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Pel-Littel RE, Buurman BM, Minkman MM, Scholte Op Reimer WJM, Twisk JWR, van Weert JCM. The influence of health literacy, anxiety and education on shared decision making and decisional conflict in older adults, and the mediating role of patient participation: A video observational study. PATIENT EDUCATION AND COUNSELING 2024; 124:108274. [PMID: 38547640 DOI: 10.1016/j.pec.2024.108274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 02/23/2024] [Accepted: 03/21/2024] [Indexed: 05/06/2024]
Abstract
OBJECTIVE To explore the relationship between personal characteristics of older adults with multiple chronic conditions (MCCs) and perceived shared decision making (SDM) resp. decisional conflict. METHODS In a video-observational study (N = 213) data were collected on personal characteristics. The main outcomes were perceived level of SDM and decisional conflict. The mediating variable was participation in the SDM process. A twostep mixed effect multilinear regression and a mediation analysis were performed to analyze the data. RESULTS The mean age of the patients was 77.3 years and 56.3% were female. Health literacy (β.01, p < .001) was significantly associated with participation in the SDM process. Education (β = -2.43, p = .05) and anxiety (β = -.26, p = .058) had a marginally significant direct effect on the patients' perceived level of SDM. Education (β = 12.12, p = .002), health literacy (β = -.70, p = .005) and anxiety (β = 1.19, p = .004) had a significant direct effect on decisional conflict. The effect of health literacy on decisional conflict was mediated by participation in SDM. CONCLUSION Health literacy, anxiety and education are associated with decisional conflict. Participation in SDM during consultations plays a mediating role in the relationship between health literacy and decisional conflict. PRACTICE IMPLICATIONS Tailoring SDM communication to health literacy levels is important for high quality SDM.
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Affiliation(s)
- Ruth E Pel-Littel
- Department of Internal Medicine, Section of Geriatric Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands; Vilans, Centre of expertise for long-term care, Utrecht, the Netherlands.
| | - Bianca M Buurman
- Department of Internal Medicine, Section of Geriatric Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands; ACHIEVE, Centre of Applied Research, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands
| | - Mirella M Minkman
- Vilans, Centre of expertise for long-term care, Utrecht, the Netherlands; TIAS School for Business and Society, Tilburg University, Tilburg, the Netherlands
| | | | - Jos W R Twisk
- Department of Epidemiology and Biostatistics, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Julia C M van Weert
- Amsterdam School of Communication Research/ASCoR, University of Amsterdam, Amsterdam, the Netherlands
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Battat M, Omair N, WildAli MA, Alkaissi A, Amer R, Koni AA, Salameh HT, Zyoud SH. Assessment of depression symptoms among cancer patients: a cross-sectional study from a developing country. Sci Rep 2024; 14:11934. [PMID: 38789579 PMCID: PMC11126617 DOI: 10.1038/s41598-024-62935-x] [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: 05/23/2023] [Accepted: 05/22/2024] [Indexed: 05/26/2024] Open
Abstract
Cancer patients experience psychological symptoms such as depression during the cancer treatment period, which increases the burden of symptoms. Depression severity can be assessed using the beck depression inventory (BDI II). The purpose of the study was to use BDI-II scores to measure depression symptoms in cancer patients at a large tertiary hospital in Palestine. A convenience sample of 271 cancer patients was used for a cross-sectional survey. There are descriptions of demographic, clinical, and lifestyle aspects. In addition, the BDI-II is a tool for determining the severity of depression. Two hundred seventy-one patients participated in the survey, for a 95% response rate. Patients ranged in age from 18 to 84 years, with an average age of 47 years. The male-to-female ratio was approximately 1:1, and 59.4% of the patients were outpatients, 153 (56.5%) of whom had hematologic malignancies. Most cancer patients (n = 104, 38.4%) had minimal depression, while 22.5%, 22.1%, and 17.0% had mild, moderate, and severe depression, respectively. Education level, economic status, smoking status, and age were significantly associated with depression. The BDI-II is a useful instrument for monitoring depressive symptoms. The findings support the practice of routinely testing cancer patients for depressive symptoms as part of standard care and referring patients who are at a higher risk of developing psychological morbidity to specialists for treatment as needed.
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Affiliation(s)
- Maher Battat
- Bone Marrow Transplant and Leukemia Unit, An-Najah National University Hospital, Nablus, 44839, Palestine
| | - Nawal Omair
- Department of Hematology and Oncology, An-Najah National University Hospital, Nablus, 44839, Palestine
| | - Mohammad A WildAli
- Department of Hematology and Oncology, An-Najah National University Hospital, Nablus, 44839, Palestine
| | - Aidah Alkaissi
- Department of Nursing, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
| | - Riad Amer
- Department of Hematology and Oncology, An-Najah National University Hospital, Nablus, 44839, Palestine
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
| | - Amer A Koni
- Division of Clinical Pharmacy, Department of Hematology and Oncology, An-Najah National University Hospital, Nablus, 44839, Palestine
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
| | - Husam T Salameh
- Department of Hematology and Oncology, An-Najah National University Hospital, Nablus, 44839, Palestine.
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine.
| | - Sa'ed H Zyoud
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine.
- Poison Control and Drug Information Center (PCDIC), College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine.
- Clinical Research Center, An-Najah National University Hospital, Nablus, 44839, Palestine.
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Zhang MQ, Liu X, Huang Y. Does Mandala Art Improve Psychological Well-Being in Patients? A Systematic Review. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2024; 30:25-36. [PMID: 37668598 PMCID: PMC10801676 DOI: 10.1089/jicm.2022.0780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/06/2023]
Abstract
Objectives: Psychological disorders and symptoms are common and can significantly impair functioning in some areas in patients. We aimed to investigate the effects of mandala art (MA) on psychological well-being in patients. Design: A systematic review. Methods: We did a systematic review to assess the associations between MA and psychological well-being among patients. A systematic search of PubMed, EMBASE, Web of Science, CINAHL, PsycINFO, and Cochrane Central Register of Controlled Trial databases was conducted by independent reviewers from database inception to April 2023. We include randomized controlled trials, quasi-experimental studies, and qualitative studies. Outcome measures included any measurement of subjective and objective psychological well-being outcomes, such as stress, anxiety, depression, distress, mindfulness, hope, resilience, pain, mood, fatigue, and trauma symptoms. Results: Eleven studies of 405 participants were identified in the systematic review. Overall, the included studies provided preliminary evidence to suggest that MA may improve negative symptoms and hope, relieving pain, and reducing some physiological indicators of stress in patients. However, the quality of the existing evidence limited the generalization of results. Conclusions: According to the current evidence, the therapeutic benefits of using mandalas for improving the psychological well-being of patients are uncertain. More well-designed and high-quality studies in the field of MA are needed in the future.
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Affiliation(s)
- Meng-Qin Zhang
- Department of Gynecological Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Xing Liu
- Department of Gynecological Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Yan Huang
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
- Department of Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Chengdu, China
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Duimel SLL, Linn AJ, Smets EMA, Smit ES, van Weert JCM. Profiling Cancer Patients Based on Their Motives for Seeking Informational and Emotional Support Online. HEALTH COMMUNICATION 2023; 38:3223-3237. [PMID: 36415021 DOI: 10.1080/10410236.2022.2144287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Understanding why patients seek informational and/or emotional support online is fundamental to providing patients with accurate and reliable support that is tailored to their needs, preferences, and personal situation. Based on the stress and coping theory and uses and gratifications theory (UGT), this study aimed to identify theoretically-founded profiles of cancer patients differing in their motives for seeking informational and/or emotional support online, and to compare the profiles in terms of patients' psychological and background characteristics, and perception of health care services. Hierarchical cluster analysis was conducted, using questionnaire data from patients visiting a large Dutch health website (N = 181). This revealed three distinctive profiles, i.e., overall seekers (n = 83, 46.0%), occasional information seekers (n = 83, 46.0%), and contact exchangers (n = 15, 8.0%). Patients across these profiles differed in their eHealth literacy, with the contact exchangers being more eHealth literate than the overall seekers and occasional information seekers. The results can be used to create awareness among health care providers, web designers, and patient organizations on different types of cancer patients with different motives for seeking informational and/or emotional support online, and help them to tailor recommendations to and development of (online) sources that fit patients' needs. Future research could further investigate the integration of stress and coping theory with UGT by acknowledging the interplay of different coping strategies and different gratifications.
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Affiliation(s)
- Song L L Duimel
- Department of Communication, Amsterdam School of Communication Research/ASCoR, University of Amsterdam
| | - Annemiek J Linn
- Department of Communication, Amsterdam School of Communication Research/ASCoR, University of Amsterdam
| | - Ellen M A Smets
- Department of Medical Psychology, Amsterdam Public Health Research Institute, Cancer Center Amsterdam, Amsterdam University Medical Centers, University of Amsterdam
| | - Eline S Smit
- Department of Communication, Amsterdam School of Communication Research/ASCoR, University of Amsterdam
| | - Julia C M van Weert
- Department of Communication, Amsterdam School of Communication Research/ASCoR, University of Amsterdam
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Franzoi IG, Granieri A, Sauta MD, Agnesone M, Gonella M, Grimaldi C, Vallauri I, Boglione A, Vana F, Bergnolo P, Comandone A. The psychological impact of sarcoma on affected patients. Psychooncology 2023; 32:1787-1797. [PMID: 37930090 DOI: 10.1002/pon.6240] [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: 07/10/2023] [Revised: 10/09/2023] [Accepted: 10/20/2023] [Indexed: 11/07/2023]
Abstract
OBJECTIVE Sarcoma diagnosis and its treatment trajectory may deeply affect the somatopsychic balance of patients and their caregivers. This systematic review aimed at deepening the understanding of sarcoma's impact on the entire family unit involved in the illness experience on a physical (e.g. fatigue), psychological (e.g. mental health, affective regulation, defense mechanisms), and interpersonal (e.g. social isolation, loneliness) level. METHODS The systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The literature search led to the identification and subsequent inclusion of 44 articles focused on sarcoma patients. Results were classified into seven categories: Quality of Life, worries and distress, anxiety and depression, suicide ideation, financial and occupational consequences, unmet needs, and coping strategies. Our search identified only one study focusing on informal caregivers, thus we could not perform a systematic review on these results. RESULTS Our findings underlined the traumatic impact of the sarcoma diagnosis. Patients can experience an impoverished emotional life, somatization, social withdrawal, difficulty in decision-making, increased feelings of discouragement and demoralization, and profound experiences of helplessness and vulnerability. Moreover, they seemed to display anxiety and depression and might present a higher suicide incidence than the general population. CONCLUSION Our review highlighted that the psychosocial aftermath of sarcoma patients should guide institutions and healthcare professionals toward the design of assessment and intervention models that could contemplate the different dimensions of their suffering. Furthermore, it points out that there is still a lack of evidence regarding the psychosocial impact affecting sarcoma patients' caregivers.
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Affiliation(s)
| | | | | | - Monica Agnesone
- S.S Psychology, Local Health Authority "Città di Torino", Turin, Italy
| | - Marco Gonella
- Department of Psychology, University of Turin, Turin, Italy
- S.S Psychology, Local Health Authority "Città di Torino", Turin, Italy
| | | | - Irene Vallauri
- Department of Psychology, University of Turin, Turin, Italy
| | | | - Federica Vana
- Department of Oncology, San Giovanni Bosco Hospital, Turin, Italy
| | - Paola Bergnolo
- Department of Oncology, San Giovanni Bosco Hospital, Turin, Italy
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Battat M, Omair N, WildAli MA, Alkaissi A, Salameh HT, Amer R, Koni AA, Zyoud SH. Factors associated with palliative care symptoms in cancer patients in Palestine. Sci Rep 2023; 13:16190. [PMID: 37758820 PMCID: PMC10533841 DOI: 10.1038/s41598-023-43469-0] [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: 03/21/2023] [Accepted: 09/24/2023] [Indexed: 09/29/2023] Open
Abstract
Palliative care is critical to redundancy in cancer patients seeking to improve their quality of life. Evaluation should be incorporated into clinical practice routines at all stages of cancer. The Edmonton Symptom Assessment System (ESAS) was used to rate the intensity of ten symptom evaluations designed and validated for cancer patients in various languages and cultures. Therefore, the study aims to assess the symptoms reported using ESAS scores to identify patients who would benefit from palliative care that can improve the integration of palliative care into standard cancer care at An-Najah National University Hospital (NNUH). A cross-sectional study was selected for 271 cancer patients using a convenience sampling method at NNUH. Demographic, clinical, and lifestyle characteristics are described. Furthermore, patients' moderate to severe symptoms (score > 4) were obtained using ESAS-R. The survey consisted of 271 patients, with a response rate of 95%. The average age of the patients was 47 ± 17.7 years, ranging from 18 to 84 years. The male-to-female ratio was approximately 1:1, 59.4% of the patients were outpatients, and 153 (56.5%) had hematologic malignancies. Fatigue (62.7%) and drowsiness (61.6%) were the most common moderate to severe symptoms in ESAS. Furthermore, pain (54.6%), nausea (40.2%), lack of appetite (55.0%), shortness of breath (28.5%), depression (40.6%), anxiety (47.2%) and poor well-being (56.5%) were reported. In conclusion, fatigue and drowsiness were the most reported symptoms according to the ESAS scale among cancer patients, while moderate to severe symptoms were reported in cancer patients using the ESAS. The ESAS is a functional tool for assessing cancer patients' symptoms and establishing palliative care services.
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Affiliation(s)
- Maher Battat
- Bone Marrow Transplant and Leukemia Unit, An-Najah National University Hospital, Nablus, 44839, Palestine
| | - Nawal Omair
- Department of Hematology and Oncology, An-Najah National University Hospital, Nablus, 44839, Palestine
| | - Mohammad A WildAli
- Department of Hematology and Oncology, An-Najah National University Hospital, Nablus, 44839, Palestine
| | - Aidah Alkaissi
- Department of Nursing, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
| | - Husam T Salameh
- Department of Hematology and Oncology, An-Najah National University Hospital, Nablus, 44839, Palestine.
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine.
| | - Riad Amer
- Department of Hematology and Oncology, An-Najah National University Hospital, Nablus, 44839, Palestine
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
| | - Amer A Koni
- Division of Clinical Pharmacy, Department of Hematology and Oncology, An-Najah National University Hospital, Nablus, 44839, Palestine
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
| | - Sa'ed H Zyoud
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine.
- Poison Control and Drug Information Center (PCDIC), College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine.
- Clinical Research Center, An-Najah National University Hospital, Nablus, 44839, Palestine.
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Zhang B, Jin X, Kuang X, Shen B, Qiu D, Peng J, Chen E, Dai X, Chen X, Wong CL. Effects of a Virtual Reality-Based Meditation Intervention on Anxiety and Depression Among Patients With Acute Leukemia During Induction Chemotherapy: A Randomized Controlled Trial. Cancer Nurs 2023; Publish Ahead of Print:00002820-990000000-00104. [PMID: 36693237 DOI: 10.1097/ncc.0000000000001206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Emerging evidence supports that virtual reality (VR)-based meditation interventions may improve anxiety and depression among patients with cancer. However, empirical studies involving patients with acute leukemia during induction chemotherapy are limited. OBJECTIVE This study aimed to examine the effects of VR-based meditation intervention on alleviating anxiety and depression and improving the quality of life among patients with acute leukemia during induction chemotherapy. METHODS This randomized controlled trial recruited 63 patients newly diagnosed with acute leukemia. Participants were randomly assigned to an intervention group (received VR-based meditation for 20 min daily for 14 days) and a control group. Anxiety, depression, and quality of life were measured using the State Anxiety Inventory, the Center for Epidemiological Studies Depression Scale, and the Functional Assessment of Cancer Therapy-Leukemia Questionnaire, respectively. All outcomes were measured at baseline and post-intervention. RESULTS Compared with patients in the control group, those in the intervention group demonstrated a significantly greater reduction in anxiety (P = .04) and improvement in quality of life (P = .04). However, no significant difference was noted in depression levels between groups (P = .09), although a decreasing trend was observed in the intervention group. CONCLUSION Virtual reality-based meditation intervention effectively alleviated anxiety and improved the quality of life among acute leukemia patients during induction chemotherapy. Future randomized controlled trials with larger sample sizes and longer follow-up periods are warranted. IMPLICATION FOR PRACTICE Virtual reality-based meditation can be applied in clinical practice virtually anytime and anywhere to provide a convenient intervention for anxiety reduction for acute leukemia patients during induction chemotherapy.
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Affiliation(s)
- Bixia Zhang
- Author Affiliations: The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong (Dr Jin and Dr Wong); The Second Clinical College of Guangzhou University of Chinese Medicine (Ms Zhang); Nursing Department, Zhuhai Hospital of Guangdong Provincial Hospital of Traditional Chinese Medicine (Ms Kuang); Nursing Department, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine (Ms Zhang and Dr Shen); Nursing Department, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine and Guangdong Provincial Hospital of Traditional Chinese Medicine (Ms Qiu); and Department of Hematology and Oncology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine and Guangdong Provincial Hospital of Traditional Chinese Medicine (Ms Peng, Ms X Chen, Dr Dai, and Mr E Chen), China
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Factors Associated with the Breast Cancer Diagnostic Interval across Five Canadian Provinces: A CanIMPACT Retrospective Cohort Study. Cancers (Basel) 2023; 15:cancers15020404. [PMID: 36672357 PMCID: PMC9857089 DOI: 10.3390/cancers15020404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 01/02/2023] [Accepted: 01/04/2023] [Indexed: 01/11/2023] Open
Abstract
The cancer diagnostic process can be protracted, and it is a time of great anxiety for patients. The objective of this study was to examine inter- and intra-provincial variation in diagnostic intervals and explore factors related to the variation. This was a multi-province retrospective cohort study using linked administrative health databases. All females with a diagnosis of histologically confirmed invasive breast cancer in British Columbia (2007-2010), Manitoba (2007-2011), Ontario (2007-2010), Nova Scotia (2007-2012), and Alberta (2004-2010) were included. The start of the diagnostic interval was determined using algorithms specific to whether the patient's cancer was detected through screening. We used multivariable quantile regression analyses to assess the association between demographic, clinical and healthcare utilization factors with the diagnostic interval outcome. We found significant inter- and intra-provincial variation in the breast cancer diagnostic interval and by screen-detection status; patients who presented symptomatically had longer intervals than screen-detected patients. Interprovincial diagnostic interval variation was 17 and 16 days for screen- and symptom-detected patients, respectively, at the median, and 14 and 41 days, respectively, at the 90th percentile. There was an association of longer diagnostic intervals with increasing comorbid disease in all provinces in non-screen-detected patients but not screen-detected. Longer intervals were observed across most provinces in screen-detected patients living in rural areas. Having a regular primary care provider was not associated with a shorter diagnostic interval. Our results highlight important findings regarding the length of the breast cancer diagnostic interval, its variation within and across provinces, and its association with comorbid disease and rurality. We conclude that diagnostic processes can be context specific, and more attention should be paid to developing tailored processes so that equitable access to a timely diagnosis can be achieved.
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Yang Y, Huang Y, Dong N, Zhang L, Zhang S. Effect of telehealth interventions on anxiety and depression in cancer patients: A systematic review and meta-analysis of randomized controlled trials. J Telemed Telecare 2022:1357633X221122727. [PMID: 36062618 DOI: 10.1177/1357633x221122727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
INTRODUCTION Cancer patients not only experience a variety of problems associated with the treatment of their disease but also a range of psychological problems such as anxiety and depression, which may lead to reduced adherence to treatment and a lower quality of life for cancer patients. Telehealth interventions are widely used for cancer patients, and their effectiveness in improving anxiety and depression in cancer patients is variable and still contradictory. METHODS Embase, Pubmed, Web of Science, PsycINFO, CINAHL Complete, and the Cochrane Central Register of Controlled Trials were searched from inception to 19 April 2022. Data synthesis was conducted using STATA 15.0, and scores for anxiety and depression were calculated using standardized mean differences and 95% confidence intervals. RESULTS A total of 13125 cancer patients from 68 randomized controlled trials were included in the systematic evaluation. The meta-analysis showed that the telehealth intervention had a significant effect on anxiety (standardized mean differences = -0.40, 95% confidence intervals: -0.6 to 0.2, p < 0.001) and depression (standardized mean differences = -0.48, 95% confidence intervals: -0.67 to 0.28, p < 0.001) in patients with cancer. DISCUSSION Telehealth interventions significantly improved anxiety and depression levels in cancer patients compared to traditional care interventions. Breast cancer patients most often received telehealth interventions; electronic device-based and application-based telehealth interventions were more effective than online interventions; short-term interventions were more effective than medium-term and long-term interventions, and different outcome measurement tools led to different intervention outcomes. More high-quality research is needed to explore the effects of telehealth interventions.
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Affiliation(s)
- Yufan Yang
- 26452The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yingying Huang
- 26452The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Ning Dong
- 26452The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Liping Zhang
- 26452The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Shuanghong Zhang
- 26452The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
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The influence of socio-demographics and clinical characteristics on coping strategies in cancer patients: a systematic review. Support Care Cancer 2022; 30:8785-8803. [PMID: 35804175 DOI: 10.1007/s00520-022-07267-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 06/27/2022] [Indexed: 10/17/2022]
Abstract
OBJECTIVES Cancer is a frequent illness and a traumatic experience for both patients and their families. This systematic review aims to analyse studies that examine socio-demographic and clinical characteristics that predict the coping strategies in cancer patients. METHODS From January 2000 to March 2021, the database searches were conducted in 7 different databases, using relevant keywords. According to PRISMA Statements, full-text, peer-reviewed articles in English which used socio-demographics as independent variables and coping as dependent variables were included. RESULTS Of 1101 abstracts and titles, 30 full-text papers were included. Overall results showed a great influence of socio-demographic characteristics (such as women, younger, in a relationship, with high educational level, with active work status, and high income) on positive coping strategies adopted by cancer patients. Regarding clinical characteristics, no-metastatic patients who have recently been diagnosed, especially in the early stage of cancer, and who know the characteristics of their illness and treatments, more frequently used adaptive coping strategies. CONCLUSIONS Both socio-demographics and clinical characteristics showed considerable influence on the coping strategies adopted by patients in most of the investigations. These results supported the assessment of basic patients' information (sociodemographic and clinical characteristics) as fundamental to quickly outline an efficient, supportive, and holistic taking-over, before all the essential and in-depth considerations. TRIAL REGISTRATION This systematic review was recorded in PROSPERO with the registration number: CRD42021254776.
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Abbas Q, Arooj N, Baig KB, Khan MU, Khalid M, Shahzadi M. A clinical trial of cognitive behavior therapy for psychiatric comorbidity and quality of life with Cancer Patients during Chemotherapy (CPdC). BMC Psychiatry 2022; 22:222. [PMID: 35351037 PMCID: PMC8966166 DOI: 10.1186/s12888-022-03863-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 03/15/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Cancer is a common worldwide illness; it evokes psychological distress at different stages, during chemotherapy patient perceives a variety of psychiatric symptoms due to various medication side-effects and psychological distress. Studies have shown a significant impact of cognitive behavior therapy (CBT) in the management of psychiatric symptoms during chemotherapy. This study aims to investigate the effectiveness of CBT for depression, anxiety, stress, death anxiety, satisfaction with life, and self-esteem among cancer patients during chemotherapy (CPdC). METHODS Place and duration of the study: Department of Applied Psychology, Government College University Faisalabad in collaboration with Department of Oncology, Allied Hospital Faisalabad from November 20, 2020 and July 31, 2021. A total of 90 cancer patients were enrolled. 70 out of 90 met the eligibility criteria and 60 participants fulfilled all requirements. Participants were randomly allocated to four different groups. The pre-assessment screening was started along with the first trial of chemotherapy. The CBT-based treatment plan was formulated and one session per week was given to each patient for 3 to 4 months. Participants' age range was 18-65 years (M ± SD = 47.51 ± 12.36. Demographic form, Depression Anxiety and Stress Scale (DASS), Death Anxiety Scale (DAS), Satisfaction with Life Scale (SWLS), and Rosenberg Self-Esteem Scale (RSES) were administered. Descriptive, t-test, and repeated measure ANOVA statistics were used to investigate the findings. RESULTS Results indicated significant mean difference on the variable of depression, anxiety and stress across four conditions (i.e. F(2, 56) = 39.55, p < .000, η2 = .679; F(2,56) = 73.32, p < .000, η2 = .797; F(2,56) = 119.77, p < .000, η2 = .865 respectively). On death anxiety significant difference across four conditions was found (F(2,56) = 22.71, p < .000, η2 = .549) with large effect size. Furthermore, findings indicated significant mean difference on the variable of satisfaction with life and self-esteem across four conditions was found (F(2,56) = 22.05, p < .000, η2 = .542; F(2,56) = 36.19, p < .000, η2 = .660) with large effect size. CONCLUSION It is concluded that CBT played a very effective role to reduce depression, anxiety, and stress-related psychiatric symptoms. CBT reduces the level of death anxiety and improving the quality of life and level of self-esteem among CPdC. TRIAL REGISTRATION The study trial was registered in the Thai Clinical Trial Registry-TCTR ( TCTR20201113002 ).
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Affiliation(s)
- Qasir Abbas
- Department of Applied Psychology, Government College University Faisalabad, Zakid Block 1st floor, Main Campus, Faisalabad, Punjab, Pakistan.
| | - Nimra Arooj
- grid.411786.d0000 0004 0637 891XDepartment of Applied Psychology, Government College University Faisalabad, Zakid Block 1st floor, Main Campus, Faisalabad, Punjab Pakistan
| | - Khawer Bilal Baig
- Department of Professional Psychology, Bahria University Lahore Campus, Lahore, Pakistan
| | - Muhammad Umar Khan
- grid.411786.d0000 0004 0637 891XDepartment of Applied Psychology, Government College University Faisalabad, Zakid Block 1st floor, Main Campus, Faisalabad, Punjab Pakistan
| | - Muhammad Khalid
- grid.444767.20000 0004 0607 1811Department of Clinical Oncology, Medical University Faisalabad, Faisalabad, Punjab Pakistan
| | - Mafia Shahzadi
- grid.411786.d0000 0004 0637 891XDepartment of Applied Psychology, Government College University Faisalabad, Zakid Block 1st floor, Main Campus, Faisalabad, Punjab Pakistan
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12
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de Looper M, Smets EMA, Schouten BC, Bolle S, Belgers EHJ, Eddes EH, Leijtens JWA, van Weert JCM. The Patient Navigator: Can a systematically developed online health information tool improve patient participation and outcomes related to the consultation in older patients newly diagnosed with colorectal cancer? BMC Cancer 2022; 22:109. [PMID: 35078438 PMCID: PMC8788912 DOI: 10.1186/s12885-021-09096-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 09/23/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Older cancer patients may search for health information online to prepare for their consultations. However, seeking information online can have negative effects, for instance increased anxiety due to finding incorrect or unclear information. In addition, existing online cancer information is not necessarily adapted to the needs of older patients, even though cancer is a disease often found in older individuals. OBJECTIVE The aim of this study was to systematically develop, implement and evaluate an online health information tool for older cancer patients, the Patient Navigator, providing information that complements the consultation with healthcare providers. METHOD For the development and evaluation of the Patient Navigator, the four phases of the MRC framework were used. In the first and second phase the Patient Navigator was developed and pilot tested based on previous research and sub-studies. During the third phase the Patient Navigator was implemented in four Dutch hospitals. In the last phase, a pilot RCT was conducted to evaluate the Patient Navigator in terms of usage (observational tracking data), user experience (self-reported satisfaction, involvement, cognitive load, active control, perceived relevance of the tool), patient participation (observational data during consultation), and patient outcomes related to the consultation (questionnaire data regarding anxiety, satisfaction, and information recall). Recently diagnosed colorectal cancer patients (N = 45) were randomly assigned to the control condition (usual care) or the experimental condition (usual care + Patient Navigator). RESULTS The Patient Navigator was well used and evaluated positively. Patients who received the Patient Navigator contributed less during the consultation by using less words than patients in the control condition and experienced less anxiety two days after the consultation than patients in the control condition. CONCLUSION Since the Patient Navigator was evaluated positively and decreased anxiety after the consultation, this tool is potentially a valuable addition to the consultation for patients. Usage of the Patient Navigator resulted in patients using less words during consultations, without impairing patients' satisfaction, possibly because information needs might be fulfilled by usage of the Patient Navigator. This could create the possibility to personalize communication during consultations and respond to other patient needs.
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Affiliation(s)
- Melanie de Looper
- Amsterdam School of Communication Research/ASCoR, University of Amsterdam, 1018, Amsterdam, WV, Netherlands.
| | - Ellen M A Smets
- Department of Medical Psychology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - Barbara C Schouten
- Amsterdam School of Communication Research/ASCoR, University of Amsterdam, 1018, Amsterdam, WV, Netherlands
| | - Sifra Bolle
- Centre for Health and Society, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | | | - Eric H Eddes
- Department of Surgery, Deventer Hospital, Deventer, The Netherlands
- Dutch Institute of Clinical Auditing, Leiden, The Netherlands
| | | | - Julia C M van Weert
- Amsterdam School of Communication Research/ASCoR, University of Amsterdam, 1018, Amsterdam, WV, Netherlands
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Vos EL, Cho JS, Schmeltz J, Teri N, Law EB, Paisley K, Begue A, Loumeau H, Suozzo SH, Anderson-Dunkley L, Gardner GJ, Jewell E, Singer S, Abu-Rustum N, Jarnagin WR, Aguilar JG, Drebin J, Strong VE. Enhanced PAtient Clinical Streamlining (EPACS): Quality Initiative to Improve Healthcare for New Surgical Outpatient Visits. Ann Surg Oncol 2022; 29:1789-1796. [PMID: 34984565 PMCID: PMC8727070 DOI: 10.1245/s10434-021-11126-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Accepted: 10/14/2021] [Indexed: 12/20/2022]
Abstract
Purpose For patients who select a specialty hospital for cancer treatment, the wait time until the initial consultation leaves patients anxious and delays treatment. To improve quality of care, we implemented an enhanced patient clinical streamlining (EPACS) process that establishes an early connection and coordinates care before the first surgical outpatient visit at our specialty cancer center. Methods During a pre-visit EPACS phone call to new patients, an advanced practice provider (APP) collected medical history and ordered work-up tests or consultations if feasible. First visit cancellation rate, number of patients who started treatment, time to start of treatment, and satisfaction by the care team and patient were compared between patients treated with versus without EPACS. Results Among 5062 consecutive new patients, 720 (14%) received an EPACS call and 4342 did not (86%); work-up was ordered pre-visit in 34% and 16%, respectively. Fewer EPACS patients cancelled the first visit (4.6% vs. 12%, p < 0.001), more started treatment (55% vs. 50%, p = 0.037), and their time to treatment was shorter, but not significantly (median 17 vs. 19 days, p = 0.086). Patient interaction was considered to be improved by EPACS by 17 of 17 APPs and 14 of 16 surgeons, and outpatient clinic efficiency by 14 of 17 APPs and 13 of 16 surgeons. EPACS reduced anxiety and increased preparedness for the first visit in 29 of 31 patients. Conclusions EPACS improved effectiveness, timeliness, and physician and patient satisfaction with health care at our cancer center. Supplementary Information The online version contains supplementary material available at 10.1245/s10434-021-11126-3.
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Affiliation(s)
- Elvira L Vos
- Gastric and Mixed Tumor Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jessica S Cho
- Gastric and Mixed Tumor Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Joseph Schmeltz
- Technology Division, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Nick Teri
- Gastric and Mixed Tumor Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Ethel B Law
- Gastric and Mixed Tumor Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Kathleen Paisley
- Gastric and Mixed Tumor Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Aaron Begue
- Advanced Practice Providers Administration, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Helen Loumeau
- Hepatopancreatobiliary Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Sherri H Suozzo
- Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Latasha Anderson-Dunkley
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Ginger J Gardner
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Elizabeth Jewell
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Samuel Singer
- Gastric and Mixed Tumor Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Nadeem Abu-Rustum
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - William R Jarnagin
- Hepatopancreatobiliary Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Julio Garcia Aguilar
- Colorectal Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jeffrey Drebin
- Hepatopancreatobiliary Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Vivian E Strong
- Gastric and Mixed Tumor Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
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14
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Sefi S, Shoval G, Lubbad N, Goldzweig G, Hasson-Ohayon I. Coping With Information Style, Self-Concealment, Internalized Stigma, and Family Burden Among Parents of Children With Psychiatric Disorders. FAMILY PROCESS 2021; 60:1523-1538. [PMID: 33521955 DOI: 10.1111/famp.12637] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Parents of children with psychiatric disorders who are hospitalized in a psychiatric unit often experience family burden. Family burden has been found to be affected by many variables related to parents' personal traits and ways of reacting to the disorder. The current study examined the association between information coping styles (monitoring and blunting) and family burden, among parents of children who were hospitalized in a day care unit. The possible role of self-stigma as a mediator between coping style and family burden and the role of self-concealment as a moderator between coping style and self-stigma were examined. A total of 41 parents completed questionnaires assessing their levels of self-stigma, information coping style, self-concealment, and family burden. Self-stigma was found to mediate the positive association between the monitoring coping style and family burden. Moreover, a moderation effect of self-concealment was found, indicating that monitoring parents suffered from higher levels of self-stigma particularly if they had a high tendency toward self-concealment. Taking into account parents' information, coping style, self-stigma, and self-concealment can help professionals tailor family interventions according to parents' diverse needs. A monitoring coping style may not be beneficial especially when combined with concealment, suggesting the need to promote other coping styles.
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Affiliation(s)
- Shir Sefi
- Department of Psychology, Bar-Ilan University, Ramat Gan, Israel
| | - Gal Shoval
- Child and Adolescent Division, Geha Mental Health Center, Petah Tikva, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Nesrin Lubbad
- Child and Adolescent Division, Geha Mental Health Center, Petah Tikva, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Gil Goldzweig
- School of Behavioral Sciences, The Academic College of Tel Aviv-Yaffo, Tel Aviv-Yaffo, Israel
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15
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Mason TB, Smith KE. Delineating the role of binge eating in cancer research. Eat Weight Disord 2021; 26:2109-2116. [PMID: 33201393 DOI: 10.1007/s40519-020-01066-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 10/26/2020] [Indexed: 12/26/2022] Open
Abstract
PURPOSE Binge eating is defined as consumption of a large amount of food accompanied by a sense of loss of control over eating. While binge eating is associated with poor physical, behavioral, and psychosocial health, it has not been studied in cancer research. Therefore, the overarching goal of this review is to delineate the role of binge eating in cancer research and to spur new research in this area. Specifically, in this review, we outlined (1) binge eating as a possible risk factor that contributes to cancer risk, (2) how binge eating may develop after cancer diagnosis, and (3) how binge eating may be associated with health and relapse during survivorship. CONCLUSIONS It is critical to elucidate the role of binge eating in the prevention of cancer and long-term cancer survivorship. This review suggested a number of ways that binge eating may increase risk for cancer as well as several pathways that may lead to the development of binge eating after cancer diagnosis. LEVEL OF EVIDENCE Level V: narrative review.
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Affiliation(s)
- Tyler B Mason
- Department of Preventive Medicine, University of Southern California, 2001 Soto St., Los Angeles, CA, 90032, USA.
| | - Kathryn E Smith
- Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, CA, USA
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16
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Arena A, Orsini B, Degli Esposti E, Manzara F, Ambrosio M, Raimondo D, Lenzi J, Casadio P, Seracchioli R. The unbearable burden of endometriosis: Results from a large cohort about anxiety reduction during the first outpatient evaluation. J Psychosom Res 2021; 147:110512. [PMID: 34020342 DOI: 10.1016/j.jpsychores.2021.110512] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 05/09/2021] [Accepted: 05/12/2021] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To evaluate the impact of the first outpatient evaluation on anxiety levels in women with suspected endometriosis. Secondarily, we investigated which individual characteristics exerted the greatest influence on distress levels. METHODS Women referred to our academic center between January 2019 and March 2020 on the suspicion of endometriosis were enrolled in this prospective, observational study. Before the visit, participants answered questionnaires such as the Generalized Anxiety Disorder-7 (GAD) and the Spielberg State Trait Anxiety Inventory (STAI) Y6. After the visit, the STAI-Y6 was resubmitted to each woman, along with the Patient Global Impression of Improvement (PGII) questionnaire. Women's and physicians' satisfaction with the visit were also evaluated using a 5-point scale. RESULTS One hundred and four women were enrolled. Anxiety levels decreased after the evaluation (STAI-Y6 60.0 ± 15.0 vs 40.8 ± 14.2, P < .001). Higher reductions were noted in patients who had higher baseline anxiety levels (est. change -24.3; 95% CI -29.2, -19.5; P < .001), had previously sought information online (est. change -15.9; 95% CI -21.4, -10.5; P < .001), and when endometriosis was not confirmed, but not in those waitlisted for surgery (est. change 1.7; 95% CI -5.9, 9.2; P 0.659). Most patients' mood improved after the examination (67%) and were satisfied with the visit (98%). CONCLUSIONS Anxiety levels are reduced after medical examination in women with higher baseline distress and who sought information online. To create a trustful relationship with women, providing them with tailored counselling, seems essential to improve their psychological wellbeing.
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Affiliation(s)
- Alessandro Arena
- Gynecology and Human Reproduction Physiopathology, Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Via Massarenti, 13, IRCCS, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Benedetta Orsini
- Gynecology and Human Reproduction Physiopathology, Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Via Massarenti, 13, IRCCS, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Eugenia Degli Esposti
- Gynecology and Human Reproduction Physiopathology, Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Via Massarenti, 13, IRCCS, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
| | - Federica Manzara
- Gynecology and Human Reproduction Physiopathology, Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Via Massarenti, 13, IRCCS, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Marco Ambrosio
- Gynecology and Human Reproduction Physiopathology, Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Via Massarenti, 13, IRCCS, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Diego Raimondo
- Gynecology and Human Reproduction Physiopathology, Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Via Massarenti, 13, IRCCS, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Jacopo Lenzi
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum - University of Bologna, 40138 Bologna, Italy
| | - Paolo Casadio
- Gynecology and Human Reproduction Physiopathology, Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Via Massarenti, 13, IRCCS, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Renato Seracchioli
- Gynecology and Human Reproduction Physiopathology, Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Via Massarenti, 13, IRCCS, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
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17
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de Looper M, van Weert JCM, Schouten BC, Bolle S, Belgers EHJ, Eddes EH, Smets EMA. The Influence of Online Health Information Seeking Before a Consultation on Anxiety, Satisfaction, and Information Recall, Mediated by Patient Participation: Field Study. J Med Internet Res 2021; 23:e23670. [PMID: 34255657 PMCID: PMC8290326 DOI: 10.2196/23670] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 12/04/2020] [Accepted: 01/31/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Today, many cancer patients engage in online health information seeking (OHIS). However, little is known about how patients differ in their OHIS levels. In addition, OHIS might influence patient participation during a consultation with a physician, which might mediate the effects on patient outcomes. OBJECTIVE The aim of this study is twofold: first, to provide insight into which personal characteristics and psychosocial factors affect patients' OHIS levels and, second, to test the hypothesis that the effects of OHIS on patient outcomes are mediated by patient participation during the consultation. METHODS Patient participation was operationalized in terms of patients' absolute word count; the relative contribution of the patient, compared with the health care provider; and the number of questions and assertions expressed during the consultation. The patient outcomes measured were anxiety after the consultation, satisfaction with the consultation, and information recall. Participants in this study were patients recently diagnosed with colorectal cancer recruited from 6 hospitals in the Netherlands (n=90). Data were collected using questionnaires and audio-recorded consultations of patients with health care providers before their surgery. RESULTS The results showed that younger patients, higher educated patients, patients with a monitoring coping style, and patients who experienced more cancer-related stress engaged more in OHIS. In turn, OHIS was related to patient participation in terms of the patient's absolute word count but not to the relative contribution to the consultation or expressing questions and assertions. We did not find a relation between OHIS and anxiety and OHIS and recall mediated by patient participation. However, we found that patients' absolute word count significantly mediated the positive association between OHIS and patients' satisfaction with the consultation. CONCLUSIONS Results indicate positive implications of OHIS for patients' care experience and, therefore, the importance of helping patients engage in OHIS. However, the results also suggest that OHIS is only successful in increasing a single aspect of patient participation, which might explain the absence of relations with anxiety and recall. The results suggest that more beneficial effects on patient outcomes may be achieved when health care providers support patients in OHIS.
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Affiliation(s)
- Melanie de Looper
- Amsterdam School of Communication Research, University of Amsterdam, Amsterdam, Netherlands
| | - Julia C M van Weert
- Amsterdam School of Communication Research, University of Amsterdam, Amsterdam, Netherlands
| | - Barbara C Schouten
- Amsterdam School of Communication Research, University of Amsterdam, Amsterdam, Netherlands
| | | | | | - Eric H Eddes
- Deparment of Surgery, Deventer Hospital, Deventer, Netherlands
| | - Ellen M A Smets
- Department of Medical Psychology, Amsterdam UMC, Amsterdam Public Health, Amsterdam, Netherlands
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18
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Beatty L, Kemp E, Turner J, Butow P, Milne D, Yates P, Lambert S, Wootten A, Koczwara B. Moderators of intervention efficacy for Finding My Way: A web-based psychosocial intervention for cancer-related distress. Support Care Cancer 2021; 29:7669-7678. [PMID: 34142280 DOI: 10.1007/s00520-021-06291-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 05/11/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE The present analysis explores whether demographic, psychosocial, or intervention adherence factors moderated treatment efficacy of Finding My Way (FMW), an efficacious self-directed web-based psychosocial program for newly diagnosed curatively treated cancer patients. METHODS Participants (n = 191) completed a 6-module intervention (n = 94) or attention-control (n = 97) program. Outcome measures were completed at baseline (T0), post-program (T1), 3-month (T2), and 6-month (T3) follow ups. Age, gender, social support, information processing style (monitoring vs blunting), emotion-regulation difficulties, and intervention adherence were examined as potential moderators. RESULTS Age moderated emotional functioning and general distress at T3 with significant intervention benefits only observed in younger participants; age moderated cognitive functioning at T1, with intervention benefits only found in older participants. Gender moderated helplessness/hopelessness, emotional functioning, and cognitive avoidance at T1 with men benefitting more from receiving the intervention vs control. Monitoring information-processing style moderated cancer distress and anxious preoccupation at T3: higher monitors benefitted more from receiving the intervention vs control. Program adherence moderated global QOL, emotional functioning and social functioning at T2 and T3; cognitive avoidance (T1), anxious preoccupation (T2) and role function (T3), with those who completed more of the program benefitting more if they received the intervention than control. Emotion dysregulation and social support each moderated role function at T2, with those more dysregulated and less socially supported benefitting more if they received the intervention than control. CONCLUSIONS For select outcomes, FMW is more effective for patients with specific characteristics; these findings can inform future tailoring and targeting of online programs for cancer-distress.
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Affiliation(s)
- Lisa Beatty
- Flinders University, Adelaide, Australia.
- Flinders Medical Centre, Adelaide, Australia.
| | - Emma Kemp
- Flinders University, Adelaide, Australia
- Flinders Medical Centre, Adelaide, Australia
| | - Jane Turner
- University of Queensland, Brisbane, Australia
| | | | - Donna Milne
- Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Patsy Yates
- Queensland University of Technology, Brisbane, Australia
| | | | | | - Bogda Koczwara
- Flinders University, Adelaide, Australia
- Flinders Medical Centre, Adelaide, Australia
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Fatigante M, Zucchermaglio C, Alby F. Being in Place: A Multimodal Analysis of the Contribution of the Patient's Companion to "First Time" Oncological Visits. Front Psychol 2021; 12:664747. [PMID: 34149558 PMCID: PMC8209470 DOI: 10.3389/fpsyg.2021.664747] [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: 02/05/2021] [Accepted: 04/22/2021] [Indexed: 11/13/2022] Open
Abstract
Companions to medical visits have been alternatively viewed as members who “support” or “inhibit” and “interfere” with the doctor-patient interaction. One way of looking at the companions' contribution to medical visits is by coding roles or functions of their communicative behavior. Our paper aims at reconsidering these findings and analyzing how the companion participation is a local and sequential accomplishment, changing from time to time in the consultation. The paper relies upon an overall collection of 58 videorecordings of first oncological visits. Visits were conducted in two different hospitals, one of which a University hospital, and by different oncologists, including both senior professionals and (in the second setting) medical students in oncology. Visits were fully transcribed according to the Jeffersonian conventions and authors examined the transcripts and video according to the methodology of Conversation Analysis. The aim of the paper focused on how patient's companions orient and contribute to the accomplishment of the different aims and activities at different stages of the visit as an institutional speech event. The multimodal analysis of turns and actions (such as, gaze shifts, prosodic modulation, bodily arrangements), and the close examination of the sequential and temporal arrangements of companions' and their co-participants' turns revealed that companions finely attune to the multiparty framework of the encounter and the institutional constraints that govern the oncological first visit. Overall, results show two relevant features: that companions act as to preserve the doctor-patient interaction and to maintain the patient as the most responsible and legitimate agent in the interaction; that companions' contributions are relevant to the activities that sequentially unfold at different stages in the consultation (e.g., history taking, problem presentation, treatment recommendation etc.). The study complements earlier findings on the companion's roles, showing how these are highly mobile, multimodal and multiparty accomplishments, and they are tied to the specific contingencies of the visit. The results solicit to consider the value of multimodal analysis in understanding the complexity of multiparty communication in medical setting, and make it usable also in medical education.
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Affiliation(s)
- Marilena Fatigante
- Department of Social and Developmental Psychology, Sapienza University of Rome, Rome, Italy
| | - Cristina Zucchermaglio
- Department of Social and Developmental Psychology, Sapienza University of Rome, Rome, Italy
| | - Francesca Alby
- Department of Social and Developmental Psychology, Sapienza University of Rome, Rome, Italy
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20
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Gutiérrez-Hermoso L, Velasco-Furlong L, Sánchez-Román S, Berzal-Pérez E, Alcocer-Castillejos N, Quiroz-Friedman P. The effect of treatment and coping on the quality of life in breast cancer patients: a moderated mediation model. Qual Life Res 2021; 31:147-158. [PMID: 34024017 DOI: 10.1007/s11136-021-02885-3] [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] [Accepted: 05/15/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE Breast cancer involves complicated emotional processes. One of the factors that impacts the psychological symptoms and decreases QoL is the side effects of treatment. The purpose of this study is to explore the effect of the main medical treatment (chemotherapy or hormone therapy) on the three domains of quality of life. For this, coping strategies were considered as psychological variables that mediate the relationship based on high or low alexithymia as a moderating variable. METHODS This study had a cross-sectional design. The participant sample comprised 129 women with breast cancer in early stage (I to III) (63 receiving chemotherapy and 66 hormone therapy) and were evaluated from September 2015 to September 2019. Physical, emotional and social functioning were measured by the Quality of Life Questionnaire for cancer patients (EORTC-QLQ-C30), coping strategies were measured by Mental Adjustment to Cancer Questionnaire (MAC) and alexithymia was evaluated by the Alexithymia Toronto Scale (TAS-20). RESULTS Treatment had a significant negative effect on physical domain in both patients receiving chemotherapy and hormone therapy. Moderated mediation analysis show that this relationship was significant when it was mediated by helplessness. Furthermore, this model is only significant when there are high levels of alexithymia. No significant effect direct was found on emotional and social functioning of quality of life. CONCLUSIONS Results confirmed that coping based on helplessness and stable emotional variables such as alexithymia can have an effect, mediator or moderator, respectively, in the decrease of the physical functionality of women with breast cancer. Our findings highlight the need to include psychological therapy to help patients alleviate their psychological state because it can affect their physical condition.
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Affiliation(s)
| | | | - Sofía Sánchez-Román
- Department of Neurology and Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City, Mexico
| | | | - Natasha Alcocer-Castillejos
- Department of Neurology and Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City, Mexico
| | - Paulina Quiroz-Friedman
- Department of Neurology and Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City, Mexico
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21
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Civilotti C, Botto R, Maran DA, Leonardis BD, Bianciotto B, Stanizzo MR. Anxiety and Depression in Women Newly Diagnosed with Breast Cancer and Waiting for Surgery: Prevalence and Associations with Socio-Demographic Variables. ACTA ACUST UNITED AC 2021; 57:medicina57050454. [PMID: 34066935 PMCID: PMC8148592 DOI: 10.3390/medicina57050454] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 04/26/2021] [Accepted: 05/04/2021] [Indexed: 12/17/2022]
Abstract
Background and Objectives: Cancer is a threatening-life disease with a significant psychological burden. The psychological morbidity varies according to the phases of the illness and is influenced by multiple socio-demographic factors, that are useful to consider in order to identify the categories of patients most at risk of developing psychiatric disorders. The present study analyzes, in a sample of women newly diagnosed with breast cancer, the relationships between their levels of anxiety and depression and several socio-demographic characteristics. The study was cross-sectional. Materials and Methods: Four hundred and seventy eight women newly diagnosed with breast cancer completed the Hospital Anxiety and Depression Scale during the pre-surgical phase. Results: Findings show that almost 40% of the sample had clinically relevant anxious symptoms and about a quarter of the sample had significant depressive symptoms. Their prevalence was higher in widows. Moreover, depressive symptoms were higher in older women and anxious symptoms were higher in patients with a lower educational level. In the pre-surgical phase, women can suffer from clinically relevant anxiety and depression, especially the widows, older women, and women with a lower educational level. Conclusions: Identifying the most psychologically vulnerable patients, due to specific socio-demographic characteristics, is essential in order to provide adequate psycho-oncological treatments to the categories of patients, who are most at risk of developing psychopathological concerns.
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Affiliation(s)
- Cristina Civilotti
- Department of Psychology, Università di Torino, 10124 Torino, Italy; (C.C.); (B.B.)
| | - Rossana Botto
- Clinical Psychology Unit, Department of Neuroscience, University of Turin, “Città della Salute e della Scienza” Hospital of Turin, 10126 Turin, Italy; (R.B.); (B.D.L.); (M.R.S.)
| | - Daniela Acquadro Maran
- Department of Psychology, Università di Torino, 10124 Torino, Italy; (C.C.); (B.B.)
- Correspondence: ; Tel.: +39-011-6702262
| | - Brigitta De Leonardis
- Clinical Psychology Unit, Department of Neuroscience, University of Turin, “Città della Salute e della Scienza” Hospital of Turin, 10126 Turin, Italy; (R.B.); (B.D.L.); (M.R.S.)
| | - Beatrice Bianciotto
- Department of Psychology, Università di Torino, 10124 Torino, Italy; (C.C.); (B.B.)
| | - Maria Rosa Stanizzo
- Clinical Psychology Unit, Department of Neuroscience, University of Turin, “Città della Salute e della Scienza” Hospital of Turin, 10126 Turin, Italy; (R.B.); (B.D.L.); (M.R.S.)
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Sterponi L, Zucchermaglio C, Fantasia V, Fatigante M, Alby F. A room of one's own: Moments of mutual disengagement between doctor and patient in the oncology visit. PATIENT EDUCATION AND COUNSELING 2021; 104:1116-1124. [PMID: 33172737 DOI: 10.1016/j.pec.2020.10.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Revised: 09/22/2020] [Accepted: 10/16/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE This paper examines a previously neglected phenomenon in doctor-patient interaction studies, i.e. the achievement of mutual disengagement-a specific state of coordination, in which participants suspend reciprocal gaze and turn into separate axes of involvement. In the specialized setting of the oncology visit, which we consider in this study, mutual disengagement is linked to important tasks that the oncologist has to carry out, notably the scrutiny of the histological exam during the diagnostic assessment phase. METHODS Our data corpus includes 56 video-recorded oncology visits. We employ conversation analysis to discern how mutual disengagement is achieved, sustained and ended. RESULTS Our analysis shows that suspension of mutual engagement is a joint accomplishment that requires intersubjective cooperation. It also reveals that when talk and reciprocal engagement are suspended, intersubjective alignment is more vulnerable to breakdown. CONCLUSION Our findings eschew a characterization of the oncologist as solo arbiter of the interactional exchange. An alignment with the patient is key to the felicitous accomplishment of the visit. We also suggest that a successful medical encounter is not only characterized by harmonious verbal communication, between doctor and patient, but also by felicitous pauses in their joint engagement. PRACTICE IMPLICATIONS In building a room of one's own, the oncologist has the responsibility to co-construct with the patient an experience of interactional attunement and mutual understanding.
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Affiliation(s)
- Laura Sterponi
- University of California, Berkeley, Institute of Human Development and Graduate School of Education, 2121 Berkeley Way, Berkeley, CA, 94720, United States.
| | - Cristina Zucchermaglio
- University of Rome, La Sapienza, Department of Social and Developmental Psychology, Via dei Marsi 78, 00185, Rome, Italy
| | - Valentina Fantasia
- University of Rome, La Sapienza, Department of Social and Developmental Psychology, Via dei Marsi 78, 00185, Rome, Italy
| | - Marilena Fatigante
- University of Rome, La Sapienza, Department of Social and Developmental Psychology, Via dei Marsi 78, 00185, Rome, Italy
| | - Francesca Alby
- University of Rome, La Sapienza, Department of Social and Developmental Psychology, Via dei Marsi 78, 00185, Rome, Italy
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Bandinelli L, Ornell F, von Diemen L, Kessler FHP. The Sum of Fears in Cancer Patients Inside the Context of the COVID-19. Front Psychiatry 2021; 12:557834. [PMID: 33897477 PMCID: PMC8058213 DOI: 10.3389/fpsyt.2021.557834] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 02/27/2021] [Indexed: 12/14/2022] Open
Abstract
The pandemic resulting from COVID-19 has led to the collapse of the health system in dozens of countries. Parallel to clinical risk, the appearance or intensification of psychiatric symptoms has also been documented. The identification of groups at risk is essential for the establishment of preventive and therapeutic strategies. Cancer patients appear to be especially vulnerable both from a clinical and psychiatric perspective. Problems related to contamination and the cancer treatments themselves are intertwined, causing a sum of patients' fears to arise, which can cause mental effects. This study aims to review and investigate the impact of COVID-19 on the mental health of cancer patients and indicate possible support strategies.
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Affiliation(s)
- Lucas Bandinelli
- Postgraduate Program in Psychology, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
- Developmental Cognitive Neuroscience Lab (DCNL), Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Felipe Ornell
- Center for Drug and Alcohol Research and Collaborating Center on Alcohol and Drugs, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Lisia von Diemen
- Center for Drug and Alcohol Research and Collaborating Center on Alcohol and Drugs, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Queen's University Department of Psychiatry, Providence Care Hospital, Kingston, ON, Canada
| | - Felix Henrique Paim Kessler
- Center for Drug and Alcohol Research and Collaborating Center on Alcohol and Drugs, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Kohei K, Toyohiro H, Jun T, Toshiyuki I, Hiromi NT, Yuji K, Naoki N, Michiko K, Shigeru M. Efficacy of attention bias modification combined with cognitive behavioral therapy for reducing anxiety in patients with hematopoietic malignancies: a quasi-randomized controlled trial. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021. [DOI: 10.1016/j.jadr.2021.100122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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25
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Yakar HK, Yilmaz B, Ozkol O, Gevher F, Celik E. Effects of art-based mandala intervention on distress and anxiety in cancer patients. Complement Ther Clin Pract 2021; 43:101331. [PMID: 33592551 DOI: 10.1016/j.ctcp.2021.101331] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 01/27/2021] [Accepted: 02/02/2021] [Indexed: 12/22/2022]
Abstract
OBJECTIVE This study was planned to determine the effect of art-based mandala intervention on the distress and anxiety experienced by cancer patients. METHODS This semi-experimental study with a single group pretest-posttest design was performed with 12 breast cancer survival patients. The data were collected through "Patient Diagnostic Form", "Distress Thermometer", "Trait Anxiety Inventory". Patients participated in the "Art-Based Mandala Interventıon" for eight weeks, one day a week, 2 h each. The distress and anxiety levels of the patients were measured before starting the program and at the end of the program. RESULTS Cancer patients experienced moderate level of anxiety (50.66 ± 6.91) and clinically significant distress (4.08 ± 2.74). Anxiety scores of cancer patients decreased significantly after the program compared to before the program (p < 0.05). The distress scores of cancer patients increased after the program compared to before the program (p > 0.05). CONCLUSION After the art-based mandala intervention program, anxiety scores of breast cancer survival patients decreased, and distress scores increased.
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Affiliation(s)
- Hatice Karabuga Yakar
- Faculty of Health Sciences, Department of Nursing, Marmara University, Istanbul, Turkey.
| | - Banu Yilmaz
- Mandala Meditation Therapy Specialist, Bachelor of Arts in Human Behavior, Newport International University, California, United States
| | - Ozan Ozkol
- License Graduated Nurse, Faculty of Health Sciences, Department of Nursing, Marmara University, Istanbul, Turkey
| | - Fadime Gevher
- License Graduated Nurse, Faculty of Health Sciences, Department of Nursing, Marmara University, Istanbul, Turkey
| | - Emine Celik
- License Graduated Nurse, Faculty of Health Sciences, Department of Nursing, Marmara University, Istanbul, Turkey
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Mercês CAMF, Souto JDSS, Souza PAD, Chagas MC, Weiss C, Benevides AB, Brandão MAG. Análise simultânea dos conceitos de ansiedade e medo: contribuições para os diagnósticos de enfermagem. ESCOLA ANNA NERY 2021. [DOI: 10.1590/2177-9465-ean-2020-0189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Objetivos Realizar a análise simultânea dos conceitos de ansiedade e medo. Método Análise simultânea de conceitos com base nas nove etapas propostas por Haase, Leidy, Coward, Britt e Penn. Resultados 43 artigos foram incluídos a partir de uma busca em cinco bases de dados. 51 atributos, 26 antecedentes e 10 consequentes foram identificados a partir da análise destes conceitos. Esta análise revelou que a ansiedade e o medo são conceitos subjetivos, multidimensionais e com altos graus de abstração. Conclusão A análise simultânea da ansiedade e do medo possibilitou o refinamento destes diagnósticos e a proposição de modificações em seus componentes. Implicações para a prática A análise destes conceitos possibilitará a identificação precisa destes fenômenos na prática clínica, proporcionando maior acurácia diagnóstica.
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27
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Conversano C, Di Giuseppe M, Miccoli M, Ciacchini R, Di Silvestre A, Lo Sterzo R, Gemignani A, Orrù G. Retrospective Analyses of Psychological Distress and Defense Style Among Cancer Patients. CLINICAL NEUROPSYCHIATRY 2020; 17:217-224. [PMID: 34908997 PMCID: PMC8629055 DOI: 10.36131/cnfioritieditore20200403] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Psychological distress is common in cancer patients during the diagnostic phase. Research demonstrated that anxiety, depression and defense mechanisms may influence physical and psychological well-being in patients with malignant tumors. The present retrospective study investigated the associations between clinical and psychological characteristics of cancer patients waiting for the diagnosis, focusing on metastatic cancer (MC) and breast cancer (BC). METHOD Patients with a new diagnosis of cancer referring to a Clinical Oncology Unit in Central Italy were interviewed during the 2017 for psychological assessment. Double-blind information about anxiety, depression, sleep disorders, defense style, and cancer diagnosis were available for the 567 patients included in this study. T-test, chi-squared and regression analyses were performed to detect associations between psychological variables and the presence of metastasis (MC) in the whole sample and in the subgroup of breast cancer (BC) patients. RESULTS Female gender and younger age were associated with anxiety, depression, and maladaptive defense style. A significant positive relationship was found between presence of metastasis and symptoms of anxiety. Depression resulted significantly more frequent in BC, while there was a trend close to statistical significance in MC. Immature defense style was widely used by BC women, with a score close to statistical significance. CONCLUSIONS This retrospective study provided empirical evidence of the relationship between psychological functioning and clinical characteristics of cancer. In line with previous research, our findings confirmed the peculiar psychological functioning of BC patients. Further investigations are needed to understand how the diagnosis of cancer may influence the individual psychological functioning and vice versa.
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Affiliation(s)
- Ciro Conversano
- Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, Italy
| | - Mariagrazia Di Giuseppe
- Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, Italy
| | - Mario Miccoli
- Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - Rebecca Ciacchini
- Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, Italy
| | | | | | - Angelo Gemignani
- Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, Italy
| | - Graziella Orrù
- Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, Italy
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Fatigante M, Heritage J, Alby F, Zucchermaglio C. Presenting treatment options in breast cancer consultations: Advice and consent in Italian medical care. Soc Sci Med 2020; 266:113175. [PMID: 32987310 DOI: 10.1016/j.socscimed.2020.113175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 06/11/2020] [Accepted: 06/25/2020] [Indexed: 01/05/2023]
Abstract
Variety, complexity and uncertainty in the therapy outcomes of cancer illness make the treatment recommendation (TR) in oncology a "monumentally difficult task". Previous studies have distinguished unilateral and bilateral formats of treatment recommendations, accordingly to whether, or to what extent, the patient's perspective is included in the consideration of therapeutic options. Others have also shown how the oncologists' presentation of therapeutic options varied accordingly to the severity of the diagnosis and the availability of alternatives. Yet, no study has systemically dentified and compared components of treatment recommendation in oncology on a common set of patients and clinicians. This paper analyzes how different options in breast cancer treatments - radiotherapy, hormone therapy and chemotherapy - are presented and discussed in a set of 12 first post-surgical breast cancer visits carried out by two oncologists of high experience and seniority in two Italian hospitals. Treatment recommendation sequences involving these three option types were analyzed using the methods of conversation analysis. They were also coded for the mention of side effects and treatment burden, and for whether consent to the recommendation was invited, or expressed by the patient. Results show that radiotherapy is presented as presupposed as an extension of surgery and is not further discussed, and hormone therapy is delivered as good news and as not implying any health or lifestyle burdens. Treatment burdens were raised in the much more extensive discussions of chemotherapy, which were also accompanied by a higher chance that the patient was asked for consent to therapy. Implications are drawn as regards the extent to which clinical practice meets theory in communication protocols available in oncology, and how to consider the doctor-patient partnership and the concept of shared decision-making in such an encounter.
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Affiliation(s)
- Marilena Fatigante
- Department of Social and Developmental Psychology, University Sapienza of Rome, Rome, Italy.
| | - John Heritage
- Department of Sociology, University of California, Los Angeles, USA
| | - Francesca Alby
- Department of Social and Developmental Psychology, University Sapienza of Rome, Rome, Italy
| | - Cristina Zucchermaglio
- Department of Social and Developmental Psychology, University Sapienza of Rome, Rome, Italy
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Bol N, Linn AJ, Smets EM, Verdam MG, van Weert JC. Tailored communication for older patients with cancer: Using cluster analysis to identify patient profiles based on information needs. J Geriatr Oncol 2020; 11:944-950. [DOI: 10.1016/j.jgo.2020.01.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 11/20/2019] [Accepted: 01/06/2020] [Indexed: 02/07/2023]
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Zimmermann FF, Burrell B, Jordan J. Patients' experiences of a mindfulness intervention for adults with advanced cancer: a qualitative analysis. Support Care Cancer 2020; 28:4911-4921. [PMID: 32016601 DOI: 10.1007/s00520-020-05331-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 01/28/2020] [Indexed: 12/15/2022]
Abstract
PURPOSE People with advanced cancer often experience significant emotional turmoil that accompanies their diagnosis and cancer-related treatments. Therefore, psychological interventions become relevant to address these impacts; however, there is a lack of research into the psychological support needs of those with advanced cancer (those not yet in palliative or end-of-life stages). In this context, we developed a mindfulness-based intervention, Coping with Cancer Mindfully (CCM), to provide psychological and emotional support to adults with advanced cancer. This article reports on qualitative interviews from a mixed method study of the CCM intervention exploring its utility and the extent it provides psychological support to this population in a pre-post-intervention design. METHODS Adults with advanced cancer (stage III or IV) were recruited via cancer-related services in Christchurch, New Zealand. Thematic analysis was used to analyse the semi-structured interviews. RESULTS Twenty participants were interviewed. Thematic analysis showed that at baseline, participants were experiencing distress but few had been offered psychological support; they reported feeling vulnerable and battling their cancers, and were seeking help. Post-intervention interviews reported that most participants' perspectives had shifted, from a state of vulnerability to one of self-encouragement, increased optimism, and taking new actions regarding their situations. The CCM intervention was identified as a readily available and positive tool of support. CONCLUSIONS Our findings suggest that those with advanced cancer should be offered options of psychological support at any stage post-diagnosis. At such an intense period in their lives, people with advanced cancer are likely to benefit from tailored psychological interventions. The CCM intervention with its focus on acceptance, meaning in life, and mindful coping has been shown to be acceptable to participants and as a supportive tool.
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Affiliation(s)
- Fernanda F Zimmermann
- Centre for Postgraduate Nursing Studies, University of Otago, Christchurch, New Zealand.
| | - Beverley Burrell
- Centre for Postgraduate Nursing Studies, University of Otago, Christchurch, New Zealand
| | - Jennifer Jordan
- Psychological Medicine, University of Otago, Christchurch, New Zealand
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Zimmermann FF, Jordan J, Burrell B. Coping with cancer mindfully: A feasibility study of a mindfulness intervention focused on acceptance and meaning in life for adults with advanced cancer. Eur J Oncol Nurs 2020; 44:101715. [DOI: 10.1016/j.ejon.2019.101715] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 12/05/2019] [Accepted: 12/19/2019] [Indexed: 01/04/2023]
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Huang J, Zhuo Y, Tian X, Zhu D, Mustafa R. Personalized disease treatment plan suggestion system based on big data and knowledge base. JOURNAL OF INTELLIGENT & FUZZY SYSTEMS 2020. [DOI: 10.3233/jifs-179425] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Jun Huang
- The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Yumin Zhuo
- The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Xuemei Tian
- School of Life Sciences, South China Normal University, Guangzhou, China
| | - Dingju Zhu
- School of Computer Science, South China Normal University, Guangzhou, China
| | - Rashed Mustafa
- Department of Computer Science and EngineeringUniversity of Chittagong, Chittagong, Bangladesh
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Zheng Y, Lei F, Liu B. Cancer Diagnosis Disclosure and Quality of Life in Elderly Cancer Patients. Healthcare (Basel) 2019; 7:healthcare7040163. [PMID: 31847309 PMCID: PMC6956195 DOI: 10.3390/healthcare7040163] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 12/02/2019] [Accepted: 12/13/2019] [Indexed: 12/12/2022] Open
Abstract
Informed consent and patient autonomy rights require an optimal cancer diagnosis disclosure strategy to be used to update the patients and caregivers with the bad news. However, a cancer diagnosis disclosure may arouse anxiety and distress which increase patients’ and caregivers’ psychological burden. This study aims to explore the influence of cancer diagnosis disclosure on the quality of life in elderly cancer patients and their caregivers, and to introduce an effective way to disclose cancer diagnosis. A total of 120 participants were randomly selected in the study. The Medical Coping Modes Questionnaire was used to select informed person. The SPIKES was used to guide the disclosure procedures. The informed patients’ or caregivers’ quality of life were evaluated by the Generic Quality of Life Inventory-74 or Caregiver Quality of Life Scale before and after the cancer diagnosis disclosure and at the discharge time. After cancer diagnosis disclosure, no significant change was found on the quality of life of the informed person. With multiple psychological interventions implemented, a significant increase was noticed on the quality of life of the informed person. Applying the cancer diagnosis disclosure strategies and psychological intervention were essential to improve cancer patients’ and caregivers’ quality of life.
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Affiliation(s)
- Ying Zheng
- School of Public Health, Fudan University, Shanghai 200032, China; (Y.Z.); (B.L.)
| | - Fang Lei
- School of Nursing, University of California, Los Angeles, CA 90095, USA
- Correspondence: ; Tel.: +1-310-733-0963
| | - Bao Liu
- School of Public Health, Fudan University, Shanghai 200032, China; (Y.Z.); (B.L.)
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Zhang H, Xie M, Archibald SD, Jackson BS, Gupta MK. Association of Marijuana Use With Psychosocial and Quality of Life Outcomes Among Patients With Head and Neck Cancer. JAMA Otolaryngol Head Neck Surg 2019; 144:1017-1022. [PMID: 30073295 DOI: 10.1001/jamaoto.2018.0486] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Importance Cannabis sativa, the most widely used illicit substance in Canada, has a unique ability to facilitate relaxation and relieve anxiety while reducing pain. However, no study to date has examined quality of life (QOL) and psychosocial issues in relation to the use of this drug among patients with newly diagnosed head and neck cancer (HNC). Objective To examine the differences in QOL and psychosocial outcomes between marijuana users and nonusers with newly diagnosed HNC. Design, Setting, and Participants This prospective cohort study was conducted at a tertiary care cancer center. Patients were enrolled consecutively and prospectively at the time of HNC diagnosis from January 1, 2011, to January 1, 2015. Seventy-four patients who were current marijuana users were case matched to 74 nonusers in a 1:1 scheme based on age, sex, and tumor subsite. All patient demographic and QOL data were collected prospectively, and data analysis was conducted from November 1 to December 1, 2017. Main Outcomes and Measure The QOL outcome was assessed using the EuroQol-5D (EQ5D) and the Edmonton Symptom Assessment System (ESAS) questionnaires. Results A total of 148 patients were included in this study: 74 in the marijuana user group (mean [SD] age, 62.3 [10.3] years; male sex, 61 patients [82%]) and 74 in the marijuana nonuser group (mean age, 62.2 years; male sex, 63 patients [85%]). There was no statistically significant difference in age, sex, tumor subsite, clinical TNM staging, treatment modality, or mean Karnofsky score between the 2 groups. On univariate analysis, there was no statistically significant difference in the mobility, self-care, and usual activities domains of the EQ5D. Marijuana users had significantly lower scores in the anxiety/depression (difference, 0.74; 95% CI, 0.557-0.930) and pain/discomfort (difference, 0.29; 95% CI, 0.037-1.541) domains. Wilcoxon rank sum test confirmed the results of the EQ5D with improvements in the pain/discomfort (z score, -2.60) and anxiety/depression (z score, -6.71) domains. Marijuana users had less pain, were less tired, were less depressed, were less anxious, had more appetite, were less drowsy, and had better general well-being according to the ESAS. A Wilcoxon rank sum test confirmed a statistically significant improvement in ESAS scores within the domains of anxiety (z score, -10.04), pain (z score, -2.36), tiredness (z score, -5.02), depression (z score, -5.96), drowsiness (z score, -5.51), appetite (z score, -4.17), and general well-being (z score, -4.43). Conclusions and Relevance This prospective case-matched study suggests that there may be significant QOL benefits, including decreased anxiety, pain, and depression and increased appetite and generalized feelings of well-being, associated with marijuana use among patients with newly diagnosed HNC.
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Affiliation(s)
- Han Zhang
- Division of Otolaryngology-Head and Neck Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Michael Xie
- Michael DeGroote Faculty of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Stuart D Archibald
- Michael DeGroote Faculty of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - B Stanley Jackson
- Division of Otolaryngology-Head and Neck Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Michael K Gupta
- Division of Otolaryngology-Head and Neck Surgery, McMaster University, Hamilton, Ontario, Canada
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Nguyen MH, Smets EM, Bol N, Loos EF, van Laarhoven HW, Geijsen D, van Berge Henegouwen MI, Tytgat KM, van Weert JC. Tailored Web-Based Information for Younger and Older Patients with Cancer: Randomized Controlled Trial of a Preparatory Educational Intervention on Patient Outcomes. J Med Internet Res 2019; 21:e14407. [PMID: 31573911 PMCID: PMC6774239 DOI: 10.2196/14407] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 07/12/2019] [Accepted: 07/19/2019] [Indexed: 12/22/2022] Open
Abstract
Background Many patients with cancer, including older patients (aged ≥65 years), consult the Web to prepare for their doctor’s visit. In particular, older patients have varying needs regarding the mode in which information is presented (eg, via textual, visual, or audiovisual modes) owing to age-related sensory (eg, impaired vision and hearing) and cognitive decline (eg, reduced processing speed). Therefore, Web-based information targeted at older patient populations is likely to be used and processed more effectively, and evaluated more positively, when tailored to age-related capabilities and preferences. This, in turn, may benefit patient outcomes. Objective This randomized controlled trial tested the effects of a Web-based tailored educational intervention among newly diagnosed younger (<65 years) and older (≥65 years) patients with cancer. We compared the intervention group who viewed a mode-tailored website (ie, enabling patients to tailor information using textual, visual, and audiovisual modes) with 3 control groups view a nontailored website (ie, text only, text with images, and text with videos). We examined website experience outcomes (ie, website satisfaction, website involvement, knowledge, anxiety, and communication self-efficacy) and consultation experience outcomes (ie, question asking during consultation, anxiety, and information recall). Methods Patients from a multidisciplinary outpatient clinic (N=232) viewed a mode-tailored or nontailored website as preparation before their hospital consultations to discuss diagnosis and treatment. Data were collected before (T1), during (T2), and after (T3) visitation. Website experience outcomes were assessed with questionnaires (T1). Patients’ question asking was coded from videotaped consultations, and anxiety was assessed through a questionnaire (T2). Telephone interviews were conducted to assess knowledge acquired from the website before (T1) and after consultation (T3), and information recall from the consultation (T3). Results The preparatory website was well used across all conditions (mean 34 min). Younger patients viewing the mode-tailored website were more satisfied before consultation (P=.02) and reported lower anxiety after consultation (P=.046; vs text only). This pattern was not found in older patients. Mode tailoring yielded no other significant differences in patient outcomes. Regression analyses showed that website involvement (beta=.15; P=.03) and, to a lesser extent, website satisfaction (beta=.15; P=.05) positively associated with knowledge before consultation (T1). In turn, higher knowledge before consultation (beta=.39; P<.001), together with time on the website (beta=.21; P=.002; T1), predicted information recall from consultations (T3). Patients with higher knowledge before consultation (T1) also reported higher knowledge from the website afterward (T3; beta=.22; P=.003). Conclusions Offering preparatory online information before consultations benefits information processing and patient outcomes of both younger and older newly diagnosed patients with cancer. Younger patients benefit even more when information is offered in a mode-tailored manner. We discuss the theoretical, methodological, and practical implications for patient-provider communication research in an electronic health era. Clinical Trial Netherlands Trial Register NTR5904; https://www.trialregister.nl/trial/5750
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Affiliation(s)
- Minh Hao Nguyen
- Amsterdam School of Communication Research, University of Amsterdam, Amsterdam, Netherlands.,Department of Communication and Media Research (IKMZ), University of Zurich, Zurich, Switzerland
| | - Ellen Ma Smets
- Department of Medical Psychology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Nadine Bol
- Amsterdam School of Communication Research, University of Amsterdam, Amsterdam, Netherlands.,Department of Communication and Cognition, Tilburg University, Tilburg, Netherlands
| | - Eugène F Loos
- Amsterdam School of Communication Research, University of Amsterdam, Amsterdam, Netherlands
| | - Hanneke Wm van Laarhoven
- Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Debby Geijsen
- Department of Radiation Oncology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Mark I van Berge Henegouwen
- Department of Surgery, Cancer Center Amsterdam, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Kristien Maj Tytgat
- Department of Gastroenterology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Julia Cm van Weert
- Amsterdam School of Communication Research, University of Amsterdam, Amsterdam, Netherlands
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Sharour LA, Omari OA, Malak MZ, Salameh AB, Yehia D, Subih M, Alrshoud M. Using Mixed-Methods Research to Study Coping Strategies among Colorectal Cancer Patients. Asia Pac J Oncol Nurs 2019; 7:81-87. [PMID: 31879688 PMCID: PMC6927164 DOI: 10.4103/apjon.apjon_20_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 04/09/2019] [Indexed: 12/04/2022] Open
Abstract
Objective: The objective was to identify and understand the coping strategies of colorectal cancer (CRC) patients. Methods: A mixed-methods approach including quantitative and qualitative methods was used to collect data from Jordanian patients. In the quantitative phase, we aimed to determine the coping strategies employed in a representative sample (n = 200) of Jordanian adult patients with CRC using the Jalowiec Coping Scale. In the qualitative phase, we aimed to understand these coping strategies through an in-depth and detailed exploration. A sample of ten participants was chosen purposefully based on their coping score in the quantitative phase, and interviews were conducted. Quantitative data were analyzed using SPSS software version 23. Qualitative data were analyzed using directed content analysis. Results: Results from the quantitative phase indicated that evasive coping strategies were used predominantly, followed by confrontive coping strategies and optimistic coping strategies. In contrast, fatalistic and emotive coping strategies had the lowest scores. In addition, the results indicated that the total scores for the effectiveness of coping strategies ranged from 42 to 143, with a mean of 93.45 (standard deviation 13.67); higher scores reflected greater effectiveness. Content analysis in the qualitative phase identified three themes, and subcategories emerged, including perceived collaborative support, increased awareness of treatment, and internal power. Conclusions: CRC patients used different coping strategies to face the new challenge. Oncology nurses can play a pivotal role in enhancing these coping strategies through implementing multidisciplinary programs.
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Affiliation(s)
- Loai Abu Sharour
- Nursing Department, Faculty of Nursing, AL-Zaytoonah University of Jordan, Amman, Jordan
| | - Omar Al Omari
- Nursing Department, Faculty of Nursing, AL-Zaytoonah University of Jordan, Amman, Jordan
| | - Malakeh Z Malak
- Nursing Department, Faculty of Nursing, AL-Zaytoonah University of Jordan, Amman, Jordan
| | - Ayman Bani Salameh
- Nursing Department, Faculty of Nursing, AL-Zaytoonah University of Jordan, Amman, Jordan
| | - Dalal Yehia
- Nursing Department, Faculty of Nursing, AL-Zaytoonah University of Jordan, Amman, Jordan
| | - Maha Subih
- Nursing Department, Faculty of Nursing, AL-Zaytoonah University of Jordan, Amman, Jordan
| | - Mohammad Alrshoud
- Adult Health and Critical Care Department, College of Nursing, Sultan Qaboos University, Amman, Jordan
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Eilami O, Moslemirad M, Naimi E, Babuei A, Rezaei K. The Effect of Religious Psychotherapy Emphasizing the Importance of Prayers on Mental Health and Pain in Cancer Patients. JOURNAL OF RELIGION AND HEALTH 2019; 58:444-451. [PMID: 30225762 DOI: 10.1007/s10943-018-0696-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
The religious aspect is the most important aspect of the human nature that helps the human achieve the meaning and purpose of life as well as playing a very important role in the health of patients. This study aimed to determine the effect of religious psychotherapy emphasizing the importance of prayers on mental health and pain in cancer patients. This study is a clinical trial that was conducted in 2017 in Yasuj, Iran. According to the purpose of the study, the patients were randomly assigned into two experimental and control groups. Prayers 15 and 23 of the SahifehSajjadiyeh book were read at the beginning of the treatment sessions, and the patients were asked to pay attention to the meaning of prayer. The data were analyzed using SPSS 16 software. Before implementing the intervention, the mean and standard deviation of mental health score of the patients in the experimental and control groups were equal to 16.40 (2.21) and 16.56 (1.56). But after implementing the intervention, the mean and standard deviation of mental health score were equal to 11.24 (2.93) and 16.82 (1.83) which illustrates a significant statistical increase. Implementing the supportive spiritual intervention has been tested to enhance the mental health and reduce the pain of patients in the experimental group. Regarding this improvement, it is suggested a religious intervention be implemented to increase these patients' health in a participatory way.
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Affiliation(s)
- Owrang Eilami
- School of Medicine Social, Determinants of Health Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
| | | | - Ebrahim Naimi
- Department of Public Health, Faulty of Health, Yasuj University of Medical Science, Yasuj, Iran
| | - Amin Babuei
- Deputy of Development of Managment, Yasuj University of Medical Science, Yasuj, Iran.
| | - Karim Rezaei
- Determinants of Health Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
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Nguyen MH, Smets EMA, Bol N, Bronner MB, Tytgat KMAJ, Loos EF, van Weert JCM. Fear and forget: how anxiety impacts information recall in newly diagnosed cancer patients visiting a fast-track clinic. Acta Oncol 2019; 58:182-188. [PMID: 30264632 DOI: 10.1080/0284186x.2018.1512156] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
INTRODUCTION One-day fast track programs for cancer diagnostics and treatment planning are increasingly being implemented in health care. Fast-track programs are highly effective at reducing waiting times, and thus well received by patients and healthcare providers. However, these programs may also burden patients, as patients generally receive a lot of information from multiple healthcare providers within a short time span. This might increase anxiety and negatively impact recall of medical information in newly diagnosed patients. This study examines whether anxiety influences information recall at the moment of diagnosis, and whether this relation differs for younger and older patients. METHODS Data were collected from 78 colorectal cancer patients visiting a one-day fast-track multidisciplinary outpatient clinic. All consultations that took place were recorded on a video. Anxiety was measured at baseline (T1) and immediately after consultations (T2) with the STAI-6. Information recall was assessed by telephone within 36-48 hours after patients' visit (T3) using open questions. RESULTS After consultations (T2), 32% of patients experienced clinical anxiety levels. Patients recalled ∼60% of medical information (T3). Information recall was negatively impacted by anxiety (β = -.28, p = .011), and negatively related to higher age (β = -.23, p = .031), and lower education level (β = .27, p = .013). Although older patients (M = 53.99) recalled 11% less information than younger patients (M = 64.84), age was not related to anxiety and did not moderate the anxiety-recall relationship. CONCLUSION High levels of anxiety after receiving a cancer diagnosis negatively influence how much information patients remember after visiting a one-day fast-track clinic. This calls for interventions that may reduce patients' anxiety as much as reasonably possible and support patients' information recall. Researchers, practitioners, and hospitals are encouraged to continue exploring ways to optimize information provision to cancer patients in current modern healthcare.
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Affiliation(s)
- Minh Hao Nguyen
- Amsterdam School of Communication Research (ASCoR), University of Amsterdam, Amsterdam, Netherlands
| | - Ellen M. A. Smets
- Department of Medical Psychology, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | - Nadine Bol
- Amsterdam School of Communication Research (ASCoR), University of Amsterdam, Amsterdam, Netherlands
| | - Madelon B. Bronner
- Amsterdam School of Communication Research (ASCoR), University of Amsterdam, Amsterdam, Netherlands
| | - Kristien M. A. J. Tytgat
- Department of Gastroenterology, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | - Eugène F. Loos
- Amsterdam School of Communication Research (ASCoR), University of Amsterdam, Amsterdam, Netherlands
| | - Julia C. M. van Weert
- Amsterdam School of Communication Research (ASCoR), University of Amsterdam, Amsterdam, Netherlands
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Bail JR, Traeger L, Pirl WF, Bakitas MA. Psychological Symptoms in Advanced Cancer. Semin Oncol Nurs 2018; 34:241-251. [DOI: 10.1016/j.soncn.2018.06.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Nguyen MH, Bol N, van Weert JCM, Loos EF, Tytgat KMAJ, Geijsen D, Drenth E, Janse M, Smets EMA. Optimising eHealth tools for older patients: Collaborative redesign of a hospital website. Eur J Cancer Care (Engl) 2018; 28:e12882. [PMID: 30015998 PMCID: PMC6588263 DOI: 10.1111/ecc.12882] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 04/26/2018] [Accepted: 06/01/2018] [Indexed: 12/12/2022]
Abstract
Most hospital websites have not been developed in collaboration with patients and, therefore, rarely take into account the preferences and abilities of older patients. This study describes the systematic redesign of an existing hospital website in a co‐design process with patients and professional stakeholders (e.g. researchers, physicians, nurses, department heads, policymakers, website designers), with the aim to make it more user‐friendly for older patients with colorectal cancer (CRC). The redesign process consisted of three phases, where (I) both existing content and design were evaluated among CRC patients; (II) a prototype website was developed based on these insights; which (III) was evaluated again before making final adjustments. Mixed research methods were used for the redesign process. Specifically, insights from existing literature, outcomes from qualitative and quantitative empirical studies conducted by our team, and expert knowledge from relevant stakeholders, were collected and discussed in multidisciplinary consensus meetings, and served as input for the redesigned website. While the existing website was evaluated poorly, the qualitative evaluation of the prototype website in phase 3 showed that the newly redesigned website was usable for older CRC patients. A practical roadmap on how to collaboratively redesign and optimise existing eHealth tools to make them suitable for and operational in clinical settings is provided.
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Affiliation(s)
- Minh Hao Nguyen
- Amsterdam School of Communication Research (ASCoR), University of Amsterdam, Amsterdam, The Netherlands
| | - Nadine Bol
- Amsterdam School of Communication Research (ASCoR), University of Amsterdam, Amsterdam, The Netherlands
| | - Julia C M van Weert
- Amsterdam School of Communication Research (ASCoR), University of Amsterdam, Amsterdam, The Netherlands
| | - Eugène F Loos
- Amsterdam School of Communication Research (ASCoR), University of Amsterdam, Amsterdam, The Netherlands
| | | | - Debby Geijsen
- Department of Radiation Oncology, Academic Medical Center, Amsterdam, The Netherlands
| | - Ellen Drenth
- Gastro-Intestinal Oncological Center Amsterdam, Academic Medical Center, Amsterdam, The Netherlands
| | - Meriam Janse
- Gastro-Intestinal Oncological Center Amsterdam, Academic Medical Center, Amsterdam, The Netherlands
| | - Ellen M A Smets
- Department of Medical Psychology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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Galindo Vázquez O. Escala de Afrontamiento al Cáncer en pacientes oncológicos en población mexicana. PSICOONCOLOGIA 1970. [DOI: 10.5209/psic.63648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Introducción: Los estilos de afrontamiento son variables psicológicas que pueden predecir la adaptación psicológica y en sentido contrario una mayor disfunción psicosocial en pacientes con cáncer. Se han descrito dos dimensiones: centrados en el problema o activos positivos, caracterizados por la búsqueda de información, planificación y resolución de problemas; y los dirigidos a la emoción o evitativos caracterizados por el escape, distanciamiento o desesperanza. Objetivo: Determinar las propiedades psicométricas de la Escala de Afrontamiento del Cáncer en una muestra de pacientes con cáncer de la población mexicana. Método: Participaron 317 pacientes del Instituto Nacional del Cáncer, de los cuales 148 eran mujeres (46,7%) y 169 hombres (53,4%), con una edad media de 46,2 años. Los participantes completaron al mismo tiempo el Mental Adjustment to Cancer (MAC), el HADS y el Termometro del Distress. Resultados: Mediante el análisis factorial se identificaron cinco factores que explicaron el 53,32% de la varianza, con 22 reactivos. La consistencia interna de la escala global fue satisfactoria (0,81). La validez concurrente mostró asociaciones significativas (Pearson r = - 0,120 – 0,586, p <0,05). Discusión y conclusión: La Escala de Afrontamiento del Cáncer derivada del Mental Adjustment to Cancer tiene propiedades psicométricas adecuadas. Es una herramienta útil para fines de investigación y atención en salud mental durante el tratamiento oncológico.
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