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Hikasa S, Ishihara M, Tsukiji M, Kunimoto Y, Nobori K, Kimura T, Onishi K, Yamamoto Y, Haruta K, Kasiwabara Y, Fujii K, Kimura T. Factors associated with patient satisfaction with antiretroviral therapy in Japan: A cross-sectional, multicenter study. J Infect Chemother 2024; 30:746-751. [PMID: 38365064 DOI: 10.1016/j.jiac.2024.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/06/2024] [Accepted: 02/11/2024] [Indexed: 02/18/2024]
Abstract
BACKGROUND Current antiretroviral therapy (ART) regimens are highly effective; therefore, to differentiate between various regimens, considering patient-reported outcomes is essential. This study aimed to assess patient satisfaction with their current ART regimens and investigate factors associated with the Human Immunodeficiency Virus Treatment Satisfaction Questionnaire: Status (HIVTSQs) score. METHODS This cross-sectional, multicenter study was conducted in Japan between April and December 2021. Patient-reported satisfaction with ART was assessed using the Japanese version of the HIVTSQs. Binary logistic regression was used to identify factors associated with a low total HIVTSQs score. RESULTS A total of 679 patients completed the questionnaire. The median total HIVTSQs score was 58 (interquartile range: 52.5-64). In the multivariable logistic regression analyses, a total HIVTSQs score in the lowest quartile (indicating low satisfaction) was independently associated with twice- or thrice-daily regimens compared with single-tablet, once-daily regimens (adjusted odds ratio: 2.80, 95% confidence interval: 1.29-6.06, p = 0.009) and depression (adjusted odds ratio: 2.30, 95% confidence interval: 1.32-4.01, p = 0.003). CONCLUSIONS Satisfaction with the current ART regimen was high. Depression and twice- or thrice-daily ART regimen were associated with low HIVTSQ. Switching to a single-tablet, once-daily regimen may improve patient satisfaction in patients receiving twice- or thrice-daily regimens.
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Affiliation(s)
- Shinichi Hikasa
- Department of Pharmacy, Hyogo Medical University Hospital, Nishinomiya, Hyogo, Japan.
| | - Masashi Ishihara
- Department of Pharmacy, Gifu University Hospital, Gifu, Gifu, Japan
| | - Mariko Tsukiji
- Division of Pharmacy, Chiba University Hospital, Chiba, Chiba, Japan
| | - Yusuke Kunimoto
- Department of Hospital Pharmacy, Sapporo Medical University Hospital, Sapporo, Hokkaido, Japan
| | - Kazuko Nobori
- Department of Pharmacy, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Takeshi Kimura
- Department of Pharmacy, Kobe University Hospital, Kobe, Japan
| | - Kenta Onishi
- Division of Pharmacy, Wakayama Medical University Hospital, Wakayama, Wakayama, Japan
| | - Yuuki Yamamoto
- Division of Pharmacy, Himeji Medical Center, Himeji, Hyogo, Japan
| | - Kyohei Haruta
- Department of Pharmacy, Nara Medical University Hospital, Kashihara, Nara, Japan
| | - Yohei Kasiwabara
- Division of Pharmacy, Japanese Red Cross Kyoto Daiichi Hospital, Higashiyama, Kyoto, Japan
| | - Kenji Fujii
- Department of Pharmaceutical Services, Hiroshima University Hospital, Hiroshima, Hiroshima, Japan
| | - Takeshi Kimura
- Department of Pharmacy, Hyogo Medical University Hospital, Nishinomiya, Hyogo, Japan
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Silva S, Paredes T, Teixeira RJ, Brandão T, Dimitrovová K, Marques D, Sousa J, Leal M, Dias A, Neves C, Marques G, Amaral N. Emotional Distress in Portuguese Cancer Patients: The Use of the Emotion Thermometers (ET) Screening Tool. Healthcare (Basel) 2023; 11:2689. [PMID: 37830726 PMCID: PMC10572115 DOI: 10.3390/healthcare11192689] [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: 06/30/2023] [Revised: 09/27/2023] [Accepted: 09/27/2023] [Indexed: 10/14/2023] Open
Abstract
Cancer patients may experience significant distress. The "Emotion Thermometers" (ETs) are a short visual analogue scale used to screen patients for psychosocial risk. This study aimed to assess emotional distress in a large sample of cancer patients attending psychological services at an non-governmental organization (NGO), and to explore factors that may contribute to it. The ETs were answered by 899 cancer patients. They were, on average, 59.9 years old, the majority were female, had breast cancer, were under treatment or were disease-free survivors, and reported high levels of emotional distress, above the cut-off (≥5). A Generalized Linear Model was used to measure the association between the level of distress, age, gender, disease phase and 33 items of the problem list. Four items-sadness, depression, sleep and breathing-were found to be significantly related to a higher level of distress. Additionally, women and patients who were in the palliative phase also had significantly higher levels of distress. The results confirm the need for early emotional screening in cancer patients, as well as attending to the characteristics of each patient. Additionally, they highlight the utility of the ETs for the clinical practice, allowing to optimize the referral to specialized psychosocial services.
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Affiliation(s)
- Sónia Silva
- Portuguese Cancer League (Central Branch), Rua Dr. António José de Almeida, nº 329—2º Sl 56, 3000-045 Coimbra, Portugal; (T.P.); (N.A.)
| | - Tiago Paredes
- Portuguese Cancer League (Central Branch), Rua Dr. António José de Almeida, nº 329—2º Sl 56, 3000-045 Coimbra, Portugal; (T.P.); (N.A.)
| | - Ricardo João Teixeira
- REACH—Mental Health Clinic, 4000-138 Porto, Portugal;
- CINEICC, Faculty of Psychology and Educational Sciences, University of Coimbra, 3004-531 Coimbra, Portugal
| | - Tânia Brandão
- William James Center for Research, ISPA—Instituto Universitário, 1149-041 Lisboa, Portugal;
| | - Klára Dimitrovová
- Comprehensive Health Research Center, CHRC, NOVA University Lisboa, 1150-082 Lisboa, Portugal;
- MOAI Consulting, 1350-346 Lisboa, Portugal; (D.M.); (J.S.)
| | - Diogo Marques
- MOAI Consulting, 1350-346 Lisboa, Portugal; (D.M.); (J.S.)
| | - Joana Sousa
- MOAI Consulting, 1350-346 Lisboa, Portugal; (D.M.); (J.S.)
| | - Monick Leal
- Portuguese Cancer League (North Branch), 4200-172 Porto, Portugal;
| | - Albina Dias
- Portuguese Cancer League (South Branch), 1099-023 Lisboa, Portugal;
| | - Carole Neves
- Portuguese Cancer League (Madeira Branch), 9050-023 Funchal, Portugal;
| | - Graciete Marques
- Portuguese Cancer League (Azores Branch), 9700-171 Angra do Heroísmo, Açores, Portugal;
| | - Natália Amaral
- Portuguese Cancer League (Central Branch), Rua Dr. António José de Almeida, nº 329—2º Sl 56, 3000-045 Coimbra, Portugal; (T.P.); (N.A.)
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Shunnmugam B, Islam T, Sinnadurai S, Seng Hui C, Mee Hong S, Chinna K, Aishah Mohd Taib N. Reliability and Validity of the Malay BREAST-Q in Women Undergoing Breast Cancer Surgery in Malaysia. Asia Pac J Public Health 2023; 35:129-135. [PMID: 37171249 DOI: 10.1177/10105395231163345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
This study aims to translate the BREAST-Q into Malay and validate it in breast cancer patients undergoing surgery. The English BREAST-Q was translated to Malay using the back-translation method. A total of 144 newly diagnosed breast cancer patients were sampled conveniently between December 2015 and November 2016. Test-retest was done after two to three weeks. Data were analyzed using SPSS and AMOS software. Content experts agreed the items in the Malay BREAST-Q were measuring the constructs appropriately. Internal consistencies were good for all items in each subscale (Cronbach's alpha = 0.83-0.95). The highest inter-item correlation for each item with at least one other item in the construct ranged from 0.47 to 0.90. The lowest corrected item-total correlation values ranged from 0.47 to 0.72. The test-retest analysis showed good reproducibility (intraclass correlation coefficient = 0.71-0.98). In exploratory factor analysis, the Kaiser-Meyer-Olkin values were excellent in all four subscales (0.76, 0.92, 0.91, and 0.86). For all subscales, the number of factors extracted cumulatively explained more than 50% of the variance. The Malay BREAST-Q demonstrated good reliability, face validity, content validity, and construct validity.
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Affiliation(s)
- Bairave Shunnmugam
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Tania Islam
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Siamala Sinnadurai
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Chua Seng Hui
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - See Mee Hong
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Karuthan Chinna
- School of Medicine, Faculty of Health & Medical Sciences, Taylor's University, Subang Jaya, Malaysia
| | - Nur Aishah Mohd Taib
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- University Malaya Cancer Research Institute, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Schulze JB, Durante L, Günther MP, Götz A, Curioni-Fontecedro A, Opitz I, von Känel R, Euler S. Clinically Significant Distress and Physical Problems Detected on a Distress Thermometer are Associated With Survival Among Lung Cancer Patients. J Acad Consult Liaison Psychiatry 2023; 64:128-135. [PMID: 36115496 DOI: 10.1016/j.jaclp.2022.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 08/09/2022] [Accepted: 09/05/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND The distress thermometer is a well-established screening tool to detect clinically significant distress in cancer patients. It is often administered in combination with the problem list, differentiating further between various (e.g., physical and emotional) sources of distress. OBJECTIVE The present study aimed to extend previous research on the association between distress and overall survival. A further exploratory analysis aimed to evaluate the predictive value of the problem list for overall survival. METHODS Patients (n = 323) with newly diagnosed lung cancer were recruited from a large cancer center. Patients were split into 2 groups, those with (distress thermometer score ≥5) and those without significant distress. The overall survival time was illustrated by a Kaplan-Meier curve and compared with a log-rank test. Univariable Cox proportional hazard models were built to control the association of distress with overall survival for age, gender, disease stage, comorbidity, and their interaction terms. Multiple linear regression was used to investigate the association of the items from the problem list with survival time. RESULTS Patients with significant distress had a shorter survival time than patients without significant distress (25 vs. 43 months). Regression analysis revealed more problems with both "bathing and dressing" and "eating," as well as absence of "diarrhea" and increased "nervousness," to negatively associated with the overall survival time. CONCLUSIONS Our results show that estimation of the survival function using cancer-related distress is possible. However, when using Cox regression, distress shows no significant value for survival as a predictor. Moreover, our study did not reveal an interaction effect among disease stage, comorbidity, and distress. Overall, results suggest that physical and emotional problems that arise from lung cancer may be useful to identify patients at risk of poor prognosis (on the basis of Kaplan-Meier estimator).
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Affiliation(s)
- Jan Ben Schulze
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
| | - Larissa Durante
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Moritz Philipp Günther
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Anna Götz
- Cancer Center Zurich, University Hospital Zurich, Zurich, Switzerland
| | | | - Isabelle Opitz
- Thoracic Surgery Department, University Hospital Zürich, University of Zurich, Zurich, Switzerland
| | - Roland von Känel
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Sebastian Euler
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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Reid HW, Selvan B, Montes de Oca MK, Falkovic M, Malone S, Fish LJ, Wheeler S, Davidson BA. "You start feeling comfortable, you just start sharing:" A qualitative study of patient distress screening in Black and White patients with endometrial cancer. Gynecol Oncol 2023; 168:166-175. [PMID: 36502783 PMCID: PMC9884512 DOI: 10.1016/j.ygyno.2022.11.008] [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: 07/04/2022] [Revised: 11/03/2022] [Accepted: 11/05/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Black patients with endometrial cancer are less likely to express distress and receive referrals for support services compared to White patients. We aim to characterize patient perceptions of the National Comprehensive Cancer Network Distress Thermometer and Problem List (NCCN DT & PL), a common distress screening tool, among Black and White patients with endometrial cancer and determine strategies to improve equity in referral to appropriate support services. METHODS We conducted semi-structured interviews with 15 Black and 15 White patients with endometrial cancer who reported varying levels of distress on the NCCN DT & PL. Interviews were audio-recorded, transcribed, evaluated through staged content analysis, and salient themes were compared by patient race. RESULTS The NCCN DT & PL was generally considered understandable, however the word "distress" could be alienating to participants who considered their stress to be less "drastic." Black participants mentioned fewer negative emotions such as worry and sadness in describing distress and spoke more often of a positive outlook. Additionally, Black participants emphasized the importance of relationship-building with clinicians for open communication on the NCCN DT & PL and clinical encounter. Finally, participants were divided on whether they would alter the way they completed the NCCN DT & PL given more information on cut off scores for referrals, but generally expressed a desire for more direct offers of support services. CONCLUSIONS Relationship-building, open communication around emotion, and longitudinal direct offers of support emerged as avenues to reduce inequities in referral to supportive services for patients with endometrial cancer.
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Affiliation(s)
- Hadley W Reid
- Duke University School of Medicine, DUMC 3710, Durham, NC 27710, USA.
| | - Bharathi Selvan
- Duke University School of Medicine, DUMC 3710, Durham, NC 27710, USA.
| | - Mary Katherine Montes de Oca
- Department of Obstetrics and Gynecology, Duke University School of Medicine, 2608 Erwin Rd, STE 210, Durham, NC 27710, USA.
| | - Margaret Falkovic
- Duke Cancer Institute, Behavioral Health and Survey Research Core, Duke University School of Medicine, Box 2715, Durham, NC 27710, USA.
| | - Shauna Malone
- Department of Population Health Sciences, Duke University School of Medicine, 215 Morris St, Durham, NC 27701, USA..
| | - Laura J Fish
- Duke Cancer Institute, Behavioral Health and Survey Research Core, Duke University School of Medicine, Box 2715, Durham, NC 27710, USA; Department of Family Medicine and Community Health, Duke University School of Medicine, DUMC 2914, Durham, NC 27710, USA.
| | - Sarahn Wheeler
- Division of Maternal Fetal Medicine, Duke University School of Medicine, DUMC 3967, Durham, NC 27710, USA.
| | - Brittany A Davidson
- Division of Gynecologic Oncology, Duke University School of Medicine, DUMC Box 3079, Durham, NC 27710, USA.
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Sheahan KL, Kroll-Desrosiers A, Goldstein KM, Sheahan MM, Oumarou A, Mattocks K. Sufficiency of Health Information During Pregnancy: What's Missing and for Whom? A Cross-Sectional Analysis Among Veterans. J Womens Health (Larchmt) 2022; 31:1557-1566. [PMID: 35404136 DOI: 10.1089/jwh.2021.0462] [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] [Indexed: 11/13/2022] Open
Abstract
Background: Women Veterans often experience trauma and physical and mental health conditions that increase risk of adverse pregnancy outcomes. Information provision during pregnancy may facilitate improved outcomes. However, little evidence exists about information women Veterans receive during pregnancy, and their perceptions of it. Materials and Methods: We recruited pregnant Veterans from 15 Veterans Affairs medical centers. Through telephone surveys, women (N = 851) provided information about sociodemographic characteristics, military service, health, and pregnancy experiences. We asked postpartum women whether, during pregnancy, they received sufficient information about nine health topics. We calculated a composite score (range: 0-9) that reflected sufficiency of information received. Multivariable logistic regression models identified determinants of perceived sufficiency of information. Results: Mean age was 32.1 years. Most reported being White (56.3%), non-Hispanic (80.3%), married/living with a partner (85.1%), and employed (54.4%). Most (54.6%) had been diagnosed with depression (54.6%); one-quarter reported current depressive symptoms. Mean sufficiency of information score was 6.9. Topics that women most reported they did not receive sufficient information on included, what to expect during delivery (32.3%) and how their spouse/partner might support them during labor (40.3%). History of depression (β = -0.35, p = 0.03), current depressive symptoms (β = -0.66, p = 0.001), military sexual trauma (β = 0.37, p = 0.03), and experience of violence (β = 0.66, p = 0.03) were associated with lower sufficiency of information scores. Conclusion: Results indicate need for enhanced and tailored provision of information for Veterans during pregnancy, particularly among those with experience of trauma, past depression diagnoses, and current depressive symptoms. This may include optimizing care coordination and increasing access to childbirth education classes and doula support.
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Affiliation(s)
- Kate L Sheahan
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Health Services Research and Development, Durham VA Health Care System, Durham, North Carolina, USA
| | - Aimee Kroll-Desrosiers
- VA Central Western Massachusetts Healthcare System, Leeds, Massachusetts, USA
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Karen M Goldstein
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Health Services Research and Development, Durham VA Health Care System, Durham, North Carolina, USA
- Division of General Internal Medicine, Duke University School of Medicine, Durham, North Carolina, USA
| | | | - Annie Oumarou
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Health Services Research and Development, Durham VA Health Care System, Durham, North Carolina, USA
| | - Kristin Mattocks
- VA Central Western Massachusetts Healthcare System, Leeds, Massachusetts, USA
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts, USA
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Reid HW, Broadwater G, Montes de Oca MK, Selvan B, Fayanju O, Havrilesky LJ, Davidson BA. Distress screening in endometrial cancer leads to disparity in referral to support services. Gynecol Oncol 2022; 164:622-627. [PMID: 35016785 PMCID: PMC8891066 DOI: 10.1016/j.ygyno.2022.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 12/01/2021] [Accepted: 01/03/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Racial disparities in survival from endometrial cancer (EC) are well known. Cancer distress has also been associated with worse clinical outcomes. We characterized the association between race/ethnicity, patient distress reported on the National Comprehensive Cancer Network Distress Thermometer and Problem List (NCCN DT & PL), referral to support services, time to surgery, and acceptance of adjuvant therapy in patients with EC. METHODS We included patients presenting at an academic gynecologic oncology practice from 1/2013-6/2020 who had not received prior EC-directed treatment. Demographics, NCCN DT scores, and treatment details were abstracted from the electronic medical record. Difference in initial DT scores by race/ethnicity and treatment type was tested using general linear modeling. The significance of interaction effects was tested using linear mixed models and logistic regression. RESULTS 393 non-Hispanic White (NHW) and 134 non-Hispanic Black (NHB) patients were included. Median distress scores were higher in NHW patients compared to NHB patients (4 vs. 2, p < 0.001); 51% of NHW patients qualified for referral to support services compared to 40% of NHB patients (p = 0.03). Distress scores were highest at initial appointment and declined over time in NHW patients regardless of treatment, but were initially low and remained low over time in NHB patients. There was no association of initial distress score with time to surgery or acceptance of adjuvant treatment (p-values >0.25). CONCLUSIONS An observed difference in NCCN DT leads to racial disparities in referral to support services. The NCCN DT may not adequately measure distress in NHB women with EC.
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Affiliation(s)
- Hadley W Reid
- Duke University School of Medicine, DUMC 3710, Durham, NC 27710, USA.
| | - Gloria Broadwater
- Duke Cancer Institute Biostatistics, Duke University Medical Center, DUMC Box 2717, Durham, NC, USA.
| | - Mary Katherine Montes de Oca
- Department of Obstetrics and Gynecology, Duke University School of Medicine, 2608 Erwin Rd, STE 210, Durham, NC 27710, USA.
| | - Bharathi Selvan
- Duke University School of Medicine, DUMC 3710, Durham, NC 27710, USA.
| | - Oluwadamilola Fayanju
- Department of Surgery, Duke University School of Medicine, DUMC 3513, Durham, NC 27710, USA.
| | - Laura J Havrilesky
- Division of Gynecologic Oncology, Duke University School of Medicine, DUMC Box 3079, Durham, NC, 27710, USA.
| | - Brittany A Davidson
- Division of Gynecologic Oncology, Duke University School of Medicine, DUMC Box 3079, Durham, NC, 27710, USA.
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Kirkham EJ, Lawrie SM, Crompton CJ, Iveson MH, Jenkins ND, Goerdten J, Beange I, Chan SWY, McIntosh A, Fletcher-Watson S. Experience of clinical services shapes attitudes to mental health data sharing: findings from a UK-wide survey. BMC Public Health 2022; 22:357. [PMID: 35183146 PMCID: PMC8858475 DOI: 10.1186/s12889-022-12694-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 02/02/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Routinely-collected mental health data could deliver novel insights for mental health research. However, patients' willingness to share their mental health data remains largely unknown. We investigated factors influencing likelihood of sharing these data for research purposes amongst people with and without experience of mental illness. METHODS We collected responses from a diverse sample of UK National Health Service (NHS) users (n = 2187) of which about half (n = 1087) had lifetime experience of mental illness. Ordinal logistic regression was used to examine the influence of demographic factors, clinical service experience, and primary mental illness on willingness to share mental health data, contrasted against physical health data. RESULTS There was a high level of willingness to share mental (89.7%) and physical (92.8%) health data for research purposes. Higher levels of satisfaction with the NHS were associated with greater willingness to share mental health data. Furthermore, people with personal experience of mental illness were more willing than those without to share mental health data, once the variable of NHS satisfaction had been controlled for. Of the mental illnesses recorded, people with depression, obsessive-compulsive disorder (OCD), personality disorder or bipolar disorder were significantly more likely to share their mental health data than people without mental illness. CONCLUSIONS These findings suggest that positive experiences of health services and personal experience of mental illness are associated with greater willingness to share mental health data. NHS satisfaction is a potentially modifiable factor that could foster public support for increased use of NHS mental health data in research.
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Affiliation(s)
- E J Kirkham
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Kennedy Tower, Royal Edinburgh Hospital, Morningside Park, Edinburgh, EH10 5HF, UK.
| | - S M Lawrie
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Kennedy Tower, Royal Edinburgh Hospital, Morningside Park, Edinburgh, EH10 5HF, UK
| | - C J Crompton
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Kennedy Tower, Royal Edinburgh Hospital, Morningside Park, Edinburgh, EH10 5HF, UK
| | - M H Iveson
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Kennedy Tower, Royal Edinburgh Hospital, Morningside Park, Edinburgh, EH10 5HF, UK
| | - N D Jenkins
- Edinburgh Dementia Prevention & Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - J Goerdten
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Kennedy Tower, Royal Edinburgh Hospital, Morningside Park, Edinburgh, EH10 5HF, UK
- Department of Epidemiological Methods and Etiological Research, Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
| | - I Beange
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Kennedy Tower, Royal Edinburgh Hospital, Morningside Park, Edinburgh, EH10 5HF, UK
| | - S W Y Chan
- Department of Clinical Psychology, School of Health in Social Science, University of Edinburgh, Edinburgh, UK
- School of Psychology & Clinical Language Sciences, University of Reading, Reading, UK
| | - A McIntosh
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Kennedy Tower, Royal Edinburgh Hospital, Morningside Park, Edinburgh, EH10 5HF, UK
| | - S Fletcher-Watson
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Kennedy Tower, Royal Edinburgh Hospital, Morningside Park, Edinburgh, EH10 5HF, UK
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Günther MP, Kirchebner J, Schulze JB, von Känel R, Euler S. Towards identifying cancer patients at risk to miss out on psycho-oncological treatment via machine learning. Eur J Cancer Care (Engl) 2022; 31:e13555. [PMID: 35137480 PMCID: PMC9286797 DOI: 10.1111/ecc.13555] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 07/14/2021] [Accepted: 01/24/2022] [Indexed: 12/23/2022]
Abstract
Objective In routine oncological treatment settings, psychological distress, including mental disorders, is overlooked in 30% to 50% of patients. High workload and a constant need to optimise time and costs require a quick and easy method to identify patients likely to miss out on psychological support. Methods Using machine learning, factors associated with no consultation with a clinical psychologist or psychiatrist were identified between 2011 and 2019 in 7,318 oncological patients in a large cancer treatment centre. Parameters were hierarchically ordered based on statistical relevance. Nested resampling and cross validation were performed to avoid overfitting. Results Patients were least likely to receive psycho‐oncological (i.e., psychiatric/psychotherapeutic) treatment when they were not formally screened for distress, had inpatient treatment for less than 28 days, had no psychiatric diagnosis, were aged 65 or older, had skin cancer or were not being discussed in a tumour board. The final validated model was optimised to maximise sensitivity at 85.9% and achieved an area under the curve (AUC) of 0.75, a balanced accuracy of 68.5% and specificity of 51.2%. Conclusion Beyond conventional screening tools, results might contribute to identify patients at risk to be neglected in terms of referral to psycho‐oncology within routine oncological care.
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Affiliation(s)
- Moritz Philipp Günther
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Johannes Kirchebner
- Department of Forensic Psychiatry, University Hospital of Psychiatry Zurich, Zurich, Switzerland
| | - Jan Ben Schulze
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Roland von Känel
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Sebastian Euler
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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Qian CL, Kaslow-Zieve ER, Azoba CC, Horick N, Wang I, Van Seventer E, Newcomb R, Cashavelly BJ, Jackson VA, Ryan DP, Greer JA, El-Jawahri A, Temel JS, Nipp RD. Associations of patient-reported care satisfaction with symptom burden and healthcare use in hospitalized patients with cancer. Support Care Cancer 2022; 30:4527-4536. [PMID: 35112210 DOI: 10.1007/s00520-021-06764-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 12/14/2021] [Indexed: 01/27/2023]
Abstract
BACKGROUND Hospitalized patients with cancer often experience a high symptom burden, which may impact care satisfaction and healthcare utilization. METHODS We prospectively enrolled patients with cancer and unplanned hospitalizations from September 2014 to April 2017. Upon admission, we assessed patients' care satisfaction (FAMCARE items: satisfaction with care coordination and speed with which symptoms are treated) and physical (Edmonton Symptom Assessment System [ESAS]) and psychological (Patient Health Questionnaire-4 [PHQ-4]) symptoms. We used regression models to identify factors associated with care satisfaction and associations of satisfaction with symptom burden and hospital length of stay (LOS). RESULTS Among 1,576 participants, most reported being "satisfied"/ "very satisfied" with care coordination (90%) and speed with which symptoms are treated (89%). Older age (coordination: B < 0.01, P = 0.02, speed: B = 0.01, P < 0.01) and admission to a dedicated oncology service (B = 0.20, P < 0.01 for each) were associated with higher satisfaction. Higher satisfaction with care coordination was associated with lower ESAS-physical (B = - 1.28, P < 0.01), ESAS-total (B = - 2.73, P < 0.01), PHQ4-depression (B = - 0.14, P = 0.02), and PHQ4-anxiety (B = - 0.16, P < 0.01) symptoms. Higher satisfaction with speed with which symptoms are treated was associated with lower ESAS-physical (B = - 1.32, P < 0.01), ESAS-total (B = - 2.46, P < 0.01), PHQ4-depression (B = - 0.14, P = 0.01), and PHQ4-anxiety (B = - 0.17, P < 0.01) symptoms. Satisfaction with care coordination (B = - 0.48, P = 0.04) and speed with which symptoms are treated (B = - 0.44, P = 0.04) correlated with shorter LOS. CONCLUSIONS Hospitalized patients with cancer report high care satisfaction, which correlates with older age and admission to a dedicated oncology service. Significant associations among higher care satisfaction, lower symptom burden, and shorter hospital LOS highlight the importance of improving symptom management and care coordination in this population.
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Affiliation(s)
- Carolyn L Qian
- Department of Medicine, Division of Hematology & Oncology, Massachusetts General Hospital Cancer Center & Harvard Medical School, 55 Fruit St., Yawkey 7B, Boston, MA, USA
| | - Emilia R Kaslow-Zieve
- Department of Medicine, Division of Hematology & Oncology, Massachusetts General Hospital Cancer Center & Harvard Medical School, 55 Fruit St., Yawkey 7B, Boston, MA, USA
| | - Chinenye C Azoba
- Department of Medicine, Division of Hematology & Oncology, Massachusetts General Hospital Cancer Center & Harvard Medical School, 55 Fruit St., Yawkey 7B, Boston, MA, USA
| | - Nora Horick
- Department of Statistics, Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA
| | - Irene Wang
- Department of Medicine, Division of Hematology & Oncology, Massachusetts General Hospital Cancer Center & Harvard Medical School, 55 Fruit St., Yawkey 7B, Boston, MA, USA
| | - Emily Van Seventer
- Department of Medicine, Division of Hematology & Oncology, Massachusetts General Hospital Cancer Center & Harvard Medical School, 55 Fruit St., Yawkey 7B, Boston, MA, USA
| | - Richard Newcomb
- Department of Medicine, Division of Hematology & Oncology, Massachusetts General Hospital Cancer Center & Harvard Medical School, 55 Fruit St., Yawkey 7B, Boston, MA, USA
| | - Barbara J Cashavelly
- Department of Medicine, Division of Hematology & Oncology, Massachusetts General Hospital Cancer Center & Harvard Medical School, 55 Fruit St., Yawkey 7B, Boston, MA, USA
| | - Vicki A Jackson
- Department of Medicine, Division of Palliative Care, Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA
| | - David P Ryan
- Department of Medicine, Division of Hematology & Oncology, Massachusetts General Hospital Cancer Center & Harvard Medical School, 55 Fruit St., Yawkey 7B, Boston, MA, USA
| | - Joseph A Greer
- Department of Psychiatry, Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA
| | - Areej El-Jawahri
- Department of Medicine, Division of Hematology & Oncology, Massachusetts General Hospital Cancer Center & Harvard Medical School, 55 Fruit St., Yawkey 7B, Boston, MA, USA
| | - Jennifer S Temel
- Department of Medicine, Division of Hematology & Oncology, Massachusetts General Hospital Cancer Center & Harvard Medical School, 55 Fruit St., Yawkey 7B, Boston, MA, USA
| | - Ryan D Nipp
- Department of Medicine, Division of Hematology & Oncology, Massachusetts General Hospital Cancer Center & Harvard Medical School, 55 Fruit St., Yawkey 7B, Boston, MA, USA.
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11
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Myers B, Reddy V, Chan S, Thibodeaux Q, Brownstone N, Koo J. Optimizing doxepin therapy in dermatology: introducing blood level monitoring and genotype testing. J DERMATOL TREAT 2022; 33:87-93. [PMID: 32347140 DOI: 10.1080/09546634.2020.1762841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Doxepin, a tricyclic antidepressant, is the most efficacious antipruritic available to dermatologists; however its use is often suboptimal because of significant interindividual variability in doxepin plasma levels and clinical response between patients taking the same dose. As result, the Food and Drug Administration approves a maximum dose of 300 mg of doxepin per day and a 10 mg per cc liquid doxepin concentrate. These allow patients to significantly increase or decrease their dose, due to either a lack of clinical efficacy or side effects at typical dermatologic doses (often 10-25 mg per day). This review initially discusses the unique advantages of doxepin in dermatology. Then, it explores internal and external reasons why doxepin plasma levels and clinical response vary so significantly between patients, including genetic polymorphisms, drug interactions, comorbidities, sex, and ethnicity. Blood level monitoring is introduced, a tool dermatologists can use to optimize doxepin dosing in patients responding subtherapeutically to typical dermatologic doses. Without blood level monitoring, patients initially unresponsive to treatment could be labeled treatment failures when in fact they may be cases of inadequate dosing. Blood level monitoring allows for safe dose adjustments in these individuals to maximize patients' chances of achieving therapeutic success with this agent.
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Affiliation(s)
- Bridget Myers
- Dermatology, University of California, San Francisco, CA, USA
| | - Vidhatha Reddy
- Dermatology, University of California, San Francisco, CA, USA
| | - Stephanie Chan
- Dermatology, University of California, San Francisco, CA, USA
| | | | | | - John Koo
- Dermatology, University of California, San Francisco, CA, USA
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12
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Olsson S, Burström B, Hensing G, Löve J. Poorer mental well-being and prior unmet need for mental healthcare: a longitudinal population-based study on men in Sweden. ACTA ACUST UNITED AC 2021; 79:189. [PMID: 34732262 PMCID: PMC8564598 DOI: 10.1186/s13690-021-00706-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 10/07/2021] [Indexed: 11/10/2022]
Abstract
Background Depression and anxiety disorder contribute to a significant part of the disease burden among men, yet many men refrain from seeking care or receive insufficient care when they do seek it. This is plausibly associated with poorer mental well-being, but there is a lack of population-based research. This study investigated 1) if men who had refrained from seeking mental healthcare at any time in life had poorer mental well-being than those who sought care, 2) if those who had sought care but perceived it as insufficient had poorer mental well-being than those who had perceived care as sufficient, and 3) if these differences persisted after 1 year. Methods This longitudinal study used questionnaire data from a population-based sample of 1240 men, aged 19–64 years, in Sweden. Having refrained from seeking mental healthcare, or perceiving the care as insufficient, at any time in life, was assessed in a questionnaire, 2008. Current mental well-being was assessed in 2008 and 2009 using mean scores on the WHO (Ten) Well-being Index. Lower scores indicate poorer mental well-being. Group differences were calculated using t-tests and multivariable linear regression analysis. Results Of the men who had perceived a need for mental healthcare, 37% had refrained from seeking such care. They had lower mental well-being scores in 2008, compared to those who sought care. Of those seeking care, 29% had perceived it as insufficient. They had lower mental well-being scores in 2008, compared to those who perceived the care as sufficient, but this was not statistically significant when controlling for potential confounders. There were no differences in mental well-being scores based on care-seeking or perceived care-sufficiency in 2009. Conclusions This population-based study indicates that men who have previously refrained from seeking mental healthcare, or perceived the care as insufficient, have poorer mental well-being. However, the lack of differences at the one-year follow-up contradicts these results. The results highlight the need for larger longitudinal studies, measuring care-seeking within a more specified time frame. This should be combined with efforts to increase men’s mental healthcare-seeking and to provide mental healthcare that is perceived as sufficient. Supplementary Information The online version contains supplementary material available at 10.1186/s13690-021-00706-0.
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Affiliation(s)
- Sara Olsson
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Box 453, 405 30, Gothenburg, Sweden.
| | - Bo Burström
- Department of Global Public Health, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Gunnel Hensing
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Box 453, 405 30, Gothenburg, Sweden
| | - Jesper Löve
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Box 453, 405 30, Gothenburg, Sweden.
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13
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Alghofaili A, Alolayan S, Alhowail A, Mobark MA, Alderaibi S, Almogbel Y. The Effect of Depression on Treatment Adherence Among a Sample of Saudi Patients Diagnosed with Acne Vulgaris. Clin Cosmet Investig Dermatol 2021; 14:1497-1506. [PMID: 34675585 PMCID: PMC8523313 DOI: 10.2147/ccid.s335007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 10/01/2021] [Indexed: 11/23/2022]
Abstract
Purpose Acne vulgaris is an inflammatory disorder of the skin and is the most common dermatological disease, affecting all ages and races. Acne is known to be associated with depression. This study aimed to assess the impact of depression on patient adherence to acne vulgaris treatment using The Expectation Confirmation Theory (ECT). Patients and Methods This cross-sectional study was conducted with 204 patients with acne using four scales (depression, satisfaction, intention to adhere to acne medication, and control for confirmation). ECT scales were used to assess patient satisfaction and intention to adhere to medication. Demographic data were also collected, and descriptive and analytical statistical analyses were performed. Results A total of 204 questionnaires were completed. The mean age of the respondents was 25 ± 7.2. The majority were female; 167 (83.50%). Multiple linear regression analysis indicated a negative association between depression (β= −0.121, p = 0.033; 95% CI, −0.232 to −0.009) and satisfaction, when holding other variables constant, and the expected medication effect (confirmation) had a positive association with satisfaction (β= 0.334, p< 0.001; 95% CI, 0.202 to 0.466), keeping all other factors constant. Male sex was negatively associated with satisfaction (β= −2.388, p= 0.015; 95% CI −4.303 to −0.473), while keeping all other covariate sconstant. Residence in central provinces was a significant predictor of satisfaction (β= 2.562, p= 0.004; 95% CI, 0.832 to 4.292), when holding other factors constant. After conducting a simple linear regression, a positive significant association was found between adherence and satisfaction (β = 0.1713; 95% CI, 0.068 to 0.274). Conclusion Adherence is the cornerstone for a successful treatment plan and prevention of relapse or treatment failure, and satisfaction is an essential indicator for improving health policies and implementing social service provisions.
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Affiliation(s)
- Alanoud Alghofaili
- Department of Pharmacy Practice, College of Pharmacy, Qassim University, Buraidah, Qassim, 51452, Kingdom of Saudi Arabia
| | - Salma Alolayan
- Department of Pharmacy Practice, College of Pharmacy, Qassim University, Buraidah, Qassim, 51452, Kingdom of Saudi Arabia
| | - Ahmad Alhowail
- Department of Pharmacology and Toxicology, College of Pharmacy, Qassim University, Buraidah, Qassim, 51452, Kingdom of Saudi Arabia
| | - Mugahid A Mobark
- Department of Pharmacy Practice, College of Pharmacy, Qassim University, Buraidah, Qassim, 51452, Kingdom of Saudi Arabia
| | - Sulaiman Alderaibi
- Qassim Armed Forces Hospital, Buraidah, Qassim, 51442, Kingdom of Saudi Arabia
| | - Yasser Almogbel
- Department of Pharmacy Practice, College of Pharmacy, Qassim University, Buraidah, Qassim, 51452, Kingdom of Saudi Arabia
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14
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Benton JZ, Bergerot CD, Woodruff P, Williams SB, Wallis CJD, Klaassen Z. Mental health screening and diagnosis in cancer patients: Impact on mortality and suggestion of racial bias. Cancer 2021; 128:234-236. [PMID: 34550606 DOI: 10.1002/cncr.33901] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 08/14/2021] [Accepted: 08/18/2021] [Indexed: 11/08/2022]
Affiliation(s)
| | - Cristiane D Bergerot
- Centro de Cancer de Brasilia (CETTRO), Instituto Unity de Ensino e Pesquisa, Brasilia, DF, Brazil
| | - Phillip Woodruff
- St. George's University School of Medicine, St. George's, Grenada
| | - Stephen B Williams
- Division of Urology, The University of Texas Medical Brach at Galveston, Galveston, Texas
| | - Christopher J D Wallis
- Department of Urological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Zachary Klaassen
- Department of Surgery, Section of Urology, Medical College of Georgia-Augusta University, Augusta, Georgia.,Georgia Cancer Center, Augusta, Georgia
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15
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Günther MP, Schulze JB, Jellestad L, Mehnert-Theuerkauf A, von Känel R, Euler S. Mental disorders, length of hospitalization, and psychopharmacy-New approaches to identify barriers to psychological support for patients with cancer. Psychooncology 2021; 30:1773-1781. [PMID: 34089283 DOI: 10.1002/pon.5743] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 05/04/2021] [Accepted: 06/01/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND Despite abundant evidence that emotional distress is frequent in cancer patients and associated with adverse health outcomes, distress screening rates and adequate referrals to psychological support programs among those in need are insufficient in many cancer centers. We therefore aimed to analyze patient- and treatment-related barriers to distress screening and referrals to psychological support as a mandatory component of best-practice cancer care. METHOD In the present explorative study, latent class analysis was used to identify homogeneous subgroups among 4837 patients diagnosed with cancer between 2011 and 2019. RESULTS Four subgroups were identified. Patients with a mental disorder and psychopharmacology were least probable to be screened for distress. Together with patients aged 65 or older and male patients, they were also less likely to receive psychological support. Patients hospitalized for 28 days or longer were most likely to be both screened and to receive psychological support. CONCLUSIONS Clinicians and researchers are recommended not neglect patients with mental disorders and psychopharmacological treatment as well as male and elderly patients when screening for distress and providing access to psychological support.
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Affiliation(s)
- Moritz Philipp Günther
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Jan Ben Schulze
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Lena Jellestad
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Anja Mehnert-Theuerkauf
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
| | - Roland von Känel
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Sebastian Euler
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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16
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Tian X, Jin Y, Tang L, Pi YP, Chen WQ, Jiménez-Herrera MF. Predicting the Risk of Psychological Distress among Lung Cancer Patients: Development and Validation of a Predictive Algorithm Based on Sociodemographic and Clinical Factors. Asia Pac J Oncol Nurs 2021; 8:403-412. [PMID: 34159233 PMCID: PMC8186387 DOI: 10.4103/apjon.apjon-2114] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 04/05/2021] [Indexed: 12/25/2022] Open
Abstract
Objective Lung cancer patients reported the highest incidence of psychological distress. It is extremely important to identify which patients at high risk for psychological distress. The study aims to develop and validate a predictive algorithm to identify lung cancer patients at high risk for psychological distress. Methods This cross-sectional study identified the risk factors of psychological distress in lung cancer patients. Data on sociodemographic and clinical variables were collected from September 2018 to August 2019. Structural equation model (SEM) was conducted to determine the associations between all factors and psychological distress, and then construct a predictive algorithm. Coincidence rate was also calculated to validate this predictive algorithm. Results Total 441 participants sent back validated questionnaires. After performing SEM analysis, educational level (β = 0.151, P = 0.004), residence (β = 0.146, P = 0.016), metastasis (β = 0.136, P = 0.023), pain degree (β = 0.133, P = 0.005), family history (β = -0.107, P = 0.021), and tumor, node, and metastasis stage (β = -0.236, P < 0.001) were independent predictors for psychological distress. The model built with these predictors showed an area under the curve of 0.693. A cutoff of 66 predicted clinically significant psychological distress with a sensitivity, specificity, positive predictive value, and negative predictive value of 65.41%, 66.90%, 28.33%, and 89.67%, respectively. The coincidence rate between predictive algorithm and distress thermometer was 64.63%. Conclusions A validated, easy-to-use predictive algorithm was developed in this study, which can be used to identify patients at high risk of psychological distress with moderate accuracy.
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Affiliation(s)
- Xu Tian
- Department of Nursing, Rovira I Virgili University, Tarragona, Spain.,Department of Gastroenterology, Chongqing University Cancer Hospital, Chongqing, China
| | - Yanfei Jin
- Department of Nursing, Rovira I Virgili University, Tarragona, Spain
| | - Ling Tang
- Department of Gastroenterology, Chongqing University Cancer Hospital, Chongqing, China
| | - Yuan-Ping Pi
- Department of Gastroenterology, Chongqing University Cancer Hospital, Chongqing, China
| | - Wei-Qing Chen
- Department of Gastroenterology, Chongqing University Cancer Hospital, Chongqing, China
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17
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Paro A, Hyer JM, Pawlik T. Association of Depression with In-Patient and Post-Discharge Disposition and Expenditures Among Medicare Beneficiaries Undergoing Resection for Cancer. Ann Surg Oncol 2021; 28:6525-6534. [PMID: 33748892 DOI: 10.1245/s10434-021-09838-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 02/24/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND The impact of depression on utilization of post-discharge care and overall episode of care expenditures remains poorly defined. We sought to define the impact of depression on postoperative outcomes, including discharge disposition, as well as overall expenditures associated with the global episode of surgical care. METHOD The Medicare 100% Standard Analytic Files were used to identify patients undergoing resection for esophageal, colon, rectal, pancreatic, and liver cancer between 2013 and 2017. The impact of depression on inpatient outcomes, as well as home health care and skilled nursing facilities utilization and expenditures, was analyzed. RESULTS Among 113,263 patients, 14,618 (12.9%) individuals had depression. Patients with depression were more likely to experience postoperative complications (odds ratio [OR] 1.36, 95% confidence interval [CI] 1.31-1.42), extended length of stay (LOS) (OR 1.41, 95% CI 1.36-1.47), readmission within 90 days (OR 1.20, 95% CI 1.14-1.25), as well as 90-day mortality (OR 1.35, 95% CI 1.27-1.42) (all p < 0.05). In turn, the proportion of patients who achieved a textbook outcome following cancer surgery was lower among patients with depression (no depression: 53.3% vs. depression: 45.3%; OR 0.70, 95% CI 0.68-0.73). Patients with a preexisting diagnosis of depression had higher odds of additional post-discharge expenditures compared with individuals without a diagnosis of depression (OR 1.42; 95% CI 1.35-1.50); patients with a preexisting diagnosis of depression ($10,500, IQR $3,200-$22,500) had higher median post-discharge expenditures versus patients without depression ($6600, IQR $2100-$17,400) (p < 0.001). On multivariable analysis, after controlling for other factors, depression remained associated with a 19.0% (95% confidence interval [CI] 15.7-22.3%) increase in post-discharge expenditures. CONCLUSIONS Patients with depression undergoing resection for cancer had worse in-patient outcomes and were less likely to achieve a TO. Patients with depression were more likely to require post-discharge care and had higher post-discharge expenditures.
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Affiliation(s)
- Alessandro Paro
- Department of Surgery, Wexner Medical Center and James Cancer Hospital and Solove Research Institute, The Ohio State University, Columbus, OH, USA
| | - J Madison Hyer
- Department of Surgery, Wexner Medical Center and James Cancer Hospital and Solove Research Institute, The Ohio State University, Columbus, OH, USA
| | - Timothy Pawlik
- Department of Surgery, Wexner Medical Center and James Cancer Hospital and Solove Research Institute, The Ohio State University, Columbus, OH, USA. .,Department of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, The Ohio State University, Wexner Medical Center, Columbus, USA.
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18
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Tian X, Jin Y, Chen H, Tang L, Jiménez‐Herrera MF. The positive effect of social support on psychological distress among Chinese lung cancer patients: The mediating role of self-esteem. Nurs Open 2021; 8:1642-1651. [PMID: 33599393 PMCID: PMC8186711 DOI: 10.1002/nop2.793] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 12/10/2020] [Accepted: 01/29/2021] [Indexed: 12/25/2022] Open
Abstract
AIM To investigate the effect of social support on psychological distress among Chinese lung cancer patients and clarify the mediating role of self-esteem. DESIGN A cross-sectional descriptive correlational survey of 441 Chinese lung cancer patients was designed. METHODS Self-esteem was supposed to play a mediating role in the association between social support and psychological distress. We collected demographic information, the Distress Thermometer, Multidimensional Scale of Perceived Social Support and Rosenberg Self-Esteem Scale. RESULTS Our revised model demonstrated an acceptable fit to the data (χ2 = 37.489, comparative fit index (CFI) = 0.965, Tucker-Lewis index (TLI) = 0.926, root mean square error of approximation [RMSEA] = 0.099). Social support had a direct effect on self-esteem and psychological distress, and self-esteem had also a direct effect on psychological distress. Meanwhile, self-esteem also partially mediated the relationship between social support and psychological distress among Chinese lung cancer patients.
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Affiliation(s)
- Xu Tian
- Nursing DepartmentUniversitat Rovira i VirgiliTarragonaSpain
- Department of GastroenterologyChongqing University Cancer HospitalSchool of MedicineChongqing UniversityChongqingChina
| | - Yanfei Jin
- Nursing DepartmentUniversitat Rovira i VirgiliTarragonaSpain
| | - Hui Chen
- Department of GastroenterologyChongqing University Cancer HospitalSchool of MedicineChongqing UniversityChongqingChina
| | - Ling Tang
- Department of NursingChongqing University Cancer HospitalSchool of MedicineChongqing UniversityChongqingChina
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19
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Tian X, Jin Y, Chen H, Tang L, Jiménez-Herrera MF. Relationships among Social Support, Coping Style, Perceived Stress, and Psychological Distress in Chinese Lung Cancer Patients. Asia Pac J Oncol Nurs 2021; 8:172-179. [PMID: 33688566 PMCID: PMC7934593 DOI: 10.4103/apjon.apjon_59_20] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Accepted: 09/29/2020] [Indexed: 12/24/2022] Open
Abstract
Objective: Social support is associated with improved psychological distress in cancer patients. This study investigates the impact of social support on Chinese lung cancer patients' psychological distress and further clarifies the mediating role of perceived stress and coping style. Methods: A cross-sectional survey study examined social support and psychological distress in 441 patients diagnosed with lung cancer from seven hospitals in Chongqing, China, between September 2018 and August 2019. Coping style and perceived stress were considered to be potential mediators of adjustment outcomes. Results: We found a detection rate of 17.7% for psychological distress among Chinese lung cancer patients. Social support was in significantly negative association with psychological distress, which was partially mediated by confrontation coping and perceived stress. Conclusions: Social support appears to contribute to ameliorate psychological distress by enhancing confrontation coping with cancer and enhancing perceived stress. There is a need for the development and evaluation of psychological intervention program to enhance the buffering effects of social support in lung cancer patients.
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Affiliation(s)
- Xu Tian
- Department of Nursing, Faculty of Nursing, Rovira I Virgili University, Tarragona, Spain.,Department of Gastroenterology, Chongqing University Cancer Hospital, School of Medicine, Chongqing, China
| | - Yanfei Jin
- Department of Nursing, Faculty of Nursing, Rovira I Virgili University, Tarragona, Spain
| | - Hui Chen
- Department of Gastroenterology, Chongqing University Cancer Hospital, School of Medicine, Chongqing, China
| | - Ling Tang
- Department of Nursing, Chongqing University Cancer Hospital, School of Medicine, Chongqing, China
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20
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Hernández-Marín JE, Galindo-Vázquez O, Costas-Muñíz R, Cabrera-Galeana P, Caballero-Tinoco MDR, Aguilar-Ponce JL, Lerma A. Validation of an instrument to assess health care quality (FACIT-TS-PS) in cancer patients. GAC MED MEX 2020; 156:397-404. [PMID: 33372920 DOI: 10.24875/gmm.m20000427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Introduction Cancer patient satisfaction with the healthcare team is of great relevance for assessing the quality of the care provided by the health system. In Mexico, no valid and reliable tool is available to assess this construct. Objective To validate the Functional Assessment of Chronic Illness Therapy-Treatment Satisfaction-Patient Satisfaction (FACIT-TS-PS) instrument, version 4, in cancer patients. Method Cross-sectional design, non-probability convenience sampling. The sample consisted of 200 cancer-diagnosed patients, with mean age of 45.86 ± 15.01 years. Exploratory and confirmatory factor analyses were conducted. Results The exploratory factor analysis identified four factors, with a Cronbach alpha of 0.945, and an explained variance of 68.15 %. The confirmatory factor analysis indicated that the proposed theoretical model adjusts to the data with an error close to zero and, in addition, it is balanced and carefully measures overall patient satisfaction with the treatment. Conclusion FACIT-TS-PS was shown to be a valid and reliable instrument for use in clinical care and research in Mexican cancer patients. Its use is recommended in the evaluation of oncology multidisciplinary healthcare teams in Mexico.
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Affiliation(s)
| | | | - Rosario Costas-Muñíz
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, United States of America
| | - Paula Cabrera-Galeana
- Medical Oncology Department Head Office, Instituto Nacional de Cancerología. Mexico City, Mexico
| | | | - José L Aguilar-Ponce
- Medical Oncology Department, Instituto Nacional de Cancerología. Mexico City, Mexico
| | - Abel Lerma
- Institute of Health Sciences, Universidad Autónoma del Estado de Hidalgo, Hidalgo, Mexico
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Granek L, Nakash O, Ariad S, Shapira S, Ben-David M. Strategies and Barriers in Addressing Mental Health and Suicidality in Patients With Cancer. Oncol Nurs Forum 2020; 46:561-571. [PMID: 31424452 DOI: 10.1188/19.onf.561-571] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To identify how oncology nurses address mental health distress and suicidality in patients, what strategies they employ in treating this distress, and the barriers they face in addressing distress and suicidality in patients with cancer. PARTICIPANTS & SETTING 20 oncology nurses at two cancer centers in Israel were interviewed. METHODOLOGIC APPROACH The grounded theory method of data collection and analysis was employed. FINDINGS Strategies used in addressing patients' mental health distress were being emotionally available, providing practical support, treating physical symptoms, and referring to counseling. Strategies in addressing suicidality were assessing the situation, offering end-of-life or palliative care, treating physical symptoms, and referring for assessment. Barriers to addressing distress were lack of training, stigma, workload or lack of time, and limited availability and accessibility of mental health resources. Barriers in addressing suicidality were lack of knowledge and training, patient reluctance to receive care, and lack of protocol. IMPLICATIONS FOR NURSING Developing guidelines for addressing and responding to mental health distress and suicidality is essential to improving patients' quality of life and reducing disease-related morbidity and mortality. Reducing mental healthcare stigma for patients is critical.
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Laranja WW, Pereira TA, Guimarães PVB, Tobias-Machado M, Leandro-Merhi VA, de Aquino JLB, Reis LO. Do rapid emotional thermometers correlate with multidimensional validated structured questionnaires in low-risk prostate cancer? Int Urol Nephrol 2020; 52:1073-1078. [PMID: 32056135 DOI: 10.1007/s11255-020-02399-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 01/30/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE To promptly identify mental suffering in low-risk prostate cancer (LRPC) patients, vulnerable to over- and undertreatment, we evaluated the correlation of rapid emotional thermometers (ET) with multidimensional validated structured questionnaires. METHODS At diagnosis, consecutive LRPC patients underwent five ET domains: emotional suffering, anxiety, depression (DT), revolt and need for help and multidimensional questionnaires: beck anxiety inventory (BAI), beck depression inventory (BDI), beck hopelessness scale, SF36 (physical functioning PF, role limitations due to physical health RP, bodily pain BP, general health perceptions GH, vitality VT, social functioning SF, role limitations due to emotional problems RE and general mental health MH), international index of erectile function and international prostate symptom score (IPSS). RESULTS Among 30 included patients, mean age 67.4 y (52-74), 20 days after the diagnosis (15-30), mean time to obtain ET 27 s (15-57) and all questionnaires 36.7 min (31-49), ETs showed moderate/strong Spearman correlation among themselves. DT domain displayed the best correlation to most of the multidimensional validated structured questionnaires: moderate to BDI, SF-36 (PF, GH, VT, SF, RE, MH) and IPSS and strong to BAI. CONCLUSION DT revealed the best correlation to validated structured questionnaires of diverse dimensions with clear potential for quick screening of patients with psychological suffering and in need of further evaluation and support.
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Affiliation(s)
- Walker Wendell Laranja
- UroScience, University of Campinas and Pontifical Catholic University of Campinas, Campinas, SP, Brazil
| | - Thairo Alves Pereira
- UroScience, University of Campinas and Pontifical Catholic University of Campinas, Campinas, SP, Brazil
| | | | - Marcos Tobias-Machado
- UroScience, University of Campinas and Pontifical Catholic University of Campinas, Campinas, SP, Brazil
| | | | - José Luis Braga de Aquino
- UroScience, University of Campinas and Pontifical Catholic University of Campinas, Campinas, SP, Brazil
| | - Leonardo Oliveira Reis
- UroScience, University of Campinas and Pontifical Catholic University of Campinas, Campinas, SP, Brazil.
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Brown SL, Hughes M, Campbell S, Cherry MG. Could worry and rumination mediate relationships between self‐compassion and psychological distress in breast cancer survivors? Clin Psychol Psychother 2019; 27:1-10. [DOI: 10.1002/cpp.2399] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Revised: 09/06/2019] [Accepted: 09/06/2019] [Indexed: 11/07/2022]
Affiliation(s)
- Stephen L. Brown
- Department of Psychological Sciences University of Liverpool Liverpool UK
| | - Maria Hughes
- Department of Psychological Sciences University of Liverpool Liverpool UK
| | - Sophie Campbell
- Department of Psychological Sciences University of Liverpool Liverpool UK
| | - M. Gemma Cherry
- Department of Psychological Sciences University of Liverpool Liverpool UK
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24
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Association of Depression Risk with Patient Experience, Healthcare Expenditure, and Health Resource Utilization Among Adults with Atherosclerotic Cardiovascular Disease. J Gen Intern Med 2019; 34:2427-2434. [PMID: 31489560 PMCID: PMC6848728 DOI: 10.1007/s11606-019-05325-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 03/29/2019] [Accepted: 08/07/2019] [Indexed: 01/14/2023]
Abstract
BACKGROUND Approximately 20% of patients with atherosclerotic cardiovascular disease (ASCVD) suffer from depression. OBJECTIVE To compare healthcare expenditures and utilization, healthcare-related quality of life, and patient-centered outcomes among ASCVD patients, based on their risk for depression (among those without depression), and those with depression (vs. risk-stratified non-depressed). DESIGN AND SETTING The 2004-2015 Medical Expenditure Panel Survey (MEPS) was used for this study. PARTICIPANTS Adults ≥ 18 years with a diagnosis of ASCVD, ascertained by ICD-9 codes and/or self-reported data. Individuals with a diagnosis of depression were identified by ICD-9 code 311. Participants were stratified by depression risk, based on the Patient Health Questionnaire-2. RESULTS A total of 19,840 participants were included, translating into 18.3 million US adults, of which 8.6% (≈ 1.3 million US adults) had a high risk for depression and 18% had a clinical diagnosis of depression. Among ASCVD patients without depression, those with a high risk (compared with low risk) had increased overall and out-of-pocket expenditures (marginal differences of $2880 and $287, respectively, both p < 0.001), higher odds for resource utilization, and worse patient experience and healthcare quality of life (HQoL). Furthermore, compared with individuals who had depression, participants at high risk also reported worse HQoL and had higher odds of poor perception of their health status (OR 1.83, 95% CI [1.50, 2.23]) and poor patient-provider communication (OR 1.29 [1.18, 1.42]). LIMITATION The sample population includes self-reported diagnosis of ASCVD; therefore, the risk of underestimation of the cohort size cannot be ruled out. CONCLUSION Almost 1 in 10 individuals with ASCVD without diagnosis of depression is at high risk for it and has worse health outcomes compared with those who already have a diagnosis of depression. Early recognition and treatment of depression may increase healthcare efficiency, positive patient experience, and HQoL among this vulnerable population.
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25
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Validity and Reliability of the Persian Version of Emotion Thermometers in Iranian Advanced Cancer Patients. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT 2019. [DOI: 10.5812/ijcm.90504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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26
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Partridge JSL, Crichton S, Biswell E, Harari D, Martin FC, Dhesi JK. Measuring the distress related to delirium in older surgical patients and their relatives. Int J Geriatr Psychiatry 2019; 34:1070-1077. [PMID: 30945343 DOI: 10.1002/gps.5110] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 03/24/2019] [Indexed: 11/11/2022]
Abstract
OBJECTIVES Delirium is a common postoperative complication with implications on morbidity and mortality. Less is known about the psychological impact of delirium in patients and relatives. This study aimed to quantitatively describe distress related to postoperative delirium in older surgical patients and their relatives using the distress thermometer, examine the association between degree of distress and features of delirium on the Delirium Rating Scale (DRS), and examine the association between recall of delirium and features of delirium on the DRS. METHODS This prospective study recruited postoperative patients and their relatives following delirium. The distress thermometer was used to examine the degree of distress pertaining to delirium and was conducted during the hospitalization on resolution of delirium and then at 12-month follow-up. Associations between delirium-related distress in patient and relative participants and severity and features of delirium (DRS) were examined. RESULTS One hundred two patients and 49 relatives were recruited. Median scores on the distress thermometer in patients who recalled delirium were 8/10. Relatives also showed distress (median distress thermometer score of 8/10). Associations were observed between severity and phenotypic features of delirium (delusions, labile affect, and agitation). Distress persisted at 12 months in patients and relatives. CONCLUSION Distress related to postoperative delirium can be measured using a distress thermometer. Alongside approaches to reduce delirium incidence, interventions to minimize distress from postoperative delirium should be sought. Such interventions should be developed through robust research and if effective administered to patients, relatives, or carers.
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Affiliation(s)
- Judith S L Partridge
- Department of Health and Ageing, Guy's and St Thomas' NHS Foundation Trust, Older Persons Assessment Unit, Ground Floor Bermondsey Wing, Guy's Hospital, London, UK.,Primary Care and Public Health Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | | | - Elizabeth Biswell
- Department of Health and Ageing, Guy's and St Thomas' NHS Foundation Trust, Older Persons Assessment Unit, Ground Floor Bermondsey Wing, Guy's Hospital, London, UK
| | - Danielle Harari
- Department of Health and Ageing, Guy's and St Thomas' NHS Foundation Trust, Older Persons Assessment Unit, Ground Floor Bermondsey Wing, Guy's Hospital, London, UK.,Primary Care and Public Health Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | | | - Jugdeep K Dhesi
- Department of Health and Ageing, Guy's and St Thomas' NHS Foundation Trust, Older Persons Assessment Unit, Ground Floor Bermondsey Wing, Guy's Hospital, London, UK.,Primary Care and Public Health Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
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27
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Erim DO, Bensen JT, Mohler JL, Fontham ETH, Song L, Farnan L, Delacroix SE, Peters ES, Erim TN, Chen RC, Gaynes BN. Prevalence and predictors of probable depression in prostate cancer survivors. Cancer 2019; 125:3418-3427. [PMID: 31246284 DOI: 10.1002/cncr.32338] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 05/12/2019] [Accepted: 05/14/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND The early diagnosis and treatment of depression are cancer care priorities. These priorities are critical for prostate cancer survivors because men rarely seek mental health care. However, little is known about the epidemiology of depression in this patient population. The goal of this study was to describe the prevalence and predictors of probable depression in prostate cancer survivors. METHODS The data were from a population-based cohort of North Carolinian prostate cancer survivors who were enrolled from 2004 to 2007 in the North Carolina-Louisiana Prostate Cancer Project (n = 1031) and were prospectively followed annually from 2008 to 2011 in the Health Care Access and Prostate Cancer Treatment in North Carolina study (n = 805). Generalized estimating equations were used to evaluate an indicator of probable depression (Short Form 12 mental composite score ≤48.9; measured at enrollment and during the annual follow-up) as a function of individual-level characteristics within the longitudinal data set. RESULTS The prevalence of probable depression fell from 38% in the year of the cancer diagnosis to 20% 6 to 7 years later. Risk factors for probable depression throughout the study were African American race, unemployment, low annual income, younger age, recency of cancer diagnosis, past depression, comorbidities, treatment decisional regret, and nonadherence to exercise recommendations. CONCLUSIONS Depression is a major challenge for prostate cancer survivors, particularly in the first 5 years after the cancer diagnosis. To the authors' knowledge, this is the first study to demonstrate an association between treatment decisional regret and probable depression.
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Affiliation(s)
- Daniel O Erim
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina.,RTI International, Research Triangle Park, North Carolina
| | - Jeannette T Bensen
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina.,Lineberger Comprehensive Cancer Center, School of Medicine, University of North Carolina, Chapel Hill, North Carolina
| | - James L Mohler
- Department of Urology, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Elizabeth T H Fontham
- School of Public Health, Louisiana State University Health Sciences Center, New Orleans, Louisiana
| | - Lixin Song
- Lineberger Comprehensive Cancer Center, School of Medicine, University of North Carolina, Chapel Hill, North Carolina.,School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Laura Farnan
- Lineberger Comprehensive Cancer Center, School of Medicine, University of North Carolina, Chapel Hill, North Carolina
| | - Scott E Delacroix
- Department of Urology, Louisiana State University, New Orleans, Louisiana
| | - Edward S Peters
- School of Public Health, Louisiana State University Health Sciences Center, New Orleans, Louisiana
| | | | - Ronald C Chen
- Lineberger Comprehensive Cancer Center, School of Medicine, University of North Carolina, Chapel Hill, North Carolina.,Department of Radiation Oncology, University of North Carolina, Chapel Hill, North Carolina
| | - Bradley N Gaynes
- Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina
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28
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Roomaney R, Kagee A, Heylen S. Biopsychosocial predictors of symptoms of depression in a sample of South African women diagnosed with endometriosis. Health Care Women Int 2019; 41:308-329. [PMID: 31242076 DOI: 10.1080/07399332.2019.1624758] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
We examined biopsychosocial predictors of symptoms of depression in women with endometriosis. The sample consisted of 202 women with endometriosis who completed a battery of measures including a demographic questionnaire, Beck Depression Inventory, Stellenbosch Endometriosis Quality of life Menstrual characteristics subscale, Short form health survey Physical functioning subscale, and three modular components of the Endometriosis Health Profile 30, namely the Sexual Relationships, Feelings about the Medical Profession, and Feelings about Infertility modules. About 43.1% of the sample reported moderate to severe symptoms of depression. Physical functioning, feelings about the medical profession and sexual relationships were significant predictors of symptoms of depression. The identification of these predictors may enable researchers and practitioners to identify patients to be screened for depression, e.g., patients who report sub-optimal physical functioning, negative feelings about the medical profession and difficult sexual relationships.
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Affiliation(s)
- Rizwana Roomaney
- Department of Psychology, Stellenbosch University, Matieland, South Africa
| | - Ashraf Kagee
- Department of Psychology, Stellenbosch University, Matieland, South Africa
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29
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Erim DO, Bensen JT, Mohler JL, Fontham ETH, Song L, Farnan L, Delacroix SE, Peters ES, Erim TN, Chen RC, Gaynes BN. Patterns and predictors of self-reported clinical diagnosis and treatment for depression in prostate cancer survivors. Cancer Med 2019; 8:3648-3658. [PMID: 31106980 PMCID: PMC6639178 DOI: 10.1002/cam4.2239] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 04/22/2019] [Accepted: 04/27/2019] [Indexed: 12/18/2022] Open
Abstract
Background Appropriate depression care is a cancer‐care priority. However, many cancer survivors live with undiagnosed and untreated depression. Prostate cancer survivors may be particularly vulnerable, but little is known about their access to depression care. The goal of this study was to describe patterns and predictors of clinical diagnosis and treatment of depression in prostate cancer survivors. Methods Generalized estimating equations were used to evaluate indicators of self‐reported clinical diagnosis and treatment depression as a function of individual‐level characteristics within a longitudinal dataset. The data were from a population‐based cohort of North Carolinian prostate cancer survivors who were enrolled from 2004 to 2007 on the North Carolina‐Louisiana Prostate Cancer Project (N = 1,031), and prospectively followed annually from 2008 to 2011 on the Health Care Access and Prostate Cancer Treatment in North Carolina (N = 805). Results The average rate of self‐reported clinical diagnosis of depression was 44% (95% CI: 39%‐49%), which declined from 60% to 40% between prostate cancer diagnosis and 5‐7 years later. Factors associated with lower odds of self‐reported clinical diagnosis of depression include African‐American race, employment, age at enrollment, low education, infrequent primary care visits, and living with a prostate cancer diagnosis for more than 2 years. The average rate of self‐reported depression treatment was 62% (95% CI: 55%‐69%). Factors associated with lower odds of self‐reported depression treatment included employment and living with a prostate cancer diagnosis for 2 or more years. Conclusion Prostate cancer survivors experience barriers when in need of depression care.
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Affiliation(s)
- Daniel O Erim
- Department of Health Policy and Management, Gillings School of Global Public Health, the University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.,RTI International, Research Triangle Park, North Carolina
| | - Jeannette T Bensen
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina.,Lineberger Comprehensive Cancer Center, School of Medicine, University of North Carolina, Chapel Hill, North Carolina
| | - James L Mohler
- Department of Urology, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Elizabeth T H Fontham
- Louisiana State University Health Sciences Center, School of Public Health, New Orleans, Louisiana
| | - Lixin Song
- Lineberger Comprehensive Cancer Center, School of Medicine, University of North Carolina, Chapel Hill, North Carolina.,School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Laura Farnan
- Lineberger Comprehensive Cancer Center, School of Medicine, University of North Carolina, Chapel Hill, North Carolina
| | - Scott E Delacroix
- Department of Urology, Louisiana State University, New Orleans, Louisiana
| | - Edward S Peters
- Louisiana State University Health Sciences Center, School of Public Health, New Orleans, Louisiana
| | | | - Ronald C Chen
- Lineberger Comprehensive Cancer Center, School of Medicine, University of North Carolina, Chapel Hill, North Carolina.,Department of Radiation Oncology, University of North Carolina, Chapel Hill, North Carolina
| | - Bradley N Gaynes
- Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina
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30
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Merluzzi TV, Chirico A, Serpentini S, Yang M, Philip EJ. The role of coping in the relationship between stressful life events and quality of life in persons with cancer. Psychol Health 2019; 34:497-513. [PMID: 30632798 DOI: 10.1080/08870446.2018.1545905] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Stressful life events (SLEs) impact the quality of life (QOL) of cancer patients. This study investigated the mediation of the relationship between SLEs and QOL (Model 1: Emotional-EQOL and Model 2: Physical/Functional-PFQOL by three types of coping: Action/Planning, Support/Advise-Seeking, and Disengagement/Denial). Design and Main Measures: 662 persons with cancer completed a Stressful Life Events Checklist, the Brief COPE scale, the FACT Emotional, Physical, and Functional Scales, and the Physical Impact Scale of the Sickness Impact Profile. RESULTS SLEs were positively associated with Action/Planning (Model 1: B = 0.195, 95% CI = [0.089, 0.304]; Model 2: B = 0.192, 95% CI = [0.086, 0.289]) and Disengagement/Denial (Model 1: B = 0.394, 95% CI = [0.281, 0.513]; Model 2: B = .392, 95% CI = [0.285, 0.508]) but not Support/Advice-Seeking; however, only Disengagement/Denial was related to Emotional-QOL (Model 1: B = -0.659, 95% CI = [-0.848, -0.498]) and Physical/Functional-QOL (Model 2: B = -1.460, 95% CI = [-1.856, -1.069]). Thus, only Disengagement/Denial mediated the relationship between SLEs and QOL. CONCLUSIONS The results indicated that SLEs represent a class of events for which there may be only one dominant coping response, disengagement. SLEs may not be controllable or predictable and reduce capacity for active coping with serious illness. However, SLEs may be detected at any point in the cancer trajectory so that supportive services might be provided.
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Affiliation(s)
- Thomas V Merluzzi
- a Department of Psychology , University of Notre Dame , Notre Dame , IN , USA
| | - Andrea Chirico
- b Department of Psychology of Developmental and Socialization Processes , 'Sapienza' University of Rome , Roma , Italy
| | | | - Miao Yang
- a Department of Psychology , University of Notre Dame , Notre Dame , IN , USA
| | - Errol J Philip
- d Laboratory for Psychooncology Research , University of Notre Dame , Notre Dame , IN , USA
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Patient satisfaction with primary healthcare services: are there any links with patients' symptoms of anxiety and depression? BMC FAMILY PRACTICE 2018; 19:90. [PMID: 29921234 PMCID: PMC6009850 DOI: 10.1186/s12875-018-0780-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 05/25/2018] [Indexed: 11/25/2022]
Abstract
Background The aim of our study was to determine the association of anxiety and depression symptoms, as well as the main socio-demographic factors, with patients’ satisfaction with primary healthcare services. Methods The respondents were asked to fill out an anonymous questionnaire that included information on the patients’ gender, age, place of residence, education, ethnicity, the type of clinic they visited and the presence of chronic diseases. Patient satisfaction was evaluated by using a short version of the Patient Satisfaction Questionnaire. We also used the Hospital Anxiety and Depression Scale. Results Poor evaluations of primary healthcare services were more characteristic of males, older patients, those living in district centres and villages, individuals with lower (secondary or lower) education levels, respondents of Russian ethnicity (compared to Lithuanian), patients with chronic diseases and higher anxiety and depression symptom scores. In the final regression analysis, better satisfaction with primary healthcare services was observed in respondents who were less depressed, of Polish ethnicity and who were living in a city rather than a village. Conclusions Being more depressed or anxious, living in the district centre or countryside related to patients’ worse satisfaction with primary healthcare services. The results of nationality of patients and their satisfaction are ambiguous. The is strong correlation between the symptoms of depression and anxiety.
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Draeger DL, Sievert KD, Hakenberg OW. Analysis of psychosocial stress factors in patients with renal cancer. Ther Adv Urol 2018; 10:175-182. [PMID: 29899758 PMCID: PMC5993071 DOI: 10.1177/1756287218754766] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 12/31/2017] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The experience of stress in patients with cancer through helplessness and the suppression of emotions correlates with unfavorable disease prognosis. Significant distress can reduce survival probability as well as subjectively perceived poor quality of life. Currently, there are few data on psychological stress in patients with renal cancer and most studies focus on survival time. The aim of the study was to evaluate the psychosocial stress of patients with renal cancer with screening questionnaires for an inpatient psychosocial treatment program. METHODS Patients undergoing inpatient surgical or medical treatment for renal cancer were prospectively assessed for psychosocial stress with two standardized stress screening questionnaires used for the identification of the need for psychosocial care [NCCN Distress Thermometer (NCCN-DT), Hornheider Screening Instrument (HSI)]. RESULTS Seventy-four patients with a mean age of 65 years were assessed. The average NCCN-DT score was 4.8 (scale of 0-10) and did not correlate with tumor stage, sex or prognosis. According to the DT results, 27% of patients were in need of psychosocial care which was significantly higher than the self-reported need. The main stressors were anxiety (32%), pain (27%), nervousness (26%), sadness, worry and sleeping difficulties (20%). CONCLUSIONS There is a significant number of patients with renal cancer with increased psychological distress and a consecutive need for psychosocial care. This is underreported and largely unrecognized by patients as well as physicians and nurses. Easy-to-use assessment tools can be very helpful in identifying patients in need and this information can be used to implement psychological support and thus improve patient care.
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Affiliation(s)
- Désirée Louise Draeger
- Department of Urology, University of Rostock, Ernst-Heydemann-Strasse 6, Schillingallee 35, 18057 Rostock, Germany
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Granek L, Nakash O, Ariad S, Shapira S, Ben-David M. Oncologists' identification of mental health distress in cancer patients: Strategies and barriers. Eur J Cancer Care (Engl) 2018; 27:e12835. [PMID: 29508452 DOI: 10.1111/ecc.12835] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2018] [Indexed: 11/30/2022]
Abstract
The purpose of this research was to examine oncologists' perspectives on indicators of mental health distress in patients: what strategies they use to identify these indicators, and what barriers they face in this task. Twenty-three oncologists were interviewed, and the grounded theory method of data collection and analysis was used. Oncologists perceived distress to be a normative part of having cancer and looked for affective, physical, verbal and behavioural indicators using a number of strategies. Barriers to identification of mental health distress included difficulty in differentiating between mental health distress and symptoms of the disease, and lack of training. A systematic, time-efficient assessment of symptoms of emotional distress is critical for identification of psychiatric disorders among patients and differentiating normative emotional responses from psychopathology. Clinical bias and misdiagnosis can be a consequence of an ad hoc, intuitive approach to assessment, which can have consequences for patients and their families. Once elevated risk is identified for mental health distress, the patient can be referred to specialised care that can offer evidence-based treatments.
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Affiliation(s)
- L Granek
- Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - O Nakash
- Baruch Ivcher School of Psychology, Interdisciplinary Center, Herzilya, Israel
| | - S Ariad
- Department of Oncology, Soroka University Medical Center, Ben- Gurion University of the Negev, Beer Sheva, Israel
| | - S Shapira
- Department of Gender Studies, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - M Ben-David
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.,Radiation Oncology Department, Sheba Medical Center, Ramat-Gan, Israel
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34
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Lam WWT, Kwong A, Suen D, Tsang J, Soong I, Yau TK, Yeo W, Suen J, Ho WM, Wong KY, Sze WK, Ng AWY, Fielding R. Factors predicting patient satisfaction in women with advanced breast cancer: a prospective study. BMC Cancer 2018; 18:162. [PMID: 29415669 PMCID: PMC5803988 DOI: 10.1186/s12885-018-4085-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Accepted: 01/31/2018] [Indexed: 11/17/2022] Open
Abstract
Background The present study (1) examined patient satisfaction with care over the first year following the diagnosis of advanced breast cancer and (2) tested if unmet health system and information needs, physical symptom distress, and psychological distress predicted patient satisfaction. Methods Prospective study of 213 Chinese women with advanced breast cancer assessed while awaiting or receiving initial chemotherapy (baseline), then again at 1.5-, 3-, 6-, and 12-months post-baseline. Health system and information unmet (HSI) needs, psychological distress, physical symptom distress, and patient satisfaction were assessed at baseline; patient satisfaction was reassessed at each follow-up assessment. Latent growth curve analysis assessed changes in patient satisfaction over the 12 months follow-up; hierarchical multiple regression analysis tested if baseline health system information needs, physical symptom distress, anxiety and depression predicted patient satisfaction at one-year post-baseline. Results The level of patient satisfaction was high and did not change significantly over time. Only HSI needs (β = − 0.27, p < 0.005) significantly associated with baseline patient satisfaction. Patient satisfaction at one-year post-baseline was predicted by HSI needs (β = − 0.26, p < 0.005), Anxiety (β = 0.23, p < 0.05) and Depression (β = − 0.28, p < 0.005), adjusting for the effect of baseline patient satisfaction (β = 0.22, p < 0.005). Conclusions Unmet health information needs and greater depressive symptoms at initial treatment phased predicted subsequent poorer patient satisfaction. This highlights a need to reinforce the importance of patient-centered care model in managing advanced breast cancer.
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Affiliation(s)
- Wendy W T Lam
- Centre for Psycho-Oncology Research & Training, Division of Behavioural Sciences, School of Public Health, The University of Hong Kong(HKU), 5/F, WMW Mong Block, Faculty of Medicine Building, 21 Sassoon Road, Pokulam, Hong Kong.
| | - Ava Kwong
- Department of Surgery, The University of Hong Kong, Pokfulam, Hong Kong
| | - Dacita Suen
- Department of Surgery, The University of Hong Kong, Pokfulam, Hong Kong
| | - Janice Tsang
- Department of Clinical Oncology, The University of Hong Kong, Pokfulam, Hong Kong
| | - Inda Soong
- Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong
| | - Tze Kok Yau
- Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong
| | - Winnie Yeo
- Department of Clinical Oncology, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - Joyce Suen
- Department of Clinical Oncology, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - Wing Ming Ho
- Department of Clinical Oncology, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - Ka Yan Wong
- Department of Oncology, Princess Margaret Hospital, Kwai Chung, Hong Kong
| | - Wing Kin Sze
- Department of Clinical Oncology, Tuen Mun Hospital, Tuen Mun, Hong Kong
| | - Alice W Y Ng
- Department of Clinical Oncology, Tuen Mun Hospital, Tuen Mun, Hong Kong
| | - Richard Fielding
- Centre for Psycho-Oncology Research & Training, Division of Behavioural Sciences, School of Public Health, The University of Hong Kong(HKU), 5/F, WMW Mong Block, Faculty of Medicine Building, 21 Sassoon Road, Pokulam, Hong Kong
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Callari A, Mauri M, Miniati M, Mancino M, Bracci G, Dell'Osso L, Greco C. Treatment of Depression in Patients with Breast Cancer: A Critical Review. TUMORI JOURNAL 2018; 99:623-33. [DOI: 10.1177/030089161309900511] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Aims and background To summarize current knowledge on psychopharmacological and psychotherapeutic options for patients with breast cancer and comorbid depression, starting from the psychiatric viewpoint. Issues on diagnostic boundaries of depression and outcome measures are raised. Methods We completed a literature review from the last 30 years (until March 2012) using PubMed by pairing the key words: ‘breast cancer and depression treatment’ (about 1431 works, including 207 reviews), ‘breast cancer and antidepressants’ (about 305 works, including 66 reviews), and in particular ‘selective serotonin reuptake inhibitors and breast cancer’ (38 works, including 10 reviews) and ‘breast cancer and psychotherapy’ (603 works, including 84 reviews). Papers in the English language were selected, including recent reviews. Results There is little evidence for the superiority of any one specific intervention with pharmacological options or psychotherapy. The heterogeneity of assessment criteria, the small number of subjects collected in systematic studies, the difficulty in adopting standardized outcome measures, and the limited numbers of available drugs with a favorable side effect profile are the main limitations that emerge from the literature. No conclusive findings are available on mid-term/long-term treatment strategies, or when depression is part of a bipolar disorder. Conclusions Further research is necessary to define the most appropriate approach to depression when it occurs in comorbidity with breast cancer. A more accurate definition of the clinical phenotypes of depression in the special population of patients with breast cancer is suggested as a key issue.
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Affiliation(s)
- Antonio Callari
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
| | - Mauro Mauri
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
| | - Mario Miniati
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
| | | | - Giulia Bracci
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
- Department of Psychiatry, Columbia University Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY, USA
| | - Liliana Dell'Osso
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
| | - Carlo Greco
- Department of Radiotherapy, University of Pisa, Pisa, Italy
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Dong X, Bergren S, Simon MA. Cross-Sectional and Longitudinal Association Between Trust in Physician and Depressive Symptoms Among U.S. Community-Dwelling Chinese Older Adults. J Gerontol A Biol Sci Med Sci 2017; 72:S125-S130. [PMID: 28575268 PMCID: PMC5861912 DOI: 10.1093/gerona/glx036] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Accepted: 02/22/2017] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Depression is a major public health concern among older adults and health care professionals play a vital role in screening and treatment. However, this process may be impeded by issues like lack of trust in physician (TIP). This study aims to examine the cross-sectional and longitudinal relationships between TIP and depressive symptoms among Chinese older adults in the Chicago area. METHODS Data were collected through the Population Study of Chinese Elderly (PINE), a longitudinal cohort study of Chinese older adults in the greater Chicago area. A total of 2,713 Chinese older adults completed both waves of data collection. TIP was measured through the Trust in Physician scale from Anderson and Dedrick (Anderson LA, Dedrick RF. Development of the Trust in Physician scale: a measure to assess interpersonal trust in patient-physician relationships. Psychol Rep. 1990;67(3 Pt 2):1091-1100. doi:10.2466/pr0.1990.67.3f.1091) (range: 11-55). Depressive symptoms were measured through Patient Health Questionnaire-9. RESULTS Every one point higher in TIP is associated with being 2% less likely to have any depressive symptoms (odds ratio [OR] 0.98, 0.97-0.99) in cross-sectional analysis. Longitudinally, every one-point increase in TIP score was associated with a 2% lower risk of depressive symptoms at Wave 2 (OR 0.98, 0.97-0.99). Improved TIP over 2 years was associated with 25% decreased risk of having any depressive symptoms at Wave 2 (OR 0.75, 0.63-0.89). Additionally, highest tertile of TIP change was associated with a 31% decreased risk of any depressive symptoms compared to lowest tertile (OR 0.68, 0.55-0.84). DISCUSSION Improved TIP over 2 years is associated with less risk of experiencing depressive symptoms. Future research should examine possible pathways and routes of intervention to improve mental health among older adults.
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Affiliation(s)
- XinQi Dong
- Chinese Health, Aging, and Policy Program, Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois
| | - Stephanie Bergren
- Chinese Health, Aging, and Policy Program, Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois
| | - Melissa A Simon
- Department of Obstetrics and Gynecology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois
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Dräger DL, Protzel C, Hakenberg OW. Psychological stress in geriatric patients with genito-urinary cancers. J Geriatr Oncol 2017; 8:216-219. [DOI: 10.1016/j.jgo.2016.12.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Revised: 11/14/2016] [Accepted: 12/01/2016] [Indexed: 11/17/2022]
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Jacobs M, Anderegg MCJ, Schoorlemmer A, Nieboer D, Steyerberg EW, Smets EMA, Sprangers MAG, van Berge Henegouwen MI, de Haes JCJM, Klinkenbijl JH. Patients with oesophageal cancer report elevated distress and problems yet do not have an explicit wish for referral prior to receiving their medical treatment plan. Psychooncology 2016; 26:452-460. [PMID: 27246192 DOI: 10.1002/pon.4161] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Revised: 04/20/2016] [Accepted: 04/21/2016] [Indexed: 12/11/2022]
Abstract
OBJECTIVE This study aims to identify patients with oesophageal cancer's level of distress, type of problems, and wish for referral prior to treatment. To identify the clinical relevance of patients with oesophageal cancer's level of distress and type of problems, we build models to predict elevated distress, wish for referral, and overall survival. METHODS We implemented the Distress Thermometer and Problem List in daily clinical practice. A score of ≥5 on the Distress Thermometer reflected elevated distress. We first created an initial model including predictors based on the literature. We then added predictors to the initial model to create an extended model based on the sample data. We used the 'least absolute shrinkage and selection operator' to define our final model. RESULTS We obtained data from 187 patients (47.9%, of 390 eligible patients with oesophageal cancer) which were similar to non-respondents in their demographic and clinical characteristics. One-hundred thirteen (60%) patients reported elevated distress. The five most frequently reported problems were as follows: eating, tension, weight change, fatigue, and pain. Most patients did not have a wish for referral. Predictors for elevated distress were as follows: being female, total number of practical, emotional, and physical problems, pain, and fatigue. For referral, we identified age, the total number of emotional problems, the level of distress, and fear. The level of distress added prognostic information in a model to predict overall survival. CONCLUSIONS Patients with oesophageal cancer report elevated distress and a myriad of problems yet do not have an explicit wish for referral prior to receiving their medical treatment plan. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- M Jacobs
- Department of Medical Psychology, Academic Medical Center/University of Amsterdam, Amsterdam, the Netherlands
| | - M C J Anderegg
- Department of Surgery, Academic Medical Center/University of Amsterdam, Amsterdam, the Netherlands
| | - A Schoorlemmer
- Department of Surgery, Academic Medical Center/University of Amsterdam, Amsterdam, the Netherlands
| | - D Nieboer
- Department of Public Health, Erasmus Medical Center, Rotterdam, the Netherlands
| | - E W Steyerberg
- Department of Public Health, Erasmus Medical Center, Rotterdam, the Netherlands
| | - E M A Smets
- Department of Medical Psychology, Academic Medical Center/University of Amsterdam, Amsterdam, the Netherlands
| | - M A G Sprangers
- Department of Medical Psychology, Academic Medical Center/University of Amsterdam, Amsterdam, the Netherlands
| | - M I van Berge Henegouwen
- Department of Surgery, Academic Medical Center/University of Amsterdam, Amsterdam, the Netherlands
| | - J C J M de Haes
- Department of Medical Psychology, Academic Medical Center/University of Amsterdam, Amsterdam, the Netherlands
| | - J H Klinkenbijl
- Department of Surgery, Gelre Ziekenhuizen, Apeldoorn, the Netherlands
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Briet JP, Hageman MGJS, Overbeek CL, Mudgal C, Ring DC, Vranceanu AM. Factors Associated With Met Expectations in Patients With Hand and Upper Extremity Disorders: A Pilot Study. PSYCHOSOMATICS 2016; 57:401-8. [PMID: 27080458 DOI: 10.1016/j.psym.2016.02.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Revised: 02/02/2016] [Accepted: 02/03/2016] [Indexed: 01/21/2023]
Abstract
PURPOSE The degree to which patients' expectations are met during an office visit consistently correlates with patients' satisfaction, whereas the relationship between previsit expectations and satisfaction varies. OBJECTIVE The aim of this pilot study was to preliminarily assess the relationship of psychosocial factors, pain intensity, and magnitude of disability to previsit expectations, met expectations, and satisfaction with medical care in patients with hand and upper extremity conditions in a surgical outpatient clinic. METHODS A cohort of 85 outpatients with upper extremity illnesses indicated their previsit expectations (Patients Intention Questionnaire), degree to which these expectations were met (Expectations Met Questionnaire), level of depressive symptoms (Patient Health Questionnaire-2), confidence about the ability to achieve one's goals in spite of pain (Pain Self-Efficacy Questionnaire), pain intensity (Numerical Rating Scale for pain), disability (Disabilities of the Arm Shoulder and Hand, short version; QuickDASH), and satisfaction with the medical visit (Medical Interview Satisfaction Scale). RESULTS Higher previsit expectations were associated with more depressive symptoms, lower pain self-efficacy, higher pain intensity, and fewer years of education. Patients in the low and moderate met expectations categories had significantly more symptoms of depression, fewer years of education, and more pain compared to those in the high-met expectations category. Fewer years of education and higher pain intensity predicted higher previsit expectations and explained 19% of variance. CONCLUSION Psychosocial factors affect both previsit expectations and met expectations during an outpatient visit to a hand surgeon. Met expectations, but not previsit expectations, affect satisfaction. LEVEL OF EVIDENCE Prognostic, level II.
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Affiliation(s)
- Jan Paul Briet
- Hand and Upper Extremity Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA
| | - Michiel G J S Hageman
- Hand and Upper Extremity Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA
| | - Celeste L Overbeek
- Hand and Upper Extremity Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA
| | - Chaitanya Mudgal
- Hand and Upper Extremity Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA
| | - David C Ring
- Hand and Upper Extremity Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA
| | - Ana-Maria Vranceanu
- Hand and Upper Extremity Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA.
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Kállay É, Pintea S, Dégi CL. Does knowledge of diagnosis really affect rates of depression in cancer patients? Psychooncology 2016; 25:1418-1423. [PMID: 26810239 DOI: 10.1002/pon.4073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Revised: 12/14/2015] [Accepted: 12/15/2015] [Indexed: 11/10/2022]
Abstract
Significant levels of distress usually accompany the entire cancer experience, affecting the patients' general functioning and adaptation to illness. OBJECTIVE The major objective of the present study was to investigate potential demographic and intrapersonal moderators of the relationship between knowing the cancer diagnosis and the level of depression experienced. METHOD The present research has a transversal comparative repeated cross-sectional design (2006-2014), sampling following the proportional quota method. Research was conducted in the four major oncological institutes in Romania, obtaining a national sample of cancer patients, maintaining gender and ethnic rates, and permitting the investigation of the stability of the results from one assessment to the other. RESULTS Results indicate that in the Romanian context, knowing the diagnosis is associated with a lower level of depression than not knowing the diagnosis, the results being similar in both assessments (2006-2014). Furthermore, from the explored demographic factors (gender, residence, age, and education), only age has a main effect upon depression (depression increasing with age), while education is the only factor from those analyzed, which has a moderator effect. Regarding the analyzed intra-individual variables, only dysfunctional attitudes, emotion-focused coping, and lack of emotional support from the family (loneliness) have main effects upon the level of depression (i.e., higher levels of dysfunctional attitudes, emotion-focused coping, and loneliness are associated with higher levels of depression), while neither of them has a moderator effect on the relationship between knowing the diagnosis and depression. CONCLUSION These results are important in the improvement of the doctor-patient relationship, the management of cancer-related distress, and implicitly for the course of illness. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Éva Kállay
- Department of Psychology, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Sebastian Pintea
- Department of Psychology, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Csaba L Dégi
- Faculty of Sociology and Social Work, Babes-Bolyai University, Cluj-Napoca, Romania
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Gillanders DT, Sinclair AK, MacLean M, Jardine K. Illness cognitions, cognitive fusion, avoidance and self-compassion as predictors of distress and quality of life in a heterogeneous sample of adults, after cancer. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2015. [DOI: 10.1016/j.jcbs.2015.07.003] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Wang H, Zhang D, Ma L, Shen Y, Ding W. Factors Predicting Patient Dissatisfaction 2 Years After Discectomy for Lumbar Disc Herniation in a Chinese Older Cohort: A Prospective Study of 843 Cases at a Single Institution. Medicine (Baltimore) 2015; 94:e1584. [PMID: 26448005 PMCID: PMC4616769 DOI: 10.1097/md.0000000000001584] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
We aim to identify factors predicting patient dissatisfaction 2 years after discectomy for lumbar disc herniation (LDH) in a Chinese older cohort. Preoperative and 2-year follow-up data for 843 patients were analyzed. After 2 years of discectomy, the patients rated their satisfaction by Patient Satisfaction Index (PSI), with response of 1 or 2 defining satisfaction and a PSI response of 3 or 4 defining dissatisfaction. Associations between perioperative variables and satisfaction with the results of surgery were examined in univariate and multivariate analysis. Six hundred fifty-seven patients had a PSI of 1 or 2 and were enrolled as satisfied group, 186 patients had a PSI of 3 or 4 and were enrolled as dissatisfied group. At baseline, no significant differences were found between the 2 groups in age, occupation, Oswestry Disability Index (ODI), Visual Analog Scale (VAS)-leg, and VAS-back. Compared to satisfied group, dissatisfied group had a significantly higher BMI and a higher incidence of depression. Two years after discectomy, no significant differences were found between the 2 groups in decrease of ODI, decrease of VAS-back, decrease of VAS-leg, surgery complications. Compared to satisfied group, dissatisfied group experienced higher incidence of symptom recurrence and depression. Logistic regression analysis showed that obesity, pre- and postoperative depression, symptom recurrence were independently associated with patient dissatisfaction 2 years after discectomy.I n conclusion, more than 70% patients expressed satisfaction with discectomy for LDH. Two factors could predict patient dissatisfaction and be assessed before surgery: obesity and preoperative depression. Symptom recurrence and postoperative depression are also associated with diminished patient satisfaction.
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Affiliation(s)
- Hui Wang
- From the Department of Spine Surgery, The Third Hospital of HeBei Medical University, Shijiazhuang, China
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Kim YS, Do H, Lee JW, Jeong J, Shin YW, Yi K, Kim J, Lee SB, Sohn G, Yang N, Oh Y, Kim L, Kim Y, Yu JH, Ko BS, Kim HJ, Son BH, Ahn SH. Patient reporting pain intensity immediately after surgery can be associated with underlying depression in women with breast cancer. Psychooncology 2015; 25:308-15. [DOI: 10.1002/pon.3919] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Revised: 06/22/2015] [Accepted: 06/24/2015] [Indexed: 11/10/2022]
Affiliation(s)
- Yoo Seok Kim
- Department of Surgery; Chosun University College of Medicine; Gwangju Korea
| | - Hyuigyung Do
- Department of Nursing; Asan Medical Center; Seoul Korea
| | - Jong Won Lee
- Department of Surgery; University of Ulsan College of Medicine, Asan Medical Center; Seoul Korea
| | - Jaesim Jeong
- Department of Nursing; University of Ulsan College of Medicine; Ulsan Korea
| | - Yong Wook Shin
- Department of Psychiatry; University of Ulsan College of Medicine, Asan Medical Center; Seoul Korea
| | - Kikyoung Yi
- Department of Psychiatry; University of Ulsan College of Medicine, Asan Medical Center; Seoul Korea
| | - Jisun Kim
- Department of Surgery; University of Ulsan College of Medicine, Asan Medical Center; Seoul Korea
| | - Sae Byul Lee
- Department of Surgery; University of Ulsan College of Medicine, Asan Medical Center; Seoul Korea
| | - Guiyun Sohn
- Department of Surgery; University of Ulsan College of Medicine, Asan Medical Center; Seoul Korea
| | - Nuri Yang
- Department of Surgery; University of Ulsan College of Medicine, Asan Medical Center; Seoul Korea
| | - Youngkyung Oh
- Department of Nursing; Asan Medical Center; Seoul Korea
| | - Leeyoung Kim
- Department of Nursing; Asan Medical Center; Seoul Korea
| | - Yeonhee Kim
- Department of Nursing; Asan Medical Center; Seoul Korea
| | - Jong Han Yu
- Department of Surgery; University of Ulsan College of Medicine, Asan Medical Center; Seoul Korea
| | - Beom Seok Ko
- Department of Surgery; University of Ulsan College of Medicine, Asan Medical Center; Seoul Korea
| | - Hee Jeong Kim
- Department of Surgery; University of Ulsan College of Medicine, Asan Medical Center; Seoul Korea
| | - Byung Ho Son
- Department of Surgery; University of Ulsan College of Medicine, Asan Medical Center; Seoul Korea
| | - Sei Hyun Ahn
- Department of Surgery; University of Ulsan College of Medicine, Asan Medical Center; Seoul Korea
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Chirico A, Lucidi F, Mallia L, D'Aiuto M, Merluzzi TV. Indicators of distress in newly diagnosed breast cancer patients. PeerJ 2015; 3:e1107. [PMID: 26244115 PMCID: PMC4517964 DOI: 10.7717/peerj.1107] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Accepted: 06/26/2015] [Indexed: 11/20/2022] Open
Abstract
Background. The diagnosis, treatment, and long-term management of cancer can present individuals with a multitude of stressors at various points in that trajectory. Psychosocial distress may appear early in the diagnostic process and have negative effects on compliance with treatment and subsequent quality of life. Purpose. The aim of the study was to determine early-phase predictors of distress before any medical treatment. Method. Consistent with the goals of the study, 123 newly diagnosed breast cancer patients (20 to 74 years old) completed multiple indicators of knowledge about breast cancer management and treatment, attitudes toward cancer, social support, coping efficacy, and distress. Results. SEM analysis confirmed the hypothesized model. Age was negatively associated with the patient’s knowledge (β = − 0.22), which, in turn, was positively associated with both attitudes toward breast cancer (β = 0.39) and coping self-efficacy (β = 0.36). Self-efficacy was then directly related to psychological distress (β = − 0.68). Conclusions. These findings establish indicators of distress in patients early in the cancer trajectory. From a practical perspective, our results have implications for screening for distress and for the development of early interventions that may be followed by healthcare professionals to reduce psychological distress.
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Affiliation(s)
- Andrea Chirico
- Breast Cancer Department, National Cancer Institute Fondazione "G.Pascale," Naples , Italy ; Department of Psychology of Developmental and Socialisation Processes, "Sapienza" University of Rome , Rome , Italy
| | - Fabio Lucidi
- Department of Psychology of Developmental and Socialisation Processes, "Sapienza" University of Rome , Rome , Italy
| | - Luca Mallia
- Department of Psychology of Developmental and Socialisation Processes, "Sapienza" University of Rome , Rome , Italy
| | - Massimiliano D'Aiuto
- Breast Cancer Department, National Cancer Institute Fondazione "G.Pascale," Naples , Italy
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Hong J, Wei Z, Wang W. Preoperative psychological distress, coping and quality of life in Chinese patients with newly diagnosed gastric cancer. J Clin Nurs 2015; 24:2439-47. [PMID: 25930090 DOI: 10.1111/jocn.12816] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2015] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES The purpose of this study was to investigate the prevalence of preoperative psychological distress and its relationship with coping style and quality of life in Chinese patients with newly diagnosed gastric cancer. BACKGROUND Being newly diagnosed with cancer can be a source of psychological distress. Understanding the preoperative psychological distress may contribute to the development of appropriate interventions. DESIGN This is a descriptive correlational survey study. METHODS The study was conducted in two teaching hospitals in Anhui province, China. A total of 165 patients with gastric cancer completed a battery of self-report questionnaires including the Distress Thermometer, the revised Chinese version of the Quality of Life Questionnaire-Stomach 22 and the Cancer Coping Modes Questionnaire. RESULTS The prevalence of clinically significant preoperative psychological distress was 76·97% in this group. Statistically significant correlations were identified between the distress score and stomach pain, eating restrictions and anxiety subscale. Positive associations were found between the distress scores and four subdimensions of coping (avoidance and suppression, resignation, fantasy and catharsis), whereas a negative association was found between the distress scores and one subdimension of coping (Confrontation). There were also significant differences in the quality of life and coping style of patients who had different psychological distress statuses. CONCLUSION These findings indicate a relatively high prevalence of preoperative psychological distress among Chinese patients with gastric cancer. Patients with clinically psychological distress were more likely to have poor quality of life and to demonstrate negative coping styles. RELEVANCE TO CLINICAL PRACTICE Nursing professionals need to carefully assess the psychological status of patients with gastric cancer. Tailored interventions can be administered to help these patients appropriately cope with the disease and to enhance their quality of life.
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Affiliation(s)
- Jingfang Hong
- School of Nursing, Anhui Medical University, Hefei, Anhui, China
| | - Zengzeng Wei
- The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China
| | - Weili Wang
- School of Nursing, Anhui Medical University, Hefei, Anhui, China.,Anhui Provincial Nursing International Research Center, Hefei, Anhui Province, China
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Halkett GKB, Lobb EA, Rogers MM, Shaw T, Long AP, Wheeler HR, Nowak AK. Predictors of distress and poorer quality of life in High Grade Glioma patients. PATIENT EDUCATION AND COUNSELING 2015; 98:525-532. [PMID: 25638306 DOI: 10.1016/j.pec.2015.01.002] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Revised: 12/05/2014] [Accepted: 01/06/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To determine High Grade Glioma (HGG) patients' levels of distress and QOL during combined chemoradiotherapy, explore predictors of distress and QOL and prioritize patients' supportive care needs. METHODS Patients diagnosed with HGG who were referred for combined chemoradiotherapy were recruited. Participants completed demographics and questionnaires assessing distress, function, and supportive care needs. Descriptive statistics, correlation coefficients, t-tests and linear and logistic regression analyses were performed. RESULTS 116 participants completed the questionnaire. Participants scored lower for QOL in physical, functional and emotional domains than the general Australian population. Poor physical function, lower education levels, loss of employment and financial impact associated with diagnosis were consistently linked with multiple domains of distress, poor QOL and high unmet needs. Having a carer who was their partner predicted lower emotional well-being. CONCLUSION Patients with HGG experience a poor QOL, increased levels of distress and high unmet needs when commencing chemoradiotherapy. Patients who experience a financial impact and those with lower education levels may report higher levels of distress and increased unmet needs. PRACTICE IMPLICATIONS Poor function, lower education and limited financial resources may help identify those who require additional screening and may benefit from additional information and psychological support at this time.
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Affiliation(s)
- Georgia K B Halkett
- School of Nursing and Midwifery, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia.
| | - Elizabeth A Lobb
- Calvary Health Care Kogarah and Cunningham Centre for Palliative Care, Sydney, New South Wales, Australia; School of Medicine, The University of Notre Dame, Sydney, New South Wales, Australia
| | - Michelle M Rogers
- School of Nursing and Midwifery, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Thérèse Shaw
- Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
| | - Anne P Long
- Department of Medical Oncology, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Helen R Wheeler
- Medical Oncology, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Anna K Nowak
- Department of Medical Oncology, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia; School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia
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Schubart JR, Mitchell AJ, Dietrich L, Gusani NJ. Accuracy of the Emotion Thermometers (ET) Screening Tool in Patients Undergoing Surgery for Upper Gastrointestinal Malignancies. J Psychosoc Oncol 2015; 33:1-14. [DOI: 10.1080/07347332.2014.977415] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Schubart JR, Emerich M, Farnan M, Stanley Smith J, Kauffman GL, Kass RB. Screening for Psychological Distress in Surgical Breast Cancer Patients. Ann Surg Oncol 2014; 21:3348-53. [DOI: 10.1245/s10434-014-3919-8] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Indexed: 11/18/2022]
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Tu CH, Hsu MC, Chi SC, Lin HY, Yen YC. Routine depression screening and diagnosing strategy for cancer inpatients. Psychooncology 2014; 23:1057-67. [PMID: 24798464 DOI: 10.1002/pon.3547] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2013] [Revised: 03/17/2014] [Accepted: 03/17/2014] [Indexed: 01/06/2023]
Abstract
BACKGROUND Clinical practice guidelines frequently recommend systematic screening for depression in cancer patients to improve recognition and prompt appropriate management. We aimed to screen major depressive disorder (MDD) in cancer inpatients using a structured tool and explore its applicability. METHODS Cancer inpatients were routinely screened by nurses using the Taiwanese Depression Questionnaire (TDQ), and for those screened positive, this was followed by a non-mandated referral to a psychiatrist for clinical evaluation and diagnosis. Patients who completed this two-stage procedure comprised the analysis sample. RESULTS Routine screening of 8800 patients in a period of 27 months yielded 1087 (26.9%) positive first-time screens. Of them, 298 (27.4%) completed the psychiatric consultation. Depressive disorders were diagnosed in 185 patients (62.1%), mainly adjustment disorder (23.8%) and MDD (21.5%). The estimated prevalence of MDD was 21.5%. Area under the curve was 0.72, a result produced by the receiver operating characteristic curve of the TDQ scores relative to the clinical psychiatric diagnoses of MDD. A TDQ cutoff score of ≧26 provided an optimal diagnostic accuracy for MDD. CONCLUSIONS This two-stage depression screening and diagnosing strategy is practical for improving recognition of MDD and other depressive disorders in cancer patients and could be routinely applied, rather than selectively, in a comprehensive cancer care system.
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Affiliation(s)
- Chun-Hsien Tu
- Department of Psychiatry, E-Da Hospital, Kaohsiung, Taiwan; Department of Nursing, College of Medicine, I-Shou University, Kaohsiung, Taiwan
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