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Yeom CW, Ha H, Hahm BJ, Hee Lee S, Joong Kim N, Shim EJ. Is fear of disease progression associated with antiretroviral therapy adherence in persons with HIV/AIDS? J Health Psychol 2024; 29:976-988. [PMID: 38251645 DOI: 10.1177/13591053231224177] [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] [Indexed: 01/23/2024] Open
Abstract
We examined the mediating role of depression and anxiety on the relationship between fear of disease progression (FoP) and antiretroviral therapy (ART) adherence and the moderating role of social support in the FoP-depression/anxiety-ART adherence relationship in persons with HIV/AIDS (PWHA). 202 PWHA completed self-report measures. Simple mediation and moderated mediation analyses were performed. FoP was directly and negatively associated with ART adherence, and the mediating role of depression in this relationship was significant. Indirect effect of FoP mediated by anxiety on ART adherence was not significant. The moderating effect of social support was significant in the FoP-depression pathway, while the indirect effect of FoP on ART adherence mediated by depression was greatest at a higher level of social support and lower level of FoP. The results suggest the relevance of high FoP and depression-mediated FoP in ART adherence and social support may attenuate the negative impact of FoP.
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Affiliation(s)
- Chan-Woo Yeom
- Uijeongbu Eulji Medical Center, Republic of Korea
- Eulji University School of Medicine, Republic of Korea
| | - Hyeju Ha
- Pusan National University, Republic of Korea
| | - Bong-Jin Hahm
- Seoul National University College of Medicine, Republic of Korea
- Seoul National University Hospital, Republic of Korea
| | - Sun Hee Lee
- Pusan National University School of Medicine and Medical Research Institute, Republic of Korea
- Pusan National University Hospital, Republic of Korea
| | - Nam Joong Kim
- Seoul National University College of Medicine, Republic of Korea
- Seoul National University Hospital, Republic of Korea
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Bai Y, Zhang J, Sun Y, Wang Y, Xu H. Latent profile analysis and related factors for fear of cancer recurrence among Chinese breast cancer patients in rehabilitation. Eur J Oncol Nurs 2024; 71:102651. [PMID: 38950499 DOI: 10.1016/j.ejon.2024.102651] [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: 08/19/2023] [Revised: 06/18/2024] [Accepted: 06/22/2024] [Indexed: 07/03/2024]
Abstract
PURPOSE Fear of cancer recurrence (FCR) is a psychological problem often faced by breast cancer patients in the rehabilitation period. The aim of this study was to identify FCR subgroups of Chinese breast cancer patients in rehabilitation and to analysis the factors affecting each subgroup. The effects of the subgroups on quality of life (QoL) were also explored. METHODS Cross-sectional data were collected from 300 breast cancer patients in a rehabilitation setting. The researchers invited the subjects to complete questionnaires on FCR, fatigue, anxiety depression, perception of illness and QoL. The researchers conducted a latent profile analysis. The factors influencing the subgroups of FCR were identified using ANOVA and multinomial logistic regression analyses. Linear regression analyses were used to explore the effect of subgroups on QoL. RESULTS There were three subgroups of FCR: profile 1 'Low FCR Group' (42.3%), profile 2 'Moderate FCR Group' (45.6%), and profile 3 'High FCR Group' (12.1%). Cancer stage II was a protective factor for FCR patients (OR = 0.107, P < 0.01) and was more likely to be categorized among the low FCR group. Anxiety depression was a risk factor for FCR patients and was more likely to be categorized in the medium FCR group (OR = 1.764, P < 0.001) and in the high FCR group (OR = 2.911, P < 0.001). In addition, patients subjected to a high perception of illness were more likely to be considered in the medium FCR group (OR = 1.041, P < 0.05), a risk factor affecting patients with FCR. Linear regression analysis showed that subgroups with higher FCR had a stronger negative predictive effect on their QoL (all P < 0.001). CONCLUSIONS The FCR was identified as three subgroups among breast cancer patients in rehabilitation, which suggests that healthcare professionals should give full consideration to the impact of cancer stage, anxiety and depression, and illness perceptions on the FCR subgroups in order to improve their QoL.
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Affiliation(s)
- Yinjie Bai
- The Fourth Affiliated Hospital of Harbin Medical University, No.37, Yiyuan Road, Harbin, Heilongjiang, 150001, China
| | - Jing Zhang
- The Fourth Affiliated Hospital of Harbin Medical University, No.37, Yiyuan Road, Harbin, Heilongjiang, 150001, China.
| | - Yujing Sun
- Harbin Medical University Daqing Campus, No. 39, Xinyang Road, Hi-Tech Zone, Daqing, Heilongjiang, 163319, China
| | - Yingying Wang
- The Fourth Affiliated Hospital of Harbin Medical University, No.37, Yiyuan Road, Harbin, Heilongjiang, 150001, China
| | - Huangfei Xu
- The Fourth Affiliated Hospital of Harbin Medical University, No.37, Yiyuan Road, Harbin, Heilongjiang, 150001, China
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Bahlburg H, Rausch P, Tully KH, Berg S, Noldus J, Butea-Bocu MC, Beyer B, Müller G. Psychosocial distress after radical prostatectomy, radical cystectomy, or (partial) nephrectomy - a comprehensive analysis of 4,290 German cancer patients during the COVID-19 pandemic. J Cancer Surviv 2024:10.1007/s11764-024-01644-w. [PMID: 38985430 DOI: 10.1007/s11764-024-01644-w] [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: 05/10/2024] [Accepted: 07/04/2024] [Indexed: 07/11/2024]
Abstract
AIM To evaluate and identify predictors of psychosocial distress (PD) in patients after surgical treatment for prostate cancer (PC), bladder cancer (BC), or kidney cancer (KC) during the COVID-19 pandemic in a large, multi-institutional cohort. MATERIAL AND METHODS Patients undergoing inpatient rehabilitation (IR) after radical prostatectomy (RP), radical cystectomy (RC), or (partial) nephrectomy in one IR center in 2021 were included. PD was evaluated by the Questionnaire on Stress in Cancer Patients (QSC-R23) at the beginning (T1) and the end (T2) of IR. Regression analyses were performed to identify disease-specific predictors for high PD. RESULTS A total of 4,290 patients (3,413 after RP, 563 after RC, 314 after (partial) nephrectomy) were included in this study. Median PD decreased significantly during IR across all tumor entities (each p < 0.001). The number of PC and BC patients suffering from high PD decreased significantly (each p < 0.001), but not in KC patients (p = 0.310). Younger age independently predicts high PD in all three malignancies, while additionally positive surgical margins (p = 0.016), ileal conduit (IC; p < 0.001), and nephrectomy (p = 0.032) independently predict high PD in PC, BC, and KC patients, respectively. During the Covid-19 pandemic the demand for individual psycho-oncologic counseling increased significantly in PC (p = 0.03) and KC (p = 0.001) patients. CONCLUSION Younger age independently predicts high PD in the three main urological malignancies. Positive surgical margins in PCa, IC in BCa, and nephrectomy in KC are disease-specific independent predictors for high PD in the early period after surgical treatment. IMPLICATIONS FOR CANCER SURVIVORS Disease-specific predictors for high PD may help clinicians identify patients at risk and may guide timely referrals to psycho-oncologic counseling in the early period after uro-oncologic surgery.
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Affiliation(s)
- Henning Bahlburg
- Department of Urology, Marien Hospital Herne, Ruhr-University Bochum, Hölkeskampring 40, 44625, Herne, Germany.
| | - Patricia Rausch
- Department of Urology, Marien Hospital Herne, Ruhr-University Bochum, Hölkeskampring 40, 44625, Herne, Germany
| | - Karl Heinrich Tully
- Department of Urology, Marien Hospital Herne, Ruhr-University Bochum, Hölkeskampring 40, 44625, Herne, Germany
| | - Sebastian Berg
- Department of Urology, Marien Hospital Herne, Ruhr-University Bochum, Hölkeskampring 40, 44625, Herne, Germany
| | - Joachim Noldus
- Department of Urology, Marien Hospital Herne, Ruhr-University Bochum, Hölkeskampring 40, 44625, Herne, Germany
| | | | - Burkhard Beyer
- Center for Urological Rehabilitation, Kliniken Hartenstein, Bad Wildungen, Germany
| | - Guido Müller
- Department of Urology, Marien Hospital Herne, Ruhr-University Bochum, Hölkeskampring 40, 44625, Herne, Germany
- Center for Urological Rehabilitation, Kliniken Hartenstein, Bad Wildungen, Germany
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Wang X, Li X, Zhang Z, Li Y, Zou Y, Yang L, Duan P, Xu R. A latent profile analysis of psychological resilience in gastric cancer survivors: A cross-sectional study. Eur J Oncol Nurs 2024; 70:102612. [PMID: 38795446 DOI: 10.1016/j.ejon.2024.102612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 05/11/2024] [Accepted: 05/14/2024] [Indexed: 05/28/2024]
Abstract
PURPOSE To characterize patterns of psychological resilience in gastric cancer survivors using latent profile analyses and to explore the factors influencing these latent profiles based on Kumpfer's resilience framework. METHODS Five hundred eighty-six gastric cancer survivors were recruited between July 30, 2021, and May 1, 2023. A demographic and clinical characteristics questionnaire, Connor and Davidson's Resilience Scale (CD-RISC), Fear of Progression Questionnaire Short Form (FoP-Q-SF), General Self-efficacy Scale (GSES), Medical Coping Modes Questionnaire (MCMQ), and Social Support Rating Scale (SSRS) were used for the investigation. Latent profile analysis of the resilience of gastric cancer survivors was conducted, and the factors influencing the latent profiles were explored by multivariate logistic regression analysis. RESULTS A total of 586 questionnaires were collected, and 572 were valid, with an effective recovery rate of 97.61%. The results of latent profile analysis showed that the resilience of gastric cancer survivors was divided into four subgroups, namely, the low-resilience group (18.4%), moderate-resilience group (43.2%), medium-high-resilience group (30.2%), and high-resilience group (8.2%). Multivariate logistic regression analysis showed that fear of disease progression, self-efficacy, medical coping mode and social support were influencing factors of subgroups. CONCLUSIONS Psychological resilience in gastric cancer survivors is individualized. Nurses should assess risk and protective factors for survivor resilience based on Kumpfer's resilience framework, identify unique needs, and develop new approaches and interventions.
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Affiliation(s)
- Xiaoqing Wang
- Department of General Surgery, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Xun Li
- Department of Nursing, Northern Jiangsu People's Hospital, Yangzhou, Jiangsu, China
| | - Ziyan Zhang
- Department of Nursing, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Yi Li
- Department of Nursing, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Yanling Zou
- Department of Nursing, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Lihua Yang
- School of Nursing, Jiangsu Health Vocational College, Nanjing, Jiangsu, China
| | - Peibei Duan
- Department of Nursing, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China.
| | - Rui Xu
- Department of General Surgery, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China.
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Liu P, Wu Q, Cheng Y, Zhuo Y, Li Z, Ye Q, Yang Q. Associations of illness perception and social support with fear of progression in young and middle-aged adults with digestive system cancer: A cross-sectional study. Eur J Oncol Nurs 2024; 70:102586. [PMID: 38657348 DOI: 10.1016/j.ejon.2024.102586] [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: 01/17/2024] [Revised: 03/27/2024] [Accepted: 03/31/2024] [Indexed: 04/26/2024]
Abstract
PURPOSE While Fear of progression (FoP) is a natural reaction in cancer, elevated FoP can impact life quality and social function. Our study aims to explore how illness perception, social support, and posttraumatic growth influence patients' FoP. METHODS This study enrolled 243 young and middle-aged adults with digestive system cancer at a hospital in Guangzhou from November 2022 to November 2023. In this study, the measurement instruments utilized included The Fear of Progression Questionnaire-Short Form, The Brief Illness Perception Questionnaire, The 12-item Perceived Social Support Scale, and The 21-item Posttraumatic Growth Inventory. Data was analyzed employing polynomial regression and response surface analyses. RESULTS The mean score of FoP was 35.45 ± 10.05, and 59.3% of the cancers (scores≥34) had clinically dysfunctional levels of FoP. Regarding congruence, patients' FoP was higher when the levels of illness perception and social support were both low or high than when the levels were both intermediate. Regarding incongruence, patients' FoP was lower when the level of illness perception was low and social support was high compared with when the level of illness perception was high and social support was low. Additionally, posttraumatic growth moderated the (in)congruence effect of illness perception-social support on the FoP of patients. CONCLUSIONS Low or high illness perception-social support congruence was detrimental to the FoP of patients. Low illness perception-high social support incongruence was beneficial to patients' FoP. Posttraumatic growth can be a positive factor for enhancing the impact of low illness perception-high social support incongruence on patients' FoP.
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Affiliation(s)
- Peng Liu
- School of Nursing, Jinan University, Guangzhou, Guangdong, China
| | - Qinyang Wu
- School of Nursing, Jinan University, Guangzhou, Guangdong, China
| | - Yingying Cheng
- School of Nursing, Jinan University, Guangzhou, Guangdong, China
| | - Yishang Zhuo
- School of Nursing, Jinan University, Guangzhou, Guangdong, China
| | - Zihan Li
- School of Nursing, Jinan University, Guangzhou, Guangdong, China
| | - Qiuyun Ye
- Tianhe Shipai Huashi Community Health Service Center, Guangdong, China.
| | - Qiaohong Yang
- School of Nursing, Jinan University, Guangzhou, Guangdong, China.
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Herzog K, Schepper F, Kamm-Thonwart R, Herrmann J, Budich M, Weiler-Wichtl L, Pletschko T, Suttorp M, Christiansen H, Martini J. Trajectories of illness perceptions in paediatric cancer patients and their parents and associations with health-related quality of life: Results of a prospective-longitudinal study. Psychooncology 2024; 33:e6332. [PMID: 38520473 DOI: 10.1002/pon.6332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 02/16/2024] [Accepted: 03/12/2024] [Indexed: 03/25/2024]
Abstract
OBJECTIVE In paediatric oncology, little is known about trajectories of illness perceptions and their longitudinal associations with health-related quality of life (HRQoL). Therefore, the aim of this study was to investigate changes in illness perceptions in children and parents over a one-year-period and to investigate predictive value of child's and parent's illness perceptions during acute treatment for child's HRQoL 1 year later. METHODS N = 65 child-parent-dyads participated in a longitudinal study (retention rate: 80.2%). Children were 4-18 years of age and underwent acute cancer treatment at baseline. Children and parents reported on their own illness perceptions (Illness-Perception-Questionnaire-Revised), as well as on the child's HRQoL (KINDL-R) at baseline and one-year-follow-up. Paired-samples t-tests were calculated to investigate changes over time. A hierarchical multiple regression analysis was performed to investigate predictive value of child's and parent's illness perceptions for child's HRQoL. RESULTS Child's HRQoL t(63) = -6.73, p < 0.001, their perceptions of coherence (i.e. understanding; t(54) = -2.36, p = 0.022) and consequences of their illness (t(54) = 2.86, p = 0.006), and parent's perception of cyclical trajectory (t(61) = 2.06, p = 0.044) improved from baseline to 1-year-follow-up. All other illness perceptions remained stable. Exploratory post-hoc analyses showed differences in the pattern of change in age-, gender-, and diagnosis-specific subgroups. After controlling for baseline levels of HRQoL, child's perceptions of symptoms and consequences were independent predictors of their HRQoL 1 year later (R2 = 0.396, F(2,52) = 10.782, p < 0.001), whereas no parent's illness perceptions added predictive value. CONCLUSION In paediatrics, child's and parent's illness perceptions should be assessed. Our findings highlight the importance of illness perceptions as potential modifiable variables in interventions to improve child's HRQoL.
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Affiliation(s)
- Kristina Herzog
- Department of Psychiatry and Psychotherapy, Faculty of Medicine of the Technische Universität Dresden, Dresden, Germany
- Elternhilfe für krebskranke Kinder e.V. Leipzig, Leipzig, Germany
| | - Florian Schepper
- Department of Paediatric Oncology, Haematology and Haemostaseology, Leipzig University, Leipzig, Germany
- Department of Paediatric Psychiatry, Psychotherapy and Psychosomatics, Leipzig University, Leipzig, Germany
| | - Remo Kamm-Thonwart
- Sonnenstrahl e.V. Dresden-Förderkreis für krebskranke Kinder und Jugendliche, Dresden, Germany
| | - Jessy Herrmann
- Elternhilfe für krebskranke Kinder e.V. Leipzig, Leipzig, Germany
| | - Mihaela Budich
- Department of Paediatrics, Paediatric Haematology and Oncology, University Hospital Carl Gustav Carus Dresden, Dresden, Germany
| | - Liesa Weiler-Wichtl
- Department of Paediatric and Adolescent Medicine, Medical University Vienna, Vienna, Austria
| | - Thomas Pletschko
- Department of Paediatric and Adolescent Medicine, Medical University Vienna, Vienna, Austria
| | - Meinolf Suttorp
- Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Holger Christiansen
- Department of Paediatric Oncology, Haematology and Haemostaseology, Leipzig University, Leipzig, Germany
| | - Julia Martini
- Department of Psychiatry and Psychotherapy, Faculty of Medicine of the Technische Universität Dresden, Dresden, Germany
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Bahlburg H, Tully KH, Bach P, Butea-Bocu MC, Reike M, Roghmann F, Noldus J, Müller G. Improvements in urinary symptoms, health-related quality of life, and psychosocial distress in the early recovery period after radical cystectomy and urinary diversion in 842 German bladder cancer patients: data from uro-oncological rehabilitation. World J Urol 2024; 42:111. [PMID: 38421452 PMCID: PMC10904548 DOI: 10.1007/s00345-024-04839-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 01/16/2024] [Indexed: 03/02/2024] Open
Abstract
PURPOSE This study aims to investigate urinary symptoms (continence and stoma care), health-related quality of life (HRQoL) and psychosocial distress (PD) in the early postoperative period after radical cystectomy (RC) and urinary diversion for ileal conduit (IC) and ileal neobladder (INB) to obtain a better basis for patient counseling. METHODS Data for 842 bladder cancer patients, who underwent 3 weeks of inpatient rehabilitation (IR) after RC and urinary diversion (447 IC, 395 INB) between April 2018 and December 2019 were prospectively collected. HRQoL, PD, and urinary symptoms were evaluated by validated questionnaires at the beginning (T1) and the end of IR (T2). In addition, continence status and micturition volume were objectively evaluated in INB patients by 24-h pad test and uroflowmetry, respectively. RESULTS Global HRQoL was severely impaired at T1, without significant difference between the two types of urinary diversion. All functioning and symptom scales of HRQoL improved significantly from T1 to T2. In INB patients, all continence parameters improved significantly during IR, while patients with an IC reported fewer problems concerning urostomy management. The proportion of patients suffering from high PD decreased significantly from 50.7 to 34.9%. Age ≤ 59 years was the only independent predictor of high PD. Female patients and patients ≤ 59 years were more likely to use individual psycho-oncological counseling. CONCLUSION HRQoL, PD and urinary symptoms improved significantly in the early recovery period after RC. Patients with urinary continence reported higher HRQoL and less PD. Psychosocial support should be offered especially to younger patients.
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Affiliation(s)
- Henning Bahlburg
- Department of Urology, Marien Hospital Herne, Ruhr-University Bochum, Hölkeskampring 40, 44625, Herne, Germany.
| | - Karl Heinrich Tully
- Department of Urology, Marien Hospital Herne, Ruhr-University Bochum, Hölkeskampring 40, 44625, Herne, Germany
| | - Peter Bach
- Department of Urology, Marien Hospital Herne, Ruhr-University Bochum, Hölkeskampring 40, 44625, Herne, Germany
| | | | - Moritz Reike
- Department of Urology, Marien Hospital Herne, Ruhr-University Bochum, Hölkeskampring 40, 44625, Herne, Germany
| | - Florian Roghmann
- Department of Urology, Marien Hospital Herne, Ruhr-University Bochum, Hölkeskampring 40, 44625, Herne, Germany
| | - Joachim Noldus
- Department of Urology, Marien Hospital Herne, Ruhr-University Bochum, Hölkeskampring 40, 44625, Herne, Germany
| | - Guido Müller
- Department of Urology, Marien Hospital Herne, Ruhr-University Bochum, Hölkeskampring 40, 44625, Herne, Germany
- Center for Urological Rehabilitation, Kliniken Hartenstein, Bad Wildungen, Germany
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Hinz A, Schulte T, Mehnert-Theuerkauf A, Richter D, Sender A, Brock H, Friedrich M, Briest S. Fear of Cancer Progression: A Comparison between the Fear of Progression Questionnaire (FoP-Q-12) and the Concerns about Recurrence Questionnaire (CARQ-4). Healthcare (Basel) 2024; 12:435. [PMID: 38391810 PMCID: PMC10888487 DOI: 10.3390/healthcare12040435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/04/2024] [Accepted: 02/05/2024] [Indexed: 02/24/2024] Open
Abstract
As cancer patients often suffer from fear of cancer progression (FoP), valid screening for FoP is of high relevance. The aims of this study were to test psychometric properties of two FoP questionnaires, to determine their relationship to other anxiety-related constructs, and to analyze the impact of sociodemographic and clinical factors on the FoP. Our sample consisted of n = 1733 patients with mixed cancer diagnoses. For measuring FoP, the Fear of Progression questionnaire (FoP-Q-12) and the Concerns About Cancer Recurrence Questionnaire (CARQ-4) were used. The mean scores of the FoP-Q-12 and the CARQ-4 were 30.0 ± 10.4 and 16.1 ± 10.8, respectively, indicating relatively high levels of FoP. Both questionnaires showed excellent internal consistency coefficients, α = 0.895 and α = 0.915, respectively. The correlation between the two FoP questionnaires was r = 0.72. Female patients reported more FoP than male patients (d = 0.84 and d = 0.54, respectively). There was a nonlinear age dependency of FoP, with an increase found in the age range from 18 to 50 years and a decrease in the older age range. Radiation, chemotherapy, and antibody therapy, but not surgery, lead to an increase in FoP. Both questionnaires show good psychometric properties and can be recommended for use in an oncological routine. Female patients and patients in the middle-age range deserve special attention from healthcare providers.
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Affiliation(s)
- Andreas Hinz
- Department of Medical Psychology and Medical Sociology, Comprehensive Cancer Center Central Germany, University Medical Center Leipzig, 04103 Leipzig, Germany
| | - Thomas Schulte
- Rehabilitation Clinic Bad Oexen, 32549 Bad Oeynhausen, Germany
| | - Anja Mehnert-Theuerkauf
- Department of Medical Psychology and Medical Sociology, Comprehensive Cancer Center Central Germany, University Medical Center Leipzig, 04103 Leipzig, Germany
| | - Diana Richter
- Department of Medical Psychology and Medical Sociology, Comprehensive Cancer Center Central Germany, University Medical Center Leipzig, 04103 Leipzig, Germany
| | - Annekathrin Sender
- Department of Medical Psychology and Medical Sociology, Comprehensive Cancer Center Central Germany, University Medical Center Leipzig, 04103 Leipzig, Germany
| | - Hannah Brock
- Department of Medical Psychology and Medical Sociology, Comprehensive Cancer Center Central Germany, University Medical Center Leipzig, 04103 Leipzig, Germany
| | - Michael Friedrich
- Department of Medical Psychology and Medical Sociology, Comprehensive Cancer Center Central Germany, University Medical Center Leipzig, 04103 Leipzig, Germany
| | - Susanne Briest
- Department of Gynecology, Comprehensive Cancer Center Central Germany, University Medical Center Leipzig, 04103 Leipzig, Germany
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Hosseinchi P, Ghalibaf E, Kamyab G, Eghbali A, Khatibi A. Health anxiety and the negative interpretation of children's bodily symptoms in mothers of cancer patients. J Cancer Surviv 2024; 18:157-164. [PMID: 37470950 PMCID: PMC10866749 DOI: 10.1007/s11764-023-01431-z] [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: 11/03/2022] [Accepted: 07/11/2023] [Indexed: 07/21/2023]
Abstract
PURPOSE Fear of progression (FoP) is a substantial concern for family caregivers of cancer survivors and is related to a number of adverse outcomes, including increased mental distress and worse quality of life. Previous research has revealed that health anxiety (HA) contributes to fear of relapse, but cognitive factors underlying establishing and maintaining FoP in mothers of cancer patients have not been examined. In this study, we were looking to investigate this association. METHODS We used the computerized interpretation bias (IB) assessment to investigate the biased interpretation of ambiguous bodily information and its association with FoP through HA among 69 mothers of cancer patients and 42 mothers of healthy kids. RESULTS Mothers of cancer patients interpreted more negatively ambiguous bodily symptoms than mothers of healthy kids. Moreover, they had higher levels of HA and FoP and lower quality of life than the healthy group. Also, among mothers of cancer patients, the relationship between negative IB and FoP is mediated by their HA. CONCLUSIONS The findings of this study imply that negative IB may contribute to increased HA, which in turn contributes to higher levels of FoP among the mothers of cancer patients, which may reduce the quality of life of their children. IMPLICATIONS FOR CANCER SURVIVORS From these findings, we propose that changing HA through modification of IB might lower the FoP in mothers of kids with cancer and improve the mother and child's quality of life.
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Affiliation(s)
| | | | - Golnoosh Kamyab
- Department of Anatomy, Université du Québec à Trois-Rivières, Trois-Rivieres, QC, Canada
- CogNAC Research Group, Université du Québec à Trois-Rivières, Trois-Rivieres, QC, Canada
| | - Aziz Eghbali
- Department of Neuroscience, Iran University of Medical Sciences, Tehran, Iran
- Ali-Asghar Clinical Research Development Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Khatibi
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK.
- Centre for Human Brain Health, University of Birmingham, Birmingham, UK.
- Institute for Mental Health, University of Birmingham, Birmingham, UK.
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Bahlburg H, Reicherz A, Reike M, Bach P, Butea-Bocu MC, Tully KH, Roghmann F, Noldus J, Müller G. A prospective evaluation of quality of life, psychosocial distress, and functional outcomes two years after radical cystectomy and urinary diversion in 842 German bladder cancer patients. J Cancer Surviv 2024:10.1007/s11764-024-01535-0. [PMID: 38291220 DOI: 10.1007/s11764-024-01535-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 01/10/2024] [Indexed: 02/01/2024]
Abstract
PURPOSE This study aims to evaluate survival, health-related quality of life (HRQoL), psychosocial distress, and functional outcomes after radical cystectomy (RC) and urinary diversion for ileal neobladder (INB) or ileal conduit (IC) in a contemporary German cohort of bladder cancer patients. METHODS Patients undergoing inpatient rehabilitation after RC between April 2018 and December 2019 in one high-volume rehabilitation center were surveyed regarding HRQoL, psychosocial distress, and functional outcomes until two years after RC. RESULTS Eight-hundred forty-two patients (683 male, 159 female; 395 INB, 447 IC) were included. Patients with an IC suffered more often from locally advanced disease (≥ pT3; 41.4% vs. 24.1%, p < 0.001) and lymph node metastases (19.9% vs. 11.8%, p = 0.002), resulting in worse probability of survival (p < 0.001). Global HRQoL improved steadily during follow-up, but significant differences in subscales persisted between cohorts. Multivariable regression analysis identified IC, male sex, and patient age ≤ 59 years as independent predictors for persistent high psychosocial distress. Almost 42% of female patients reported severe urinary incontinence two years after RC. Most men reported severely diminished erectile function, even after nerve-sparing surgery. CONCLUSION Global HRQoL two years after RC is comparable to the general German population. Female patients should be informed about worse continence rates. Conversely, men should be educated about erectile dysfunction. Aftercare should include psycho-oncologic counseling, especially for patients at risk. IMPLICATIONS FOR CANCER SURVIVORS Patients should be counseled on long-term functional outcomes and persistent psychosocial distress after RC. Closer cooperation between urologists and psycho-oncologists is needed.
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Affiliation(s)
- Henning Bahlburg
- Department of Urology, Marien Hospital Herne, Ruhr-University Bochum, Hölkeskampring 40, 44625, Herne, Germany.
| | - Alina Reicherz
- Department of Urology, Marien Hospital Herne, Ruhr-University Bochum, Hölkeskampring 40, 44625, Herne, Germany
| | - Moritz Reike
- Department of Urology, Marien Hospital Herne, Ruhr-University Bochum, Hölkeskampring 40, 44625, Herne, Germany
| | - Peter Bach
- Department of Urology, Marien Hospital Herne, Ruhr-University Bochum, Hölkeskampring 40, 44625, Herne, Germany
| | | | - Karl Heinrich Tully
- Department of Urology, Marien Hospital Herne, Ruhr-University Bochum, Hölkeskampring 40, 44625, Herne, Germany
| | - Florian Roghmann
- Department of Urology, Marien Hospital Herne, Ruhr-University Bochum, Hölkeskampring 40, 44625, Herne, Germany
| | - Joachim Noldus
- Department of Urology, Marien Hospital Herne, Ruhr-University Bochum, Hölkeskampring 40, 44625, Herne, Germany
| | - Guido Müller
- Department of Urology, Marien Hospital Herne, Ruhr-University Bochum, Hölkeskampring 40, 44625, Herne, Germany
- Center for Urological Rehabilitation, Kliniken Hartenstein, Bad Wildungen, Germany
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Liu C, Liu C, Gao H, Yu X, Chen C, Lin H, Qiu L, Chen L, Tian H. Mediation Effects of Coping Styles on Fear of Progression and Reproductive Concerns in Breast Cancer Patients of Reproductive Age. Asian Nurs Res (Korean Soc Nurs Sci) 2023; 17:245-252. [PMID: 37944797 DOI: 10.1016/j.anr.2023.11.002] [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: 01/19/2023] [Revised: 10/31/2023] [Accepted: 11/01/2023] [Indexed: 11/12/2023] Open
Abstract
PURPOSE This study aimed to investigate reproductive concerns among breast cancer patients of reproductive age, analyze the influencing factors, explore the relationship between coping styles, fear of progression (FOP), and reproductive concerns, and identify the multiple effects of coping styles on the relationship between FOP and reproductive concerns among Chinese breast cancer patients. METHODS A cross-sectional, descriptive study was conducted among breast cancer patients in four tertiary grade A hospitals in Fujian, China, from January 2022 to September 2022. A total of 210 patients were recruited to complete paper-based questionnaires, which included the general data questionnaires, the Reproductive Concerns After Cancer Scale (RCACS), the Fear of Progression Questionnaire-Short Form (FOP-Q-SF), and the Medical Coping Modes Questionnaire (MCMQ). Structural equation models were utilized to evaluate the multiple effects of coping styles on FOP and reproductive concerns. RESULTS Reproductive concerns in breast cancer patients had a mean score of 53.02 (SD, 10.69), out of a total score of 90, and coping styles for cancer (confrontation, avoidance) were closely associated with FOP and reproductive concerns. FOP showed a significant positive correlation with reproductive concerns (r = .52, p < .01). At the same time, confrontation was significantly negatively correlated with both FOP (r = -.28, p < .01) and reproductive concerns (r = -.39, p < .01). Avoidance was positively correlated to both FOP (r = .25, p < .01) and reproductive concerns (r = .34, p < .01). The impact of FOP on reproductive concerns is partially mediated by confrontation and avoidance, with effect sizes of .07 and .04, respectively. These mediating factors account for 22.0% of the total effect. CONCLUSIONS The FOP directly impacted reproductive concerns, while coping styles could partially mediate the association between FOP and reproductive concerns. This study illustrates the role of confrontation and avoidance in alleviating reproductive concerns, suggesting that it is necessary to focus on the changes in reproductive concerns among reproductive-age breast cancer patients. Healthcare professionals can improve disease awareness and reduce patients' FOP, thereby promoting positive psychological and coping behaviors and ultimately alleviating reproductive concerns.
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Affiliation(s)
- Cuiting Liu
- School of Nursing, Putian University, Putian, Fujian, China
| | - Cuiping Liu
- Department of Hepatopancreatobiliary Surgery, Affiliated Hospital of Putian University, Putian, Fujian, China
| | - Huiting Gao
- Department of Breast Surgery, Women and Children Hospital, Xiamen University, Xiamen, Fujian, China
| | - Xuefen Yu
- Department of Breast Surgery, Women and Children Hospital, Xiamen University, Xiamen, Fujian, China
| | - Chunying Chen
- Nursing Department, The First Hospital of Putian City, Putian, Fujian, China
| | - Hangying Lin
- Department of Breast Surgery, Affiliated Hospital of Putian University, Putian, Fujian, China
| | - Lijuan Qiu
- Department of Neurology, The First Hospital of Longyan City, Longyan, Fujian, China
| | - Liangying Chen
- School of Nursing, Putian University, Putian, Fujian, China.
| | - Hongmei Tian
- School of Nursing, Chongqing Medical and Pharmaceutical College, Chongqing, China.
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Song J, Cho E, Cho IK, Lee D, Kim J, Kim H, Chung S. Mediating Effect of Intolerance of Uncertainty and Cancer-Related Dysfunctional Beliefs About Sleep on Psychological Symptoms and Fear of Progression Among Cancer Patients. Psychiatry Investig 2023; 20:912-920. [PMID: 37899214 PMCID: PMC10620329 DOI: 10.30773/pi.2023.0127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 07/02/2023] [Accepted: 07/22/2023] [Indexed: 10/31/2023] Open
Abstract
OBJECTIVE This study aimed to explore the mediating effects of cancer-related dysfunctional beliefs regarding sleep and intolerance of uncertainty on the effect of depression, insomnia, and anxiety on fear of progression (FoP). METHODS We retrospectively reviewed medical records of patients with cancer who visited the Sleep Clinic for cancer patients in Asan Medical Center for the first time between December 2021 and March 2022. Data collected included age, sex, types of cancer, staging, current treatment modalities, and history of surgical procedures. In addition, psychological symptoms were rated using the Insomnia Severity Scale (ISI), Patient Health Questionnaire-9 items (PHQ-9), State subcategory of the State and Trait of Anxiety Inventory (STAI-S), Short form of Fear of Progression Questionnaire, Cancer-related Dysfunctional Beliefs about Sleep scale (C-DBS), single item of pain and fatigue, Connor Davidson Resilience Scale 2-item (CD-RISC2), and Intolerance of Uncertainty-12 (IUS-12). The predictive variables for FoP were determined by linear regression analysis. RESULTS The FoP was significantly correlated with age (r=-0.289), ISI (r=0.178), PHQ-9 (r=0.703), STAI-S (r=0.377), fatigue (r=0.452), CD-RISC2 (r=-0.270), IUS-12 (r=0.585), and C-DBS (r=0.427, all p<0.01). A mediation analysis showed that intolerance of uncertainty and dysfunctional beliefs about sleep mediated the relationship of FoP with insomnia, depression, or anxiety. CONCLUSION Psychological support for intolerance of uncertainty and cancer-related dysfunctional beliefs about sleep in patients with cancer may be beneficial to reduce their FoP.
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Affiliation(s)
- Jaeeun Song
- University of Ulsan College of Medicine, Ulsan, Republic of Korea
| | - Eulah Cho
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Inn-Kyu Cho
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Dongin Lee
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jiyoung Kim
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Harin Kim
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Seockhoon Chung
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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13
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Conor Rork W, Hertz AG, Wiese AD, Kostick KM, Nguyen D, Schneider SC, Shepherd WS, Cho H, Murali CN, Lee B, Reid Sutton V, Storch EA. A qualitative exploration of patient perspectives on psychosocial burdens and positive factors in adults with osteogenesis imperfecta. Am J Med Genet A 2023; 191:2267-2275. [PMID: 37317786 PMCID: PMC10525007 DOI: 10.1002/ajmg.a.63323] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 05/11/2023] [Accepted: 05/26/2023] [Indexed: 06/16/2023]
Abstract
Osteogenesis imperfecta (OI) is a pleiotropic, heritable connective tissue disorder associated with a wide range of health implications, including frequent bone fracture. While progress has been made to understand the spectrum of these physical health implications, the impact of OI on psychosocial well-being, as well as protective factors that buffer against adverse psychosocial outcomes, remain understudied. This present study relies on a qualitative approach to assess patient perspectives on both protective and adverse psychosocial factors specific to OI in 15 adults with varying disease status. Semi-structured interviews were conducted, subsequently coded, and themes extracted. Themes concerning psychosocial burdens (i.e., negative affective and behavioral impacts of disease status) and protective factors were identified from cooperatively-coded transcripts (two coders per transcript). Participants reported experiencing an increase in negative affect and disease-related distress after fracturing a bone and during recovery. Fear and concern specific to the uncertainty of future bone fractures and negative self-image was common. In contrast to these negative impacts, participants additionally described positive orientations toward their disease and attributed positive traits to their lived experience with a chronic disease. While limited due to small sample size and lack of ethno-racial diversity, findings highlight a need for continued research on the relationship between OI disease status and psychosocial outcomes, as well as the development of psychological interventions designed for OI populations. Findings have relevant clinical applications for healthcare providers working with those diagnosed with OI.
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Affiliation(s)
- W. Conor Rork
- Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
| | - Alyssa G. Hertz
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas
| | - Andrew D. Wiese
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas
| | - Kristin M. Kostick
- Center for Medical Ethics & Health Policy, Baylor College of Medicine, Houston, Texas
| | - Dianne Nguyen
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas
| | - Sophie C. Schneider
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas
| | - Whitney S. Shepherd
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas
| | - Hannah Cho
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas
| | | | - Chaya N. Murali
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas
- Texas Children’s Hospital, Houston, Texas
| | - Brendan Lee
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas
- Texas Children’s Hospital, Houston, Texas
| | - V. Reid Sutton
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas
- Texas Children’s Hospital, Houston, Texas
| | - Eric A. Storch
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas
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He JL, Xu HQ, Yang J, Hou DJ, Gong XY, Lu XY, Wang W, Cai MJ, Yu YF, Gao J. Fear of disease progression among breast cancer patients in China: a meta-analysis of studies using the fear of progression questionnaire short form. Front Psychol 2023; 14:1222798. [PMID: 37680239 PMCID: PMC10482266 DOI: 10.3389/fpsyg.2023.1222798] [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: 05/20/2023] [Accepted: 08/09/2023] [Indexed: 09/09/2023] Open
Abstract
Background Fear of disease progression (FoP) is among the most prevalent and major psychological burdens breast cancer patients encounter. Excessive FoP may result in serious adverse effects for patients. FoP in breast cancer patients has gained attention recently; however, its prevalence in China is unknown. Objectives This meta-analysis and systematic review aimed to assess the overall FoP among Chinese breast cancer patients to make recommendations for treatment and care. Methods Systematic search databases included PubMed, EMbase, The Cohrane Library, Web of Science, CINAHL, PsycINFO and 4 Chinese databases (Wan Fang Data, CBM, VIP and CNKI). The retrieval time ranged from the database's establishment to March 20, 2023. After two researchers independently evaluated the literature, retrieved information, and assessed the risk of bias for the included literature, Stata 15.1 software was used to conduct a meta-analysis. Results A total of 37 moderate or high-quality studies involving 9,689 breast cancer patients were included. Meta-analysis showed that the pooled mean score of FoP for Chinese breast cancer patients was 33.84 [95% CI (31.91, 35.77)], prediction interval (21.57 ~ 46.11). The subgroup study found that FoP levels varied among breast cancer patients of different regions, ages, educational levels, marital statuses, residences, illness stages, and disease statuses. Conclusion Breast cancer patients have higher FoP scores. Healthcare workers should be concerned. We expect that more relevant research will be undertaken and more effective interventions will be developed. Patients can manage their illness and improve their quality of life by reducing their fears. Systematic review registration https://www.crd.york.ac.uk/prospero/, identifier: PROSPERO CRD42023408914.
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Affiliation(s)
- Jia-Li He
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Hui-Qiong Xu
- Division of Abdominal Tumor Multimodality Treatment, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- West China School of Nursing, Sichuan University. Chengdu, Sichuan, China
| | - Jing Yang
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Dong-Jiang Hou
- School of Medicine and Life Science, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Xiao-Yan Gong
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Xian-Ying Lu
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Wei Wang
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Ming-Jin Cai
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Yu-Feng Yu
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Jing Gao
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
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15
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Li B, Liu D, Zhang Y, Xue P. Stigma and related factors among renal dialysis patients in China. Front Psychiatry 2023; 14:1175179. [PMID: 37583843 PMCID: PMC10423816 DOI: 10.3389/fpsyt.2023.1175179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 07/17/2023] [Indexed: 08/17/2023] Open
Abstract
Background Stigma is an important psychological concept that is being studied in many diseases. However, there have been few studies on stigma in renal dialysis patients in China. This study aimed to investigate the level of stigma and its potential influencing factors among Chinese renal dialysis patients. Methods A cross-sectional study was conducted among renal dialysis patients in two Chinese dialysis centers between April 2022 and July 2022. Two hundred four renal kidney patients were interviewed with a questionnaire on demographic variables using the Social Impact Scale (SIS), Resilience Scale-14 (RS-14), Herth Hope Index(HHI), Multidimensional Scale of Perceived Social Support (MSPSS), Revised Life Orientation Test(LOT-R), Perceived Stress Scale (PSS-4) and Fear of Progression (FoP). T-test/univariate one-way ANOVA, Pearson's R, and hierarchical linear regression analysis were used to investigate the factors that influence stigma. Results Renal dialysis patients in China experienced a moderate level of stigma (52.36 ± 8.16). Stigma was negatively correlated with resilience, hope, and perceived social support, whereas it was positively associated with perceived stress and fear of progression. However, it showed no significant relationship between optimism and stigma. Hierarchical linear regression analysis showed that hope (β = -0.318, P < 0.001), social support (β = -0.193, P < 0.01), perceived stress (β = 0.197, P < 0.01), and fear of progression (β = 199, P < 0.01) were found to be associated with stigma among the renal dialysis patients. All four variables in the model could explain 34.6% of the variance in stigma among renal dialysis patients in China. Conclusion According to this study, renal dialysis patients in China face a moderate level of stigma. Stigma was found to be negatively related to hope and social support but positively associated with perceived stress and fear of progression. Future research on the stigma of renal dialysis patients should include hope-based interventions, proper and specific social support strategies, stress management interventions, and more disease-related information.
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Affiliation(s)
| | | | | | - Pengshi Xue
- Department of Nursing, Shengjing Hospital of China Medical University, Shenyang, China
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16
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Chen R, Yang H, Zhang H, Chen J, Liu S, Wei L. Fear of progression among postoperative patients with newly diagnosed lung cancer: a cross-sectional survey in China. BMC Psychol 2023; 11:168. [PMID: 37217966 DOI: 10.1186/s40359-023-01211-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 05/17/2023] [Indexed: 05/24/2023] Open
Abstract
BACKGROUND More lung cancer cases are becoming diagnosed earlier in recent years. The diagnosis is often accompanied by fear of progression (FoP). There is a clear research gap in the existing literature on FoP and the most frequent concerns in newly diagnosed lung cancer patients. OBJECTIVE To identify the status and factors related to FoP in newly diagnosed Chinese lung cancer patients undergoing thoracoscopic lung cancer resection. METHODS A cross-sectional design with convenience sampling was used in this study. Participants (N = 188) with newly diagnosed lung cancer (≤ 6 months) at one hospital in Zhengzhou were recruited. A demographic questionnaire, Fear of Progression Questionnaire-Short Form, Social Support Rating Scale (SSRS), Simplified Coping Style Questionnaire, and Brief Illness Perception Questionnaire were used to assess characteristics, FoP, social support, coping style, and patient illness perceptions. Multivariable logistic regression analysis was used to identify factors associated with FoP. RESULTS The mean score of FoP was 35.39 ± 8.03. There are 56.4% of the patients (scores ≥ 34) have a clinically dysfunctional level of FoP. FoP was higher in young (18-39 years) than middle-aged patients (40-59 years) and elderly patients (≧60 years) (P = 0.004). Patients aged 40-59 years showed significantly higher fear of family-related concerns (P < 0.001), a fear of potential harm from medications (P = 0.001); Patients aged 18-39 years and 40-59 years showed significantly higher fears of work-related concerns (P = 0.012). Multiple logistic regression analyses showed that patients' age, the time from surgery and SSRS score were found to be independently associated with higher FoP. CONCLUSIONS High FoP is a frequently reported problem among newly diagnosed lung cancer patients, especially those less than 60 years old. Professional psychoeducation, psychological interventions, and personalized support are needed for patients with a high FoP.
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Affiliation(s)
- Ruiyun Chen
- Department of Thoracic Surgery, Henan Key Laboratory for Nursing, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Henan University People's Hospital, No.7 Weiwu Road, Jinshui District, Zhengzhou, 450003, Henan, People's Republic of China
| | - Hui Yang
- Department of Thoracic Surgery, Henan Key Laboratory for Nursing, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Henan University People's Hospital, No.7 Weiwu Road, Jinshui District, Zhengzhou, 450003, Henan, People's Republic of China.
| | - Hongmei Zhang
- Department of Nursing, Henan Key Laboratory for Nursing, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Henan University People's Hospital, Zhengzhou, 450003, Henan, People's Republic of China
| | - Jingru Chen
- Department of Thoracic Surgery, Henan Key Laboratory for Nursing, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Henan University People's Hospital, No.7 Weiwu Road, Jinshui District, Zhengzhou, 450003, Henan, People's Republic of China
| | - Saisai Liu
- Department of Thoracic Surgery, Henan Key Laboratory for Nursing, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Henan University People's Hospital, No.7 Weiwu Road, Jinshui District, Zhengzhou, 450003, Henan, People's Republic of China
| | - Li Wei
- Department of Thoracic Surgery, Henan Key Laboratory for Nursing, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Henan University People's Hospital, No.7 Weiwu Road, Jinshui District, Zhengzhou, 450003, Henan, People's Republic of China
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17
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Bahlburg H, Hellmann T, Tully K, Butea-Bocu MC, Reike M, Roghmann F, Noldus J, Müller G. Psychosocial distress and quality of life in patients after radical cystectomy - one year follow-up in 842 German patients. J Cancer Surviv 2023:10.1007/s11764-023-01400-6. [PMID: 37162683 DOI: 10.1007/s11764-023-01400-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 05/04/2023] [Indexed: 05/11/2023]
Abstract
PURPOSE This study aims to report on psychosocial distress and QoL in bladder cancer patients after radical cystectomy (RC) and urinary diversion to obtain a better basis for patient counseling and postoperative care. METHODS The study relied on prospectively collected data for 842 patients, who underwent three weeks of inpatient rehabilitation after RC and creation of an ileal conduit (IC) or ileal neobladder (INB). Data on QoL and psychosocial distress were collected by validated questionnaires. Multivariate logistic regression was performed to identify predictors for high psychosocial distress. RESULTS Four-hundred and forty-seven patients (326 male, 121 female) received an IC, while 395 patients (357 male, 38 female) received an INB. Health-related QoL improved steadily in the whole cohort during follow-up. Patients with an INB reported better physical function but suffered more from diarrhea and financial worries. Patients with an IC reported reduced satisfaction with their body image, increased worries about the future, and suffered more from constipation. Psychosocial distress increased significantly during follow-up. One year after surgery, 43.1% of patients suffered from high psychosocial distress. Multivariate regression analysis identified age ≤ 59 years (OR 1.731; CI 1.056-2.838; p = 0.030) and lymph node metastases (OR 2.073; CI 1.133-3.793; p = 0.018) as independent predictors for high psychosocial distress. CONCLUSION QoL improves significantly in all patients one year after RC. However, psychosocial distress remains high in a substantial number of patients. IMPLICATIONS FOR CANCER SURVIVORS To prevent chronic psychological disorders, easily accessible opportunities for psycho-oncological counseling are needed for patients following RC.
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Affiliation(s)
- Henning Bahlburg
- Department of Urology, Marien Hospital Herne, Ruhr-University Bochum, Hölkeskampring 40, 44625, Herne, Germany.
| | - Tabea Hellmann
- Department of Urology, Marien Hospital Herne, Ruhr-University Bochum, Hölkeskampring 40, 44625, Herne, Germany
| | - Karl Tully
- Department of Urology, Marien Hospital Herne, Ruhr-University Bochum, Hölkeskampring 40, 44625, Herne, Germany
| | | | - Moritz Reike
- Department of Urology, Marien Hospital Herne, Ruhr-University Bochum, Hölkeskampring 40, 44625, Herne, Germany
| | - Florian Roghmann
- Department of Urology, Marien Hospital Herne, Ruhr-University Bochum, Hölkeskampring 40, 44625, Herne, Germany
| | - Joachim Noldus
- Department of Urology, Marien Hospital Herne, Ruhr-University Bochum, Hölkeskampring 40, 44625, Herne, Germany
| | - Guido Müller
- Department of Urology, Marien Hospital Herne, Ruhr-University Bochum, Hölkeskampring 40, 44625, Herne, Germany
- Center for Urological Rehabilitation, Kliniken Hartenstein, Bad Wildungen, Germany
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18
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Göbel P, Kuba K, Götze H, Mehnert-Theuerkauf A, Spitzer C, Hartung T, Esser P. Interconnectivity of fear of progression and generalized anxiety - Network analysis among a sample of hematological cancer survivors. Support Care Cancer 2023; 31:238. [PMID: 36973563 PMCID: PMC10042941 DOI: 10.1007/s00520-023-07701-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 03/20/2023] [Indexed: 03/29/2023]
Abstract
PURPOSE Fear of cancer progression and recurrence (FoP) and generalized anxiety disorder (GAD) are syndromes commonly seen in cancer patients. This study applied network analysis to investigate how symptoms of both concepts are interconnected. METHODS We used cross-sectional data from hematological cancer survivors. A regularized Gaussian graphical model including symptoms of FoP (FoP-Q) and GAD (GAD-7) was estimated. We investigated (i) the overall network structure and (ii) tested on pre-selected items whether both syndromes could be differentiated based on their worry content (cancer related vs. generalized). For this purpose, we applied a metric named bridge expected influence (BEI). Lower values mean that an item is only weakly connected with the items of the other syndrome, which can be an indication of its distinctive characteristic. RESULTS Out of 2001 eligible hematological cancer survivors, 922 (46%) participated. The mean age was 64 years and 53% were female. The mean partial correlation within each construct (GAD: r = .13; FoP: r = .07) was greater than between both (r = .01). BEI values among items supposed to discriminate between the constructs (e.g., worry about many things within GAD and fear not to endure treatment within FoP) were among the smallest so our assumptions were confirmed. CONCLUSIONS Our findings based on the network analysis support the hypothesis that FoP and GAD are different concepts within oncology. Our exploratory data needs to be validated in future longitudinal studies.
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Affiliation(s)
- Philipp Göbel
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany.
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Rostock, Rostock, Germany.
| | - Katharina Kuba
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
| | - Heide Götze
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
| | - Anja Mehnert-Theuerkauf
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
| | - Carsten Spitzer
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Rostock, Rostock, Germany
| | - Tim Hartung
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
- Klinik Und Hochschulambulanz Für Neurologie, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Peter Esser
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
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19
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Meissner VH, Peter C, Ankerst DP, Schiele S, Gschwend JE, Herkommer K, Dinkel A. Prostate cancer-related anxiety among long-term survivors after radical prostatectomy: A longitudinal study. Cancer Med 2023; 12:4842-4851. [PMID: 36254563 PMCID: PMC9972104 DOI: 10.1002/cam4.5304] [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: 04/01/2022] [Revised: 09/10/2022] [Accepted: 09/15/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Prostate cancer (PC)-related anxiety is associated with clinically significant declines in health-related quality of life (HRQoL) and psychological well-being. This longitudinal study investigates course and predictors of PC-related anxiety in long-term PC survivors treated by radical prostatectomy (RP). METHODS Two thousand nine hundred and three survivors from the multicenter German Familial PC Database completed the Memorial Anxiety Scale for PC on average 11 years after RP at the initial assessment in 2015 and then 5 years later. Hierarchical multiple linear regression was used to assess predictors of PC-related anxiety at follow-up. RESULTS PC-related anxiety remained stable over the 5 years. In hierarchical multiple linear regression, longitudinal predictors of PC-related anxiety 5 years later included a lower level of education (beta: -0.035, p = 0.019), biochemical recurrence (BCR; beta: 0.054, p = 0.002), late BCR (beta: 0.054, p < 0.001), PC anxiety at initial assessment (beta: 0.556, p < 0.001), HRQoL (beta: -0.076, p < 0.001), depression and anxiety symptoms (beta: 0.072, p = 0.001; beta: 0.165, p < 0.001). Predictors of prostate-specific antigen (PSA) anxiety 5 years later included late BCR (beta: 0.044, p = 0.019), PSA anxiety at initial assessment (beta: 0.339, p < 0.001), depression and anxiety symptoms (beta: 0.074, p = 0.008; beta: 0.191, p < 0.001), and treatment decision regret (beta: 0.052, p = 0.006). CONCLUSION PC-related anxiety remains a burden to survivors many years after diagnosis and treatment. The respective disease-specific anxiety was the strongest predictor of this anxiety 5 years later, which emphasizes the need of screening and monitoring in a timely manner for PC-related anxiety. Treating urologists should screen, identify, and monitor patients at risk for targeted referrals to psychosocial services.
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Affiliation(s)
- Valentin H Meissner
- Department of Urology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Cornelia Peter
- Department of Urology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Donna P Ankerst
- Departments of Mathematics and Life Science Systems, Munich Data Science Institute, Technical University of Munich, Garching, Germany
| | - Stefan Schiele
- Department of Urology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Jürgen E Gschwend
- Department of Urology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Kathleen Herkommer
- Department of Urology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Andreas Dinkel
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
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20
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Wang Y, Yu Q, Zeng Z, Yuan R, Wang R, Chen J, Zhou H, Tang J. Predictors of fear of diabetes progression: A multi-center cross-sectional study for patients self-management and healthcare professions education. Front Public Health 2022; 10:910145. [PMID: 36600932 PMCID: PMC9806215 DOI: 10.3389/fpubh.2022.910145] [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: 05/13/2022] [Accepted: 11/21/2022] [Indexed: 12/23/2022] Open
Abstract
Objective Excessive fear of progression can affect the mental health, social function, and wellbeing of patients with chronic diseases. This study investigated the fear of progression (FoP) and the socio-demographic and clinical predictors among patients with type 2 diabetes mellitus (T2DM). Method The present study is a multi-center cross-sectional study. Inpatients with T2DM were recruited by a multi-stage convenience sampling method from the department of endocrinology in 5 tertiary hospitals in Southwest China. 459 T2DM patients were consecutively enrolled. Socio-demographic, clinical data, and answers to the fear of progression questionnaire (FoP-Q) were collected. Results 385 patients with complete data were eligible. The average score of FoP-Q-SF was 26.84 and 23.1% of patients reached the dysfunctional fear of progression criterion. The greatest fears were worrying about "disease progression," "the adverse reactions of medication," and "relying on strangers for activities of daily living." Health education (P < 0.001), age (P = 0.002), hypoglycemia history (P = 0.006), employment status (P = 0.025) and duration since being diagnosed with type 2 diabetes mellitus (P = 0.032) were the related factors of fear of progression. Conclusion Early assessment of the fear of progression was imperative to identify dysfunctional fear of progression in patients with type 2 diabetes mellitus. Meanwhile, the meaning of these predictors for strengthening healthcare professions education and patients self-management might help healthcare givers timely perform related interventions and help patients reduce their fear of progression thus actively cooperate with T2DM treatments.
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Affiliation(s)
- Yanhao Wang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China,Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences, College of Stomatology, Chongqing Medical University, Chongqing, China,Department of Orthodontics, School of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Qiuhua Yu
- Department of Breast Surgery, Peking Union Medical College Hospital (Xidan Campus), Beijing, China
| | - Zihuan Zeng
- State Key Laboratory of Trauma, Burn and Combined Injury, Institute of Burn Research, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China,Department of Plastic Surgery, State Key Laboratory of Trauma, Burns and Combined Injury, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Ruizhu Yuan
- School of Nursing, Chongqing Medical University, Chongqing, China
| | - Ruiding Wang
- Department of Critical Care Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Jianli Chen
- Guangzhou Women and Children Medical Center, Guangzhou Medical University Affiliated Women and Children Medical Center, Guangzhou, China
| | - Hengyu Zhou
- School of Nursing, Chongqing Medical University, Chongqing, China,*Correspondence: Hengyu Zhou
| | - Jiao Tang
- School of Nursing, Chongqing Medical University, Chongqing, China,Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China,Jiao Tang
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21
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Profiles of social constraints and associated factors among breast cancer patients: a latent profile analysis. BMC Psychiatry 2022; 22:750. [PMID: 36451108 PMCID: PMC9714186 DOI: 10.1186/s12888-022-04407-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 11/18/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The present study aimed to identify profiles of social constraints among Chinese breast cancer patients and to explore the variables associated with these patterns. METHODS The study recruited 133 Chinese breast cancer patients in Liaoning Province, China, between June 2021 and February 2022. The questionnaire package included the Social Constraints Scale (SCS), the Multidimensional Scale of Perceived Social Support (MSPSS), the Fear of Progression Questionnaire-Short Form (FoP-Q-SF), and the Social Impact Scale (SIS). The methods of statistical analysis used included latent profile analysis (LPA) and multinomial logistic regression. RESULTS Three latent patterns of social constraints were found: class 1-the low social constraints group (51.9%), class 2-the moderate social constraints group (35.3%), and class 3-the high social constraints group (12.8%). Patients with high social support were more likely to report a low level of social constraint, while patients with a greater fear of progression were more likely to report a moderate or high level of social constraints. Significant differences existed among the latent classes identified by reference to social constraint in terms of education. CONCLUSION These results suggest that breast cancer patients' perceptions of social constraints vary and exhibit individual differences. Health care providers should take into account patients' fear of progression as well as their social support when developing interventions for patients with a high level of social constraints.
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22
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Zhen J, Wang J, Wang YL, Jiao J, Li J, Du XJ, Li YL. Fear of recurrence in elderly patients with coronary heart disease: the current situation and influencing factors according to a questionnaire analysis. BMC Cardiovasc Disord 2022; 22:419. [PMID: 36131233 PMCID: PMC9494841 DOI: 10.1186/s12872-022-02853-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 08/26/2022] [Indexed: 11/10/2022] Open
Abstract
Objective Fear of recurrence is a common psychosocial sequela among patients with heart disease. Analyses of coronary heart disease, particularly in elderly patients, are relatively rare. This study aimed to investigate the current situation in this context, as well as the influencing fear factors concerning recurrence in elderly patients with coronary heart disease. Methods A total of 200 elderly outpatients with coronary heart disease were recruited to participate in this survey from a tertiary hospital in Baoding (China). The questionnaires included items from the Disease Progression Simplified Scale, the Simplified Coping Style Questionnaire, and the Social Support Rating Scale (SSRS). Univariate and multivariate regression analyses were adopted to investigate the influencing factors on the fear of recurrence. Results The fear of recurrence score in elderly patients with coronary heart disease was (38.46 ± 8.13), among which 119 cases (59.5%) scored higher than 34 points. The SSRS total average score was (34.89 ± 9.83) points. Positive coping style and social support were negatively correlated with the total score of recurrence fear (r = − 0.621, − 0.413, both P < 0.001). There was a positive correlation between negative coping style and the total score of recurrence fear (r = 0.232, P < 0.001). Multiple linear regression analysis showed that the course of the disease, the number of disease recurrence cases, active coping, and social support were relevant factors in fear of recurrence (all P < 0.05). Conclusion The detection rate of fear of recurrence in elderly patients with coronary heart disease was relatively high but could be reduced by active interventions and enhancing social support.
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Affiliation(s)
- Jing Zhen
- Neurosurgery Intensive Care Unit, Affiliated Hospital of Hebei University, No. 212 of Yuhua East Road, Lianchi District, Baoding, 071000, Hebei, China
| | - Jing Wang
- Inspection department, Affiliated Hospital of Hebei University, Baoding, 071000, Hebei, China
| | - Yi-Lin Wang
- School of Basic Medicine of Shandong University, Jinan, 250012, Shandong, China
| | - Jin Jiao
- Neurosurgery Intensive Care Unit, Affiliated Hospital of Hebei University, No. 212 of Yuhua East Road, Lianchi District, Baoding, 071000, Hebei, China.,Medical Oncology Department, Affiliated Hospital of Hebei University, Baoding, China
| | - Jing Li
- Neurosurgery Intensive Care Unit, Affiliated Hospital of Hebei University, No. 212 of Yuhua East Road, Lianchi District, Baoding, 071000, Hebei, China.,Cardiovascular Department, Affiliated Hospital of Hebei University, Baoding, China
| | - Xiao-Jing Du
- School of Basic Medicine of Shandong University, Jinan, 250012, Shandong, China.,School of Nursing, He Bei University, Baoding, China
| | - Yan-Ling Li
- Department of Tuberculosis, Affiliated Hospital of Hebei University, Baoding, China.
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23
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Grajek M, Krupa-Kotara K, Rozmiarek M, Sobczyk K, Działach E, Górski M, Kobza J. The Level of COVID-19 Anxiety among Oncology Patients in Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191811418. [PMID: 36141692 PMCID: PMC9517625 DOI: 10.3390/ijerph191811418] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/05/2022] [Accepted: 09/06/2022] [Indexed: 05/13/2023]
Abstract
Cancer patients tend to have a high psychological burden. Half of cancer patients suffer from severe affective disorders and anxiety disorders, while one-third struggle with mild forms of these. The COVID-19 pandemic is damaging the mental health of the population due to social restrictions. A growing number of studies note the role of COVID-19 anxiety in the health and quality of life of cancer patients. The purpose of this study is to estimate the level of COVID-19 anxiety among oncology patients and to test the utility of the FCV-19S scale in a population study of cancer patients. The study included 600 respondents (300 oncology patients and 300 control subjects not undergoing oncological treatment). The FCV-19S scale and the GAD-7 scale were used in the study. The results were interpreted according to the following verbal scale: 76-100%, high anxiety; 56-75%, moderate anxiety; 26-55%, low COVID-19 anxiety; <25%, no COVID-19 anxiety. In the analysis of the GAD-7 questionnaire results, the mean score obtained was 8.21 (min. 0; max. 21; SD 5.32). For 81% of respondents in the group of oncology patients, the total score indicated the presence of anxiety symptoms with varying degrees of severity; in the control group, this proportion was 55% of respondents. The FCV-19S scale score as a percentage was 57.4% for oncology patients, indicating a moderate level of fear of the SARS-CoV-2 virus, and 30.3% for the control group, indicating a low level of fear of the SARS-CoV-2 virus. One-fifth of oncology patients were afraid of losing their lives due to the SARS-CoV-2 virus; in the control group, this proportion was 13% of respondents. Oncology patients were characterized by a higher prevalence of sleep disturbance than control group respondents, which was associated with greater anxiety. The study, therefore, shows that oncology patients have moderate levels of anxiety associated with the COVID-19 pandemic, and non-oncology patients show lower levels of anxiety.
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Affiliation(s)
- Mateusz Grajek
- Department of Public Health, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, 40055 Katowice, Poland
- Correspondence: (M.G.); (K.K.-K.)
| | - Karolina Krupa-Kotara
- Department of Epidemiology, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, 40055 Katowice, Poland
- Correspondence: (M.G.); (K.K.-K.)
| | - Mateusz Rozmiarek
- Department of Sports Tourism, Faculty of Physical Culture Sciences, Poznan University of Physical Education, 61871 Poznan, Poland
| | - Karolina Sobczyk
- Department of Health Economics and Health Management, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, 40055 Katowice, Poland
| | - Eliza Działach
- Department of Public Health, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, 40055 Katowice, Poland
| | - Michał Górski
- Department of Dietetics, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, 40055 Katowice, Poland
| | - Joanna Kobza
- Department of Public Health, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, 40055 Katowice, Poland
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24
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Yang Y, Zhang Y, Liang L, Liao X, Meng J, Cai R, Ye H, Hu J, He X, Shi L. Fear of progression and its associated factors in parents of children undergoing cancer treatment: A CROSS-SECTIONAL STUDY. Psychooncology 2022; 31:1737-1744. [PMID: 36073576 DOI: 10.1002/pon.6027] [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: 12/14/2021] [Revised: 07/04/2022] [Accepted: 08/29/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Fear of progression (FoP) is a common psychosocial problem among adult cancer patients, but data on parents of children undergoing cancer treatment are scarce. This study aimed to determine the prevalence of FoP in parents of children undergoing cancer treatment and explore the associated factors. METHODS Overall, 285 parents of children undergoing cancer treatment were recruited from three general hospitals in China. FoP in the parents was assessed using the Chinese version of the Fear of Progression Questionnaire-parent version (FoP-Q-SF/PR). Other questionnaires included the Self-Compassion Scale, Pittsburgh Sleep Quality Index, Posttraumatic Stress Disorder Checklist-Civilian Version, and items on socio-demographic and medical characteristics. Pearson correlation and multiple linear regression analysis were used to identify factors associated with FoP. RESULTS A total of 75.1% of the participants showed dysfunctional levels of FoP. The mean FoP-Q-SF/PR score was 39.98 (standard deviation=9.18). Parental FoP was significantly associated with a shorter time since diagnosis, lower levels of self-compassion, poor sleep quality, and severe posttraumatic stress symptoms (Adjusted R Squared=0.369, F=12.838, p<0.01). CONCLUSIONS FoP is a frequently reported problem among parents of children undergoing cancer treatment. In this cohort, parents of children with a shorter time since cancer diagnosis were at higher risk of suffering from FoP. Interventions to enhance self-compassion, improve sleep quality, and mitigate posttraumatic stress symptoms may help with the psychological adjustment and well-being of parents whose children are undergoing cancer treatment. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Yiling Yang
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Yuwei Zhang
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Lichan Liang
- Department of Pediatric Hematology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Xiaomei Liao
- Department of Pediatric Oncology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Jiangnan Meng
- Department of Pediatrics, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Ruiqing Cai
- Department Pediatric Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Hongyu Ye
- Department of Pediatric Hematology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Jiamin Hu
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Xiaofeng He
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Lei Shi
- School of Nursing, Southern Medical University, Guangzhou, China
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25
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Pijnappel EN, Dijksterhuis WPM, Sprangers MAG, Augustinus S, de Vos-Geelen J, de Hingh IHJT, Molenaar IQ, Busch OR, Besselink MG, Wilmink JW, van Laarhoven HWM. The fear of cancer recurrence and progression in patients with pancreatic cancer. Support Care Cancer 2022; 30:4879-4887. [PMID: 35169873 PMCID: PMC9046341 DOI: 10.1007/s00520-022-06887-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 01/28/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE It is plausible that patients with pancreatic cancer experience fear of tumor recurrence or progression (FOP). The aim of this study was to compare FOP in patients with pancreatic cancer treated with surgical resection, palliative systemic treatment, or best supportive care (BSC) and analyze the association between quality of life (QoL) and FOP and the effect of FOP on overall survival (OS). METHODS This study included patients diagnosed with pancreatic cancer between 2015 and 2018, who participated in the Dutch Pancreatic Cancer Project (PACAP). The association between QoL and WOPS was assessed with logistic regression analyses. OS was evaluated using Kaplan-Meier curves with the log-rank tests and multivariable Cox proportional hazard analyses adjusted for clinical covariates and QoL. RESULTS Of 315 included patients, 111 patients underwent surgical resection, 138 received palliative systemic treatment, and 66 received BSC. Patients who underwent surgical resection had significantly lower WOPS scores (i.e., less FOP) at initial diagnosis compared to patients who received palliative systemic treatment or BSC only (P < 0.001). Better QoL was independently associated with the probability of having a low FOP in the BSC (OR 0.95, 95% CI 0.91-0.98) but not in the surgical resection (OR 0.97, 95% CI 0.94-1.01) and palliative systemic treatment groups (OR 0.97, 95% CI 0.94-1.00). The baseline WOPS score was not independently associated with OS in any of the subgroups. CONCLUSION Given the distress that FOP evokes, FOP should be explicitly addressed by health care providers when guiding pancreatic cancer patients through their treatment trajectory, especially those receiving palliative treatment or BSC.
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Affiliation(s)
- Esther N Pijnappel
- Department of Medical Oncology, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
| | - Willemieke P M Dijksterhuis
- Department of Medical Oncology, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
- Netherlands Cancer Registry, Netherlands Comprehensive Cancer Organization (IKNL), PO Box 19079, Utrecht, 3501 DB, The Netherlands
| | - Mirjam A G Sprangers
- Department of Psychology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Simone Augustinus
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Judith de Vos-Geelen
- Department of Internal Medicine, Division of Medical Oncology, GROW-School for Oncology and Developmental Biology, Maastricht UMC+, P. Debyelaan 25, Maastricht, 6229 HX, The Netherlands
| | | | - Izaak Q Molenaar
- Department of Surgery, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Olivier R Busch
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Marc G Besselink
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Johanna W Wilmink
- Department of Medical Oncology, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Hanneke W M van Laarhoven
- Department of Medical Oncology, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
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26
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Benefit Finding and Related Factors of Patients with Early-Stage Cancer in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074284. [PMID: 35409965 PMCID: PMC8999120 DOI: 10.3390/ijerph19074284] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 03/30/2022] [Accepted: 03/31/2022] [Indexed: 02/04/2023]
Abstract
(1) Background: Although the research on benefit finding (BF) in China has increased in recent years, it remains in its infancy. Few previous studies have focused on early-stage cancer patients. Therefore, this research study aimed to explore BF and its influencing factors for early-stage cancer patients in China. (2) Methods: From April to August 2019, 319 patients with early-stage cancer in the treatment period were selected by the convenience sampling method and evaluated using the Benefit Finding of Cancer Patients Scale-Chinese (BFS-C), Perceived Social Support Scale (PSSS), and Medical Coping Modes Questionnaire (MCMQ). (3) Results: The mean BF score was 47.57 (SD = 12.26). The results of the correlation analysis show that benefit finding was positively correlated with social support, but negatively correlated with acceptance-resignation. In addition, social support was negatively correlated with avoidance and acceptance-resignation. The results of the multiple linear regression indicate that the variables of self-assessment of disease severity, exercise time, coping mode (acceptance-resignation), and social support, affect BF. Finally, social support was shown to exert an intermediary effect on acceptance-resignation and BF. (4) Conclusions: In this study, the score of BF of patients with early-stage cancer was low. Medical staff should be more aware of the health behavior of patients with early-stage cancer, guide them to actively face the disease, and fully mobilize the social support of patients’ friends and family, so as to help patients increase their disease BF.
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27
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Sharpe L, Michalowski M, Richmond B, Menzies RE, Shaw J. Fear of Progression in chronic illnesses other than cancer: A systematic review and meta-analysis of a transdiagnostic construct. Health Psychol Rev 2022; 17:301-320. [PMID: 35132937 DOI: 10.1080/17437199.2022.2039744] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Fear of cancer recurrence (FCR) is the most common psychosocial issue amongst cancer survivors. However, fear of progression (FoP) has been studied outside of the cancer context. This review aimed to: (1) meta-synthesize qualitative studies of FoP in illnesses other than cancer; and (2) quantify the relationship between FoP and anxiety, depression, and quality of life (QoL) in non-cancer chronic illnesses. We identified 25 qualitative and 11 quantitative studies in a range of chronic illnesses. Participants described fears of progression and recurrence of their illness, including fears of dying, and fears of becoming a burden to family. Fears were often triggered by downward comparison (i.e. seeing people worse off than themselves). Participants coped in different ways, including by accepting the illness or seeking knowledge. Those for whom these fears caused distress reported hypervigilance to physical symptoms and avoidance. Distress, and seeking information, were associated with adherence. In quantitative analyses, FoP was moderately associated with QoL, and strongly associated with anxiety and depression. These results suggest that FoP in illnesses other than cancer is similar to FCR. FoP appears to be an important transdiagnostic construct associated with distress. Evidence-based FCR interventions could be adapted to better manage FoP in other illnesses.
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Affiliation(s)
- Louise Sharpe
- School of Psychology, Faculty of Science, The University of Sydney, NSW 2006
| | - M Michalowski
- School of Psychology, Faculty of Science, The University of Sydney, NSW 2006
| | - B Richmond
- School of Psychology, Faculty of Science, The University of Sydney, NSW 2006
| | - R E Menzies
- School of Psychology, Faculty of Science, The University of Sydney, NSW 2006
| | - J Shaw
- School of Psychology, Faculty of Science, The University of Sydney, NSW 2006.,Psycho-Oncology Co-operative Group (POCOG), The University of Sydney, NSW 2006
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28
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Herzog K, Schepper F, Kamm R, Engelhardt‐Lohrke C, Kreisch A, Pletschko T, Hauer J, Christiansen H, Suttorp M, Kiel J, Martini J. Illness perceptions in patients and parents in paediatric oncology during acute treatment and follow‐up care. Psychooncology 2022; 31:950-959. [DOI: 10.1002/pon.5883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 01/04/2022] [Accepted: 01/06/2022] [Indexed: 11/08/2022]
Affiliation(s)
- Kristina Herzog
- Department of Psychiatry and Psychotherapy Faculty of Medicine of the Technische Universität Dresden Germany
- Department of Paediatric Oncology Haematology and Haemostaseology Leipzig University Germany
| | - Florian Schepper
- Department of Paediatric Oncology Haematology and Haemostaseology Leipzig University Germany
| | - Remo Kamm
- Sonnenstrahl e.V. Dresden – Förderkreis für krebskranke Kinder und Jugendliche Germany
| | | | - Andrea Kreisch
- Department of Paediatrics Paediatric Haematology and Oncology University Hospital Carl Gustav Carus Dresden Germany
| | - Thomas Pletschko
- Department of Paediatric and Adolescent Medicine Medical University Vienna Austria
| | - Julia Hauer
- Department of Paediatrics Paediatric Haematology and Oncology University Hospital Carl Gustav Carus Dresden Germany
| | - Holger Christiansen
- Department of Paediatric Oncology Haematology and Haemostaseology Leipzig University Germany
| | - Meinolf Suttorp
- Faculty of Medicine of the Technische Universität Dresden Germany
| | - Julia Kiel
- Department of Psychiatry and Psychotherapy Faculty of Medicine of the Technische Universität Dresden Germany
| | - Julia Martini
- Department of Psychiatry and Psychotherapy Faculty of Medicine of the Technische Universität Dresden Germany
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Guo HT, Wang SS, Zhang CF, Zhang HJ, Wei MX, Wu Y, Su CX. Investigation of Factors Influencing the Fear of Cancer Recurrence in Breast Cancer Patients Using Structural Equation Modeling: A Cross-Sectional Study. Int J Clin Pract 2022; 2022:2794408. [PMID: 36545346 PMCID: PMC9747310 DOI: 10.1155/2022/2794408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 10/12/2022] [Accepted: 11/08/2022] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE This study aimed to investigate the fear of cancer recurrence (FCR) in breast cancer patients and develop a structural equation model of influencing factors to help formulate clinical intervention strategies. METHODS A convenience sample of 325 patients was surveyed using a general and disease-related data questionnaire, which combined the Fear of Progression Questionnaire-Short Form, Mishel Uncertainty in Illness Scale, Perceived Social Support Scale, and Medical Coping Modes Questionnaire. RESULTS The total score of FCR in breast cancer patients was 35.06 ± 10.83, and 53.8% of patients reached the clinical level. The structural equation model demonstrated that illness uncertainty had a direct positive impact on FCR (β = 0.275, p < 0.05), and it could have an indirect impact through social support and resignation coping methods (β = 0.254, p < 0.05). CONCLUSION The fear of cancer recurrence in breast cancer patients needs further understanding. Medical staff can reduce or buffer FCR in breast cancer patients by strengthening positive influences, such as social support, or weakening negative influences, such as illness uncertainty and resignation coping.
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Affiliation(s)
- Hai-Tao Guo
- Department of Operation, Affiliated Hospital of Hebei University, Baoding, China
| | - Shuang-Shuang Wang
- Department of Radiation Oncology, Affiliated Hospital of Hebei University, Baoding, China
| | - Chun-Fang Zhang
- Department of Administrative, Affiliated Hospital of Hebei University, Baoding, China
| | - Hong-Jie Zhang
- College of Public Health Hebei University, Baoding, China
| | - Min-Xiang Wei
- Department of Breast Surgery, Affiliated Hospital of Hebei University, Baoding, China
| | - Yu Wu
- Department of Breast Surgery, Affiliated Hospital of Hebei University, Baoding, China
| | - Chen-Xiao Su
- Department of Breast Surgery, Affiliated Hospital of Hebei University, Baoding, China
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Abstract
Recent decades have demonstrated significant strides in cancer screening, diagnostics and therapeutics. As such there have been dramatic changes in survival following a diagnosis of cancer.
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Affiliation(s)
- Matthew R D Brown
- The Royal Marsden NHS Foundation Trust, Fulham Road, London, SW3 6JJ, UK
| | | | - David J Magee
- The Royal Marsden Hospital, Fulham Road, London, SW3 6JJ, UK.
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Jahnen M, Mynzak E, Meissner VH, Schiele S, Schulwitz H, Ankerst DP, Gschwend JE, Herkommer K, Dinkel A. Diversity of cancer-related identities in long-term prostate cancer survivors after radical prostatectomy. BMC Cancer 2021; 21:1041. [PMID: 34544381 PMCID: PMC8454161 DOI: 10.1186/s12885-021-08776-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 09/08/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Individuals affected by cancer need to integrate this experience into their personal biography as their life continues after primary therapy, leading to substantial changes in self-perception. This study identified factors uniquely associated with 5 different cancer-related identities in order to improve the understanding of how self-perception in men affected by prostate cancer is associated with certain clinical and psychosocial characteristics. METHODS In this cross-sectional study, long-term prostate cancer survivors after radical prostatectomy were asked to choose one of 5 cancer-related identities that described them best. Associations with sociodemographic, clinical, and psychological variables were investigated using multivariable logistic regression. RESULTS Three thousand three hundred forty-seven men (mean age 78.1 years) surveyed on average 15.6 years after prostatectomy were included. Most men favored the terms "someone who has had cancer" (43.9%) which was associated with a mild disease course, and "patient" (26.3%) which was associated with ongoing therapy and biochemical disease recurrence. The self-descriptions "cancer survivor" (16.8%), "cancer conqueror" (10.9%) and "victim" (2.1%) were less common. "Cancer survivor" was associated with high perceived disease severity (OR: 1.86 [1.44-2.40]). "Cancer survivor" and "cancer conqueror" were related to high benefit finding (OR: 1.89 [1.48-2.40], OR: 1.46 [1.12-1.89] respectively), and only "cancer conqueror" was associated with high well-being (OR: 1.84 [1.35-2.50]). Identification as "victim" was associated with a positive depression screening and low well-being (OR: 2.22 [1.15-4.31], OR: 0.38 [0.20-0.72] respectively) (all p < 0.05). CONCLUSIONS Although long-term survival is common among men affected by PCa, they display a large diversity in cancer-related identities, which are associated with unique clinical and psychological characteristics. These cancer-related identities and their distinctive properties are associated with psychological well-being even after a long follow-up.
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Affiliation(s)
- Matthias Jahnen
- Department of Urology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Eike Mynzak
- Department of Urology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Valentin H Meissner
- Department of Urology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Stefan Schiele
- Department of Urology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Helga Schulwitz
- Department of Urology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Donna P Ankerst
- Department of Mathematics, Technical University of Munich, Boltzmannstr. 3, 85748, Garching, Germany
| | - Jürgen E Gschwend
- Department of Urology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Kathleen Herkommer
- Department of Urology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Andreas Dinkel
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Langerstr.3, 81675, Munich, Germany.
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Al-Husban RY, Obeidat R, Shamieh O. Unmet Supportive Care Needs of Jordanian Patients with Colorectal Cancer: A Cross-Sectional Survey. Asia Pac J Oncol Nurs 2021; 8:565-572. [PMID: 34527787 PMCID: PMC8420928 DOI: 10.4103/apjon.apjon-2110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 04/09/2021] [Indexed: 11/17/2022] Open
Abstract
Objective: Colorectal cancer (CRC) is ranked the second most common cancer diagnosed in both men and women in Jordan. This paper aims to explore the unmet supportive care needs (USCNs), and their predictors among Jordanian survivors with CRC. Methods: A cross-sectional descriptive correlational research design with a convenience sample of 180 patients with CRC was conducted. Participants completed the Supportive Care Needs Survey-Short Form 34. Results: Jordanian patients with CRC reported their highest perceived level of need in the information and psychological domains. Multiple linear regression revealed that income and the number of chemotherapy sessions were significant predictors in the physical and daily living domains. Age, type of surgical treatment, and type of clinical setting were significant predictors of USCN in the psychological, patient care and support, and the health system and information domains. Conclusions: The health-care systems should work to meet all the supportive care needs for patients with CRC, particularly the informational and psychological needs domains where patients express unmet needs. Special care should be given according to age, type of surgery, and the doses of chemotherapy received. This study further confirms a disparity in the care and support provided to Jordanian cancer patients with different health-care settings in the country.
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Affiliation(s)
| | - Rana Obeidat
- Faculty of Nursing, Adult Health Nursing, Zarqa University, Zarqa, Jordan
| | - Omar Shamieh
- Department of Palliative Medicine, King Hussein Cancer Center, Amman, Jordan
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Dinkel A, Marten-Mittag B, Kremsreiter K. Association Between Daily Worry, Pathological Worry, and Fear of Progression in Patients With Cancer. Front Psychol 2021; 12:648623. [PMID: 34456783 PMCID: PMC8384960 DOI: 10.3389/fpsyg.2021.648623] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Accepted: 07/08/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Fear of progression (FoP), or fear of cancer recurrence (FCR), is characterized by worries or concerns about negative illness-related future events. Actually, to worry is a common cognitive process that, in its non-pathological form, belongs to daily life. However, worry can also become pathological appearing as a symptom of mental disorders. This study aimed at investigating the associations among daily worry, pathological worry, and FoP in patients with cancer. Methods: This is a cross-sectional study that includes 328 hospitalized patients with cancer. Patients filled out the FoP Questionnaire (FoP-Q), the Worry Domains Questionnaire (WDQ) for the assessment of daily worry, and the Penn State Worry Questionnaire (PSWQ) for the assessment of pathological worry. Depressive, anxiety, and somatic symptoms were measured with modules of the Patient Health Questionnaire [Patient Health Questionnaire-Depressive Symptoms (PHQ-2), Generalized Anxiety Disorder-2 (GAD-2), and Patient Health Questionnaire-Somatic Symptoms (PHQ-15)]. Furthermore, a structured clinical interview was conducted for the assessment of anxiety disorders. The hierarchical multiple linear regression analysis was used to identify factors independently associated with FoP. Results: Mean age of the participants was M = 58.5 years (SD = 12.8), and 64.6% were men. FoP and worry were significantly intercorrelated (r = 0.58–0.78). The level of FoP was most strongly associated with daily worry (β = 0.514, p < 0.001), followed by pathological worry (β = 0.221, p < 0.001). Further significant determinants were younger age and depressive and anxiety symptoms. Clinical variables were not independently associated with FoP. The final model explained 74% of the variance. Discussion: Fear of progression is strongly associated with daily worry and pathological worry. These results bring up the question of whether FoP is an expression of a general tendency to worry. Whether a general tendency to worry, in fact, represents an independent vulnerability factor for experiencing FCR/FoP needs to be investigated in a longitudinal research design.
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Affiliation(s)
- Andreas Dinkel
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Birgitt Marten-Mittag
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Katrin Kremsreiter
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany.,Institute of Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health Mannheim, University Medical Center Mannheim, Mannheim, Germany
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34
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Meissner VH, Olze L, Schiele S, Ankerst DP, Jahnen M, Gschwend JE, Herkommer K, Dinkel A. Fear of cancer recurrence and disease progression in long-term prostate cancer survivors after radical prostatectomy: A longitudinal study. Cancer 2021; 127:4287-4295. [PMID: 34358337 DOI: 10.1002/cncr.33836] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 04/08/2021] [Accepted: 05/03/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND Although fear of cancer recurrence (FCR) or disease progression is among the most endorsed unmet needs and concerns of cancer survivors, research on the course of FCR in long-term survivors is scarce. The objective of this study was to assess longitudinally the prevalence and predictors of FCR in long-term prostate cancer (PCa) survivors. METHODS In all, 2417 survivors from the multicenter German Familial Prostate Cancer Database completed the Fear of Progression Questionnaire-Short Form on average 7 years (T1 in 2010) after radical prostatectomy and at follow-up 9 years later (T2 in 2019). Hierarchical multivariable logistic regression was used to assess predictors of FCR at follow-up. RESULTS The mean age at the initial assessment was 69.5 years (standard deviation, 5.9 years); 6.5% and 8.4% of patients reported clinical FCR at the initial assessment (T1) and at the follow-up (T2), respectively. In a multivariable analysis controlling for concurrent associations, longitudinal predictors of FCR 9 years later included a lower level of education (odds ratio [OR], 4.35; 95% confidence interval [CI], 2.33-8.33), years since radical prostatectomy (OR, 1.10; 95% CI, 1.03-1.18), biochemical recurrence (OR, 1.67; 95% CI, 1.02-2.72), no current adjuvant therapy (OR, 2.38; 95% CI, 1.19-4.76), FCR (OR, 10.75; 95% CI, 6.18-18.72), and anxiety (OR, 1.35; 95% CI, 1.06-1.72). CONCLUSIONS FCR remains a burden to certain PCa survivors even many years after their diagnosis and treatment. Health care professionals should monitor for FCR and identify patients at risk to provide appropriate psychosocial care because FCR is leading to limitations in quality of life and psychological well-being.
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Affiliation(s)
- Valentin H Meissner
- Department of Urology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Lisa Olze
- Department of Urology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Stefan Schiele
- Department of Urology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Donna P Ankerst
- Departments of Mathematics and Life Science Systems, Technical University of Munich, Garching, Germany
| | - Matthias Jahnen
- Department of Urology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Jürgen E Gschwend
- Department of Urology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Kathleen Herkommer
- Department of Urology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Andreas Dinkel
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
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Peikert ML, Inhestern L, Krauth KA, Escherich G, Rutkowski S, Kandels D, Schiekiera LJ, Bergelt C. Fear of progression in parents of childhood cancer survivors: prevalence and associated factors. J Cancer Surviv 2021; 16:823-833. [PMID: 34302272 PMCID: PMC9300493 DOI: 10.1007/s11764-021-01076-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 06/14/2021] [Indexed: 10/29/2022]
Abstract
PURPOSE Recent research demonstrated that fear of progression (FoP) is a major burden for adult cancer survivors. However, knowledge on FoP in parents of childhood cancer survivors is scarce. This study aimed to determine the proportion of parents who show dysfunctional levels of FoP, to investigate gender differences, and to examine factors associated with FoP in mothers and fathers. METHODS Five hundred sixteen parents of pediatric cancer survivors (aged 0-17 years at diagnosis of leukemia or central nervous system (CNS) tumor) were consecutively recruited after the end of intensive cancer treatment. We conducted hierarchical multiple regression analyses for mothers and fathers and integrated parent-, patient-, and family-related factors in the models. RESULTS Significantly more mothers (54%) than fathers (41%) suffered from dysfunctional levels of FoP. Maternal FoP was significantly associated with depression, a medical coping style, a child diagnosed with a CNS tumor in comparison to leukemia, and lower family functioning (adjusted R2 = .30, p < .001). Paternal FoP was significantly associated with a lower level of education, depression, a family coping style, a child diagnosed with a CNS tumor in comparison to leukemia, and fewer siblings (adjusted R2 = .48, p < .001). CONCLUSIONS FoP represents a great burden for parents of pediatric cancer survivors. We identified associated factors of parental FoP. Some of these factors can be targeted by health care professionals within psychosocial interventions and others can provide an indication for an increased risk for higher levels of FoP. IMPLICATIONS FOR CANCER SURVIVORS Psychosocial support targeting FoP in parents of childhood cancer survivors is highly indicated.
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Affiliation(s)
- Mona L Peikert
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Laura Inhestern
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
| | - Konstantin A Krauth
- Department of Pediatrics, Pediatric Hematology and Oncology, Klinik Bad Oexen, Oexen 27, 32549, Bad Oeynhausen, Germany
| | - Gabriele Escherich
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Stefan Rutkowski
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Daniela Kandels
- Swabian Children's Cancer Center, Medical Faculty, University of Augsburg, Stenglinstraße 2, 86156, Augsburg, Germany
| | - Louis J Schiekiera
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Corinna Bergelt
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
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36
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Ban Y, Li M, Yu M, Wu H. The effect of fear of progression on quality of life among breast cancer patients: the mediating role of social support. Health Qual Life Outcomes 2021; 19:178. [PMID: 34253195 PMCID: PMC8276515 DOI: 10.1186/s12955-021-01816-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 07/04/2021] [Indexed: 11/26/2022] Open
Abstract
Background Women with breast cancer are prone to have mental stress and be stimulated by the fear of progression (FOP), then giving rise to a lower quality of life (QOL). The study aimed to examine the relationships between FOP, social support and QOL, and further explore whether social support mediates the association between FOP and QOL among Chinese patients with breast cancer. Methods The cross-sectional study was conducted from October 2019 to May 2020 at Anshan Cancer Hospital in Liaoning, China. 244 female breast cancer patients completed questionnaires including the Functional Assessment of Cancer Therapy for Breast (FACT-B), Multi-Dimensional Scale of Perceived Social Support (MSPSS), and Fear of Progression (FOP). Hierarchical multiple regression analysis was performed to assess the associations between FOP, social support and QOL. Asymptotic and resampling strategies were used to explore the mediating role of social support. Results The mean QOL score was 90.6 ± 17.0 among the patients with breast cancer. FOP was negatively correlated with QOL, while social support was positively related to QOL. Social support partly mediated the association between FOP and QOL, and the proportion of the mediating effect accounted for by social support was 25%. Conclusions Chinese breast cancer patients expressed low QOL. Social support could mediate the association between FOP and QOL. Medical staffs and cancer caregivers should alleviate patients’ FOP to improve their QOL by facilitating social support.
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Affiliation(s)
- Yue Ban
- Department of Social Medicine, School of Public Health, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, 110122, Liaoning, China
| | - Mengyao Li
- Department of Social Medicine, School of Public Health, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, 110122, Liaoning, China
| | - Mingli Yu
- Department of Social Medicine, School of Public Health, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, 110122, Liaoning, China
| | - Hui Wu
- Department of Social Medicine, School of Public Health, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, 110122, Liaoning, China.
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Individual courses and determinants of fear of cancer recurrence in long-term breast cancer survivors with and without recurrence. Support Care Cancer 2021; 29:7647-7657. [PMID: 34137933 PMCID: PMC8549971 DOI: 10.1007/s00520-021-06329-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 05/30/2021] [Indexed: 11/05/2022]
Abstract
Objective This study investigated the prevalence, individual courses, and determinants of fear of cancer recurrence (FoR) in long-term breast cancer survivors (BCSs) with and without recurrence. Methods A total of 184 breast cancer survivors were surveyed at four measurement time points: during hospitalization (T1), 10 weeks (T2), 40 weeks (T3), and 5–6 years (T4) after hospital discharge. Descriptive statistics, chi-square tests, and logistic regression were performed. Results Respondents were females and 57 years old, on average. At T1, T3, and T4, 54.8%, 31.6%, and 29.7% of BCSs, respectively, were classified as having dysfunctional levels of FoR. Dysfunctional FoR decreased from T1 to T3 (χ2(1) = 17.11, p = 0.000; N = 163) and remained stable afterwards. Eight subgroups of individual courses of FoR over time could be described: (1) constant functional FoR; (2) constant dysfunctional FoR; (3) improving from dysfunctional to functional FoR from T1 to T3; (4) improving from dysfunctional to functional FoR from T3 to T4; (5) worsening from functional to dysfunctional FoR from T1 to T3; (6) worsening from functional to dysfunctional FoR from T3 to T4; (7) dysfunctional FoR at T1 and T4, and functional FoR in between; and (8) functional FoR at T1 and T4, and dysfunctional FoR in between. Logistic regression analysis revealed that being divorced/widowed, showing high levels of fatigue, being treated by chemotherapy, and having low confidence in treatment were associated with dysfunctional FoR 5 to 6 years after diagnosis (Nagelkerkes’ Pseudo-R2 = 0.648). Conclusions The findings reveal that FoR is a significant issue in long-term BCSs and has the potential to become a persistent psychological strain. We emphasize the need for increased awareness of FoR among BCSs and the need for support programs.
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Liu QW, Qin T, Hu B, Zhao YL, Zhu XL. Relationship between illness perception, fear of progression and quality of life in interstitial lung disease patients: A cross-sectional study. J Clin Nurs 2021; 30:3493-3505. [PMID: 33998090 DOI: 10.1111/jocn.15852] [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: 12/28/2020] [Revised: 03/31/2021] [Accepted: 04/22/2021] [Indexed: 01/02/2023]
Abstract
AIMS AND OBJECTIVES This study aimed to investigate whether fear of progression mediates the association between illness perception and quality of life among interstitial lung disease patients. BACKGROUND So far, the physiological treatment of interstitial lung disease is limited. In addition to immunosuppressants such as glucocorticoids, two anti-fibrosis drugs (pirfenidone and nintedanib) have shown moderately beneficial effects on slowing the progression of interstitial lung disease fibrosis. However, none of these drugs has shown reliable or strong beneficial effects on improving quality of life. Psychological care and mental health support strategies focusing on improving patients' quality of life are particularly important. DESIGN A cross-sectional study. METHODS A convenience sample of patients suffering from interstitial lung disease were enrolled from August to December 2019. Data including sociodemographic and clinical characteristics, illness perception, fear of progression and quality of life were collected. The descriptive analysis and Pearson correlations were analysed by SPSS 26.0 (IBM Corp.). PROCESS v3.4 (by Andrew F. Hayes) macro was applied to analyse the mediating effects. We used the STROBE checklist to report the results. RESULTS Both illness perception and fear of progression were correlated with quality of life. Fear of progression mediated the association between illness perception and quality of life. The indirect effect was 0.121, and the proportion of intermediary effect in the main effect was 26.36%. CONCLUSION Interstitial lung disease patients experience relatively poor quality of life and fear of progression exerts a mediating role between illness perception and quality of life. RELEVANCE TO CLINICAL PRACTICE This study alerts medical staff to pay attention to negative illness perception and excessive fear, which is helpful to formulate effective interventions to manage interstitial lung disease patients' quality of life.
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Affiliation(s)
- Qing-Wei Liu
- Department of Medicine, School of Nursing, Qingdao University, Qingdao, China
| | - Tong Qin
- Department of Medicine, School of Nursing, Qingdao University, Qingdao, China
| | - Bo Hu
- Department of Thoracic Surgery, Municipal Hospital, Qingdao, China
| | - Ya-Ling Zhao
- Department of Medicine, School of Nursing, Qingdao University, Qingdao, China
| | - Xiu-Li Zhu
- Department of Medicine, School of Nursing, Qingdao University, Qingdao, China
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Youssef Y, Mehnert-Theuerkauf A, Götze H, Friedrich M, Esser P. Rapid screener for the assessment of fear of progression in cancer survivors: The Fear of progression-Questionnaire Rapid Screener. Eur J Cancer Care (Engl) 2021; 30:e13400. [PMID: 33459435 DOI: 10.1111/ecc.13400] [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] [Received: 07/25/2020] [Revised: 11/24/2020] [Accepted: 12/23/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Fear of progression (FoP) among cancer survivors can adversely affect all areas of life. Existing instruments are too long for implementation in routine care. Therefore, we developed and tested a rapid screener for FoP (FoP-Q-RS). METHODS Data were derived from a register-based study among cancer survivors. The 12-item short form of the Fear-of-Progression Questionnaire (FoP-Q-SF) served as item-pool. Confirmatory factor analysis (CFA) was applied to determine (a) fit indices including comparative fit index (CFI) and standardised root mean square residual (SRMR) and (b) measures of reliability including composite reliability (CR). Fit indices were compared to the FoP-Q-SF. Sensitivity and specificity were calculated to recommend a cut-off (criterion: GAD-7 score ≥10). RESULTS One thousand two cancer survivors participated (response rate: 53%). We selected five items for the FoP-Q-RS. CFA indicated acceptable fit (CFI = 0.936; SRMR = 0.048) and reliability (CR = 0.793). Fit indices were better than for the FoP-Q-SF. The cut-off ≥12 showed optimal balance between sensitivity (72%) and specificity (70%), the cut-off ≥10 revealed higher sensitivity (86%) with still tolerable specificity (52%). CONCLUSION The FoP-Q-RS shows good psychometric properties and may be applied in routine care. Further studies on preferable cut-offs and other populations are needed.
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Affiliation(s)
- Yasmin Youssef
- Department of Medical Psychology and Medical Sociology, University Medical Centre Leipzig, Leipzig, Germany
| | - Anja Mehnert-Theuerkauf
- Department of Medical Psychology and Medical Sociology, University Medical Centre Leipzig, Leipzig, Germany
| | - Heide Götze
- Department of Medical Psychology and Medical Sociology, University Medical Centre Leipzig, Leipzig, Germany
| | - Michael Friedrich
- Department of Medical Psychology and Medical Sociology, University Medical Centre Leipzig, Leipzig, Germany
| | - Peter Esser
- Department of Medical Psychology and Medical Sociology, University Medical Centre Leipzig, Leipzig, Germany
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Li MC, Cheng HL. Fear of cancer recurrence, supportive care needs, and the utilization of psychosocial services in cancer survivors: A cross-sectional survey in Hong Kong. Psychooncology 2020; 30:602-613. [PMID: 33247969 DOI: 10.1002/pon.5609] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 11/26/2020] [Indexed: 01/31/2023]
Abstract
OBJECTIVE Fear of cancer recurrence (FCR) is the top-ranked psychological concern in cancer survivors. We examined the prevalence of FCR and the relationships among FCR, supportive care needs, and the utilization of psychosocial services among Chinese cancer survivors. METHODS This cross-sectional, correlational study included 311 cancer survivors within 5 years of survivorship in Hong Kong. The participants were invited to complete an online survey: the Fear of Progression Questionnaire-Short Form to assess FCR; the 34-item Supportive Care Needs-Short Form to assess supportive care needs, and a self-constructed questionnaire to assess psychosocial services utilization. A score of ≥34 indicated FCR. Descriptive statistics and hierarchical regression analyses were performed. RESULTS Of the participants surveyed, 38.3% were classified as having FCR. The most frequently reported supportive care needs in five domains were in the psychological domain (M = 39.5; SD = 27.6), followed by the health system and information domain (M = 38.6, SD = 26.9). Of the three categories of psychosocial services, informational/educational healthcare services were the most frequently utilized (81%), while the least utilized services were mental health/psychological well-being support (46.9%). FCR was a consistent factor that was associated with needs in five domains (b = 8.73-39.58, all p < 0.001). However, FCR was not associated with any of the three categories of psychosocial services utilization. CONCLUSION FCR is frequent in cancer survivors. FCR may play an important role in supportive care needs, but not in psychosocial services utilization. There is an increasing demand to bridge the service gap between the need for and the use of mental health and psychological well-being services.
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Affiliation(s)
- Man Chung Li
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China
| | - Hui Lin Cheng
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China
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Peikert ML, Inhestern L, Krauth KA, Escherich G, Rutkowski S, Kandels D, Bergelt C. Fear of progression in parents of childhood cancer survivors: A dyadic data analysis. Psychooncology 2020; 29:1678-1685. [PMID: 32779255 DOI: 10.1002/pon.5508] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 07/28/2020] [Accepted: 08/03/2020] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Fear of progression (FoP), also referred to as fear of cancer recurrence, is gaining increasing interest in survivorship research as it constitutes a great burden for patients and relatives. However, only little is known about FoP in parents of childhood cancer survivors. The objective of this study was to investigate the impact of FoP on quality of life (QoL) in parental couples. METHODS We analyzed dyadic data of 197 couples parenting childhood cancer survivors (aged 0-17 years at diagnosis of leukemia or central nervous system tumor) after the end of intensive cancer treatment. The actor-partner interdependence model calculated by structural equation modelling was used to examine actor effects (effect of one's own FoP on one's own QoL) and partner effects (effect of one's own FoP on the partner's QoL). RESULTS Eighty-one percentage of the parents reported moderate or high FoP levels. Mothers reported higher FoP levels (p < .01) and lower overall QoL levels than fathers (p < .01). The results revealed a significantly positive intra-dyadic correlation between FoP of mothers and fathers of the same dyad (r = .431, p < .001). We found significantly negative actor effects for both mothers and fathers for the overall QoL (p < .001) as well as for several QoL subscales. No significant partner effects were found. CONCLUSIONS Most parents reported elevated levels of FoP. Our results show that FoP in parents of childhood cancer survivors is strongly negatively associated with QoL. Parental FoP should therefore be explored in future research and needs to be targeted by health care providers.
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Affiliation(s)
- Mona L Peikert
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Laura Inhestern
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Konstantin A Krauth
- Department of Pediatrics, Pediatric Hematology & Oncology, Klinik Bad Oexen, Bad Oeynhausen, Germany
| | - Gabriele Escherich
- Clinic of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Stefan Rutkowski
- Clinic of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Daniela Kandels
- Swabian Children's Cancer Center, Medical Faculty, University of Augsburg, Augsburg, Germany
| | - Corinna Bergelt
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Knebel C, Menzemer J, Pohlig F, Herschbach P, Burgkart R, Obermeier A, von Eisenhart-Rothe R, Mühlhofer HML. Peri-Prosthetic Joint Infection of the Knee Causes High Levels of Psychosocial Distress: A Prospective Cohort Study. Surg Infect (Larchmt) 2020; 21:877-883. [PMID: 32282286 DOI: 10.1089/sur.2019.368] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background: Peri-prosthetic joint infection (PJI) is a major complication of knee arthroplasty that can cause long-term disability. In addition to its physical impact, there is a clear psychological burden that has not been measured yet. We hypothesized that the psychosocial burden of PJI can be assessed quantitatively using standardized questionnaires and may be correlated with treatment stage. Methods: Thirty-one patients were enrolled in this longitudinal prospective cohort study from August 2015 to November 2016. Participants had clinically established knee PJI after primary total knee replacement in osteoarthritis according to the Musculoskeletal Infection Society criteria and underwent a standardized two-stage protocol. After explantation of the prosthesis and implantation of a polymethylmethacrylate knee spacer, patients were treated with organism-specific intravenous antibiotics for two weeks, followed by oral antibiotics for four weeks; and then reimplantation was performed in all cases. Psychometrically validated standardized questionnaires were used to measure psychosocial stress via self-assessment at four time points: (1) Before explantation of the prosthesis; (2) after explantation; (3) after the antibiotic treatment before reimplantation; and (4) three months after reimplantation (follow-up). The Patient Health Questionnaire (PHQ)-4, Short Form (SF)-12 (including PSK and KSK), Questions about Life Satisfaction (FLZM) and Fear of Progression (PA-F-KF) (titles and abbreviations in German) scores were interpreted according to cut-off values for depression, fear of progression, anxiety, and quality of life. Results: Eighteen patients (58.1%) showed a PHQ-4 score above the cut-off value for depression at least once, with the highest score before reimplantation (time point 3). On the SF-12, the mean subtest mental scale (PSK) score was 42.6 (± 14.5), and the mean subtest physical scale (KSK) score was 26.9 (± 7.5) over the four time points, which was significantly lower than that of the general German population (PSK 53.1, KSK 44.0; p < 0.05). The SF-12 scores did not change significantly over time. On the FLZ, health was least satisfactory, followed by recreational activities and work. On the PA-F-KF, patients had the greatest fear of being dependent on outside help, drastic medical interventions, and infection progression. The mean PA-F-KF value was 31.24 (± 9.60; values ≥34 are regarded as critical). Conclusion: Peri-prosthetic joint infection is a measurable, relevant psychosocial stressor for patients. Their quality of life and fear of the disease progressing are comparable to those of oncology patients. Routine screening should be conducted to identify affected patients early for appropriate treatment, improving long-term outcomes. Orthopaedic surgeons who treat patients with PJI should initiate by psychologists as well in order to maintain the patient's long-term quality of life.
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Affiliation(s)
- Carolin Knebel
- Klinikum rechts der Isar, Clinic for Orthopaedic and Sportorthopaedic, Technical University of Munich, School of Medicine, Munich, Germany
| | - Jennifer Menzemer
- Klinikum rechts der Isar, Clinic for Orthopaedic and Sportorthopaedic, Technical University of Munich, School of Medicine, Munich, Germany
| | - Florian Pohlig
- Klinikum rechts der Isar, Clinic for Orthopaedic and Sportorthopaedic, Technical University of Munich, School of Medicine, Munich, Germany
| | - Peter Herschbach
- Department of Psychosomatic Medicine and Psychotherapy, Technical University of Munich, Comprehensive Cancer Center Munich, Munich
| | - Rainer Burgkart
- Klinikum rechts der Isar, Clinic for Orthopaedic and Sportorthopaedic, Technical University of Munich, School of Medicine, Munich, Germany
| | - Andreas Obermeier
- Klinikum rechts der Isar, Clinic for Orthopaedic and Sportorthopaedic, Technical University of Munich, School of Medicine, Munich, Germany
| | - Rüdiger von Eisenhart-Rothe
- Klinikum rechts der Isar, Clinic for Orthopaedic and Sportorthopaedic, Technical University of Munich, School of Medicine, Munich, Germany
| | - Heinrich M L Mühlhofer
- Klinikum rechts der Isar, Clinic for Orthopaedic and Sportorthopaedic, Technical University of Munich, School of Medicine, Munich, Germany
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Mutsaers B, Butow P, Dinkel A, Humphris G, Maheu C, Ozakinci G, Prins J, Sharpe L, Smith AB, Thewes B, Lebel S. Identifying the key characteristics of clinical fear of cancer recurrence: An international Delphi study. Psychooncology 2019; 29:430-436. [PMID: 31713279 DOI: 10.1002/pon.5283] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 10/29/2019] [Accepted: 11/03/2019] [Indexed: 01/27/2023]
Abstract
OBJECTIVE Without an agreed-upon set of characteristics that differentiate clinical from nonclinical levels of fear of cancer recurrence (FCR), it is difficult to ensure that FCR severity is appropriately measured, and that those in need of intervention are identified. The objective of this study was to establish expert consensus on the defining features of clinical FCR. METHOD A three-round Delphi was used to reach consensus on the defining features of clinical FCR. Sixty-five experts in FCR (researchers, psychologists, physicians, nurses, and allied health professionals) were recruited to suggest and rate potential features of clinical FCR. Participants who indicated they could communicate diagnoses within their clinical role were also asked to consider the application of established DSM-5 and proposed ICD-11 diagnostic criteria (Health Anxiety, Illness Anxiety Disorder, Somatic Symptom Disorder) to clinical FCR. RESULTS Participants' ratings suggested that the following four features are key characteristics of clinical FCR: (a) high levels of preoccupation; (b) high levels of worry; (c) that are persistent; and (d) hypervigilance to bodily symptoms. Of participants whose professional role allowed them to diagnose mental disorders, 84% indicated it would be helpful to diagnose clinical FCR, but the use of established diagnostic criteria related to health anxiety or somatic-related disorders to clinical FCR was not supported. This suggests that participants consider clinical FCR as a presentation that is specific to cancer survivors. CONCLUSION Clinical FCR was conceptualized as a multidimensional construct. Further research is needed to empirically validate the proposed defining features.
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Affiliation(s)
| | - Phyllis Butow
- School of Psychology, The University of Sydney, Sydney, Australia
| | - Andreas Dinkel
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Gerald Humphris
- School of Medicine, University of St Andrews, St Andrews, United Kingdom
| | | | - Gozde Ozakinci
- School of Medicine, University of St Andrews, St Andrews, United Kingdom
| | | | - Louise Sharpe
- School of Psychology, The University of Sydney, Sydney, Australia
| | - Allan Ben Smith
- Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, Sydney, Australia
| | - Belinda Thewes
- School of Psychology, The University of Sydney, Sydney, Australia
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Cherny NI, Paluch-Shimon S, Berner-Wygoda Y. Palliative care: needs of advanced breast cancer patients. BREAST CANCER-TARGETS AND THERAPY 2018; 10:231-243. [PMID: 30584354 PMCID: PMC6284851 DOI: 10.2147/bctt.s160462] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Advanced breast cancer is characterized by many physical manifestations with the potential to undermine the quality of life (most related to the cancer and some to treatments), as well as substantial impact on psychosocial well-being. Patients with advanced breast cancer and their families have complex needs that have to be addressed in order to minimize severe distress and deterioration in the quality of life of patients and their family members. This task requires the full engagement of an interdisciplinary approach to palliative care with strong emphasis on the assessment of needs and anticipated needs, patient expectations, skilled therapeutics, and commitment to continuity of care. In this review, we address four issues: 1) organizational and conceptual issues in palliative care of patients with breast cancer, 2) common physical symptoms among patients with breast cancer and their management, 3) common psychological issues among patients with breast cancer, and 4) common challenging palliative care problems in breast cancer.
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Affiliation(s)
- Nathan I Cherny
- Integrated Oncology and Palliative Medicine Department, Breast Oncology Unit, Shaare Zedek Medical Center, Jerusalem, Israel,
| | - Shani Paluch-Shimon
- Integrated Oncology and Palliative Medicine Department, Breast Oncology Unit, Shaare Zedek Medical Center, Jerusalem, Israel,
| | - Yael Berner-Wygoda
- Integrated Oncology and Palliative Medicine Department, Breast Oncology Unit, Shaare Zedek Medical Center, Jerusalem, Israel,
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Yang Y, Sun H, Liu T, Zhang J, Wang H, Liang W, Chen Y, Zhang B. Factors associated with fear of progression in chinese cancer patients: sociodemographic, clinical and psychological variables. J Psychosom Res 2018; 114:18-24. [PMID: 30314574 DOI: 10.1016/j.jpsychores.2018.09.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 09/06/2018] [Accepted: 09/06/2018] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Fear of progression (FoP) is a widespread problem among cancer patients and is considered to be one of the most distressing psychological consequences of cancer. The aim of this study was to investigate the association of sociodemographic, clinical, and psychological variables to FoP in Chinese cancer patients. METHODS In this cross-sectional study, six hundred and thirty-six cancer patients were recruited. All participants were asked to complete a personal information sheet, the Chinese version of Fear of Progression Questionnaire-Short Form (FoP-Q-SF), Patient Health Questionnaire (PHQ-9) and General Anxiety Disorder Questionnaire (GAD-7). Descriptive statistics and hierarchical multiple regression was conducted to analyze the data. RESULTS Hierarchical multiple regression revealed that childhood severe illness experience (P = .011), stress (P < .001), anxiety (P < .001), depressive symptom (P < .001) and personality (P = .042) were independently predictive of higher FoP. The final regression model explained up to 40.0% (adjusted R square: 38.8%) of the observed variance. CONCLUSION There are a number of factors that increase the likelihood of the development of FoP. The findings underline the necessity to provide effective psychological intervention for patients with high FoP in the future.
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Affiliation(s)
- Yuan Yang
- Department of Psychiatry, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong 510515, China
| | - Hengwen Sun
- Department of Radiotherapy, Cancer Centre, Guangdong General Hospital, Guangzhou, Guangdong 510080, China
| | - Ting Liu
- Department of Psychiatry, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong 510515, China
| | - Jingying Zhang
- Department of Psychiatry, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong 510515, China
| | - Hongmei Wang
- Department of Radiotherapy, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong 510515, China
| | - Weijiang Liang
- Department of Oncology, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong 510515, China
| | - Yu Chen
- Nursing School, Southern Medical University, Guangzhou, Guangdong 510515, China
| | - Bin Zhang
- Department of Psychiatry, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong 510515, China.
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