hospital of Army Medical University, Chongqing 400037, China
| | - Yuexia He
- Department of Thoracic Surgery, The Second Affiliated Hospital of Army Medical University, Chongqing 400037, China
| | - Minghua Liu
- Emergency Department, The First Affiliated Hospital of Army Medical University, Chongqing 400038, China.
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Omari M, Amaadour L, Zarrouq B, Al-Sheikh YA, El Asri A, Kriya S, Nadi S, Benbrahim Z, Mellas N, Rhazi KE, Ragala MEA, Hilaly JE, Giesy JP, Aboul-Soud MAM, Halim K. Evaluation of psychological distress is essential for patients with locally advanced breast cancer prior to neoadjuvant chemotherapy: baseline findings from cohort study. BMC Womens Health 2023; 23:445. [PMID: 37612725 PMCID: PMC10464406 DOI: 10.1186/s12905-023-02571-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 07/25/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND patients with locally advanced breast cancer (LABC) are often treated by neoadjuvant chemotherapy (NACT). This study aims to determine the prevalence of psychological distress and their sociodemographic and clinical factors in patients recently diagnosed with LABC and before NACT. METHODS A total of 209 LABC patients without metastatic localization were recruited between 2021 and 2022 in the oncology hospital at Fez. A structured questionnaire and the Hospital Anxiety and Depression Scale were used. A descriptive analysis and linear model were performed. RESULTS a mean age of participants was 47.43 ± 9.45 years. The prevalence of depression, anxiety and psychological distress among participants was 59.62% (95% CI: 52.61-33.34), 47.85% (95% CI: 40.91-54.85), and 65.07 (95% CI: 58.19-71.52) respectively. Depression was associated to age (< 50 years) (AOR = 2.19; 95% CI = 1.13-4.23) and health insurance (AOR = 3.64; 95% CI: 1.18-11.26). Anxiety was associated to age (< 50) (AOR = 2.21; 95% CI: 1.18-4.13) and right breast cancer (AOA = 2.01; 95% CI: 1.11-3.65). Psychological distress was associated to chronic illness (AOR = 2.78; 95% CI: 1.32-5.85) and lymph node status (AOR = 2.39; 95% CI: 1.26-4.57). CONCLUSIONS Based on the high prevalence of depression and anxiety it appears opportune to treat psychological distress among LABC patient candidates for NACT. Each psychological intervention should take into account sociodemographic and clinical factors found associated in our study. Psychological therapeutic interventions are crucial for LABC patients as early as the time of diagnosis and through subsequent steps in NACT to improve their overall mental health.
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Affiliation(s)
- Majid Omari
- Laboratory of Epidemiology and Research in Health Sciences, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdallah University, Fez, Morocco.
- Laboratory of Natural Substances, Pharmacology, Environment, Modeling, Health & Quality of Life, Faculty of Sciences Dhar El Mahraz, Sidi Mohamed Ben Abdellah University, Fez, Morocco.
| | - Lamiae Amaadour
- Department of Medical Oncology, Hassan II University Hospital, Fez, Morocco
| | - Btissame Zarrouq
- Laboratory of Epidemiology and Research in Health Sciences, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdallah University, Fez, Morocco
- Department of Biology and Geology, Teacher's Training College (Ecole Normale Supérieure), Sidi Mohamed Ben Abdallah University, Fez, Morocco
| | - Yazeed A Al-Sheikh
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh, 11433, Saudi Arabia
| | - Achraf El Asri
- Laboratory of Epidemiology and Research in Health Sciences, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdallah University, Fez, Morocco
| | - Salima Kriya
- Higher Institute of Nursing Professions and Health Techniques, Fez, Morocco
| | - Sara Nadi
- Higher Institute of Nursing Professions and Health Techniques, Fez, Morocco
| | - Zineb Benbrahim
- Department of Medical Oncology, Hassan II University Hospital, Fez, Morocco
| | - Nawfel Mellas
- Department of Medical Oncology, Hassan II University Hospital, Fez, Morocco
| | - Karima El Rhazi
- Laboratory of Epidemiology and Research in Health Sciences, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdallah University, Fez, Morocco
| | - Mohammed El Amine Ragala
- Laboratory of Natural Substances, Pharmacology, Environment, Modeling, Health & Quality of Life, Faculty of Sciences Dhar El Mahraz, Sidi Mohamed Ben Abdellah University, Fez, Morocco
- Department of Biology and Geology, Teacher's Training College (Ecole Normale Supérieure), Sidi Mohamed Ben Abdallah University, Fez, Morocco
| | - Jaouad El Hilaly
- Laboratory of Pedagogical and Didactic Engineering of Sciences and Mathematics, Regional Center of Education and Training (CRME F) of Fez, Fez, Morocco
- R.N.E Laboratory, Multidisciplinary Faculty of Taza, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - John P Giesy
- Toxicology Centre, University of Saskatchewan, Saskatoon, SK, S7N 5B3, Canada
- Department of Veterinary Biomedical Sciences, University of Saskatchewan, Saskatoon, SK, S7N 5B4, Canada
- Department of Integrative Biology, Michigan State University, East Lansing, MI, 48824, USA
- Department of Environmental Sciences, Baylor University, Waco, TX, 76706, USA
| | - Mourad A M Aboul-Soud
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh, 11433, Saudi Arabia
| | - Karima Halim
- Laboratory of Natural Substances, Pharmacology, Environment, Modeling, Health & Quality of Life, Faculty of Sciences Dhar El Mahraz, Sidi Mohamed Ben Abdellah University, Fez, Morocco
- Department of Human and Social Sciences - Education Sciences, Teachers Training College (Ecole Normale Superieure), Sidi Mohamed Ben Abdellah University, Fez, Morocco
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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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Li S, Zhong L, Zhou D, Zhang X, Liu Y, Zheng B. Predictors of Psychological Distress among Patients with Colorectal Cancer-Related Enterostomy: A Cross-sectional Study. Adv Skin Wound Care 2023; 36:85-92. [PMID: 36662041 DOI: 10.1097/01.asw.0000911012.63191.4c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVE To identify variables that may predict psychological distress in patients with an enterostomy. METHODS Investigators recruited 77 patients with a stoma from a stoma clinic according to the inclusion criteria. Patients' psychological distress was assessed with the Distress Thermometer (DT) tool, and their personality type was determined by the Eysenck Personality Questionnaire. Researchers also collected demographic and disease-related data. Predictive values were estimated using multiple regression analyses. RESULTS The mean DT score of all patients was 5.94 (SD, 1.81), and approximately 85.7% consistently suffered from psychological distress. Being unmarried and having peristomal complications were associated with higher psychological distress, whereas having a monthly income 5,000 ¥ or more was associated with lower levels of distress. Moreover, patients with a melancholic personality type tended to have higher DT scores, which could act as a strong independent predictor for psychological distress. CONCLUSIONS The majority of patients with a stoma endured moderate to severe psychological distress during follow-up care. Exploring the related factors that predict the levels of psychological distress could enable clinicians to identify at-risk patients as early as possible and thus provide optimal care for improving patients' quality of life.
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Affiliation(s)
- Siqing Li
- At the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China, Siqing Li, MD, is Enterostomal Therapist, Department of Gastrointestinal Surgery and Liping Zhong, MS, is Enterostomal Therapist, Radiology Department. Danyan Zhou, MS, is Nursing Student, Xinhua College of Sun Yat-sen University, Guangzhou, China. Also at the Fifth Affiliated Hospital of Sun Yat-sen University, Xiumin Zhang, MS, is Nurse, Intensive Care Unit; Yuxia Liu, MS, is Nurse, Department of Gastrointestinal Surgery; and Baojia Zheng, MD, is Health Manager, Health Management Center. Acknowledgment: Siqing Li and Liping Zhong contributed equally to this study, and Baojia Zheng and Yuxia Liu contributed equally to this study. The authors thank the Fifth Affiliated Hospital of Sun Yat-sen University for its free database use. This study was supported financially by the Young Talents of Sun Yat-sen University (N: N2020Y05). The authors have disclosed no other financial relationships related to this article. Submitted March 19, 2022; accepted in revised form May 2, 2022
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The correlations between psychological distress, cognitive impairment and quality of life in patients with brain metastases after whole-brain radiotherapy. CLINICAL & TRANSLATIONAL ONCOLOGY : OFFICIAL PUBLICATION OF THE FEDERATION OF SPANISH ONCOLOGY SOCIETIES AND OF THE NATIONAL CANCER INSTITUTE OF MEXICO 2023; 25:207-217. [PMID: 36038750 DOI: 10.1007/s12094-022-02927-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 08/09/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Psychological distress and cognitive impairment are highly prevalent among patients with brain metastases after whole-brain radiotherapy (WBRT). Our purpose was to evaluate the correlations between psychological distress, cognitive impairment and quality of life in patients with brain metastases after WBRT. METHODS Seventy-one patients with brain metastasis treated with WBRT were enrolled in this study and were investigated with several scales, including the Montreal Cognitive Assessment Scale (MoCA), the Functional Assessment of Cancer Therapy-Cognitive Function version 3 (FACT-Cog, version 3), the Functional Assessment of Cancer Therapy-Brain Module version 4 (FACT-Br, version 4) and the Psychological Distress Thermometer (DT), before and after WBRT. RESULTS The MoCA, FACT-Cog and FACT-Br scores in patients with brain metastases were significantly decreased after WBRT compared with before WBRT (z = - 7.106, - 6.933 and - 6.250, respectively, P < 0.001), while the DT scores were significantly increased (z = 6.613, P < 0.001). There was an obvious negative correlation between the DT score and the FACT-Cog score (r = - 0.660, P < 0.001), a significant negative correlation between the DT score and the FACT-Br score (r = - 0.833, P < 0.001), and an obvious positive correlation between the FACT-Cog score and the FACT-Br score (r = 0.603, P < 0.001). These results suggest that WBRT can cause cognitive impairment in patients with brain metastases, increase their psychological distress and reduce their quality of life (QOL). CONCLUSION After receiving WBRT, the cognitive function and QOL of patients with brain metastases were decreased, while psychological distress increased. The cognitive impairment and the decline of QOL after WBRT are associated with increased psychological distress, and that the decline of QOL is associated with cognitive impairment of patients.
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Tao R, Chen Y, Kim S, Ocier K, Lloyd S, Poppe MM, Lee CJ, Glenn MJ, Smith KR, Fraser A, Deshmukh V, Newman MG, Snyder J, Rowe KG, Gaffney DK, Haaland B, Hashibe M. Mental health disorders are more common in patients with Hodgkin lymphoma and may negatively impact overall survival. Cancer 2022; 128:3564-3572. [PMID: 35916651 DOI: 10.1002/cncr.34359] [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: 04/14/2021] [Revised: 04/19/2022] [Accepted: 05/19/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Long-term mental health outcomes were characterized in patients who were diagnosed with Hodgkin lymphoma (HL), and risk factors for the development of mental health disorders were identified. METHODS Patients who were diagnosed with HL between 1997 and 2014 were identified in the Utah Cancer Registry. Each patient was matched with up to five individuals from a general population cohort identified within the Utah Population Database, a unique source of linked records that includes patient and demographic data. RESULTS In total, 795 patients who had HL were matched with 3575 individuals from the general population. Compared with the general population, patients who had HL had a higher risk of any mental health diagnosis (hazard ratio, 1.77; 95% confidence interval, 1.57-2.00). Patients with HL had higher risks of anxiety, depression, substance-related disorders, and suicide and intentional self-inflicted injuries compared with the general population. The main risk factor associated with an increased risk of being diagnosed with mental health disorders was undergoing hematopoietic stem cell transplantation, with a hazard ratio of 2.06 (95% confidence interval, 1.53-2.76). The diagnosis of any mental health disorder among patients with HL was associated with a detrimental impact on overall survival; the 10-year overall survival rate was 70% in patients who had a mental health diagnosis compared with 86% in those patients without a mental health diagnosis (p < .0001). CONCLUSIONS Patients who had HL had an increased risk of various mental health disorders compared with a matched general population. The current data illustrate the importance of attention to mental health in HL survivorship, particularly for patients who undergo therapy with hematopoietic stem cell transplantation.
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Affiliation(s)
- Randa Tao
- Department of Radiation Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, United States
| | - Yuji Chen
- Division of Public Health, Department of Family and Preventive Medicine and Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, United States
| | - Seungmin Kim
- Division of Public Health, Department of Family and Preventive Medicine and Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, United States
| | - Krista Ocier
- Division of Public Health, Department of Family and Preventive Medicine and Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, United States
| | - Shane Lloyd
- Department of Radiation Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, United States
| | - Matthew M Poppe
- Department of Radiation Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, United States
| | - Catherine J Lee
- Division of Hematology and Hematologic Malignancies, Department of Internal Medicine, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, United States
| | - Martha J Glenn
- Division of Hematology and Hematologic Malignancies, Department of Internal Medicine, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, United States
| | - Ken R Smith
- Pedigree and Population Resource, Population Sciences, Huntsman Cancer Institute, Salt Lake City, Utah, United States
| | - Alison Fraser
- Pedigree and Population Resource, Population Sciences, Huntsman Cancer Institute, Salt Lake City, Utah, United States
| | - Vikrant Deshmukh
- University of Utah Health Sciences Center, Salt Lake City, Utah, United States
| | - Michael G Newman
- University of Utah Health Sciences Center, Salt Lake City, Utah, United States
| | - John Snyder
- Intermountain Healthcare, Salt Lake City, Utah, United States
| | - Kerry G Rowe
- Intermountain Healthcare, Salt Lake City, Utah, United States
| | - David K Gaffney
- Department of Radiation Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, United States
| | - Ben Haaland
- Department of Population Health Sciences, University of Utah, Salt Lake City, Utah, United States
| | - Mia Hashibe
- Division of Public Health, Department of Family and Preventive Medicine and Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, United States
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10
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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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11
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Øvlisen AK, Jakobsen LH, Kragholm KH, Nielsen RE, Nully Brown P, Dahl‐Sørensen RB, Frederiksen H, Mannering N, Josefsson PL, Ludvigsen Al‐Mashhadi A, Jørgensen JM, Dessau‐Arp A, Clausen MR, Pedersen RS, Torp‐Pedersen C, Severinsen MT, El‐Galaly TC. Mental health among patients with non-Hodgkin lymphoma: A Danish nationwide study of psychotropic drug use in 8750 patients and 43 750 matched comparators. Am J Hematol 2022; 97:749-761. [PMID: 35298039 PMCID: PMC9310853 DOI: 10.1002/ajh.26538] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 02/21/2022] [Accepted: 03/07/2022] [Indexed: 11/12/2022]
Abstract
Psychological distress following cancer diagnosis may lead to mental health complications including depression and anxiety. Non-Hodgkin lymphomas (NHLs) include indolent and aggressive subtypes for which treatment and prognosis differ widely. Incident use of psychotropic drugs (PDs-antidepressants, antipsychotics, and anxiolytics) and its correlation to lymphoma types can give insights into the psychological distress these patients endure. In this prospective matched cohort study, we used nationwide population-based registries to investigate the cumulative risk of PD use in NHL patients compared to a sex- and age-matched cohort from the Danish background population. In addition, contact patterns to psychiatric departments and incident intentional self-harm or completed suicide were explored. In total, 8750 NHL patients and 43 750 matched comparators were included (median age 68; male:female ratio 1.6). Median follow-up was 7.1 years. Two-year cumulative risk of PD use was higher in NHL patients (16.4%) as compared to the matched comparators (5.1%, p < .01); patients with aggressive NHL subtypes had the highest incidence. Prescription rates were higher in the first years after diagnosis but approached the rate of the matched population 5 years into survivorship in aggressive NHLs, whereas patients with indolent subtypes continued to be at higher risk. NHL patients had a slightly higher two-year risk of suicide/intentional self-harm (0.3%) as compared to the matched comparators (0.2%, p = .01). These results demonstrate that mental health complications among NHL patients are frequent. Routine assessment for symptoms of depression and anxiety should be consider as part of standard follow-up of NHL patients.
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Affiliation(s)
- Andreas Kiesbye Øvlisen
- Department of Hematology Aalborg University Hospital Aalborg Denmark
- Department of Clinical Medicine Aalborg University Aalborg Denmark
| | - Lasse Hjort Jakobsen
- Department of Hematology Aalborg University Hospital Aalborg Denmark
- Department of Clinical Medicine Aalborg University Aalborg Denmark
| | - Kristian Hay Kragholm
- Unit of Epidemiology and Biostatistics Aalborg University Hospital Aalborg Denmark
- Department of Cardiology Aalborg University Hospital Aalborg Denmark
| | - René Ernst Nielsen
- Department of Clinical Medicine Aalborg University Aalborg Denmark
- Department of Psychiatry Aalborg University Hospital Aalborg Denmark
| | - Peter Nully Brown
- Department of Hematology, Rigshospitalet Copenhagen University Hospital Copenhagen Denmark
| | | | | | | | | | | | | | | | | | | | - Christian Torp‐Pedersen
- Unit of Epidemiology and Biostatistics Aalborg University Hospital Aalborg Denmark
- Department of Cardiology and Clinical Research Nordsjællands Hospital Hillerød Denmark
| | - Marianne Tang Severinsen
- Department of Hematology Aalborg University Hospital Aalborg Denmark
- Department of Clinical Medicine Aalborg University Aalborg Denmark
- Clinical Cancer Research Unit Aalborg University Hospital Aalborg Denmark
| | - Tarec Christoffer El‐Galaly
- Department of Hematology Aalborg University Hospital Aalborg Denmark
- Department of Clinical Medicine Aalborg University Aalborg Denmark
- Clinical Cancer Research Unit Aalborg University Hospital Aalborg Denmark
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12
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Agostinelli G, Muzzatti B, Serpentini S, Spina M, Annunziata MA. Cancer-Related Psychological Distress in Lymphoma Survivor: An Italian Cross-Sectional Study. Front Psychol 2022; 13:872329. [PMID: 35558708 PMCID: PMC9088809 DOI: 10.3389/fpsyg.2022.872329] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 03/18/2022] [Indexed: 11/16/2022] Open
Abstract
Cancer is becoming a chronic disease, and the number of cancer survivors continues to increase. Lymphoma survivors are also increasing in numbers, and anxiety and depression are among the consequences they face. This study aimed to explore psychological distress in a sample of 212 lymphoma survivors. Information through a socio-demographic form and the compilation of questionnaires to assess anxiety, depression, quality of life, and the impact of cancer on lymphoma survivors was collected and analyzed. In the sample examined, 17% of lymphoma survivors were anxiety caseness, and 12.3% were depression caseness, and of these, 8% presented with concomitant anxiety depression. This study identified some variables associated with psychological distress in lymphoma survivors: female sex; living as a couple; a diagnosis of Hodgkin lymphoma; systematic treatment and/or radiotherapy; sleep disorders; no regular physical activity; and present or past use of psychiatric drugs. Our cross-sectional study results suggest that some of the variables investigated may be useful in identifying lymphoma survivors who are more likely to report psychological distress. It is important to monitor psychological distress along the entire trajectory of survivorship in order to identify early the presence of anxiety and depression and to provide timely psychological support.
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Affiliation(s)
- Giulia Agostinelli
- Unit of Oncological Psychology - Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | - Barbara Muzzatti
- Unit of Oncological Psychology - Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | | | - Michele Spina
- Unit of Oncological Medicine - Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
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13
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Ellis S, Brown RF, Thorsteinsson EB, Pakenham KI, Perrott C. Quality of life and fear of cancer recurrence in patients and survivors of non-Hodgkin lymphoma. PSYCHOL HEALTH MED 2021; 27:1649-1660. [PMID: 33928815 DOI: 10.1080/13548506.2021.1913756] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Non-Hodgkin lymphoma (NHL) is a common haematological cancer that is comprised of approximately 30 subtypes, of which Waldenström Macroglobulinemia (WM) is a rare incurable form. It is typically managed using a watch-and-wait strategy that can contribute to illness uncertainty which may result in fear of cancer recurrence (FCR) and poor health-related quality of life (QOL). However, few studies have examined the correlates of FCR and QOL in NHL patients, including WM patients. One-hundred males and 92 females with a mean age of 62.7 years who were an average of 6.8 years from diagnosis completed the online questionnaire which asked about demographics, medical history, QOL, FCR, stress, anxiety and depression. Few NHL patients reported significant stress or affective distress, most had moderate-high QOL and 41% experienced recent FCR, relative to published cut-off scores. Poorer QOL was related to depression symptoms, FCR, higher illness burden (i.e. comorbidity) and fewer personal resources (i.e. unemployed), whereas FCR was related to shorter time since diagnosis and more depressive symptoms. Results suggest that FCR and depressive symptoms may adversely impact QOL, whereas a recent cancer diagnosis and depression-related pessimism may contribute to FCR.
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Affiliation(s)
- Susan Ellis
- University of Queensland, Brisbane, Australia
| | - Rhonda F Brown
- Research School of Psychology, The Australian National University, Canberra, Australia
| | | | | | - Colin Perrott
- School of Psychology, University of New England, Armidale, Australia
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14
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Tarnasky AM, Troy JD, LeBlanc TW. The patient experience of ABVD treatment in Hodgkin lymphoma: a retrospective cohort study of patient-reported distress. Support Care Cancer 2021; 29:4987-4996. [PMID: 33576877 DOI: 10.1007/s00520-021-06044-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 02/04/2021] [Indexed: 12/13/2022]
Abstract
PURPOSE Psychological distress is prevalent in Hodgkin lymphoma (HL). Many patients, regardless of prognosis, receive ABVD chemotherapy as first-line treatment, but few studies have specifically examined the nature of distress during this shared treatment experience. METHODS We conducted a retrospective study of patient-reported distress in HL patients receiving ABVD treatment at a single tertiary care facility. Distress was measured using the National Comprehensive Cancer Network Distress Thermometer and Problem List (PL). We used descriptive statistics and generalized estimating equations to assess the prevalence of distress and specific problem items during treatment and associations with patient- and disease-related factors. RESULTS We collected data from 50 patients comprising 467 unique encounters, with 369/467 (79.0%) reporting a distress thermometer score. Median distress score was 2 (IQR: 0-5), but actionable distress (distress thermometer ≥4) was noted for 118/369 (32.0%) encounters. Actionable distress was only related to having a prior cancer, which conferred lower odds of actionable distress (OR 0.23, 95% CI 0.07-0.74, p=0.01) Physical and emotional problems were reported for 287/369 (77.8%) and 125/369 (33.9%) visits, respectively. Female patients had greater odds of both physical (OR 3.17, 95% CI 1.32-7.66, p=0.01) and emotional (OR 3.31, 95% CI 1.25-8.73, p=0.02) problems. CONCLUSION ABVD treatment is associated with a high frequency of actionable distress, with physical and emotional problems acting as primary drivers. Female patients may be particularly vulnerable, while cancer survivors may be uniquely resilient. These findings demonstrate the need to thoroughly screen for and appropriately tailor distress management strategies for HL patients during treatment with ABVD.
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Affiliation(s)
| | - Jesse D Troy
- Division of Biostatistics, Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC, 27710, USA
| | - Thomas W LeBlanc
- Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University School of Medicine, Durham, NC, 27710, USA. .,Duke Cancer Institute, Box 2715, DUMC,, Durham, NC, 27710, USA.
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15
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Performance of Distress Thermometer and Associated Factors of Psychological Distress among Chinese Cancer Patients. JOURNAL OF ONCOLOGY 2020; 2020:3293589. [PMID: 33029142 PMCID: PMC7528146 DOI: 10.1155/2020/3293589] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 09/10/2020] [Accepted: 09/12/2020] [Indexed: 12/14/2022]
Abstract
Objective We aimed to examine the performance of the distress thermometer (DT) and identify the prevalence and risk factors associated with psychological distress (PD) in heterogeneous cancer patients. Methods This cross-sectional study enrolled 1496 heterogeneous cancer patients from the inpatient and outpatient departments. Receiver operating characteristic analysis (ROC) of DT was evaluated against the Hospital Anxiety and Depression Scale-Total (HADS-T ≥15). An area under the curve (AUC), sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and clinical utility index were calculated. Multiple binary logistic regression was used to identify the factors associated with PD. Results Referring to ROC analysis, DT showed good discriminating accuracy (AUC = 0.88). A cutoff score of 4 was established, and it yielded sensitivity (0.81), specificity (0.88), PPV (0.87), NPV (0.82), and clinical utility indexes (screening utility = 0.71 and case-finding utility = 0.73). 46.5% of our participants was distressed. Lower education levels (odd ratio (OR) = 1.39), advanced stage (OR = 1.85), active disease status (OR = 1.82), lack of exercise (OR = 3.03), diagnosis known (OR = 0.64), emotional problems (OR = 3.54), and physical problems (OR = 8.62) were the predictive factors for PD. Conclusion DT with a cutoff score (≥4) is a comprehensive, appropriate, and practical initial screener for PD in cancer patients. Predicting factors should be considered together for effective management of PD in such population.
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16
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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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17
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Riba MB, Donovan KA, Andersen B, Braun II, Breitbart WS, Brewer BW, Buchmann LO, Clark MM, Collins M, Corbett C, Fleishman S, Garcia S, Greenberg DB, Handzo RGF, Hoofring L, Huang CH, Lally R, Martin S, McGuffey L, Mitchell W, Morrison LJ, Pailler M, Palesh O, Parnes F, Pazar JP, Ralston L, Salman J, Shannon-Dudley MM, Valentine AD, McMillian NR, Darlow SD. Distress Management, Version 3.2019, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw 2019; 17:1229-1249. [PMID: 31590149 PMCID: PMC6907687 DOI: 10.6004/jnccn.2019.0048] [Citation(s) in RCA: 352] [Impact Index Per Article: 70.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Distress is defined in the NCCN Guidelines for Distress Management as a multifactorial, unpleasant experience of a psychologic (ie, cognitive, behavioral, emotional), social, spiritual, and/or physical nature that may interfere with the ability to cope effectively with cancer, its physical symptoms, and its treatment. Early evaluation and screening for distress leads to early and timely management of psychologic distress, which in turn improves medical management. The panel for the Distress Management Guidelines recently added a new principles section including guidance on implementation of standards of psychosocial care for patients with cancer.
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Affiliation(s)
| | | | - Barbara Andersen
- The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute
| | - IIana Braun
- Dana-Farber/Brigham and Women's Cancer Center
| | | | | | | | | | | | | | | | - Sofia Garcia
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University
| | | | | | - Laura Hoofring
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
| | | | | | | | | | | | | | | | | | | | - Janice P Pazar
- St. Jude Children's Research Hospital/The University of Tennessee Health Science Center
| | - Laurel Ralston
- Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute
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18
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Yılmaz Karabulutlu E, Yaralı S, Karaman S. Evaluation of Distress and Religious Coping Among Cancer Patients in Turkey. JOURNAL OF RELIGION AND HEALTH 2019; 58:881-890. [PMID: 28733948 DOI: 10.1007/s10943-017-0453-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The purpose of this study was to determine distress levels and religious coping styles of cancer patients and the relationship between religious coping styles and distress. This study was conducted as descriptive design. It was determined that 60.7% of the patients experienced distress related to the disease. The field of problem from which the patients mostly experienced distress was physical problems. It was observed that positive coping scores of the patients were higher. There was a negative correlation between their mean scores for positive religious styles and distress total scores.
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Affiliation(s)
| | - Süheyla Yaralı
- Faculty of Health Sciences, Atatürk University, 25000, Erzurum, Turkey
| | - Seda Karaman
- Faculty of Health Sciences, Atatürk University, 25000, Erzurum, Turkey
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Abstract
BACKGROUND Lymphoma patients encounter many problems. Studies investigating the illness experiences of Chinese patients with lymphoma are limited. OBJECTIVE The objectives of this study were to explore the illness experiences of lymphoma patients in China and describe the impacts of this disease on the everyday lives of these individuals. METHODS A descriptive qualitative design was used. The data were collected through face-to-face semistructured interviews and analyzed using the conventional content analysis method. RESULTS Nine men and 7 women participated in this study. The following 6 themes emerged: (1) cancer diagnosis reactions, (2) self-image altered, (3) interpersonal relationships influenced, (4) career development hindered, (5) life philosophy changed, and (6) personal growth achieved. CONCLUSIONS This study contributes new knowledge to the understanding of the illness experiences of lymphoma patients within the Chinese social and cultural context. This study also reveals how these individuals cope with the complex problems they face. IMPLICATIONS FOR PRACTICE Nurses could help Chinese patients with lymphoma accept the disease and its treatments by emphasizing the importance of family integrity. Information, such as how to act in response to workplace discrimination, should be provided to patients by oncology nurses.
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20
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Guan B, Wang K, Shao Y, Cheng X, Hao J, Tian C, Chen L, Ji K, Liu W. The use of distress thermometer in advanced cancer inpatients with pain. Psychooncology 2019; 28:1004-1010. [PMID: 30762263 DOI: 10.1002/pon.5032] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 02/10/2019] [Accepted: 02/12/2019] [Indexed: 01/18/2023]
Abstract
OBJECTIVE This study aimed to provide support for the extensive application of Distress Thermometer (DT) in advanced cancer inpatients with pain and explored factors associated with high DT scores among this population. METHODS Advanced cancer patients with pain were recruited from Department of Pain Relief in Tianjin Cancer Hospital and Institute, China. They completed the DT with problems list and HADS within 48 h after admission. The cutoff score of DT was evaluated against Hospital Anxiety and Depression Scale (HADS) for its sensitivity and specificity by using receiver operating characteristic (ROC) curves. Multiple logistic regression model analysis was performed to investigate correlates of DT scores. RESULTS Four hundred forty one inpatients with mixed diagnoses were recruited. Referring to the cutoff of 15 on HADS, DT cutoff score of 5 yielded AUC of 0.757, with an optimal sensitivity of 0.861 and specificity of 0.531. Using the cutoff scores of greater than or equal to 5, 70.5% of the patients were distressed. Logistic regression analysis of DT found that the breakthrough pain, poorer KPS, higher pain degree, and emotional problems were the predictive factor for current distress. CONCLUSION DT is efficacious in screening for psychological distress in advanced cancer inpatients with pain. Psychological distress is prevalent with a cutoff score of greater than or equal to five. To better identify the distressed cancer patients with pain, pain degree, performance status, and emotional problems should be considered together.
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Affiliation(s)
- Bingqing Guan
- Department of Pain Relief, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy (Tianjin), Tianjin's Clinical Research Center for Cancer, Tianjin
| | - Kun Wang
- Department of Pain Relief, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy (Tianjin), Tianjin's Clinical Research Center for Cancer, Tianjin
| | - Yuejuan Shao
- Department of Pain Relief, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy (Tianjin), Tianjin's Clinical Research Center for Cancer, Tianjin
| | - Xianjiang Cheng
- Department of Pain Relief, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy (Tianjin), Tianjin's Clinical Research Center for Cancer, Tianjin
| | - Jianlei Hao
- Department of Pain Relief, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy (Tianjin), Tianjin's Clinical Research Center for Cancer, Tianjin
| | - Chang Tian
- Department of Pain Relief, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy (Tianjin), Tianjin's Clinical Research Center for Cancer, Tianjin
| | - Lei Chen
- Department of Pain Relief, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy (Tianjin), Tianjin's Clinical Research Center for Cancer, Tianjin
| | - Kai Ji
- Department of Pain Relief, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy (Tianjin), Tianjin's Clinical Research Center for Cancer, Tianjin
| | - Weishuai Liu
- Department of Pain Relief, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy (Tianjin), Tianjin's Clinical Research Center for Cancer, Tianjin
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21
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Patient-reported distress in Hodgkin lymphoma across the survivorship continuum. Support Care Cancer 2018; 27:2453-2462. [PMID: 30377801 PMCID: PMC6541572 DOI: 10.1007/s00520-018-4523-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 10/19/2018] [Indexed: 12/25/2022]
Abstract
Purpose Hodgkin lymphoma (HL) survivors face long-term, elevated risk of treatment-related sequelae, including psychosocial distress associated with poor health outcomes. The magnitude and sources of distress are not well described in the routine care of HL outside of clinical trials. Methods We conducted a retrospective cohort study of patients visiting a tertiary-care center for treatment or long-term follow-up of HL. Patient-reported distress was documented using the National Comprehensive Cancer Network Distress Thermometer (DT) and Problem List. Three survivor groups were compared using descriptive methods: on treatment, surviving < 5 years, and surviving ≥ 5 years since diagnosis. Results A total of 1524 DT were abstracted for 304 patients (106 on treatment, 77 surviving < 5 years, and 121 surviving ≥ 5 years). Distress was low overall (median DT = 1, inter-quartile range 0–4) and was similar across survivor groups. However, actionable distress (score ≥ 4) was reported at 29.5% of clinical encounters. Patients on treatment more frequently reported actionable distress (32.5% of visits) compared with patients surviving < 5 years (20.4%) and ≥ 5 years (28.7%) (P = 0.065). Distress was associated primarily with physical and emotional problems, especially fatigue, worry, and sleep. We did not observe any associations between distress and clinical prognostic factors. Conclusions Distress burden is low in HL, but survivorship is marked by periods of actionable distress, largely related to physical symptoms and emotional issues. This burden may be higher when on treatment and is unrelated to disease-related prognostic factors. Survivorship research typically focuses on the post-therapy period, but our results support testing the efficacy of interventions to address distress in HL during active treatment as well.
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22
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Zheng B, Du P, Yi T, Liu J, Zeng Z, Luo D, Jiang Y. Effects of two translated phrases of distress thermometer on screening distress in Chinese cancer patients: A comparative study. J Clin Nurs 2018; 28:828-835. [PMID: 30230077 DOI: 10.1111/jocn.14678] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2017] [Revised: 08/13/2018] [Accepted: 08/30/2018] [Indexed: 02/05/2023]
Abstract
AIMS AND OBJECTIVES To compare the screening effectiveness of two translated phrases of the Distress Thermometer (DT), namely the XinLiTongKu Thermometer (DT-X) and KunRao Thermometer (DT-K), in Chinese patients with cancer. BACKGROUND The DT is one of the most commonly used tools to screen cancer patients' psychological states. However, translations of the DT are not uniform in China; this may affect the screening effectiveness of this tool. DESIGN Cross-sectional survey with randomisation and self-control. METHODS A sample of 172 cases was screened using the two DT translations, to check and compare the screening effectiveness of the two translations. The correlation between them was also investigated. The causes of the differences in screening effectiveness of the two translations were analysed, using 90 of the above 172 cases and an additional 68 cases. STROBE guidelines were used in reporting this study. RESULTS For the DT-X (using a cut-off score of 4), the sensitivity value was 0.82 and the specificity value was 0.95, where for the DT-K (using a cut-off score of 3), the values were 0.78 and 0.79, respectively. The area under the receiver operating characteristic curve (AUC) was 0.914 and 0.797, respectively. Scores of the DT-X and the DT-K were positively correlated. In concepts of the participants, for both phrases, the sequences of the first three meanings were the same-worried, anxious and tired-while the fourth to sixth meanings were differed between phrases. CONCLUSION The DT-X and DT-K were both effective screening tools. However, in this study, the DT-X had a larger AUC than the DT-K. RELEVANCE TO CLINICAL PRACTICE This study may be useful for enabling better measurement of distress in Chinese patients and improving the indigenisation of the DT.
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Affiliation(s)
- Bo Zheng
- Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - PeiXin Du
- Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - TingWu Yi
- Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Jie Liu
- Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Zhi Zeng
- Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Di Luo
- Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Yu Jiang
- Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
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Mojs E, Warchoł-Biedermann K, Samborski W. What Do We Know About Psychological Outcomes of Lymphoma in Adults? EUROPEAN PSYCHOLOGIST 2017. [DOI: 10.1027/1016-9040/a000285] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Abstract. The goal of this review is to present the results of research on the influence of lymphoma on patients’ emotional status and cognitive functioning. A literature search was conducted to identify articles in English that investigated short- and long-term psychological outcomes of lymphoma and lymphoma treatment. Studies published prior to July 2016 were located by an electronic search using relevant databases such as ScienceDirect and PubMed. The search terms used included both medical subject headings and keywords such as “Hodgkin lymphoma,” “non-Hodgkin lymphoma,” “therapy,” “treatment,” “malignant,” “psychology,” “cognitive function,” “emotion,” “psychological adaptation,” “depression,” and “anxiety.” The retrieved publications were independently evaluated by two reviewers. Articles were selected based on the applicable titles and abstracts. The lists of eligible publications were compared and disagreements were resolved by discussion. Of the 1,418 articles identified in the search, we chose 39 publications, which in our opinion could be interesting or useful for psychologists. Studies show that lymphoma and its treatment lead to severe distress. Thirty-six percent of patients manifest symptoms of anxiety and depression, which are most often associated with the so-called “B-symptoms,” which mark poor prognosis or with side effects of chemotherapy such as nausea or vomiting. Reports also indicate that lymphoma patients may develop mild to severe cognitive decline. Its manifestations may range from benign problems with attention, thinking, and memory to severe cognitive impairment, that is, subcortical dementia. The etiology of intellectual deterioration in lymphoma has not been well described yet, but it may be related to the disease process or to the treatment. Additionally, literature demonstrates that lymphoma may lead to adverse changes in patient’s professional life such as resignation or early retirement.
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Affiliation(s)
- Ewa Mojs
- Department of Clinical Psychology, Poznan University of Medical Sciences, Poznan, Poland
| | | | - Włodzimierz Samborski
- Department of Rheumatology and Rehabilitation, Poznan University of Medical Sciences, Poznan, Poland
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Prevalence, risk factors, and the desire for help of distressed newly diagnosed cancer patients: A large-sample study. Palliat Support Care 2016; 15:295-304. [DOI: 10.1017/s1478951516000717] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
ABSTRACTObjective:Beginning in 2007, all newly diagnosed cancer patients at the Koo Foundation Sun Yat-Sen Cancer Center (KF–SYSCC) were screened for psychosocial distress. Our social workers, as part of the psychosocial care team (PCT), have engaged in proactive outreach with patients identified as distressed. The goal of the present study was to assess the prevalence of psychosocial distress and the extent of contact between the PCT and distressed patients.Method:Newly diagnosed patients who were treated at KF–SYSCC between 2007 and 2010 for cancer were eligible if there were at least 100 patients with the same type of cancer. Before treatment began, they were screened with the Pain Scale and the Distress Thermometer (DT) and had the option to specify a desire for help. The rates of distress were analyzed by cancer type and by probable related factors. Information regarding contact with the PCT was retrieved from computerized databases.Results:Overall, some 5,335 cancer patients representing 12 major cancer types were included in our study. Of these, 1,771 (33.20%) were significantly distressed. By multivariate logistic regression, younger age, female gender, higher pain score, and disease stage, but not cancer type, were found to be associated with higher rates of distress. Among these distressed patients, 628 (36%) had some contact with the PCT.Significance of results:This Taiwanese study with a large sample size revealed a prevalence rate of psychosocial distress similar to rates found in Western countries. Contact with the PCT was established in only 36% of significantly distressed patients, despite a proactive outreach program. It is very important to have screening results made available in a timely fashion to the psycho-oncology team so that appropriate care can be offered promptly.
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Musiello T, Dixon G, O'Connor M, Cook D, Miller L, Petterson A, Saunders C, Joske D, Johnson C. A pilot study of routine screening for distress by a nurse and psychologist in an outpatient haematological oncology clinic. Appl Nurs Res 2016; 33:15-18. [PMID: 28096010 DOI: 10.1016/j.apnr.2016.09.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 07/28/2016] [Accepted: 09/22/2016] [Indexed: 10/21/2022]
Abstract
AIM To explore the: 1) prevalence of distress, type of problems experienced by haematological patients, and referrals for supportive care; 2) effect of demographic and clinical variables on distress, and 3) effect on the time of health professionals conducting the screening in the ambulatory chemotherapy setting. METHODS Participants completed the National Comprehensive Cancer Network Distress Thermometer and Problem List and had a follow-up screening discussion with a health professional. RESULTS Of 68 participants, 40% reported significant distress (≥4) on the Distress Thermometer (mean 3.2, SD 2.4). All patients reported physical problems and 72% reported emotional problems-the major contributors to distress and to time spent with the health professional. Distress was unrelated to age, gender or cancer type. Patients were less likely to have significant distress at the end of treatment than at the beginning (OR=0.15, 95% CI: 0.03; 0.72,). Forty patients (59%) were referred to supportive services. The psychologist spent less time with patients compared to the nurse (18 vs 48min, p<0.001). The more emotional problems reported, the greater the time spent with the patient (rs=0.34, p=0.009). CONCLUSIONS Nurses can appropriately screen for distress and address significant distress reported by haematology patients undergoing chemotherapy without over burdening the nurse or patient.
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Affiliation(s)
- Toni Musiello
- School of Surgery, The University of Western Australia, 35 Stirling Highway, Crawley, Western Australia 6009, Australia
| | - Glenys Dixon
- School of Surgery, The University of Western Australia, 35 Stirling Highway, Crawley, Western Australia 6009, Australia
| | - Moira O'Connor
- School of Psychology and Speech Pathology, Curtin University, Kent St, Bentley, Western Australia 6102, Australia
| | - Deb Cook
- Department of Haematology, Sir Charles Gairdner Hospital, 1 Hospital Ave, Nedlands, Western Australia 6009, Australia
| | - Lisa Miller
- Department of Psychiatry, Sir Charles Gairdner Hospital, 1 Hospital Ave, Nedlands, Western Australia 6009, Australia
| | - Anna Petterson
- SolarisCare, Sir Charles Gairdner Hospital, 1 Hospital Ave, Nedlands, Western Australia 6009, Australia
| | - Christobel Saunders
- School of Surgery, The University of Western Australia, 35 Stirling Highway, Crawley, Western Australia 6009, Australia
| | - David Joske
- Department of Haematology, Sir Charles Gairdner Hospital, 1 Hospital Ave, Nedlands, Western Australia 6009, Australia; SolarisCare, Sir Charles Gairdner Hospital, 1 Hospital Ave, Nedlands, Western Australia 6009, Australia
| | - Claire Johnson
- School of Surgery, The University of Western Australia, 35 Stirling Highway, Crawley, Western Australia 6009, Australia.
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Zhang J, Deng YT, Liu J, Wang YQ, Yi TW, Huang BY, He SS, Zheng B, Jiang Y. Norepinephrine induced epithelial-mesenchymal transition in HT-29 and A549 cells in vitro. J Cancer Res Clin Oncol 2015; 142:423-35. [PMID: 26358081 DOI: 10.1007/s00432-015-2044-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2015] [Accepted: 09/03/2015] [Indexed: 02/05/2023]
Abstract
PURPOSE Norepinephrine (NE) has been implicated in epithelial-mesenchymal transition (EMT) of cancer cells. However, the underlying mechanism is poorly understood. The goal of this study was to explore the effect of NE on cancer cell EMT and to investigate the potential mechanism. METHODS HT-29 and A549 cells were treated with NE, β-adrenergic receptor (β-AR) antagonist (propranolol) or inhibitor of transforming growth factor-β (TGF-β) receptor type I kinase (Ly2157299). Morphology of cells was observed with optical and electron microscope and immunofluorescence staining. Cellular migration and invasion were tested with transwell migration assay and Matrigel invasion assay, respectively. TGF-β1 and cyclic adenosine monophosphate (cAMP) were quantified. EMT markers and signaling pathway were measured by RT-PCR and western blot. RESULTS NE stimulated TGF-β1 secretion and intracellular cAMP synthesis, induced morphological alterations in HT-29 and A549 cells, and enhanced their ability of migration and invasion. EMT markers induction was observed in NE-treated cancer cells. The effect of NE could be inhibited by propranolol or Ly2157299. β-AR/TGF-β1 signaling/p-Smad3/Snail and β-AR/TGF-β1 signaling/HIF-1α/Snail were two signaling pathways. CONCLUSION These findings demonstrated that TGF-β1 signaling pathway was a significant factor of NE-induced cancer cells EMT. The data also suggested that psychological stress might be a risk factor which enhances the ability of migration or invasion of cancer cells.
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Affiliation(s)
- Jie Zhang
- Department of Medical Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, No. 37 Guo-Xue Xiang, Chengdu, 610041, Sichuan, People's Republic of China
| | - Yao-tiao Deng
- Department of Medical Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, No. 37 Guo-Xue Xiang, Chengdu, 610041, Sichuan, People's Republic of China
| | - Jie Liu
- Department of Medical Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, No. 37 Guo-Xue Xiang, Chengdu, 610041, Sichuan, People's Republic of China
| | - Yu-qing Wang
- Department of Medical Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, No. 37 Guo-Xue Xiang, Chengdu, 610041, Sichuan, People's Republic of China
| | - Ting-wu Yi
- Department of Medical Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, No. 37 Guo-Xue Xiang, Chengdu, 610041, Sichuan, People's Republic of China
| | - Bo-yan Huang
- Department of Medical Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, No. 37 Guo-Xue Xiang, Chengdu, 610041, Sichuan, People's Republic of China
| | - Sha-sha He
- Department of Medical Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, No. 37 Guo-Xue Xiang, Chengdu, 610041, Sichuan, People's Republic of China
| | - Bo Zheng
- Department of Medical Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, No. 37 Guo-Xue Xiang, Chengdu, 610041, Sichuan, People's Republic of China
| | - Yu Jiang
- Department of Medical Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, No. 37 Guo-Xue Xiang, Chengdu, 610041, Sichuan, People's Republic of China.
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Hyde MK, Chambers SK, Shum D, Ip D, Dunn J. Psycho-oncology assessment in Chinese populations: a systematic review of quality of life and psychosocial measures. Eur J Cancer Care (Engl) 2015; 25:691-718. [PMID: 26292029 DOI: 10.1111/ecc.12367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/02/2015] [Indexed: 11/26/2022]
Abstract
This systematic review describes psychosocial and quality of life (QOL) measures used in psycho-oncology research with cancer patients and caregivers in China. Medline and PsycINFO databases were searched (1980-2014). Studies reviewed met the following criteria: English language; peer-reviewed; sampled Chinese cancer patients/caregivers; developed, validated or assessed psychometric properties of psychosocial or QOL outcome measures; and reported validation data. The review examined characteristics of measures and participants, translation and cultural adaptation processes and psychometric properties of the measures. Ninety five studies met review criteria. Common characteristics of studies reviewed were they: assessed primarily QOL measures, sampled patients with breast, colorectal, or head and neck cancer, and validated existing measures (>80%) originating in North America or Europe. Few studies reported difficulties translating measures. Regarding psychometric properties of the measures >50% of studies reported subscale reliabilities <α = 0.70, <50% reported test-retest reliability, and <30% reported divergent validity. Few reported sensitivity, specificity or responsiveness. Improved accuracy and transparency of reporting for translation, cultural adaptation and psychometric testing of psychosocial measures is needed. Developing support structures for translating and validating psychosocial measures would enable this and ensure Chinese psycho-oncology clinical practice and research keeps pace with international focus on patient reported outcome measures and data management.
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Affiliation(s)
- M K Hyde
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Qld, Australia.,Cancer Council Queensland, Spring Hill, Qld, Australia
| | - S K Chambers
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Qld, Australia.,Cancer Council Queensland, Spring Hill, Qld, Australia.,Health and Wellness Institute, Edith Cowan University, Perth, WA, Australia.,Centre for Clinical Research, The University of Queensland, Herston, Qld, Australia.,Prostate Cancer Foundation of Australia, St Leonards, NSW, Australia
| | - D Shum
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Qld, Australia
| | - D Ip
- The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - J Dunn
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Qld, Australia.,Cancer Council Queensland, Spring Hill, Qld, Australia.,School of Social Science, The University of Queensland, St Lucia, Qld, Australia
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28
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Liu J, Deng GH, Zhang J, Wang Y, Xia XY, Luo XM, Deng YT, He SS, Mao YY, Peng XC, Wei YQ, Jiang Y. The effect of chronic stress on anti-angiogenesis of sunitinib in colorectal cancer models. Psychoneuroendocrinology 2015; 52:130-42. [PMID: 25437118 DOI: 10.1016/j.psyneuen.2014.11.008] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Revised: 10/22/2014] [Accepted: 11/10/2014] [Indexed: 02/05/2023]
Abstract
Epidemiological and experimental evidence has shown that psychological stress can propel cancer progression. However, its role in anti-angiogenic therapy is not well understood. We previously found that exogenous norepinephrine attenuated the effect of sunitinib, a multi-targeted anti-angiogenic agent, in a mouse melanoma model. Here, we further evaluated the effects of chronic stress on sunitinib therapy in colorectal cancer models. We found that chronic restraint stress markedly weakened the efficacy of sunitinib, primarily through promoting the expression of vascular endothelial growth factor (VEGF) and interleukin-8 (IL-8) to stimulate tumor angiogenesis in vivo. This effect could be sufficiently mimicked by exogenous norepinephrine and blocked by the β-antagonist propranolol. In vitro, norepinephrine up-regulated expression of VEGF and IL-8 in sunitinib-treated cancer cells mainly through the β-adrenoceptor-cAMP-PKA signaling pathway. Norepinephrine also abrogated sunitinib-induced inhibition of cancer cell migration, but had no effect on direct anti-proliferative activity of sunitinib on cancer cells. These findings suggest that psychological stress might attenuate anti-angiogenic therapy primarily through activating beta-adrenergic signaling to promote tumor angiogenesis. It is also suggested that β-blockers might improve anti-angiogenic outcome under psychological stress.
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Affiliation(s)
- Jie Liu
- Department of Medical Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China
| | - Guo-Hua Deng
- Department of Medical Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China
| | - Jie Zhang
- Department of Medical Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China
| | - Ying Wang
- Department of Medical Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China
| | - Xiang-Yu Xia
- Department of Medical Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China
| | - Xin-Mei Luo
- Department of Medical Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China
| | - Yao-Tiao Deng
- Department of Medical Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China
| | - Sha-Sha He
- Department of Medical Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China
| | - Yin-Yan Mao
- Department of Medical Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China
| | - Xing-Chen Peng
- Department of Medical Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China
| | - Yu-Quan Wei
- Department of Medical Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China
| | - Yu Jiang
- Department of Medical Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China.
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The course of anxiety and depression for patients with Hodgkin’s lymphoma or diffuse large B cell lymphoma: a longitudinal study of the PROFILES registry. J Cancer Surviv 2014; 8:555-64. [DOI: 10.1007/s11764-014-0367-1] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Accepted: 04/28/2014] [Indexed: 12/22/2022]
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30
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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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