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Jakimowicz S, Levett-Jones T, Rossiter C, Sara S, Pierce H, Demant D, Chambers S. Improving Distress Screening for People with Prostate Cancer: Evaluation of an E-Learning Course to Increase Healthcare Professionals' Knowledge. Semin Oncol Nurs 2024; 40:151656. [PMID: 38866646 DOI: 10.1016/j.soncn.2024.151656] [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: 10/02/2023] [Revised: 05/04/2024] [Accepted: 05/08/2024] [Indexed: 06/14/2024]
Abstract
OBJECTIVES Psychological distress can occur following diagnosis and treatment for prostate cancer, compromising psychosocial wellbeing. Improved recognition and management of distress by healthcare professionals can enhance clinical practice and promote evidence-based prostate cancer care. This paper explores the effectiveness and feasibility of the online Distress Screening for Prostate Cancer course, designed to improve healthcare professionals' understanding of screening for prostate cancer-related distress. It aims to evaluate whether this e-learning course increases learners' knowledge of distress screening for prostate cancer. METHODS Healthcare professionals were invited to enroll in the online course and complete optional evaluation questions. The pretest posttest design identified changes in learners' knowledge about distress screening for people with prostate cancer, including prevalence, risk factors, assessment and management strategies for distress (n = 149). Learners also rated satisfaction in a cross-sectional survey (n = 116). Most respondents were nurses, including Prostate Cancer Specialist Nurses. RESULTS Learners' knowledge of distress screening was higher after course completion. Improvement between pre- and posttest results was statistically significant for four of ten items, including risk of prostate cancer-related distress, and suicidality, and the purpose of distress screening. Learners reported high satisfaction with course content, structure, engagement, relevance, and approach. They particularly valued the narrative-based approach and interactivity. Small numbers encountered technological problems and some offered suggestions to improve learner feedback. CONCLUSIONS The course improved healthcare professionals' knowledge of distress among people affected by prostate cancer. Learners found the e-learning format feasible and acceptable. IMPLICATIONS FOR NURSING PRACTICE Deeper understanding of the psychological implications of diagnosis and treatment of prostate cancer can help healthcare professionals respond to and manage distress among men and their families, and provide supportive care to improve health-related quality of life. Access to an online course can offer effective, feasible education on distress screening.
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Affiliation(s)
- Samantha Jakimowicz
- School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, Broadway, NSW, Australia; School of Nursing, Paramedicine & Healthcare Sciences, Charles Sturt University, Wagga Wagga, NSW, Australia.
| | - Tracy Levett-Jones
- School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, Broadway, NSW, Australia
| | - Chris Rossiter
- School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, Broadway, NSW, Australia
| | - Sally Sara
- School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, Broadway, NSW, Australia; Prostate Cancer Foundation of Australia, St Leonards, NSW, Australia
| | - Heather Pierce
- School of Nursing and Midwifery, Western Sydney University, Penrith, NSW, Australia
| | - Daniel Demant
- School of Public Health, Faculty of Health, University of Technology Sydney, Broadway, NSW, Australia
| | - Suzanne Chambers
- Faculty of Health Sciences, Australian Catholic University, Banyo, QLD, Australia
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2
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Zhang L, Liu X, Tong F, Zou R, Peng W, Yang H, Huang X, Yi L, Wen M, Jiang L, Liu F. Lung cancer distress: screening thermometer meta-analysis. BMJ Support Palliat Care 2024; 13:e1084-e1092. [PMID: 35172980 PMCID: PMC10850644 DOI: 10.1136/bmjspcare-2021-003290] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 01/25/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVES The distress is associated with the life quality and prognosis of patients with lung cancer. Distress thermometer (DT) has been widely recommended for distress screening. This study was conducted to summarise the positive rate of distress in patients with lung cancer using DT screenings. METHODS The PubMed, Embase, PsyclNFO and Cochrane Library databases were comprehensively searched to identify all eligible studies published before 31 December 2021. Studies were eligible if they were published in peer-reviewed literature and evaluated distress levels by DT. RESULTS Ten eligible studies, including a total of 2111 patients, were included in this analysis, and their methodological quality was moderate. The pooled positive rate of distress in patients with lung cancer was 49.04% (95% CI 41.51% to 56.60%). The subgroup analysis revealed that the distress positive rate was significantly different (p<0.05) across North America, Europe and China with values of 53.33% (95% CI 45.22% to 61.37%), 43.81% (95% CI 31.57% to 56.43%) and 38.57% (95% CI 33.89% to 43.41%), respectively. Moreover, the distress positive rate was significantly different between men and women (p<0.05). Additionally, in terms of histological type, clinical tumour, node, metastasis stage, previous treatment and DT threshold, the distress positive rate had no significant differences. No significant publication bias was identified by Begg's funnel plot and Egger's test. CONCLUSIONS The summarised distress positive rate was high and was significantly different according to gender and region. DT screening should be recommended for routine clinical practice and more attention should be given towards distress management.
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Affiliation(s)
- Lemeng Zhang
- Department of Thoracic Medicine, Hunan Cancer Hospital/ The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Xiaohong Liu
- Department of Clinical Spiritual Care, Hunan Cancer Hospital/ The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, CHINA
| | - Fei Tong
- Psychological Clinic, Hunan Cancer Hospital/ The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, CHANGSHA, CHINA
| | - Ran Zou
- Department of Hospice Unit, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, CHINA
| | - Wanglian Peng
- Department of Hospice Unit, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, CHINA
| | - Hui Yang
- Department of Clinical Spiritual Care, Hunan Cancer Hospital/ The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, CHINA
| | - Xufen Huang
- Department of Hospice Unit, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, CHINA
| | - Lili Yi
- Department of Clinical Spiritual Care, Hunan Cancer Hospital/ The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, CHINA
| | - Minni Wen
- Department of Clinical Spiritual Care, Hunan Cancer Hospital/ The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, CHINA
| | - Ling Jiang
- Department of Clinical Spiritual Care, Hunan Cancer Hospital/ The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, CHINA
| | - Feng Liu
- Department of Radiation Oncology, Hunan Cancer Hospital/ The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, CHINA
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García-Torres F, Jacek Jabłoński M, Gómez-Solís Á, Jaén-Moreno MJ, Moriana JA, Moreno-Díaz MJ, Aranda E. Psychological distress predicts quality of life in the first months of cancer diagnosis in cancer caregivers. PSYCHOL HEALTH MED 2023; 28:2872-2882. [PMID: 37142554 DOI: 10.1080/13548506.2023.2208367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 04/21/2023] [Indexed: 05/06/2023]
Abstract
In cancer caregivers, anxiety and depression may negatively impact quality of life. Information regarding correlations and the predictive capacity of anxiety and depression with regard to the domains of quality of life of caregivers 6 months after a patient's cancer diagnosis is sparse. Sixty-seven caregivers of cancer patients were recruited and completed the Hospital Anxiety and Depression Scale (HADS) and the Short-Form Health Survey (SF-36) 30-45 days (T1) and 180-200 days (T2) after diagnosis. Depression and anxiety (T1) correlated with quality of life in terms of general health, vitality, social functioning, as well as role limitations due to emotional problems, and mental health (T2). Depression scores at T1 predicted general health, vitality, social functioning, role limitations due to emotional problems and mental health. Although these results are interesting, it must be noted that the sample size was somewhat limited and that the patients' cancer types may have influenced the results obtained. Psychological distress, particularly depression, correlated with and acted as a predictor for changes in the different domains of quality of life, highlighting the relevance of the evaluation of psychological distress in cancer caregivers shortly after cancer diagnosis. These results underscore the importance of differentiating between the different domains in the evaluation of impairments of quality of life in cancer caregivers.
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Affiliation(s)
- Francisco García-Torres
- Department of Psychology, University of Cordoba, Cordoba, Spain/IMIBIC Health Research Institute/Reina Sofía University Hospital of Cordoba, Cordoba, Spain
| | | | | | - María José Jaén-Moreno
- IMIBIC Health Research Institute/Department of Social Health Sciences, Radiology and Physical Medicine/University of Córdoba, Spain
| | - Juan A Moriana
- Department of Psychology, University of Cordoba, Cordoba, Spain/IMIBIC Health Research Institute/Reina Sofía University Hospital of Cordoba, Cordoba, Spain
| | - María José Moreno-Díaz
- Department of Social Health Sciences, Radiology and Physical Medicine/University of Córdoba, Córdoba, Spain
| | - Enrique Aranda
- Medical Oncology Department, Reina Sofía University Hospital, Spain
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Martín-Núñez J, Raya-Benítez J, López-López L, Calvache-Mateo A, Heredia-Ciuró A, Navas-Otero A, Valenza MC. Efficacy in urinary symptom burden, psychological distress, and self-efficacy of education-enhanced interventions in prostate cancer patients: a systematic review and meta-analyses. Support Care Cancer 2023; 31:340. [PMID: 37191890 DOI: 10.1007/s00520-023-07803-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 05/09/2023] [Indexed: 05/17/2023]
Abstract
BACKGROUND Worldwide, prostate cancer is both the second-most diagnosed cancer and most common solid tumor in men. Prostate cancer patients present with a symptom burden that is compounded by the impact of medical oncology treatment, affecting different domains of their perceived health status. Education active techniques are a key role in chronic disease to increase participation in their recovery. PURPOSE The purpose of the current review was to examine the efficacy of education-enhanced in urinary symptom burden, psychological distress, and self-efficacy in patients diagnosed with prostate cancer. METHODS A wide search of the literature was conducted for articles from their inception to June 2022. Only randomized controlled trials were included. Data extraction and methodologic quality assessment of the studies were carried out by two reviewers. We previously registered the protocol of this systematic review on PROSPERO (CRD42022331954). RESULTS A total of six studies were included in the study. After education-enhanced intervention showed significant improvements in any of perceived urinary symptom burden, one in psychological distress, and one in self-efficacy in the experimental group. The meta-analysis showed that education-enhanced interventions have a significant effect on depression. CONCLUSION Education-enhanced could have positive effects on urinary symptom burden, psychological distress, and self-efficacy in prostate cancer survivors. Our review was unable to demonstrate the best timing to apply education-enhanced strategies.
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Affiliation(s)
- Javier Martín-Núñez
- Faculty of Health Sciences, Department of Physiotherapy, University of Granada, Av. De La Ilustración, 60, 18016, Granada, Spain
| | - Julia Raya-Benítez
- Faculty of Health Sciences, Department of Physiotherapy, University of Granada, Av. De La Ilustración, 60, 18016, Granada, Spain
| | - Laura López-López
- Faculty of Health Sciences, Department of Physiotherapy, University of Granada, Av. De La Ilustración, 60, 18016, Granada, Spain
| | - Andrés Calvache-Mateo
- Faculty of Health Sciences, Department of Physiotherapy, University of Granada, Av. De La Ilustración, 60, 18016, Granada, Spain
| | - Alejandro Heredia-Ciuró
- Faculty of Health Sciences, Department of Physiotherapy, University of Granada, Av. De La Ilustración, 60, 18016, Granada, Spain
| | - Alba Navas-Otero
- Faculty of Health Sciences, Department of Physiotherapy, University of Granada, Av. De La Ilustración, 60, 18016, Granada, Spain
| | - Marie Carmen Valenza
- Faculty of Health Sciences, Department of Physiotherapy, University of Granada, Av. De La Ilustración, 60, 18016, Granada, Spain.
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Lv G, Zhao D, Li G, Qi M, Dong X, Li P. When Experiencing a Surgery: Gastrointestinal Cancer Patients’ Longitudinal Trajectories in Psychological Stress and Their Association with Quality of Recovery. Asia Pac J Oncol Nurs 2022; 9:100064. [PMID: 35615664 PMCID: PMC9125671 DOI: 10.1016/j.apjon.2022.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 04/05/2022] [Indexed: 11/16/2022] Open
Abstract
Objective Surgical treatment, particularly for gastrointestinal cancer, is a burdensome prospect for many patients. Psychological stress is a common complaint; however, little is known about its patterns in perioperative patients. This study aimed to identify distinct trajectories of perioperative stress and explore antecedent factors and hospitalization outcomes among different trajectories in patients with gastrointestinal cancer. Methods A longitudinal study was conducted on 203 patients with gastrointestinal surgical cancer at a specialized oncology hospital in China. Psychological stress was assessed at five perioperative time points (1–3 days before surgery; 1–3 days, 4–6 days, 7–9 days after surgery, and before discharge). A growth mixture model was used to analyze the potential stress trajectories. Multinomial logistic regression was used to identify the characteristics associated with different trajectories. Results Three stress trajectories were identified: recovery class (RC, 60.6%), chronic class (CC, 29.5%), and deterioration class (DC, 9.9%). Compared with CC, RC exhibited a shorter length of stay and better recovery quality, and was related to employment, low illness perception, and positive coping; DC reported lower recovery quality from 7 to 9 days after surgery to discharge and was associated with poor education level, history of surgery, stoma, smoking, and preoperative insomnia. Conclusions Most surgical patients were insulated from stress due to psychosocial resources, and thus displayed good recovery. However, many patients had moderate stress that did not improve or worsen over the perioperative period, which still needs to be screened and provided with early stress management.
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Grimmett C, Heneka N, Chambers S. Psychological Interventions Prior to Cancer Surgery: a Review of Reviews. CURRENT ANESTHESIOLOGY REPORTS 2022; 12:78-87. [PMID: 35125973 PMCID: PMC8801554 DOI: 10.1007/s40140-021-00505-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2021] [Indexed: 01/26/2023]
Abstract
Purpose of Review Patients with cancer who have high levels of psychological distress have poor treatment compliance and worse outcomes. This “review of reviews” provides a narrative synthesis of the impact of psychological prehabilitation interventions on individuals awaiting cancer surgery. Recent Findings Twenty reviews of prehabilitation with psychological interventions were identified. There is a trend towards improved psychological outcomes following intervention, particularly when psychologist-led. However, there was considerable heterogeneity within interventions, outcome measures, and timing of assessment precluding numeric synthesis. Methodological limitations including non-blinding, absence of stratification, and underpowered studies were also pervasive. Summary Providing psychological support early in the cancer pathway and prior to surgery has the potential to improve psychological health and outcomes. The application of existing knowledge in psycho-oncology, including distress screening, is needed in the prehabilitation setting. Consistent outcome assessments, accurate reporting of intervention components and delivery methods, and a consideration of effective systems and economical implementation strategies would facilitate advancements in this field. Supplementary Information The online version contains supplementary material available at 10.1007/s40140-021-00505-x.
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Affiliation(s)
- Chloe Grimmett
- School of Health Sciences, University of Southampton, Southampton, UK
| | - Nicole Heneka
- Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Suzanne Chambers
- Faculty of Health Sciences, Australian Catholic University, Brisbane, Australia
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7
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Sarchi L, Eissa A, Puliatti S, Amato M, Assumma S, Calcagnile T, Ticonosco M, Iseppi A, Toso S, Sighinolfi MC, Bianchi G, Micali S, Rocco B. Psychological distress among patients awaiting histopathologic results after prostate biopsy: An unaddressed concern. Urologia 2021; 89:382-387. [PMID: 34612746 DOI: 10.1177/03915603211049889] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Prostate cancer is the most commonly diagnosed neoplasm in men. From the introduction of PSA testing, an increasing number of men undergoes prostate biopsy (PBX). While the physical side effects of PBx have been well investigated, its psychological impact has been under-evaluated. AIM The aim of our study is to investigate the presence of psychological distress (anxiety and depression) in patients waiting for histopathological results after prostate biopsy (PBx). METHODS From February to April 2019, 51 consecutive patients undergoing prostate biopsies at our institution were included. Age, PSA, DRE, familiarity for prostate cancer, number of previous biopsies, type of anesthesia, number of cores were recorded. All patients filled the Hospital Anxiety and Depression Scale (HADS), a psychometric Likert-scale questionnaire, before receiving the histopathological results of their PBx. RESULTS The prevalence of psychological distress among patients awaiting histopathologic results is 41% (21/51 patients), with anxiety being the main component of their distress. On multivariate analysis, PSA, family history, and repeat biopsy were significantly associated with anxiety and depression. CONCLUSION Patients undergoing PBx experience a burden of psychological distress waiting for histopathologic results, especially anxiety. Appropriate counseling should be offered to patients at high risk of developing psychological distress after PBx. Future goals would include technological improvements to shorten the time between biopsy and definitive results.
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Affiliation(s)
- Luca Sarchi
- Urology Department, University of Modena & Reggio Emilia, Modena, Italy
| | - Ahmed Eissa
- Urology Department, University of Modena & Reggio Emilia, Modena, Italy.,Urology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Stefano Puliatti
- Urology Department, University of Modena & Reggio Emilia, Modena, Italy.,ORSI Academy, Gent, Belgium.,Department of Urology, Onze Lieve Vrouw Hospital, Aalst, Belgium
| | - Marco Amato
- Urology Department, University of Modena & Reggio Emilia, Modena, Italy.,ORSI Academy, Gent, Belgium.,Department of Urology, Onze Lieve Vrouw Hospital, Aalst, Belgium
| | - Simone Assumma
- Urology Department, University of Modena & Reggio Emilia, Modena, Italy
| | | | - Marco Ticonosco
- Urology Department, University of Modena & Reggio Emilia, Modena, Italy
| | - Andrea Iseppi
- Urology Department, University of Modena & Reggio Emilia, Modena, Italy
| | - Stefano Toso
- Urology Department, University of Modena & Reggio Emilia, Modena, Italy
| | | | - Giampaolo Bianchi
- Urology Department, University of Modena & Reggio Emilia, Modena, Italy
| | - Salvatore Micali
- Urology Department, University of Modena & Reggio Emilia, Modena, Italy
| | - Bernardo Rocco
- Urology Department, University of Modena & Reggio Emilia, Modena, Italy
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8
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The effectiveness of psychological intervention for depression, anxiety, and distress in prostate cancer: a systematic review of literature. Prostate Cancer Prostatic Dis 2021; 24:674-687. [PMID: 33750905 DOI: 10.1038/s41391-021-00342-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 02/04/2021] [Accepted: 02/18/2021] [Indexed: 02/01/2023]
Abstract
BACKGROUND The increasing incidence and declining mortality rates seen in prostate cancer will result in a growing survivorship with a burden of health conditions, warranting attention to psychological health. Depression, anxiety, and distress have prognostic significance; attempts have been made to reduce them with psychological interventions using cognitive- and/or education-based approaches. The review of literature attempted to measure a clinically meaningful difference between pre- and post-intervention scores that were previously reported in randomized clinical trials. METHODS Using the PRISMA-checklist, we identified 22 studies that assessed psychological interventions by randomizing against care as usual (CAU). We calculated a percent change between pre- and post-trial mean scores for depression, anxiety, and distress in each study and analyzed effectiveness of intervention versus CAU. RESULTS The patient group receiving intervention showed significantly greater improvement in depression, anxiety, as well as general and cancer-specific distress as compared to CAU. The effectiveness of intervention was retained even in subgroups upon limiting analysis to seven studies that used one single assessment tool, the Hospital Anxiety and Depression Scale (HADS), or to 14 studies with localized prostate cancer (LPC). Improvement in depression did not correlate with anxiety but correlated significantly with a reduction in distress. Lastly, improvement in all three parameters was numerically greater in three studies that combined cognitive- and education-based approaches versus studies using either approach alone. CONCLUSIONS The present analysis underscores the utility of psychological intervention for depression, anxiety, and distress related to prostate cancer. Future research should ascertain their impact on long-term clinical outcomes, like disease progression and survival.
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Ilie G, White J, Mason R, Rendon R, Bailly G, Lawen J, Bowes D, Patil N, Wilke D, MacDonald C, Rutledge R, Bell D. Current Mental Distress Among Men With a History of Radical Prostatectomy and Related Adverse Correlates. Am J Mens Health 2021; 14:1557988320957535. [PMID: 32938266 PMCID: PMC7503014 DOI: 10.1177/1557988320957535] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Recent reviews and observational studies have reported that patients with prostate cancer (PCa) are at increased risk of mental health issues, which in turn negatively affects oncological outcomes. Here, we examine possible explanatory variables of mental distress in a population-based cohort of men who have undergone radical prostatectomy (RP). Data were derived from a Maritimes-Canada online survey assessing patient-reported quality of life outcomes between 2017 and 2019 administered to 136 men (47–88 years old, currently in a relationship) who have undergone RP for their PCa diagnosis. The primary outcome was a validated assessment of mental distress, the Kessler Psychological Distress Scale (K10). Urinary function was assessed using the International Prostate Symptom Score, and relationship satisfaction was assessed using the Dyadic Assessment Scale. A multivariate logistic regression assessed the contribution of urinary function, relationship satisfaction, age, multimorbidity, additional treatments, medication for depression and/or anxiety, and survivorship time. A total of 16.2% men in this sample screened positive for mental distress. The severity of urinary problems was positively associated with increased mental distress (OR = 4.79, 95% CI [1.04, 22.03]), while increased age (OR = 0.87, 95% CI [0.78, 0.97]), relationship satisfaction (OR = 0.14, 95% CI [0.3, .077]), and current medication for anxiety, depression, or both (OR = 0.09, 95% CI [0.02, 0.62]) were protective factors. Survivorship time, the presence of additional comorbidities, or PCa treatments were not identified to be statistically significant contributions to the fitted model. Here, we report that RP survivors are prone to presenting with increased mental distress long after treatment. Screening for mental distress during RP survivorship is recommended.
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Affiliation(s)
- Gabriela Ilie
- Department of Urology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada.,Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada.,Department of Radiation Oncology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Joshua White
- Department of Urology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Ross Mason
- Department of Urology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Ricardo Rendon
- Department of Urology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Greg Bailly
- Department of Urology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Joseph Lawen
- Department of Urology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - David Bowes
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Nikhilesh Patil
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Derek Wilke
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Cody MacDonald
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Robert Rutledge
- Department of Radiation Oncology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - David Bell
- Department of Urology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
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10
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Sevier-Guy LJ, Ferreira N, Somerville C, Gillanders D. Psychological flexibility and fear of recurrence in prostate cancer. Eur J Cancer Care (Engl) 2021; 30:e13483. [PMID: 34191379 DOI: 10.1111/ecc.13483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 04/29/2021] [Accepted: 05/06/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Psychological flexibility and fear of cancer recurrence are important variables that influence psychosocial outcomes in individuals diagnosed with a range of different types of cancer. Their role and how they impact on psychological distress and quality of life in men with prostate cancer specifically have not been established. METHODS A cross-sectional sample of 144 men with prostate cancer was recruited. Multiple regression and conditional process analysis were used to assess whether psychological flexibility moderates the relationship between fear of recurrence and distress and quality of life. RESULTS Psychological flexibility significantly predicted psychological distress (β = -0.56, p < 0.0001) and quality of life (β = 0.21, p < 0.0001), appearing a stronger predictor of psychological distress than fear of recurrence (β = 0.25, p < 0.0001). Fear of recurrence was a stronger predictor of quality of life (β = -0.41, p < 0.0001) than psychological flexibility. Psychological flexibility moderated the relationship between fear of recurrence and psychological distress (β = -0.01, p < 0.001). At low and average levels of psychological flexibility, psychological distress mediated the relationship between fear of recurrence and quality of life (β = -0.33 to -0.16, p < 0.05). At high levels of psychological flexibility, distress no longer mediated this relationship (β = 0.01, ns), supporting the role of psychological flexibility as a moderator. CONCLUSIONS These findings suggest that psychological flexibility might be a useful treatment target, through interventions such as Acceptance and Commitment Therapy, to buffer the effects of fear of recurrence and distress and improve psychosocial outcomes in this population.
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Affiliation(s)
- Lindsay-Jo Sevier-Guy
- School of Health and Social Science, University of Edinburgh, Edinburgh, UK.,Psychology Department, NHS Fife, Kirkcaldy, UK.,Psychology Department, NHS Tayside, Dundee, UK
| | - Nuno Ferreira
- School of Health and Social Science, University of Edinburgh, Edinburgh, UK.,School of Humanities and Social Sciences, University of Nicosia, Nicosia, Cyprus
| | | | - David Gillanders
- School of Health and Social Science, University of Edinburgh, Edinburgh, UK
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11
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Tagai EK, Miller SM, Hudson SV, Diefenbach MA, Handorf E, Bator A, Marziliano A, Kutikov A, Hall SJ, Vira M, Schwartz M, Kim IY, Kim S. Improved cancer coping from a web-based intervention for prostate cancer survivors: A randomized controlled trial. Psychooncology 2021; 30:1466-1475. [PMID: 33855796 DOI: 10.1002/pon.5701] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 04/02/2021] [Accepted: 04/06/2021] [Indexed: 12/29/2022]
Abstract
OBJECTIVES Prostate cancer (PCa) survivors report poor physical functioning alongside negative psychological outcomes as they cope with treatment side effects and practical concerns after treatment completion. This study evaluated PROGRESS, a web-based intervention designed to improve adaptive coping among PCa survivors. METHODS Localized PCa patients (N = 431) within one year of treatment completion were randomized to receive educational booklets or PROGRESS + educational booklets. Surveys completed at baseline, 1-, 3-, and 6-months assessed patient characteristics; functional quality of life and coping (primary outcomes); and psychosocial outcomes (e.g., self-efficacy, marital communication; secondary outcomes). Intent-to-treat and as-treated analyses were completed to assess change in outcomes from baseline to 6 months using linear mixed effects regression models. RESULTS In the intent-to-treat analyses, participants randomized to the intervention group had improved diversion coping (i.e., healthy redirection of worrying thoughts about their cancer), but more difficulties in marital communication (ps < 0.05). However, PROGRESS usage was low among those randomized to the intervention group (38.7%). The as-treated analyses found PROGRESS users reported fewer practical concerns but had worse positive coping compared to PROGRESS non-users (ps < 0.05). CONCLUSIONS The findings suggest PROGRESS may improve certain aspects of adaptive coping among PCa survivors that use the website, but does not adequately address the remaining coping and psychosocial domains. Additional research is needed to better understand the gaps in intervention delivery contributing to low engagement and poor improvement across all domains of functional quality of life and adaptive coping.
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Affiliation(s)
- Erin K Tagai
- Cancer Prevention and Control, Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA
| | - Suzanne M Miller
- Cancer Prevention and Control, Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA
| | - Shawna V Hudson
- Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA.,Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| | - Michael A Diefenbach
- Center for Health Innovations and Outcomes Research, Feinstein Institute for Medical Research, Northwell Health, New York, USA
| | - Elizabeth Handorf
- Department of Biostatistics and Bioinformatics, Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA
| | - Alicja Bator
- Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
| | - Allison Marziliano
- Center for Health Innovations and Outcomes Research, Feinstein Institute for Medical Research, Northwell Health, New York, USA
| | - Alexander Kutikov
- Division of Urology, Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA
| | - Simon J Hall
- The Arthur Smith Institute for Urology, Feinstein Institute for Medical Research, Northwell Health, New York, USA
| | - Manish Vira
- The Arthur Smith Institute for Urology, Feinstein Institute for Medical Research, Northwell Health, New York, USA
| | - Michael Schwartz
- The Arthur Smith Institute for Urology, Feinstein Institute for Medical Research, Northwell Health, New York, USA
| | - Issac Yi Kim
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| | - Sung Kim
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
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12
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Taylor-Robinson SD, Dykes K, Hawkes B. Personal Perspectives: Having a Prostatectomy and the Role of the Cancer Specialist Nurse. Int J Gen Med 2020; 13:897-901. [PMID: 33116782 PMCID: PMC7586018 DOI: 10.2147/ijgm.s267559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Accepted: 09/09/2020] [Indexed: 11/23/2022] Open
Abstract
Background Doctors are often ill-prepared to become patients, despite knowing the technicalities of surgical procedures and the day-to-day workings of hospital life intimately. Surrendering the decision-making process to other healthcare professionals can be an unnerving process for many of those who are medically qualified. Aim Although the sequelae of prostatectomy have often been written about, little is in the literature from medically qualified patients about their personal experiences of the procedure. We aimed to highlight areas where communication between medically qualified patients and their carers may be strengthened. Methods and Results We present a personal perspective of the emotional issues surrounding a potential cancer diagnosis, the experience of having a prostatectomy and what the hospital encounters were like in reality with a viewpoint of informing the medical profession in providing better patient information when they ask “what will it be like?”. From this perspective, the critical role of the cancer specialist nurse is highlighted as the lynch pin in providing a continuing source of information to medically qualified patients and in not treating them as omniscient, simply because of a medical degree. Conclusion Prostatectomy is a common procedure, but often questions about recovery after the procedure including impotence and incontinence are left unanswered in dealing with medically qualified colleagues when they are patients. Human behaviour is predictable, and medically qualified patients are just as apt to forget what is said to them as anyone else. However, the central role of the cancer specialist nurse as the bridge between the medical team and the patient should not be underestimated.
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Affiliation(s)
- Simon D Taylor-Robinson
- Department of Surgery and Cancer, Imperial College London, St Mary's Hospital Campus, London W2 1NY, UK
| | - Kathy Dykes
- Department of Surgery, Morriston Hospital, Swansea, Wales SA6 6NL, UK
| | - Bethan Hawkes
- Wales Cancer Network, NHS Wales Health Collaborative, Cardiff, Wales CF15 9SS, UK
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13
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Wu L, Zou Y. Psychological nursing intervention reduces psychological distress in patients with thyroid cancer: A randomized clinical trial protocol. Medicine (Baltimore) 2020; 99:e22346. [PMID: 32957406 PMCID: PMC7505398 DOI: 10.1097/md.0000000000022346] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Thyroidectomy has been considered an effective method to treat thyroid cancer. However, about 20% of patients have psychological distress before surgery. Psychological distress is considered common mental illnesses and it has been reported that the patients who suffer psychological distress have poor clinical outcomes than the patients without psychosocial disorder. Therefore, we design this randomized controlled study to explore the effect of psychological nursing intervention against quality of life and psychological distress of the patients with thyroid cancer. METHOD The trial will be conducted from September 2020 to December 2020 at Wuhan Fourth Hospital on the basis of the International Council for Harmonisation's Good Clinical Practice Guidelines and the principles of the Helsinki Declaration. The study was authorized via the Research Ethics Committee of the Wuhan Fourth Hospital (Approval number: 20200721-046). This study is a single-center, randomized, 2-arm, evaluator-blinded clinical trial. In all, 90 patients with thyroid cancer undergoing thyroidectomy will be enrolled in this study. The inclusion criteria includes: patients aged between 20 and 60 years old; ASA I-II classification; normal platelet coagulation and count function. The exclusion criteria contains: people with the intellectual and cognitive impairment (behavioral-cognitive intervention); BMI above 35 kg/m; the history of renal and hepatic dysfunction; and patients refuse to participate in this study. Both the patients in psychological intervention group and control group should receive the routine care, while the psychological intervention group also needs to receive the additional proper psychological nursing interventions. The emotional disorders are detected with the Chinese version of Profile of Mood States-Brief. And the patients' life quality is evaluated with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core Questionnaire (QLQ-C30, version 3.0). All the data are collated into Microsoft Excel 2010 and analyzed with SPSS 12.0 (IBM). RESULTS It is assumed that psychological nursing intervention could alleviate the psychological distress of patients with thyroid cancer and improve their quality of life. CONCLUSION This study can provide the reliable evidence regarding the influence of psychological nursing intervention against the life quality and psychological distress of the patients with thyroid cancer. TRIAL REGISTRATION This study protocol is registered in Research Registry (researchregistry5937).
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14
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Dunn J, Green A, Ralph N, Newton RU, Kneebone A, Frydenberg M, Chambers SK. Prostate cancer survivorship essentials framework: guidelines for practitioners. BJU Int 2020; 128 Suppl 3:18-29. [PMID: 32627306 PMCID: PMC9291032 DOI: 10.1111/bju.15159] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Objective To develop contemporary and inclusive prostate cancer survivorship guidelines for the Australian setting. Participants and Methods A four‐round iterative policy Delphi was used, with a 47‐member expert panel that included leaders from key Australian and New Zealand clinical and community groups and consumers from diverse backgrounds, including LGBTQIA people and those from regional, rural and urban settings. The first three rounds were undertaken using an online survey (94–96% response) followed by a fourth final face‐to‐face panel meeting. Descriptors for men’s current prostate cancer survivorship experience were generated, along with survivorship elements that were assessed for importance and feasibility. From these, survivorship domains were generated for consideration. Results Six key descriptors for men’s current prostate cancer survivorship experience that emerged were: dealing with side effects; challenging; medically focused; uncoordinated; unmet needs; and anxious. In all, 26 survivorship elements were identified within six domains: health promotion and advocacy; shared management; vigilance; personal agency; care coordination; and evidence‐based survivorship interventions. Consensus was high for all domains as being essential. All elements were rated high on importance but consensus was mixed for feasibility. Seven priorities were derived for immediate action. Conclusion The policy Delphi allowed a uniquely inclusive expert clinical and community group to develop prostate cancer survivorship domains that extend beyond traditional healthcare parameters. These domains provide guidance for policymakers, clinicians, community and consumers on what is essential for step change in prostate cancer survivorship outcomes.
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Affiliation(s)
- Jeff Dunn
- Prostate Cancer Foundation of Australia; Sydney NSW Australia
- Division of Research and Innovation; University of Southern Queensland; Springfield Qld Australia
- Cancer Council Queensland; Brisbane Qld Australia
- Faculty of Health; University of Technology Sydney; Ultimo NSW Australia
| | - Anna Green
- Faculty of Health; University of Technology Sydney; Ultimo NSW Australia
| | - Nicholas Ralph
- Division of Research and Innovation; University of Southern Queensland; Springfield Qld Australia
- Cancer Council Queensland; Brisbane Qld Australia
- Faculty of Health; University of Technology Sydney; Ultimo NSW Australia
- School of Nursing and Midwifery; University of Southern Queensland; Toowoomba Qld Australia
| | - Robert U. Newton
- Exercise Medicine Research Institute; Edith Cowan University; Perth WA Australia
- School of Human Movement and Nutrition Sciences; University of Queensland; Brisbane Qld Australia
| | - Andrew Kneebone
- Royal North Shore Hospital; Sydney NSW Australia
- School of Medicine; University of Sydney; Sydney NSW Australia
| | | | - Suzanne K. Chambers
- Division of Research and Innovation; University of Southern Queensland; Springfield Qld Australia
- Faculty of Health; University of Technology Sydney; Ultimo NSW Australia
- Exercise Medicine Research Institute; Edith Cowan University; Perth WA Australia
- Menzies Health Institute Queensland; Gold Coast Qld Australia
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15
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Jakimowicz S, Levett-Jones T, Chambers SK. Distress Screening for Men with Prostate Cancer. Semin Oncol Nurs 2020; 36:151041. [PMID: 32674974 DOI: 10.1016/j.soncn.2020.151041] [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: 12/24/2022]
Abstract
OBJECTIVE Although screening for distress and referral to evidence-based psychosocial support is a well-endorsed standard of cancer care, the extent to which this standard has been implemented varies widely. Lack of awareness, knowledge and skills in screening for distress in this patient group are likely key barriers to psychosocial care provision. The objective therefore was to discuss the development, design and evaluation of the effectiveness of the Distress Screening for Prostate Cancer (DSPC) module in targeting the perceived challenges and barriers to distress screening and psychological care by healthcare professionals. DATA SOURCES The DSPC module was piloted with five senior prostate cancer specialist nurses prior to the planned implementation with 50 prostate cancer nurses. Their average age was 49.8 years (range 43 to 57 years); there were three females and two males. Results from the Satisfaction with the Distress Screening Prostate Cancer E-Learning Module instrument indicated a high level of overall satisfaction with individual participants' scores ranging from 83-125/125 (mean 108.2). CONCLUSION Distress screening is an essential component of prostate cancer care and based on the information collected from stakeholders an e-learning module was designed and developed as an interactive and engaging evidence-based, pedagogically sound educational platform. The preliminary results from piloting the e-learning module indicated a high level of learner satisfaction and a measurable improvement in pre-post knowledge acquisition scores. These results suggest that this approach has the potential to increase screening for distress in men with prostate cancer and lead to more timely referral to psychosocial and supportive care to improve men's quality of life after diagnosis and over the illness trajectory. IMPLICATIONS FOR NURSING PRACTICE Specialist nurses and other healthcare professionals play an important role in screening men with prostate cancer for distress. This newly designed educational resource supports nurses in their practice of screening men with prostate cancer and the appropriate referral process.
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Affiliation(s)
| | - Tracy Levett-Jones
- Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - Suzanne K Chambers
- Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia; Centre for Health Research, University of Southern Queensland, Darling Heights, QLD, Australia; Menzies Health Institute Queensland, Griffith, University, QLD, Australia; Exercise Medicine Research Institute, Edith Cowan University, Perth, WA, Australia
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