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Amaslidou A, Ierodiakonou-Benou I, Bakirtzis C, Nikolaidis I, Tatsi T, Grigoriadis N, Nimatoudis I. Multiple sclerosis and mental health related quality of life: The role of defense mechanisms, defense styles and family environment. AIMS Neurosci 2023; 10:354-375. [PMID: 38188008 PMCID: PMC10767059 DOI: 10.3934/neuroscience.2023027] [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: 08/09/2023] [Revised: 11/13/2023] [Accepted: 11/21/2023] [Indexed: 01/09/2024] Open
Abstract
Background Multiple sclerosis is a demyelinating chronic neurologic disease that can lead to disability and thus to deterioration of quality of life. Psychological parameters such as ego defense mechanisms, defense styles and family environment are important factors in the adaptation process, and as such they can play important roles in QoL. This study aims to assess the psychological factors as well as the clinical and demographic characteristics related to mental health quality of life (MHQoL). Methods This was an observational, cross-sectional study conducted in a sample of 90 people with MS in the years 2018-2020. All participants completed the following questionnaires: MSQoL-54, DSQ-88, LSI, FES-R, SOC, BDI-II, STAI. Disability was assessed using EDSS. Results In multiple linear regression, significant roles were played by depression (R2: 41.1%, p: 0.001) and, to a lesser extent, the event of a relapse (R2: 3.5%, p: 0.005), expressiveness (R2: 3.6%, p < 0.05) and image distortion style (R2: 4.5%, p: 0.032). After performing a hierarchical-stepwise analysis (excluding depression), the important factors were maladaptive defense style (R2: 23.7%, p: 0.002), the event of relapse (R2: 8.1%, p < 0.001), expressiveness (R2: 5.5%, p: 0.004) and self-sacrificing defense style (R2: 2.4%, p: 0.071). Conclusion Psychological factors play important roles in MHQoL of people with multiple sclerosis. Thus, neurologists should integrate in their practice an assessment by mental health specialists. Moreover, targeted psychotherapeutic interventions could be planned i to improve QoL.
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Affiliation(s)
- Anthi Amaslidou
- 3 Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Ioanna Ierodiakonou-Benou
- 3 Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Christos Bakirtzis
- 2 Department of Neurology, MS Center, School of Medicine, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Ioannis Nikolaidis
- 2 Department of Neurology, MS Center, School of Medicine, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Theano Tatsi
- 2 Department of Neurology, MS Center, School of Medicine, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Nikolaos Grigoriadis
- 2 Department of Neurology, MS Center, School of Medicine, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Ioannis Nimatoudis
- 3 Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
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2
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Simin T, Jin Y, Aidi Z, Xiaofang T, Chunhong R, Lezhi L. Gender Comparison of Psychological Reaction Between Breast Cancer Survivors and Their Spouses. Front Psychol 2021; 12:722877. [PMID: 34552536 PMCID: PMC8450368 DOI: 10.3389/fpsyg.2021.722877] [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: 06/16/2021] [Accepted: 08/05/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Scant evidence exists among the different psychological issues between patients with breast cancer and their spouses. The objective of our study was to develop the measuring instrument testing psychological reaction and compare the difference in psychological reaction between patients with breast cancer and their spouses during the period of diagnosis and treatment. Method: The semi-structured interview guideline was guided by the psychological stress model. In-depth interviews were conducted among patients with breast cancer and their spouses. Qualitative data was used to establish the item pool for the psychological reaction. Delphi method was used for item modifications. The items were conducted to find common factors through exploration factor analysis. Comparing the differences of common factors through t-test between patients with breast cancer and their spouses. Results: Five couples were interviewed directed by the semi-structured interview guideline. About 38 items were reserved to formulate the questionnaire through the Delphi method. A total of 391 respondents (216 patients and 175 spouses) were recruited to complete the questionnaire. Two common structures were found through exploration factor analysis, which was named as reaction to role and body image change and negative coping reaction. The t-test found that the dimension of reaction to role and body image change (95% CI = 2.34-5.01, p < 0.001) reflects the difference between patients with breast cancer and their spouses. Conclusion: The reactions to role and body image change between patients with breast cancer and their spouses are different during the period of diagnosis and treatment. Clinical workers should pay attention to the different reactions and help couples deal with breast cancer smoothly.
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Affiliation(s)
- Tan Simin
- Xiang Ya Nursing School, Central South University, Changsha, China
| | - Yan Jin
- Nursing Department, Central South University Third Xiangya Hospital, Changsha, China
| | - Zhang Aidi
- Nursing Department, Central South University Third Xiangya Hospital, Changsha, China
| | - Tan Xiaofang
- Nursing Department, Central South University Third Xiangya Hospital, Changsha, China
| | - Ruan Chunhong
- Nursing Department, Central South University Third Xiangya Hospital, Changsha, China
| | - Li Lezhi
- Xiang Ya Nursing School, Central South University, Changsha, China
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Nardone V, Reginelli A, Vinciguerra C, Correale P, Calvanese MG, Falivene S, Sangiovanni A, Grassi R, Di Biase A, Polifrone MA, Caraglia M, Cappabianca S, Guida C. Mood Disorder in Cancer Patients Undergoing Radiotherapy During the COVID-19 Outbreak. Front Psychol 2021; 12:568839. [PMID: 33815186 PMCID: PMC8017226 DOI: 10.3389/fpsyg.2021.568839] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 02/25/2021] [Indexed: 12/26/2022] Open
Abstract
Introduction: Novel coronavirus (COVID-19) is having a devastating psychological impact on patients, especially patients with cancer. This work aims to evaluate mood disorders of cancer patients undergoing radiation therapy during COVID-19 in comparison with cancer patients who underwent radiation therapy in 2019. Materials and Methods: We included all the patients undergoing radiation therapy at our department in two-time points (once a week for a month in May 2019) and during the COVID-19 outbreak (in April 2020). All the patients were asked to fulfill a validated questionnaire (STAI-Y1, State trait anxiety inventory scale), the Symptom Distress thermometer (SDT) (from 0 to 10 score), and the Beck Depression Inventory v.2 (BDI-2). We took into account the COVID-19 outbreak and also sex, age, week of radiation treatment, and disease. Results: We included 458 patients (220 males and 238 females), with a median age of 64 years. STAI-Y1 median score was 40 (mean 41,3, range 19-79), whereas the median score of SDT was five and BDI-2 median score was 11. STAI-Y1, SDT, and BDI-2 were significantly correlated with the COVID-19 outbreak (p < 0,001 for all the tests), sex (p: 0,016 for STAI-Y1, p < 0.001 for SDT, p:0.013 for BDI-2), week of treatment (p: 0.012 for STAI-Y1 and p: 0.031 for SDT), and disease (p:0.015 for STAI-Y1, p < 0.001 for SDT and p:0.020 for BDI-2). Conclusions: The prevalence of mood disorders in patients undergoing radiation therapy is higher than expected and even higher during the COVID-19 outbreak. These measurements could be useful as a baseline to start medical humanities programs to decrease these scores.
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Affiliation(s)
- Valerio Nardone
- Unit of Radiation Oncology, Ospedale del Mare, Naples, Italy
| | - Alfonso Reginelli
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli," Naples, Italy
| | | | - Pierpaolo Correale
- Unit of Medical Oncology, Grand Metropolitan Hospital "Bianchi Melacrino Morelli," Reggio Calabria, Italy
| | | | - Sara Falivene
- Unit of Radiation Oncology, Ospedale del Mare, Naples, Italy
| | - Angelo Sangiovanni
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli," Naples, Italy
| | - Roberta Grassi
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli," Naples, Italy
| | - Angela Di Biase
- Unit of Radiation Oncology, Ospedale del Mare, Naples, Italy
| | - Maria Angela Polifrone
- Unit of Medical Oncology, Grand Metropolitan Hospital "Bianchi Melacrino Morelli," Reggio Calabria, Italy
| | - Michele Caraglia
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli," Naples, Italy
| | - Salvatore Cappabianca
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli," Naples, Italy
| | - Cesare Guida
- Unit of Radiation Oncology, Ospedale del Mare, Naples, Italy
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Mackenzie L, Mansfield E, Herrmann A, Grady A, Evans TJ, Sanson-Fisher R. Perceived problems with involvement in decision making about breast cancer treatment and care: A cross-sectional study. PATIENT EDUCATION AND COUNSELING 2021; 104:505-511. [PMID: 32928596 DOI: 10.1016/j.pec.2020.08.044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 08/10/2020] [Accepted: 08/29/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To examine perceived problems with involvement in medical decision making among people with breast cancer from various phases of the cancer care trajectory. METHODS Breast cancer outpatients (n = 663) from 13 treatment centres completed a survey of perceived involvement in treatment and care decisions in the last month, psychological distress, demographic and clinical factors. A subsample (n = 98) from three centres completed a follow-up survey on preferred and perceived treatment decision making roles. RESULTS Overall, 112 (17 %) of 663 respondents from 13 oncology centres had experienced problems with involvement in decision making about their treatment and care in the last month, and of these, 36 (32 %) reported an unmet need for help with this problem. Elevated psychological distress was associated with 5.7 times the odds of reporting this problem and 6.6 times the odds of reporting this unmet need in the last month. Among the follow-up subsample (n = 98), 39% (n = 38) reported discordance between preferred and perceived role in a major treatment decision. Psychological distress was not associated with this outcome. CONCLUSION Psychological distress was significantly associated with recently experiencing problems with involvement in treatment and care decisions, but not with misalignment of preferred and perceived roles in prior major treatment decisions. PRACTICE IMPLICATIONS There is a need to maintain support for patient involvement in healthcare decisions across the cancer care continuum.
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Affiliation(s)
- Lisa Mackenzie
- Health Behaviour Research Collaborative & Priority Research Centre for Health Behaviour, School of Medicine and Public Health, University of Newcastle, Newcastle, Australia; Hunter Medical Research Institute, Newcastle, Australia.
| | - Elise Mansfield
- Health Behaviour Research Collaborative & Priority Research Centre for Health Behaviour, School of Medicine and Public Health, University of Newcastle, Newcastle, Australia; Hunter Medical Research Institute, Newcastle, Australia
| | - Anne Herrmann
- Health Behaviour Research Collaborative & Priority Research Centre for Health Behaviour, School of Medicine and Public Health, University of Newcastle, Newcastle, Australia; Hunter Medical Research Institute, Newcastle, Australia; Department of Haematology and Internal Oncology, University Hospital Regensburg, F. J. Strauß Allee 11, 93053 Regensburg, Germany
| | - Alice Grady
- Health Behaviour Research Collaborative & Priority Research Centre for Health Behaviour, School of Medicine and Public Health, University of Newcastle, Newcastle, Australia; Hunter Medical Research Institute, Newcastle, Australia; Hunter New England Local Health District, Population Health, Wallsend, Australia
| | - Tiffany-Jane Evans
- Clinical Research, Design and Statistics, Hunter Medical Research Institute, Newcastle, Australia
| | - Robert Sanson-Fisher
- Health Behaviour Research Collaborative & Priority Research Centre for Health Behaviour, School of Medicine and Public Health, University of Newcastle, Newcastle, Australia; Hunter Medical Research Institute, Newcastle, Australia
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5
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Conversano C, Di Giuseppe M. Psychological Factors as Determinants of Chronic Conditions: Clinical and Psychodynamic Advances. Front Psychol 2021; 12:635708. [PMID: 33584488 PMCID: PMC7876054 DOI: 10.3389/fpsyg.2021.635708] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 01/08/2021] [Indexed: 12/11/2022] Open
Affiliation(s)
| | - Mariagrazia Di Giuseppe
- Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, Pisa, Italy
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6
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Di Mattei VE, Perego G, Rancoita PMV, Taranto P, Carnelli L, Mangili G, Sarais V, Bergamini A, Candiani M. Psychological Aspects Associated With Fertility Preservation in Oncology: An Exploratory Study. Front Psychol 2021; 11:608651. [PMID: 33414749 PMCID: PMC7783324 DOI: 10.3389/fpsyg.2020.608651] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 11/25/2020] [Indexed: 11/13/2022] Open
Abstract
Objective Gonadotoxicity is considered one of the most distressing side effects of cancer treatment. Although fertility preservation can be a valid solution, it also involves a challenging process. A clear understanding of the features of women who decide to pursue fertility preservation after cancer diagnosis is missing. The purpose of the present study was therefore to analyze the personality profile of female patients referred to oncofertility prior to gonadotoxic treatment. Methods Fifty-two female cancer patients took part in the study. The Temperament and Character Inventory-Revised (TCI-R), the Response Evaluation Measure-71 (REM-71), the Beck Depression Inventory (BDI-II), and the State-Trait Anxiety Inventory-Y Form (STAI-Y) were administered to examine personality characteristics, defense mechanisms, depression and anxiety symptoms. Results Compared with reference data of the Italian population, our sample reported significantly lower scores in Harm Avoidance and trait anxiety, and significantly higher levels of mature defense mechanisms. Most of the patients reported low scores in immature defense mechanisms, depression, and trait anxiety, and medium scores in state anxiety. Conclusions Our findings suggest that these women display functional personality traits and defensive style, in association with low levels of depression and trait anxiety. These features may enable a proactive attitude to cancer and the ability to make long-term plans. This may favor psychological adjustment to cancer and a projection toward the future.
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Affiliation(s)
- Valentina Elisabetta Di Mattei
- Division of Neuroscience, Clinical and Health Psychology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,School of Psychology, Vita-Salute San Raffaele University, Milan, Italy
| | - Gaia Perego
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Paola Maria Vittoria Rancoita
- University Centre for Statistics in the Biomedical Sciences (CUSSB), Vita-Salute San Raffaele University, Milan, Italy.,School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
| | - Paola Taranto
- Division of Neuroscience, Clinical and Health Psychology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Letizia Carnelli
- Division of Neuroscience, Clinical and Health Psychology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Giorgia Mangili
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Veronica Sarais
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Alice Bergamini
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Massimo Candiani
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.,Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
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de Mol M, Visser S, Aerts J, Lodder P, van Walree N, Belderbos H, den Oudsten B. The association of depressive symptoms, personality traits, and sociodemographic factors with health-related quality of life and quality of life in patients with advanced-stage lung cancer: an observational multi-center cohort study. BMC Cancer 2020; 20:431. [PMID: 32423432 PMCID: PMC7236491 DOI: 10.1186/s12885-020-06823-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 04/02/2020] [Indexed: 01/11/2023] Open
Abstract
Background Identification of patient-related factors associated with Health-Related Quality of Life (HRQoL) and Quality of Life (QoL) at the start of treatment may identify patients who are prone to a decrease in HRQoL and/or QoL resulting from chemotherapy. Identification of these factors may offer opportunities to enhance patient care during treatment by adapting communication strategies and directing medical and psychological interventions. The aim was to examine the association of sociodemographic factors, personality traits, and depressive symptoms with HRQoL and QoL in patients with advanced-stage lung cancer at the start of chemotherapy. Methods Patients (n = 151) completed the State-Trait Anxiety Inventory (trait anxiety subscale), the Neuroticism-Extraversion-Openness-Five Factor Inventory (NEO-FFI), the Center for Epidemiologic Studies Depression (CES-D), the World Health Organization Quality of Life-BREF (WHOQOL-BREF), and the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30). Simple linear regression analyses were performed to select HRQoL and QoL associated factors (a P ≤ 0.10 was used to prevent non-identification of important factors) followed by multiple linear regression analyses (P ≤ 0.05). Results In the multiple regression analyses, CES-D score (β = − 0.63 to − 0.53; P-values < 0.001) was most often associated with the WHOQOL-BREF domains and general facet, whereas CES-D score (β = − 0.67 to − 0.40; P-values < 0.001) and Eastern Cooperative Oncology Group (ECOG) performance status (β = − 0.30 to − 0.30; P-values < 0.001) were most often associated with the scales of the EORTC QLQ-C30. Personality traits were not related with HRQoL or QoL except for trait anxiety (Role functioning: β = 0.30; P = 0.02, Environment: β = − 0.39; P = 0.007) and conscientiousness (Physical health: β = 0.20; P-value < 0.04). Conclusions Higher scores on depressive symptoms and ECOG performance status were related to lower HRQoL and QoL in patients with advanced-stage non-small cell lung cancer. Supportive care interventions aimed at improvement of depressive symptoms and performance score may facilitate an increase of HRQoL and/or QoL during treatment.
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Affiliation(s)
- Mark de Mol
- Department of Pulmonary Diseases, Amphia Hospital, P.O. Box 90158, 4800, RK, Breda, The Netherlands.,Department of Pulmonary Diseases, Erasmus MC Cancer Institute, P.O. Box 2040, 3000, CA, Rotterdam, The Netherlands
| | - Sabine Visser
- Department of Pulmonary Diseases, Amphia Hospital, P.O. Box 90158, 4800, RK, Breda, The Netherlands.,Department of Pulmonary Diseases, Erasmus MC Cancer Institute, P.O. Box 2040, 3000, CA, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus MC - University Medical Centre Rotterdam, P.O. Box 2040, 3000, CA, Rotterdam, The Netherlands
| | - Joachim Aerts
- Department of Pulmonary Diseases, Amphia Hospital, P.O. Box 90158, 4800, RK, Breda, The Netherlands.,Department of Pulmonary Diseases, Erasmus MC Cancer Institute, P.O. Box 2040, 3000, CA, Rotterdam, The Netherlands
| | - Paul Lodder
- Department of Methodology and Statistics, Tilburg University, P.O. Box 90151, 5000, LE, Tilburg, The Netherlands.,Department of Medical and Clinical Psychology, Centre of Research on Psychological and Somatic Disorders (CoRPS), Tilburg University, P.O. Box 90151, 5000, LE, Tilburg, The Netherlands
| | - Nico van Walree
- Department of Pulmonary Diseases, Amphia Hospital, P.O. Box 90158, 4800, RK, Breda, The Netherlands
| | - Huub Belderbos
- Department of Pulmonary Diseases, Amphia Hospital, P.O. Box 90158, 4800, RK, Breda, The Netherlands
| | - Brenda den Oudsten
- Department of Medical and Clinical Psychology, Centre of Research on Psychological and Somatic Disorders (CoRPS), Tilburg University, P.O. Box 90151, 5000, LE, Tilburg, The Netherlands.
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8
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Fox J, Picciotto G. The Mediating Effects of Spiritual Bypass on Depression, Anxiety, and Stress. COUNSELING AND VALUES 2019. [DOI: 10.1002/cvj.12116] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Jesse Fox
- Department of Counselor EducationStetson University
| | - Gabriela Picciotto
- Faculdade de Psicologia e de Ciências da Educação da Universidade do Porto Porto Portugal
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9
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Schwartz RM, Ornstein KA, Liu B, Alpert N, Bevilacqua KG, Taioli E. Change in Quality of Life after a Cancer Diagnosis among a Nationally Representative Cohort of Older Adults in the US. Cancer Invest 2019; 37:299-310. [PMID: 31379217 DOI: 10.1080/07357907.2019.1645160] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Age-related decreases in Quality of Life (QoL) are often compounded by comorbidities, including cancer. This study aimed to examine QoL changes before and after a new cancer diagnosis using data from the National Health and Aging Trend Study (NHATS), linked to Medicare claims (N = 136). There was a significant increase in the relative odds of fair/poor self-reported health and needing help with Activities of Daily Living. There was also a marginal increase in depression, but no change in anxiety or pain scores. Results underscore importance of considering pre-cancer QoL when making treatment decisions for older adult cancer patients.
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Affiliation(s)
- Rebecca M Schwartz
- Northwell Health, Occupational Medicine, Epidemiology and Prevention , Great Neck , NY , USA.,Institute for Translational Epidemiology, Department of Population Health Science and Policy, The Icahn School of Medicine at Mount Sinai , New York , NY , USA.,Tisch Cancer Institute, The Icahn School of Medicine at Mount Sinai , New York , NY , USA
| | - Katherine A Ornstein
- Institute for Translational Epidemiology, Department of Population Health Science and Policy, The Icahn School of Medicine at Mount Sinai , New York , NY , USA.,Brookdale Department of Geriatrics and Palliative Medicine, The Icahn School of Medicine at Mount Sinai , New York , NY , USA
| | - Bian Liu
- Institute for Translational Epidemiology, Department of Population Health Science and Policy, The Icahn School of Medicine at Mount Sinai , New York , NY , USA
| | - Naomi Alpert
- Brookdale Department of Geriatrics and Palliative Medicine, The Icahn School of Medicine at Mount Sinai , New York , NY , USA
| | - Kristin G Bevilacqua
- Northwell Health, Occupational Medicine, Epidemiology and Prevention , Great Neck , NY , USA
| | - Emanuela Taioli
- Institute for Translational Epidemiology, Department of Population Health Science and Policy, The Icahn School of Medicine at Mount Sinai , New York , NY , USA
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Karadag E, Uğur Ö, Çetinayak O. The effect of music listening intervention applied during radiation therapy on the anxiety and comfort level in women with early-stage breast cancer: A randomized controlled trial. Eur J Integr Med 2019. [DOI: 10.1016/j.eujim.2019.02.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Russo S, Jongerius C, Faccio F, Pizzoli SFM, Pinto CA, Veldwijk J, Janssens R, Simons G, Falahee M, de Bekker-Grob E, Huys I, Postmus D, Kihlbom U, Pravettoni G. Understanding Patients' Preferences: A Systematic Review of Psychological Instruments Used in Patients' Preference and Decision Studies. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2019; 22:491-501. [PMID: 30975401 DOI: 10.1016/j.jval.2018.12.007] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 09/25/2018] [Accepted: 12/20/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Research has been mainly focused on how to elicit patient preferences, with less attention on why patients form certain preferences. OBJECTIVES To assess which psychological instruments are currently used and which psychological constructs are known to have an impact on patients' preferences and health-related decisions including the formation of preferences and preference heterogeneity. METHODS A systematic database search was undertaken to identify relevant studies. From the selected studies, the following information was extracted: study objectives, study population, design, psychological dimensions investigated, and instruments used to measure psychological variables. RESULTS Thirty-three studies were identified that described the association between a psychological construct, measured using a validated instrument, and patients' preferences or health-related decisions. We identified 33 psychological instruments and 18 constructs, and categorized the instruments into 5 groups, namely, motivational factors, cognitive factors, individual differences, emotion and mood, and health beliefs. CONCLUSIONS This review provides an overview of the psychological factors and related instruments in the context of patients' preferences and decisions in healthcare settings. Our results indicate that measures of health literacy, numeracy, and locus of control have an impact on health-related preferences and decisions. Within the category of constructs that could explain preference and decision heterogeneity, health locus of control is a strong predictor of decisions in several healthcare contexts and is useful to consider when designing a patient preference study. Future research should continue to explore the association of psychological constructs with preference formation and heterogeneity to build on these initial recommendations.
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Affiliation(s)
- Selena Russo
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, Milan, Italy; Discipline of Paediatrics, School of Women's and Children's Health, University of New South Wales, Kensington, New South Wales, Australia.
| | - Chiara Jongerius
- Department of Medical Psychology-Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Flavia Faccio
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, Milan, Italy; Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
| | - Silvia F M Pizzoli
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, Milan, Italy; Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
| | - Cathy Anne Pinto
- Department of Pharmacoepidemiology, Merck & Co, Inc, Kenilworth, NJ, USA
| | - Jorien Veldwijk
- Centre for Research Ethics and Bioethics, Uppsala University, Uppsala, Sweden; Erasmus School of Health Policy and Management and Erasmus Choice Modelling Center, Erasmus University, Rotterdam, the Netherlands
| | - Rosanne Janssens
- Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
| | - Gwenda Simons
- Rheumatology Research Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - Marie Falahee
- Rheumatology Research Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - Esther de Bekker-Grob
- Erasmus School of Health Policy and Management and Erasmus Choice Modelling Center, Erasmus University, Rotterdam, the Netherlands
| | - Isabelle Huys
- Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
| | - Douwe Postmus
- University Medical Center Groningen, Groningen, the Netherlands
| | - Ulrik Kihlbom
- Centre for Research Ethics and Bioethics, Uppsala University, Uppsala, Sweden
| | - Gabriella Pravettoni
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, Milan, Italy; Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
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Di Giuseppe M, Di Silvestre A, Lo Sterzo R, Hitchcott P, Gemignani A, Conversano C. Qualitative and quantitative analysis of the defensive profile in breast cancer women: A pilot study. Health Psychol Open 2019; 6:2055102919854667. [PMID: 31218073 PMCID: PMC6558547 DOI: 10.1177/2055102919854667] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
This study analyzed the defensive functioning and profile of nine breast cancer women and identifies the differences from other cancer patients (N0) in the way they deal with internal conflicts and stressful situations related to the illness. Patients were interviewed and evaluated using the Defense Mechanisms Rating Scale Q-sort. Mean differences analysis showed that breast cancer patients use more reaction formation, omnipotence, and rationalization and less idealization of others-image and autistic fantasy, compared with other-site cancer patients. From the qualitative analysis of the defensive profile, displacement and repression appeared among the most representative defense mechanisms of breast cancer patients.
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Affiliation(s)
- Mariagrazia Di Giuseppe
- Department of Surgical, Medical and
Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa,
Italy
| | | | - Rosa Lo Sterzo
- Department of Clinical Oncology,
Hospital Santo Spirito, Pescara, Italy
| | - Paul Hitchcott
- Department of Surgical, Medical and
Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa,
Italy
| | - Angelo Gemignani
- Department of Surgical, Medical and
Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa,
Italy
| | - Ciro Conversano
- Department of Surgical, Medical and
Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa,
Italy
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Anxiety and Depression Disorders in Relation to the Quality of Life of Breast Cancer Patients with Locally Advanced or Disseminated Stage. ACTA ACUST UNITED AC 2018; 47:211-220. [PMID: 30286843 DOI: 10.1016/j.rcp.2017.04.003] [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: 08/25/2016] [Revised: 03/21/2017] [Accepted: 04/23/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To evaluate patterns of association between anxiety and depression and the different elements of the construct of quality of life, in patients with locally advanced breast cancer or disseminated stages METHODS: With a single measure over time, HADS and FACIT-B scales were applied in 107 women histologically confirmed to have breast cancer, in stages IIB, IIIA, IIIB, IIIC and IV. Factor analysis and multidimensional scaling methods were used to analyze patterns of association RESULTS: In 84.1% of the patients clinical anxiety was found (95%CI, 75.8-90.5%) and clinical depression in 25.2% (95%CI, 17.3-34.6%). Factor analysis groups items of the two scales in 4 domains which accounted for 59% of the total variance, where 2 items (H11 and B8) showed high values of uniqueness and low factor loadings. Multidimensional scaling suggests five groups, showing proximity between depressive symptoms and physical symptoms, as well as between anxious symptoms and related to functionality and social and family environment CONCLUSIONS: The HADS in patients with neoplastic disease detects a high frequency of depressive and especially anxious symptoms, which makes it advisable to reevaluate their psychometric properties in patients with cancer. The association between depressive symptoms of HADS and physical symptoms of quality of life construct is in favor of the difficulty of diagnosing depressive disorder in patients with cancer, so it may be necessary to develop instruments that allow locating symptoms or clinical characteristics that facilitate this diagnosis.
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Relationship Between Defense Mechanisms and the Quality of Life in Women With Breast Cancer. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT 2018. [DOI: 10.5812/ijcm.11116] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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15
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Howells L, Chisholm A, Cotterill S, Chinoy H, Warren RB, Bundy C. Impact of Disease Severity, Illness Beliefs, and Coping Strategies on Outcomes in Psoriatic Arthritis. Arthritis Care Res (Hoboken) 2017; 70:295-302. [PMID: 28771988 DOI: 10.1002/acr.23330] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 07/25/2017] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Little is known about how people with psoriatic arthritis (PsA) cope with and manage their condition, but data show that psychological problems are underrecognized and undertreated. The Common Sense Self-Regulatory Model (CS-SRM) suggests illness beliefs, mediated by coping, may influence health outcomes. The study aimed to investigate the roles of disease severity, illness beliefs, and coping strategies in predicting depression, anxiety, and quality of life (QoL) in people with PsA. Additionally, we aimed to assess the role of depression and anxiety in predicting QoL. METHODS We conducted a cross-sectional observational study, where adults with PsA (n = 179) completed validated measures of predictor (illness beliefs, coping strategies, disease severity) and outcome variables (depression, anxiety, QoL) using an online survey distributed via social media. RESULTS The participants were a community sample of 179 adults with PsA, ages 20 to 72 years (77.1% female). After controlling for disease severity, hierarchical multiple regression models indicated that more negative beliefs about consequences and behavioral disengagement as a coping method predicted levels of depression, and self-blame predicted anxiety. Beliefs about consequences and the presence of depression predicted quality of life scores after controlling for disease severity. CONCLUSION This study offers support for the use of the CS-SRM in explaining variation on psychological outcomes in individuals with PsA. The illness beliefs and coping strategies identified as predictors in this article are potential targets for interventions addressing PsA-related distress and QoL.
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Faller H, Strahl A, Richard M, Niehues C, Meng K. Symptoms of depression and anxiety as predictors of physical functioning in breast cancer patients. A prospective study using path analysis. Acta Oncol 2017; 56:1677-1681. [PMID: 28595474 DOI: 10.1080/0284186x.2017.1333630] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Although symptoms of depression and anxiety are linked to health-related quality of life (HRQoL), the nature of this relationship remained unclear. We therefore aimed to examine, in a prospective study, both possible directions of impact in this relationship. To avoid conceptual and measurement overlap between depressive and anxiety symptoms, on the one hand, and HRQoL, on the other hand, we focused on the physical functioning component of HRQoL. MATERIAL AND METHODS We conducted a secondary analysis of a prospective cohort study with 436 female breast cancer patients (mean age 51 years). Both at baseline and after 12 months, we measured symptoms of depression and anxiety with the four-item Patient Heath Questionnaire (PHQ-4) and physical functioning with the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30). Using path analysis, we estimated (1) the predictive value of symptoms of depression/anxiety for subsequent physical functioning and (2) the predictive value of physical functioning for subsequent symptoms of depression/anxiety, in the same model. RESULTS Baseline symptoms of depression/anxiety predicted 1-year levels of physical functioning (depression: standardized β = -.09, p = .024; anxiety: standardized β = -.10, p = .009), while the reciprocal paths linking baseline physical functioning to subsequent depressive and anxiety symptoms were not significant, adjusting for the baseline scores of all outcome variables. CONCLUSIONS Depressive and anxiety symptoms were predictors of the physical functioning component of HRQoL. Thus, if this relation is causal, treating breast cancer patients' depressive and anxiety symptoms may have a favorable impact on their self-reported physical functioning.
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Affiliation(s)
- Hermann Faller
- Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, University of Würzburg, Würzburg, Germany
- Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg, Germany
| | - André Strahl
- Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, University of Würzburg, Würzburg, Germany
| | - Matthias Richard
- Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, University of Würzburg, Würzburg, Germany
| | - Christiane Niehues
- Reha-Zentrum Ückeritz, Klinik Ostseeblick, Ückeritz, Germany
- Deutsche Rentenversicherung Bund, Berlin, Germany
| | - Karin Meng
- Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, University of Würzburg, Würzburg, Germany
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Barel-Shoshani ZA, Kreitler S. Changes in self-perception following breast cancer as expressed in self-figure drawings: Present-past. ARTS IN PSYCHOTHERAPY 2017. [DOI: 10.1016/j.aip.2017.05.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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18
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You J, Lu Q, Zvolensky MJ, Meng Z, Garcia K, Cohen L. Anxiety- and Health-Related Quality of Life Among Patients With Breast Cancer: A Cross-Cultural Comparison of China and the United States. J Glob Oncol 2017; 4:1-9. [PMID: 30241191 PMCID: PMC6180812 DOI: 10.1200/jgo.2016.008763] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Purpose Literature has documented the prevalence of anxiety and its adverse effect on
quality of life among patients with breast cancer from Western countries,
yet cross-cultural examinations with non-Western patients are rare. This
cross-cultural study investigated differences in anxiety and its association
with quality of life between US and Chinese patients with breast cancer. Methods Patients with breast cancer from the United States and China completed
measures for anxiety (Spielberger State-Trait Anxiety Inventory) and quality
of life (Functional Assessment of Cancer Therapy-Breast). Results After controlling for demographic and medical characteristics, Chinese
patients reported higher levels of trait and state anxiety than US patients.
Although there was an association between anxiety and quality of life in
both groups of patients, the association between state anxiety and quality
of life was stronger among Chinese patients than among US patients, with the
association between trait anxiety and quality of life the same between the
two cultural samples. Conclusion These findings suggest that anxiety and its association with quality of life
among patients with breast cancer varies depending on cultural context,
which reveals greater anxiety and poorer quality of life among Chinese
patients compared with US patients. This suggests greater unmet psychosocial
needs among Chinese patients and highlights the need to build comprehensive
cancer care systems for a better quality of life in Chinese populations.
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Affiliation(s)
- Jin You
- Jin You, Wuhan University, Wuhan; Zhiqiang Meng, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China; Qian Lu and Michael J. Zvolensky, University of Houston; and Kay Garcia and Lorenzo Cohen, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Qian Lu
- Jin You, Wuhan University, Wuhan; Zhiqiang Meng, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China; Qian Lu and Michael J. Zvolensky, University of Houston; and Kay Garcia and Lorenzo Cohen, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Michael J Zvolensky
- Jin You, Wuhan University, Wuhan; Zhiqiang Meng, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China; Qian Lu and Michael J. Zvolensky, University of Houston; and Kay Garcia and Lorenzo Cohen, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Zhiqiang Meng
- Jin You, Wuhan University, Wuhan; Zhiqiang Meng, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China; Qian Lu and Michael J. Zvolensky, University of Houston; and Kay Garcia and Lorenzo Cohen, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Kay Garcia
- Jin You, Wuhan University, Wuhan; Zhiqiang Meng, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China; Qian Lu and Michael J. Zvolensky, University of Houston; and Kay Garcia and Lorenzo Cohen, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Lorenzo Cohen
- Jin You, Wuhan University, Wuhan; Zhiqiang Meng, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China; Qian Lu and Michael J. Zvolensky, University of Houston; and Kay Garcia and Lorenzo Cohen, The University of Texas MD Anderson Cancer Center, Houston, TX
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Abstract
A group of 49 patients who had been diagnosed with cancer during the preceding year and who were receiving radiation therapy were assessed for their use of defense mechanisms, as well as for their level of psychological distress. In addition, their utilization of medical services was determined. It was predicted that the use of services that were under the patients' control-namely, requesting extra outpatient visits and making trips to the emergency department-would be related to the patients' use of defense mechanisms, whereas a treatment option not under the patients' control-overnight hospitalization based on physicians' assessment of condition-would not be related to defense use. The findings confirmed the hypotheses. Outpatient visits were strongly predicted by defense use, whereas hospitalization was determined by psychological distress. However, emergency department visits were determined by both defense use and psychological distress. In addition, an interaction between defense and distress was found to predict hospitalization.
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Yamauchi K, Nakao M, Nakashima M, Ishihara Y. Congruence between Preferred and Actual Participation Roles Increases Satisfaction with Treatment Decision Making among Japanese Women with Breast Cancer. Asian Pac J Cancer Prev 2017; 18:987-994. [PMID: 28545197 PMCID: PMC5494249 DOI: 10.22034/apjcp.2017.18.4.987] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Objective: This study investigated the correlation between participation in the treatment decision-making process and satisfaction with the process among Japanese women with breast cancer. The influence of sociodemographic and clinical characteristics on satisfaction with the treatment decision-making process was also examined. Methods: We conducted a cross-sectional, self-administered internet survey of 650 Japanese women with breast cancer in March 2016. Decisional role (active, collaborative, passive) in the treatment decision-making was elicited using the Japanese version of the Control Preference Scale. Satisfaction with the decision-making process was assessed. Result: About half of the participants preferred to play a collaborative role, while half of the participants perceived that they played an active role. Satisfaction among the participants who made their treatment choice collaboratively with their physicians was significantly higher than that of participants who made the choice by themselves or entrusted their physicians to make the decision. However, two-way ANOVA demonstrated that satisfaction level was associated with the congruence between the participants’ preferred and actual decisional roles, but not with the actual decisional roles that they played. This association had no interaction with sociodemographic and clinical status, except for education level. A majority of the participants who participated in the roles they preferred in choosing their treatment option indicated that they would participate in the same role if they were to face a similar decision-making situation in the future. Conclusion: Regardless of their role played in the cancer treatment decision-making process, and irrespective of their sociodemographic and clinical status, Japanese women with breast cancer are more satisfied with the treatment decision-making process when their participation in the process matches their preferred role in the process.
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Affiliation(s)
- Keiko Yamauchi
- Department of Public Health, School of Medicine, Kurume University, Kurume, Japan.
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Colley A, Halpern J, Paul S, Micco G, Lahiff M, Wright F, Levine JD, Mastick J, Hammer MJ, Miaskowski C, Dunn LB. Factors associated with oncology patients' involvement in shared decision making during chemotherapy. Psychooncology 2016; 26:1972-1979. [PMID: 27649058 DOI: 10.1002/pon.4284] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 09/08/2016] [Accepted: 09/15/2016] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Oncology patients are increasingly encouraged to play an active role in treatment decision making. While previous studies have evaluated relationships between demographic characteristics and decision-making roles, less is known about the association of symptoms and psychological adjustment characteristics (eg, coping styles and personality traits) and decision-making roles. METHODS As part of a larger study of symptom clusters, patients (n = 765) receiving chemotherapy for breast, gastrointestinal, gynecological, or lung cancer provided information on demographic, clinical, symptom, and psychological adjustment characteristics. Patient-reported treatment decision-making roles (ie, preferred role and role actually played) were assessed using the Control Preferences Scale. Differences among patients, who were classified as passive, collaborative, or active, were evaluated using χ2 analyses and analyses of variance. RESULTS Over half (56.3%) of the patients reported that they both preferred and actually played a collaborative role. Among those patients with concordant roles, those who were older, those with less education and lower income, and those who were less resilient were more likely to prefer a passive role. Several psychological adjustment characteristics were associated with decision-making role, including coping style, personality, and fatalism. CONCLUSIONS Oncology patients' preferences for involvement in treatment decision making are associated with demographic characteristics as well as with symptoms and psychological adjustment characteristics, such as coping style and personality. These results reaffirm the complexities of predicting patients' preferences for involvement in decision making. Further study is needed to determine if role or coping style may be influenced by interventions designed to teach adaptive coping skills.
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Affiliation(s)
- Alexis Colley
- UC Berkeley-UC San Francisco Joint Medical Program, University of California, Berkeley School of Public Health, Berkeley, CA, USA
| | - Jodi Halpern
- UC Berkeley-UC San Francisco Joint Medical Program, University of California, Berkeley School of Public Health, Berkeley, CA, USA
| | - Steven Paul
- School of Nursing, University of California, San Francisco, CA, USA
| | - Guy Micco
- UC Berkeley-UC San Francisco Joint Medical Program, University of California, Berkeley School of Public Health, Berkeley, CA, USA
| | - Maureen Lahiff
- School of Public Health, Division of Biostatistics, University of California, Berkeley, CA, USA
| | - Fay Wright
- School of Nursing, Yale University, New Haven, CT, USA
| | - Jon D Levine
- School of Medicine, University of California, San Francisco, CA, USA
| | - Judy Mastick
- School of Nursing, University of California, San Francisco, CA, USA
| | | | | | - Laura B Dunn
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
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Brandão T, Schulz MS, Matos PM. Psychological adjustment after breast cancer: a systematic review of longitudinal studies. Psychooncology 2016; 26:917-926. [PMID: 27440317 DOI: 10.1002/pon.4230] [Citation(s) in RCA: 133] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Revised: 05/24/2016] [Accepted: 07/18/2016] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Breast cancer (BC) can be a traumatic and stressful experience for women, but there are wide-ranging differences in the ways in which women respond and adapt to BC. This systematic review examines which sociodemographic, disease-related, and psychosocial factors near diagnosis predict later psychological adjustment to BC. METHODS Database searches were conducted in 9 different health-related databases from 2000 to December 2015 using relevant search terms. Full-text, peer-reviewed articles in English that analyzed potential predictors of psychological adjustment in longitudinal studies were considered for inclusion. RESULTS Of 1780 abstracts, 41 studies fulfilled inclusion criteria. Consistent sociodemographic and disease-related variable predictors of adjustment were income, fatigue, cancer stage, and physical functioning. Psychosocial factors, particularly optimism and trait anxiety, as well as perceived social support, coping strategies, and initial levels of psychological functioning, were found to be predictive of later depressive and anxiety symptoms, psychological distress, and quality of life for women with BC, in predictable ways. Other psychosocial variables, such as cognitive and body image factors, predicted psychological adjustment but were explored only by a few studies. CONCLUSIONS The majority of studies showed a significant relationship between psychosocial factors and psychological adjustment. These results point to specific sociodemographic, disease-related, and psychosocial factors that can help to identify women at the time of diagnosis who are at risk for long-term psychological challenges so they can be referred for psychological support that targets their specific needs and can improve their quality of life and mood and decrease indicators of anxiety, depression, and psychological distress.
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Affiliation(s)
- Tânia Brandão
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal.,Center for Psychology, University of Porto, Porto, Portugal
| | - Marc S Schulz
- Department of Psychology, Bryn Mawr College, Bryn Mawr, PA, USA
| | - Paula Mena Matos
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal.,Center for Psychology, University of Porto, Porto, Portugal
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Li L, Li S, Wang Y, Yi J, Yang Y, He J, Zhu X. Coping Profiles Differentiate Psychological Adjustment in Chinese Women Newly Diagnosed With Breast Cancer. Integr Cancer Ther 2016; 16:196-204. [PMID: 27154183 PMCID: PMC5739123 DOI: 10.1177/1534735416646854] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Objective. The study aimed to explore latent profiles of coping in Chinese women newly diagnosed with breast cancer and examine the differences of psychological distress, demographic, and medical characteristics across profiles. Methods. Latent profile analysis was used to identify 3 classes of copers based on data from 618 Chinese women newly diagnosed with breast cancer who completed questionnaires assessing their coping strategies and psychological distress. Results. “Adaptive coper,” reporting most use of adaptive cognitive coping strategies, behaviors of acceptance and shifting attention, and least use of maladaptive cognitive coping strategies, had the best psychological adjustment. “Negative coper,” characterized by most use of maladaptive cognitive coping strategies, least use of adaptive cognitive coping strategies except “putting in perspective,” and median levels of medical coping behaviors, had the worst psychological adjustment. “Inconsistent coper,” with great use of all cognitive coping strategies, and most behaviors of fighting against the disease, and fewest behaviors of attention shift, had relatively high levels of psychological distress. Younger age, less education, shorter time since diagnosis, widowed, living in rural areas, and undergoing chemotherapy are possible markers for patients with less adaptive coping patterns. Conclusions. Interventions should be developed according to the different coping profiles of patients, and the key group to target is “negative copers,” who may benefit from cognitive behavioral approaches that combine emotion, cognition and behavior, which could help them more effectively appraise and cope with stressful events.
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Affiliation(s)
- Lingyan Li
- 1 Medical Psychological Institute, Second Xiangya Hospital, Central South University, Changsha, China
| | - Shichen Li
- 1 Medical Psychological Institute, Second Xiangya Hospital, Central South University, Changsha, China
| | - Yuping Wang
- 1 Medical Psychological Institute, Second Xiangya Hospital, Central South University, Changsha, China.,2 School of Humanities and Social Sciences, Xi'an Jiaotong University, Xi'an, China
| | - Jinyao Yi
- 1 Medical Psychological Institute, Second Xiangya Hospital, Central South University, Changsha, China
| | - Yanjie Yang
- 3 Public Health Institute of Harbin Medical University, Harbin, China
| | - Jincai He
- 4 The First Affiliated Hospital, Wenzhou Medical College, Wenzhou, China
| | - Xiongzhao Zhu
- 1 Medical Psychological Institute, Second Xiangya Hospital, Central South University, Changsha, China
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Hyphantis T, Goulia P, Zerdes I, Solomou S, Andreoulakis E, Carvalho AF, Pavlidis N. Sense of Coherence and Defense Style Predict Sleep Difficulties in Early Non-metastatic Colorectal Cancer. Dig Dis Sci 2016; 61:273-82. [PMID: 26289259 DOI: 10.1007/s10620-015-3843-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 08/02/2015] [Indexed: 12/09/2022]
Abstract
BACKGROUND Sleep disturbances are common in cancer patients, but little is known about the complex interplay between the background psychological profile, coping with health stressors capacities and psychological distress in the formation of sleep difficulties in colorectal cancer. AIMS To study the course and to identify psychological predictors of sleep difficulties in early non-metastatic colorectal cancer patients over a one-year period. METHODS In this 1-year prospective study, we assessed in 84 early non-metastatic colorectal cancer patients the association of psychological distress (SCL-90-R), sense of coherence (SOC-29), and defense styles (Defense Style Questionnaire) with sleep difficulties (SCL-90-R) in multiple regression models. Eighty-two patients with breast cancer and 50 patients with cancer of unknown primary site served as disease controls, and 84 matched for age and sex alleged healthy individuals served as healthy controls. RESULTS Colorectal cancer patients presented more sleep difficulties compared to healthy participants but fewer than patients with breast cancer and cancer of unknown primary site. Colorectal cancer patients' trouble falling asleep (p = 0.033) and wakening up early in the morning (p < 0.001) deteriorated over time. Sleep that was restless or disturbed was independently associated with low SOC (p = 0.046) and maladaptive defenses (p = 0.008). Anxiety symptoms (p < 0.001) predicted deterioration in trouble falling asleep, while depressive symptoms (p = 0.022) and self-sacrificing defense style (p = 0.049) predicted deterioration in wakening up early in the morning. CONCLUSIONS Psychological parameters and coping with health stressors capacities are independently associated with sleep difficulties in colorectal cancer patients, indicating the need for psychological interventions aiming at improving adjustment to the disease.
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Affiliation(s)
- Thomas Hyphantis
- Department of Psychiatry, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, 45110, Greece.
| | - Panagiota Goulia
- Department of Psychiatry, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, 45110, Greece
| | - Ioannis Zerdes
- Department of Psychiatry, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, 45110, Greece
| | - Solomis Solomou
- Department of Psychiatry, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, 45110, Greece
| | - Elias Andreoulakis
- 3rd Department of Psychiatry, Aristotle University of Thessaloniki, University Campus, Thessaloniki, 54124, Greece
| | - André F Carvalho
- Department of Clinical Medicine, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Nicholas Pavlidis
- Department of Medical Oncology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, 45110, Greece
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Miyashita M, Ohno S, Kataoka A, Tokunaga E, Masuda N, Shien T, Kawabata K, Takahashi M. Unmet Information Needs and Quality of Life in Young Breast Cancer Survivors in Japan. Cancer Nurs 2015; 38:E1-11. [PMID: 25254410 PMCID: PMC4612149 DOI: 10.1097/ncc.0000000000000201] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2015] [Indexed: 01/28/2023]
Abstract
BACKGROUND Young breast cancer survivors have specific needs related to age. Clarifying the relationships between unmet information needs and quality of life (QOL) in young breast cancer survivors can contribute to constructing a support system to enhance QOL in patients. OBJECTIVE This study aimed to identify the unmet information needs and examine the relationships between unmet information needs and QOL in young breast cancer survivors in Japan. METHODS Participants completed an information needs questionnaire containing 26 items, the World Health Organization Quality of Life Instrument-Short Form (WHOQOL-BREF), and a demographic and medical information questionnaire. RESULTS Fifty participants (30.7%) were unsatisfied with "overall communication with medical professionals." The mean scores on all subscales of the WHOQOL-BREF of the participants who were satisfied with "overall communication with medical professionals" were significantly higher than those of the unsatisfied group. "follow-up tests," "treatment for recurrence of breast cancer," "strategies about communication with medical staff," and "nutrition" were significantly related with all subscales in the WHOQOL-BREF. "Secondary menopause caused by hormonal therapy" was significantly related with physical and psychological health. CONCLUSIONS Japanese young breast cancer survivors have unmet information needs, including age-specific issues. These unmet information needs are related to QOL. In particular, "overall communication with medical professionals," which is the most unmet information need, is related to QOL. IMPLICATIONS FOR PRACTICE Oncology nurses should teach patients communication skills, provide adequate information, and provide education and emotional support to medical professionals to improve QOL in young breast cancer survivors.
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Affiliation(s)
- Mika Miyashita
- Author Affiliations: Division of Nursing Science, Graduate School of Biomedical and Health Sciences, Hiroshima University (Dr Miyashita); Clinical Cancer Institute, National Hospital Organization Kyushu Cancer Center, Fukuoka (Dr Ohno); Department of Breast and Endocrine Surgery, Toho University Omori Medical Center, Tokyo (Dr Kataoka); Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka (Dr Tokunaga); Department of Surgery, Breast Oncology, National Hospital Organization Osaka National Hospital (Dr Masuda); Department of Breast and Endocrine Surgery, Okayama University Hospital (Dr Shien); Department of Nursing School of Health and Social Services, Saitama Prefectural University, Koshigaya (Dr Kawabata); and Cancer Survivorship Research Division, Center for Cancer Control and Information Services, National Cancer Center, Tokyo (Dr Takahashi), Japan
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Fujisawa D, Temel JS, Traeger L, Greer JA, Lennes IT, Mimura M, Pirl WF. Psychological factors at early stage of treatment as predictors of receiving chemotherapy at the end of life. Psychooncology 2015; 24:1731-7. [DOI: 10.1002/pon.3840] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2015] [Revised: 03/25/2015] [Accepted: 04/09/2015] [Indexed: 11/10/2022]
Affiliation(s)
- Daisuke Fujisawa
- Massachusetts General Hospital Cancer Center; Boston MA USA
- Department of Neuropsychiatry; Keio University School of Medicine; Tokyo Japan
| | | | - Lara Traeger
- Massachusetts General Hospital Cancer Center; Boston MA USA
| | | | - Inga T. Lennes
- Massachusetts General Hospital Cancer Center; Boston MA USA
| | - Masaru Mimura
- Department of Neuropsychiatry; Keio University School of Medicine; Tokyo Japan
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Faller H, Brähler E, Härter M, Keller M, Schulz H, Wegscheider K, Weis J, Boehncke A, Richard M, Sehner S, Koch U, Mehnert A. Performance status and depressive symptoms as predictors of quality of life in cancer patients. A structural equation modeling analysis. Psychooncology 2015; 24:1456-62. [PMID: 25851732 DOI: 10.1002/pon.3811] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Revised: 02/09/2015] [Accepted: 02/28/2015] [Indexed: 11/12/2022]
Abstract
OBJECTIVE This study aimed to examine whether depressive symptoms and performance status are independent predictors of both the physical and psychological domains of health-related quality of life (HRQoL) in cancer patients. METHODS A sample of 4020 cancer patients (mean age 58 years, 51% women) was evaluated. Depressive symptoms were measured with the patient health questionnaire and HRQoL with the European Organisation for Research and Treatment of Cancer quality of life questionnaire core 30. The impact of the illness on everyday activities was assessed with physician ratings of both the Karnofsky performance status and the Eastern Cooperative Oncology Group performance status. The simultaneous effects of depression and performance status on quality of life outcomes were estimated using structural equation modeling. RESULTS Both depressive symptoms and performance status independently predicted the physical and psychological domains of HRQoL. However, the impact of depressive symptoms on the physical HRQoL was stronger than the impact of performance status on the psychological HRQoL. CONCLUSION Our results suggest that comorbid depressive symptoms are independently associated with both physical and psychological HRQoL in cancer patients after controlling for the physician-rated performance status. Thus, comorbid depression should be taken into account when evaluating reduced HRQoL in cancer patients. To support a causal impact of depression on HRQoL, intervention studies are needed to show that improving depression enhances cancer patients' HRQoL.
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Affiliation(s)
- Hermann Faller
- Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, and Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg, Germany
| | - Elmar Brähler
- Department of Medical Psychology and Medical Sociology, Section of Psychosocial Oncology, University Medical Center Leipzig, Leipzig, Germany.,Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz, Germany
| | - Martin Härter
- Department and Outpatient Clinic of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Monika Keller
- Division of Psychooncology, Department for Psychosomatic and General Clinical Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Holger Schulz
- Department and Outpatient Clinic of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Karl Wegscheider
- Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Joachim Weis
- Department of Psychooncology, Tumor Biology Center, University of Freiburg, Freiburg, Germany
| | - Anna Boehncke
- Department of Psychooncology, Tumor Biology Center, University of Freiburg, Freiburg, Germany
| | - Matthias Richard
- Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, and Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg, Germany
| | - Susanne Sehner
- Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Uwe Koch
- Department and Outpatient Clinic of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Anja Mehnert
- Department of Medical Psychology and Medical Sociology, Section of Psychosocial Oncology, University Medical Center Leipzig, Leipzig, Germany.,Department and Outpatient Clinic of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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28
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Tuncer G, Yucel SC. Comfort and anxiety levels of women with early stage breast cancer who receive radiotherapy. Asian Pac J Cancer Prev 2014; 15:2109-14. [PMID: 24716942 DOI: 10.7314/apjcp.2014.15.5.2109] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of this planned research was to determine the comfort and anxiety levels of women with breast cancer receiving radiotherapy. MATERIALS AND METHODS This descriptive type study covered patients that applied to the radiation oncology breast polyclinic of our university hospital between January and May 2011. Patient Identification Form, Radiation Therapy Comfort Questionnaire (RTCQ), Spielberger State Trait Anxiety Inventory (STAI) were completed and analysed. RESULTS The mean age of the women who participated in the study was 51.6 ± 10.4 years. Mean scores of women were 3.73 ± 0.31 for RTCQ, 29.1 ± 5.88 for SAI and 37.8±6.91 for TAI. While the comfort levels of the women with breast cancer receiving radiotherapy were moderate, they experienced only low levels of anxiety. CONCLUSIONS By determining the comfort level of the patient before radiotherapy, besides providing comfort in this direction, eliminating/minimizing anxiety and stress will positively affect radiotherapy application. More attention of nurses to this issue is to be recommended.
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Affiliation(s)
- Gamze Tuncer
- Zeynep Kamil Women and Children Diseases Education and Research Hospital, Istanbul, Turkey E-mail :
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