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Zhen J, Stefanolo JP, Temprano MDLP, Seiler CL, Caminero A, de-Madaria E, Huguet MM, Santiago V, Niveloni SI, Smecuol EG, Dominguez LU, Trucco E, Lopez V, Olano C, Mansueto P, Carroccio A, Green PH, Duerksen D, Day AS, Tye-Din JA, Bai JC, Ciacci C, Verdú EF, Lebwohl B, Pinto-Sanchez MI. Risk perception and knowledge of COVID-19 in patients with celiac disease. World J Gastroenterol 2021; 27:1213-1225. [PMID: 33828395 PMCID: PMC8006100 DOI: 10.3748/wjg.v27.i12.1213] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 01/07/2021] [Accepted: 03/12/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND We recently demonstrated that the odds of contracting coronavirus disease 2019 (COVID-19) in patients with celiac disease (CeD) is similar to that of the general population. However, how patients with CeD perceive their COVID-19 risk may differ from their actual risk.
AIM To investigate risk perceptions of contracting COVID-19 in patients with CeD and determine the factors that may influence their perception.
METHODS We distributed a survey throughout 10 countries between March and June 2020 and collected data on demographics, diet, COVID-19 testing, and risk perceptions of COVID-19 in patients with CeD. Participants were recruited through various celiac associations, clinic visits, and social media. Risk perception was assessed by asking individuals whether they believe patients with CeD are at an increased risk of contracting COVID-19 when compared to the general population. Logistic regression was used to determine the influencing factors associated with COVID-19 risk perception, such as age, sex, adherence to a gluten-free diet (GFD), and comorbidities such as cardiac conditions, respiratory conditions, and diabetes. Data was presented as adjusted odds ratios (aORs)
RESULTS A total of 10737 participants with CeD completed the survey. From them, 6019 (56.1%) patients with CeD perceived they were at a higher risk or were unsure if they were at a higher risk of contracting COVID-19 compared to the non-CeD population. A greater proportion of patients with CeD perceived an increased risk of contracting COVID-19 when compared to infections in general due to their CeD (56.1% vs 26.7%, P < 0.0001). Consequently, 34.8% reported taking extra COVID-19 precautions as a result of their CeD. Members of celiac associations were less likely to perceive an increased risk of COVID-19 when compared to non-members (49.5% vs 57.4%, P < 0.0001). Older age (aOR: 0.99; 95%CI: 0.99 to 0.99, P < 0.001), male sex (aOR: 0.84; 95%CI: 0.76 to 0.93, P = 0.001), and strict adherence to a GFD (aOR: 0.89; 95%CI: 0.82 to 0.96, P = 0.007) were associated with a lower perception of COVID-19 risk and the presence of comorbidities was associated with a higher perception of COVID-19 risk (aOR: 1.38; 95%CI: 1.22 to 1.54, P < 0.001).
CONCLUSION Overall, high levels of risk perceptions, such as those found in patients with CeD, may increase an individual’s pandemic-related stress and contribute to negative mental health consequences. Therefore, it is encouraged that public health officials maintain consistent communication with the public and healthcare providers with the celiac community. Future studies specifically evaluating mental health in CeD could help determine the consequences of increased risk perceptions in this population.
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Affiliation(s)
- Jamie Zhen
- Department of Medicine, Farncombe Family Digestive Health Research Institute, McMaster University Medical Center, Hamilton Health Sciences, Hamilton L8S4K1, ON, Canada
| | - Juan Pablo Stefanolo
- Department of Medicine, Dr. C. Bonorino Udaondo Gastroenterology Hospital, Buenos Aires 1264, Argentina
| | - María de la Paz Temprano
- Department of Medicine, Dr. C. Bonorino Udaondo Gastroenterology Hospital, Buenos Aires 1264, Argentina
| | - Caroline L Seiler
- Department of Medicine, Farncombe Family Digestive Health Research Institute, McMaster University Medical Center, Hamilton Health Sciences, Hamilton L8S4K1, ON, Canada
| | - Alberto Caminero
- Department of Medicine, Farncombe Family Digestive Health Research Institute, McMaster University Medical Center, Hamilton Health Sciences, Hamilton L8S4K1, ON, Canada
| | - Enrique de-Madaria
- Department of Pancreatic Unit, Hospital General Universitario de Alicante, Alicante 03010, Spain
| | - Miguel Montoro Huguet
- Department of Medicine, Instituto Aragonés de Ciencias de la Salud (IACS), Zaragoza 50009, Spain
- Department of Medicine, Hospital Universitario San Jorge. Huesca, Zaragoza 50004, Spain
| | - Vivas Santiago
- Department of Gastroenterology, Univ Hosp Leon, Gastroenterol Unit, Altos de Nava S-N, Leon 24071, Spain
| | - Sonia Isabel Niveloni
- Department of Medicine, Dr. C. Bonorino Udaondo Gastroenterology Hospital, Buenos Aires 1264, Argentina
| | - Edgardo Gustavo Smecuol
- Department of Medicine, Dr. C. Bonorino Udaondo Gastroenterology Hospital, Buenos Aires 1264, Argentina
| | - Luis Uzcanga Dominguez
- Department of Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico DF 14080, Mexico
| | - Elena Trucco
- Department of Medicine, Universidad de la Republic, Montevideo 11800, Uruguay
| | - Virginia Lopez
- Department of Medicine, Universidad de la Republic, Montevideo 11800, Uruguay
| | - Carolina Olano
- Department of Medicine, Universidad de la Republic, Montevideo 11800, Uruguay
| | - Pasquale Mansueto
- Department of Internal Medicine, PROMISE Department, University of Palermo, Palermo 90127, Italy
| | - Antonio Carroccio
- Department of Internal Medicine, V. Cervello Hospital, PROMISE Department, University of Palermo, Palermo 90127, Italy
| | - Peter H Green
- Celiac Disease Center, Columbia University Medical Center, Columbia Univ, Celiac Dis Ctr, Div Digest and Liver Dis, New York, NY 10032, United States
| | - Donald Duerksen
- Department of Medicine, St Boniface Gen Hosp, University of Manitoba, Winnipeg R2H 2A6, Canada
| | - Andrew S Day
- Department of Paediatrics, University of Otago Christchurch, Christchurch 8041, New Zealand
| | - Jason A Tye-Din
- Department of Gastroenterology, Royal Melbourne Hospital, Immunology Division, Walter and Eliza Hall Institute, Melbourne 3052, Australia
| | - Julio César Bai
- Department of Medicine, Dr. C. Bonorino Udaondo Gastroenterology Hospital, Buenos Aires 1264, Argentina
| | - Carolina Ciacci
- Department of Medicine, Surgery and Dentry, Scuola Medica Salernitana, University of Salerno, Celiac Center at the University Hospital San Giovanni di Dio e Ruggi di Aragona, Salerno 84131, Italy
| | - Elena F Verdú
- Department of Medicine, Farncombe Family Digestive Research Institute, McMaster University, Hamilton L8S4K1, ON, Canada
| | - Benjamin Lebwohl
- The Celiac Disease Center, Columbia University, New York, NY 10032, United States
| | - M Ines Pinto-Sanchez
- Department of Medicine, Farncombe Family Digestive Research Institute, McMaster University, Hamilton L8S4K1, ON, Canada
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Rönningås U, Fransson P, Holm M, Wennman-Larsen A. Prostate-specific antigen (PSA) and distress: - a cross-sectional nationwide survey in men with prostate cancer in Sweden. BMC Urol 2019; 19:66. [PMID: 31299962 PMCID: PMC6626380 DOI: 10.1186/s12894-019-0493-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 07/02/2019] [Indexed: 02/01/2023] Open
Abstract
Background The prostate-specific antigen (PSA) -value is often used during the prostate cancer trajectory as a marker of progression or response to treatment. Concerns about PSA-values are often expressed by patients in clinical situations. Today there is a lack of larger studies that have investigated the association between PSA-value and distress. The aim was to investigate the association between PSA-values and distress adjusted for sociodemographic factors, hormonal therapy and quality of life (QoL), among men with prostate cancer. Methods In this cross-sectional survey of 3165 men with prostate cancer, members of the Swedish Prostate Cancer Federation, answered questions about sociodemographic factors, PSA, distress, QoL and treatments. Descriptive statistics, and bivariate and multivariable analyses were performed. The result was presented based on four PSA-value groups: 0–19, 20–99, 100–999, and ≥ 1000 ng/ml. Results Of the men, 53% experienced distress. An association between distress and PSA-values was found where higher PSA-values were associated with higher OR:s for experiencing distress in the different PSA-groups: 0–19 ng/ml (ref 1), 20–99 ng/ml (OR 1.25, 95% CI 1.01–1.55), 100–999 ng/ml (OR 1.47, 95% CI 1.12–1.94), ≥1000 ng/ml (OR 1.77, 95% CI 1.11–2.85). These associations were adjusted for sociodemographic factors and hormonal therapy. In the multivariable analyses, beside PSA-values, higher levels of distress were associated with being without partner or hormonal therapy. When adding QoL in the multivariable analysis, the association between PSA and distress did not remain significant. Conclusion These results indicate that the PSA-values are associated with distress, especially for those with higher values. However, to be able to support these men, continued research is needed to gain more knowledge about the mechanisms behind the association between emotional distress and PSA-values.
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Affiliation(s)
- Ulrika Rönningås
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, 171 77, Stockholm, Sweden. .,Department of Oncology, Sundsvall County Hospital, 851 86, Sundsvall, Sweden. .,Department of Nursing Science, Sophiahemmet University, 114 86, Stockholm, Sweden.
| | - Per Fransson
- Department of Nursing, Umeå University, 901 87, Umeå, Sweden.,Cancercentrum, Norrlands University Hospital, 901 85, Umeå, Sweden
| | - Maja Holm
- Department of Nursing Science, Sophiahemmet University, 114 86, Stockholm, Sweden
| | - Agneta Wennman-Larsen
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, 171 77, Stockholm, Sweden.,Department of Nursing Science, Sophiahemmet University, 114 86, Stockholm, Sweden
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Juuso P, Söderberg S, Olsson M, Skär L. The significance of FM associations for women with FM. Disabil Rehabil 2013; 36:1755-61. [PMID: 24350657 DOI: 10.3109/09638288.2013.868046] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE Living with fibromyalgia (FM) means living with a long-term pain syndrome that is invisible to others. Support and understanding from others seem to be important to managing the affected daily life. The aim of this study was to describe the significance of FM associations for women with FM. METHODS Data collection was carried out through focus group discussions with seventeen women with FM. Data were analyzed through thematic content analysis. RESULTS The findings show that women experienced associations for people with FM as important as they gave access to contacts with others with similar experiences. Their need of togetherness was fulfilled at the association and they described being strengthened by the support received. Because of the lack of information and knowledge about FM, the association was described as an important venue for getting and mediating information about the illness. CONCLUSIONS At the association the women seem to be empowered, which increases their ability to manage their daily lives despite the limitations imposed by FM. Healthcare personnel could not satisfy the women's needs and to manage to support women with FM. There is a need for communication based on a shared understanding between the women and healthcare personnel. IMPLICATIONS FOR REHABILITATION This study highlighted the need for communication based on a shared understanding between people with chronic illness and healthcare personnel to support and strengthen women with FM in their daily lives. The FM associations meet the needs for togetherness, confirmation, and information that the women with FM in this study described and healthcare personnel could not satisfy. Healthcare personnel can learn from FM associations how to empower women with FM in their everyday lives.
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Affiliation(s)
- Päivi Juuso
- Division of Nursing, Department of Health Science, Luleå University of Technology , Luleå , Sweden
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Dellson P, Nilbert M, Bendahl PO, Malmström P, Carlsson C. Towards optimised information about clinical trials; identification and validation of key issues in collaboration with cancer patient advocates. Eur J Cancer Care (Engl) 2010; 20:445-54. [PMID: 20738392 DOI: 10.1111/j.1365-2354.2010.01207.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Clinical trials are crucial to improve cancer treatment but recruitment is difficult. Optimised patient information has been recognised as a key issue. In line with the increasing focus on patients' perspectives in health care, we aimed to study patients' opinions about the written information used in three clinical trials for breast cancer. Primary data collection was done in focus group interviews with breast cancer patient advocates. Content analysis identified three major themes: comprehensibility, emotions and associations, and decision making. Based on the advocates' suggestions for improvements, 21 key issues were defined and validated through a questionnaire in an independent group of breast cancer patient advocates. Clear messages, emotionally neutral expressions, careful descriptions of side effects, clear comparisons between different treatment alternatives and information about the possibility to discontinue treatment were perceived as the most important issues. Patients' views of the information in clinical trials provide new insights and identify key issues to consider in optimising future written information and may improve recruitment to clinical cancer trials.
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Affiliation(s)
- P Dellson
- Department of Oncology, Institute of Clinical Sciences, Lund University, Department of Oncology, Skåne University Hospital, Lund, Sweden.
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Carlsson C, Bendahl PO, Nilsson K, Nilbert M. Benefits from membership in cancer patient associations: relations to gender and involvement. Acta Oncol 2009; 45:559-63. [PMID: 16864169 DOI: 10.1080/02841860600724419] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Cancer patient associations report a growing number of members and increasing possibilities to influence health care, but knowledge about the members' views on the benefit of involvement is scarce. We therefore investigated how members (n = 1742) of Swedish patient associations for breast cancer and prostate cancer rate the benefit of membership for their physical and psychological well-being and social adjustment to cancer. Using a scoring scale, 2/3 of the members reported that membership had benefit for psychological well-being, whereas half of the members reported benefit for physical well-being and social adjustment. Individuals who had been actively involved in board work and/or contact person activities within the associations reported significantly more benefit for all three parameters. Gender differences were observed with men, represented by individuals affected by prostate cancer, reporting greater benefit for all three parameters, although especially evident for psychological well-being. Individuals who obtained membership within two years of diagnosis reported greater benefit for psychological well-being and social adjustment compared to those who became members later. In conclusion, members in patient associations for cancer report benefit particularly for their psychological well-being and actively involved members and men affected by prostate cancer perceive the greatest benefit from membership.
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Affiliation(s)
- Christina Carlsson
- Department of Oncology, Institute of Clinical Sciences, Lund University, SE-221 85, Lund, Sweden.
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