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Li S, Wu L, He J, Ge Y, Li S. Early postoperative core symptoms and their relationship with resilience in oesophageal cancer patients-A multicentre cross-sectional study. J Adv Nurs 2024. [PMID: 39176978 DOI: 10.1111/jan.16388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 06/30/2024] [Accepted: 07/31/2024] [Indexed: 08/24/2024]
Abstract
AIM To assess early postoperative core symptoms in oesophageal cancer patients and their relationship with resilience. BACKGROUND Patients with oesophageal cancer face a high number of severe symptoms in the early post-operative period and require the development of an effective symptom management programme. Identifying core symptoms through network analysis helps in accurate patient care. DESIGN A multicentre cross-sectional study. METHODS A cross-sectional survey was conducted from August 2022 to August 2023 at three hospitals in Anhui Province, China. A total of 469 patients were recruited for this study and 418 (89.1%) patients completed this investigation. Using network analysis to find early post-operative core symptoms in oesophageal cancer patients. Multiple linear regression was used to analyse resilience factors affecting core symptoms. RESULTS Sadness was the most core symptom in oesophageal cancer patients in the early post-operative period (rs = 1.41), followed by incision pain and difficulty breathing while resting (rs = 1.20, rs = 1.08). Resilience was significantly associated with patients' feelings of sadness, with optimism having the greatest impact on sadness (p < .01). CONCLUSION Sadness is the most core symptom in patients in the early post-operative period and special attention should be paid to improving their level of resilience. Local symptoms and dysfunction in the early post-operative period should be treated in a synergistic manner. IMPACT This study identifies core symptoms and their relationship to resilience in patients with oesophageal cancer in the early post-operative period. Symptoms as the main core symptom in patients in the early post-operative period, which was sadness and was significantly associated with resilience. Precise interventions can be made to target patients' core post-operative symptoms, which can help improve the effectiveness of symptom management. REPORTING METHOD We have complied with the relevant EQUATOR research reporting checklist. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution in the study.
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Affiliation(s)
- Shaoxue Li
- School of Nursing, Anhui Medical University, Hefei, China
| | - Lijun Wu
- School of Nursing, Anhui Medical University, Hefei, China
| | - Jie He
- School of Nursing, Anhui Medical University, Hefei, China
| | - Yaping Ge
- School of Nursing, Anhui Medical University, Hefei, China
| | - Shuwen Li
- School of Nursing, Anhui Medical University, Hefei, China
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Verri V, Pepe I, Abbatantuono C, Bottalico M, Semeraro C, Moschetta M, De Caro MF, Taurisano P, Antonucci LA, Taurino A. The influence of body image on psychological symptomatology in breast cancer women undergoing intervention: a pre-post study. Front Psychol 2024; 15:1409538. [PMID: 38952834 PMCID: PMC11216037 DOI: 10.3389/fpsyg.2024.1409538] [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: 04/03/2024] [Accepted: 05/29/2024] [Indexed: 07/03/2024] Open
Abstract
Introduction Body image concerns related to breast cancer surgery may challenge patients' quality of life and their treatment outcomes, thus representing a key aspect to be assessed in the psycho-oncological settings. The present longitudinal study is aimed to (1) investigate the association between preoperative body image and postoperative psychological symptoms in breast cancer patients; (2) explore the impact of pre-/post-surgery variation in body image on psychological symptomatology. Methods N = 72 women undergoing breast cancer surgery were preoperatively screened (T1) using the Body Uneasiness Test (BUT) and were assessed postoperatively (T2) using the Symptom Checklist-90 Revised (SCL-90-R) and re-administered the BUT. Spearman's correlation was used to investigate the relationship between age, preoperative body image and postoperative psychological symptoms, and variation in body image. To predict post-surgical psychological symptomatology, two separated multiple regression models were used to evaluate preoperative body image and its variation after surgery controlling for covariates (i.e., education; intervention type). P significance was set as 0.05 for all analyses and adjusted for multiple comparisons. Results At T1, anxiety in relation to body image scores emerged as the most frequently experienced psychological symptomatology after surgery (all adjusted p < 0.05). Significant correlations were observed between all SCL-90-R scores at T2 and avoidance behaviors and depersonalization scores at T1. The associations were most significantly strong for somatization, depression, anxiety, and hostility (all adjusted p < 0.05). However, change in body image between pre- and post-intervention was not associated with psychological symptomatology at T2 (all adjusted p > 0.05). Pre-surgery body avoidance was significantly associated with post-intervention psychological symptoms (SOMβ = 0.453, p = 0.0001; DEPβ = 0.507, p = 0.0001; AXβ = 0.459, p = 0.0001; HOSβ = 0.410, p=. 0001). However, increased weight phobia between pre- and post-surgery was statistically associated with increased somatization, anxiety, depression and hostility at T2 (βSOM = 0.439, p = 0.0001; βDEP = 0.454, p = 0.0001; βANX = 0.471, p = 0.0001). Discussion Overall, pre-/post-intervention body concerns were significantly associated with primary psychological symptoms in breast cancer patients undergoing surgery. Higher levels of body avoidance and weight phobia were significantly associated with the primary psychological dimensions assessed. As body concerns might act as quality-of-life predictors, their evaluation is crucial in fostering patients' well-being and treatment adherence.
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Affiliation(s)
- Veronica Verri
- Department of Education, Psychology, Communication (For.Psi.Com.), University of Bari Aldo Moro, Bari, Italy
| | - Ilaria Pepe
- Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Bari Aldo Moro, Bari, Italy
| | - Chiara Abbatantuono
- Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Bari Aldo Moro, Bari, Italy
| | - Morena Bottalico
- Department of Education, Psychology, Communication (For.Psi.Com.), University of Bari Aldo Moro, Bari, Italy
| | - Cristina Semeraro
- Department of Education, Psychology, Communication (For.Psi.Com.), University of Bari Aldo Moro, Bari, Italy
| | - Marco Moschetta
- Interdisciplinary Department of Medicine (D.I.M.), Breast Care Unit, University of Bari Aldo Moro, Bari, Italy
| | - Maria Fara De Caro
- Department of Education, Psychology, Communication (For.Psi.Com.), University of Bari Aldo Moro, Bari, Italy
| | - Paolo Taurisano
- Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Bari Aldo Moro, Bari, Italy
| | - Linda Antonella Antonucci
- Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Bari Aldo Moro, Bari, Italy
| | - Alessandro Taurino
- Department of Education, Psychology, Communication (For.Psi.Com.), University of Bari Aldo Moro, Bari, Italy
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Li Y, Dong W, Tang H, Guo X, Wu S, Lu G, Li X, Chen C. Correlates of death anxiety for patients with cancer: A systematic review and meta-analysis. J Clin Nurs 2024; 33:1933-1947. [PMID: 38284499 DOI: 10.1111/jocn.17021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 11/24/2023] [Accepted: 01/07/2024] [Indexed: 01/30/2024]
Abstract
OBJECTIVE A systematic review and meta-analysis was performed to identify the factors related to cancer death anxiety based on available evidence. DESIGN This systematic review and meta-analysis followed the PRISMA 2020 guidelines. METHODS Seven databases were searched to identify studies on the relationships of cancer death anxiety with demographic characteristics, disease factors and psychosocial factors from inception to May 2023. The Agency for Medical Research and Quality (AHRQ) scale was used to evaluate the quality of the included studies. After two researchers independently completed the literature search, data extraction and quality evaluation, meta-analysis was conducted by using RevMan5.3 and Stata 17.0 software. RESULTS In total, 52 studies were included in this review. The results revealed that there were positive correlations of death anxiety with female sex, the symptom burden, anxiety levels, depression levels, fear of recurrence, attachment avoidance, psychological distress, resignation and confrontation coping. Death anxiety was negatively correlated with age, education level, ability to perform daily activities, self-esteem, spiritual well-being, sense of meaning in life, resilience, quality of life, social support and religious beliefs. CONCLUSIONS Our results can inform the design of interventions to address death anxiety and improve the overall quality of life of cancer patients. Healthcare professionals should promptly identify and focus on death anxiety in high-risk populations of cancer patients. RELEVANCE TO CLINICAL PRACTICE Cancer patients commonly experience death anxiety, and this anxiety has a nonnegligible impact on patients' mental health and overall quality of life. This study can inform the development of interventions by clinical healthcare professionals. NO PATIENT OR PUBLIC CONTRIBUTION This was a meta-analysis based on data from previous studies.
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Affiliation(s)
- Yuanyuan Li
- Institute of Nursing and Health, School of Nursing and Health, Henan University, Kaifeng, China
| | - Wanglin Dong
- Institute of Nursing and Health, School of Nursing and Health, Henan University, Kaifeng, China
| | - Haishan Tang
- Institute of Nursing and Health, School of Nursing and Health, Henan University, Kaifeng, China
| | - Xiajun Guo
- Institute of Nursing and Health, School of Nursing and Health, Henan University, Kaifeng, China
| | - Sijia Wu
- Institute of Nursing and Health, School of Nursing and Health, Henan University, Kaifeng, China
| | - Guangli Lu
- Institute of Business Administration, School of Business, Henan University, Kaifeng, China
| | - Xia Li
- Institute of Nursing and Health, School of Nursing and Health, Henan University, Kaifeng, China
| | - Chaoran Chen
- Institute of Nursing and Health, School of Nursing and Health, Henan University, Kaifeng, China
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Alhofaian A, Alaamri MM, Abdalmajeed MA, Wadaah LS, Aljuhani LA, Amin MA, Tunsi A, Alharazi R. The Role of Illness Perception and Self-Efficacy in Determining Quality of Life among Cancer Patients. Clin Pract 2024; 14:498-507. [PMID: 38525717 PMCID: PMC10961753 DOI: 10.3390/clinpract14020038] [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: 02/05/2024] [Revised: 03/11/2024] [Accepted: 03/13/2024] [Indexed: 03/26/2024] Open
Abstract
BACKGROUND The quality of life for people with chronic illnesses like cancer has been shown to be significantly impacted by self-efficacy and perceptions of their illness. OBJECTIVES This study investigates the relationship between cancer patients' perceptions of their illness, their self-efficacy beliefs, and their quality of life. METHOD Conducted from December 2022 to February 2023, this research involved 120 adults undergoing cancer treatment. We utilized the Illness Perception Questionnaire (IPQ), the Arabic version of the Cancer Behavioral Inventory Brief (CBI-B), and the Arabic EORTC QLQ-C30, alongside clinical data collection. Statistical analyses included Pearson correlation and descriptive statistics. RESULTS Breast cancer emerged as the most common type among participants. A positive correlation was found between self-efficacy and quality of life, as measured by the EORTC QLQ-C30, particularly in relation to symptom management. Interestingly, all dimensions of illness perception correlated with quality of life, except for control and concerns. CONCLUSIONS The findings underscore the vital role of nurses and healthcare providers in aiding cancer patients to develop and utilize self-management strategies effectively. The study reveals that a patient's capacity to manage their illness is significantly influenced by their confidence, understanding of their condition, and overall quality of life. Addressing these aspects can greatly enhance healthcare professionals' contribution to improving the resilience and well-being of individuals battling cancer.
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Affiliation(s)
- Aisha Alhofaian
- Faculty of Nursing, Medical Surgical Nursing Department, King Abdul Aziz University, P.O. Box 4929, Jeddah 22246, Saudi Arabia; (M.M.A.); (M.A.A.); (L.S.W.); (L.A.A.); (M.A.A.); (A.T.); (R.A.)
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Shen H, Masingboon K, Samartkit N. Factors related to preoperative uncertainty among patients with breast cancer in Wenzhou, China: A cross-sectional study. BELITUNG NURSING JOURNAL 2023; 9:236-243. [PMID: 37492757 PMCID: PMC10363974 DOI: 10.33546/bnj.2648] [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: 03/30/2023] [Revised: 04/30/2023] [Accepted: 06/02/2023] [Indexed: 07/27/2023] Open
Abstract
Background One of the most prevalent psychological signs of breast cancer is uncertainty, which is more prevalent in Chinese patients during the preoperative period. Despite the numerous factors contributing to preoperative uncertainty, there is limited relevant research conducted in China. Objective This study aimed to describe the current state of preoperative uncertainty and to investigate the relationship between anxiety, illness perception, social support, and preoperative uncertainty in patients with breast cancer in Wenzhou, China. Methods This cross-sectional research used a simple random sampling technique to select 122 participants from a university hospital in Wenzhou, China, from July 2022 to December 2022, employing validated instruments. Descriptive statistics and Pearson's correlation coefficient were utilized to analyze the data. Results The average preoperative uncertainty scores of the patients fell within a moderate range (M = 61.92, SD = 7.51). Significant correlations were found between anxiety (r = 0.638, p <0.01), illness perception (r = 0.704, p <0.01), social support (r = -0.481, p <0.01), and preoperative uncertainty. Conclusions The results can assist healthcare professionals, especially nurses, in recognizing the factors contributing to uncertainty before surgery in patients with breast cancer. This knowledge enables them to promptly address and minimize this issue, leading to improved outcomes.
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Affiliation(s)
- Huaiyu Shen
- Faculty of Nursing, Burapha University, Chon Buri, Thailand
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Frank T, Pichler T, Maier S, Batenhorst I, Abawi T, Harbeck N, Algül H, Heinemann V, Hermelink K, Mumm F, Dinkel A. Stressors related to the COVID-19 pandemic and their association with distress, depressive, and anxiety symptoms in cancer out-patients. Front Psychol 2023; 14:1100236. [PMID: 37333585 PMCID: PMC10272444 DOI: 10.3389/fpsyg.2023.1100236] [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: 11/16/2022] [Accepted: 03/30/2023] [Indexed: 06/20/2023] Open
Abstract
Patients with cancer might be particularly prone to stress caused by the COVID-19 pandemic. The aim of this study was to investigate the impact of pandemic-related stressors on oncological patients' psychological well-being. During the second wave of the COVID-19 pandemic in Germany 122 cancer out-patients of the Comprehensive Cancer Center Munich reported on COVID-19-related stressors (information satisfaction, threat perception, and fear of disease deterioration) and answered standardized questionnaires for psychosocial distress (DT) as well as depression and anxiety symptoms (PHQ-2, GAD-2). Multiple linear regression analyses were used to identify associations of the COVID-19-related stressors with psychological symptoms, controlling for sociodemographic, psychological (self-efficacy, ASKU) and clinical (somatic symptom burden, SSS-8) variables. Initially, satisfaction with information was significantly negatively associated with all three outcome variables. Fear of disease deterioration was associated with distress and depressive symptoms. After controlling for additional variables, only satisfaction with information remained an independent determinant of anxiety (β = -0.35, p < 0.001). All three outcomes were most strongly determined by somatic symptom burden (β ≥ 0.40, p < 0.001). The results of this study tentatively suggest that physical well-being overrides the relevance of some COVID-19-related stressors for oncological patients' psychological wellbeing. Physical symptoms are strongly tied to personal wellbeing as they are associated with suffering from cancer, which might be more central to personal wellbeing than the possibility of getting infected with SARS-CoV-2. However, satisfaction with the information received seems to be important beyond physical wellbeing, as this emerged as an independent determinant of anxiety.
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Affiliation(s)
- Tamara Frank
- Comprehensive Cancer Center Munich, Munich, Germany
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | | | | | | | - Tanja Abawi
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Nadia Harbeck
- Comprehensive Cancer Center Munich, Munich, Germany
- Department of Obstetrics and Gynecology, LMU University Hospital, Munich, Germany
| | - Hana Algül
- Comprehensive Cancer Center Munich, Munich, Germany
- Mildred-Scheel-Professor of Tumor Metabolism, Technical University of Munich, Munich, Germany
| | - Volker Heinemann
- Comprehensive Cancer Center Munich, Munich, Germany
- Department of Internal Medicine III, LMU University Hospital, Munich, Germany
| | - Kerstin Hermelink
- Department of Obstetrics and Gynecology, LMU University Hospital, Munich, Germany
| | - Friederike Mumm
- Comprehensive Cancer Center Munich, Munich, Germany
- Department of Internal Medicine III, LMU University Hospital, Munich, Germany
| | - Andreas Dinkel
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
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Li Z, Zhang Y, Pang Y, He Y, Song L, Wang Y, He S, Tang L. The mediating effect of somatic symptom disorder between psychological factors and quality of life among Chinese breast cancer patients. Front Psychiatry 2023; 14:1076036. [PMID: 37252145 PMCID: PMC10213318 DOI: 10.3389/fpsyt.2023.1076036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 04/18/2023] [Indexed: 05/31/2023] Open
Abstract
Objective We conducted this cross-sectional study to explore the mediating and predicting role of somatic symptom disorder (SSD) between psychological measures and quality of life (QOL) among Chinese breast cancer patients. Methods Breast cancer patients were recruited from three clinics in Beijing. Screening tools included the Patient Health Questionnaire-15 (PHQ-15), the Patient Health Questionnaire-9 (PHQ-9), the General Anxiety Disorder-7 scale (GAD-7), the Health Anxiety Scale (Whiteley Index-8, WI-8), the Somatic Symptom Disorder B-Criteria Scale (SSD-12), the Fear of Cancer Recurrence scale (FCR-4), the Brief Illness Perception Questionnaire (BIPQ-8), and the Functional Assessment of Cancer Therapy-Breast (FACT-B). Chi-square tests, nonparametric tests, mediating effect analysis, and linear regression analysis were used for the data analysis. Results Among the 264 participants, 25.0% were screened positive for SSD. The patients with screened positive SSD had a lower performance status, and a greater number of patients with screened positive SSD received traditional Chinese medicine (TCM) (p < 0.05). Strong mediating effects of SSD were found between psychological measures and QOL among patients with breast cancer after adjusting for sociodemographic variables as covariates (p < 0.001). The range of the percentage mediating effects was 25.67% (independent variable = PHQ-9) to 34.68% (independent variable = WI-8). Screened positive SSD predicted low QOL in physical (B = -0.476, p < 0.001), social (B = -0.163, p < 0.001), emotional (B = -0.304, p < 0.001), and functional (B = -0.283, p < 0.001) well-being, as well as substantial concerns caused by breast cancer (B = -0.354, p < 0.001). Conclusion Screened positive SSD had strong mediating effects between psychological factors and quality of life among breast cancer patients. Additionally, screened positive SSD was a significant predictor of lower QOL among breast cancer patients. Effective psychosocial interventions for improving QOL should consider the prevention and treatment of SSD or integrated SSD caring dimensions for breast cancer patients.
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Hinz A, Kocalevent RD, Glaesmer H, Rauscher FG, Wirkner K, Treudler R, Mehnert-Theuerkauf A. Changes in bodily complaints (PHQ-15) over six years in a large general population sample. J Psychosom Res 2022; 161:111014. [PMID: 35994924 DOI: 10.1016/j.jpsychores.2022.111014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 08/08/2022] [Accepted: 08/12/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The Patient Health Questionnaire-15 (PHQ-15) is a widely used instrument for measuring bodily complaints. The aims of this study were to analyze changes of bodily complaints over a six-year period in a large general population community sample, to test age and sex differences in these changes, and to examine associations between these changes and changes in other health-related variables. METHODS A total of 4821 adult subjects took part this longitudinal study at baseline (t1) and six years later (t2). The participants completed the PHQ-15 and several other questionnaires. RESULTS Over the six-year period, the mean score of the complaints increased from 5.18 ± 3.67 to 5.75 ± 3.97. The highest increase in terms of effect sizes was found for sexual pain/problems. While the increase in the PHQ-15 mean score was nearly identical for males and females, there were age differences in these increase rates: Participants of the oldest age group (70 years and above) experienced the greatest increase in complaints. Participants from lower socioeconomic levels also reported high increases in complaints. The correlation between the t1 and the t2 PHQ-15 score was r = 0.66. Changes in complaints from t1 to t2 were associated with changes in multiple other variables such as anxiety, social support, optimism, life satisfaction, and quality of life. CONCLUSION The data reported here can be used to better interpret changes in patients' health state over several years.
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Affiliation(s)
- Andreas Hinz
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany.
| | - Rüya-Daniela Kocalevent
- Institute and Polyclinic for Primary Medical Care, University Medical Center Hamburg-Eppendorf, Germany
| | - Heide Glaesmer
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Franziska G Rauscher
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany
| | - Kerstin Wirkner
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany; Leipzig Research Centre for Civilization Diseases, University of Leipzig, Leipzig, Germany
| | - Regina Treudler
- Department of Dermatology, Venerology and Allergology, University of Leipzig Medical Center, Leipzig, Germany
| | - Anja Mehnert-Theuerkauf
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
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Su Z, Zhou Y, Han X, Pang Y, He S, Tang L. Symptom burden in advanced breast cancer patients and its association between death anxiety and psychological distress. Chin J Cancer Res 2022; 34:298-308. [PMID: 35873892 DOI: 10.21147/j.issn.1000-9604.2022.03.09] [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: 02/12/2022] [Accepted: 06/15/2022] [Indexed: 11/18/2022] Open
Abstract
Objective Recent research has documented psychological distress in advanced breast cancer (ABC) patients, but few studies have examined how death anxiety is affected by the symptom burden. Therefore, this study aims to explore the association among symptom burden, death anxiety and psychological distress (depression and anxiety) in ABC patients. Methods This cross-sectional study used the Death and Dying Anxiety Scale (DADDS), 9-item Patient Health Questionnaire (PHQ-9), General Anxiety Disorder-7 (GAD-7) and MD Anderson Symptom Inventory (MDASI) to assess death anxiety, depression, anxiety, and symptom burden, respectively. Bias-corrected bootstrapping methods were used to estimate indirect effects and 95% confidence intervals. Results Two hundred ABC patients completed the questionnaires. All of the respondents were females, with a mean age of 50±10 years. Initial correlation analyses revealed significant associations of death anxiety with depression (r=0.57, P<0.001), anxiety (r=0.60, P<0.001) and symptom burden (r=0.43, P<0.001). Moreover, depression (r=0.53, P<0.001) and anxiety (r=0.45, P<0.001) were significantly correlated with symptom burden. An analysis using Hayes' PROCESS macro revealed the partial effecting role of death anxiety in the relationship between depression and symptom burden, and between anxiety and symptom burden (contributions to the total effect of 0.247 and 0.469, respectively). Conclusions This study provides insight into the relationship between death anxiety and symptom burden. The results suggest that interventions addressing death anxiety may be more effective for alleviating the depression and anxiety experienced by ABC patients with a symptom burden.
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Affiliation(s)
- Zhongge Su
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-Oncology, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Yuhe Zhou
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-Oncology, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Xinkun Han
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-Oncology, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Ying Pang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-Oncology, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Shuangzhi He
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-Oncology, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Lili Tang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-Oncology, Peking University Cancer Hospital & Institute, Beijing 100142, China
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Li J, Fritzsche K, Glinka M, Pang Y, Song L, Wang Y, Li Z, He Y, Zhang Y, He S, Leonhart R, Toussaint AK, Tang L. Prevalence of DSM-5 somatic symptom disorder in Chinese patients with breast cancer. Psychooncology 2022; 31:1302-1312. [PMID: 35353396 DOI: 10.1002/pon.5932] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 02/09/2022] [Accepted: 03/19/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVE The aims of this study were to explore the frequency of somatic symptom disorder (SSD) and the relationship between SSD and somatic, psychological, and social factors in Chinese patients with breast cancer. METHODS This multicenter cross-sectional study enrolled 264 patients with breast cancer from 3 different departments in Beijing. The structured clinical interview for DSM-5 (SCID-5) for SSD. Standardized questionnaires and clinical data were used to compare patients with and without SSD. RESULTS SSD was diagnosed in 21.6% (57/264) of all enrolled patients. No differences were found between SSD patients and non-SSD patients in terms of sociodemographic characteristics and tumor-specific variables, except radiotherapy.However, patients with SSD reported higher levels of depression, anxiety and cancer-related worry. They also showed a longer duration of symptoms, greater impairment in daily life, more concern over their physical complaints and more doctor visits. In a stepwise binary logistic regression analysis, among others, higher health anxiety (WI-8, Exp(B) = 0.107, p = 0.009) and more doctor visits (OR = -1.841, p < 0.001) showed a significant association with SSD; the model explained 53.7% of the variance. CONCLUSIONS Similar to other physical diseases, there is a high prevalence of SSD in patients with breast cancer. SSD patients differ from non-SSD patients by exhibiting higher cancer-related emotional distress and dysfunctional illness perception and behavior. There remain substantial challenges in the diagnosis of SSD in patients with cancer and other medical conditions. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Jinjiang Li
- Department of Psycho-oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, China.,Department of Outpatient, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Kurt Fritzsche
- Department of Psychosomatic Medicine and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, Germany
| | - Mark Glinka
- Department of Psychosomatic Medicine and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, Germany
| | - Ying Pang
- Department of Psycho-oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, China
| | - Lili Song
- Department of Psycho-oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, China
| | - Yan Wang
- Department of Psycho-oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, China
| | - Zimeng Li
- Department of Psycho-oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, China
| | - Yi He
- Department of Psycho-oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, China
| | - Yening Zhang
- Department of Psycho-oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, China
| | - Shuangzhi He
- Department of Psycho-oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, China
| | | | - Anne-Kristin Toussaint
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Germany
| | - Lili Tang
- Department of Psycho-oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, China
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11
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Pan X, Xiao Y, Ren D, Xu ZM, Zhang Q, Yang LY, Liu F, Hao YS, Zhao F, Bai YH. Prevalence of mental health problems and associated risk factors among military healthcare workers in specialized COVID-19 hospitals in Wuhan, China: A cross-sectional survey. Asia Pac Psychiatry 2022; 14:e12427. [PMID: 33089622 PMCID: PMC7645907 DOI: 10.1111/appy.12427] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 09/11/2020] [Indexed: 12/12/2022]
Abstract
INTRODUCTION China has been severely affected by coronavirus disease 2019 (COVID-19) since December 2019. Military healthcare workers in China have experienced many pressures when combating COVID-19. This study aimed to investigate the current psychological status and associated risk factors among military healthcare workers. METHODS We collected data from 194 military healthcare workers from three inpatient wards in two specialized COVID-19 hospitals using a web-based cross-sectional survey. The survey covered demographic information, the patient health questionnaire-9, the Generalized Anxiety Disorder-7, and the patient health questionnaire-15. Hierarchical regression analysis was used to explore potential risk factors for mental health problems. RESULTS The overall prevalence rates of depressive, generalized anxiety, and somatic symptoms were 37.6%, 32.5%, and 50%, respectively. Rates of severe depression, generalized anxiety, and somatic symptoms were 5.2%, 3.6%, and 15.5%, respectively. In 22.7% of cases, comorbidities existed between depression, generalized anxiety, and somatization. A junior-grade professional title was associated with depression, older age was associated with generalized anxiety and somatization, and short sleep duration and poor sleep quality were associated with all three symptoms. DISCUSSION The prevalence of depression, generalized anxiety, and somatic symptoms among military healthcare workers in specialized COVID-19 hospitals is high during the current COVID-19 outbreak. A junior-grade professional title, older age, short sleep duration, and poor sleep quality significantly affect military healthcare workers' mental health. Continuous surveillance and monitoring of the psychological consequences of the COVID-19 outbreak should be routine to promote mental health among military healthcare workers.
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Affiliation(s)
- Xiao Pan
- Department of Medical Psychology, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Ying Xiao
- Hongkou District of Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Ding Ren
- Department of Medical Psychology, PLA Navy No.905 Hospital, Second Military Medical University, Shanghai, China
| | - Zheng-Mei Xu
- Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Qian Zhang
- Department of Hyperbaric, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Li-Ying Yang
- Department of Radiotherapy, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Fen Liu
- Department of Critical Medicine, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Yu-Shi Hao
- Department of Medical Psychology, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Feng Zhao
- Hongkou District of Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Yong-Hai Bai
- Department of Medical Psychology, Changzheng Hospital, Second Military Medical University, Shanghai, China
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12
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Castro-Figueroa EM, Torres-Blasco N, Rosal MC, Jiménez JC, Castro-Rodríguez WP, González-Lorenzo M, Vélez-Cortés H, Toro-Bahamonde A, Costas-Muñiz R, Armaiz-Peña GN, Jim H. Brief Report: Hispanic Patients' Trajectory of Cancer Symptom Burden, Depression, Anxiety, and Quality of Life. NURSING REPORTS 2021; 11:475-483. [PMID: 34968222 PMCID: PMC8608069 DOI: 10.3390/nursrep11020044] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 05/27/2021] [Accepted: 05/31/2021] [Indexed: 01/11/2023] Open
Abstract
Background: Anxiety and depression symptoms are known to increase cancer symptom burden, yet little is known about the longitudinal integrations of these among Hispanic/Latinx patients. The goal of this study was to explore the trajectory and longitudinal interactions among anxiety and depression, cancer symptom burden, and health-related quality of life in Hispanic/Latinx cancer patients undergoing chemotherapy. Methods: Baseline behavioral assessments were performed before starting chemotherapy. Follow-up behavioral assessments were performed at 3, 6, and 9 months after starting chemotherapy. Descriptive statistics, chi-square tests, Fisher’s exact tests, and Mann–Whitney tests explored associations among outcome variables. Adjusted multilevel mixed-effects linear regression models were also used to evaluate the association between HADS scores, follow-up visits, FACT—G scale, MDASI scale, and sociodemographic variables. Results: Increased cancer symptom burden was significantly related to changes in anxiety symptoms’ scores (adjusted β^ = 0.11 [95% CI: 0.02, 0.19]. Increased quality of life was significantly associated with decreased depression and anxiety symptoms (adjusted β^ = −0.33; 95% CI: −0.47, −0.18, and 0.38 adjusted β^= −0.38; 95% CI: −0.55, −0.20, respectively). Conclusions: Findings highlight the need to conduct periodic mental health screenings among cancer patients initiating cancer treatment.
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Affiliation(s)
- Eida M. Castro-Figueroa
- Ponce Health Sciences University-Ponce Research Institute, Ponce 00716, Puerto Rico; (N.T.-B.); (J.C.J.); (M.G.-L.); (H.V.-C.); (G.N.A.-P.)
- Correspondence:
| | - Normarie Torres-Blasco
- Ponce Health Sciences University-Ponce Research Institute, Ponce 00716, Puerto Rico; (N.T.-B.); (J.C.J.); (M.G.-L.); (H.V.-C.); (G.N.A.-P.)
| | - Milagros C. Rosal
- Population and Quantitative Health Sciences, School of Medicine, University of Massachusetts Medical School, Worcester, MA 01605, USA;
| | - Julio C. Jiménez
- Ponce Health Sciences University-Ponce Research Institute, Ponce 00716, Puerto Rico; (N.T.-B.); (J.C.J.); (M.G.-L.); (H.V.-C.); (G.N.A.-P.)
| | | | - Marilis González-Lorenzo
- Ponce Health Sciences University-Ponce Research Institute, Ponce 00716, Puerto Rico; (N.T.-B.); (J.C.J.); (M.G.-L.); (H.V.-C.); (G.N.A.-P.)
| | - Héctor Vélez-Cortés
- Ponce Health Sciences University-Ponce Research Institute, Ponce 00716, Puerto Rico; (N.T.-B.); (J.C.J.); (M.G.-L.); (H.V.-C.); (G.N.A.-P.)
| | | | - Rosario Costas-Muñiz
- Memorial Sloan Kettering Cancer Center, Department of Psychiatry and Behavioral Sciences, Puerto Rico, CA 00984, USA;
| | - Guillermo N. Armaiz-Peña
- Ponce Health Sciences University-Ponce Research Institute, Ponce 00716, Puerto Rico; (N.T.-B.); (J.C.J.); (M.G.-L.); (H.V.-C.); (G.N.A.-P.)
| | - Heather Jim
- Moffitt Cancer Center, Tampa, FL 33612, USA;
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13
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Becker JP, Paixão R, Quartilho MJ. Psychopathology and Somatic Complaints: A Cross-Sectional Study with Portuguese Adults. Healthcare (Basel) 2021; 9:healthcare9040478. [PMID: 33920545 PMCID: PMC8073042 DOI: 10.3390/healthcare9040478] [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: 03/19/2021] [Revised: 04/12/2021] [Accepted: 04/15/2021] [Indexed: 11/16/2022] Open
Abstract
(1) Background: Functional somatic symptoms (FSS) are physical symptoms that cannot be fully explained by medical diagnosis, injuries, and medication intake. More than the presence of unexplained symptoms, this condition is associated with functional disabilities, psychological distress, increased use of health services, and it has been linked to depressive and anxiety disorders. Recognizing the difficulty of diagnosing individuals with FSS and the impact on public health systems, this study aimed to verify the concomitant incidence of psychopathological symptoms and FSS in Portugal. (2) Methods: For this purpose, 93 psychosomatic outpatients (91.4% women with a mean age of 53.9 years old) and 101 subjects from the general population (74.3% women with 37.8 years old) were evaluated. The survey questionnaire included the 15-item Patient Health Questionnaire, the 20-Item Short Form Survey, the Brief Symptom Inventory, the Depression, Anxiety and Stress Scale, and questions on sociodemographic and clinical characteristics. (3) Results: Increases in FSS severity were correlated with higher rates of depression, anxiety, and stress symptoms. The findings also suggest that increased rates of FSS are associated with lower educational level and female gender. (4) Conclusion: Being aware of the relationship between FSS and psychopathological symptoms and the need to explore psychosocial issues during clinical interviews may favor early detection of these cases. The early detection of mental disorders is essential for individuals’ adherence to treatments, reflecting on healthcare costs.
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Affiliation(s)
- Joana Proença Becker
- Faculty of Psychology and Education Sciences, University of Coimbra, 3000-115 Coimbra, Portugal;
- Correspondence: or ; Tel.: +351-910741887
| | - Rui Paixão
- Faculty of Psychology and Education Sciences, University of Coimbra, 3000-115 Coimbra, Portugal;
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14
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Lebel S, Mutsaers B, Tomei C, Leclair CS, Jones G, Petricone-Westwood D, Rutkowski N, Ta V, Trudel G, Laflamme SZ, Lavigne AA, Dinkel A. Health anxiety and illness-related fears across diverse chronic illnesses: A systematic review on conceptualization, measurement, prevalence, course, and correlates. PLoS One 2020; 15:e0234124. [PMID: 32716932 PMCID: PMC7384626 DOI: 10.1371/journal.pone.0234124] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 05/19/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Patients with chronic diseases commonly report fears of illness or symptoms recurring or worsening. These fears have been addressed from an illness-specific perspective (e.g., fear of cancer recurrence), a generic illness perspective (e.g., fear of progression), and a psychiatric perspective (DSM-5 illness anxiety disorder and somatic symptom disorder). The broader concept of health anxiety (HA) can also be applied to patients with a chronic disease. This review was conducted to investigate the conceptual, theoretical, measurement-overlap, and differences between these distinct perspectives. We also aimed to summarize prevalence, course, and correlates of these fears in different chronic illnesses. METHODS We used PsycINFO, PubMED, CINAHL, Web of Science, SCOPUS, and PSYNDEX to conduct a systematic review of studies pertaining to these fears in chronic illness published from January 1996 to October 2017. A total of 401 articles were retained. RESULTS There were commonalities across different conceptualizations and diseases: a high prevalence of clinical levels of fears (>20%), a stable course over time, and a deleterious impact on quality of life. Reviewed studies used definitions, models, and measures that were illness-specific, with only a minority employing a psychiatric perspective, limiting cross-disease generalizability. There appears to be some applicability of DSM-5 disorders to the experience of fear of illness/symptoms in patients with a chronic illness. While conceptualizing HA on a continuum ranging from mild and transient to severe may be appropriate, there is a lack of agreement about when the level of fear becomes 'excessive.' The definitions, models, and measures of HA across chronic illnesses involve affective, cognitive, behavioral, and perceptual features. CONCLUSIONS The concept of HA may offer a unifying conceptual perspective on the fears of illness/symptoms worsening or returning commonly experienced by those with chronic disease.
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Affiliation(s)
- Sophie Lebel
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Christina Tomei
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Georden Jones
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Nicole Rutkowski
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Viviane Ta
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Geneviève Trudel
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | | | | | - Andreas Dinkel
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
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15
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Voute M, Morel V, Joly D, Villatte C, Martin E, Durando X, Pereira B, Pickering G. Predicting Pain Trajectories in the One Year Following Breast Cancer Diagnosis-An Observational Study. J Clin Med 2020; 9:E1907. [PMID: 32570868 PMCID: PMC7356308 DOI: 10.3390/jcm9061907] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 06/10/2020] [Accepted: 06/15/2020] [Indexed: 11/24/2022] Open
Abstract
The impact of psychosocial vulnerability on pain in the year following breast cancer diagnosis has been little studied. To identify a score of psychosocial vulnerability (cognitive, emotional, quality of life and precariousness parameters) as a predictor of a pain trajectory, we conducted an observational prospective study and included women with newly diagnosed breast cancer. One year follow-up with 3 visits (day of breast cancer diagnosis; 6 and 12 months) aimed to identify distinct pain-time trajectories. Baseline psychosocial vulnerability was characterized by z-score transformation, a higher score representing a more vulnerable patient. A total of 89 patients were included (59.3 ± 10.7 years). Two trajectories of pain were identified-"Transient Pain trajectory" (TP) (39/89 patients) and "Persistent Pain trajectory" (PP) (50/89). A significant difference of pain over time between trajectories (PP vs. TP at 6 months: 2.23 ± 0.23 vs. 0.27 ± 0.09, p < 0.001) was observed. Psychosocial vulnerability showed a large effect size (d, -0.82; 95% CI, -1.25 to -0.38; p < 0.001) and a higher score in "Persistent pain trajectory" (PP vs. TP: 0.12 ± 0.36 vs. -0.14 ± 0.26, p < 0.001). A predictive vulnerability marker of pain development is proposed and could be used at cancer diagnosis to orientate the care pathway of patients experiencing breast cancer.
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Affiliation(s)
- Marion Voute
- CHU Clermont-Ferrand, Inserm, Centre d’Investigation Clinique, CIC Inserm 1405, F-63000 Clermont–Ferrand, France; (M.V.); (V.M.); (E.M.)
| | - Véronique Morel
- CHU Clermont-Ferrand, Inserm, Centre d’Investigation Clinique, CIC Inserm 1405, F-63000 Clermont–Ferrand, France; (M.V.); (V.M.); (E.M.)
| | - Dominique Joly
- CHU Clermont-Ferrand, Centre Jean Perrin, Centre de Lutte contre le Cancer, F-63003 Clermont-Ferrand, France; (D.J.); (C.V.)
| | - Christine Villatte
- CHU Clermont-Ferrand, Centre Jean Perrin, Centre de Lutte contre le Cancer, F-63003 Clermont-Ferrand, France; (D.J.); (C.V.)
| | - Elodie Martin
- CHU Clermont-Ferrand, Inserm, Centre d’Investigation Clinique, CIC Inserm 1405, F-63000 Clermont–Ferrand, France; (M.V.); (V.M.); (E.M.)
| | - Xavier Durando
- Division de Recherche Clinique, Délégation Recherche Clinique et Innovation, Centre de Lutte contre le Cancer, Centre Jean Perrin, F-63003 Clermont-Ferrand, France;
| | - Bruno Pereira
- CHU de Clermont-Ferrand, Délégation Recherche Clinique & Innovation, 58 Rue Montalembert, F-63003 Clermont-Ferrand, France;
| | - Gisèle Pickering
- CHU Clermont-Ferrand, Inserm, Centre d’Investigation Clinique, CIC Inserm 1405, F-63000 Clermont–Ferrand, France; (M.V.); (V.M.); (E.M.)
- Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand, France
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16
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Screening for depression in cancer patients using the PHQ-9: The accuracy of somatic compared to non-somatic items. J Affect Disord 2019; 254:74-81. [PMID: 31108283 DOI: 10.1016/j.jad.2019.05.026] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 04/25/2019] [Accepted: 05/12/2019] [Indexed: 11/20/2022]
Abstract
BACKGROUND The PHQ-9 is a standard screening tool for depressive disorders in cancer patients. As for the frequently reported symptom overlap with somatic disease, it has been debated whether somatic items are suitable for identifying depressive disorders in cancer patients. Thus, this study examines the diagnostic accuracy of somatic versus cognitive-emotional PHQ-9 items. METHODS The routine data of 4,705 patients, screened at the National Center for Tumor Diseases in Heidelberg between 2011 and 2016, was analyzed. For the single PHQ-9 items, receiver operating characteristics (ROC), sensitivity, specificity, positive, and negative predictive values (PPV and NPV), the Youden Index (YI), and the Clinical Utility Index (UI+/UI-) were applied for the diagnoses of major depressive disorder (MDD) and any depressive disorder (ADD). RESULTS The non-somatic items played a pivotal role in the diagnosis of MDD, whereas the diagnostic accuracy of the somatic items increased in the diagnosis of ADD. For both MDD and ADD, the best performance was achieved by the non-somatic items "little interest" and "feeling down." LIMITATIONS In this study, only one self-reported instrument was used (i.e., the PHQ-9). In other words, the diagnoses were not validated by clinical interviews or other self-reported instruments. CONCLUSION The somatic PHQ-9 items showed less discriminatory value than the non-somatic items. However, they may be useful as screening mechanisms for identifying at-risk cancer patients with mild/moderate depression. Disregarding the somatic items would lead to an underestimation of depressive syndromes and inadequate treatment of somatic symptoms.
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17
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Wang JHY, Gomez SL, Brown RL, Davis K, Allen L, Huang E, Chentsova Dutton Y, Schwartz MD. Factors associated with Chinese American and White cancer survivors' physical and psychological functioning. Health Psychol 2019; 38:455-465. [PMID: 31045429 PMCID: PMC6501801 DOI: 10.1037/hea0000666] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To examine whether health-related stressors and resources are associated with physical function, depression, and anxiety in Chinese American and White breast cancer survivors. METHOD During 2011-2013, this cross-sectional study enrolled Chinese American and White women from California cancer registries diagnosed with Stage 0-III breast cancer between 2006 and 2012. Survivors completed a telephone survey assessing health-related factors including comorbidity, treatment-related symptoms, medical communication, perceived threat, use of coping, and social support resources. Outcomes were assessed using the Patient-Reported Outcome Measurement Information System® (PROMIS®) short forms. Chinese were classified as low- or high-acculturated based on English proficiency, years in the United States, and interview language. Analyses were conducted using Tobit regression models. RESULTS Low-acculturated Chinese (n = 136) had worse physical functioning than Whites (n = 216), controlling for demographics, cancer stage, and time since diagnosis (β = -3.33, p = .01). This disparity was attenuated after adjusting for comorbidity and symptoms (β = -1.63, p = .18). Perceived threat, disengagement coping, and lack of social support were associated with poorer psychological outcomes, regardless of ethnicity. Although low-acculturated Chinese had lower scores on all health-related factors than Whites, the former reported significantly lower level of depression (β = -3.23) and anxiety (β = -5.8) after adjusting for covariates (both p < .05). High-acculturated Chinese (n = 84) did not differ from Whites except that the former had significantly lower anxiety. CONCLUSION Low-acculturated Chinese may benefit from interventions aimed to improve their physical problems. However, despite experiencing greater psychosocial stress, they reported better emotional functioning. Whether Chinese culture shapes this resiliency, or if it is a reporting bias will need further investigation. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Judy Huei-Yu Wang
- Department of Oncology, Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Georgetown University
| | | | - Roger L Brown
- Department of Family Medicine, School of Nursing, University of Wisconsin-Madison
| | - Kimberly Davis
- Department of Oncology, Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Georgetown University
| | | | - Ellen Huang
- Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Georgetown University
| | | | - Marc D Schwartz
- Department of Oncology, Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Georgetown University
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18
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Horne R, Cooper V, Wileman V, Chan A. Supporting Adherence to Medicines for Long-Term Conditions. EUROPEAN PSYCHOLOGIST 2019. [DOI: 10.1027/1016-9040/a000353] [Citation(s) in RCA: 83] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Abstract. Pharmaceutical prescriptions are core to the treatment of most chronic illnesses, yet only half are taken as prescribed. Despite the high costs of nonadherence to individuals and society, effective adherence-promoting interventions are elusive. This is partly due to the sheer complicity of the issue. There are numerous determinants of adherence, both internal to the patient (intrinsic) and external (extrinsic, e.g., environmental or health system-related factors). Also, the relative importance of these determinants varies between individuals and even within the same individual over time and across treatments, presenting a challenge for intervention design. One complication is that interventions can target several levels: (1) patient (e.g., enhancing motivation and/or ability to adhere), (2) patient-provider interactions (e.g., improving communication and the prescribing process), and (3) the healthcare system (e.g., providing the opportunity to access medication through regulatory approval and co-payment schemes). Here, we focus on level 1: the patient. Although environmental factors are important, the effect of an intervention designed to change them will depend on how they impact on the individual. We describe the Perceptions and Practicalities Approach (PAPA), a pragmatic framework positing that adherence/nonadherence is essentially a produce of individual motivation and ability. Adherence interventions, targeted at any level, will therefore be more effective if tailored to address the perceptions and practicalities underpinning individual motivation and ability. We discuss how PAPA can be operationalized, including the application of theoretical models of illness and treatment representation (Necessity-Concerns Framework and Leventhal’s Common-Sense Model) to address salient adherence-related perceptions.
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Affiliation(s)
- Rob Horne
- Centre of Behavioral Medicine, Department of Practice and Policy, UCL School of Pharmacy, London, UK
| | - Vanessa Cooper
- Centre of Behavioral Medicine, Department of Practice and Policy, UCL School of Pharmacy, London, UK
| | - Vari Wileman
- Centre of Behavioral Medicine, Department of Practice and Policy, UCL School of Pharmacy, London, UK
| | - Amy Chan
- Centre of Behavioral Medicine, Department of Practice and Policy, UCL School of Pharmacy, London, UK
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19
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Lee Y, Baek JM, Jeon YW, Im EO. Illness perception and sense of well-being in breast cancer patients. Patient Prefer Adherence 2019; 13:1557-1567. [PMID: 31571838 PMCID: PMC6754328 DOI: 10.2147/ppa.s225561] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 09/02/2019] [Indexed: 11/26/2022] Open
Abstract
PURPOSE The objective of the study was to explore breast cancer patients' illness perception, its relationship to perceived sense of well-being, and the role of perceived social support. METHODS Women with diagnosed breast cancer were recruited from the two university hospitals in South Korea between January and April 2018. The questionnaires included the Illness Perception Questionnaire-Revised (IPQ-R) and the Functional Assessment of Cancer Therapy for Breast cancer (FACT-B). A total of 321 participants' data was analyzed using descriptive analyses, multiple regression, and structural equation modeling. RESULTS Negative illness perception was greater in participants currently receiving chemotherapy (p=0.044) or had received chemotherapy in the past (p=0.006). Positive illness perception was lower in older participants (p=0.001) or those who had received chemotherapy (p=0.018). Negative illness perception had a direct effect on a low sense of well-being (p<0.001). Perceived social support had a significant mediation effect on the relationship between negative/positive illness perception and sense of well-being (p<0.001). CONCLUSION Significant relationships between illness perception and sense of well-being were observed in breast cancer patients. Strengthening patients' perceived social support would be helpful in improving their sense of well-being.
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Affiliation(s)
- Yaelim Lee
- Department of Nursing, Red Cross College of Nursing, Chung-Ang University, Dongjak-gu, Seoul, Republic of Korea
- Correspondence: Yaelim Lee Department of Nursing, Red Cross College of Nursing, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul06974, Republic of KoreaTel +82 10 9950 2731 Email
| | - Jong-Min Baek
- Department of Surgery, Yeouido St. Mary’s Hospital, Seoul, Republic of Korea
| | - Ye-Won Jeon
- Department of Surgery, St. Vincent’s Hospital, Gyeonggi-do, Republic of Korea
| | - Eun-Ok Im
- Department of Nursing, School of Nursing, Duke University, Durham, NC, USA
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20
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Behnke A, Conrad D, Kolassa IT, Rojas R. Higher sense of coherence is associated with better mental and physical health in emergency medical services: results from investigations on the revised sense of coherence scale (SOC-R) in rescue workers. Eur J Psychotraumatol 2019; 10:1606628. [PMID: 31164965 PMCID: PMC6534248 DOI: 10.1080/20008198.2019.1606628] [Citation(s) in RCA: 10] [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: 12/04/2018] [Revised: 04/01/2019] [Accepted: 04/02/2019] [Indexed: 12/28/2022] Open
Abstract
As rescue workers are regularly confronted with potentially traumatising on-duty events, they have an increased risk to develop trauma-related mental and physical health impairments, including post-traumatic, depressive, and somatic symptoms. For this high-risk group, it could be of particular importance to experience their occupational burden as manageable, meaningful, and coherent. This mindset - called sense of coherence - may be a potential resilience factor against the development of mental and physical health problems. In a cross-sectional cohort of 102 rescue workers (Mdn(QD)age = 26.0 (8.5), age range: 18-61), including 36 women, we investigated whether higher values on the Revised Sense of Coherence Scale (SOC-R) predicted lower post-traumatic, depressive, and somatic symptoms. In addition, we evaluated the factor structure of the SOC-R using confirmatory factor analyses. Linear regressions indicated that higher SOC-R, but particularly manageability scores were associated with less post-traumatic (β = -.31, p = .009), depressive (β = -.44, p < .001), and somatic symptoms (β = -.36, p = .002). Furthermore, we found that all symptom scores significantly increased with occupational and private-life trauma exposure. The SOC-R's factor structure was replicated, comprising the three subscales manageability, reflection, and balance. However, the SOC-R's convergent factor validity was rather low in the present sample. Taken together, a high sense of coherence, and in particular a high manageability conviction, was observed as resilience factors for high-risk groups that are frequently exposed to potentially traumatic events. Future studies might investigate whether strengthening the sense of coherence could be one building block in an effective prevention program for maintaining long-term health in risk groups.
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Affiliation(s)
- Alexander Behnke
- Clinical & Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Daniela Conrad
- Clinical & Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany.,Clinical Psychology and Neuropsychology, Department of Psychology, University of Konstanz, Konstanz, Germany
| | - Iris-Tatjana Kolassa
- Clinical & Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Roberto Rojas
- Universitary Psychotherapeutic Outpatient Clinic, Institute of Psychology and Education, Ulm University, Ulm, Germany
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Ha SH, Shim IH, Bae DS. Differences in depressive and anxiety symptoms between cancer and noncancer patients with psychological distress. Indian J Psychiatry 2019; 61:395-399. [PMID: 31391644 PMCID: PMC6657556 DOI: 10.4103/psychiatry.indianjpsychiatry_342_18] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Cancer patients are particularly vulnerable to psychological problems. The purpose of the present study was to compare differences in psychological difficulties, including depression and anxiety, between cancer patients and noncancer patients. This study assessed the differences in depressive and anxiety symptoms between patients with and without cancer. MATERIALS AND METHODS Participants included 219 patients at The Cancer Center, Dongnam Institute of Radiological and Medical Sciences, Busan, Korea, who reported depressive or anxiety symptoms between April 2014 and April 2016. Patients were categorized into cancer and noncancer groups based on medical histories showing a diagnosis of any type of cancer. The Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) were used to evaluate psychological distress at each patient's first visit. Patients' charts were reviewed for clinical data, including BDI and BAI scores and duration of cancer treatment, and for demographic data such as age and sex. RESULTS The results showed that patients in the cancer group experienced greater discomfort related to somatic symptoms; higher BDI subscale scores were related to work difficulties, insomnia, loss of appetite, somatic worries (fatigue), and loss of libido compared with patients in the noncancer group. The BAI subscale scores for fear of the worst happening, feeling unsteady, feeling terrified or afraid, a sense of choking, fear of dying, and feeling scared were higher in patients with than in those without cancer. CONCLUSION High levels of depressive symptoms related to somatic discomfort and anxiety symptoms related to fear of cancer were associated with considerable psychological distress in patients with cancer diagnosis and treatment.
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Affiliation(s)
- Su Hong Ha
- Department of Psychiatry, Cancer Center, Dongnam Institute of Radiological and Medical Sciences, Busan, Korea
| | - In Hee Shim
- Department of Psychiatry, Cancer Center, Dongnam Institute of Radiological and Medical Sciences, Busan, Korea
| | - Dong Sik Bae
- Department of Surgery, College of Medicine, Haeundae Paik Hospital, Inje University, Busan, Korea
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Jabłoński MJ, Mirucka B, Streb J, Słowik AJ, Jach R. Exploring the relationship between the body self and the sense of coherence in women after surgical treatment for breast cancer. Psychooncology 2018; 28:54-60. [PMID: 30286514 DOI: 10.1002/pon.4909] [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: 07/07/2018] [Revised: 09/14/2018] [Accepted: 10/01/2018] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Analysis of the relationship between the body self (BS) and the sense of coherence (SOC) in women after breast surgery due to cancer in comparison with a control group. METHODS A cross-sectional study in a group of 78 women using the body-self questionnaire (BS-Q), and the life orientation questionnaire (SOC-29). Statistics based on the IBM SPSS v.25. RESULTS Multivariate analysis of variance (MANOVA) has shown significant differences based on groups in experiencing intimacy, manifesting femininity, body acceptance, and manageability. In particular, manifesting femininity and body acceptance showed a big effect size (0.30 < partial ɳ2 < 0.32). Correlation analysis between the BS-Q and SOC-29 subscales and Fisher's r to z transformation determines that the differences between groups were significant in favour of healthy women in two sets of variables: experiencing intimacy/meaningfulness and attitude to food and weight/manageability. CONCLUSIONS Breast cancer survivors are at greater risk of developing decreased body acceptance and problems in intimacy, and have less correlation than the healthy control group between manageability and meaningfulness with an appropriate attitude to food and intimate relationship with their partner, respectively. A higher manifestation of femininity in the treated group can be considered a positive but socioculturally conditioned coping strategy.
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Affiliation(s)
- Marcin J Jabłoński
- Institute of Psychology, Faculty of Philosophy, The Jesuit University Ignatianum, Cracow, Poland
| | - Beata Mirucka
- Department of General and Clinical Psychology, Faculty of Pedagogy and Psychology, The University of Bialystok, Bialystok, Poland
| | - Joanna Streb
- Department of Oncology, Jagiellonian University Medical College, Cracow, Poland
| | - Agnieszka J Słowik
- Department of Oncology, Jagiellonian University Medical College, Cracow, Poland
| | - Robert Jach
- Department of Gynaecology and Oncology, Jagiellonian University Medical College, Cracow, Poland
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Brown SL, Hope-Stone L, Heimann H, Damato B, Salmon P. Predictors of anxiety and depression 2 years following treatment in uveal melanoma survivors. Psychooncology 2018; 27:1727-1734. [DOI: 10.1002/pon.4715] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 03/08/2018] [Accepted: 03/17/2018] [Indexed: 02/03/2023]
Affiliation(s)
- Stephen L. Brown
- Institute of Psychology, Health and Society; University of Liverpool; Liverpool UK
| | - Laura Hope-Stone
- Institute of Psychology, Health and Society; University of Liverpool; Liverpool UK
- Liverpool Ocular Oncology Centre; Royal Liverpool and Broadgreen University Hospital, NHS Trust; Liverpool UK
| | - Heinrich Heimann
- Liverpool Ocular Oncology Centre; Royal Liverpool and Broadgreen University Hospital, NHS Trust; Liverpool UK
| | - Bertil Damato
- Liverpool Ocular Oncology Centre; Royal Liverpool and Broadgreen University Hospital, NHS Trust; Liverpool UK
- Ocular Oncology Service; University of California; San Francisco CA USA
| | - Peter Salmon
- Institute of Psychology, Health and Society; University of Liverpool; Liverpool UK
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Tang L, Fritzsche K, Leonhart R, Pang Y, Li J, Song L, Fischer I, Koch M, Wuensch A, Mewes R, Schaefert R. Emotional distress and dysfunctional illness perception are associated with low mental and physical quality of life in Chinese breast cancer patients. Health Qual Life Outcomes 2017; 15:231. [PMID: 29191208 PMCID: PMC5709963 DOI: 10.1186/s12955-017-0803-9] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Accepted: 11/17/2017] [Indexed: 12/29/2022] Open
Abstract
Background To evaluate the relationship between quality of life (QOL) and physical as well as psychological variables in Chinese breast cancer patients. Methods This multicenter cross-sectional study enrolled 254 Chinese breast cancer patients in different stages and treatment phases. They answered standard instruments assessing QOL (EORTC), somatic symptom severity (PHQ-15), depression (PHQ-9), anxiety (GAD-7), health-related anxiety (WI-7), illness perception (BIPQ), and sense of coherence (SOC-9). Canonical correlation was applied to identify the strongest correlates between the physical, emotional and social QOL scales and the physical and psychological variables. Results In our sample, a low global QOL was significantly associated with the following physical and psychological variables: symptom-related disability (Karnofsky Index) (r = .211, p < .01), somatic symptom severity (r = −.391, p < .001), depression (r = −.488, p < .001), anxiety (r = −.439, p < .001), health-related anxiety (r = −.398, p < .001), dysfunctional illness perception (r = −.411, p < .001), and sense of coherence (r = .371, p < .001). In the canonical correlation analysis, high somatic symptom severity, depression, anxiety, dysfunctional illness perception, and low sense of coherence showed the strongest correlations with low physical, emotional and social functioning. The first three significant canonical correlations between these two sets of variables were .78, .56, and .45. Conclusions QOL in Chinese breast cancer patients is strongly associated with psychological factors. Our results suggest that Chinese physicians and nurses should incorporate these factors into their care for women with breast cancer to improve patients’ QOL.
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Affiliation(s)
- Lili Tang
- Psycho-Oncology Department, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Psycho-Oncology, Peking University School of Oncology, Beijing Cancer Hospital & Institute, Beijing, China
| | - Kurt Fritzsche
- Center for Mental Health, Department of Psychosomatic Medicine and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany.
| | - Rainer Leonhart
- Institute of Psychology, University of Freiburg, Freiburg, Germany
| | - Ying Pang
- Psycho-Oncology Department, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Psycho-Oncology, Peking University School of Oncology, Beijing Cancer Hospital & Institute, Beijing, China
| | - Jinjiang Li
- Psycho-Oncology Department, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Psycho-Oncology, Peking University School of Oncology, Beijing Cancer Hospital & Institute, Beijing, China
| | - Lili Song
- Psycho-Oncology Department, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Psycho-Oncology, Peking University School of Oncology, Beijing Cancer Hospital & Institute, Beijing, China
| | - Irmela Fischer
- Institute of Psychology, University of Freiburg, Freiburg, Germany
| | - Maike Koch
- Institute of Psychology, University of Freiburg, Freiburg, Germany
| | | | - Ricarda Mewes
- Department of Psychology, University of Marburg, Marburg, Germany
| | - Rainer Schaefert
- Department of Psychosomatic Medicine, Division of Internal Medicine, University Hospital Basel, Hebelstrasse 2, 4031, Basel, Switzerland
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