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G P, Ramalingam K, Ramani P, Krishnan M. Longitudinal Assessment of the Quality of Life in Oral Squamous Cell Carcinoma Patients. Cureus 2024; 16:e60596. [PMID: 38894763 PMCID: PMC11185025 DOI: 10.7759/cureus.60596] [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] [Accepted: 05/19/2024] [Indexed: 06/21/2024] Open
Abstract
Background Studies evaluating the quality of life (QoL) among oral cancer patients in the Indian population are scarce. Regular follow-ups and QoL assessment in oral squamous cell carcinoma (OSCC) patients can aid in comprehensive support strategies to improve their QoL outcomes. Aim and objectives This study aimed to assess the QoL of oral cancer patients and correlate the QoL with demographic and treatment parameters. Materials and methods The study included oral cancer patients who had previously reported to the Department of Oral and Maxillofacial Surgery. QoL assessment was done using the EORTC QLQ-C30 and QLQ-HN43 questionnaires before and after treatment. The clinico-demographic details, treatment data, follow-up data, and recorded mean QoL were procured from the patient records in Dental Information Archival Software. Assessment of QoL was done before treatment and at intervals of one month, three months, six months, 12 months, 24 months, and 36 months postoperatively after treatment. Statistical analysis was performed using IBM SPSS Statistics for Windows, Version 23 (released 2015; IBM Corp., Armonk, New York, United States). A repeated measures analysis of variance (ANOVA) was utilized for comparing the average QoL scores and frequency of follow-ups across various intervals. Chi-square tests assessed differences in mean QoL among genders, across different sites, and between primary closure and graft placement. The significance was set at a p-value of less than 0.05. Results A total of 90 OSCC patients had reported to the department. A preoperative assessment of QoL was done for 90 (100%) patients. Out of these patients, surgery has been performed on 41 (45%). Twenty-five out of 41 (60%) patients had responded to regular follow-up, and QoL was assessed for these patients. After the immediate postoperative phase, only 12 (48%) had reported after three months. Only six (24%) had a 12-month follow-up, five (20%) had a two-year follow-up, and one (4%) had a three-year follow-up. There was a constant decrease in the number of follow-ups after the treatment of OSCC (p=0.00). Prior to treatment, the mean QoL index was 4.64. Females had a slightly higher preoperative QoL of 4.76 compared to males, with a score of 4.67 (p=0.157). Immediately after the treatment of OSCC, a decline in QoL scores was noted, with a mean score of 4.25 (p=0.32). Patients who underwent primary closure after excision had a mean post-op QoL score of 4.9, while patients who underwent graft placement had a mean score of 4.6 (p=0.157). Conclusion This study highlights the enduring impact of oral cancer on a patient's quality of life and emphasizes the need for ongoing research to explore specific interventions that can contribute to sustained improvement in QoL. It emphasizes personalized, holistic care approaches for such patients.
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Affiliation(s)
- Priyadharshini G
- Oral Pathology and Microbiology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Karthikeyan Ramalingam
- Oral Pathology and Microbiology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Pratibha Ramani
- Oral Pathology and Microbiology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Murugesan Krishnan
- Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
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Lu CH, Hung CY, Hsueh SW, Yeh KY, Hung YS, Chou WC. Frailty is an independent factor for health-related quality of life in patients with head and neck cancer receiving definitive concurrent chemoradiotherapy. Support Care Cancer 2024; 32:106. [PMID: 38221588 DOI: 10.1007/s00520-024-08313-9] [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: 10/06/2023] [Accepted: 01/08/2024] [Indexed: 01/16/2024]
Abstract
PURPOSE Health-related quality of life (HRQoL) is associated with treatment-related complications and poor survival in patients with head and neck cancer (HNC). We investigated the effects of frailty on HRQoL in patients with HNC receiving definitive concurrent chemoradiotherapy (CCRT). METHODS A total of 461 consecutive patients with locally advanced HNC who received CCRT between 2017 and 2018 at three medical centers in Taiwan were included. Frailty and HRQoL were assessed using the Comprehensive Geriatric Assessment and QLQ-H&N35 before CCRT. The sum score was calculated based on the first 30 questions of QLQ-H&N35. Multivariate analysis was performed to evaluate the impact of frailty on HRQoL. RESULTS The overall sum score was 39 (34-49). The sum scores of patients with impairments in 0, 1, 2, 3, and ≥ 4 frailty domains were 34 (32-38), 40 (34-47), 46 (36-55), 48 (41-64), and 56 (50-60), respectively. Patients with impairments in more frailty domains had a higher symptom burden (p for trend < 0.001). Frail patients tended to experience symptoms across all QLQ-H&N35 subscales. Sex, body mass index, tumor type, tumor stage, Eastern Cooperative Oncology Group performance status, and frailty were determinants of HRQoL in the univariate analysis. Frailty was an independent determinant of HRQoL in the multivariate analysis. CONCLUSION Routine frailty assessment may serve as a surrogate for the selection of patients with HNC with poor HRQoL before CCRT. Further studies are needed to determine whether appropriate interventions in frail patients would improve their HRQoL during CCRT.
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Affiliation(s)
- Chang-Hsien Lu
- Department of Hematology and Oncology, Chang Gung Memorial Hospital at Chiayi, Chiayi, Taiwan
| | - Chia-Yen Hung
- Department of Hematology and Oncology, Chang Gung Memorial Hospital at Linkou and College of Medicine, Chang Gung University, 5 Fu-Hsing Street, Kwei-Shan Shiang, Taoyuan, Taiwan
- Division of Hematology and Oncology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan
| | - Shun-Wen Hsueh
- Department of Hematology and Oncology, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan
| | - Kun-Yun Yeh
- Department of Hematology and Oncology, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan
| | - Yu-Shin Hung
- Department of Hematology and Oncology, Chang Gung Memorial Hospital at Linkou and College of Medicine, Chang Gung University, 5 Fu-Hsing Street, Kwei-Shan Shiang, Taoyuan, Taiwan
| | - Wen-Chi Chou
- Department of Hematology and Oncology, Chang Gung Memorial Hospital at Linkou and College of Medicine, Chang Gung University, 5 Fu-Hsing Street, Kwei-Shan Shiang, Taoyuan, Taiwan.
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Sırlıer Emir B, Yıldız S, Kurt O, Emre E, Aydın S. Relationships between Anxiety, Depression, and Illness Perceptions in Lung and Breast Cancer Patients throughout the Cancer Continuum. Healthcare (Basel) 2023; 11:2794. [PMID: 37893868 PMCID: PMC10606067 DOI: 10.3390/healthcare11202794] [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: 09/24/2023] [Revised: 10/17/2023] [Accepted: 10/20/2023] [Indexed: 10/29/2023] Open
Abstract
Cancer is a devastating disease that has significant psychological and biological impacts. Generally, lung cancer primarily affects men while breast cancer primarily affects women. Thus, this study aimed to investigate the levels of anxiety and depression in patients with these prevalent cancer types, as well as their perceptions of the illness and any potential connections between them. The study included a total of 252 participants, consisting of 110 breast cancer patients, 112 lung cancer patients, and 30 healthy individuals as controls. The Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) were administered to assess mood, while the Illness Perception Questionnaire (IPQ) was used to evaluate cancer perceptions. Results revealed that both breast cancer and lung cancer patients had significantly higher BDI and BAI scores compared to the control group. Furthermore, the BDI and BAI scores were lower in breast cancer patients compared to lung cancer patients. The IPQ causal representation-immunity score was significantly higher in lung cancer patients than in breast cancer patients (p = 0.01). Positive correlations were found between BDI scores and BAI scores, as well as between BDI scores and certain subscale scores of the IPQ related to illness representation and causal representation. Additionally, a positive correlation was observed between BAI scores and the IPQ illness representation-timeline acute/chronic subscale, while a negative correlation was found between BAI scores and the IPQ causal representation-accident or chance scores. Overall, the study findings demonstrated that breast and lung cancer patients possess negative perceptions of their disease and experience high levels of anxiety and depression. To enhance the quality of life and promote resilience in these patients, it is recommended to incorporate psychological interventions that consider anxiety, depression, and disease perception.
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Affiliation(s)
- Burcu Sırlıer Emir
- Department of Psychiatry, Elazığ Fethi Sekin City Hospital, 23100 Elazığ, Turkey;
| | - Sevler Yıldız
- Department of Psychiatry, Elazığ Fethi Sekin City Hospital, 23100 Elazığ, Turkey;
| | - Osman Kurt
- Department of Public Health, Adıyaman Provincial Health Directorate, 02100 Adıyaman, Turkey;
| | - Elif Emre
- Department of Anatomy, Faculty of Medicine, University of Fırat, 23119 Elazığ, Turkey;
| | - Süleyman Aydın
- Department of Biochemistry, Faculty of Medicine, University of Fırat, 23119 Elazığ, Turkey;
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Li Z, Zhang Y, Pang Y, He Y, Song L, Wang Y, He S, Tang L. The mediating effect of somatic symptom disorder between psychological factors and quality of life among Chinese breast cancer patients. Front Psychiatry 2023; 14:1076036. [PMID: 37252145 PMCID: PMC10213318 DOI: 10.3389/fpsyt.2023.1076036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 04/18/2023] [Indexed: 05/31/2023] Open
Abstract
Objective We conducted this cross-sectional study to explore the mediating and predicting role of somatic symptom disorder (SSD) between psychological measures and quality of life (QOL) among Chinese breast cancer patients. Methods Breast cancer patients were recruited from three clinics in Beijing. Screening tools included the Patient Health Questionnaire-15 (PHQ-15), the Patient Health Questionnaire-9 (PHQ-9), the General Anxiety Disorder-7 scale (GAD-7), the Health Anxiety Scale (Whiteley Index-8, WI-8), the Somatic Symptom Disorder B-Criteria Scale (SSD-12), the Fear of Cancer Recurrence scale (FCR-4), the Brief Illness Perception Questionnaire (BIPQ-8), and the Functional Assessment of Cancer Therapy-Breast (FACT-B). Chi-square tests, nonparametric tests, mediating effect analysis, and linear regression analysis were used for the data analysis. Results Among the 264 participants, 25.0% were screened positive for SSD. The patients with screened positive SSD had a lower performance status, and a greater number of patients with screened positive SSD received traditional Chinese medicine (TCM) (p < 0.05). Strong mediating effects of SSD were found between psychological measures and QOL among patients with breast cancer after adjusting for sociodemographic variables as covariates (p < 0.001). The range of the percentage mediating effects was 25.67% (independent variable = PHQ-9) to 34.68% (independent variable = WI-8). Screened positive SSD predicted low QOL in physical (B = -0.476, p < 0.001), social (B = -0.163, p < 0.001), emotional (B = -0.304, p < 0.001), and functional (B = -0.283, p < 0.001) well-being, as well as substantial concerns caused by breast cancer (B = -0.354, p < 0.001). Conclusion Screened positive SSD had strong mediating effects between psychological factors and quality of life among breast cancer patients. Additionally, screened positive SSD was a significant predictor of lower QOL among breast cancer patients. Effective psychosocial interventions for improving QOL should consider the prevention and treatment of SSD or integrated SSD caring dimensions for breast cancer patients.
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Restivo L, Apostolidis T, Julian-Reynier C. Les représentations de la maladie : choix des outils de mesure et applications dans le champ du cancer. PSYCHO-ONCOLOGIE 2022. [DOI: 10.3166/pson-2022-0207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Objectif : Dresser un bilan des outils quantitatifs disponibles pour mesurer les représentations de la maladie et analyser leur utilisation empirique auprès de patients atteints de cancer.
Matériel et méthodes : Revue de la littérature.
Résultats : Sept outils de mesure des représentations de la maladie existent dont un spécifique au cancer. L’Illness Perception Questionnaire est utilisé dans 29 des 33 études retenues.
Conclusion : Associer ces échelles avec des méthodes reposant sur des approches davantage centrées sur le contexte socioculturel semble à privilégier.
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Shipston-Sharman O, Popkirov S, Hansen CH, Stone J, Carson A. Prognosis in functional and recognised pathophysiological neurological disorders - a shared basis. J Psychosom Res 2021; 152:110681. [PMID: 34872006 DOI: 10.1016/j.jpsychores.2021.110681] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 11/15/2021] [Accepted: 11/16/2021] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To compare self-reported outcomes, clinical trajectory and utility of baseline questionnaire responses in predicting prognosis in functional and recognised pathophysiological neurological disorders. METHODS Baseline data on 2581 patients included health-related quality of life, psychological and physical symptoms, illness perceptions, consultation satisfaction and demographics. The prospective cohort included neurology outpatients classified with a functional (reporting symptoms 'not at all' or 'somewhat explained' by 'organic disease'; n = 716) or recognised pathophysiological disorder ('largely' or 'completely explained'; n = 1865). Logistic regression and deep neural network models were used to predict self-reported global clinical improvement (CGI) at 12-months. RESULTS Patients with functional and recognised pathophysiological disorders reported near identical outcomes at 12-months with 67% and 66% respectively reporting unchanged or worse CGI. In multivariable modelling 'negative expectation of recovery' and 'disagreement with psychological attribution' predicted same or worse outcome in both groups. Receipt of disability-related state benefit predicted same or worse CGI outcome in the functional disorder group only (OR = 2.28 (95%-CI: 1.36-3.84) in a group-stratified model) and was not related to a measure of economic deprivation. Deep neural network models trained on all 92 baseline features predicted poor outcome with area under the receiver-operator curve of 0.67 in both groups. CONCLUSIONS Those with functional and recognised pathophysiological neurological disorder share similar outcomes, clinical trajectories, and poor prognostic markers in multivariable models. Prediction of outcome at a patient level was not possible using the baseline data in this study.
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Affiliation(s)
| | - Stoyan Popkirov
- Department of Neurology, University Hospital Knappschaftskrankenhaus Bochum, Ruhr University Bochum, Bochum, Germany
| | - Christian H Hansen
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Jon Stone
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Alan Carson
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
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Evaluation of Malnutrition and Quality of Life in Patients Treated for Oral and Oropharyngeal Cancer. ScientificWorldJournal 2021; 2021:9936715. [PMID: 34381320 PMCID: PMC8352700 DOI: 10.1155/2021/9936715] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 07/28/2021] [Indexed: 11/18/2022] Open
Abstract
Background Oral and oropharyngeal cancer is a debilitating disease with high morbidity and mortality. Depending on the site and extent of the involvement of the cancer and the type of treatment modality, these patients can develop pain, trismus, xerostomia, dysphagia, and taste disturbances, compromising them socially and nutritionally. The aim of the study was to evaluate malnutrition and quality of life in patients treated for oral and oropharyngeal cancer. Methodology. A cross-sectional study was conducted which included 97 patients treated for oral and oropharyngeal cancer. The quality of life of the selected patients was assessed by using a validated European Organization for the Research and Treatment of Cancer's Quality of Life Questionnaire, Head and Neck and Mandibular Function Impairment Questionnaire. Pre- and posttreatment weight of the patients were assessed, and weight loss of ≥10% of pretreatment weight was considered as malnutrition. The chi-square test was used to correlate the symptoms with the quality of life. A paired t test was used to assess the differences in weight before and after treatment, and a p value of <0.005 was considered as significant. Results The most commonly reported symptoms were xerostomia (93.81%), pain (81.44%), and dysphagia (76.3%). A total of 40.2% of the individuals in the study had malnutrition. Malnutrition was comparatively lower in the group who had nutritional supplements. Conclusion The quality of life in patients treated for oral and oropharyngeal cancer deteriorates immediately after the treatment; however, it significantly improves over time.
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Bashir A, Kumar D, Dewan D, Sharma R. Quality of life of head and neck cancer patients before and after cancer-directed treatment - A longitudinal study. J Cancer Res Ther 2020; 16:500-507. [PMID: 32719257 DOI: 10.4103/jcrt.jcrt_311_18] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Context Head-and-neck cancer (HNC) is a major health problem worldwide and even disproportionately bigger in India. Their diagnosis and treatment create severe impact on the quality of life (QOL). We chose to study such patients because we were already reporting these cancers to the Indian Council of Medical Research as part of project titled "Pattern of care and survival studies." Aims The aim of the study is to assess and compare QOL of H and N cancer patients before and after the completion of cancer-directed treatment (CDT). Settings and Design The present study was a hospital-based study conducted in the tertiary care hospital of Jammu with longitudinal study design. Subjects and Methods All newly diagnosed HNC patients registered with the Department of Radiotherapy and ENT on inpatient or outpatient basis were included over a period of 6 months. Each patient was followed for 4-6 weeks after the completion of CDT. QOL was assessed by the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core 30 (QLQ C30) (general) and EORTC QLQ H and N-35 (specific) questionnaires. Statistical Analysis Paired t-test was calculated to compare pre- and postmean scores. Pre- and post-Cronbach alpha reliability coefficient was also calculated. Results The most frequent site was larynx followed by the oral cavity. Regarding both EORTC QLQ C-30 questionnaire and Global health status and EORTC H and N-35 specific questionnaires, the mean scores across all domains showed worsening of QoL from their baseline. The worsening was more severe in emotional function (functional scale), while physical, cognitive, and social functions were comparatively less affected. Pain, swallowing, speech, and mouth problems were most worsened. Conclusions QoL showed worsening after CDT in all domains due to acute and subacute adverse effects of chemotherapy and radiotherapy in treatment course.
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Affiliation(s)
- Abroo Bashir
- Department of Community Medicine, Government Medical College, Jammu, Jammu and Kashmir, India
| | - Dinesh Kumar
- Department of Community Medicine, Government Medical College, Jammu, Jammu and Kashmir, India
| | - Deepika Dewan
- Department of Community Medicine, Government Medical College, Jammu, Jammu and Kashmir, India
| | - Rahul Sharma
- Department of Radiotherapy and Oncology, Government Medical College, Jammu, Jammu and Kashmir, India
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Firkins J, Hansen L, Driessnack M, Dieckmann N. Quality of life in "chronic" cancer survivors: a meta-analysis. J Cancer Surviv 2020; 14:504-517. [PMID: 32162194 DOI: 10.1007/s11764-020-00869-9] [Citation(s) in RCA: 98] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 02/18/2020] [Indexed: 12/18/2022]
Abstract
PURPOSE Cancer survivors are now living longer giving rise to a new concept-chronic cancer as survivors continue to face long-term consequences of cancer and its treatment. For these survivors, QOL becomes a vital consideration in understanding their survivorship and the long-term impact of cancer and its treatment. The primary aim of this review is to describe QOL in cancer survivors two or more years from diagnosis. METHODS A meta-analysis was completed of relevant studies assessing QOL in long-term cancer survivorship using PubMed, CINHAL, and PsycINFO. A total of 64 articles met inclusion criteria and included in the analysis. Standardized effect sizes and errors were calculated using previously published standard QOL pass rates to compare QOL across measurement tools and calculate cumulative effect sizes (CES). Fixed-effect or random-effects models were used based on the presence of significant heterogeneity of ≤ 0.10. RESULTS Physical health (CES = - 0.894; CI, - 1.472, - 0.316), role-physical health (CES = - 2.039; CI, - 2.643, - 1.435), and mental health (CES = - 0.870; CI, - 1.447, - 0.292) had large, negative cumulative effect sizes signifying worse QOL compared with acceptable QOL rates. Tested moderators, cancer type, average age, country of origin, time since diagnosis, or decade of diagnosis, were not significant to explain heterogeneity between included studies. CONCLUSION QOL is significantly impacted 2 to 26 years after cancer diagnosis. More research is needed to determine possible moderators of QOL in long-term cancer survivors. IMPLICATIONS FOR CANCER SURVIVORS QOL continues to be significantly impacted in long-term cancer survivorship. More research is needed to understand the impact of these findings on care needs for survivors with chronic cancer.
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Affiliation(s)
- Jenny Firkins
- Oregon Health & Science University School of Nursing, 3455 SW US Veterans Hospital Road, Portland, OR, 97239, USA.
| | - Lissi Hansen
- Oregon Health & Science University School of Nursing, 3455 SW US Veterans Hospital Road, Portland, OR, 97239, USA
| | - Martha Driessnack
- Oregon Health & Science University School of Nursing, 3455 SW US Veterans Hospital Road, Portland, OR, 97239, USA
| | - Nathan Dieckmann
- Oregon Health & Science University School of Nursing, 3455 SW US Veterans Hospital Road, Portland, OR, 97239, USA.,Division of Clinical Psychology, Oregon Health & Science University, 3314 SW US Veterans Hospital Road, Portland, OR, 97239, USA
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Blaauwgeers MW, Kruip MJHA, Beckers EAM, Coppens M, Eikenboom J, van Galen KPM, Tamminga RYJ, Urbanus RT, Schutgens REG. Congenital platelet disorders and health status-related quality of life. Res Pract Thromb Haemost 2020; 4:100-105. [PMID: 31989090 PMCID: PMC6971322 DOI: 10.1002/rth2.12281] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 10/15/2019] [Accepted: 10/16/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Patients with congenital blood platelet disorders (CPDs) demonstrate a predominantly mucocutaneous bleeding tendency. Repeated bleeds throughout life can have a significant impact on health status-related quality of life (HR-QoL), but few studies have investigated HR-QoL in patients with CPDs. OBJECTIVES To determine HR-QoL in patients with suspected or confirmed CPDs as compared with the general Dutch population and to assess the association between bleeding phenotype and HR-QoL. METHODS Data were derived from the Thrombocytopathy in the Netherlands (TiN) study, a cross-sectional study of individuals suspected for a congenital platelet defect. TiN patients with an increased ISTH Bleeding Assessment Tool (ISTH-BAT) score (>3 in men and > 5 in women) were included for analysis. HR-QoL was assessed with the Short Form (SF)-36 survey. Bleeding symptoms were evaluated with the ISTH-BAT, resulting in a bleeding score. RESULTS One hundred fifty-six patients were analyzed, of whom 126 (81%) were women. Sixty-two patients (40%) had a confirmed CPD. Compared to the general Dutch population, patients with a suspected or confirmed CPD reported decreased physical functioning, limitations in daily activities due to physical health problems, limitations in social activities, decreased energy levels and fatigue, pain, and lower general health status. HR-QoL was not correlated with the ISTH-BAT score and was similar in patients with a confirmed CPD and those in whom a CPD could not be diagnosed. CONCLUSION A bleeding tendency in patients with a suspected or confirmed CPD significantly impacts HR-QoL, independent of a confirmed explanatory diagnosis.
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Affiliation(s)
- Maaike W. Blaauwgeers
- Van CreveldkliniekUniversity Medical Center UtrechtUniversity UtrechtUtrechtThe Netherlands
| | | | - Erik A. M. Beckers
- Department of HematologyMaastricht University Medical CenterMaastrichtThe Netherlands
| | - Michiel Coppens
- Department of Vascular MedicineAmsterdam Cardiovascular SciencesAmsterdam University Medical CenterAmsterdamThe Netherlands
| | - Jeroen Eikenboom
- Department of Internal MedicineDivision of Thrombosis and HaemostasisLeiden University Medical CenterLeidenThe Netherlands
| | - Karin P. M. van Galen
- Van CreveldkliniekUniversity Medical Center UtrechtUniversity UtrechtUtrechtThe Netherlands
| | - Rienk Y. J. Tamminga
- Department of Pediatric HematologyBeatrix Children's HospitalUniversity Medical Center GroningenGroningenThe Netherlands
| | - Rolf T. Urbanus
- Van CreveldkliniekUniversity Medical Center UtrechtUniversity UtrechtUtrechtThe Netherlands
- Van Creveld LaboratoryUniversity Medical Center UtrechtUniversity UtrechtUtrechtThe Netherlands
| | - Roger E. G. Schutgens
- Van CreveldkliniekUniversity Medical Center UtrechtUniversity UtrechtUtrechtThe Netherlands
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Karimi AM, Gairola M, Ahlawat P, Tandon S, Pal M, Sachdeva N, Sharief MI, Dobriyal K. Health-related quality of life assessment for head-and-neck cancer patients during and at 3 months after radiotherapy - A prospective, analytical questionnaire-based study. Natl J Maxillofac Surg 2019; 10:134-140. [PMID: 31798246 PMCID: PMC6883888 DOI: 10.4103/njms.njms_92_18] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Revised: 02/18/2019] [Accepted: 03/06/2019] [Indexed: 11/04/2022] Open
Abstract
Introduction Health-related quality of life (HRQoL) is a more specific area of QoL that deals with the evaluation and assessment of the impact of the disease and its treatment-related morbidities on a patient's physical, psychological, and social aspects. The aim of the present study was to assess the HRQoL of patients with head-and-neck cancer (HNCs) during and at 3 months after completion of radiotherapy (RT) by intensity-modulated RT. Materials and Methods This study was a prospective, longitudinal, observational, and self-completed questionnaire-based study that included 120 patients with HNC who underwent intensity-modulated RT. The questionnaire had adequate internal consistency. The questionnaires were given to each patient at the beginning of treatment (pretreatment), weekly visits during the course of RT (at the end of 1st, 2nd, 3rd, 4th, 5th, and 6th week), on the day of completion of RT, and then finally at 3 months after completion of RT. Thus, a total of successive nine time points were assessed. Results and Conclusions One hundred and eleven patients completed the questionnaires at all nine time points. HRQoL usually decreases during treatment and then increases to pretreatment levels by 3 months after treatment. The Quality of Life Questionnaire, Core Module and Quality of Life Questionnaire, Head and Neck Module were found to be both valid and reliable. There was a significant QoL reduction for the patients throughout treatment in relation to functions and symptoms in the treatment of HNC. However, all the functions and most of the symptoms returned to baseline at the 3-month follow-up.
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Affiliation(s)
| | - Munish Gairola
- Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre, Rohini, New Delhi, India
| | - Parveen Ahlawat
- Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre, Rohini, New Delhi, India
| | - Sarthak Tandon
- Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre, Rohini, New Delhi, India
| | - Manoj Pal
- Department of Medical Oncology, Millennium Cancer Center, Gurugram, Haryana, India
| | - Nishtha Sachdeva
- Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre, Rohini, New Delhi, India
| | - Muhammed Ismail Sharief
- Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre, Rohini, New Delhi, India
| | - Kiran Dobriyal
- Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre, Rohini, New Delhi, India
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Durazo A, Cameron LD. Representations of cancer recurrence risk, recurrence worry, and health-protective behaviours: an elaborated, systematic review. Health Psychol Rev 2019; 13:447-476. [PMID: 31117924 DOI: 10.1080/17437199.2019.1618725] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
An expanded Common-Sense Model (CSM) contextualised to the self-regulation of cancer recurrence risk identifies risk representational attributes and recurrence worry as primary processes motivating protective behaviours in cancer survivors. A systematic review examined evidence for CSM hypotheses regarding how these processes influence diet and physical activity (PA) among survivors. A research agenda is outlined and used to evaluate the evidence base. Common databases were searched for eligible, peer-reviewed, English language reports, yielding 18 studies quantitatively testing hypothesised relationships among representations of prior cancer, recurrence risk representations, recurrence worry, and diet and PA. The findings provide promising, but mixed and limited evidence for some of the hypothesised associations of specific risk recurrence attributes with recurrence worry, and risk recurrence attributes and recurrence worry with diet and PA. Findings support the distinction of recurrence risk representations and illness representations of the prior cancer, with each showing different relationships with recurrence worry and behaviours. We discuss the status of the evidence base in relation to assessment, design, and analysis priorities and propose strategies that can yield more sensitive, rigorous tests of the CSM for cancer recurrence risk as applied to diet and PA.
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Affiliation(s)
- Arturo Durazo
- Psychological Sciences, School of Social Sciences, Humanities and Arts (SSHA), University of California, Merced, San Francisco, CA, USA
| | - Linda D Cameron
- Psychological Sciences, School of Social Sciences, Humanities and Arts (SSHA), University of California, Merced, San Francisco, CA, USA
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13
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Pourfallahi M, Gholami M, Tarrahi MJ, Toulabi T, Kordestani Moghadam P. The effect of informational-emotional support program on illness perceptions and emotional coping of cancer patients undergoing chemotherapy. Support Care Cancer 2019; 28:485-495. [PMID: 31065837 DOI: 10.1007/s00520-019-04842-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 04/24/2019] [Indexed: 12/18/2022]
Abstract
PURPOSE The present study aims to assess the effect of a nurse-led informational-emotional support program on illness perceptions and emotional coping of cancer patients undergoing chemotherapy. METHODS We used a quasi-experimental design, pre- and post-test. A total of 80 cancer patients undergoing chemotherapy were selected by convenience sampling method and assigned to experimental (n = 40) and control groups (n = 40). The nurse-led informational-emotional support program included five face-to-face sessions, educational booklet, and five phone follow-ups, and was conducted for the experimental group over 10 weeks. The control group received routine cares. The outcomes were assessed at baseline and end of intervention and included illness perceptions, which were assessed using the Illness Perception Questionnaire-Revised (IPQ-R), and emotional coping as the secondary outcome using the Coping Through Emotional Approach Scale. Data were analyzed in SPSS using multivariate analysis of covariance (MANCOVA) models, t test, paired t test, and chi-square. RESULTS Between group analysis showed that the mean scores of global illness perceptions and subscales including timeline, consequences, controllability, and coherence significantly increased in the experimental group compared to the control (P < 0.001), but no significant change was observed in two groups in the subscale of emotional representation (P < 0.571) and in the secondary outcome including emotional coping (P < 0.08). CONCLUSIONS A 10-week nurse-led informational-emotional support program can lead to changed illness perceptions without changing emotional coping. The effect of this support program should be studied on the coping and illness perceptions over the trajectory of cancer, especially in end stages in the future.
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Affiliation(s)
- Masoumeh Pourfallahi
- Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Mohammad Gholami
- School of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran.
| | - Mohammad Javad Tarrahi
- Department of Epidemiology and Biostatistics School Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Tahereh Toulabi
- School of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran
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Nelson AM, Juckett MB, Coe CL, Costanzo ES. Illness perceptions predict health practices and mental health following hematopoietic stem cell transplantation. Psychooncology 2019; 28:1252-1260. [PMID: 30942921 DOI: 10.1002/pon.5075] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 03/19/2019] [Accepted: 03/23/2019] [Indexed: 01/15/2023]
Abstract
OBJECTIVE Beliefs about illness have been shown to shape health practices and coping efforts. The present study investigated illness perceptions among patients undergoing hematopoietic stem cell transplant (HSCT). We also examined the extent to which perceptions predicted health practices and mental health following transplant. METHODS Participants (N = 332) completed measures of illness perceptions (beliefs about cancer consequences and course, personal and treatment control over cancer, and understanding of one's cancer) prior to HSCT. Health practices (diet, physical activity, and alcohol use) and mental health (depression, anxiety, and psychological well-being) were assessed pre transplant and at 1, 3, 6, and 12 months post transplant. RESULTS On average, HSCT recipients felt they understood their cancer, viewed their cancer to be a chronic condition with severe consequences, and believed they had moderate personal control over their cancer but that medical treatment provided more control. Perceptions varied by transplant type. Mixed-effects linear regression models revealed that HSCT recipients who perceived the consequences of their cancer to be more serious experienced more depression and anxiety, less well-being, and ate a healthier diet, but were less physically active during the year following transplant. Those with greater personal and treatment control ate a healthier diet and reported greater well-being. Patients with a better understanding of their cancer also ate a healthier diet and reported less depression, less anxiety, and greater well-being. CONCLUSIONS Perceptions of cancer shape HSCT recipients' health practices and psychological well-being during the critical first year of recovery after transplant.
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Affiliation(s)
- Ashley M Nelson
- Department of Psychology, University of South Florida, Tampa, Florida.,Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts
| | - Mark B Juckett
- Department of Medicine, Hematology/Oncology Division, University of Wisconsin-Madison, Madison, Wisconsin.,Carbone Cancer Center, University of Wisconsin-Madison, Madison, Wisconsin
| | - Christopher L Coe
- Department of Psychology, University of Wisconsin-Madison, Madison, Wisconsin
| | - Erin S Costanzo
- Carbone Cancer Center, University of Wisconsin-Madison, Madison, Wisconsin.,Department of Psychiatry, University of Wisconsin-Madison, Madison, Wisconsin
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15
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Quality of life after total laryngectomy: evaluating the effect of socioeconomic status. The Journal of Laryngology & Otology 2019; 133:129-134. [PMID: 30773143 DOI: 10.1017/s0022215119000215] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Total laryngectomy is considered the primary treatment modality for advanced laryngeal carcinoma. This study assessed the quality of life in patients after total laryngectomy, and ascertained whether quality of life is affected by socioeconomic status. METHOD Forty-seven patients (20 state- and 27 private-sector) who underwent total laryngectomy between 1998 and 2014 responded to the University of Washington Quality of Life Questionnaire, the Voice-Related Quality of Life Questionnaire and the Brief Illness Perception Questionnaire. RESULTS Significant differences were found in socioeconomic status between state- and private-sector patients (p < 0.001). There was no significant difference in overall quality of life between groups (p = 0.210). State-sector patients scored significantly higher Voice-Related Quality of Life Questionnaire scores (p = 0.043). Perception of illness did not differ significantly between groups. CONCLUSION Overall quality of life after total laryngectomy appears to be similar in patients from different socioeconomic backgrounds. However, patients from lower socioeconomic circumstances have better voice-related quality of life. The results illustrate the importance of including socioeconomic status when reporting voice outcomes in total laryngectomy patients.
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The existence and importance of patients' mental images of their head and neck cancer: A qualitative study. PLoS One 2019; 13:e0209215. [PMID: 30596669 PMCID: PMC6312291 DOI: 10.1371/journal.pone.0209215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Accepted: 11/30/2018] [Indexed: 11/19/2022] Open
Abstract
Objectives To explore the existence and importance of mental images of cancer among people with head and neck cancers with a focus on the perceived origins and meaning of mental images, their development over time, and their relationship to illness beliefs. Methods A longitudinal qualitative study consisting of 44 in-depth semi-structured interviews with 25 consecutive, newly-diagnosed head and neck cancer patients. Participants were invited to draw their images during the interviews. Follow-up interviews occurred after treatment completion. Analysis drew upon the principles of Interpretative Phenomenological Analysis (IPA). Results Many participants had mental images of their cancer which appeared to both embody and influence their beliefs about their illness, and affect their emotional response. For those who held them, mental images appeared to constitute an important part of their cognitive representation (understanding) of their illness. For some, their images also had a powerful emotional impact, being either reassuring or frightening. Images often appeared to originate from early clinical encounters, and remained fairly stable throughout treatment. Images could be conceptualised as ‘concrete’ (the perceived reality) and/or ‘similic’ (figurative). Patients’ images reflected the perceived meaning, properties or ‘intent’ of the cancer–that is beliefs concerning the disease’s identity, consequences and prognosis (likelihood of cure or control). Conclusions People with head and neck cancer may develop a mental image of their disease, often generated early within clinical encounters, which can both reflect and influence their understanding of the cancer. Such images tend to be stable over time. We theorise that careful use of images in early consultations could avoid or minimise some distress, including fears of outcome or recurrence. Concrete or similic images and language could be employed later to change perceptions and reduce distress.
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Abstract
Abstract Objective: The aim of this manuscript was to understand and describe the experience of radiotherapy on the perspective of a woman with oral cancer. Methods: This is a qualitative, exploratory, descriptive study, with theoretical reference of medical anthropology and instrumental case study methodology. Data collection was performed in the oncology sector of a public university hospital in the Southeast region of Brazil, State of Minas Gerais, Brazil and at the participant’s residence, during from March to August, 2016. The case selected was of a female patient, diagnosed with Spinocellular Carcinoma in oral cavity, submitted to radiotherapy. Five semi-structured interviews and participant observation were performed and audio-taped. Results: Three thematic units are presented: the radiotherapy trajectory, family support and refuge in God and the importance of the multiprofessional team. The adverse reactions such as odynophagia, dysgeugia and weight loss were the ones that stood out the most, being causes of the social isolation of the participant, nonetheless the patient showed optimism and hope, despite the social isolation. Conclusion: The qualitative methodology allowed the whole trajectory of radiotherapy follow-up which made it possible to understand the treatment experience from the perspective of the participant. Despite the adverse reactions, no negative experience with radiotherapy was found. New studies using the qualitative methodology are suggested with groups presenting similar characteristics of the participant, thus providing a better understanding of the topic addressed, as well as the identification and adoption of strategies that aim at improving care and the quality of life of this population, as well.
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Okanli A, Karabulutlu EY, Asi Karakaş S, Şahin Altun Ö, Yildirim N. Alexithymia and perception of illness in patients with cancer. Eur J Cancer Care (Engl) 2018; 27:e12839. [PMID: 29611248 DOI: 10.1111/ecc.12839] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2018] [Indexed: 11/26/2022]
Abstract
This study aimed to determine how alexithymia affects the perception of illness in patients with cancer. This was a descriptive study conducted at the Atatürk University Health, Research and Practice Hospital and the Erzurum Regional Training and Research Hospital's Medical Oncology Clinic and Chemotherapy Unit. The study data were collected between July 2013 and January 2014. In total, data were collected from 283 patients with cancer. The data were collected using questionnaires enquiring about demographic and medical information: the IPQ and TAS-20. The study concluded that 50.5% of the participating patients had alexithymia. It was found that the alexithymic patients with cancer perceived the negative outcomes of their illness more strongly, and their negative feelings about the illness were more intense. This study suggests that further research should be carried out on alexithymia in patients with cancer and that their positive beliefs about the illness could be enhanced using psychosocial interventions.
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Affiliation(s)
- A Okanli
- Faculty of Health Sciences, Department of Psychiatric Nursing, İstanbul Medeniyet University, İstanbul, Turkey
| | - E Y Karabulutlu
- Faculty of Health Sciences, Department of Internal Medicine Nursing, Atatürk Unıversity, Erzurum, Turkey
| | - S Asi Karakaş
- Faculty of Health Sciences, Department of Psychiatric Nursing, Atatürk Unıversity, Erzurum, Turkey
| | - Ö Şahin Altun
- Faculty of Health Sciences, Department of Psychiatric Nursing, Atatürk Unıversity, Erzurum, Turkey
| | - N Yildirim
- Psychiatry Department, Erzurum Research Hospital, Erzurum, Turkey
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A Self-Regulatory Intervention for Patients with Head and Neck Cancer: Pilot Randomized Trial. Ann Behav Med 2018; 51:629-641. [PMID: 28244003 DOI: 10.1007/s12160-017-9885-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND Research is yet to investigate whether psychological interventions delivered early after diagnosis can benefit patients with head and neck cancer (HNC). PURPOSE The aim of this study was to investigate the effectiveness of a brief self-regulatory intervention (targeting illness perceptions and coping) at improving HNC patient health-related quality of life (HRQL). METHODS A pilot randomized controlled trial was conducted, in which 64 patients were assigned to receive three sessions with a health psychologist in addition to standard care or standard care alone. Participants completed questionnaires assessing HRQL, general distress, and illness perceptions at baseline and again 3 and 6 months later. RESULTS Compared to the control group, patients who received the intervention had increased treatment control perceptions at 3 months (p = .01), and increased social quality of life at 6 months (p = .01). The intervention was particularly helpful for patients exhibiting distress at baseline. CONCLUSION A brief psychological intervention following HNC diagnosis can improve patient perceptions of treatment and social quality of life over time. Such interventions could be targeted to patients who are distressed in order to confer the greatest benefit. TRIAL REGISTRATION NUMBER 12614000813684.
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Cook SA, Salmon P, Hayes G, Byrne A, Fisher PL. Predictors of emotional distress a year or more after diagnosis of cancer: A systematic review of the literature. Psychooncology 2018; 27:791-801. [PMID: 29318702 PMCID: PMC5873392 DOI: 10.1002/pon.4601] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 10/27/2017] [Accepted: 11/23/2017] [Indexed: 11/12/2022]
Abstract
Objective Why some people recover emotionally after diagnosis and treatment of cancer and others do not is poorly understood. To identify factors around the time of diagnosis that predict longer‐term distress is a necessary step in developing interventions to reduce patients' vulnerability. This review identified the demographic, clinical, social, and psychological factors available at or within 3 months of diagnosis that are reliable predictors of emotional distress at least 12 months later. Methods A systematic search of literature for prospective studies addressing our research question and predicting a range of distress outcomes was conducted. Thirty‐nine papers (reporting 36 studies) were subjected to narrative synthesis of the evidence. Results There was no consistent evidence that demographic, clinical, or social factors reliably predicted longer‐term distress. Of the psychological factors examined, only baseline distress (significant in 26 of 30 relevant papers; 24 of 28 studies) and neuroticism (significant in all 5 papers/studies that examined it) consistently predicted longer‐term distress. The heterogeneity of included studies, particularly in populations studied and methodology, precluded meta‐analytic techniques. Conclusions This review supports current clinical guidance advising early assessment of distress as a marker of vulnerability to persistent problems. Additionally, neuroticism is also indicated as a useful marker of vulnerability. However, the review also highlights that more sophisticated research designs, capable of identifying the psychological processes that underlie the association between these marker variables and persistent distress, are needed before more effective early interventions can be developed.
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Affiliation(s)
- Sharon A Cook
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK
| | - Peter Salmon
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK.,The Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, UK
| | - Gemma Hayes
- The Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, UK
| | - Angela Byrne
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK.,The Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, UK
| | - Peter L Fisher
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK.,The Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, UK.,Nidaros DPS, Østmarka University Hospital, Trondheim, Norway
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Do Cancer-Related Beliefs Influence the Severity, Incidence, and Persistence of Psychological Symptoms? Cancer Nurs 2017; 40:E50-E58. [DOI: 10.1097/ncc.0000000000000412] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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22
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Villalobos-Galvis FH, Mafla AC, Burbano-Trujillo WF, Sanchez-Figueroa AA. Psychometric Properties of the Revised Illness Perception Questionnaire for Oral Health. Caries Res 2017; 51:244-254. [DOI: 10.1159/000468993] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Accepted: 03/06/2017] [Indexed: 11/19/2022] Open
Abstract
Aims: The aim of this study was to test the hypothesis that, for patients with dental caries, the Spanish version of the Revised Illness Perception Questionnaire for Oral Health (IPQ-R-OH) has 7 dimensions, including personal and treatment control, timeline-acute/chronic and timeline-cyclical, illness coherence, consequences, and emotional representations. Methods: A Spanish adaptation of the IPQ-R, with a self-reported 38-item scale, was developed. Exploratory and confirmatory factor analyses were conducted using data from 520 patients with dental caries attending the Dental Clinic at Universidad Cooperativa de Colombia, Pasto, Colombia. Results: Exploratory factor analysis revealed 7 dimensions with 36 items (2 items were removed because of poor factor loadings or discriminant ability). The internal consistency coefficients of each factor ranged from 0.72 to 0.91, and all item loadings were >0.52. Confirmatory factor analysis indicated that a 7-factor model with 36 items had superior fit compared to the 38-item original model: χ2 = 1,784.291 (df = 573, p < 0.001); nonnormal fit index = 0.941; comparative fit index = 0.946; root mean square error of approximation = 0.062 (90% CI = 0.057-0.066); standardized root mean square residual = 0.072; and Akaike information criterion = 638.291. Control (integrated by items from personal control, treatment control, and timeline-acute factors) and hopelessness (PC15 and PC17) were the 2 reconfigured factors that were identified. Conclusions: These findings suggest that the modified 36-item model has satisfactory reliability and construct factorial validity; therefore, it could be a valuable instrument in the screening of illness perceptions in oral health.
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Memtsa PT, Tolia M, Tzitzikas I, Bizakis J, Pistevou-Gombaki K, Charalambidou M, Iliopoulou C, Kyrgias G. Assessment of xerostomia and its impact on quality of life in head and neck cancer patients undergoing radiation therapy. Mol Clin Oncol 2017; 6:789-793. [PMID: 28529753 DOI: 10.3892/mco.2017.1200] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 03/01/2017] [Indexed: 11/12/2022] Open
Abstract
Xerostomia in head and neck (H&N) cancer patients significantly affects their quality of life (QoL). The aim of the present study was to investigate the associations among QoL, xerostomia and quantity of saliva in a sample of H&N cancer patients who had received conventional radiotherapy (RT). A total of 60 H&N adult patients were enrolled in this prospective study. The patients completed the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (QLQ-C30), the Quality of Life Questionnaire Head and Neck Module (QLQ-H&N35) and the Greek version of the XQ questionnaire at 4 timepoints: At the beginning of RT, at the end of RT, 6 months after RT completion and 1 year after RT completion. Patients with distant metastases or serious comorbidities were excluded from the study. Salivary pH, and stimulated and unstimulated salivary flow rate were assessed. All functional scales and symptom scales, apart from cognitive functioning in QLQ-C30 and feeding tube in H&N35 exhibited an abrupt deterioration at timepoint 3 and were then gradually restored over time. The difference was statistically significant (P<0.001). XQ scores at different timepoints exhibited a statistically significant negative correlation with salivary flow rates. Salivary flow rate and XQ scores almost parallelled one another. Flow rates recovered at a mean level of 20% below baseline values at the end of the follow-up period. The subjective symptom of xerostomia parallelled salivary flow and QoL. Despite receiving conventional RT, the participants exhibited a considerable preservation of salivary gland function after 12 months, allowing some optimism regarding the course of xerostomia in selected patients.
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Affiliation(s)
- Pinelopi-Theopisti Memtsa
- Department of Radiation Oncology, AHEPA University Hospital of Thessaloniki, Faculty of Medicine, School of Health Sciences, Aristoteleion University of Thessaloniki, 546 21 Thessaloniki, Greece
| | - Maria Tolia
- Department of Radiation Oncology, University Hospital of Larissa, School of Health Sciences, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece
| | - Ioannis Tzitzikas
- Department of Radiation Oncology, AHEPA University Hospital of Thessaloniki, Faculty of Medicine, School of Health Sciences, Aristoteleion University of Thessaloniki, 546 21 Thessaloniki, Greece
| | - John Bizakis
- Department of Head and Neck Surgery, University Hospital of Larissa, School of Health Sciences, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece
| | - Kyriaki Pistevou-Gombaki
- Department of Radiation Oncology, AHEPA University Hospital of Thessaloniki, Faculty of Medicine, School of Health Sciences, Aristoteleion University of Thessaloniki, 546 21 Thessaloniki, Greece
| | - Martha Charalambidou
- Department of Radiation Oncology, Theagenio Cancer Hospital of Thessaloniki, 546 39 Thessaloniki, Greece
| | - Chrysoula Iliopoulou
- Department of Radiation Oncology, Theagenio Cancer Hospital of Thessaloniki, 546 39 Thessaloniki, Greece
| | - George Kyrgias
- Department of Radiation Oncology, University Hospital of Larissa, School of Health Sciences, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece
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La IS, Yun EK. Effects of stress appraisal on the quality of life of adult patients with multiple myeloma and their primary family caregivers in Korea. Psychooncology 2017; 26:1640-1646. [DOI: 10.1002/pon.4348] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 11/01/2016] [Accepted: 12/12/2016] [Indexed: 12/23/2022]
Affiliation(s)
- In Seo La
- College of Nursing Science, Kyung Hee University; Seoul South Korea
| | - Eun Kyoung Yun
- College of Nursing Science, Kyung Hee University; Seoul South Korea
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Pereira MG, Ponte M, Ferreira G, Machado JC. Quality of life in patients with skin tumors: the mediator role of body image and social support. Psychooncology 2016; 26:815-821. [DOI: 10.1002/pon.4236] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Revised: 07/24/2016] [Accepted: 07/26/2016] [Indexed: 11/11/2022]
Affiliation(s)
| | - Mafalda Ponte
- School of Psychology; University of Minho; Braga Portugal
| | | | - José C. Machado
- Institute of Social Sciences; University of Minho; Braga Portugal
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Richardson EM, Schüz N, Sanderson K, Scott JL, Schüz B. Illness representations, coping, and illness outcomes in people with cancer: a systematic review and meta-analysis. Psychooncology 2016; 26:724-737. [PMID: 27412423 DOI: 10.1002/pon.4213] [Citation(s) in RCA: 107] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Revised: 06/27/2016] [Accepted: 07/07/2016] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Cancer is associated with negative health and emotional outcomes in those affected by it, suggesting the need to better understand the psychosocial determinants of illness outcomes and coping. The common sense model is the leading psychological model of self-regulation in the face of illness and assumes that subjective illness representations explain how people attempt to cope with illness. This systematic review and meta-analysis examines the associations of the common sense model's illness representation dimensions with health and coping outcomes in people with cancer. METHODS A systematic literature search located 54 studies fulfilling the inclusion criteria, with 38 providing sufficient data for meta-analysis. A narrative review of the remaining studies was also conducted. RESULTS Random-effects models revealed small to moderate effect sizes (Fisher Z) for the relations between illness representations and coping behaviors (in particular between control perceptions, problem-focused coping, and cognitive reappraisal) and moderate to large effect sizes between illness representations and illness outcomes (in particular between identity, consequences, emotional representations, and psychological distress). The narrative review of studies with insufficient data provided similar results. CONCLUSIONS The results indicate how illness representations relate to illness outcomes in people with cancer. However, more high-quality studies are needed to examine causal effects of illness representations on coping and outcomes. High heterogeneity indicates potential moderators of the relationships between illness representations and health and coping outcomes, including diagnostic, prognostic, and treatment-related variables. This review can inform the design of interventions to improve coping strategies and mental health outcomes in people with cancer.
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Affiliation(s)
- Emma M Richardson
- Division of Psychology, School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Natalie Schüz
- School of Health Sciences, University of Tasmania, Hobart, Tasmania, Australia
| | - Kristy Sanderson
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Jennifer L Scott
- Division of Psychology, School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Benjamin Schüz
- Division of Psychology, School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
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Richardson AE, Morton RP, Broadbent EA. Changes over time in head and neck cancer patients' and caregivers' illness perceptions and relationships with quality of life. Psychol Health 2016; 31:1203-19. [PMID: 27315836 DOI: 10.1080/08870446.2016.1203686] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE This study investigated changes in illness perceptions from diagnosis to six months later in patients with head and neck cancer (HNC) and their caregivers. The study also examined whether discrepancy in patient and caregiver perceptions at diagnosis predicted patient health-related quality of life (HRQL) at six months. DESIGN Forty-two patient-caregiver dyads completed the Brief Illness Perception Questionnaire (Brief IPQ) at diagnosis and again six months later. Patients also completed a HRQL questionnaire at both time points. Analyses were performed using the Actor-Partner Interdependence Model. MAIN OUTCOME MEASURE Total patient HRQL assessed by the Functional Assessment of Cancer Therapy (FACT-H&N). RESULTS Perceptions of emotional impact and illness concern reduced over time in patients and caregivers. Perceptions of treatment control and identity increased in caregivers only. After controlling for the effects of baseline HRQL, and the individual contribution of patient and caregiver illness perceptions, greater discrepancy in perceptions of timeline, personal control, and illness identity among dyads at diagnosis predicted lower patient HRQL at six-month follow-up. CONCLUSION Patients' and their caregivers' perceptions of HNC are dynamic over time. Greater discrepancy between patients' and caregivers' illness perceptions at diagnosis predict poorer subsequent patient HRQL.
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Affiliation(s)
- Amy E Richardson
- a Faculty of Medical and Health Sciences, Department of Psychological Medicine , University of Auckland , Auckland , New Zealand
| | - Randall P Morton
- b Faculty of Medical and Health Sciences, Department of Surgery , University of Auckland , Auckland , New Zealand
| | - Elizabeth A Broadbent
- a Faculty of Medical and Health Sciences, Department of Psychological Medicine , University of Auckland , Auckland , New Zealand
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28
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Richardson AE, Morton RP, Broadbent EA. Illness perceptions and coping predict post-traumatic stress in caregivers of patients with head and neck cancer. Support Care Cancer 2016; 24:4443-50. [DOI: 10.1007/s00520-016-3285-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 05/23/2016] [Indexed: 10/21/2022]
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Les représentations de la maladie : choix des outils de mesure et applications dans le champ du cancer. PSYCHO-ONCOLOGIE 2016. [DOI: 10.1007/s11839-015-0544-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Richardson AE, Morton R, Broadbent E. Caregivers' Illness Perceptions Contribute to Quality of Life in Head and Neck Cancer Patients at Diagnosis. J Psychosoc Oncol 2015; 33:414-32. [PMID: 25996835 DOI: 10.1080/07347332.2015.1046011] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This study investigated the contribution of patient and caregiver illness perceptions to the quality of life of head and neck cancer (HNC) patients. Ninety-eight patients and their caregivers (n = 80) completed questionnaires at diagnosis. Caregivers' illness perceptions were significantly more negative than patients with respect to consequences, timeline, treatment, concern, and the emotional impact of HNC. The interaction between some patient and caregiver illness perceptions explained additional variance in patient quality of life, above and beyond patients' own illness perceptions. These findings suggest that caregivers should be included in psychological interventions to improve HNC patient quality of life.
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Affiliation(s)
- Amy E Richardson
- a Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland , Auckland , New Zealand
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Shavi GR, Thakur B, Bhambal A, Jain S, Singh V, Shukla A. Oral Health Related Quality of Life in Patients of Head and Neck Cancer Attending Cancer Hospital of Bhopal City, India. J Int Oral Health 2015; 7:21-7. [PMID: 26464534 PMCID: PMC4588784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND To assess the oral health related quality of life (OHRQoL) of head and neck cancer patients and to find association between QoL, demographic and disease variables. METHODS This cross-sectional study was conducted on 153 patients diagnosed and being treated for head and neck cancer in Jawaharlal Nehru Cancer Hospital, India. Data collected from the survey included demographic details and OHRQoL, which was measured by European Organization of Research for Treatment of Cancer QoL questionnaire head & neck-35. Cancer measurements (location of tumor, stages of cancer, treatment type) were collected from the patient's hospital records. RESULTS The majority of the population 84 (54.9%) belonged to 41-60 years age group and most of them were male (78.4%). The most frequent site of the primary tumor was the oral cavity (71.3%) and the majority of patients had Stage II and III cancer. Main factors affecting QoL were loss of weight, use of painkillers, sticky saliva, reduced mouth opening and problems in social eating. Significant association found between pain (P = 0.044), swallowing (P = 0.018), sense (P = 0.001), Social eating (P = 0.003), social contact (P = 0.008), reduced mouth opening (P = 0.008) with respect to type of treatment. CONCLUSIONS We conclude that there was a significant reduction in the QoL in cancer patients resulting from myriad forms of cancers. An assessment of the QoL and symptoms can help the dentist to direct attention to most important symptoms and provide counseling for appropriate interventions towards improving QoL outcomes and the response to the treatment.
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Affiliation(s)
- Girish R Shavi
- Professor & Head, Department of Public Health Dentistry, Rajasthan Dental College and Hospital, Jaipur, Rajasthan, India,Correspondence: Dr. Shavi GR. 301 A, Giri Apts JP Nagar, 2 Phase, Bengaluru - 560 078, Karnataka, India. Phone: +91-9448486526.
| | - Bhanupriya Thakur
- Post-graduate Student, Department of Public Health Dentistry, People’s College of Dental Science & Research Centre, Bhopal, Madhya Pradesh, India
| | - Ajay Bhambal
- Professor & Head, Department of Public Health Dentistry, People’s College of Dental Science & Research Centre, Bhopal, Madhya Pradesh, India
| | - Swapnil Jain
- Reader, Department of Public Health Dentistry, People’s College of Dental Science & Research Centre, Bhopal, Madhya Pradesh, India
| | - Vani Singh
- Post-graduate Student, Department of Public Health Dentistry, People’s College of Dental Science & Research Centre, Bhopal, Madhya Pradesh, India
| | - Ankita Shukla
- Post-graduate Student, Department of Public Health Dentistry, People’s College of Dental Science & Research Centre, Bhopal, Madhya Pradesh, India
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Ashley L, Marti J, Jones H, Velikova G, Wright P. Illness perceptions within 6 months of cancer diagnosis are an independent prospective predictor of health-related quality of life 15 months post-diagnosis. Psychooncology 2015; 24:1463-70. [PMID: 25946704 DOI: 10.1002/pon.3812] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Revised: 03/06/2015] [Accepted: 03/07/2015] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Studies have found that illness perceptions explain significant variance in health outcomes in numerous diseases. However, most of the research is cross-sectional and non-oncological. We examined, for the first time in breast, colorectal and prostate cancer patients, if cognitive and emotional illness perceptions near diagnosis predict future multidimensional health-related quality of life (HRQoL). METHODS UK-based patients (N = 334) completed the illness perception questionnaire-revised within 6 months post-diagnosis and the quality of life in adult cancer survivors scale 15 months post-diagnosis. Sociodemographic and clinical data were obtained from medical records. Hierarchical multiple regression analyses were conducted. RESULTS The sociodemographic and clinical factors collectively significantly predicted 8/12 HRQoL domains, although for 5/8 accounted for <10% of the variance. For all 12 HRQoL domains, illness perceptions collectively explained significant substantial additional variance (∆R(2) range: 5.6-27.9%), and a single illness perception questionnaire-revised dimension was the best individual predictor of 9/12 HRQoL domains. The consequences dimension independently predicted 7/12 HRQoL domains; patients who believed their cancer would have a more serious negative impact on their life reported poorer future HRQoL. The emotional representations and identity dimensions also predicted multiple HRQoL domains. CONCLUSIONS Future research should focus on realising the potential of illness perceptions as a modifiable target for and mediating mechanism of interventions to improve patients' HRQoL.
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Affiliation(s)
- Laura Ashley
- Faculty of Health and Social Sciences, Leeds Beckett University, Leeds, UK
| | - Joachim Marti
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Helen Jones
- Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK
| | - Galina Velikova
- Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK
| | - Penny Wright
- Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK
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Cook SA, Salmon P, Dunn G, Holcombe C, Cornford P, Fisher P. The association of metacognitive beliefs with emotional distress after diagnosis of cancer. Health Psychol 2015; 34:207-15. [PMID: 25133826 PMCID: PMC4321533 DOI: 10.1037/hea0000096] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Revised: 01/27/2014] [Accepted: 03/03/2014] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Emotional distress after a diagnosis of cancer is normal and, for most people, will diminish over time. However, a significant minority of patients with cancer experience persistent or recurrent symptoms of emotional distress for which they need help. A model developed in mental health, the self-regulatory executive function model (S-REF), specifies that maladaptive metacognitive beliefs and processes, including persistent worry, are key to understanding why such emotional problems persist. This cross-sectional study explored, for the first, time whether metacognitive beliefs were associated with emotional distress in a cancer population, and whether this relationship was mediated by worry, as predicted by the S-REF model. METHOD Two hundred twenty-nine participants within 3 months of diagnosis of, and before treatment for, primary breast or prostate cancer completed self-report questionnaires measuring anxiety, depression, posttraumatic stress disorder (PTSD) symptoms, metacognitive beliefs, worry, and illness perceptions. RESULTS Regression analysis showed that metacognitive beliefs were associated with symptoms of anxiety, depression, and PTSD, and explained additional variance in these outcomes after controlling for age, gender, and illness perceptions. Structural equation modeling was consistent with cross-sectional hypotheses derived from the theory that metacognitive beliefs cause and maintain distress both directly and indirectly by driving worry. CONCLUSIONS The findings provide promising first evidence that the S-REF model may be usefully applied in cancer. Further study is required to establish the predictive and clinical utility of these findings.
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Affiliation(s)
| | | | - Graham Dunn
- Centre for Biostatistics, The University of Manchester
| | - Chris Holcombe
- Royal Liverpool and Broadgreen University Hospitals NHS Trust
| | - Philip Cornford
- Royal Liverpool and Broadgreen University Hospitals NHS Trust
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Cook SA, Salmon P, Dunn G, Holcombe C, Cornford P, Fisher P. A Prospective Study of the Association of Metacognitive Beliefs and Processes with Persistent Emotional Distress After Diagnosis of Cancer. COGNITIVE THERAPY AND RESEARCH 2015; 39:51-60. [PMID: 25657483 PMCID: PMC4312385 DOI: 10.1007/s10608-014-9640-x] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Two hundred and six patients, diagnosed with primary breast or prostate cancer completed self-report questionnaires on two occasions: before treatment (T1) and 12 months later (T2). The questionnaires included: the Hospital Anxiety and Depression Scale; Impact of Events Scale; the Metacognitions Questionnaire-30 (MCQ-30) and the Illness Perceptions Questionnaire-revised. A series of regression analyses indicated that metacognitive beliefs at T1 predicted between 14 and 19 % of the variance in symptoms of anxiety, depression and trauma at T2 after controlling for age and gender. For all three outcomes, the MCQ-30 subscale 'negative beliefs about worry' made the largest individual contribution with 'cognitive confidence' also contributing in each case. For anxiety, a third metacognitive variable, 'positive beliefs about worry' also predicted variance in T2 symptoms. In addition, hierarchical analyses indicated that metacognitive beliefs explained a small but significant amount of variance in T2 anxiety (2 %) and T2 depression (4 %) over and above that explained by demographic variables, T1 symptoms and T1 illness perceptions. The findings suggest that modifying metacognitive beliefs and processes has the potential to alleviate distress associated with cancer.
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Affiliation(s)
- Sharon A. Cook
- Psychological Sciences, University of Liverpool, The Whelan Building, Brownlow Hill, Liverpool, L69 3GB UK
- Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, UK
| | - Peter Salmon
- Psychological Sciences, University of Liverpool, The Whelan Building, Brownlow Hill, Liverpool, L69 3GB UK
- Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, UK
| | - Graham Dunn
- Centre for Biostatistics, The University of Manchester, Manchester, UK
| | - Chris Holcombe
- Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, UK
| | - Philip Cornford
- Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, UK
| | - Peter Fisher
- Psychological Sciences, University of Liverpool, The Whelan Building, Brownlow Hill, Liverpool, L69 3GB UK
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Lee LY, Chen SC, Chen WC, Huang BS, Lin CY. Postradiation trismus and its impact on quality of life in patients with head and neck cancer. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 119:187-95. [DOI: 10.1016/j.oooo.2014.10.003] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Revised: 09/17/2014] [Accepted: 10/06/2014] [Indexed: 11/16/2022]
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Marcus E, Garety P, Weinman J, Emsley R, Dunn G, Bebbington P, Freeman D, Kuipers E, Fowler D, Hardy A, Waller H, Jolley S. A pilot validation of a modified Illness Perceptions Questionnaire designed to predict response to cognitive therapy for psychosis. J Behav Ther Exp Psychiatry 2014; 45:459-66. [PMID: 25011076 PMCID: PMC4157321 DOI: 10.1016/j.jbtep.2014.06.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Revised: 04/18/2014] [Accepted: 06/06/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVES Clinical responsiveness to cognitive behavioural therapy for psychosis (CBTp) varies. Recent research has demonstrated that illness perceptions predict active engagement in therapy, and, thereby, better outcomes. In this study, we aimed to investigate the psychometric properties of a modification of the Illness Perceptions Questionnaire (M-IPQ) designed to predict response following CBTp. METHODS Fifty-six participants with persistent, distressing delusions completed the M-IPQ; forty before a brief CBT intervention targeting persecutory ideation and sixteen before and after a control condition. Additional predictors of outcome (delusional conviction, symptom severity and belief inflexibility) were assessed at baseline. Outcomes were assessed at baseline and at follow-up four to eight weeks later. RESULTS The M-IPQ comprised two factors measuring problem duration and therapy-specific perceptions of Cure/Control. Associated subscales, formed by summing the relevant items for each factor, were reliable in their structure. The Cure/Control subscale was also reliable over time; showed convergent validity with other predictors of outcome; predicted therapy outcomes; and differentially predicted treatment effects. LIMITATIONS We measured outcome without an associated measure of engagement, in a small sample. Findings are consistent with hypothesis and existing research, but require replication in a larger, purposively recruited sample. CONCLUSIONS The Cure/Control subscale of the M-IPQ shows promise as a predictor of response to therapy. Specifically targeting these illness perceptions in the early stages of cognitive behavioural therapy may improve engagement and, consequently, outcomes.
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Affiliation(s)
- Elena Marcus
- King's College London, Institute of Psychiatry, Department of Psychology, PO77, De Crespigny Park, Denmark Hill, London SE5 8AF, UK.
| | - Philippa Garety
- King's College London, Institute of Psychiatry, Department of Psychology, PO77, De Crespigny Park, Denmark Hill, London SE5 8AF, UK.
| | - John Weinman
- King's College London, Institute of Pharmaceutical Science, 5th Floor Franklin Wilkins Building, 150 Stamford Street, London SE1 9NH, UK.
| | - Richard Emsley
- Centre for Biostatistics, Institute of Population Health, The University of Manchester, Manchester Academic Health Science Centre, 4.304 Jean McFarlane Building, Oxford Road, Manchester M13 9PL, UK.
| | - Graham Dunn
- Centre for Biostatistics, Institute of Population Health, The University of Manchester, Manchester Academic Health Science Centre, 4.304 Jean McFarlane Building, Oxford Road, Manchester M13 9PL, UK.
| | - Paul Bebbington
- Division of Psychiatry, University College, London, 67-73 Riding House Street, London W1W 7EJ, UK.
| | - Daniel Freeman
- University of Oxford, Department of Psychiatry, Warneford Hospital, Oxford OX3 7JX, UK.
| | - Elizabeth Kuipers
- King's College London, Institute of Psychiatry, Department of Psychology, PO77, De Crespigny Park, Denmark Hill, London SE5 8AF, UK.
| | - David Fowler
- School of Psychology, University of Sussex, Pevensey Building, Falmer BN1 9QH, UK.
| | - Amy Hardy
- King's College London, Institute of Psychiatry, Department of Psychology, PO77, De Crespigny Park, Denmark Hill, London SE5 8AF, UK.
| | - Helen Waller
- King's College London, Institute of Psychiatry, Department of Psychology, PO77, De Crespigny Park, Denmark Hill, London SE5 8AF, UK.
| | - Suzanne Jolley
- King's College London, Institute of Psychiatry, Department of Psychology, PO77, De Crespigny Park, Denmark Hill, London SE5 8AF, UK.
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Wissinger E, Griebsch I, Lungershausen J, Byrnes M, Travers K, Pashos CL. The humanistic burden of head and neck cancer: a systematic literature review. PHARMACOECONOMICS 2014; 32:1213-1229. [PMID: 25145800 DOI: 10.1007/s40273-014-0199-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND Head and neck cancer (HNC) and its treatment can affect communication, nutrition, and physical appearance, and the global impact of this disease on patients' quality of life may be substantial. OBJECTIVE The aim of this systematic literature review was to describe the impact of HNC and its treatment on the physical, emotional, and social well-being of patients over time, by examining longitudinal studies of patient-reported outcomes (PRO) evaluating these domains. METHODS Databases (MEDLINE and Embase) were searched to identify studies published in English between January 2004 and January 2014 analyzing the humanistic aspects of HNC in adult patients. Additional relevant publications were identified through manual searches of abstracts from recent conference proceedings. RESULTS Of 1,566 studies initially identified, 130 met the inclusion criteria and were evaluated in the assessment. Investigations using a variety of PRO instruments in heterogeneous patient populations consistently reported that PRO scores decrease significantly from diagnosis through the treatment period, but generally recover to baseline in the first year post-treatment. This trend was observed for many functional domains, although some side effects, such as xerostomia, persisted well beyond 1 year. In addition, considerable evidence exists that baseline PRO scores can predict clinical endpoints such as overall and progression-free survival. CONCLUSIONS Many aspects of HNC, both disease and treatment specific, profoundly affect patients' quality of life. Improved knowledge of these effects on PRO may allow for more informed treatment decisions and can help physicians to better prepare patients for changes they may experience during therapy. Furthermore, the predictive value of baseline PRO data may enable healthcare providers to identify at-risk patients in need of more intensive intervention.
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Patient education, upper-limb symptom perception, and quality of life among Japanese breast cancer survivors. Qual Life Res 2014; 23:2327-32. [DOI: 10.1007/s11136-014-0680-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2014] [Indexed: 10/25/2022]
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Brakel TM, Dijkstra A, Buunk AP. Targeting cancer patients’ quality of life through social comparison: A randomised trial. Psychol Health 2014; 29:950-66. [DOI: 10.1080/08870446.2014.901514] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Thecla M. Brakel
- Faculty of Behavioral and Social Science, Department of Social Psychology, University of Groningen, Groningen, The Netherlands
| | - Arie Dijkstra
- Faculty of Behavioral and Social Science, Department of Social Psychology, University of Groningen, Groningen, The Netherlands
| | - Abraham P. Buunk
- Faculty of Behavioral and Social Science, Department of Social Psychology, University of Groningen, Groningen, The Netherlands
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Ashley L, Smith AB, Keding A, Jones H, Velikova G, Wright P. Psychometric evaluation of the revised Illness Perception Questionnaire (IPQ-R) in cancer patients: confirmatory factor analysis and Rasch analysis. J Psychosom Res 2013; 75:556-62. [PMID: 24290046 DOI: 10.1016/j.jpsychores.2013.08.005] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Revised: 07/23/2013] [Accepted: 08/07/2013] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To provide new insights into the psychometrics of the revised Illness Perception Questionnaire (IPQ-R) in cancer patients. To undertake, for the first time using data from breast, colorectal and prostate cancer patients, a confirmatory factor analysis (CFA) to assess the validity of the IPQ-R's core seven-factor structure. Also, for the first time in any illness group, to undertake Rasch analysis to explore the extent to which the IPQ-R factors form unidimensional scales, with linear measurement properties and no Differential Item Functioning (DIF). METHODS Patients with potentially curable breast, colorectal or prostate cancer, within 6months post-diagnosis, completed the IPQ-R online (N=531). CFA was conducted, including multi-sample analysis, and for each IPQ-R factor fit to the Rasch model was assessed by examining, amongst other things, item fit, DIF and unidimensionality. RESULTS The CFA showed a moderate fit of the data to the IPQ-R model, and stability across diagnosis, although fit was significantly improved following the removal of selected items. All seven factors achieved fit to the Rasch model, and exhibited unidimensionality and minimal DIF, although in most cases this was after some item rescoring and/or deletion. In both analyses, IPQ-R items 12, 18 and 24 were indicated as misfitting and removed. CONCLUSION Given the rigorous standard of Rasch measurement, and the generic nature of the IPQ-R, it stood up well to the demands of the Rasch model in this study. Importantly, the results show that with some relatively minor, pragmatic modifications the IPQ-R could possess Rasch-standard measurement in cancer patients.
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Affiliation(s)
- Laura Ashley
- School of Social, Psychological & Communication Sciences, Faculty of Health & Social Sciences, Leeds Metropolitan University, Leeds, UK.
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The significance of fellow patients for head and neck cancer patients in the radiation treatment period. Eur J Oncol Nurs 2013; 17:618-24. [DOI: 10.1016/j.ejon.2013.01.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2012] [Revised: 12/19/2012] [Accepted: 01/05/2013] [Indexed: 11/19/2022]
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Melo Filho MRD, Rocha BA, Pires MBDO, Fonseca ES, Freitas EMD, Martelli Junior H, Santos FBG. Quality of life of patients with head and neck cancer. Braz J Otorhinolaryngol 2013; 79:82-8. [PMID: 23503912 PMCID: PMC9450864 DOI: 10.5935/1808-8694.20130014] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2012] [Accepted: 10/27/2012] [Indexed: 11/21/2022] Open
Abstract
Patients with head and neck cancer have to deal with the impact of treatment on its functional and aesthetic aspects, and its self-report enables improvements in clinical and social support. Objective To evaluate the quality of life of patients dealing with squamous cell carcinoma of the head and neck. Method A prospective analytical study. Twenty nine patients with mean age of 57 years answered at three stages: onset, middle and end of treatment, the questionnaires: Quality of Life Core Questionnaire - Cancer 30 and the Quality of Life Questionnaire - Head and Neck, the European Organization for Research and Treatment of Cancer. We used the Friedman test at: 0.05. Results There were high mean values concerning physical, cognitive, social functions; improvements in general health and social function decline during treatment; and a significant difference in taste and smell (p = 0.020), swallowing (p = 0.040), cough (p = 0.013) and weight loss (p = 0.011). Conclusion There was a significant reduction in the quality of life for some common symptoms resulting from cancer treatment, which was not seen in the evaluation of the aspects related to physical, cognitive and social functions, and general health.
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Kaptein AA, Yamaoka K, Snoei L, van der Kloot WA, Inoue K, Tabei T, Kroep JR, Krol-Warmerdam E, Ranke G, Meirink C, Does A, Nortier H. Illness perceptions and quality of life in Japanese and Dutch women with breast cancer. J Psychosoc Oncol 2013; 31:83-102. [PMID: 23311973 DOI: 10.1080/07347332.2012.741092] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Knowledge on cross-cultural quality of life (QOL) and illness perceptions may help women with breast cancer cope more effectively. The self regulation model (SRM) guided the current exploratory longitudinal pilot-study. Central to SRM is the perception of health threats and their effects on QOL. Illness perceptions and QOL were assessed in 22 Dutch and 21 Japanese patients with breast cancer who filled out questionnaires before, 1 week, and 8 weeks after the first chemotherapy course. The questionnaires assessed QOL and illness perceptions. Patients' scores were compared with groups of patients with other chronic somatic illnesses (asthma, diabetes). Patients in both samples reported major impact of chemotherapy on global health status, physical functioning, role functioning, emotional functioning, constipation and diarrhea. Differences between Japanese and Dutch patients were limited to social functioning and financial problems. Japanese patients expressed stronger concerns about their illness than Dutch patients. Results of the Japanese and Dutch patients with breast cancer differed from data in patients with asthma on consequences, timeline, concern and emotional response. Results of Japanese patients differed from patients with type 2 diabetes on timeline and concern, whereas Dutch patients differed on timeline and consequences. Japanese and Dutch breast cancer patients have-overall-similar illness perceptions and QOL responses and are aware of the typical characteristics of their disease. The results support the feasibility of cross-cultural psychosocial research in oncology and offer implications for clinical interventions which impact on self-efficacy to empower patients with breast cancer.
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Affiliation(s)
- Adrian A Kaptein
- Medical Psychology, Leiden University Medical Centre, Leiden, The Netherlands.
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van Wilgen CP, van Ittersum MW, Kaptein AA. Do illness perceptions of people with chronic low back pain differ from people without chronic low back pain? Physiotherapy 2013; 99:27-32. [DOI: 10.1016/j.physio.2011.09.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2010] [Accepted: 09/08/2011] [Indexed: 11/26/2022]
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45
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Fischer MJ, Wiesenhaan ME, Does-den Heijer A, Kleijn WC, Nortier JWR, Kaptein AA. From despair to hope: a longitudinal study of illness perceptions and coping in a psycho-educational group intervention for women with breast cancer. Br J Health Psychol 2012; 18:526-45. [PMID: 23006141 DOI: 10.1111/j.2044-8287.2012.02100.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Accepted: 08/06/2012] [Indexed: 11/27/2022]
Abstract
OBJECTIVES This study examined the cross-sectional and longitudinal relationships of illness perceptions, coping, and distress in women with breast cancer. Illness perceptions and coping at baseline and changes in these variables over time served as possible predictors of distress at two follow-up points. DESIGN AND METHODS Fifty-seven women with breast cancer who participated in a psychosocial aftercare programme completed a questionnaire before the start of the intervention, directly after the end of the intervention, and 1 year after the start of the intervention. Study variables were assessed with the Illness Perception Questionnaire-Revised (illness perceptions), the COPE (coping), and the Hopkins Symptom Check List (distress). RESULTS Results showed that 43% of variance in distress at baseline was explained by participants' illness perceptions. Cyclical timeline perceptions were the strongest predictor of distress at baseline. Longitudinal data revealed that after the end of the intervention, the intensity of general distress and breast cancer-related emotions had decreased significantly. Partial correlations showed that baseline illness perceptions were unrelated to distress at follow-up. However, changes in illness perceptions (perceptions about the cyclical and chronic timeline and symptoms associated with breast cancer) showed significant associations with distress at both follow-up assessments. Associations of follow-up distress with coping styles were less consistent. CONCLUSIONS Our results suggest that changes in illness perceptions are related to an improvement or worsening of patients' emotional well-being over time. These findings hold promise for the development of interventions that specifically target patients' representations of their illness.
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Affiliation(s)
- Maarten J Fischer
- Department of Clinical Oncology, Leiden University Medical Center, The Netherlands.
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Wu LM, Mohamed NE, Winkel G, Diefenbach MA. Patient and spouse illness beliefs and quality of life in prostate cancer patients. Psychol Health 2012; 28:355-68. [PMID: 22971045 DOI: 10.1080/08870446.2012.722219] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE Among married prostate cancer (PC) patients, the spouse is often the primary provider of emotional support and personal care. However, few studies have investigated spouses' illness beliefs (i.e. about disease duration and treatment control) and their impact on patients' quality of life (QOL). Spouses' beliefs about disease duration (timeline) were hypothesised to mediate relationships between spouses' treatment control beliefs and patients' QOL six months later. METHODS Fifty-three patients who underwent localised treatment for PC, and their spouses, completed an illness beliefs measure (the revised Illness Perception Questionnaire). Patients completed a QOL measure (the Functional Assessment of Cancer Therapy - General) six months later. RESULTS Spouse timeline beliefs mediated the association between spouse treatment control beliefs and patient QOL six months later (total indirect effect = -0.71, 95% CI 0.02-2.03). That is, spouse beliefs that the treatment would control their loved one's illness led to beliefs that the disease would be of shorter duration, which in turn led to improved patient QOL six months later. This relationship did not occur with patients' beliefs. CONCLUSION Results highlight the important influence of spouse illness beliefs over time on patient QOL with implications for clinical care and dyadic research.
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Affiliation(s)
- Lisa M Wu
- Department of Oncological Sciences, Mount Sinai School of Medicine, New York, NY, USA
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Howren MB, Christensen AJ, Karnell LH, Funk GF. Psychological factors associated with head and neck cancer treatment and survivorship: evidence and opportunities for behavioral medicine. J Consult Clin Psychol 2012; 81:299-317. [PMID: 22963591 DOI: 10.1037/a0029940] [Citation(s) in RCA: 113] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Individuals diagnosed with head and neck cancer (HNC) not only face a potentially life-threatening diagnosis but must endure treatment that often results in significant, highly visible disfigurement and disruptions of essential functioning, such as deficits or complications in eating, swallowing, breathing, and speech. Each year, approximately 650,000 new cases are diagnosed, making HNC the 6th most common type of cancer in the world. Despite this, however, HNC remains understudied in behavioral medicine. In this article, the authors review available evidence regarding several important psychosocial and behavioral factors associated with HNC diagnosis, treatment, and recovery, as well as various psychosocial interventions conducted in this patient population, before concluding with opportunities for behavioral medicine research and practice.
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Affiliation(s)
- M Bryant Howren
- Veterans Affairs Iowa City Healthcare System, Iowa City, Iowa 52242, USA.
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The value of quality-of-life questionnaires in head and neck cancer. Curr Opin Otolaryngol Head Neck Surg 2012; 20:142-7. [PMID: 22249168 DOI: 10.1097/moo.0b013e32834f5fd7] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
PURPOSE OF REVIEW To review the recent literature on health-related quality of life (HRQOL) in head and neck cancer (HNC) patients. RECENT FINDINGS HRQOL is an important part of well designed clinical trials. HRQOL seems to be an independent predictor of survival, but this association may be influenced by various cancer-related, personal, biological, psychobehavioural, physical, lifestyle-related, and social factors. Less is known about the course of HRQOL over time and about the same above-mentioned possible factors associated with (change in) HRQOL of HNC patients. Symptom management and psychosocial care may be beneficial for HNC patients to improve HRQOL, but more randomized controlled trials are needed. Studies on HRQOL in HNC are most often based on cross-sectional designs. The variability in the outcome measures hampers the generalizability of the results of these studies. Information on HRQOL of caregivers is scarce. SUMMARY Better information on all aspects of the course of HRQOL from diagnosis and treatment to long-term survivorship or death is highly needed in both patients and their caregivers, enabling reliable and valid predictive modelling. More evidence of efficacy of (new) treatment options, symptom management, and psychosocial care is needed, also in the context of increasing long-term survival and growing attention for cancer survivorship.
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Fan SY, Eiser C, Ho MC, Lin CY. Health-related quality of life in patients with hepatocellular carcinoma: the mediation effects of illness perceptions and coping. Psychooncology 2012; 22:1353-60. [DOI: 10.1002/pon.3146] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2011] [Revised: 07/03/2012] [Accepted: 07/09/2012] [Indexed: 01/12/2023]
Affiliation(s)
- Sheng-Yu Fan
- Department of Human Development; Tzu Chi University; Hualien Taiwan
| | - Christine Eiser
- Department of Psychology; University of Sheffield; Sheffield UK
| | - Ming-Chih Ho
- Department of Surgery; National Taiwan University Hospital; Taipei Taiwan
| | - Cheng-Yao Lin
- Department of Hematology and Oncology; Chi-Mei Medical Center; Liou Ying Taiwan
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Farin E, Nagl M. The patient-physician relationship in patients with breast cancer: influence on changes in quality of life after rehabilitation. Qual Life Res 2012; 22:283-94. [PMID: 22419450 DOI: 10.1007/s11136-012-0151-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2012] [Indexed: 10/28/2022]
Abstract
PURPOSE The objective of this study was to examine whether aspects of the patient-physician relationship for breast cancer patients have an influence on the change in health-related quality of life (HRQOL) after inpatient rehabilitation. METHODS N = 329 breast cancer patients undergoing inpatient rehabilitation in Germany were surveyed using questionnaires at the beginning of rehabilitation, end of rehabilitation, and 6 months after rehabilitation. Multiple imputations and multilevel models of change were used in the data analyses. RESULTS Even after comprehensive adjustment for sociodemographic, medical, psychological variables, and center effects, aspects of the physician-patient relationship were statistically and clinically relevant predictors of HRQOL after rehabilitation. Satisfaction with physician's care appears to have a rather short-term effect, but the effect of promoting patient participation can still be partially determined 6 months after rehabilitation. Other important predictors of HRQOL improvement are optimism, higher level of education, higher income, living with a partner, and the ability to work. CONCLUSIONS By taking into consideration the patient's communication and participation needs, physicians can contribute to an improved HRQOL after rehabilitation. The high predictive power of socioeconomic factors shows that rehabilitation care can be more effective if it accounts for the specific situation of socially disadvantaged individuals.
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Affiliation(s)
- Erik Farin
- Department of Quality Management and Social Medicine, University Freiburg - Medical Center, Engelbergerstr. 21, 79106, Freiburg, Germany.
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