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Reed DE, Patel SG, Bagheri-Pele T, Dailami M, Kapoor-Pabrai M, Husic A, Kohli S, Wickham RE, Brown LM. A Comparison of Psychosocial Services for Enhancing Cultural Adaptation and Global Functioning for Immigrant Survivors of Torture. J Immigr Minor Health 2023; 25:968-978. [PMID: 36607594 DOI: 10.1007/s10903-022-01439-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2022] [Indexed: 01/07/2023]
Abstract
Forced migrants suffer from significant psychological distress. However, they often prioritize urgent practical resettlement needs over mental health needs. The present study used a quasi-experimental design to compare pathways of treatment for survivors of torture (N = 369) from 42 different counties receiving care from a refugee health clinic. Random intercept ANOVAs were used to compare combined case management services and psychological treatment (CM-PT) to case management services only (CM) on changes in cultural adaptation and global functioning over time. Results showed that both groups improved on each outcome. Importantly, the CM-PT group endorsed greater improvements in cultural adaptation (b = 0.28, 95% CI 0.14, 0.41, p ≤ 0.001) and global functioning (b = 3.29, 95% CI 1.33, 5.25, p = 0.001) compared to the CM group. These findings suggest that treatment for survivors of torture should be multifaceted and include case management and psychological treatment. Case management services alone may be beneficial when socio-cultural and resource barriers exist for mental health treatment.
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Affiliation(s)
- David E Reed
- Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound Health Care, Seattle, WA, USA.
- University of Washington, Seattle, WA, USA.
- Palo Alto University, Palo Alto, CA, USA.
| | | | | | | | | | - Armina Husic
- Center for Survivors of Torture at Asian Americans for Community Involvement, San Jose, CA, USA
| | - Sarita Kohli
- Center for Survivors of Torture at Asian Americans for Community Involvement, San Jose, CA, USA
| | | | - Lisa M Brown
- Palo Alto University, Palo Alto, CA, USA
- Stanford University School of Medicine, Stanford, CA, USA
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Cohen MG, Althouse AD, Arnold RM, White D, Chu E, Rosenzweig M, Smith KJ, Schenker Y. Primary Palliative Care Improves Uptake of Advance Care Planning Among Patients With Advanced Cancers. J Natl Compr Canc Netw 2023; 21:383-390. [PMID: 37015338 PMCID: PMC10477933 DOI: 10.6004/jnccn.2023.7002] [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: 11/14/2022] [Accepted: 01/06/2023] [Indexed: 04/06/2023]
Abstract
BACKGROUND Palliative care specialists are experts in conducting advance care planning (ACP) but are a limited resource. Oncology nurses often have special relationships with their patients and thus may be poised to provide primary palliative care. We sought to determine the impact of a nurse-led primary palliative care intervention on ACP uptake among patients with advanced cancer. METHODS We performed a secondary analysis of a cluster randomized controlled trial examining the impact of nurse-based primary palliative care. In the parent trial, patients with advanced cancer received either monthly primary palliative care visits with trained nurses within their cancer center or standard care. Nurses in the intervention arm received special training in ACP. ACP uptake was assessed at enrollment and 3 months later evaluating (1) whether an end-of-life conversation (EOLC) occurred with one's oncologist, and (2) completion of an advance directive (AD). Multivariable logistic regression tested differences in ACP uptake by treatment arm adjusted for age, religious importance, education, time with current oncologist, and performance status. RESULTS Of 672 patients enrolled, 182/336 (54%) patients in the intervention arm and 196/336 (58%) in the standard care arm lacked an EOLC at baseline and completed the 3-month assessment. Of those, 82/182 (45.1%) patients in the intervention arm and 29/196 (14.8%) in the standard care arm reported having an EOLC at 3 months (adjusted odds ratio, 5.28; 95% CI, 3.10-8.97; P<.001). Similarly, 111/336 (33%) patients in the intervention arm and 105/336 (31%) in the standard care arm lacked an AD at baseline and completed the 3-month assessment. Of those, 48/111 (43.2%) patients in the intervention arm and 19/105 (18.1%) in the standard care arm completed an AD over the study period (adjusted odds ratio, 3.68; 95% CI, 1.89-7.16; P<.001). CONCLUSIONS Nurse-led primary palliative care increased ACP uptake among patients with advanced cancer. Training oncology nurses embedded within community cancer centers to provide primary palliative care may help improve ACP access.
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Affiliation(s)
- Michael G. Cohen
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Andrew D. Althouse
- Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Robert M. Arnold
- Section of Palliative Care and Medical Ethics, Palliative Research Center and Division of General Internal Medicine, University of Pittsburgh Medical School, Pittsburgh, Pennsylvania
| | - Douglas White
- Program on Ethics and Decision Making in Critical Illness, Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Edward Chu
- Albert Einstein Cancer Center, Albert Einstein College of Medicine, Bronx, New York
| | | | - Kenneth J. Smith
- Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Yael Schenker
- Section of Palliative Care and Medical Ethics, Palliative Research Center and Division of General Internal Medicine, University of Pittsburgh Medical School, Pittsburgh, Pennsylvania
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Osowiecka K, Kurowicki M, Kołb-Sielecki J, Gwara A, Szwiec M, Nawrocki S, Rucińska M. Is It Possible to Notice the Unmet Non-Medical Needs among Cancer Patients? Application of the Needs Evaluation Questionnaire in Men with Lung Cancer. Curr Oncol 2023; 30:3484-3493. [PMID: 36975477 PMCID: PMC10047714 DOI: 10.3390/curroncol30030264] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 03/16/2023] [Accepted: 03/18/2023] [Indexed: 03/22/2023] Open
Abstract
BACKGROUND Lung cancer is the most common cause of cancer death worldwide. It is the most frequently diagnosed cancer in men. Lung cancer causes not only physical symptoms related to the disease itself and its treatment but also numerous mental, social and spiritual problems. The aim of the study was to assess non-medical needs among male lung cancer patients during oncological treatment. MATERIALS AND METHODS The study was conducted on a group of 160 men (mean age 67 years) treated for lung cancer from June 2022 until November 2022 in 5 oncological centers in Poland. The Needs Evaluation Questionnaire (NEQ) was used. The NEQ explores five areas of patients' needs: informative, connected with assistance/care, relational, material and psycho-emotional support. RESULTS All participants (except one) expressed some unmet non-medical needs (mean and median 11). Male lung cancer patients indicated informative needs most frequently. There were no significant differences between expressed unmet needs based on age, place of residence, professional activity or marital status. CONCLUSIONS The NEQ seems to be a proper instrument to explore the non-medical needs of cancer patients. Adequate measures to address the unmet needs of lung cancer patients could contribute to an improved quality of life.
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Affiliation(s)
- Karolina Osowiecka
- Department of Psychology and Sociology of Health and Public Health, School of Public Health, University of Warmia and Mazury in Olsztyn, Warszawska 30, 10-082 Olsztyn, Poland
| | - Marcin Kurowicki
- Department of Radiotherapy, NU-MED Radiotherapy Center in Elblag, Królewiecka 146, 82-300 Elblag, Poland
| | - Jarosław Kołb-Sielecki
- Department of Oncology, The Center for Pulmonary Diseases in Olsztyn, Jagiellońska 78, 10-357 Olsztyn, Poland
| | - Anna Gwara
- Department of Nursing, Faculty of Medicine and Health Sciences, University of Zielona Gora, ul. Zyty 28, 65-046 Zielona Gora, Poland
| | - Marek Szwiec
- Department of Surgery and Oncology, Faculty of Medicine and Health Sciences, University of Zielona Gora, Zyty 28, 65-046 Zielona Gora, Poland
| | - Sergiusz Nawrocki
- Department of Oncology, Collegium Medicum University of Warmia and Mazury in Olsztyn, Wojska Polskiego 37, 10-228 Olsztyn, Poland
| | - Monika Rucińska
- Department of Oncology, Collegium Medicum University of Warmia and Mazury in Olsztyn, Wojska Polskiego 37, 10-228 Olsztyn, Poland
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What Aspects of Religion and Spirituality Affect the Physical Health of Cancer Patients? A Systematic Review. Healthcare (Basel) 2022; 10:healthcare10081447. [PMID: 36011104 PMCID: PMC9408220 DOI: 10.3390/healthcare10081447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 07/28/2022] [Accepted: 07/29/2022] [Indexed: 11/17/2022] Open
Abstract
In recent years, the literature on the relationship between religion and spirituality (R/S) and the health of cancer patients has been flourishing. Although most studies focus on mental health, many study the physical health of these individuals. In order to summarize the findings of these studies, we reviewed the most recent research on this subject using the PubMed and PsycInfo databases. The objective of this systematic review was to recognize the primary R/S variables studied in research on physical health in cancer contexts. We found that spiritual well-being was the most-researched variable in studies of these characteristics, followed by R/S struggles and other variables such as religious coping; religious commitment or practice; or self-rated R/S. In general, R/S seems to have a positive association with the physical health of cancer patients, although the results are quite heterogeneous, and occasionally there are no relationships or the association is negative. Our results may assist in improving interventions that include spirituality in clinical settings as well as the development of holistic approaches, which may have a positive impact on the quality of life and well-being of cancer patients.
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Walker JG, Armstrong TS, O'Brien BJ, Gilbert MR, Casarez RL, Fagundes C, Heijnen CJ, Andersen CR, Yuan Y, Wu J, LoBiondo-Wood G. Associations of meaning of illness with psychosocial, clinical, and immunological characteristics in patients with Leptomeningeal metastasis. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY 2021; 8:100099. [PMID: 35757676 PMCID: PMC9216264 DOI: 10.1016/j.cpnec.2021.100099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 10/13/2021] [Accepted: 11/17/2021] [Indexed: 11/13/2022] Open
Abstract
Background Leptomeningeal metastasis (LM) creates symptoms related to both the disease within the nervous system and treatment toxicities. Biologic processes, such as inflammation and behavioral processes, such as the meaning ascribed to illness (Meaning of Illness: MoI), can impact physical and psychosocial symptoms. The aim of this study was to understand the relationships among MoI, physical and psychosocial symptoms, and inflammation in patients with LM. Methods Thirty enrolled participants completed the MD Anderson Symptom Inventory-Brain Tumor with spine experimental symptoms added. Meaning of illness, quality of life (QoL), and depression were captured by validated instruments. Interleukin (IL)-6 and tumor necrosis factor (TNF)-α in serum and cerebrospinal fluid (CSF) were measured by ELISA. Correlations were performed to assess relationships among the variables. Results Participants were primarily white (73%), female (63%). Median age was 54 years (34–83). Breast (50%) and lung (20%) were most common diagnosis. Higher MoI scores were associated with better QoL (p < .01) and fewer depressive symptoms (p < .01). All CSF samples contained IL-6 and all but one sample had elevated IL-6. Higher levels of IL-6 in the CSF were associated with greater symptom burden (p < .01) and interference of symptoms in daily life (p = .02) but not MoI. Conclusions MoI was associated with QoL and depression. High levels of IL-6 in the CSF were associated with more severe symptoms. This study provides the groundwork for future research, including interventional studies to improve QoL in patients with LM. Ascribing positive meaning to illness is associated with higher reported QoL in patients with LM. High IL-6 in the CSF was associated with increased symptom burden but not depressive symptoms. Fostering meaning in patients with LM may help mood, reduce inflammation, and improve symptoms.
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Li Y, Zhou Z, Ni N, Li J, Luan Z, Peng X. Quality of Life and Hope of Women in China Receiving Chemotherapy for Breast Cancer. Clin Nurs Res 2021; 31:1042-1049. [PMID: 34519566 DOI: 10.1177/10547738211046737] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We explore the association of hope and quality of life in breast cancer chemotherapy women. Their quality of life is related to treatment effects and disease outcomes. This cross-sectional study was conducted in City, China, in 2017. In a convenience sampling, 450 women who underwent breast cancer chemotherapy were selected from two hospitals. Descriptive statistics, single-factor analysis, Spearman correlation, linear regression, and structural equation modeling were used to analyze data. The mean quality of life score was 65.65. In linear regression analysis, we found patients' quality of life was significantly related to age, marital status, education level, chemotherapy cycle, and hope. Structural equation results showed the "temporality and future" and "interconnectedness" subscales of the HHI explained 43% of the variance in quality of life. We found hope is an important aspect in quality of life, and further research is needed to determine if nurses can influence this aspect of care.
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Affiliation(s)
- Yuan Li
- Jilin University, Changchun, China
| | | | - Na Ni
- Inner Mongolia Medical University, Hohhot, China
| | | | - Ze Luan
- Jilin University, Changchun, China
| | - Xin Peng
- Jilin University, Changchun, China
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7
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Weng N, Li K, Lan H, Zhang T, Zhang X, Gui Y, Fu X, Liu Q. Evaluation of the reliability and validity of Functional Assessment Of Chronic Illness Therapy-Spiritual Well-Being-Expanded in elderly patients with chronic orthopaedic diseases. Psychogeriatrics 2021; 21:32-41. [PMID: 33179396 DOI: 10.1111/psyg.12624] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 08/20/2020] [Accepted: 09/08/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND The Functional Assessment Of Chronic Illness Therapy-Spiritual Well-Being-Expanded (FACIT-Sp-Ex) scale can simultaneously evaluate the quality of life and spiritual health level of patients with chronic orthopaedic diseases. We performed the FACIT-Sp-Ex scale in Chinese, and tested its reliability and validity in patients with chronic orthopaedic diseases. METHODS There were 249 patients with chronic orthopaedic diseases who were selected for the questionnaire survey. AMOS 23.0 and SPSS 25.0 were used for statistical analysis to calculate the reliability and validity of the Chinese version of the scale. RESULTS The Chinese version of FACIT-Sp-Ex scale showed that root mean square error of approximation (RMSEA) was 0.06. Cronbach's alpha coefficient was 0.83, the subscale was 0.72 ~ 0.82. The meaning, peace, relational subscales and total scale of the FACIT-Sp-Ex were negatively correlated with hospital anxiety and depression scale (HADS) and positively correlated with health-related quality of life (HRQOL). All four subdomains were inversely associated with HADS anxiety symptoms, the peace and relational subscales were inversely associated with HADS depressive symptoms. Elderly female patients score higher than male patients in faith subscale. The highest-scoring disease in FACIT-Sp-Ex faith scale was osteoarthritis, which in FACIT-Sp-Ex total scale are piriformis syndrome and osteoarthritis. CONCLUSION The Chinese version of FACIT-Sp-Ex scale has good reliability and validity, which can be used as an evaluation tool for the spiritual status and quality of life of Chinese elderly chronic orthopaedic patients.
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Affiliation(s)
- Nengyuan Weng
- First Knee Trauma Ward, Tianjin Hospital, Tianjin University, Tianjin, China
| | - Kainan Li
- Department of Orthopedics, the Affiliated Hospital of Chengdu University, Chengdu, China
| | - Hai Lan
- Department of Orthopedics, the Affiliated Hospital of Chengdu University, Chengdu, China
| | - Tao Zhang
- First Knee Trauma Ward, Tianjin Hospital, Tianjin University, Tianjin, China
| | | | - Yongxia Gui
- Centre for Mental Health Research and Education, Henan University of Economics and Law, Zhengzhou, China
| | - Xuefei Fu
- First Knee Trauma Ward, Tianjin Hospital, Tianjin University, Tianjin, China
| | - Qixin Liu
- First Knee Trauma Ward, Tianjin Hospital, Tianjin University, Tianjin, China
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8
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Reed DE, Williamson RE, Wickham RE. Memento mori: Understanding existential anxiety through the existential pathway model. JOURNAL OF THEORETICAL SOCIAL PSYCHOLOGY 2020. [DOI: 10.1002/jts5.79] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- David E. Reed
- Center of Innovation for Veteran‐Centered and Value‐Driven Care VA Puget Sound Health Care Seattle WA USA
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Esselen K, Sinno A, Varughese J, Wethington S, Prendergast E, Chu C. Social needs in gynecologic oncology: A Society of Gynecologic Oncology (SGO) clinical practice statement. Gynecol Oncol 2020; 158:521-525. [DOI: 10.1016/j.ygyno.2020.06.497] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 06/18/2020] [Indexed: 01/22/2023]
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Mediating effect of interpersonal coping on meaning in spirituality and quality of life and the influences of depression and anxiety thereon in cancer patients. Palliat Support Care 2020; 17:388-395. [PMID: 30394253 DOI: 10.1017/s1478951518000731] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
OBJECTIVE This study aimed to investigate associations among spirituality, coping strategies, quality of life (QOL), and the effects of depression and anxiety thereon in cancer patients. METHOD In total, 237 cancer patients referred to a psycho-oncology clinic at a university hospital in Korea were enrolled. After identifying predictors of patient QOL in a stepwise regression model, we developed a hypothetical path model wherein interpersonal coping was considered as a mediating variable between spirituality (meaning/peace) and QOL and wherein depression and anxiety affected each of these three variables. RESULT The direct effect of spirituality (meaning/peace) on QOL was 36.7%. In an indirect model, interpersonal coping significantly mediated the relationship between spirituality (meaning/peace) and QOL. Depression exerted the largest negative effect on spirituality (meaning/peace), interpersonal coping, and QOL. Anxiety had negative effects on spirituality (meaning/peace) and QOL, but a positive effect on interpersonal coping. SIGNIFICANCE OF RESULTS Interpersonal coping strategies work as a partial mediator of the relationship between meaning/peace subscales of spirituality and QOL. Effective management of depression may help in achieving better outcomes associated therewith. Greater attention and efforts to improve social connectedness and meaning of life in spiritual well-being may improve the QOL of cancer patients.
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Bovero A, Tosi C, Botto R, Opezzo M, Giono-Calvetto F, Torta R. The Spirituality in End-of-Life Cancer Patients, in Relation to Anxiety, Depression, Coping Strategies and the Daily Spiritual Experiences: A Cross-Sectional Study. JOURNAL OF RELIGION AND HEALTH 2019; 58:2144-2160. [PMID: 31165319 DOI: 10.1007/s10943-019-00849-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
This study aimed to investigate "Faith" and "Meaning/Peace" dimensions of the functional assessment of chronic illness therapy-spiritual well-being scale (FACIT-Sp-12) in relation to coping strategies, anxiety and depression, and to analyze the relationship between FACIT-Sp-12 and the daily spiritual experience scale in end-of-life cancer patients. A sample of 152 participants were involved. The daily spiritual experiences correlated the most with "Faith" subscale. Moreover, religious coping, depression and daily spiritual experiences resulted "Faith" significant predictors, while depression, anxiety, self-distraction, positive reframing and behavioral disengagement were "Meaning/Peace" subscale's significant predictors. These findings highlighted the considerable impact of the daily spiritual experiences on patients' spiritual well-being.
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Affiliation(s)
- Andrea Bovero
- Clinical Psychology and Psycho-Oncology Unit, Department of Neuroscience, University of Turin, "Città della Salute e della Scienza" Hospital, Turin, Italy.
- A.O.U. "Città della Salute e della Scienza", Corso Bramante n. 88, 10126, Turin, Italy.
| | - Chiara Tosi
- Clinical Psychology and Psycho-Oncology Unit, Department of Neuroscience, University of Turin, "Città della Salute e della Scienza" Hospital, Turin, Italy
| | - Rossana Botto
- Clinical Psychology and Psycho-Oncology Unit, Department of Neuroscience, University of Turin, "Città della Salute e della Scienza" Hospital, Turin, Italy
| | - Marta Opezzo
- Clinical Psychology and Psycho-Oncology Unit, Department of Neuroscience, University of Turin, "Città della Salute e della Scienza" Hospital, Turin, Italy
| | - Federica Giono-Calvetto
- Clinical Psychology and Psycho-Oncology Unit, Department of Neuroscience, University of Turin, "Città della Salute e della Scienza" Hospital, Turin, Italy
| | - Riccardo Torta
- Clinical Psychology and Psycho-Oncology Unit, Department of Neuroscience, University of Turin, "Città della Salute e della Scienza" Hospital, Turin, Italy
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Chaar EA, Hallit S, Hajj A, Aaraj R, Kattan J, Jabbour H, Khabbaz LR. Evaluating the impact of spirituality on the quality of life, anxiety, and depression among patients with cancer: an observational transversal study. Support Care Cancer 2018; 26:2581-2590. [PMID: 29453604 DOI: 10.1007/s00520-018-4089-1] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 01/30/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Spiritual well-being was found to have some protective effect against end-of life despair in cancer patients. We aimed at assessing the impact of spirituality on the quality of life, depression, and anxiety of Lebanese cancer patients. METHODS Our observational transversal monocentric study was conducted between January and April 2016 among a convenient sample of 115 Lebanese cancer patients admitted to Hôtel-Dieu de France Hospital (HDF), Beirut-Lebanon. In addition to socio-demographic and clinical data, three questionnaires were used: EORTC QLQ-C30 (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, 3rd version), FACIT-Sp-12 (Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being; The 12-item Spiritual Well-Being Scale, 4th version), and HADS (Hospital Anxiety and Depression Scale). Eighteen patients taking anxiolytic and/or antidepressants were not included in the analysis. The remaining 97 patients were analyzed. RESULTS Better emotional and cognitive functioning was seen in patients with higher meaning, peace, faith, and total FACIT scores. Meaning, peace, and total FACIT scores were also higher among patients with better global health status and quality of life. Anxiety as well as depression was significantly associated to all spiritual well-being factors. CONCLUSION Spirituality can improve quality of life and decrease the incidence of anxiety and depression in cancer patients. Our results highlight the need to incorporate spiritual care in healthcare systems.
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Affiliation(s)
- Emile Abou Chaar
- Laboratoire de Pharmacologie, pharmacie clinique et contrôle de qualité des médicaments, Pôle technologie Santé, Faculté de Pharmacie, Université Saint-Joseph de Beyrouth, Beirut, Lebanon
- Faculty of Pharmacy, Saint-Joseph University, Beirut, Lebanon
| | - Souheil Hallit
- Faculty of Pharmacy, Saint-Joseph University, Beirut, Lebanon
- Faculty of Pharmacy, Lebanese University, Beirut, Lebanon
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Kaslik, Lebanon
- Research Department, Psychiatric Hospital of the Cross, P.O Box 60096, Jal Eddib, Lebanon
- Occupational Health Environment Research Team, U1219 BPH Bordeaux Population Health Research Center Inserm, Université de Bordeaux, Bordeaux, France
- INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Faculty of Public Health, Lebanese University, Beirut, Lebanon
| | - Aline Hajj
- Laboratoire de Pharmacologie, pharmacie clinique et contrôle de qualité des médicaments, Pôle technologie Santé, Faculté de Pharmacie, Université Saint-Joseph de Beyrouth, Beirut, Lebanon
- Faculty of Pharmacy, Saint-Joseph University, Beirut, Lebanon
| | - Racha Aaraj
- Faculty of Pharmacy, Saint-Joseph University, Beirut, Lebanon
| | - Joseph Kattan
- Faculty of Medicine, Université Saint-Joseph de Beyrouth, Beirut, Lebanon
- Department of oncology, Hotel-Dieu de France de Beyrouth, Beirut, Lebanon
| | - Hicham Jabbour
- Faculty of Medicine, Université Saint-Joseph de Beyrouth, Beirut, Lebanon
- Department of anesthesia and reanimation, Hotel-Dieu de France de Beyrouth, Beirut, Lebanon
| | - Lydia Rabbaa Khabbaz
- Laboratoire de Pharmacologie, pharmacie clinique et contrôle de qualité des médicaments, Pôle technologie Santé, Faculté de Pharmacie, Université Saint-Joseph de Beyrouth, Beirut, Lebanon.
- Faculty of Pharmacy, Saint-Joseph University, Beirut, Lebanon.
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Exploring the individual patterns of spiritual well-being in people newly diagnosed with advanced cancer: a cluster analysis. Qual Life Res 2016; 25:2765-2773. [PMID: 27271809 DOI: 10.1007/s11136-016-1328-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE Research shows that spiritual well-being correlates positively with quality of life (QOL) for people with cancer, whereas contradictory findings are frequently reported with respect to the differentiated associations between dimensions of spiritual well-being, namely peace, meaning and faith, and QOL. This study aimed to examine individual patterns of spiritual well-being among patients newly diagnosed with advanced cancer. METHODS Cluster analysis was based on the twelve items of the 12-item Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale at Time 1. A combination of hierarchical and k-means (non-hierarchical) clustering methods was employed to jointly determine the number of clusters. Self-rated health, depressive symptoms, peace, meaning and faith, and overall QOL were compared at Time 1 and Time 2. RESULTS Hierarchical and k-means clustering methods both suggested four clusters. Comparison of the four clusters supported statistically significant and clinically meaningful differences in QOL outcomes among clusters while revealing contrasting relations of faith with QOL. Cluster 1, Cluster 3, and Cluster 4 represented high, medium, and low levels of overall QOL, respectively, with correspondingly high, medium, and low levels of peace, meaning, and faith. Cluster 2 was distinguished from other clusters by its medium levels of overall QOL, peace, and meaning and low level of faith. CONCLUSIONS This study provides empirical support for individual difference in response to a newly diagnosed cancer and brings into focus conceptual and methodological challenges associated with the measure of spiritual well-being, which may partly contribute to the attenuated relation between faith and QOL.
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Lucette A, Ironson G, Pargament KI, Krause N. Spirituality and Religiousness are Associated With Fewer Depressive Symptoms in Individuals With Medical Conditions. PSYCHOSOMATICS 2016; 57:505-13. [PMID: 27156858 DOI: 10.1016/j.psym.2016.03.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 03/11/2016] [Accepted: 03/19/2016] [Indexed: 01/06/2023]
Abstract
BACKGROUND The increased prevalence of depressive symptoms among adults diagnosed with chronic health issues has been largely documented. OBJECTIVES Research is needed to clarify the effect of religiousness/spirituality in relation to chronic health conditions and depression, to establish whether these variables can serve as protective factors. METHODS Self-report data from a nationwide study of spirituality and health were used. Individuals with at least 1 chronic illness (N = 1696) formed the subsample for this study. Religiousness/spirituality variables included frequency of church attendance, prayer, religious meaning, religious hope, general meaning, general hope, peace, and view of God. Other variables included depressive symptoms and demographics (age, gender, ethnicity, and education). RESULTS A series of hierarchical regression analyses revealed that chronic conditions were consistently associated with more depressive symptoms. Greater religiousness/spirituality was significantly associated with fewer depressive symptoms, contributing 16% of the variance above demographics and the number of chronic illnesses. The religiousness/spirituality variables conferring the greatest protection against depression were psychospiritual variables (general meaning and general hope, followed by peace). Also significant but making a smaller contribution to less depression were church attendance, religious meaning, religious hope, and positive view of God. Only prayer did not relate significantly to less depression. CONCLUSION Maintaining a sense of spirituality or religiousness can benefit well-being of individuals diagnosed with a chronic health condition, especially having meaning, maintaining hope, and having a sense of peace. Patients could potentially benefit from being offered the resources that support their spiritual/religious practices and beliefs as they cope with chronic illness.
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Affiliation(s)
- Aurelie Lucette
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Coral Gables, FL
| | - Gail Ironson
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Coral Gables, FL.
| | | | - Neal Krause
- School of Public Health, University of Michigan, Ann Arbor, MI
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15
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Antoniu SA, Boiculese LV. Palliative care outcome measures in COPD patients: a conceptual review. Expert Rev Pharmacoecon Outcomes Res 2016; 16:267-74. [PMID: 26967768 DOI: 10.1586/14737167.2016.1162714] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
In chronic obstructive pulmonary disease (COPD), palliative care is appropriate in very advanced stages based on recognition of its need when conventional therapy is no longer able to control symptoms, disease morbidity, or to improve/maintain an acceptable quality of life. Palliative care aims to improve quality of life, or, if applied specifically at the end-of-life, to ensure comfortable care. In COPD palliative care effectiveness of interventions should be quantified with outcome measures able to better capture the holistic nature of approaches and not only the specific features of disease. These should include: physical outcomes, psychological outcomes, social outcomes, spiritual outcomes. Such measures are discussed in this review along with arguments supporting their use.
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Affiliation(s)
- Sabina Antonela Antoniu
- a Department of Preventive Medicine Interdisciplinarity, Medicine-Palliative Care Nursing , University of Medicine and Pharmacy, 'Gr.T.Popa' Iasi , Iasi , Romania
| | - Lucian Vasile Boiculese
- a Department of Preventive Medicine Interdisciplinarity, Medicine-Palliative Care Nursing , University of Medicine and Pharmacy, 'Gr.T.Popa' Iasi , Iasi , Romania
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16
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Ripamonti CI, Miccinesi G, Pessi MA, Di Pede P, Ferrari M. Is it possible to encourage hope in non-advanced cancer patients? We must try. Ann Oncol 2015; 27:513-9. [PMID: 26681679 DOI: 10.1093/annonc/mdv614] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 12/09/2015] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Data are lacking on the relationship between hope and other variables in non-advanced cancer patients. The study explored the relationship between hope, symptoms, needs, and spirituality/religiosity in patients treated in a supportive care unit (SCU). PATIENTS AND METHODS From September 2013 to March 2014, the consecutive patients who accepted to complete: (i) Needs Evaluation Questionnaire (NEQ), (ii) the Edmonton Symptom Assessment System (ESAS), (iii) Hope Herth Index (HHI), and (iv) the System of Belief Inventory (SBI) were enrolled. Moreover, clinical/demographic data were collected and the findings were analyzed. RESULTS A total of 276 patients who completed the HHI questionnaire (participation rate 276/300 = 92%) were included; 131 reported HHI total score >37 (median value). The majority of patients had a Karnofsky performance status >80; 71% were on cancer therapies, and only 29 patients had metastases or relapse. Patients with higher HHI scores were less educated (P = 0.012), reported lower ESAS total score (15.4 versus 22.6, P < 0.001), and had less often been referred to a psychologist previously to the study (P = 0.002); patients with a higher HHI score also reported higher spirituality (P < 0.001). Some NEQ items resulted significantly associated with HHI score after adjustment for other variables: the need to have sincere clinicians (β = -2.7), better dialogue (β = -2.1), and more reassurance from the clinicians (β = -2.5); better attention (β = -4.4) and respect for intimacy (β = -3.3) from nurses; to speak with people who have the same illness experience (β = -2.5), to be more reassured by relatives (β = -3.3) and to feel less abandoned (β = -4.3). Higher SBI scores were independently associated with higher HHI scores (β = 1.7 for 10 points increase). CONCLUSIONS In cancer patients, hope can be encouraged by clinicians through dialogue, sincerity, and reassurance, as well as assessing and considering the patients' needs (above all the psycho-emotional), symptoms, psychological frailty, and their spiritual/religious resources.
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Affiliation(s)
- C I Ripamonti
- Supportive Care in Cancer Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - G Miccinesi
- ISPO Cancer Prevention and Research Institute, Florence, Italy
| | - M A Pessi
- Supportive Care in Cancer Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - P Di Pede
- Supportive Care in Cancer Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - M Ferrari
- Department of Psychology, University of Chester, Chester, UK
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17
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Davis LZ, Slavich GM, Thaker PH, Goodheart MJ, Bender DP, Dahmoush L, Farley DM, Markon KE, Penedo FJ, Lubaroff DM, Cole SW, Sood AK, Lutgendorf SK. Eudaimonic well-being and tumor norepinephrine in patients with epithelial ovarian cancer. Cancer 2015; 121:3543-50. [PMID: 26096769 DOI: 10.1002/cncr.29516] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 05/01/2015] [Accepted: 05/18/2015] [Indexed: 12/29/2022]
Abstract
BACKGROUND The impact of psychological well-being on the physiologic processes involved in cancer progression remains unclear. Prior research has implicated adrenergic signaling in tumor growth and metastasis. Given that adrenergic signaling is influenced by both positive and negative factors, the authors examined how 2 different aspects of well-being (eudaimonic and positive affect) and psychological distress were associated with tumor norepinephrine (NE) in patients with ovarian cancer. METHODS A total of 365 women with suspected ovarian cancer completed psychosocial assessments before surgery and clinical information was obtained from medical records. Study inclusion was confirmed after histological diagnosis. Tumor NE was measured in frozen tissue samples using high-performance liquid chromatography with electrochemical detection. Confirmatory factor analysis was used to model eudaimonic well-being, positive affect, and psychological distress, and structural equation modeling was used to examine associations between these factors and tumor NE. RESULTS Eudaimonic well-being, positive affect, and psychological distress, modeled as distinct but correlated constructs, best fit the data (ie, compared with unitary or 2-factor models) (root mean square error of approximation, 0.048; comparative fit index, 0.982; and standardized root-mean-squared residual, 0.035). Structural equation modeling analysis that included physical well-being, stage of disease, histology, psychological treatment history, beta-blocker use, and caffeine use as covariates was found to have good model fit (root mean square error of approximation, 0.052; comparative fit index, 0.955; and standardized root-mean-squared residual, 0.036) and demonstrated that eudaimonic well-being was related to lower tumor NE (β = -.24 [P = .045]). In contrast, no effects were found for positive affect or psychological distress. CONCLUSIONS Eudaimonic well-being was found to be associated with lower tumor NE, independent of positive affect and psychological distress. Because adrenergic signaling is implicated in tumor progression, increasing eudaimonic well-being may improve both psychological and physiologic resilience in patients with ovarian cancer.
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Affiliation(s)
- Lauren Z Davis
- Department of Psychology, University of Iowa, Iowa City, Iowa
| | - George M Slavich
- Cousins Center for Psychoneuroimmunology, Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, California
| | - Premal H Thaker
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri
| | - Michael J Goodheart
- Department of Obstetrics and Gynecology, University of Iowa, Iowa City, Iowa
| | - David P Bender
- Department of Obstetrics and Gynecology, University of Iowa, Iowa City, Iowa
| | - Laila Dahmoush
- Department of Pathology, University of Iowa, Iowa City, Iowa
| | - Donna M Farley
- College of Pharmacy, University of Iowa, Iowa City, Iowa
| | | | - Frank J Penedo
- Department of Medical and Social Sciences, Northwestern University, Evanston, Illinois.,Department of Psychology, Northwestern University, Evanston, Illinois.,Department of Psychiatry and Behavioral Sciences, Northwestern University, Evanston, Illinois
| | - David M Lubaroff
- Department of Urology, University of Iowa, Iowa City, Iowa.,Holden Comprehensive Cancer Center, University of Iowa, Iowa City, Iowa.,Department of Microbiology, University of Iowa, Iowa City, Iowa
| | - Steve W Cole
- Cousins Center for Psychoneuroimmunology, Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, California.,Division of Hematology/Oncology, Jonsson Comprehensive Cancer Center, University of California at Los Angeles School of Medicine, Los Angeles, California.,University of California at Los Angeles Molecular Biology Institute, Los Angeles, California
| | - Anil K Sood
- Department of Gynecologic Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.,Department of Cancer Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Susan K Lutgendorf
- Department of Psychology, University of Iowa, Iowa City, Iowa.,Department of Obstetrics and Gynecology, University of Iowa, Iowa City, Iowa.,Department of Urology, University of Iowa, Iowa City, Iowa.,Holden Comprehensive Cancer Center, University of Iowa, Iowa City, Iowa
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