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Sharp J, Mulcare H, Schofield P. Trajectories of distress in women with gynaecological cancer treated with curative-intent radiotherapy. Psychol Health 2024; 39:1466-1484. [PMID: 36628613 DOI: 10.1080/08870446.2022.2162555] [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: 09/05/2022] [Revised: 11/11/2022] [Accepted: 12/18/2022] [Indexed: 01/12/2023]
Abstract
OBJECTIVE The aims of this study were to investigate trajectories of anxiety and depression symptoms among gynaecological cancer (GC) patients having curative-intent radiotherapy (RT) treatment and identify which patient characteristics predict anxiety and depression trajectories. METHODS AND MEASURES Latent profile analysis (LPA) was used to identify unique trajectories of anxiety and depression symptoms, spanning prior to the start of RT until 12-month post-RT, among 151 GC patients in the PeNTAGOn randomized control trial. Demographic and clinical characteristics were assessed at baseline, and anxiety and depression symptoms were assessed five times over 12 months. A bias-adjusted 3-step maximum likelihood approach was used to identify demographic and clinical predictors of trajectory profiles. RESULTS Four latent profiles each were identified for anxiety and depression trajectories. Most patients had minimal to mild levels of anxiety or depression that remained steady or declined over 12 months following treatment. A minority of patients were in profiles that exhibited clinically significant distress; either 'High fluctuating' anxiety or 'Mild-moderate fluctuating' depression. Anxiety and depression profiles were predicted by clinical and demographic factors, such as age, living arrangements, RT type, cancer stage, physical symptom distress and use of support services. CONCLUSIONS Psychological care of patients in the higher distress trajectories is paramount and, importantly, they could be identified prior to treatment based on the factors identified. Review for at least a month post-RT is warranted.
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Affiliation(s)
- Jessica Sharp
- Department of Psychological Sciences, Swinburne University of Technology, Melbourne, Australia
| | - Hunter Mulcare
- Department of Psychological Sciences, Swinburne University of Technology, Melbourne, Australia
- Psychology Department, Western Health, St Albans, Australia
| | - Penelope Schofield
- Department of Psychological Sciences, Swinburne University of Technology, Melbourne, Australia
- Iverson Health Innovation Research Institute, Swinburne University of Technology, Melbourne, Australia
- Behavioural Sciences Unit, Health Service Research, Peter MacCallum Cancer Centre, Melbourne, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Australia
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2
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Moldes-Moro R, de Dios-Duarte MJ. Colorectal Cancer Surgery: Influence of Psychosocial Factors. Cancers (Basel) 2023; 15:4140. [PMID: 37627168 PMCID: PMC10452599 DOI: 10.3390/cancers15164140] [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: 06/23/2023] [Revised: 08/08/2023] [Accepted: 08/14/2023] [Indexed: 08/27/2023] Open
Abstract
(1) Background: In the treatment of colorectal cancer, it is important to consider different psychosocial factors. Our first objective was to measure the levels of perceived stress in subjects diagnosed with colorectal cancer awaiting potentially curative surgery. Also, we aimed to analyse what coping styles these patients used, how they perceived their illness, and the subsequent influence of these factors on their levels of stress. (2) Methods: Stress, coping styles and illness perception were assessed in a sample of 107 patients. The instruments used were the Perceived Stress Scale (PSS-14), the Stress Coping Questionnaire (SCQ) and the Brief Illness Perception Questionnaire (BIPQ-R). (3) Results: Patients using active coping styles have lower levels of perceived stress (p = 0.000; p = 0.002) than patients making use of passive coping styles (p = 0.000; p = 0.032; p = 0.001). A multi-linear regression model found that the perception of illness and the use of the negative approach coping style (p = 0.000; p = 0.001) influence an increase in perceived stress, and that a decrease in stress levels was influenced by the problem solving coping style (p = 0.001). (4) Conclusions: Based on our results, we recommend preventive interventions in care patients undergoing colorectal cancer surgery.
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Affiliation(s)
- Regina Moldes-Moro
- Madrilenian Health Service (SERMAS), 28046 Madrid, Spain
- Department of Nursing, Faculty of Health Sciences, Alfonso X el Sabio University, 28691 Madrid, Spain
| | - María José de Dios-Duarte
- Nursing Department, Faculty of Nursing, University of Valladolid, 47005 Valladolid, Spain
- Nursing Care Research (GICE), University of Valladolid, 47005 Valladolid, Spain
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3
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Johnson AM, Teoh D, Jewett P, Darst BF, Mattson J, Hoffmann C, Brown K, Makaram A, Keller C, Blaes AH, Everson-Rose SA, Vogel RI. Genetic variants associated with post-traumatic stress symptoms in patients with gynecologic cancer. Gynecol Oncol 2023; 170:102-107. [PMID: 36681010 PMCID: PMC10023401 DOI: 10.1016/j.ygyno.2023.01.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 12/29/2022] [Accepted: 01/08/2023] [Indexed: 01/21/2023]
Abstract
OBJECTIVE Patients with cancer experience symptoms of post-traumatic stress disorder (PTSD) more commonly than the general population. The objective of this study was to identify single nucleotide polymorphisms (SNPs) associated with increased risk of post-traumatic stress disorder (PTSD) in patients with gynecologic cancer. METHODS A prospective cohort study recruited 181 gynecologic cancer survivors receiving care at the University of Minnesota between 2017 and 2020 who completed PTSD DSM-V surveys to self-report their symptoms of PTSD and provided saliva samples. DNA samples were genotyped for 11 SNPs in 9 genes involved in dopaminergic, serotonergic, and opioidergic systems previously associated with risk of PTSD in populations without cancer. RESULTS Most participants had either ovarian (42.5%) or endometrial (46.4%) cancer; fewer had cervical (7.7%) or vaginal/vulvar (3.3%) cancer. Two SNPS were identified as statistically significantly associated with higher PTSD scores: rs622337 in HTR2A and rs510769 in OPRM1. CONCLUSIONS Genetic variation likely plays a role in development of PTSD. HTR2A is involved in the serotonin pathway, and OPRM1 is involved in the opioid receptor pathway. This information can be used by oncologic providers to identify patients at greater risk of developing PTSD and may facilitate referral to appropriate consultants and resources early in their treatment.
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Affiliation(s)
- Andrea M Johnson
- University of Minnesota, Department of Obstetrics, Gynecology and Women's Health, Minneapolis, MN, United States of America
| | - Deanna Teoh
- University of Minnesota, Department of Obstetrics, Gynecology and Women's Health, Minneapolis, MN, United States of America
| | - Patricia Jewett
- University of Minnesota, Department of Obstetrics, Gynecology and Women's Health, Minneapolis, MN, United States of America; University of Minnesota, Division of Hematology and Oncology, Minneapolis, MN, United States of America
| | - Burcu F Darst
- Fred Hutchinson Cancer Center, Public Health Sciences, Seattle, WA, United States of America
| | - Jordan Mattson
- University of Minnesota, Department of Obstetrics, Gynecology and Women's Health, Minneapolis, MN, United States of America
| | - Cody Hoffmann
- University of Minnesota Genomics Center, University of Minnesota, Minneapolis, MN, United States of America
| | - Katherine Brown
- University of Minnesota, Department of Obstetrics, Gynecology and Women's Health, Minneapolis, MN, United States of America
| | - Aditi Makaram
- University of Minnesota, College of Biological Sciences, Minneapolis, MN, United States of America
| | - Ciana Keller
- University of Minnesota, Medical School, Minneapolis, MN, United States of America
| | - Anne H Blaes
- University of Minnesota, Division of Hematology and Oncology, Minneapolis, MN, United States of America
| | - Susan A Everson-Rose
- University of Minnesota, Division of Geriatrics, Palliative and Primary Care, Minneapolis, MN, United States of America
| | - Rachel I Vogel
- University of Minnesota, Department of Obstetrics, Gynecology and Women's Health, Minneapolis, MN, United States of America.
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Maras D, Balfour L, Lefebvre M, Tasca GA. Attachment insecurity predicts outcomes in an ACT-CBT group therapy for adults in a physical rehabilitation centre. RESEARCH IN PSYCHOTHERAPY (MILANO) 2022; 25:634. [PMID: 36052881 PMCID: PMC9893049 DOI: 10.4081/ripppo.2022.634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 08/23/2022] [Indexed: 02/05/2023]
Abstract
Adapting to chronic illness or disability is accompanied by acute and ongoing illness stressors. Psychological factors such as emotional distress and low self-efficacy are common experiences in chronic illness and disability and interfere with adaptation and psychosocial outcomes such as health-related quality of life. Transdiagnostic group psychotherapy may provide a parsimonious approach to psychological treatment in rehabilitation care by targeting shared illness stressors across mixed chronic illnesses and disabilities, and shared processes that maintain psychological symptoms. Attachment theory may explain individual differences in outcomes and help identify individuals at risk of poor health-related quality of life trajectories. Adults (N=109) participated in an 8-week process-based ACT-CBT psychotherapy group at a tertiary care physical rehabilitation centre between 2016 and 2020. Participants completed measures of emotional distress, self-efficacy, health-related quality of life, and attachment at pre- and post-treatment. Multilevel analyses indicated that patients improved on most outcomes at post-treatment. Attachment anxiety at pre-treatment was associated with more positive outcomes. Reliable change indices suggest clinically meaningful change for the majority of participants, but most were not recovered. Results provide proof-of-concept for the transdiagnostic group intervention and suggest that a longer course of treatment may be clinically indicated. Results warrant replication with larger and more diverse samples, and more robust designs.
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Affiliation(s)
- Danijela Maras
- School of Psychology, University of Ottawa; and The Ottawa Hospital Research Institute, Ottawa, ON.
| | - Louise Balfour
- School of Psychology, Faculty of Medicine, University of Ottawa; and The Ottawa Hospital Research Institute, Ottawa, ON.
| | - Monique Lefebvre
- School of Psychology, University of Ottawa; The Ottawa Hospital; and The Ottawa Hospital Research Institute, Ottawa, ON.
| | - Giorgio A Tasca
- School of Psychology, Faculty of Medicine, University of Ottawa; and The Ottawa Hospital Research Institute, Ottawa, ON.
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5
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Brennen R, Lin KY, Denehy L, Soh SE, Frawley H. Patient and clinician perspectives of pelvic floor dysfunction after gynaecological cancer. Gynecol Oncol Rep 2022; 41:101007. [PMID: 35663847 PMCID: PMC9157224 DOI: 10.1016/j.gore.2022.101007] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 05/19/2022] [Indexed: 11/19/2022] Open
Abstract
Purpose To explore and compare patient and clinician experiences, knowledge and preferences in relation to screening and management of pelvic floor (PF) dysfunction in the gynaecology-oncology setting. Methods Semi-structured interviews were conducted with women reporting PF symptoms after gynaecological cancer treatment, and gynaecology-oncology clinicians. Interviews were transcribed and thematically analysed and were conducted until data saturation was reached. Results We interviewed 12 patients and 13 clinicians. We identified two main themes: (1) Experience with PF symptoms, screening, disclosure and management and (2) Future hope of what should happen to screen and manage PF symptoms. Differences between what participants had experienced and what they felt should happen highlighted a perceived need for improving PF screening and management. A sub-theme that reflected relevant barriers and enablers was also identified. Barriers included time pressure, being focussed on cancer treatment and not side-effects, and patients feeling unwell, emotional, and overwhelmed with the logistics of oncology appointments. Enablers included the patient-clinician relationship, and opportunities for improving management included integrating nursing and PF physiotherapy with oncology appointments. Conclusions Gynaecological cancer survivors and clinicians perceive a need to improve screening and management for PF symptoms. While barriers and differences in perception exist, there are opportunities to improve how PF symptoms can be screened and managed in this population. Further studies exploring the feasibility of providing integrated multidisciplinary PF therapy services may be warranted.
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Affiliation(s)
- Robyn Brennen
- Department of Physiotherapy, The University of Melbourne, Parkville, Vic 3010, Australia
- Monash Health, Cheltenham, Vic 3192, Australia
- Corresponding author.
| | - Kuan-Yin Lin
- Department of Physical Therapy, National Cheng Kung University, Tainan 701, Taiwan
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
| | - Linda Denehy
- School of Health Sciences, The University of Melbourne, Parkville, Vic 3010, Australia
- The Peter MacCallum Cancer Centre, Melbourne, Vic 3000, Australia
| | - Sze-Ee Soh
- School of Primary and Allied Health Care, Monash University, Frankston, Vic 3199, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Vic 3004, Australia
| | - Helena Frawley
- School of Health Sciences, The University of Melbourne, Parkville, Vic 3010, Australia
- The Royal Women’s Hospital, Parkville, Vic 3010, Australia
- Mercy Hospital for Women, Heidelberg, Vic 3084, Australia
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You H, Lei A, Li X, Liao X, Chang J. Discharge teaching, patient-reported discharge readiness and postsurgical outcomes in gynecologic patients undergoing day surgery: a generalized estimating equation. BMC Surg 2022; 22:166. [PMID: 35538567 PMCID: PMC9092867 DOI: 10.1186/s12893-022-01607-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 04/18/2022] [Indexed: 12/02/2022] Open
Abstract
Background Gynecologic patients undergoing day surgery are discharged in an intermediate stage of recovery. The quality of discharge teaching and discharge readiness are important to patients’ postsurgical outcomes, but little research has focused on them. Methods Quality of discharge teaching and discharge readiness were measured, and Spearman correlations were conducted. Postsurgical outcomes were recorded on postoperative Day 1, postoperative Day 7, and postoperative Day 28. Generalized estimating equations were used to explore factors that influence postsurgical outcomes. Results Discharge teaching was verified to be positively correlated with the discharge readiness of participants. The generalized estimating equations indicated that discharge teaching skills, effects of doctors and nurses, patient-reported physical conditions and social support following discharge were protective factors for postsurgical outcomes. Conclusions Doctors and nurses should improve discharge teaching skills and effects to improve the postsurgical outcomes of gynecological patients undergoing day surgery. At discharge, doctors and nurses should assess patients’ physical condition and facilitate a social support system.
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Affiliation(s)
- Huaxuan You
- Department of Obstetrics and Gynecology Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China
| | - Anjiang Lei
- Department of Obstetrics and Gynecology Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China
| | - Xin Li
- Department of Obstetrics and Gynecology Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China. .,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China.
| | - Xu Liao
- Department of Obstetrics and Gynecology Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China. .,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China.
| | - Jing Chang
- Department of Obstetrics and Gynecology Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China
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7
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Salem H, Kazak AE, Andersen EW, Belmonte F, Johansen C, Schmiegelow K, Winther JF, Wehner PS, Hasle H, Rosthøj S, Bidstrup PE. Home-based cognitive behavioural therapy for families of young children with cancer (FAMOS): A nationwide randomised controlled trial. Pediatr Blood Cancer 2021; 68:e28853. [PMID: 33369038 DOI: 10.1002/pbc.28853] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 11/30/2020] [Accepted: 12/02/2020] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Evidence-based knowledge is needed to reduce psychological symptoms in families of young children with cancer after treatment ends. OBJECTIVE To evaluate the effect of a psychotherapeutic intervention, FAMily-Oriented Support (FAMOS) on parents of young children after cancer treatment. METHODS All families of children aged 0-6 years who had been treated for cancer at one of the four paediatric oncology departments in Denmark were invited to participate after ending intensive medical treatment. The families were randomly assigned 1:1 to up to seven sessions of FAMOS, a cognitive-behavioural manualised home intervention, for 6 months or to usual psychosocial care. The primary outcome was parents' symptoms of posttraumatic stress disorder (PTSD) at 6 and 12 months after enrolment. The secondary outcomes were parents' symptoms of depression and anxiety. RESULTS We enrolled 109 families (204 parents). Parents in the intervention group did not show a statistically significant decrease in symptoms of PTSD as compared with the control group at 6 months (predicted mean difference, -0.10; 95% confidence interval [CI] -0.19, 0.01), but a statistically significant decrease was seen at 12 months (predicted mean difference, -0.15; 95% CI -0.28, -0.02), and they had significantly lower symptoms of depression at both 6 and 12 months. Differences in reductions in symptoms of anxiety were not statistically significant. CONCLUSIONS The FAMOS intervention reduced parents' symptoms of PTSD and depression. Next step is to also report on psychological effects in the children and siblings (clinicaltrials.gov: NCT02200731).
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Affiliation(s)
- Hanin Salem
- Psychological Aspects of Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Anne E Kazak
- Nemours Children's Health System, Wilmington, Delaware
| | | | - Federica Belmonte
- Statistics and Data Analysis, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Christoffer Johansen
- Psychological Aspects of Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark.,Late Effect Research Unit, Oncology Clinic, University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Kjeld Schmiegelow
- Department of Pediatrics and Adolescent Medicine, University Hospital Rigshospitalet, Institute of Clinical Medicine, Medical Faculty, University of Copenhagen, Copenhagen, Denmark
| | - Jeanette Falck Winther
- Childhood Cancer Research Group, Danish Cancer Society Research Center, Copenhagen, and Department of Clinical Medicine, Faculty of Health, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
| | | | - Henrik Hasle
- Department of Paediatrics, Aarhus University Hospital, Aarhus, Denmark
| | | | - Pernille E Bidstrup
- Psychological Aspects of Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
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Azami-Aghdash S. Meta-synthesis of qualitative evidence in road traffic injury prevention: a scoping review of qualitative studies (2000 to 2019). Arch Public Health 2020; 78:110. [PMID: 33292547 PMCID: PMC7607842 DOI: 10.1186/s13690-020-00493-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 10/21/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND A considerable number of qualitative studies have been published in recent years on the issues that the quantitative studies have limitations on. This study aimed at performing a meta-synthesis on qualitative studies on Road Traffic Injuries (RTIs) with a scoping review approach. METHODS This meta-synthesis study was conducted as a scoping review in 2019. The Arkesy and O'Malley framework was applied which has six steps of identifying the research question, identifying the relevant studies, selecting the studies, charting the data, data analysis and reporting the results, and consultation exercise. The required data were gathered by searching the relevant keywords in databases of PubMed, web of knowledge, Scopus, Cochrane Library, Science Direct, Google scholar, Sid, IranMedex. Extracted data were analyzed by the Content-Analysis method. RESULTS Finally, 30 studies were included. Extracted data summarized in five main themes and 17 sub-themes. The main themes were: consequences (individual, family, social, financial), the needs of survivors (social support and healthcare), risk factors (general risk factors, risk factors for motorcyclists, risk factors for children and adolescents), barriers of prevention (general barriers, pre-hospital barriers, emergency, and hospital barriers), and prevention solutions (increasing safety, rules and regulations, education, increasing equipment, scientific solutions) of RTIs. CONCLUSION This study combined the methods of the scoping review and the meta-synthesis to mapping all qualitative studies on the RTIs, with this approach, this study provides extensive and practical information for policy-makers, managers, practitioners, and researchers in the field of RTIs. Also, by applying this approach, the gaps in the existing knowledge and areas in need of further research are identified.
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Affiliation(s)
- Saber Azami-Aghdash
- Research Center for Evidence Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
- Tabriz Health Services Management Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran.
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The body in the mind – Assessing the phenomenal self through paintings created by gynaecological cancer survivors. ARTS IN PSYCHOTHERAPY 2020. [DOI: 10.1016/j.aip.2020.101691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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10
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Jie B, Zhou YH, Qiu Y, Yang GY, Feng ZZ. Impact of the disclosure of diagnosis on posttraumatic stress and growth and quality of life in Chinese patients with hepatocellular carcinoma. Support Care Cancer 2019; 28:3371-3379. [DOI: 10.1007/s00520-019-05141-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 10/17/2019] [Indexed: 11/24/2022]
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Horsboel TA, Kjaer SK, Johansen C, Suppli NP, Ammitzbøll G, Frøding LP, Lajer H, Dalton SO. Increased risk for depression persists for years among women treated for gynecological cancers - a register-based cohort study with up to 19 years of follow-up. Gynecol Oncol 2019; 153:625-632. [PMID: 30975472 DOI: 10.1016/j.ygyno.2019.03.259] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 03/28/2019] [Accepted: 03/31/2019] [Indexed: 01/17/2023]
Abstract
OBJECTIVE Little is known about long-term risk of depression in women treated for gynecological cancers. We aim to investigate risk for depression among these women compared to women without a history of cancer. METHODS We followed 16,833 women diagnosed with gynecological cancers between 1998 and 2013 and 138,888 reference women in nationwide registers for up to 19 years. Women with a history of severe psychiatric disorders, and those who had redeemed a prescription for antidepressants three years before study entry were excluded from analyses. Regression analyses were applied to compare the risk for antidepressant use among patients compared to reference women, and to investigate associations between socio-demographic as well as clinical risk factors and use of antidepressants. RESULTS We found an increased risk for antidepressant use among women treated for ovarian (HR 4.14, 95% CI 3.74-4.59), endometrial (HR 2.19, 95% CI 1.97-2.45), and cervical cancer (HR 3.14, 95% CI 2.74-3.61) one year after diagnosis. This increased risk persisted years after diagnosis in all three groups, with the longest (up to eight years) found for ovarian cancer. Advanced disease was strongly associated with antidepressant use followed by short education, and comorbidity. CONCLUSIONS Women diagnosed with gynecological cancer have an increased risk for depression compared to reference women. The risk remains increased for years after diagnosis throughout and beyond standard oncological follow-up care. Advanced disease, short education, and comorbidity are factors associated with antidepressant use in this patient group.
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Affiliation(s)
- Trine Allerslev Horsboel
- Survivorship Unit, Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Nursing and Nutrition, Faculty of Health, University College Copenhagen, Denmark.
| | - Susanne K Kjaer
- Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Gynecology, Juliane Marie Center, Copenhagen University Hospital, Denmark
| | - Christoffer Johansen
- Late Effect Research Unit CASTLE, Finsen Center, Copenhagen University Hospital, Denmark; Survivorship Unit, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Nis Palm Suppli
- Mental Health Centre Copenhagen, Copenhagen University Hospital, Denmark; Survivorship Unit, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Gunn Ammitzbøll
- Survivorship Unit, Danish Cancer Society Research Center, Copenhagen, Denmark
| | | | - Henrik Lajer
- Department of Gynecology, Juliane Marie Center, Copenhagen University Hospital, Denmark
| | - Susanne Oksbjerg Dalton
- Survivorship Unit, Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Clinical Oncology & Palliative Care, Zealand University Hospital, Næstved, Denmark
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12
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Sekse RJT, Dunberger G, Olesen ML, Østerbye M, Seibaek L. Lived experiences and quality of life after gynaecological cancer-An integrative review. J Clin Nurs 2019; 28:1393-1421. [PMID: 30461101 PMCID: PMC7328793 DOI: 10.1111/jocn.14721] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 09/07/2018] [Accepted: 11/03/2018] [Indexed: 01/09/2023]
Abstract
Aim and objectives To review the literature on Nordic women's lived experiences and quality of life (QoL) after gynaecological cancer treatment. Background While incidence and survival are increasing in all groups of gynaecological cancers in the Nordic countries, inpatient hospitalisation has become shorter in relation to treatment. This has increased the need for follow‐up and rehabilitation. Design Integrative literature review using the Equator PRISMA guidelines. Methods The review was selected, allowing inclusion of both experimental and nonexperimental research. The search included peer‐reviewed articles published 1995–2017. To frame the search strategy, we applied the concept of rehabilitation, which holds a holistic perspective on health. Results Fifty‐five articles were included and were contextualised within three themes. Physicalwell-being in a changed body encompasses bodily changes comprising menopausal symptoms, a changed sexual life, complications in bowels, urinary tract, lymphoedema and pain, bodily‐based preparedness and fear of recurrence. Mental well-being as a woman deals with questioned womanliness, the experience of revitalised values in life, and challenges of how to come to terms with oneself after cancer treatment. Psychosocial well-being and interaction deals with the importance of having a partner or close person in the process of coming to terms with oneself after cancer. Furthermore, the women needed conversations with health professionals around the process of coping with changes and late effects, including intimate and sensitive issues. Conclusion Years after gynaecological cancer, women have to deal with fundamental changes and challenges concerning their physical, mental and psychosocial well‐being. Future research should focus on how follow‐up programmes can be organised to target the multidimensional aspects of women's QoL. Research collaboration across Nordic countries on rehabilitation needs and intervention is timely and welcomed. Relevance to clinical practice To ensure that all aspects of cancer rehabilitation are being addressed, we suggest that the individual woman is offered an active role in her follow‐up.
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Affiliation(s)
- Ragnhild Johanne Tveit Sekse
- Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Sciences, University of Bergen, Bergen, Norway
| | - Gail Dunberger
- Department of Health Care Science, Ersta Sköndal Bräcke University College, Stockholm, Sweden
| | - Mette Linnet Olesen
- Research Unit Womens and Childrens Health Department, Copenhagen, Denmark.,Department of Gynaecology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Maria Østerbye
- AU Library, Health Sciences Aarhus University, Aarhus C, Denmark
| | - Lene Seibaek
- Department of Gynecology and Obstetrics, Aarhus University Hospital, Aarhus N, Denmark
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Liu CL, Liu L, Zhang Y, Dai XZ, Wu H. Prevalence and its associated psychological variables of symptoms of depression and anxiety among ovarian cancer patients in China: a cross-sectional study. Health Qual Life Outcomes 2017; 15:161. [PMID: 28818112 PMCID: PMC5561632 DOI: 10.1186/s12955-017-0738-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 08/09/2017] [Indexed: 12/18/2022] Open
Abstract
Background It is well known that cancer patients tend to have high levels of perceived stress and symptoms of depression and anxiety. However, there is less study on the association between perceived stress and symptoms of depression and anxiety among ovarian cancer patients in China. And the mediating effect of hope and resilience needs to be further studied. In this study, we aim to examine the prevalence of depression and anxiety symptoms, to analyze the association between perceived stress and symptoms of depression and anxiety, and to test whether hope and resilience mediate the association of perceived stress with symptoms of depression and anxiety among Chinese patients with ovarian cancer. Method A total of 220 questionnaires were distributed and collected from the First Affiliated Hospital of China Medical University and Shengjing Hospital of China Medical University. All participants in this study were ovarian cancer inpatients. After excluding the incomplete questionnaires, 198 questionnaires were valid for the analysis. Qualified patients were asked to response to the questionnaires including Hospital anxiety and depression scale (HADS), perceived stress scale (PSS-10), and the Herth hope scale and the resilience scale. Hierarchical regression analyses were used to test the associations among perceived stress, symptoms of depression and anxiety, and hope and resilience. Bootstrapping method was conducted to examine whether the indirect effect of hope and resilience was significant respectively. Results The prevalence of symptoms of depression and anxiety in ovarian cancer patients was 47.0% and 51.5% respectively. Perceived stress correlated significantly with symptoms of depression (r = 0.709, P < 0.01) and anxiety (r = 0.660, P < 0.01). Hope (a*b = 0.155, BCa 95% CI: 0.094, 0.223) partly mediated the association between perceived stress and symptoms of depression; similarly, hope (a*b = 0.129, BCa 95% CI: 0.048, 0.205) partly mediated the effect of perceived stress on symptoms of anxiety. However, resilience (a*b = 0.004, BCa 95% CI: -0.030, 0.040) did not mediate the association between perceived stress and symptoms of depression. And resilience (a*b = 0.041,BCa 95% CI: -0.013, 0.098) did not mediate the association between perceived stress and symptoms of anxiety. Conclusions The present study suggests that perceived stress might be one of the impact factors of symptoms of depression and anxiety, while hope might ease symptoms of depression and anxiety. In view of the role of hope, medical workers and patient caregivers should pay more attention to hope, and then to intervene perceived stress among patients with ovarian cancer.
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Affiliation(s)
- Chun Li Liu
- Library of China Medical University, Shenyang, Liaoning, China
| | - Li Liu
- Department of Social Medicine, School of Public Health, China Medical University, Shenyang, Liaoning, China
| | - Yi Zhang
- First Affiliated Hospital, China Medical University, Shenyang, Liaoning, China
| | - Xiao Ze Dai
- Department of Social Medicine, School of Public Health, China Medical University, Shenyang, Liaoning, China
| | - Hui Wu
- Department of Social Medicine, School of Public Health, China Medical University, Shenyang, Liaoning, China.
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Abstract
This study aims to investigate the relationships of personality and social support with posttraumatic stress disorder (PTSD) after traffic accidents.The 90 Symptom Checklist (SCL-90) and Eysenck Personality Questionnaire (EPQ) were completed 1 week after trauma. The Checklist-Civilian Version (PCL-C) was surveyed 3 months after discharge.PCL-C score of 38 was used as cutoff point. The older age and lower education significantly increased the PTSD incidence. SCL-90 score was positively correlated with PTSD symptom score. The psychoticism (P) (0.230) and neuroticism (N) (0.302) was positively correlated with PTSD symptom score in a linear relationship. Objective support, subjective support, exploitation degree, and social support were negatively associated with PTSD scores. Force symptoms, psychoticism, subjective support, introversion, and extroversion could explain 65.0% of degree of variation for PTSD with the estimated standard error of 4.758.PTSD associated social factors include force symptoms, psychoticism, subjective support, introversion, and extroversion.
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15
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Jacob L, Kalder M, Kostev K. Incidence of depression and anxiety among women newly diagnosed with breast or genital organ cancer in Germany. Psychooncology 2017; 26:1535-1540. [PMID: 27897353 DOI: 10.1002/pon.4328] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2016] [Revised: 11/17/2016] [Accepted: 11/22/2016] [Indexed: 12/12/2022]
Abstract
BACKGROUND To analyze the incidence of depression and anxiety among women newly diagnosed with breast or genital organ cancer (BC or GOC) in Germany. METHODS A total of 29 366 women initially diagnosed with BC or GOC between 2005 and 2014 were available for analysis. The main outcome measure was the incidence of depression and anxiety among women newly diagnosed with BC or GOC within 5 years after the first cancer diagnosis in German gynecologist practices. Demographic and clinical data included age, type of cancer, and presence of metastases at diagnosis. The incidence rate of depression and anxiety per 100 person-years was calculated. We performed a multivariate regression model to analyze the association between depression and the variables of interest. RESULTS In total, 7994 women were diagnosed with depression/anxiety (81.3% had BC and 18.7% had GOC). The incidence of depression and anxiety was 8.8 per 100 person-years in women with BC. In individuals with GOC, the incidence of depression/anxiety was 5.9 per 100 person-years. Breast cancer was associated with a 1.41-fold increase in the risk of developing depression or anxiety as compared with GOC. Patients with metastases also had a higher risk of being depressed and anxious than others (odds ratio = 1.40). Finally, women in the age groups of 41 to 50, 51 to 60, and 61 to 70 years were at a higher risk of depression/anxiety than women in the age group of 71 to 80 years (odds ratios equal to 1.50, 1.38, and 1.22). CONCLUSIONS Women diagnosed with BC were at a higher risk of developing depression or anxiety than women with GOC.
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Affiliation(s)
- Louis Jacob
- Faculty of Medicine, University of Paris 5, Paris, France
| | - Matthias Kalder
- Department of Gynecology and Obstetrics, Philipps-Universität Marburg, Marburg, Germany
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