1
|
Lojacono M, McClenahan BJ, Borgehammar JS, Young JL, Schenk RJ, Rhon DI. Associations between smoking history, baseline pain interference and symptom distribution, and physical function at discharge, in individuals seeking care for musculoskeletal pain. Addict Behav 2024; 158:108133. [PMID: 39163696 DOI: 10.1016/j.addbeh.2024.108133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 07/13/2024] [Accepted: 08/12/2024] [Indexed: 08/22/2024]
Abstract
OBJECTIVE Study of the association between smoking and pain intensity has produced conflicting results; with less focus on pain interference. Different pain constructs could have varying associations with smoking behaviors. This study sought to investigate the association between smoking history and not only pain intensity, but also pain interference, symptom distribution and physical function. METHODS Smoking history (current, past, or none), pain interference (Pain, Enjoyment of Life, and General Activity scale), symptom distribution and physical function scores were extracted from medical records of patients seen in physical therapy for common sites of musculoskeletal pain (lumbar and cervical spine, knee, or hip). Generalized linear models assessed the relationship between smoking history and pain/function. RESULTS 833 patients from an integrated healthcare system were included (mean: 57.6 years, SD=16.3; 43 % male). After controlling for several variables, current smokers had significantly higher baseline pain interference scores compared to never and former smokers (beta [B]: 0.65, 95 %CI: 0.13 to 1.18, P=.02). Smoking was not a significant predictor of symptom distribution at baseline [B: 0.17, 95 %CI -0.06 to 0.42, P=.16] or physical function scores at discharge [B: -0.03, 95 %CI: -0.08 to 0.02, P=.25]. CONCLUSION Smokers experienced a greater impact of pain at baseline. However, symptom distribution at intake and function upon discharge were similar between all smoking groups. These findings suggest smoking cessation and abstinence may be important recommendations to help curb pain interference.
Collapse
Affiliation(s)
- Margaux Lojacono
- Doctor of Science in Physical Therapy Program, Bellin College, 3201 Eaton Rd, Green Bay, WI 54311, USA.
| | - Brian J McClenahan
- Doctor of Science in Physical Therapy Program, Bellin College, 3201 Eaton Rd, Green Bay, WI 54311, USA; Rehabilitation Department, WellSpan, Quentin Circle, 950 Isabel Dr., Lebanon, PA 17042, USA.
| | - Jane S Borgehammar
- Doctor of Science in Physical Therapy Program, Bellin College, 3201 Eaton Rd, Green Bay, WI 54311, USA.
| | - Jodi L Young
- Doctor of Science in Physical Therapy Program, Bellin College, 3201 Eaton Rd, Green Bay, WI 54311, USA.
| | - Ronald J Schenk
- Doctor of Physical Therapy Program, Tufts University School of Medicine, 136 Harrison AvenueBoston, MA 02111, USA.
| | - Daniel I Rhon
- Doctor of Science in Physical Therapy Program, Bellin College, 3201 Eaton Rd, Green Bay, WI 54311, USA; Department of Rehabilitation Medicine, Uniformed Services University of Health Sciences School of Medicine, 4301 Jones Bridge Road, Bethesda, MD, USA.
| |
Collapse
|
2
|
Watabe S, Watanabe T, Yada S, Aramaki E, Yajima H, Kizaki H, Hori S. Exploring a method for extracting concerns of multiple breast cancer patients in the domain of patient narratives using BERT and its optimization by domain adaptation using masked language modeling. PLoS One 2024; 19:e0305496. [PMID: 39241041 PMCID: PMC11379386 DOI: 10.1371/journal.pone.0305496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 05/30/2024] [Indexed: 09/08/2024] Open
Abstract
Narratives posted on the internet by patients contain a vast amount of information about various concerns. This study aimed to extract multiple concerns from interviews with breast cancer patients using the natural language processing (NLP) model bidirectional encoder representations from transformers (BERT). A total of 508 interview transcriptions of breast cancer patients written in Japanese were labeled with five types of concern labels: "treatment," "physical," "psychological," "work/financial," and "family/friends." The labeled texts were used to create a multi-label classifier by fine-tuning a pre-trained BERT model. Prior to fine-tuning, we also created several classifiers with domain adaptation using (1) breast cancer patients' blog articles and (2) breast cancer patients' interview transcriptions. The performance of the classifiers was evaluated in terms of precision through 5-fold cross-validation. The multi-label classifiers with only fine-tuning had precision values of over 0.80 for "physical" and "work/financial" out of the five concerns. On the other hand, precision for "treatment" was low at approximately 0.25. However, for the classifiers using domain adaptation, the precision of this label took a range of 0.40-0.51, with some cases improving by more than 0.2. This study showed combining domain adaptation with a multi-label classifier on target data made it possible to efficiently extract multiple concerns from interviews.
Collapse
Affiliation(s)
- Satoshi Watabe
- Division of Drug Informatics, Keio University Faculty of Pharmacy, Tokyo, Japan
| | - Tomomi Watanabe
- Division of Drug Informatics, Keio University Faculty of Pharmacy, Tokyo, Japan
| | - Shuntaro Yada
- Nara Institute of Science and Technology, Nara, Japan
| | - Eiji Aramaki
- Nara Institute of Science and Technology, Nara, Japan
| | | | - Hayato Kizaki
- Division of Drug Informatics, Keio University Faculty of Pharmacy, Tokyo, Japan
| | - Satoko Hori
- Division of Drug Informatics, Keio University Faculty of Pharmacy, Tokyo, Japan
| |
Collapse
|
3
|
Ban Y, Bai H. Association between perceived stress, loneliness and sleep disorders among breast cancer patients: the moderating roles of resilience. PSYCHOL HEALTH MED 2024; 29:1466-1478. [PMID: 38634531 DOI: 10.1080/13548506.2024.2344127] [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: 04/17/2023] [Accepted: 04/10/2024] [Indexed: 04/19/2024]
Abstract
Sleep disorders are prevalent and often neglected among breast cancer patients. This study aimed to identify the association among perceived stress, loneliness, resilience and sleep disorders and to further explore whether resilience could be a moderator in the association between them and sleep disorders. A cross-sectional study was conducted by 492 female breast cancer patients. Patients were asked in response to the questionnaires including the Pittsburgh Sleep Quality Index, Perceived Stress Scale-10, the Three-Item Loneliness Scale and Resilience Scale-14. The association among perceived stress, loneliness, resilience and perceived stress/loneliness × resilience interaction with sleep disorders were examined by hierarchical multiple regression analysis. The interaction was visualized by using simple slope analysis. 36.58% of the female breast cancer patients reported sleep disorders in our study. Perceived stress and loneliness were related to sleep disorders. Resilience could moderate the relationship between them and sleep disorders. When resilience was higher, perceived stress and loneliness had a weaker impact on sleep disorders. Medical staff should systematically evaluate the internal environmental factors related to patients' sleep quality and help patients relieve their emotional distress caused by the disease through positive psychological guidance.
Collapse
Affiliation(s)
- Yue Ban
- School of Humanities and Management, Guangdong Medical University, Dongguan, Guangdong Province, China
| | - He Bai
- Breast Surgery, Anshan Cancer Hospital, Anshan, Liaoning Province, China
| |
Collapse
|
4
|
Jeon JH, Adams M, Higgins MG, Vemuru SR, Ludwigson AM, Huynh V, Baurle E, Rojas K, Matlock DD, Lee C, Kim S, Tevis S. Breast Cancer Surgery: A Qualitative Exploration of Concerns Over Time. J Surg Res 2024; 300:272-278. [PMID: 38830302 PMCID: PMC11345857 DOI: 10.1016/j.jss.2024.05.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 05/07/2024] [Accepted: 05/09/2024] [Indexed: 06/05/2024]
Abstract
INTRODUCTION As outcomes for breast cancer patients improve, addressing the side effects and distress of treatment can optimize survivorship. Although distress in breast cancer is well known in literature, there is a lack of information on how these concerns change through the phases of the cancer care continuum. Therefore, this study investigates the longitudinal trajectory of worry in patients with nonmetastatic breast cancer. METHODS Female patients with newly diagnosed stage I-III breast cancer comprised a mixed-methods, longitudinal study at a cancer center from June 2019 to June 2023. Patients completed an open-ended survey regarding their top three concerns. Responses were obtained before surgery and two weeks, three, six, nine months, and one year postoperatively. Responses were qualitatively coded and analyzed to determine themes of cancer-related distress. RESULTS Participants (n = 262) were aged an average 57.53 y (±12.54), 65.8% had stage I disease at diagnosis, and 91.1% were White. Responses revealed that patients' top three sources of concerns varied by treatment phase. Overall, patients were worried about their cancer diagnosis and the risk of recurrence. Preoperatively, patients were worried about treatment timeline, while postoperative concerns transitioned to physical appearance and surgical side effects. CONCLUSIONS Breast cancer patients consistently reported worries about cancer diagnosis, recurrence, and metastasis as well as the side effects and fear of treatments. However, patient worry appeared to be intrinsically linked with their treatment phase. Therefore, support and interventions should be catered to reflect the changing patterns of patients' sources of distress to optimize breast cancer patients' quality of life.
Collapse
Affiliation(s)
- Jasmine H Jeon
- Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts.
| | - Monica Adams
- Adult and Child Center for Outcomes Research and Delivery Science (ACCORDS), University of Colorado Anschutz Medical Center, Aurora, Colorado
| | - Madeline G Higgins
- Department of Surgery, University of Colorado Anschutz Medical Center, Aurora, Colorado
| | - Sudheer R Vemuru
- Department of Surgery, University of Colorado Anschutz Medical Center, Aurora, Colorado
| | | | - Victoria Huynh
- Department of Surgery, University of Colorado Anschutz Medical Center, Aurora, Colorado
| | - Erin Baurle
- Division of Medical Oncology, Department of Medicine, University of Colorado Anschutz Medical Center, Aurora, Colorado
| | - Kristin Rojas
- Division of Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Dan D Matlock
- Division of Geriatric Medicine, University of Colorado Anschutz Medical Center, Aurora, Colorado
| | - Clara Lee
- Division of Surgery, University of North Carolina, Chapel Hill, North Carolina
| | - Simon Kim
- Department of Surgery, University of Colorado Anschutz Medical Center, Aurora, Colorado; Division of Urology, University of Colorado Anschutz Medical Center, Aurora, Colorado
| | - Sarah Tevis
- Department of Surgery, University of Colorado Anschutz Medical Center, Aurora, Colorado
| |
Collapse
|
5
|
Goerling U, Ernst J, Esser P, Haering C, Hermann M, Hornemann B, Hövel P, Keilholz U, Kissane D, von dem Knesebeck O, Lordick F, Springer F, Zingler H, Zimmermann T, Engel C, Mehnert-Theuerkauf A. Estimating the prevalence of mental disorders in patients with newly diagnosed cancer in relation to socioeconomic status: a multicenter prospective observational study. ESMO Open 2024; 9:103655. [PMID: 39088984 PMCID: PMC11345380 DOI: 10.1016/j.esmoop.2024.103655] [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: 04/18/2024] [Revised: 06/25/2024] [Accepted: 07/01/2024] [Indexed: 08/03/2024] Open
Abstract
BACKGROUND The purpose of this study was to provide the 4-week prevalence estimates of mental disorders in newly diagnosed cancer patients in relation to socioeconomic status (SES). PATIENTS AND METHODS We enrolled newly diagnosed patients with a confirmed solid tumor within 2 months of diagnosis. We calculated patients' SES on the basis of their educational level, professional qualification, income and occupational status. We used the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition-Clinical Version (SCID-5-CV) to assess the 4-week prevalence of mental disorders in addition to a comorbidity questionnaire to assess the level of physical impairment. RESULTS We identified a total of 1702 patients with mixed cancers after reviewing their medical records and contacting them in person or by post due to coronavirus pandemic patient safety restrictions. 1030 patients (53.2% men, mean age 60.2 years) had completed SCID-5-CV. When weighted according to the SES distribution to account for over- and under-sampling of SES groups, 20.9% [95% confidence interval (CI) 18.1% to 23.6%] of patients were diagnosed with any mental disorder. The most prevalent were depressive disorders (9.9%, 95% CI 7.9% to 11.9%), trauma and stress-related disorders (6.3%, 95% CI 4.7% to 7.9%) and anxiety disorders (4.2%, 95% CI 2.9% to 5.6%). We found no difference in any mental disorder between patients with high, medium or low SES. Multivariate logistic regression analyses revealed higher proportion of patients with any mental disorder in patients younger than 60 years [odds ratio (OR) 0.42; P < 0.001], in patients without a partner (OR 1.84; P < 0.001), in women with tumor in female genital organs (OR 2.45; P < 0.002) and in those with a higher level of impairment (OR 1.05, 95% CI 1.03-1.07; P < 0.001). CONCLUSIONS SES had no significant influence on mental comorbidity in early cancer survivorship.
Collapse
Affiliation(s)
- U Goerling
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charité Comprehensive Cancer Center, Berlin
| | - J Ernst
- Department of Medical Psychology and Medical Sociology, Comprehensive Cancer Center Central Germany (CCCG), University Medical Center Leipzig, Leipzig
| | - P Esser
- Department of Medical Psychology and Medical Sociology, Comprehensive Cancer Center Central Germany (CCCG), University Medical Center Leipzig, Leipzig
| | - C Haering
- Comprehensive Cancer Center, University Clinic Centre Dresden, Dresden, Germany
| | - M Hermann
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charité Comprehensive Cancer Center, Berlin
| | - B Hornemann
- Comprehensive Cancer Center, University Clinic Centre Dresden, Dresden, Germany
| | - P Hövel
- Department of Medical Psychology and Medical Sociology, Comprehensive Cancer Center Central Germany (CCCG), University Medical Center Leipzig, Leipzig
| | - U Keilholz
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charité Comprehensive Cancer Center, Berlin
| | - D Kissane
- School of Medicine, University of Notre Dame Australia, Sydney; Departments of Palliative Care, Cabrini Health, Melbourne; Department of Palliative Care, St Vincent's Hospital Sydney, Sydney; School of Clinical Sciences, Monash Health and Monash University, Melbourne, Australia
| | - O von dem Knesebeck
- Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg
| | - F Lordick
- Department of Medicine II (Oncology, Gastroenterology, Hepatology, and Pulmonology), Comprehensive Cancer Center Central Germany (CCCG), University of Leipzig Medical Center, Leipzig
| | - F Springer
- Department of Medical Psychology and Medical Sociology, Comprehensive Cancer Center Central Germany (CCCG), University Medical Center Leipzig, Leipzig
| | - H Zingler
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover
| | - T Zimmermann
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover
| | - C Engel
- Institute for Medical Informatics, Statistics and Epidemiology, Leipzig University, Leipzig, Germany
| | - A Mehnert-Theuerkauf
- Department of Medical Psychology and Medical Sociology, Comprehensive Cancer Center Central Germany (CCCG), University Medical Center Leipzig, Leipzig.
| |
Collapse
|
6
|
Miller NE, Lally P, Conway R, Steptoe A, Frank P, Beeken RJ, Fisher A. Psychological distress and health behaviours in people living with and beyond cancer: a cross-sectional study. Sci Rep 2024; 14:15367. [PMID: 38965364 PMCID: PMC11224398 DOI: 10.1038/s41598-024-66269-6] [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: 03/21/2024] [Accepted: 07/01/2024] [Indexed: 07/06/2024] Open
Abstract
This study aimed to examine whether psychological distress was cross-sectionally associated with meeting World Cancer Research Fund (WCRF) recommendations in people living with and beyond cancer. Participants were adults living with and beyond breast, prostate and colorectal cancer, participating in the baseline wave of the Advancing Survivorship after Cancer Outcomes Trial (ASCOT). Anxiety/depression was assessed using the EQ-5D-5L and dichotomised into any/no problems. WCRF recommendations were assessed via pedometers, 24-h dietary recalls, self-reported alcohol intake (AUDIT-C), and self-reported smoking status. Participants were categorised as meeting WCRF recommendations using the following cut-offs: average daily steps (≥ 10,000/day), average weekly aerobic steps (≥ 15,000/day), fruit and vegetables (≥ 400 g/day), fibre (≥ 30 g/day), red meat (< 500 g/week), processed meat (0 g/day), high calorie food (fat ≤ 33% of total daily energy intake and free sugar ≤ 5% of total daily energy intake), alcohol (≤ 14 units/week) and smoking (non-smoking). A composite health behaviour risk index (CHBRI) was calculated by summing the number of WCRF recommendations met (range: 0-9). Among 1348 participants (mean age = 64 years (SD = 11.4)), 41.5% reported anxiety/depression problems. The mean CHBRI score was 4.4 (SD = 1.4). Anxiety/depression problems were associated with lower odds of meeting WCRF recommendations for average daily steps (odds ratio (OR) = 0.73; 95% CI 0.55, 0.97), but not for any other health behaviour. Psychological distress is associated with lower adherence to WCRF recommendations for physical activity in people living with and beyond cancer. Physical activity may be a mechanism linking psychological distress and poorer outcomes among people living with and beyond cancer, and this should be explored in longitudinal studies.
Collapse
Affiliation(s)
- Natalie Ella Miller
- Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, 1-19 Torrington Place, Gower Street, London, UK.
| | - Phillippa Lally
- Department of Psychological Sciences, University of Surrey, Guildford, Surrey, GU2 7XH, UK
| | - Rana Conway
- Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, 1-19 Torrington Place, Gower Street, London, UK
| | - Andrew Steptoe
- Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, 1-19 Torrington Place, Gower Street, London, UK
| | - Philipp Frank
- UCL Brain Sciences, University College London, 149 Tottenham Court Rd, London, W1T 7BN, UK
| | - Rebecca J Beeken
- Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, 1-19 Torrington Place, Gower Street, London, UK
- Leeds Institute of Health Sciences, University of Leeds, Leeds, LS2 9JT, UK
| | - Abi Fisher
- Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, 1-19 Torrington Place, Gower Street, London, UK
| |
Collapse
|
7
|
Huang H, Yang Z, Dong Y, Wang YQ, Wang AP. Cancer cost-related subjective financial distress among breast cancer: a scoping review. Support Care Cancer 2024; 32:484. [PMID: 38958768 DOI: 10.1007/s00520-024-08698-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 06/25/2024] [Indexed: 07/04/2024]
Abstract
PURPOSE This article provided a comprehensive scoping review, synthesizing existing literature on the financial distress faced by breast cancer patients. It examined the factors contributing to financial distress, the impact on patients, coping mechanisms employed, and potential alleviation methods. The goal was to organize existing evidence and highlight possible directions for future research. METHODS We followed the scoping review framework proposed by the Joanna Briggs Institute (JBI) to synthesize and report evidence. We searched electronic databases, including PubMed, Web of Science, Embase, and Cochrane Library, for relevant literature. We included English articles that met the following criteria: (a) the research topic was financial distress or financial toxicity, (b) the research subjects were adult breast cancer patients, and (c) the article type was quantitative, qualitative, or mixed-methods research. We then extracted and integrated relevant information for reporting. RESULTS After removing duplicates, 5459 articles were retrieved, and 43 articles were included based on the inclusion and exclusion criteria. The articles addressed four main themes related to financial distress: factors associated with financial distress, impact on breast cancer patients, coping mechanisms, and potential methods for alleviation. The impact of financial distress on patients was observed in six dimensions: financial expenses, financial resources, social-psychological reactions, support seeking, coping care, and coping lifestyle. While some studies reported potential methods for alleviation, few discussed the feasibility of these solutions. CONCLUSIONS Breast cancer patients experience significant financial distress with multidimensional impacts. Comprehensive consideration of possible confounding factors is essential when measuring financial distress. Future research should focus on exploring and validating methods to alleviate or resolve this issue.
Collapse
Affiliation(s)
- Hao Huang
- Department of Public Service, The First Affiliated Hospital of China Medical University, No.155, Nanjing North Street, Heping District, Shenyang, Liaoning Province, China
| | - Zhen Yang
- Department of Public Service, The First Affiliated Hospital of China Medical University, No.155, Nanjing North Street, Heping District, Shenyang, Liaoning Province, China
| | - Yu Dong
- Department of Public Service, The First Affiliated Hospital of China Medical University, No.155, Nanjing North Street, Heping District, Shenyang, Liaoning Province, China
| | - Yu Qi Wang
- Department of Public Service, The First Affiliated Hospital of China Medical University, No.155, Nanjing North Street, Heping District, Shenyang, Liaoning Province, China
| | - Ai Ping Wang
- Department of Public Service, The First Affiliated Hospital of China Medical University, No.155, Nanjing North Street, Heping District, Shenyang, Liaoning Province, China.
| |
Collapse
|
8
|
Rennoldson M, Baliousis M, Potter A, Ashraf E, Gajjar K. Predicting psychological distress in advanced ovarian cancer patients during the COVID-19 pandemic. Support Care Cancer 2024; 32:481. [PMID: 38954223 PMCID: PMC11219381 DOI: 10.1007/s00520-024-08675-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 06/21/2024] [Indexed: 07/04/2024]
Abstract
PURPOSE This longitudinal study investigated distress rates in patients with advanced ovarian cancer during the COVID-19 pandemic and examined whether time, illness representations, and coping strategies predicted distress levels. METHODS UK patients with stage 3 or 4 ovarian cancer were recruited between September 2020 and March 2021. Data were collected at baseline (T0), 2 months (T1), and 4 months (T2) post-enrolment. Validated questionnaires assessed distress (anxiety, depression, PTSD, fear of progression) and predictors (coping strategies and illness perceptions), analysed via multilevel modelling. RESULTS Seventy-two participants returned a questionnaire at T0, decreasing to 49 by T2. High distress was observed, with over 50% of participants experiencing anxiety and depression consistently. Nearly 60% reported clinical levels of fear of progression at some point. PTSD rates resembled the general population. Although distress levels remained stable over time, some individual variability was observed. Time had minimal effect on distress. Coping strategies and illness perceptions remained stable. Threatening illness perceptions consistently predicted distress, while specific coping strategies such as active coping, acceptance, self-blame, and humour predicted various aspects of distress. Together, these factors explained up to half of the distress variance. CONCLUSION The findings have implications for routine screening for distress and the inclusion of psychological treatment pathways in advanced ovarian cancer care. Addressing illness representations is crucial, with attention to informational support. Future research should explore the long-term effects of heightened distress and the effectiveness of interventions targeting illness perceptions. This study informs current clinical practice and future pandemic preparedness in cancer care.
Collapse
Affiliation(s)
| | - Michael Baliousis
- Nottingham University Hospitals NHS Trust, Nottingham, UK.
- University of Lincoln, Lincoln, UK.
| | | | | | - Ketan Gajjar
- Nottingham University Hospitals NHS Trust, Nottingham, UK
| |
Collapse
|
9
|
Xiao Z, Cao J, Wu S, Zhou T, Li C, Duan J, Yang Z, Xu F. Spectrum of psychiatric adverse reactions to cyclin-dependent kinases 4/6 inhibitors: A pharmacovigilance analysis of the FDA adverse event reporting system. CNS Neurosci Ther 2024; 30:e14862. [PMID: 39009505 PMCID: PMC11250168 DOI: 10.1111/cns.14862] [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: 03/29/2024] [Revised: 06/19/2024] [Accepted: 06/24/2024] [Indexed: 07/17/2024] Open
Abstract
BACKGROUND The emergence of cyclin-dependent kinases 4/6 inhibitors (CDK4/6i) represented a major breakthrough in the treatment of breast cancer over the past decade. In both clinical trials and real-world settings, it was observed that patients using CDK4/6i might experience psychiatric adverse events (PAEs). Herein, we conducted a pharmacovigilance study to comprehensively assess the correlation between CDK4/6i and PAEs. METHOD We obtained individual case safety reports submitted to the FDA Adverse Events Reporting System (FAERS) during the period from January 2015 to December 2023. In disproportionality analysis, the reporting odds ratio (ROR) and information component (IC) values were calculated for each adverse event-drug combination. Univariate logistic regression analysis was utilized to explore factors associated with PAEs following CDK4/6i treatment. RESULTS A total of 95,591 reports related to CDK4/6i were identified, with 6.72% reporting PAEs, and this proportion exhibited an annual upward trend. Based on the ROR and IC values, 17 categories of PAEs were defined as CDK4/6i-related PAEs. Among these PAEs, insomnia, stress, eating disorder, depressed mood, and sleep disorder were very common, each accounting for over 10% of CDK4/6i reports. Ribociclib showed the highest risk signal of CDK4/6i-related PAEs (ROR = 1.89[1.75-2.04], IC025 = 0.79), followed by palbociclib (ROR = 1.47[1.41-1.53], IC025 = 0.49), while abemaciclib did not exhibit a significant signal (ROR = 0.52[0.44-0.62], IC025 = -1.13). Female sex, younger age and weight exceeding 80 kg were significant risk factors for the incidence of CDK4/6i-related PAEs. CONCLUSIONS Using data from a real-world, large-scale spontaneous reporting system for adverse drug reactions, our study delineated the spectrum of PAEs to CDK4/6i. This potentially offered valuable insights for healthcare professionals to manage the risk of PAEs in patients receiving CDK4/6i treatment, particularly those with psychiatric disorders.
Collapse
Affiliation(s)
- Zhijun Xiao
- Department of PharmacyShanghai University of Medicine & Health Sciences Affiliated Sixth People's Hospital South CampusShanghaiChina
| | - Jinming Cao
- Department of PharmacyShanghai University of Medicine & Health Sciences Affiliated Sixth People's Hospital South CampusShanghaiChina
| | - Shenghong Wu
- Department of OncologyShanghai University of Medicine & Health Sciences Affiliated Sixth People's Hospital South CampusShanghaiChina
| | - Ting Zhou
- Department of PharmacyShanghai University of Medicine & Health Sciences Affiliated Sixth People's Hospital South CampusShanghaiChina
| | - Canye Li
- Department of PharmacyShanghai University of Medicine & Health Sciences Affiliated Sixth People's Hospital South CampusShanghaiChina
| | - Jingjing Duan
- Department of PharmacyShanghai University of Medicine & Health Sciences Affiliated Sixth People's Hospital South CampusShanghaiChina
| | - Zhen Yang
- Department of Central LaboratoryShanghai University of Medicine & Health Sciences Affiliated Sixth People's Hospital South CampusShanghaiChina
| | - Feng Xu
- Department of PharmacyShanghai University of Medicine & Health Sciences Affiliated Sixth People's Hospital South CampusShanghaiChina
| |
Collapse
|
10
|
Park JH, Chun M, Bae SH, Woo J, Chon E, Kim HJ. Factors influencing psychological distress among breast cancer survivors using machine learning techniques. Sci Rep 2024; 14:15052. [PMID: 38956137 PMCID: PMC11219858 DOI: 10.1038/s41598-024-65132-y] [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: 04/24/2024] [Accepted: 06/17/2024] [Indexed: 07/04/2024] Open
Abstract
Breast cancer is the most commonly diagnosed cancer among women worldwide. Breast cancer patients experience significant distress relating to their diagnosis and treatment. Managing this distress is critical for improving the lifespan and quality of life of breast cancer survivors. This study aimed to assess the level of distress in breast cancer survivors and analyze the variables that significantly affect distress using machine learning techniques. A survey was conducted with 641 adult breast cancer patients using the National Comprehensive Cancer Network Distress Thermometer tool. Participants identified various factors that caused distress. Five machine learning models were used to predict the classification of patients into mild and severe distress groups. The survey results indicated that 57.7% of the participants experienced severe distress. The top-three best-performing models indicated that depression, dealing with a partner, housing, work/school, and fatigue are the primary indicators. Among the emotional problems, depression, fear, worry, loss of interest in regular activities, and nervousness were determined as significant predictive factors. Therefore, machine learning models can be effectively applied to determine various factors influencing distress in breast cancer patients who have completed primary treatment, thereby identifying breast cancer patients who are vulnerable to distress in clinical settings.
Collapse
Affiliation(s)
- Jin-Hee Park
- College of Nursing, Research Institute of Nursing Science, Ajou University, Suwon, Republic of Korea
| | - Misun Chun
- Department of Radiation Oncology, School of Medicine, Ajou University, Suwon, Republic of Korea
| | - Sun Hyoung Bae
- College of Nursing, Research Institute of Nursing Science, Ajou University, Suwon, Republic of Korea
| | - Jeonghee Woo
- Management Team, Cancer Center, Gyeonggi Regional Cancer Center, Suwon, Republic of Korea
| | - Eunae Chon
- Management Team, Cancer Center, Gyeonggi Regional Cancer Center, Suwon, Republic of Korea
| | - Hee Jun Kim
- College of Nursing, Ajou University, 164, World Cup-ro, Yeongtong-gu, Suwon, 16499, Republic of Korea.
| |
Collapse
|
11
|
Miller NE, Fisher A, Frank P, Lally P, Steptoe A. Depressive Symptoms, Socioeconomic Position, and Mortality in Older People Living With and Beyond Cancer. Psychosom Med 2024; 86:523-530. [PMID: 38497671 PMCID: PMC11230845 DOI: 10.1097/psy.0000000000001294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Indexed: 03/19/2024]
Abstract
OBJECTIVE Evidence shows that higher depressive symptoms are associated with mortality among people living with and beyond cancer (LWBC). However, prior studies have not accounted for a wider range of potential confounders, and no study has explored whether socioeconomic position (SEP) moderates the association. This study aimed to examine the association between depressive symptoms and mortality among people LWBC, and moderation by SEP. METHODS Participants from the English Longitudinal Study of Aging, diagnosed with cancer and with a measure of depressive symptoms within 4 years after their diagnosis, were included. Elevated depressive symptoms were indicated by a score of ≥3 on the eight-item Center for Epidemiologic Studies Depression Scale. Cox regression models examined associations with all-cause mortality. Competing risk regression examined associations with cancer mortality. RESULTS In 1352 people LWBC (mean age = 69.6 years), elevated depressive symptoms were associated with a 93% increased risk of all-cause mortality (95% confidence interval = 1.52-2.45) within the first 4 years of follow-up and a 48% increased risk within a 4- to 8-year follow-up (95% confidence interval = 1.02-2.13) after multivariable adjustment. Elevated depressive symptoms were associated with a 38% increased risk of cancer mortality, but not after excluding people who died within 1 year after baseline assessments. There were no interactions between depressive symptoms and SEP. CONCLUSIONS Elevated depressive symptoms are associated with a greater risk of all-cause mortality among people LWBC within an 8-year follow-up period. Associations between depressive symptoms and cancer mortality might be due to reverse causality.
Collapse
|
12
|
Pinheiro LC, An A, Zeng C, Walker D, Mercurio AM, Hershman DL, Rosenberg SM. Racial and Ethnic Differences in Psychosocial Care Use Among Adults With Metastatic Breast Cancer: A Retrospective Analysis Across Six New York City Health Systems. JCO Oncol Pract 2024; 20:984-991. [PMID: 38466926 DOI: 10.1200/op.23.00528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 11/07/2023] [Accepted: 02/05/2024] [Indexed: 03/13/2024] Open
Abstract
PURPOSE A metastatic breast cancer (mBC) diagnosis can affect physical and emotional well-being. However, racial and ethnic differences in receipt of outpatient psychosocial care and supportive care medications in adults with mBC are not well described. METHODS Adults with mBC were identified in the INSIGHT-Clinical Research Network, a database inclusive of >12 million patients receiving care across six New York City health systems. Outpatient psychosocial care was operationalized using Common Procedure Terminology codes for outpatient psychotherapy or counseling. Psychosocial/supportive care medications were defined using Rx Concept Unique Identifier codes. Associations between race/ethnicity and outpatient care and medication use were evaluated using logistic regression. RESULTS Among 5,429 adults in the analytic cohort, mean age was 61 years and <1% were male; 53.6% were non-Hispanic White (NHW), 21.4% non-Hispanic Black (NHB), 15.9% Hispanic, 6.1% Asian/Native Hawaiian/Pacific Islander (A/NH/PI), and 3% other or unknown. Overall, 4.1% had ≥one outpatient psychosocial care visit and 63.4% were prescribed ≥one medication. Adjusted for age, compared with NHW, Hispanic patients were more likely (odds ratio [OR], 2.14 [95% CI, 1.55 to 2.92]) and A/NH/PI patients less likely (OR, 0.35 [95% CI, 0.12 to 0.78]) to have an outpatient visit. NHB (OR, 0.59 [95% CI, 0.51 to 0.68]) and Asian (OR, 0.36 [95% CI, 0.29 to 0.46]) patients were less likely to be prescribed medications. CONCLUSION Despite the prevalence of depression, anxiety, and distress among patients with mBC, we observed low utilization of psychosocial outpatient care. Supportive medication use was more prevalent, although differences observed by race/ethnicity suggest that unmet needs exist.
Collapse
Affiliation(s)
- Laura C Pinheiro
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, New York, NY
- Division of Epidemiology, Department of Population Health Sciences, Weill Cornell Medicine, New York, NY
| | - Anjile An
- Division of Biostatistics, Department of Population Health Sciences, Weill Cornell Medicine, New York, NY
| | - Caroline Zeng
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, New York, NY
| | | | | | - Dawn L Hershman
- Division of Medical Oncology, Columbia University Medical Center, New York, NY
| | - Shoshana M Rosenberg
- Division of Epidemiology, Department of Population Health Sciences, Weill Cornell Medicine, New York, NY
| |
Collapse
|
13
|
Andreu Y, Soto-Rubio A, Picazo C, Gil-Juliá B, Fernández S, Chulvi R. Risk of cancer-related distress by age in colorectal cancer survivors: The modulatory role of unmet support needs. J Health Psychol 2024:13591053241253358. [PMID: 38898666 DOI: 10.1177/13591053241253358] [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: 06/21/2024] Open
Abstract
To explore the modulating role of unmet support needs on the relationship between age and the prevalence of cancer-related distress in colorectal cancer (CRC) survivors. Two hundred and forty four participants completed the questionnaires; linear regression and odd ratios were calculated. Both the prevalence of needs and their interaction with age were predictors of cancer-related distress. The risk of significant clinically distress associated with physical and socio/family needs was high in both age subgroups. Higher risk of clinical distress was associated with life perspective, sexual, occupational and health care needs in the younger subgroup and with needs for specific support resources in the older subgroup. In reducing cancer-related distress, two key issues arise: (i) the importance of managing the persistent negative symptoms following CRC treatment in survivors of any age and (ii) the need for a differentiated attention to other care needs based on the survivor's age.
Collapse
Affiliation(s)
| | | | | | | | | | - R Chulvi
- Medical Oncology Service, Doctor Peset University Hospital, Valencia, Spain
- FISABIO, Valencia, Spain
| |
Collapse
|
14
|
Yin P, Fan Q, Liu L, Yang M, Zhang S, Li X, Hou W, Feng Q, Wang X, Jin Z, Li F, Chen Y. Efficacy of acupuncture treatment for breast cancer-related insomnia: study protocol for a multicenter randomized controlled trial. Front Psychiatry 2024; 15:1301338. [PMID: 38846918 PMCID: PMC11153751 DOI: 10.3389/fpsyt.2024.1301338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 05/06/2024] [Indexed: 06/09/2024] Open
Abstract
Background Insomnia is one of the most common symptoms among breast cancer patients, which can be present throughout all stages of breast cancer. As a non-pharmacological alternative treatment, acupuncture has been suggested to improve sleep situations in patients with cancer suffering from insomnia. However, there is a lack of well-designed, high-quality clinical evidence regarding the efficacy of acupuncture in the treatment of breast cancer-related insomnia. This study is conducted to evaluate the efficacy and safety of acupuncture treatment for breast cancer-related insomnia. Methods This study was designed as a multicenter, randomized, sham-controlled clinical trial. A total of 264 eligible patients with breast cancer-related insomnia will be randomized into an acupuncture group and a sham acupuncture group in a 1:1 ratio. In the trial, patients in the acupuncture and sham acupuncture groups will receive 12 sessions over a consecutive 4-week period. The primary outcome will be the treatment response rate of Insomnia Severity Index (ISI) at week 4; secondary outcomes include treatment remission rate of ISI, Sleep Efficiency (SE) obtained by the use of Sleep diary, treatment response rate of ISI at 8th and 16th weeks of follow-up, the mean changes of ISI, Generalized Anxiety Disorder Scale (GAD-7), Patient Health Questionnaire-9 (PHQ-9), Quality of Life Questionnaire - Core 30 (QLQ-C30), sleep parameters recorded in Actigraphy and weekly usage of remedial drugs. Adverse events will be recorded throughout the study. All analyses will be based on the ITT principle and performed with SAS 9.4 statistical software. Discussion This trial will evaluate the clinical efficacy and safety of acupuncture for breast cancer-related insomnia. If proven effective, acupuncture will provide an effective option for patients with breast cancer-related insomnia, which will play a positive role in helping patients reduce their use of sleeping medications. Clinical trial registration ClinicalTrials.gov, identifier NCT05510700.
Collapse
Affiliation(s)
- Ping Yin
- LongHua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Qian Fan
- LongHua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Lumin Liu
- LongHua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ming Yang
- LongHua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Shunxian Zhang
- LongHua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xu Li
- LongHua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wenguang Hou
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine of Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Qifan Feng
- Hainan Traditional Chinese Medicine Hospital, Haikou, China
| | - Xi Wang
- Xuhui District Central Hospital of Shanghai, Shanghai, China
| | - Zhu Jin
- Shanghai Seventh People’s Hospital, Shanghai, China
| | - Fang Li
- Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Yuelai Chen
- LongHua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| |
Collapse
|
15
|
Voskanyan V, Marzorati C, Sala D, Grasso R, Pietrobon R, van der Heide I, Engelaar M, Bos N, Caraceni A, Couspel N, Ferrer M, Groenvold M, Kaasa S, Lombardo C, Sirven A, Vachon H, Velikova G, Brunelli C, Apolone G, Pravettoni G. Psychosocial factors associated with quality of life in cancer survivors: umbrella review. J Cancer Res Clin Oncol 2024; 150:249. [PMID: 38727730 PMCID: PMC11087342 DOI: 10.1007/s00432-024-05749-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 04/10/2024] [Indexed: 05/13/2024]
Affiliation(s)
- Viktorya Voskanyan
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Chiara Marzorati
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy.
| | - Diana Sala
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Roberto Grasso
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | | | - Iris van der Heide
- Nivel, Netherlands Institute for Health Services Research, Utrecht, Netherlands
| | - Merel Engelaar
- Nivel, Netherlands Institute for Health Services Research, Utrecht, Netherlands
| | - Nanne Bos
- Nivel, Netherlands Institute for Health Services Research, Utrecht, Netherlands
| | - Augusto Caraceni
- Dipartimento Di Scienze Cliniche E Di Comunità, Università Degli Studi Di Milano, Milan, Italy
| | | | - Montse Ferrer
- Health Services Research Group, Hospital del Mar Research Institute, Barcelona, Spain
| | - Mogens Groenvold
- Department of Public Health, Bispebjerg Hospital and University of Copenhagen, Copenhagen, Denmark
| | - Stein Kaasa
- Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - Claudio Lombardo
- OECI-EEIG Organisation of European Cancer Institutes-European Economic Interest Grouping, Brussels, Belgium
| | | | | | - Galina Velikova
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK
- Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Cinzia Brunelli
- Scientific Directorate, Fondazione Istituto Di Ricovero E Cura a Carattere Scientifico, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - Giovanni Apolone
- Scientific Directorate, Fondazione Istituto Di Ricovero E Cura a Carattere Scientifico, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - Gabriella Pravettoni
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| |
Collapse
|
16
|
Dekker J, Doppenberg-Smit E, Braamse A, Lamers F, van Linde M, Verheul HMW, Sprangers M, Beekman ATF. Toward an improved conceptualization of emotions in patients with cancer. Front Psychiatry 2024; 15:1352026. [PMID: 38600981 PMCID: PMC11004313 DOI: 10.3389/fpsyt.2024.1352026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 03/11/2024] [Indexed: 04/12/2024] Open
Abstract
Cancer and its associated treatment is a major stressor, leading to emotions such as anxiety or depressive mood. Human emotions have developed through the course of evolution because they facilitate adaptation to important events, such as cancer and its associated treatment. On the other hand, emotions can be maladaptive and interfere with adaptation to cancer. Emotions are maladaptive if they are disproportionally severe or persistent, and if they interfere with functioning. We aim to expand the conceptualization of adaptive and maladaptive emotions in patients with cancer. We draw on major theories in the field of mental disorder and mental health, and apply these theories to conceptualize adaptive and maladaptive emotions in patients with cancer. (i) Maladaptive emotions have two essential features: mental dysfunction and patient harm. Maladaptive emotions are characterized by a network of strongly associated emotional symptoms, which may include cancer-related somatic symptoms. The dysfunctional symptom network is hypothesized to be the result of disturbance of life goal pursuit caused by cancer. (ii) Adaptive emotions have two essential features: ability to deal with cancer and functioning well. The ability to use emotions in an adaptive way depends on skills to recognize, express, and regulate emotions in a flexible manner. A secure attachment style facilitates adaptive emotional responses to cancer. The present conceptualization of adaptive and maladaptive emotions is expected to contribute to better understanding and management of emotions in patients with cancer.
Collapse
Affiliation(s)
- Joost Dekker
- Department of Psychiatry, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Amsterdam Public Health, Mental Health Program, Amsterdam, Netherlands
- Cancer Centre Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, Netherlands
| | - Elise Doppenberg-Smit
- Department of Psychiatry, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Amsterdam Public Health, Mental Health Program, Amsterdam, Netherlands
- Cancer Centre Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, Netherlands
| | - Annemarie Braamse
- Cancer Centre Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, Netherlands
- Department of Medical Psychology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | - Femke Lamers
- Department of Psychiatry, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Amsterdam Public Health, Mental Health Program, Amsterdam, Netherlands
| | - Myra van Linde
- Department of Medical Oncology, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Henk M. W. Verheul
- Department of Medical Oncology, Erasmus University Rotterdam, Erasmus Medical Center Cancer Institute, Rotterdam, Netherlands
| | - Mirjam Sprangers
- Amsterdam Public Health, Mental Health Program, Amsterdam, Netherlands
- Cancer Centre Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, Netherlands
- Department of Medical Psychology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | - Aartjan T. F. Beekman
- Department of Psychiatry, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Amsterdam Public Health, Mental Health Program, Amsterdam, Netherlands
| |
Collapse
|
17
|
Liu L, Wang R, Sun Y, Xiao Y, Du G, Zhang Q. Study on the cut-off point and the influencing factors of distress in newly diagnosed breast cancer patients. Front Psychol 2024; 15:1281469. [PMID: 38445051 PMCID: PMC10913590 DOI: 10.3389/fpsyg.2024.1281469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 01/24/2024] [Indexed: 03/07/2024] Open
Abstract
Objective Our aim is to investigate the cut-off point of distress and the influencing factors associated with distress in patients with newly diagnosed breast cancer. Methods A cross-sectional survey of distress was conducted in 167 patients with newly diagnosed breast cancer admitted to the Department of General Surgery of a tertiary care hospital from July 2020 to March 2022. Patients completed the Hospital Anxiety and Depression Scale (HADS) and the Distress Thermometer (DT) questionnaire within 3 days of admission. The HADS ≥15 was used as the gold standard, and the cut-off point of the DT measure was analyzed using the Receiver Operating Characteristic (ROC) curve. The cut-off point obtained by ROC curve analysis was used to analyze the influencing factors of distress in breast cancer patients by univariate and multivariate regression analysis. Results A total of 167 patients completed the survey, with an average HADS score of 8.43 ± 5.84 and a total HADS score of ≥15 in 37 (22.16%) patients, the mean DT score was 2.96 ± 1.85. ROC curve analysis showed an area under the curve of 0.885, with a maximum Jorden index (0.723) at a DT score of 4, the sensitivity was 100.0% and specificity was 72.3%. There were 73 (43.71%) patients with DT score ≥ 4. Regression analysis showed that insurance/financial problems, dealing with partner problems, tension, bathing/dressing problems, pain, and sleep problems were independent risk factors for l distress in newly diagnosed breast cancer patients. Conclusion A DT score 4 is the cut-off point for distress in patients with newly diagnosed breast cancer. In clinical practice, target intervention should be carried out according to the risk factors of distress of patients.
Collapse
Affiliation(s)
- Ling Liu
- Department of General Surgery, The Second Affiliated Hospital of Army Medical University, Chongqing, China
| | - Rong Wang
- Department of General Surgery, The Second Affiliated Hospital of Army Medical University, Chongqing, China
| | - Yiming Sun
- Department of General Surgery, The Second Affiliated Hospital of Army Medical University, Chongqing, China
| | - Ying Xiao
- Department of General Surgery, The Second Affiliated Hospital of Army Medical University, Chongqing, China
| | - Guangsheng Du
- Department of General Surgery, The Second Affiliated Hospital of Army Medical University, Chongqing, China
| | - Qingling Zhang
- Department of Medical Psychology, The Second Affiliated Hospital of Army Medical University, Chongqing, China
| |
Collapse
|
18
|
Velasco-Durantez V, Cruz-Castellanos P, Hernandez R, Rodriguez-Gonzalez A, Fernandez Montes A, Gallego A, Manzano-Fernandez A, Sorribes E, Zafra M, Carmona-Bayonas A, Calderon C, Jiménez-Fonseca P. Prospective study of predictors for anxiety, depression, and somatization in a sample of 1807 cancer patients. Sci Rep 2024; 14:3188. [PMID: 38326426 PMCID: PMC10850144 DOI: 10.1038/s41598-024-53212-y] [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: 02/17/2023] [Accepted: 01/29/2024] [Indexed: 02/09/2024] Open
Abstract
In cancer patients, psychological distress, which encompasses anxiety, depression, and somatization, arises from the complex interplay of emotional and behavioral reactions to the diagnosis and treatment, significantly influencing their functionality and quality of life. The aim was to investigate factors associated with psychological distress in cancer patients. This prospective and multicenter study, conducted by the Spanish Society of Medical Oncology (SEOM), included two cohorts of patients with cancer (localized resected or advanced unresectable). They completed surveys assessing psychological distress (BSI-18) before and after cancer treatment and coping (MINI-MAC) and spirituality (FACIT-sp) prior to therapy. A multivariable logistic regression analysis and a Structural Equation Modeling (SEM) were conducted. Between 2019 and 2022, 1807 patients were evaluated, mostly women (54%), average age 64 years. The most frequent cancers were colorectal (30%), breast (25%) and lung (18%). Men had lower levels of anxiety and depression (OR 0.66, 95% CI 0.52-0.84; OR 0.72, 95% CI 0.56-0.93). Colorectal cancer patients experienced less anxiety (OR 0.63, 95% CI 0.43-0.92), depression (OR 0.55, 95% CI 0.37-0.81), and somatization (OR 0.59, 95% CI 0.42-0.83). Patients with localized cancer and spiritual beliefs had reduced psychological distress, whereas those with anxious preoccupation had higher level. SEM revealed a relationship between psychological distress and coping strategies, emphasizing how baseline anxious preoccupation exacerbates post-treatment distress. This study suggests that age, sex, extension and location of cancer, coping and spirituality influence psychological distress in cancer patients.
Collapse
Affiliation(s)
- Veronica Velasco-Durantez
- Department of Medical Oncology, Hospital Universitario Central de Asturias, ISPA, Avenida Roma sn, 33011, Oviedo, Spain.
- Universidad de Valladolid, Valladolid, Spain.
| | | | - Raquel Hernandez
- Department of Medical Oncology, Hospital Universitario de Canarias, Tenerife, Spain
| | - Adan Rodriguez-Gonzalez
- Department of Medical Oncology, Hospital Universitario Central de Asturias, ISPA, Avenida Roma sn, 33011, Oviedo, Spain
| | - Ana Fernandez Montes
- Department of Medical Oncology, Complejo Hospitalario Universitario de Ourense, Orense, Spain
| | - Alejandro Gallego
- Department of Medical Oncology, Clínica Universidad de Navarra, Madrid, Spain
| | | | - Elena Sorribes
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Barcelona, Spain
| | - Marta Zafra
- Department of Hematology and Medical Oncology, Hospital Universitario Morales Meseguer, Murcia, Spain
| | - Alberto Carmona-Bayonas
- Department of Hematology and Medical Oncology, Hospital Universitario Morales Meseguer, UMU, IMIB, Murcia, Spain
| | - Caterina Calderon
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Barcelona, Spain
| | - Paula Jiménez-Fonseca
- Department of Medical Oncology, Hospital Universitario Central de Asturias, ISPA, Avenida Roma sn, 33011, Oviedo, Spain
| |
Collapse
|
19
|
Cenit-García J, Buendia-Gilabert C, Contreras-Molina C, Puente-Fernández D, Fernández-Castillo R, García-Caro MP. Development and Psychometric Validation of the Breast Cancer Stigma Assessment Scale for Women with Breast Cancer and Its Survivors. Healthcare (Basel) 2024; 12:420. [PMID: 38391796 PMCID: PMC10887980 DOI: 10.3390/healthcare12040420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/14/2024] [Accepted: 01/26/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND The increase in breast cancer cases and breast cancer survival makes it advisable to quantify the impact of the health-related stigma of this disease. PURPOSE/OBJECTIVES To develop and validate a breast cancer stigma scale in Spanish. METHODS Women diagnosed with, or survivors of, breast cancer were included. The development of the Breast Cancer Stigma Assessment Scale (BCSAS) involved both a literature review and personal interviews. Content validity was assessed using a Delphi study and a pilot test; construct validity was evaluated using an exploratory factor analysis; and convergent validity was assessed using six scales. Cronbach's α internal consistency and test-retest reliability were used to determine the reliability of the scales. RESULTS 231 women responded to the 28-item scale. The BCSAS showed good reliability, with α = 0.897. Seven factors emerged: concealment (α = 0.765), disturbance (α = 0.772), internalized stigma (α = 0.750), aesthetics (α = 0.779), course (α = 0.599), danger (α = 0.502), and origin (α = 0.350). The test-retest reliability was 0.830 (p < 0.001). Significant correlation was observed with event centrality (r = 0.701), anxiety-depression (r = 0.668), shame (r = 0.645), guilt (r = 0.524), and quality of life (r = -0.545). CONCLUSIONS The BCSAS is a reliable and valid measure of stigma in women with breast cancer and its survivors. It could be useful for detecting stigma risk and establishing psychotherapeutic and care priorities.
Collapse
Affiliation(s)
- Judit Cenit-García
- Virgen de las Nieves University Hospital, 18014 Granada, Spain
- ibs.GRANADA-Biosanitary Research Institute, 18012 Granada, Spain
| | | | | | - Daniel Puente-Fernández
- ibs.GRANADA-Biosanitary Research Institute, 18012 Granada, Spain
- Department of Nursing, Faculty of Health Sciences, University of Granada, Avda. de la Ilustración, 60, 18016 Granada, Spain
| | - Rafael Fernández-Castillo
- Department of Nursing, Faculty of Health Sciences, University of Granada, Avda. de la Ilustración, 60, 18016 Granada, Spain
| | - María Paz García-Caro
- ibs.GRANADA-Biosanitary Research Institute, 18012 Granada, Spain
- Department of Nursing, Faculty of Health Sciences, University of Granada, Avda. de la Ilustración, 60, 18016 Granada, Spain
- CIMCYC-Mind, Brain and Behavior Research Center, University of Granada, 18071 Granada, Spain
| |
Collapse
|
20
|
Zach D, Jensen PT, Falconer H, Kolkova Z, Bohlin KS, Kjølhede P, Åvall Lundqvist E, Flöter Rådestad A. Anxiety and depression among women with newly diagnosed vulvar cancer - A nationwide longitudinal study. Acta Obstet Gynecol Scand 2024; 103:396-406. [PMID: 37891709 PMCID: PMC10823412 DOI: 10.1111/aogs.14710] [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: 08/14/2023] [Revised: 10/08/2023] [Accepted: 10/13/2023] [Indexed: 10/29/2023]
Abstract
INTRODUCTION Our objective was to investigate the trajectories of anxiety, depression, emotional and social functioning in women with newly diagnosed vulvar cancer from the time of diagnosis to 12 months after treatment. A further aim was to identify risk factors for high levels of anxiety. MATERIAL AND METHODS PROVE (PROspective Vulvar Cancer Evaluation) is a nationwide longitudinal cohort study investigating quality of life in women with newly diagnosed vulvar cancer by the following validated patient-reported outcome measures at diagnosis, and 3 and 12 months after treatment: The Hospital Anxiety and Depression Scale, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30, and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Vulvar module VU34. Mean scores, changes over time and associations were analyzed by generalized estimated equations and log-linear regression models, adjusted for possible confounders. RESULTS Between 2019 and 2021, 105 (69%) women completed the questionnaires at all three time points. At diagnosis, 42% of the women reported elevated anxiety levels, decreasing significantly to 30% during the first 12 months. Insomnia, persisting vulvar symptoms and high information needs were significantly associated with a high level of anxiety (relative risk [RR] 2.1, 95% CI 1.2-3.7 for insomnia; RR 2.8, 95% CI 1.7-4.6 for vulvar symptoms, RR 2.7, 95% CI 1.5-4.9 for information needs). We found a trend towards a higher level of anxiety in younger women (<65 years: RR 1.5, 95% CI 1.0-2.5). Participants reported a low and stable prevalence of depression (14%) and high social functioning throughout the study period. CONCLUSIONS Women with newly diagnosed vulvar cancer report a high level of anxiety at diagnosis. Despite a significant improvement, anxiety remains widely prevalent during the first year of follow-up. Targeting insomnia, vulvar symptoms and unmet needs may decrease anxiety during surveillance.
Collapse
Affiliation(s)
- Diana Zach
- Department of Gynecological Cancer, Karolinska University Hospital, Department of Women's and Children's HealthKarolinska InstitutetStockholmSweden
| | - Pernille T. Jensen
- Department of Gynecology and ObstetricsAarhus University HospitalAarhusDenmark
- Department of Clinical MedicineAarhus UniversityAarhusDenmark
| | - Henrik Falconer
- Department of Gynecological Cancer, Karolinska University Hospital, Department of Women's and Children's HealthKarolinska InstitutetStockholmSweden
| | - Zuzana Kolkova
- Department of Obstetrics and Gynecology, Skåne University Hospital, Department of Clinical SciencesLund UniversityLundSweden
| | - Katja Stenström Bohlin
- Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, Gothenburg, Sahlgrenska AcademyGothenburg UniversityGothenburgSweden
| | - Preben Kjølhede
- Department of Obstetrics and Gynecology and Department of Biomedical and Clinical SciencesLinköping UniversityLinköpingSweden
| | - Elisabeth Åvall Lundqvist
- Department of Oncology and Department of Biomedical and Clinical SciencesLinköping UniversityLinköpingSweden
| | - Angelique Flöter Rådestad
- Department of Gynecological Cancer, Karolinska University Hospital, Department of Women's and Children's HealthKarolinska InstitutetStockholmSweden
| |
Collapse
|
21
|
Von Reusner MJ, Märtens B, Barthel S, Weiser A, Ziert Y, Steinmann D, Babadağ-Savaş B. Interdisciplinary Integrative Oncology Group-Based Program: Evaluation of Long-Term Effects on Resilience and Use of Complementary and Alternative Medicine in Patients With Cancer. Integr Cancer Ther 2024; 23:15347354241269931. [PMID: 39155547 PMCID: PMC11331462 DOI: 10.1177/15347354241269931] [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] [Revised: 03/06/2024] [Accepted: 07/22/2024] [Indexed: 08/20/2024] Open
Abstract
BACKGROUND Cancer often causes reduced resilience, quality of life (QoL) and poorer overall well-being. To mitigate these problems, complementary and alternative medicine (CAM) is widely used among patients with cancer. This study aimed to evaluate the long-term effects of an interdisciplinary integrative oncology group-based program (IO-GP) on the resilience and use of CAM in patients with cancer. METHODS This was a prospective, observational, single-center study. Resilience (RS-13), CAM usage (I-CAM-G), QoL (SF-12) and health-related lifestyle factor (nutrition, smoking, alcohol consumption and physical exercise) data were collected for 70 patients who participated in a 10-week IO-GP between January 2019 and June 2022 due to cancer. The IO-GP is offered at the setting of a university hospital and is open to adult patients with cancer. It contains elements from mind-body medicine and positive psychology, as well as recommendations on healthy diet, exercise and CAM approaches. Patients who completed the IO-GP at least 12 months prior (1-4.5 years ago) were included in this study. Statistical analysis included descriptive analysis and parametric and nonparametric tests to identify significant differences (P < .05). RESULTS Resilience increased significantly ≥12 months after participation in the IO-GP (n = 44, P = .006, F = 8.274) and had a medium effect size (r = .410). The time since the IO-GP was completed ("12-24 months," "24-36 months," and ">36 months") showed no statistically significant interaction with changes in resilience (P = .226, F = 1.544). The most frequently used CAM modalities within the past 12 months were vitamins/minerals (85.7%), relaxation techniques (54.3%), herbs and plant medicine (41.1%), yoga (41.4%) and meditation (41.4%). The IO-GP was the most common source informing study participants about relaxation techniques (n = 24, 64.9%), meditation (n = 21, 72.4%) and taking vitamin D (n = 16, 40.0%). Significantly greater levels of resilience were found in those practicing meditation (P = .010, d = -.642) or visualization (P = .003, d = -.805) compared to non-practitioners. CONCLUSION IO-GPs have the potential to empower patients with cancer to continue using CAM practices-especially from mind-body medicine-even 1 to 4.5 years after completing the program. Additionally, resilience levels increased. These findings provide notable insight into the long-term effects of integrative oncology interventions on resilience and the use of CAM, especially in patients with breast cancer.
Collapse
Affiliation(s)
| | - Bettina Märtens
- Department of Radiotherapy, Hannover Medical School, Hannover, Germany
- CCC Hannover (Claudia von Schilling Center), Klaus Bahlsen Center for Integrative Oncology, Hannover Medical School, Hannover, Germany
| | - Stephanie Barthel
- CCC Hannover (Claudia von Schilling Center), Klaus Bahlsen Center for Integrative Oncology, Hannover Medical School, Hannover, Germany
| | - Axel Weiser
- Quality Management, Hannover Medical School, Hannover, Germany
| | - Yvonne Ziert
- Institute of Biometrics, Hannover Medical School, Hannover, Germany
| | - Diana Steinmann
- Department of Radiotherapy, Hannover Medical School, Hannover, Germany
- CCC Hannover (Claudia von Schilling Center), Klaus Bahlsen Center for Integrative Oncology, Hannover Medical School, Hannover, Germany
| | | |
Collapse
|
22
|
Joulaei H, Parhizkar M, Fatemi M, Afrashteh S, Parhizkar P, Akrami M, Foroozanfar Z. Mental Health Care Utilization and its Barriers among Iranian Breast Cancer Survivors: A Cross-sectional Study. INTERNATIONAL JOURNAL OF COMMUNITY BASED NURSING AND MIDWIFERY 2024; 12:44-56. [PMID: 38328011 PMCID: PMC10844875 DOI: 10.30476/ijcbnm.2023.99133.2289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 11/07/2023] [Accepted: 11/21/2023] [Indexed: 02/09/2024]
Abstract
Background Depression and anxiety are common comorbidities complicating the care of breast cancer patients, but many patients do not receive the needed care. We aimed to assess utilization of mental health care and its barriers in breast cancer survivors. Methods This cross-sectional study was conducted on 311 patients with breast cancer, in Iran, November 2021 to March 2022. Perceived need and utilization of mental health care and barriers to service utilization were measured based on self-report. Depression, Anxiety, and Stress Scale-21 and Multidimensional Scale of Perceived Social Support were used to assess depression, anxiety, and stress as well as social support, respectively. A linear and logistic regression model was used to analyze the data using SPSS version 22. A P-value less than 0.05 was considered statistically significant. Results 70.1% of the participants perceived need for mental health care, 28.0% of them had used mental health services, and 72% were classified as having unmet needs. The most common perceived barrier to service use was patients' self-adequacy. The prevalence of extremely severe levels of depression, anxiety, and stress was 14.8%, 23.5%, and 10.6%. Also, 48.6%, 78.5%, and 75.6% of patients received a high level of social support from friends, family, and significant others. Conclusion Findings highlight a substantial unmet need for mental health care and low utilization of mental health services among breast cancer survivors. Given the significant prevalence of depression, anxiety, and stress in this population, it is imperative to address the underutilization of mental health services and to further examine the barriers preventing patients from seeking the care they require.
Collapse
Affiliation(s)
- Hassan Joulaei
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohamad Parhizkar
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Fatemi
- Department of Psychology, Shiraz Branch, Islamic Azad University, Shiraz, Iran
| | - Sima Afrashteh
- Clinical Research Development Center, The Persian Gulf Martyrs Hospital, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Pardis Parhizkar
- Student Research Committee, Fasa University of Medical Sciences, Fasa, Iran
| | - Majid Akrami
- Breast Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zohre Foroozanfar
- HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
23
|
Karveli S, Galanis P, Mitropoulou EM, Karademas E, Markopoulos C. The Role of Attachment Styles on Quality of Life and Distress Among Early-Stage Female Breast Cancer Patients: A Systematic Review. J Clin Psychol Med Settings 2023; 30:724-739. [PMID: 36773123 PMCID: PMC10560157 DOI: 10.1007/s10880-023-09940-w] [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] [Accepted: 01/10/2023] [Indexed: 02/12/2023]
Abstract
Cancer patients' quality of life (QoL) and distress are affected by dispositional factors such as attachment anxiety or avoidance. In this review, we aimed to provide a thorough overview of the relationship between attachment dimensions and QoL and distress among early-stage breast cancer patients. Following PRISMA guidelines, we conducted a systematic search using PubMed, PsycINFO, Scopus, Cinahl, Google Scholar, and PMC Europe. We reviewed 8 eligible studies describing 1180 patients. Insecure attachment appeared to be related to poorer QoL and higher distress levels. Avoidant attachment was more frequent and was more often associated with more negative outcomes. Healthcare providers should consider investigating modifiable personality traits in the immediate post diagnosis period to identify patients more vulnerable to mental health problems, deliver personalized care, and reduce emotional burden.
Collapse
Affiliation(s)
- Spyridoula Karveli
- School of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias Str, 11527, Athens, Greece.
| | - Petros Galanis
- Clinical Epidemiology Laboratory, Faculty of Nursing, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Evangelos Karademas
- Department of Psychology, Faculty of Social Sciences, University of Crete, Rethymnon, Greece
| | - Christos Markopoulos
- School of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias Str, 11527, Athens, Greece
| |
Collapse
|
24
|
Im EO, Yi JS, Chee W. A Decision Tree Analysis on Symptom Experience of Asian American Breast Cancer Survivors. West J Nurs Res 2023; 45:1076-1084. [PMID: 37882470 DOI: 10.1177/01939459231204294] [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: 10/27/2023]
Abstract
BACKGROUND Mainly due to their cultural attitudes toward symptoms and breast cancer, Asian American breast cancer survivors tend to suffer from symptoms and often delay in getting treatments, information, and support. To improve their symptom management, it would be important to determine risk groups among them. Decision tree analyses reportedly help determine risk groups by identifying the characteristics that are directly associated with target health outcomes. OBJECTIVE Using a decision tree analysis, this study aimed at identifying the characteristics that were closely linked to the symptom experience of Asian American breast cancer survivors. METHODS This was a part of a parent randomized controlled trial among Asian American breast cancer survivors. Only the data from 135 women at the pre-test were included. Multiple instruments were used to collect the data: the Memorial Symptom Assessment Scale-Short Form, the Cancer Behavior Inventory, the PRQ-2000, the Perceived Isolation Scale, and the Supportive Care Needs Survey-Short Form 34. The data were analyzed using latent profile analysis and decision tree analyses. RESULTS Two most frequently found profiles included the low symptom experience profile (72.6%) and the high symptom experience profile (27.4%). The high symptom experience profile was predicted by 2 combined characteristics; (a) high psychological needs for help (over 60.00 points), and (b) low psychological needs for help (cut point = 60.00), high perceived barriers (cut point = 1.62), and high social isolation (social support) (cut point = 2.33). CONCLUSIONS These characteristics linked to Asian American breast cancer survivors with high symptom experience need to be considered in future intervention development.
Collapse
Affiliation(s)
| | - Jee-Seon Yi
- Emory University, Atlanta, GA, USA
- College of Nursing, Institute of Health Sciences, Gyeongsang National University, Jinju, Republic of Korea
| | | |
Collapse
|
25
|
Zhang Y, Gan C, Xu J, Pang L, Li W, Cheng H. Psychological distress as a risk factor for the efficacy of chemotherapy in advanced gastric cancer patients. Support Care Cancer 2023; 31:669. [PMID: 37922088 DOI: 10.1007/s00520-023-08143-1] [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: 02/03/2023] [Accepted: 10/24/2023] [Indexed: 11/05/2023]
Abstract
AIM To assess the relationship between psychological distress and quality of life (QoL), cancer-related fatigue (CRF), and chemotherapy efficacy in advanced gastric cancer patients. METHODS Advanced gastric cancer patients (39 with psychological distress and 35 without psychological distress) completed the Distress Thermometer (DT), QoL, and CRF test before receiving chemotherapy and assessed the efficacy after completing 2 courses of chemotherapy. RESULTS Psychological distress was a significant factor in the efficacy of chemotherapy in advanced gastric cancer patients (χ2 = 6.324; p = 0.042). Compared to advanced gastric cancer patients with no psychological distress, advanced gastric cancer patients with psychological distress had a poorer QoL (50.41 ± 6.17 vs. 60.01 ± 7.94, t = - 5.882, p < 0.01) and more pronounced CRF (5.75 ± 1.16 vs. 3.22 ± 0.75, t = 11.231, p < 0.01) while receiving chemotherapy. FACT-G (p = 0.0035, r = - 0.4568), as well as PFS (p < 0.0001, r = 0.6599), correlated significantly with efficacy for patients in the psychological distress group. The FACT-G (p = 0.0134, r = - 0.4139) of patients in the no psychological distress group correlated significantly with efficacy. CONCLUSION Psychological distress has a negative impact on QoL, CRF, and efficacy and may be a potential risk for the efficacy of palliative chemotherapy in advanced gastric cancer patients.
Collapse
Affiliation(s)
- Yongkang Zhang
- Department of Oncology, Hefei Cancer Hospital, Chinese Academy of Sciences, Hefei, 230088, China
| | - Chen Gan
- Department of Oncology, Anhui Medical University, Hefei, 230601, China
| | - Jian Xu
- Department of Oncology, Anhui Medical University, Hefei, 230601, China
| | - Lulian Pang
- Department of Oncology, Anhui Medical University, Hefei, 230601, China
| | - Wen Li
- Department of Oncology, Anhui Medical University, Hefei, 230601, China
| | - Huaidong Cheng
- Department of Oncology, Anhui Medical University, Hefei, 230601, China.
- Department of Oncology, Shenzhen Hospital of Southern Medical University, Shenzhen, 518000, China.
| |
Collapse
|
26
|
Delikanli C, Janssen S, Yu NY, Rades D. Development of Distress During a Radiotherapy Course in Patients Irradiated for Breast Cancer. In Vivo 2023; 37:2755-2759. [PMID: 37905616 PMCID: PMC10621448 DOI: 10.21873/invivo.13386] [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: 06/28/2023] [Revised: 07/27/2023] [Accepted: 07/28/2023] [Indexed: 11/02/2023]
Abstract
BACKGROUND/AIM Breast cancer patients receiving radiation therapy (RT) may experience considerable distress. We investigated the course of distress during an RT-course for breast cancer. PATIENTS AND METHODS Three-hundred-and-thirty breast cancer patients completed Distress Thermometers before and directly after RT. Distress was evaluated in the entire cohort and different groups of age, sex, Karnofsky performance score (KPS), intent of RT, and previous RT. RESULTS Mean change of distress scores was - 0.4 points, which was significantly associated with KPS. Decrease of distress was more pronounced in patients with KPS ≤80 or age <64 years. Deterioration (yes vs. no) was non-significantly associated with no previous RT. In patients with pre-RT distress scores ≤5 points, mean score increased by +0.5 points; no significant associations between characteristics and investigated endpoints were found. CONCLUSION Psychological assistance should be offered to all patients irradiated for breast cancer, particularly to those with risk factors, regardless of the pre-RT distress score.
Collapse
Affiliation(s)
- Cansu Delikanli
- Department of Radiation Oncology, University of Lübeck, Lübeck, Germany
| | - Stefan Janssen
- Department of Radiation Oncology, University of Lübeck, Lübeck, Germany
- Medical Practice for Radiotherapy and Radiation Oncology, Hannover, Germany
| | - Nathan Y Yu
- Department of Radiation Oncology, Mayo Clinic, Phoenix, AZ, U.S.A
| | - Dirk Rades
- Department of Radiation Oncology, University of Lübeck, Lübeck, Germany;
| |
Collapse
|
27
|
Yi SJ, Kim KS, Lee S, Lee H. Effects of Post Traumatic Growth on Successful Aging in Breast Cancer Survivors in South Korea: The Mediating Effect of Resilience and Intolerance of Uncertainty. Healthcare (Basel) 2023; 11:2843. [PMID: 37957988 PMCID: PMC10650018 DOI: 10.3390/healthcare11212843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 10/23/2023] [Accepted: 10/26/2023] [Indexed: 11/15/2023] Open
Abstract
This study aimed to identify post-traumatic growth and successful aging and the mediating effects of resilience and intolerance of uncertainty in breast cancer survivors. This study employed a descriptive survey approach. Data were collected from 143 breast cancer survivors between 27 January and 10 December 2021, at a cancer center in Gyeongsangnam-do, South Korea. SPSS/WIN 25.0 and PROCESS Macro version 3.5 were used for data analysis. Descriptive statistics were analyzed with SPSS. PROCESS was used to conduct a mediation analysis and the significance of the mediating effect was evaluated using 95% confidence intervals. Successful aging was significantly associated with post-traumatic growth, resilience, and the intolerance of uncertainty. The impact of post-traumatic growth on successful aging was mediated by resilience in breast cancer survivors. Resilience should be considered when developing nursing interventions to enhance post-traumatic growth and promote successful aging in breast cancer survivors.
Collapse
Affiliation(s)
- Su Jeong Yi
- College of Nursing, Dankook University, Cheonan 31116, Republic of Korea
| | - Ku Sang Kim
- Department of Breast Surgery, Kosin University Gospel Hospital, Busan 49267, Republic of Korea
| | - Seunghee Lee
- College of Nursing, Dankook University, Cheonan 31116, Republic of Korea
| | - Hyunjung Lee
- College of Nursing, Chungnam National University, Daejeon 35015, Republic of Korea
| |
Collapse
|
28
|
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.
Collapse
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.)
| |
Collapse
|
29
|
Dorfman CS, Fisher HM, Thomas S, Kelleher SA, Winger JG, Mitchell NS, Miller SN, Somers TJ. Breast cancer survivors with pain: an examination of the relationships between body mass index, physical activity, and symptom burden. Support Care Cancer 2023; 31:604. [PMID: 37782420 PMCID: PMC10721211 DOI: 10.1007/s00520-023-08064-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 09/22/2023] [Indexed: 10/03/2023]
Abstract
PURPOSE Overweight and obesity are common for breast cancer survivors and associated with high symptom burden (i.e., pain, fatigue, depressive symptoms). Physical activity may protect breast cancer survivors with higher body mass indexes (BMI) from increased symptoms. However, the role of physical activity in buffering the relationship between higher BMI and greater symptoms is unclear. METHODS Baseline data from a randomized trial investigating Pain Coping Skills Training among breast cancer survivors (N = 327) with pain were used to examine the relationship between self-reported BMI (kg/m2) and physical activity level (Rapid Assessment of Physical Activity; suboptimal vs. optimal) with pain (Brief Pain Inventory; severity and interference), fatigue (PROMIS-Fatigue short form), and depressive symptoms (Center for Epidemiological Studies Depression Scale). Analyses were conducted in SPSS. Hayes PROCESS macro (Model 1) assessed whether physical activity moderated the relationship between BMI and symptoms. RESULTS Lower BMI (B = .06, p < .01) and optimal physical activity (B = - .69, p < .01) were independently associated with lower pain interference. Lower BMI was also associated with lower pain severity (B = .04, p < .001). Neither BMI nor physical activity was associated with fatigue or depressive symptoms. Physical activity did not moderate the relationship between BMI and symptoms. CONCLUSIONS Among breast cancer survivors experiencing pain, higher BMI and being less physically active were related to greater pain (i.e., severity and/or interference). Physical activity did not buffer the relationships between BMI and pain, fatigue, and depressive symptoms, suggesting that physical activity alone may not be sufficient to influence the strength of the relationships between BMI and symptoms.
Collapse
Affiliation(s)
- Caroline S Dorfman
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.
- Duke Cancer Institute, Duke University Medical Center, Durham, NC, USA.
| | - Hannah M Fisher
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - Samantha Thomas
- Duke Cancer Institute, Duke University Medical Center, Durham, NC, USA
- Department of Biostatistics & Bioinformatics, Duke University Medical Center, Durham, NC, USA
| | - Sarah A Kelleher
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
- Duke Cancer Institute, Duke University Medical Center, Durham, NC, USA
| | - Joseph G Winger
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
- Duke Cancer Institute, Duke University Medical Center, Durham, NC, USA
| | - Nia S Mitchell
- Duke Cancer Institute, Duke University Medical Center, Durham, NC, USA
- Department of Medicine, Duke University Medical Center, Durham, NC, USA
| | - Shannon N Miller
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - Tamara J Somers
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
- Duke Cancer Institute, Duke University Medical Center, Durham, NC, USA
| |
Collapse
|
30
|
Rometsch C, Teufel M, Skoda EM, Schweda A, Cosci F, Zipfel S, Stengel A, Salewski C. Depression and anxiety mediate the relationship between illness representations and perceived distress in patients with chronic pain. Sci Rep 2023; 13:15527. [PMID: 37726367 PMCID: PMC10509225 DOI: 10.1038/s41598-023-42156-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 09/06/2023] [Indexed: 09/21/2023] Open
Abstract
Illness representations explain the individual's perception and processing of health-related information. In a chronic condition such as persistent pain, illness representations might influence treatment adherence and outcome. This study aims to exploratively identify illness representations of patients with chronic pain and their association to mental disorders and subjective distress. 95 participants admitted to an inpatient university clinic were included. Validated instruments were used to assess illness representations (IPQ-R), mental health disorders (PHQ-D), and subjective distress (PSQ). Sociodemographic data and scores for the instruments were first inspected descriptively. Correlation, regression, and mediator analyses were conducted. Analyses indicated that the distributions of the IPQ-R range toward higher values. In regard to mental disorders (PHQ-D) and subjective distress (PSQ), we found several significant correlations with subscales of the IPQ-R. A regression analysis showed the IPQ-R subscales personal control, emotional representation and sex (males) to be significant predictors of subjective distress measured with the PSQ (F(11,86) = 11.55, p < .001, adjusted R2 = 0.545). Depression, anxiety, and stress syndromes (PHQ-D) significantly mediated the positive association between emotional representations (IPQ-R, predictor) and subjective distress (PSQ, outcome) with a total effect of c = .005, 95% CI [.005; .129]. Illness representations play a significant role in evaluating patients' subjective distress and mental health. It is advised to incorporate illness representations into standard protocols for psychological interventions to comprehend their influence on targeted therapeutic strategies, particularly those tailored for pain management.
Collapse
Affiliation(s)
- Caroline Rometsch
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany.
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR University-Hospital Essen, University of Duisburg-Essen, Essen, Germany.
- Department of Psychology, University of Hagen, Hagen, Germany.
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
| | - Martin Teufel
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR University-Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Eva-Maria Skoda
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR University-Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Adam Schweda
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR University-Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Fiammetta Cosci
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
- German Center for Mental Health (DZPG), Site Tübingen, Tübingen, Germany
| | - Andreas Stengel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
- German Center for Mental Health (DZPG), Site Tübingen, Tübingen, Germany
- Charité Center for Internal Medicine and Dermatology, Department for Psychosomatic Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | | |
Collapse
|
31
|
Myers C, Waldron C, Bennett K, Cahir C. Impact of the COVID-19 pandemic on women living with and beyond breast cancer: a qualitative study of women's experiences and how they varied by social determinants of health. BMC Cancer 2023; 23:867. [PMID: 37715181 PMCID: PMC10503161 DOI: 10.1186/s12885-023-11351-x] [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: 02/08/2023] [Accepted: 08/30/2023] [Indexed: 09/17/2023] Open
Abstract
BACKGROUND The aim of this study is to explore the general impact of COVID-19 on the access and use of BC services and support and overall well-being in women living with a diagnosis of breast cancer (BC) and to investigate how these experiences varied by the social determinants of health (SDH). METHODS Semi-structured qualitative interviews were conducted with women selected through stratified purposive sampling to ensure data were available on information-rich cases. Interviews were conducted in early 2021 during government restrictions due to COVID-19. Thematic analysis was conducted to obtain overall experience and variation of experience based on SDH. RESULTS Thirty seven women participated in interviews. Three major themes, with additional subthemes, emerged from analysis: 1. breast cancer services (screening, active treatment, and routine care); 2. breast cancer support and communication (continuity of care, role of liaison, and support services); and 3. quality of life (QoL) and well-being (emotional well-being; social well-being; and functional well-being). Women's experiences within the themes varied by socio-economic status (SES) and region of residence (urban/rural) specifically for BC services and support. CONCLUSION The pandemic impacted women living with and beyond BC, but the impact has not been the same for all women. This study highlights areas for improvement in the context of BC care in Ireland and the findings will inform further policy and practice, including standardized BC services, improved communication, and enhancement of cancer support services.
Collapse
Affiliation(s)
- Charlotte Myers
- School of Population Health, RCSI University of Medicine and Health Sciences, Dublin, Ireland.
| | - Catherine Waldron
- School of Population Health, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Kathleen Bennett
- Data Science Centre, School of Population Health, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Caitriona Cahir
- Data Science Centre, School of Population Health, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| |
Collapse
|
32
|
Omari M, Amaadour L, Zarrouq B, Al-Sheikh YA, El Asri A, Kriya S, Nadi S, Benbrahim Z, Mellas N, Rhazi KE, Ragala MEA, Hilaly JE, Giesy JP, Aboul-Soud MAM, Halim K. Evaluation of psychological distress is essential for patients with locally advanced breast cancer prior to neoadjuvant chemotherapy: baseline findings from cohort study. BMC Womens Health 2023; 23:445. [PMID: 37612725 PMCID: PMC10464406 DOI: 10.1186/s12905-023-02571-1] [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: 05/08/2023] [Accepted: 07/25/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND patients with locally advanced breast cancer (LABC) are often treated by neoadjuvant chemotherapy (NACT). This study aims to determine the prevalence of psychological distress and their sociodemographic and clinical factors in patients recently diagnosed with LABC and before NACT. METHODS A total of 209 LABC patients without metastatic localization were recruited between 2021 and 2022 in the oncology hospital at Fez. A structured questionnaire and the Hospital Anxiety and Depression Scale were used. A descriptive analysis and linear model were performed. RESULTS a mean age of participants was 47.43 ± 9.45 years. The prevalence of depression, anxiety and psychological distress among participants was 59.62% (95% CI: 52.61-33.34), 47.85% (95% CI: 40.91-54.85), and 65.07 (95% CI: 58.19-71.52) respectively. Depression was associated to age (< 50 years) (AOR = 2.19; 95% CI = 1.13-4.23) and health insurance (AOR = 3.64; 95% CI: 1.18-11.26). Anxiety was associated to age (< 50) (AOR = 2.21; 95% CI: 1.18-4.13) and right breast cancer (AOA = 2.01; 95% CI: 1.11-3.65). Psychological distress was associated to chronic illness (AOR = 2.78; 95% CI: 1.32-5.85) and lymph node status (AOR = 2.39; 95% CI: 1.26-4.57). CONCLUSIONS Based on the high prevalence of depression and anxiety it appears opportune to treat psychological distress among LABC patient candidates for NACT. Each psychological intervention should take into account sociodemographic and clinical factors found associated in our study. Psychological therapeutic interventions are crucial for LABC patients as early as the time of diagnosis and through subsequent steps in NACT to improve their overall mental health.
Collapse
Affiliation(s)
- Majid Omari
- Laboratory of Epidemiology and Research in Health Sciences, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdallah University, Fez, Morocco.
- Laboratory of Natural Substances, Pharmacology, Environment, Modeling, Health & Quality of Life, Faculty of Sciences Dhar El Mahraz, Sidi Mohamed Ben Abdellah University, Fez, Morocco.
| | - Lamiae Amaadour
- Department of Medical Oncology, Hassan II University Hospital, Fez, Morocco
| | - Btissame Zarrouq
- Laboratory of Epidemiology and Research in Health Sciences, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdallah University, Fez, Morocco
- Department of Biology and Geology, Teacher's Training College (Ecole Normale Supérieure), Sidi Mohamed Ben Abdallah University, Fez, Morocco
| | - Yazeed A Al-Sheikh
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh, 11433, Saudi Arabia
| | - Achraf El Asri
- Laboratory of Epidemiology and Research in Health Sciences, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdallah University, Fez, Morocco
| | - Salima Kriya
- Higher Institute of Nursing Professions and Health Techniques, Fez, Morocco
| | - Sara Nadi
- Higher Institute of Nursing Professions and Health Techniques, Fez, Morocco
| | - Zineb Benbrahim
- Department of Medical Oncology, Hassan II University Hospital, Fez, Morocco
| | - Nawfel Mellas
- Department of Medical Oncology, Hassan II University Hospital, Fez, Morocco
| | - Karima El Rhazi
- Laboratory of Epidemiology and Research in Health Sciences, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdallah University, Fez, Morocco
| | - Mohammed El Amine Ragala
- Laboratory of Natural Substances, Pharmacology, Environment, Modeling, Health & Quality of Life, Faculty of Sciences Dhar El Mahraz, Sidi Mohamed Ben Abdellah University, Fez, Morocco
- Department of Biology and Geology, Teacher's Training College (Ecole Normale Supérieure), Sidi Mohamed Ben Abdallah University, Fez, Morocco
| | - Jaouad El Hilaly
- Laboratory of Pedagogical and Didactic Engineering of Sciences and Mathematics, Regional Center of Education and Training (CRME F) of Fez, Fez, Morocco
- R.N.E Laboratory, Multidisciplinary Faculty of Taza, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - John P Giesy
- Toxicology Centre, University of Saskatchewan, Saskatoon, SK, S7N 5B3, Canada
- Department of Veterinary Biomedical Sciences, University of Saskatchewan, Saskatoon, SK, S7N 5B4, Canada
- Department of Integrative Biology, Michigan State University, East Lansing, MI, 48824, USA
- Department of Environmental Sciences, Baylor University, Waco, TX, 76706, USA
| | - Mourad A M Aboul-Soud
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh, 11433, Saudi Arabia
| | - Karima Halim
- Laboratory of Natural Substances, Pharmacology, Environment, Modeling, Health & Quality of Life, Faculty of Sciences Dhar El Mahraz, Sidi Mohamed Ben Abdellah University, Fez, Morocco
- Department of Human and Social Sciences - Education Sciences, Teachers Training College (Ecole Normale Superieure), Sidi Mohamed Ben Abdellah University, Fez, Morocco
| |
Collapse
|
33
|
Danielsen JT, Strøm L, Knutzen SM, Schmidt H, Amidi A, Wu LM, Zachariae R. Psychological and behavioral symptoms in patients with melanoma: A systematic review and meta-analysis. Psychooncology 2023; 32:1208-1222. [PMID: 37370196 DOI: 10.1002/pon.6184] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 06/12/2023] [Accepted: 06/18/2023] [Indexed: 06/29/2023]
Abstract
OBJECTIVE Improved survival rates have made it increasingly important for clinicians to focus on cancer survivorship issues affecting the quality of life of melanoma patients. To provide a comprehensive overview of the disease and treatment-related issues affecting such patients, we conducted a systematic review and meta-analysis of the literature to estimate the prevalence of symptoms of depression, anxiety, fatigue, sleep disturbance, and cognitive problems among melanoma patients, both uveal and cutaneous, before, during and after treatment. METHODS The review was preregistered with PROSPERO (#CRD42020189847) and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive search of the literature published up until June 2022 was undertaken using PubMed, PsycInfo, the Cochrane Library, and CINAHL. Two independent reviewers screened 1418 records and quality-rated included studies. The reported prevalence rates of symptoms were pooled using a random-effects model. RESULTS Sixty-six studies including a total of 12,400 melanoma patients published between 1992 and 2022 were included. Pooled prevalence rates ranged from 6% to 16% for depression and 7%-30% for anxiety across diagnoses (uveal and cutaneous melanoma) and assessment time points. One third of the patients (35%) reported clinically significant fatigue, 20%-44% had cognitive complaints, while prevalence of sleep disturbance was not reported. Quality assessment indicated that 80% of the studies were of good quality. CONCLUSION A large body of research shows that depression and anxiety symptoms are prevalent in melanoma patients before, during and after treatment. However, research examining other symptoms known to affect quality of life, such as fatigue, sleep disturbances, and cognitive problems, is still needed.
Collapse
Affiliation(s)
- Josefine T Danielsen
- Unit for Psycho-Oncology & Health Psychology, Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | - Louise Strøm
- Unit for Psycho-Oncology & Health Psychology, Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | - Sofie M Knutzen
- Unit for Psycho-Oncology & Health Psychology, Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | - Henrik Schmidt
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - Ali Amidi
- Unit for Psycho-Oncology & Health Psychology, Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | - Lisa M Wu
- Unit for Psycho-Oncology & Health Psychology, Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
- Aarhus Institute of Advanced Studies, Aarhus University, Aarhus, Denmark
| | - Robert Zachariae
- Unit for Psycho-Oncology & Health Psychology, Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| |
Collapse
|
34
|
Şengün İnan F, Yedigün T, Er İ. Exploring the Unmet Supportive Care Needs of Breast Cancer Survivors Experiencing Psychological Distress: Qualitative Study. Semin Oncol Nurs 2023; 39:151449. [PMID: 37246015 DOI: 10.1016/j.soncn.2023.151449] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 02/03/2023] [Accepted: 04/19/2023] [Indexed: 05/30/2023]
Abstract
OBJECTIVES This study aimed to explore the unmet supportive care needs of breast cancer survivors who experience psychological distress. DATA SOURCES A qualitative study design with inductive content analysis was used. Semistructured interviews were conducted with 18 Turkish breast cancer survivors who experienced psychological distress. The Consolidated Criteria for Reporting Qualitative Research checklist was used to report the study. CONCLUSION Three key themes emerged from data analysis: sources of psychological distress, unmet supportive care needs, and barriers to support. The survivors who experienced psychological distress defined a variety of unmet supportive care needs, in the areas of information support, psychological/emotional support, social support, and individualized health care support. They also described personal and health professional-related factors as barriers. IMPLICATIONS FOR NURSING PRACTICE Nurses should assess psychosocial well-being and supportive care needs of breast cancer survivors. Survivors should be supported to discuss their experiences of symptoms in the early survival phase, and they should be referred to an appropriate supportive care resource. A multidisciplinary survivorship services model is needed to offer posttreatment psychological support routinely in Turkey. Early, effective psychological care integrated into follow-up services for survivors can be protective against psychological morbidity.
Collapse
Affiliation(s)
- Figen Şengün İnan
- Assistant Professor, Faculty of Nursing, Psychiatric Nursing Department, Gazi University, Çankaya, Ankara, Turkey
| | | | - İlhami Er
- Radiation Oncologist, İzmir Katip Celebi University Atatürk Education and Research Hospital, İzmir, Turkey
| |
Collapse
|
35
|
Henneghan AM, Van Dyk K, Zhou X, Moore RC, Root JC, Ahles TA, Nakamura ZM, Mandeblatt J, Ganz PA. Validating the PROMIS cognitive function short form in cancer survivors. Breast Cancer Res Treat 2023; 201:139-145. [PMID: 37330430 PMCID: PMC10729147 DOI: 10.1007/s10549-023-06968-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 05/03/2023] [Indexed: 06/19/2023]
Abstract
PURPOSE The Patient-Reported Outcome Measurement Information System Cognitive Function Short Form 8a (PROMIS Cog) could provide a shorter, useful alternative to the often used Functional Assessment of Cancer Therapy - Cognition (FACT-Cog) in research and clinical care. This study aimed to determine the convergent validity and internal reliability of the PROMIS Cog in 3 separate samples of breast cancer survivors and to explore clinical cut points. METHODS Data from three samples of breast cancer survivors were used for this secondary analysis. Convergent validity was determined by evaluating correlation strength among the derived PROMIS Cog and measures of depression, anxiety, stress, fatigue, sleep, loneliness, the FACT-Cog . Clinical cut-points for the PROMIS Cog were determined by plotting the receiver operating characteristic curves. RESULTS 3 samples of breast cancer survivors (N = 471, N = 132, N = 90) were included. Absolute values of correlations demonstrating convergent validity ranged from 0.21 to 0.82, p's < 0.001, and were comparable to correlations with the full FACT-Cog 18 item perceived cognitive impairments (PCI) scale. ROC curve plots indicated a clinical cut off < 34 for the combined sample. CONCLUSION The 8-item PROMIS Cog demonstrated good convergent validity and internal reliability in breast cancer survivors, comparable to the 18-item FACT-Cog PCI. The PROMIS Cog 8a is a brief self-report measure that can be easily incorporated into cancer-related cognitive impairment research designs or used in clinical settings.
Collapse
Affiliation(s)
| | - Kathleen Van Dyk
- Semel Institute of Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA.
- Jonsson Comprehensive Cancer Center, University of California Los Angeles, Los Angeles, CA, USA.
| | - Xingtao Zhou
- Georgetown Lombardi Comprehensive Cancer Center Georgetown University, Washington, DC, USA
| | - Raeanne C Moore
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - James C Root
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Tim A Ahles
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Zev M Nakamura
- Department of Psychiatry, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA
| | - Jeanne Mandeblatt
- Georgetown Lombardi Comprehensive Cancer Center Georgetown University, Washington, DC, USA
| | - Patricia A Ganz
- Jonsson Comprehensive Cancer Center, University of California Los Angeles, Los Angeles, CA, USA
- Department of Health Policy and Management, UCLA Fielding School of Public Health, University of California at Los Angeles, Los Angeles, CA, USA
| |
Collapse
|
36
|
Renna ME, Shrout MR, Madison AA, Lustberg M, Povoski SP, Agnese DM, Reinbolt RE, Wesolowski R, Williams NO, Ramaswamy B, Sardesai SD, Noonan AM, VanDeusen JB, Stover DG, Cherian M, Malarkey WB, Di Gregorio M, Kiecolt-Glaser JK. Distress Disorder Histories Relate to Greater Physical Symptoms Among Breast Cancer Patients and Survivors: Findings Across the Cancer Trajectory. Int J Behav Med 2023; 30:463-472. [PMID: 35831698 PMCID: PMC10278051 DOI: 10.1007/s12529-022-10115-4] [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] [Accepted: 07/07/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Psychological disorders can substantially worsen physical symptoms associated with breast cancer diagnosis and treatment, reducing survivors' quality of life and increasing recurrence risk. Distress disorders may be particularly detrimental given their physical correlates. Across two studies, we examined the relationship between a distress disorder history and physical symptoms pre- and post-adjuvant treatment - two important periods of the cancer trajectory. METHODS Breast cancer patients awaiting adjuvant treatment (n = 147; mean age = 52.54) in study 1 and survivors 1-10 years post-treatment (n = 183; mean age = 56.11) in study 2 completed a diagnostic interview assessing lifetime presence of psychological disorders. They also rated their pain, fatigue, physical functioning, and self-rated health. Covariates included body mass index, age, cancer stage, menopause status, and physical comorbidities. RESULTS Results from both studies indicated that a distress disorder history was associated with higher pain, fatigue, and sleep difficulties as well as lower self-rated health compared to those without such a history. CONCLUSIONS These findings suggest that breast cancer survivors with a distress disorder may be particularly at risk for more physical symptoms, poorer sleep, and worse self-rated health both prior to and following adjuvant treatment.
Collapse
Affiliation(s)
- Megan E Renna
- School of Psychology, University of Southern Mississippi, 118 College Drive #5025, Hattiesburg, MS, 39406, USA.
| | | | | | | | | | - Doreen M Agnese
- The Ohio State University College of Medicine, Columbus, USA
| | | | | | | | | | | | - Anne M Noonan
- The Ohio State University College of Medicine, Columbus, USA
| | | | - Daniel G Stover
- The Ohio State University College of Medicine, Columbus, USA
| | - Mathew Cherian
- The Ohio State University College of Medicine, Columbus, USA
| | | | | | | |
Collapse
|
37
|
Nishigami T, Manfuku M, Lahousse A. Central Sensitization in Cancer Survivors and Its Clinical Implications: State of the Art. J Clin Med 2023; 12:4606. [PMID: 37510721 PMCID: PMC10380903 DOI: 10.3390/jcm12144606] [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: 06/12/2023] [Revised: 07/04/2023] [Accepted: 07/06/2023] [Indexed: 07/30/2023] Open
Abstract
Although the prevalence of cancer pain is 47% after treatment, cancer pain is often underestimated, and many patients are undertreated. The complexity of cancer pain contributes to the lack of its management. Recently, as the mechanism of cancer pain, it has become clear that central sensitization (CS) influences chronic pain conditions and the transition from acute to chronic pain. In this state-of-the-art review, we summarized the association of CS or central sensitivity syndrome with pain and the treatment for pain targeting CS in cancer survivors. The management of patients with CS should not only focus on tissue damage in either the affected body regions or within the central nervous system; rather, it should aim to target the underlying factors that sustain the CS process. Pain neuroscience education (PNE) is gaining popularity for managing chronic musculoskeletal pain and could be effective for pain and CS in breast cancer survivors. However, there is a study that did not demonstrate significant improvements after PNE, so further research is needed. Precision medicine involves the classification of patients into subgroups based on a multifaceted evaluation of disease and the implementation of treatment tailored to the characteristics of each patient, which may play a central role in the treatment of CS.
Collapse
Affiliation(s)
- Tomohiko Nishigami
- Department of Physical Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima, Hiroshima 723-0053, Japan
| | - Masahiro Manfuku
- Graduate School of Comprehensive Scientific Research, Prefectural University of Hiroshima, Hiroshima 723-0053, Japan
- Department of Rehabilitation, Breast Care Sensyu Clinic, Osaka 596-0076, Japan
| | - Astrid Lahousse
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy (KIMA), Vrije Universiteit Brussel, 1090 Brussels, Belgium
- Chronic Pain Rehabilitation, Department of Physical Medicine and Physiotherapy, University Hospital Brussels, 1090 Brussels, Belgium
- Research Foundation Flanders (FWO), 1000 Brussels, Belgium
- Rehabilitation Research (RERE) Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy (KIMA), Vrije Universiteit Brussel, 1090 Brussels, Belgium
| |
Collapse
|
38
|
Kumar R, Pasricha R, Gupta MK, Ravi B. Psychosocial well-being and quality of life in women with breast cancer in foothills of North India. J Cancer Res Ther 2023; 19:1176-1185. [PMID: 37787281 DOI: 10.4103/jcrt.jcrt_672_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Introduction Breast cancer remains a leading cause of unintended death among Indian women. Cancer treatment-induced pain, fatigue, nausea/vomiting, body image, and sexual problems could affect the patient psychosocial well-being and quality of life (QOL). The study aims to determine the QOL and psychosocial well-being among women with breast cancer. Materials and Methods A cross-sectional survey completed by 244 women with breast cancer at a tertiary level teaching hospital. The European Organisation for Research and Treatment of Cancer QOL Questionnaire C30, the Breast Module (QLQ-BR23), and the Hospital Anxiety and Depression Scale (HADS) is used to measure the QOL, and psychological well-being, respectively. Appropriate descriptive and inferential statistics are applied to compute the results. Results The total number of women with breast cancer interviewed was 244, with a mean age of 45.06 (standard deviation ± 11.17) years. The mean global health score was 70.97 ± 15.63. As per the QLQ-C30 scale, "physical functioning" scored the highest (70.54 ± 22.00), and "role functioning" reported the lowest (49.45 ± 36.15) mean score. Further, on the QLQ-C30 symptoms scale, "appetite loss" (45.09 ± 35.09) was the worst reported symptom, followed by "nausea and vomiting" (34.97 ± 38.39). On the BR-23 scale, body image said (68.42 ± 22.28) higher score than other domains and experience of arm-related problems (43.80 ± 26.06) were more frequently reported symptom in women. As per the HADS scale, 24.6% and 36.1% of women were in moderate anxiety and depression, respectively. The mean HADS score was 14.39 ± 5.82. Findings on predictors for the individual patient remained the same as that earlier published literature. Conclusions and Recommendations Women with breast cancer have an overall good QOL and poor psychosocial well-being. However, using a holistic approach, including identifying psychological problems and their time management, signifies the need for the studied population.
Collapse
Affiliation(s)
- Rajesh Kumar
- Department of Nursing, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Rajesh Pasricha
- Department of Radiation Oncology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Manoj Kumar Gupta
- Department of Radiation Oncology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Bina Ravi
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| |
Collapse
|
39
|
Husain N, Kiran T, Chaudhry IB, Sultan S, Dawood S, Lunat F, Nizami A, Shanahan L, Qureshi A, Un Nisa Z, Husain M, Shakoor S, Alvi MH, Zadeh Z, Memon R, Chaudhry N. Integrated Moving on After Breast Cancer and Culturally Adapted Cognitive Behavior Therapy intervention for depression and anxiety among Pakistani women with breast cancer: Protocol of a randomized controlled trial. SAGE Open Med 2023; 11:20503121231177549. [PMID: 37441193 PMCID: PMC10333993 DOI: 10.1177/20503121231177549] [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: 11/03/2022] [Accepted: 05/05/2023] [Indexed: 07/15/2023] Open
Abstract
Objective The diagnosis and treatment of breast cancer is associated with significant distress that has huge impact on survivors' quality of life. The objective of this study is to assess the effectiveness of an integrated intervention "Moving on After Breast Cancer (ABC) Plus culturally adapted Cognitive Behavior Therapy" (Moving on ABC Plus). Method This is a randomized controlled trial that aims to recruit 354 breast cancer survivors from the inpatient and outpatient oncology departments in public and private hospitals in Karachi, Hyderabad, Lahore, Multan, and Rawalpindi in Pakistan. Patients scoring 10 or above on either the Patient Health Questionnaire-9 and/or the Generalized Anxiety Disorder scale (GAD-7) will be recruited. Baseline assessments will include Functional Assessment of Cancer Therapy-Breast; EuroQol-5D; Multidimensional Scale for Perceived Social Support; Intrusive Thoughts Scale; and Rosenberg Self-Esteem Scale. Participants randomized into intervention arm, Moving on ABC Plus, will receive 12 individual therapy sessions over 4 months. Follow-up will be completed at 4- and 6-month post-randomization, using all baseline instruments along with the Client Satisfaction Questionnaire (CSQ-8). We will also explore the participants', their family members', and the therapists' experiences of the trial and intervention. Results We will be assessing the effectiveness of intervention in reducing depression and anxiety in breast cancer survivors as a primary outcome of the trial. The secondary outcomes will include effectiveness of intervention in terms of reduction in intrusive thoughts and improvement in health-related quality of life, self-esteem, and perceived social support. Conclusion The results of the study will inform the design of a future larger randomized control trial with long-term follow-up.
Collapse
Affiliation(s)
- Nusrat Husain
- Division of Psychology and Mental
Health, University of Manchester, Manchester, UK
- Manchester Global foundation,
Manchester, UK
| | - Tayyeba Kiran
- Manchester Global foundation,
Manchester, UK
- Pakistan Institute of Living and
Learning, Karachi, Pakistan
| | | | - Sarwat Sultan
- Department of Psychology, Bahauddin
Zakaria University, Multan, Pakistan
| | - Saima Dawood
- Center for Clinical Psychology,
University of Punjab, Lahore, Pakistan
| | - Farah Lunat
- Lancashire and South Cumbria NHS
Foundation Trust, Preston, UK
| | - Asad Nizami
- Institute of Psychiatry, Benazir Bhutto
Hospital, Rawalpindi, Pakistan
| | | | - Afshan Qureshi
- Pakistan Institute of Living and
Learning, Karachi, Pakistan
| | - Zaib Un Nisa
- Pakistan Institute of Living and
Learning, Karachi, Pakistan
| | - Mina Husain
- South London and Maudsley NHS
Foundation Trust, London, UK
| | - Suleman Shakoor
- Pakistan Institute of Living and
Learning, Karachi, Pakistan
| | - Mohsin H Alvi
- Pakistan Institute of Living and
Learning, Karachi, Pakistan
| | - Zainab Zadeh
- Pakistan Institute of Living and
Learning, Karachi, Pakistan
| | - Rakhshi Memon
- Manchester Global foundation,
Manchester, UK
- Department of Science and Technology
Studies, University College London, London, UK
| | - Nasim Chaudhry
- Manchester Global foundation,
Manchester, UK
- Pakistan Institute of Living and
Learning, Karachi, Pakistan
| |
Collapse
|
40
|
Podina IR, Bucur AM, Todea D, Fodor L, Luca A, Dinu LP, Boian RF. Mental health at different stages of cancer survival: a natural language processing study of Reddit posts. Front Psychol 2023; 14:1150227. [PMID: 37425170 PMCID: PMC10326387 DOI: 10.3389/fpsyg.2023.1150227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 06/07/2023] [Indexed: 07/11/2023] Open
Abstract
Introduction The purpose of this study was to use text-based social media content analysis from cancer-specific subreddits to evaluate depression and anxiety-loaded content. Natural language processing, automatic, and lexicon-based methods were employed to perform sentiment analysis and identify depression and anxiety-loaded content. Methods Data was collected from 187 Reddit users who had received a cancer diagnosis, were currently undergoing treatment, or had completed treatment. Participants were split according to survivorship status into short-term, transition, and long-term cancer survivors. A total of 72524 posts were analyzed across the three cancer survivor groups. Results The results showed that short-term cancer survivors had significantly more depression-loaded posts and more anxiety-loaded words than long-term survivors, with no significant differences relative to the transition period. The topic analysis showed that long-term survivors, more than other stages of survivorship, have resources to share their experiences with suicidal ideation and mental health issues while providing support to their survivor community. Discussion The results indicate that Reddit texts seem to be an indicator of when the stressor is active and mental health issues are triggered. This sets the stage for Reddit to become a platform for screening and first-hand intervention delivery. Special attention should be dedicated to short-term survivors.
Collapse
Affiliation(s)
- Ioana R. Podina
- Laboratory of Cognitive Clinical Sciences, University of Bucharest, Bucharest, Romania
- Department of Applied Psychology, University of Bucharest, Bucharest, Romania
| | - Ana-Maria Bucur
- Interdisciplinary School of Doctoral Studies, University of Bucharest, Bucharest, Romania
| | - Diana Todea
- Interdisciplinary School of Doctoral Studies, University of Bucharest, Bucharest, Romania
| | - Liviu Fodor
- International Institute for The Advanced Studies of Psychotherapy and Applied Mental Health, Babeș-Bolyai University, Cluj-Napoca, Romania
- Evidence Based Psychological Assessment and Interventions Doctoral School, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Andreea Luca
- Interdisciplinary School of Doctoral Studies, University of Bucharest, Bucharest, Romania
| | - Liviu P. Dinu
- Human Language Technology Research Center, University of Bucharest, Bucharest, Romania
- Faculty of Mathematics and Computer Science, University of Bucharest, Bucharest, Romania
| | - Rareș F. Boian
- Department of Computer Science, Babeş-Bolyai University, Cluj-Napoca, Romania
| |
Collapse
|
41
|
Abdelhadi O. The impact of psychological distress on quality of care and access to mental health services in cancer survivors. FRONTIERS IN HEALTH SERVICES 2023; 3:1111677. [PMID: 37405330 PMCID: PMC10316283 DOI: 10.3389/frhs.2023.1111677] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 05/29/2023] [Indexed: 07/06/2023]
Abstract
Introduction Psychological distress is highly prevalent among cancer survivors and significantly impacts their health outcomes. Our study aim is to examine the impact of psychological distress on the quality of care in cancer survivors. Methods We utilized longitudinal panels from the Medical Expenditure Panel Survey data spanning from 2016 to 2019 to estimate the impact of psychological distress on quality of care. We compared a sample of cancer survivors with psychological distress (N = 176) to a matched sample of cancer survivors without psychological distress (N = 2,814). We employed multivariable logistic regression models and Poisson regression models. In all models, we adjusted for age at the survey, sex, race/ethnicity, education, income, insurance, exercise, chronic conditions, body mass index, and smoking status. Descriptive statistics and regression models were performed using STATA software. Results Our findings revealed a higher prevalence of psychological distress among younger survivors, females, individuals with lower incomes, and those with public insurance. Cancer survivors with psychological distress reported more adverse patient experiences compared to those without distress. Specifically, survivors with distress had lower odds of receiving clear explanations of their care (OR: 0.40; 95% CI: 0.17-0.99) and lower odds of feeling respected in expressing their concerns (OR: 0.42; 95% CI: 0.18-0.99) by their healthcare providers. Furthermore, psychological distress was associated with increased healthcare utilization, as evidenced by a higher number of visits (p = 0.02). It also correlated with a decrease in healthcare service ratings (p = 0.01) and the affordability of mental health services (p < 0.01) for cancer survivors. Discussion These findings indicate that psychological distress can significantly impact the delivery of healthcare and the patient experience among cancer survivors. Our study underscores the importance of recognizing and addressing the mental health needs of cancer survivors. It provides insights for healthcare professionals and policymakers to better understand and cater to the mental health needs of this population.
Collapse
|
42
|
Roy P, Kovalenko I, Gomez JC, Lu K, Rudge B, Wert Y, Torp L. Identifying at risk populations amongst breast cancer survivors and their common symptoms and concerns. BMC Womens Health 2023; 23:302. [PMID: 37291544 PMCID: PMC10251599 DOI: 10.1186/s12905-023-02458-1] [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: 04/16/2022] [Accepted: 10/17/2022] [Indexed: 06/10/2023] Open
Abstract
PURPOSE The survival rate amongst breast cancer survivors (BCS) have been increasing, with a 5-year survival rate of almost 90%. These women face many quality of life (QOL) issues either due to either cancer itself or the complex treatment regimen. Our retrospective analysis aims to identify at risk populations among the BCS and their most common concerns. METHODS This is a single-institution, retrospective, descriptive analysis of patients who were seen at our Breast Cancer Survivorship Program from October 2016 to May 2021. Patients completed a comprehensive survey which assessed self-reported symptoms, their concerns and degree of worry and recovery to baseline. The descriptive analysis on the patient characteristics included age, cancer stage and treatment type. The bivariate analysis included the relationship between the patient characteristics and their outcomes. Analysis of group differences was completed with Chi-square test. When the expected frequencies were five or less, Fisher exact test was used. Logistic regression models were developed to identify significant predictors for outcomes. RESULTS 902 patients (age 26-94; median 64) were evaluated. Majority of women had stage 1 breast cancer. The most common self-reported concerns affecting the patients were fatigue (34%), insomnia (33%), hot flashes (26%), night sweats (23%), pain (22%), trouble concentrating (19%), and neuropathy (21%). Though 13% of BCS felt isolated at least 50% of their time, the majority of patients (91%) reported having a positive outlook and felt that they have a sense of purpose (89%). Younger patients were more likely to worry about their cancer more than 50% of the time (p < 0.0001). Patients that were less likely to return back to at least 50% of their pre-treatment baseline were younger (age ≤ 45) (p = 0.0280), had higher stage breast cancer (Stage 2-4) (p = 0.0061), and had chemotherapy either alone or as part of their multi-modality treatment (p < 0.0001). CONCLUSION According to our study, younger patients, those with higher stage breast cancer and survivors who had chemotherapy may experience significant QOL issues. Fortunately, majority of BCS report a positive and optimistic outlook post treatment. Identifying common concerns after treatments and vulnerable populations are especially important to deliver quality care and to optimize interventions. IMPLICATIONS FOR CANCER SURVIVORS Our study identified the most common self-reported concerns affecting BCS. In addition, our results suggest that younger patients, patients with higher stage breast cancer and survivors who had chemotherapy were more likely to have QOL issues. Despite this, our study showed, the majority of BCS reported positive outlooks and emotions.
Collapse
Affiliation(s)
- Pooja Roy
- University of Pittsburgh Medical Center (UPMC) Harrisburg Hospital, 205 S Front St, Suite 3C, Harrisburg, PA, 17104, USA.
| | - Iuliia Kovalenko
- University of Pittsburgh Medical Center (UPMC) Harrisburg Hospital, 205 S Front St, Suite 3C, Harrisburg, PA, 17104, USA
| | - Janet Chan Gomez
- University of Pittsburgh Medical Center (UPMC) Harrisburg Hospital, 205 S Front St, Suite 3C, Harrisburg, PA, 17104, USA
| | - Kit Lu
- UPMC Hillman Cancer Center, 4300 Londonderry Rd, Suite 201, Harrisburg, PA, 17109, USA
| | - Beth Rudge
- UPMC Hillman Cancer Center, 4300 Londonderry Rd, Suite 201, Harrisburg, PA, 17109, USA
| | - Yijin Wert
- UPMC Hillman Cancer Center, 4300 Londonderry Rd, Suite 201, Harrisburg, PA, 17109, USA
| | - Lisa Torp
- UPMC Hillman Cancer Center, 4300 Londonderry Rd, Suite 201, Harrisburg, PA, 17109, USA
| |
Collapse
|
43
|
Schlaiss T, Singer S, Herbert SL, Diessner J, Bartmann C, Kiesel M, Janni W, Kuehn T, Flock F, Felberbaum R, Schwentner L, Leinert E, Woeckel A. Psycho-Oncological Care Provision in Highly Distressed Breast Cancer Patients. Geburtshilfe Frauenheilkd 2023; 83:702-707. [PMID: 37288248 PMCID: PMC10243917 DOI: 10.1055/a-2044-0072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 02/19/2023] [Indexed: 06/09/2023] Open
Abstract
Objective To evaluate the proportion of breast cancer (BC) patients with distress or psychological comorbidity as well as offer and use of psychological support in subgroups of BC patients with different extents of distress. Methods 456 patients with BC were evaluated at baseline (t1) and until 5 years after diagnosis (t4) at the BRENDA certified BC centers. Logistic regression was used to analyze if patients with distress at t1 received offers and actual psychological support more often than patients without distress at t1. Regression analyses were used to examine if acute, emerging or chronic disease was associated with higher rates of offer and use of psychotherapy as well as intake of psychotropic drugs. Results In 45% of BC patients psychological affection was detected at t4. The majority of patients with moderate or severe distress at t1 (77%) received the offer for psychological service, while 71% of those received the offer for support at t4. Patients, who were psychologically affected at t1, have not been offered psychological services more often than those without, but they significantly more often used services if offered. Especially patients with acute comorbidity received significantly more often an offer for psychotherapy compared to unimpaired patients, while those patients with emerging or chronic disease did not. 14% of BC patients took psychopharmaceuticals. This mainly concerns patients with chronic comorbidity. Conclusion Psychological services were offered to and used by a fair amount of BC patients. All subgroups of BC patients should be addressed, in order to improve the comprehensive supply with psychological services.
Collapse
Affiliation(s)
- Tanja Schlaiss
- Department of Gynaecology and Obstetrics, University of Würzburg, Würzburg, Germany
| | - Susanne Singer
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Centre, Johannes Gutenberg University Mainz, Mainz, Germany
- University Cancer Centre Mainz, Mainz, Germany
| | | | - Joachim Diessner
- Department of Gynaecology and Obstetrics, University of Würzburg, Würzburg, Germany
| | - Catharina Bartmann
- Department of Gynaecology and Obstetrics, University of Würzburg, Würzburg, Germany
| | - Matthias Kiesel
- Department of Gynaecology and Obstetrics, University of Würzburg, Würzburg, Germany
| | - Wolfgang Janni
- Department of Gynaecology and Obstetrics, University of Ulm, Ulm, Germany
| | - Thorsten Kuehn
- Department of Gynaecology and Obstetrics, Hospital Esslingen, Esslingen, Germany
| | - Felix Flock
- Department of Gynaecology and Obstetrics, Hospital Memmingen, Memmingen, Germany
| | - Ricardo Felberbaum
- Department of Gynaecology and Obstetrics, Hospital Kempten, Kempten, Germany
| | - Lukas Schwentner
- Department of Gynaecology and Obstetrics, University of Ulm, Ulm, Germany
| | - Elena Leinert
- Department of Gynaecology and Obstetrics, University of Ulm, Ulm, Germany
| | - Achim Woeckel
- Department of Gynaecology and Obstetrics, University of Würzburg, Würzburg, Germany
| | | |
Collapse
|
44
|
Svendsen K, Nes LS, Meland A, Larsson IM, Gjelsvik YM, Børøsund E, Rygg CM, Myklebust TÅ, Reinertsen KV, Kiserud CE, Skjerven H, Antoni MH, Chalder T, Mjaaland I, Carlson LE, Eriksen HR, Ursin G. Coping After Breast Cancer (CABC): Protocol for a randomized controlled trial of stress management e-health interventions. JMIR Res Protoc 2023; 12:e47195. [PMID: 37103493 DOI: 10.2196/47195] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 04/15/2023] [Accepted: 04/23/2023] [Indexed: 04/28/2023] Open
Abstract
BACKGROUND One-third or more of breast cancer survivors report stress and other psychological and physical complaints that can negatively impact quality of life. Psychosocial stress-management interventions, shown to mitigate the negative impact of these complaints, can now be delivered as accessible and convenient (for the patient and provider) e-health interventions. In the present randomized controlled trial (RCT), Coping After Breast Cancer (CABC), two modified versions of the stress management e-health intervention program StressProffen were created: one with predominantly cognitive-behavioral stress-management content (Stressproffen-CBI) and one with predominantly mindfulness-based stress-management content (StressProffen-MBI). OBJECTIVE To investigate the effects in breast cancer survivors of using StressProffen-CBI and StressProffen-MBI compared to a control group (treatment as usual). METHODS Women diagnosed with breast cancer (stage I-III, unequivocally HER2+ or ER- tumors) or DCIS aged 21-69 years who completed the Cancer Registry of Norway- initiated health survey on quality of life, are invited to the CABC trial about seven months after diagnosis. Women who give consent to participate are randomized (1:1:1) to: Stressproffen-CBI, Stressproffen-MBI, or control group. Both Stressproffen interventions consist of 10 modules of stress management content delivered through text, sound, video, and images. The primary outcome is between-groups changes in perceived stress at six months, assessed with Cohen's Perceived Stress Scale. Secondary outcomes comprise changes in quality of life, anxiety, depression, fatigue, sleep, neuropathy, coping, mindfulness and work-related outcomes approximately 1, 2 and 3 years after diagnosis. Long-term effects of the interventions on work participation, comorbidities, relapse or new cancers and mortality will be obtained from national health registries. RESULTS We plan to recruit 430 participants in total (100 in each group). Recruitment is scheduled from January 2021 through May 2023. CONCLUSIONS The CABC trial is possibly the largest ongoing psychosocial e-health RCT in breast cancer patients at current. If one or both interventions prove to be effective in reducing stress and improving psychosocial and physical complains, the StressProffen e-health interventions could be beneficial, inexpensive, and easily implementable tools for breast cancer survivors when coping with late effects after cancer and cancer treatments. CLINICALTRIAL Clinicaltrials.gov identifier NCT04480203. First posted: July 7th 2020. https://clinicaltrials.gov/ct2/show/NCT04480203.
Collapse
Affiliation(s)
- Karianne Svendsen
- Cancer Registry of Norway, Oslo University Hospital, Ullernchausseen 64, Oslo, NO
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, NO
- Lipid Clinic, Oslo University Hospital, Oslo, NO
| | - Lise Solberg Nes
- Department of Digital Health Research, Division of Medicine, Oslo University Hospital, Oslo, NO
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, NO
- Department of Psychiatry and Psychology, College of Medicine and Science, Mayo Clinic, Rochester, US
| | - Anders Meland
- Department of Sport and Social Sciences, School of Sport Sciences, Oslo, NO
| | - Ine Marie Larsson
- Cancer Registry of Norway, Oslo University Hospital, Ullernchausseen 64, Oslo, NO
| | - Ylva M Gjelsvik
- Cancer Registry of Norway, Oslo University Hospital, Ullernchausseen 64, Oslo, NO
| | - Elin Børøsund
- Department of Digital Health Research, Division of Medicine, Oslo University Hospital, Oslo, NO
- Department of Nursing and Health Sciences, Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, NO
| | - Christine M Rygg
- Department of Digital Health Research, Division of Medicine, Oslo University Hospital, Oslo, NO
| | - Tor Åge Myklebust
- Cancer Registry of Norway, Oslo University Hospital, Ullernchausseen 64, Oslo, NO
| | - Kristin V Reinertsen
- National Advisory Unit for Late Effects After Cancer, Department of Oncology, Oslo University hospital, Oslo, NO
| | - Cecilie E Kiserud
- National Advisory Unit for Late Effects After Cancer, Department of Oncology, Oslo University hospital, Oslo, NO
| | - Helle Skjerven
- Section for Breast and Endocrine Surgery Department, Vestre Viken Hospital Trust, Drammen, NO
| | - Michael H Antoni
- Department of Psychology, Sylvester Comprehensive Cancer Center, University of Miami, Miami, US
| | - Trudie Chalder
- Department of Psychological Medicine, King's College London, London, GB
| | - Ingvil Mjaaland
- Department of Oncology and Hematology, Stavanger University Hospital, Stavanger, NO
| | - Linda E Carlson
- Departments of Oncology and Psychology, University of Calgary, Calgary, CA
| | - Hege R Eriksen
- Department of Sport, Food and Natural Sciences, Western Norway University of Applied Sciences, Bergen, NO
| | - Giske Ursin
- Cancer Registry of Norway, Oslo University Hospital, Ullernchausseen 64, Oslo, NO
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, NO
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, LA, US
| |
Collapse
|
45
|
Mehnert-Theuerkauf A, Hufeld JM, Esser P, Goerling U, Hermann M, Zimmermann T, Reuter H, Ernst J. Prevalence of mental disorders, psychosocial distress, and perceived need for psychosocial support in cancer patients and their relatives stratified by biopsychosocial factors: rationale, study design, and methods of a prospective multi-center observational cohort study (LUPE study). Front Psychol 2023; 14:1125545. [PMID: 37151329 PMCID: PMC10157044 DOI: 10.3389/fpsyg.2023.1125545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 03/31/2023] [Indexed: 05/09/2023] Open
Abstract
Background Despite remarkable progress, cancer remains a life-threatening disease for millions of people worldwide, also resulting in significant psychosocial limitations. High-quality, comprehensive cancer care requires patient and family involvement and the provision of needs-based, targeted psychosocial services. Although progress has been made in understanding the occurrence of mental comorbidity and psychosocial distress in cancer patients, comparatively little is known about the course of psychological comorbidity and psychosocial distress in early survivorship among patients and their families. We therefore aim to estimate the prevalence of mental disorders according to the DSM-5, psychosocial distress, perceived needs for psychosocial support and utilization of psychosocial support offers in newly diagnosed cancer patients and their relatives, taking into account potential contributing biopsychosocial factors for the occurrence of psychological comorbidity. Methods/design This study follows a prospective multi-center observational cohort design across four measurement time points: within 2 months after cancer diagnosis (t1), and in the follow-up period at 6 months (t2), at 12 months (t3), and at 18 months (t4) after t1. Patients older than 18 years who have a confirmed initial diagnosis of a malignant solid tumor and are scheduled for cancer treatment at one of the participating cancer centers are eligible for study participation. Relatives of eligible patients are also eligible for study participation if they are older than 18 years. Patients are interviewed using the Structured Clinical Interview for DSM-5 Disorders (SCID-5-CV). In addition, patients and relatives receive a set of validated questionnaires at each measurement time point, covering comorbid conditions and functional performance, perceived psychological distress and quality of life, partnership aspects and social relationships, supportive care needs and use of psychosocial support services, health literacy, and health behavior and meaning in life. Discussion This prospective multi-center observational cohort study has a major focus on increasing quality of care and quality of life in cancer survivors through providing rigorous longitudinal data for the development and implementation of target group-specific psychosocial support services. Trial registration NCT04620564, date of registration 9/11/2020; DKG OnkoZert: Registrier-No.: ST-U134, date of registration 5/11/2021.
Collapse
Affiliation(s)
- Anja Mehnert-Theuerkauf
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
| | - Julia Marie Hufeld
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
| | - Peter Esser
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
| | - Ute Goerling
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Charité Comprehensive Cancer Center, Berlin, Germany
| | - Myriel Hermann
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Charité Comprehensive Cancer Center, Berlin, Germany
| | - Tanja Zimmermann
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Hannah Reuter
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Jochen Ernst
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
| |
Collapse
|
46
|
Gandhi A, Xu T, DeSnyder SM, Smith GL, Lin R, Barcenas CH, Stauder MC, Hoffman KE, Strom EA, Ferguson S, Smith BD, Woodward WA, Perkins GH, Mitchell MP, Garner D, Goodman CR, Aldrich M, Travis M, Lilly S, Bedrosian I, Shaitelman SF. Prospective, early longitudinal assessment of lymphedema-related quality of life among patients with locally advanced breast cancer: The foundation for building a patient-centered screening program. Breast 2023; 68:205-215. [PMID: 36863241 PMCID: PMC9996356 DOI: 10.1016/j.breast.2023.02.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 02/08/2023] [Accepted: 02/21/2023] [Indexed: 03/04/2023] Open
Abstract
BACKGROUND We examined how breast cancer-related lymphedema (BCRL) affects health-related quality of life (HRQOL), productivity, and compliance with therapeutic interventions to guide structuring BCRL screening programs. METHODS We prospectively followed consecutive breast cancer patients who underwent axillary lymph node dissection (ALND) with arm volume screening and measures assessing patient-reported health-related quality of life (HRQOL) and perceptions of BCRL care. Comparisons by BCRL status were made with Mann-Whitney U, Chi-square, Fisher's exact, or t tests. Trends over time from ALND were assessed with linear mixed-effects models. RESULTS With a median follow-up of 8 months in 247 patients, 46% self-reported ever having BCRL, a proportion that increased over time. About 73% reported fear of BCRL, which was stable over time. Further in time from ALND, patients were more likely to report that BCRL screening reduced fear. Patient-reported BCRL was associated with higher soft tissue sensation intensity, biobehavioral, and resource concerns, absenteeism, and work/activity impairment. Objectively measured BCRL had fewer associations with outcomes. Most patients reported performing prevention exercises, but compliance decreased over time; patient-reported BCRL was not associated with exercise frequency. Fear of BCRL was positively associated with performing prevention exercises and using compressive garments. CONCLUSIONS Both incidence and fear of BCRL were high after ALND for breast cancer. Fear was associated with improved therapeutic compliance, but compliance decreased over time. Patient-reported BCRL was more strongly associated with worse HRQOL and productivity than was objective BCRL. Screening programs must support patients' psychological needs and aim to sustain long-term compliance with recommended interventions.
Collapse
Affiliation(s)
- Anusha Gandhi
- Baylor College of Medicine, USA; Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, USA
| | - Tianlin Xu
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, USA
| | - Sarah M DeSnyder
- Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, USA
| | - Grace L Smith
- Department of GI Radiation Oncology, The University of Texas MD Anderson Cancer Center, USA
| | - Ruitao Lin
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, USA
| | - Carlos H Barcenas
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, USA
| | - Michael C Stauder
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, USA
| | - Karen E Hoffman
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, USA
| | - Eric A Strom
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, USA
| | - Susan Ferguson
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, USA
| | - Benjamin D Smith
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, USA
| | - Wendy A Woodward
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, USA
| | - George H Perkins
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, USA
| | - Melissa P Mitchell
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, USA
| | - Desmond Garner
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, USA
| | - Chelain R Goodman
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, USA
| | - Melissa Aldrich
- Center for Molecular Imaging, UT Health Science Center at Houston, USA
| | - Marigold Travis
- Department of Rehabilitative Therapy, The University of Texas MD Anderson Cancer Center, USA
| | - Susan Lilly
- Department of Rehabilitative Therapy, The University of Texas MD Anderson Cancer Center, USA
| | - Isabelle Bedrosian
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, USA
| | - Simona F Shaitelman
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, USA.
| |
Collapse
|
47
|
Kittel JA, Seplaki CL, van Wijngaarden E, Richman J, Magnuson A, Conwell Y. Mental health outcomes and correlates in cancer patients entering survivorship after curative treatment. Int J Psychiatry Med 2023:912174231165184. [PMID: 36927086 DOI: 10.1177/00912174231165184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
OBJECTIVE Cancer survivors face numerous physical and mental health challenges even after treatment completion. However, few studies have examined mental health in cancer survivors who received curative treatment during the transition out of active treatment and into survivorship. The current study describes the prevalence of mental health outcomes and their correlates in cancer survivors treated with curative intent during the first year of survivorship. METHODS A total of 120 cancer survivors of any cancer type completed a survey that assessed depression, anxiety, death ideation, alcohol and substance use, and demographic characteristics. Data regarding cancer type and treatment were extracted from the medical record. RESULTS Approximately 15% of the sample reported depression symptoms. Fifteen percent also reported anxiety symptoms in the past two weeks. 10 percent of the sample reported experiencing death ideation since their treatment ended and 7.5% reported death ideation in the past two weeks. Younger age, previous psychiatric diagnosis, and current substance use were associated with reports of depression symptoms, anxiety symptoms, and death ideation. CONCLUSION Cancer survivors entering survivorship after curative treatment experience elevated prevalence of depressive symptoms, anxiety symptoms, and death ideation. Younger cancer survivors and those with previous psychiatric diagnoses or substance use may be at particular risk for mental health problems during the first year of survivorship. Future research should further examine modifiable risk factors for depression, anxiety, and death ideation in cancer survivors at the transition into survivorship after curative treatment in order to improve survivorship care within both oncology and primary care.
Collapse
Affiliation(s)
- Julie A Kittel
- Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Christopher L Seplaki
- Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA.,Department of Psychiatry, 6923University of Rochester Medical Center, Rochester, NY, USA
| | - Edwin van Wijngaarden
- Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Jennifer Richman
- Department of Psychiatry, 6923University of Rochester Medical Center, Rochester, NY, USA
| | - Allison Magnuson
- Department of Medicine, 6923University of Rochester Medical Center, Rochester, NY, USA
| | - Yeates Conwell
- Department of Psychiatry, 6923University of Rochester Medical Center, Rochester, NY, USA
| |
Collapse
|
48
|
Nilsen TS, Sæter M, Sarvari SI, Reinertsen KV, Johansen SH, Edvardsen ER, Hallén J, Edvardsen E, Grydeland M, Kiserud CE, Lie HC, Solberg PA, Wisløff T, Sharples AP, Raastad T, Haugaa KH, Thorsen L. Effects of Aerobic Exercise on Cardiorespiratory Fitness, Cardiovascular Risk Factors, and Patient-Reported Outcomes in Long-Term Breast Cancer Survivors: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e45244. [PMID: 36920460 PMCID: PMC10131898 DOI: 10.2196/45244] [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: 12/22/2022] [Revised: 01/31/2023] [Accepted: 01/31/2023] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Anthracycline-based chemotherapy has been mainstay of adjuvant breast cancer therapy for decades. Although effective, anthracyclines place long-term breast cancer survivors at risk of late effects, such as reduced cardiorespiratory fitness and increased risk of cardiovascular disease. Previous research has shown beneficial effects of exercise training on cardiorespiratory fitness, but the effects of exercise on limiting factors for cardiorespiratory fitness, cardiovascular risk factors, and patient-reported outcomes in long-term survivors are less clear. Whether previous exposure to breast cancer therapy modulates the effects of exercise is also unknown. OBJECTIVE The primary aim of the CAUSE (Cardiovascular Survivors Exercise) trial is to examine the effect of aerobic exercise on cardiorespiratory fitness in anthracycline-treated long-term breast cancer survivors. Secondary aims are to examine effects of exercise training on limiting factors for cardiorespiratory fitness, cardiovascular risk factors, and patient-reported outcomes, and to compare baseline values and effects of exercise training between similar-aged women with and those without prior breast cancer. A third aim is to examine the 24-month postintervention effects of aerobic exercise on primary and secondary outcomes. METHODS The CAUSE trial is a 2-armed randomized controlled trial, where 140 long-term breast cancer survivors, 8-12 years post diagnosis, are assigned to a 5-month nonlinear aerobic exercise program with 3 weekly sessions or to standard care. Seventy similar-aged women with no history of cancer will undergo the same exercise program. Cardiorespiratory fitness measured as peak oxygen consumption (VO2peak), limiting factors for VO2peak (eg, cardiac function, pulmonary function, hemoglobin mass, blood volume, and skeletal muscle characteristics), cardiovascular risk factors (eg, hypertension, diabetes, dyslipidemia, obesity, physical activity level, and smoking status), and patient-reported outcomes (eg, body image, fatigue, mental health, and health-related quality of life) will be assessed at baseline, post intervention, and 24 months post intervention. RESULTS A total of 209 patients were included from October 2020 to August 2022, and postintervention assessments were completed in January 2023. The 24-month follow-up will be completed in February 2025. CONCLUSIONS The findings from the CAUSE trial will provide novel scientific understanding of the potential benefits of exercise training in long-term breast cancer survivors. TRIAL REGISTRATION ClinicalTrials.gov NCT04307407; https://clinicaltrials.gov/ct2/show/NCT04307407. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/45244.
Collapse
Affiliation(s)
- Tormod Skogstad Nilsen
- Department of Physical Performance, The Norwegian School of Sport Sciences, Oslo, Norway
| | - Mali Sæter
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- ProCardio Center for Innovation, Department of Cardiology, Oslo University Hospital, Oslo, Norway
| | - Sebastian Imre Sarvari
- ProCardio Center for Innovation, Department of Cardiology, Oslo University Hospital, Oslo, Norway
| | - Kristin Valborg Reinertsen
- National Advisory Unit on Late Effects after Cancer Treatment, Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - Sara Hassing Johansen
- Department of Physical Performance, The Norwegian School of Sport Sciences, Oslo, Norway
| | | | - Jostein Hallén
- Department of Physical Performance, The Norwegian School of Sport Sciences, Oslo, Norway
| | - Elisabeth Edvardsen
- Department of Physical Performance, The Norwegian School of Sport Sciences, Oslo, Norway
- Department of Pulmonary Medicine, Oslo University Hospital, Oslo, Norway
| | - May Grydeland
- Department of Physical Performance, The Norwegian School of Sport Sciences, Oslo, Norway
| | - Cecilie Essholt Kiserud
- National Advisory Unit on Late Effects after Cancer Treatment, Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - Hanne Cathrine Lie
- Department of Behavioural Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Paul André Solberg
- Norwegian Olympic and Paralympic Committee and Confederation of Sports, Oslo, Norway
| | - Torbjørn Wisløff
- Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway
| | - Adam Philip Sharples
- Department of Physical Performance, The Norwegian School of Sport Sciences, Oslo, Norway
| | - Truls Raastad
- Department of Physical Performance, The Norwegian School of Sport Sciences, Oslo, Norway
| | - Kristina Hermann Haugaa
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- ProCardio Center for Innovation, Department of Cardiology, Oslo University Hospital, Oslo, Norway
| | - Lene Thorsen
- National Advisory Unit on Late Effects after Cancer Treatment, Department of Oncology, Oslo University Hospital, Oslo, Norway
- Department for Clinical Service, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
| |
Collapse
|
49
|
Song CV, van Gils CH, Yip CH, Soerjomataram I, Taib NAM, See MH, Lim A, Abdul Satar NF, Bhoo-Pathy N. Discriminatory Ability and Clinical Utility of the AJCC7 and AJCC8 Staging Systems for Breast Cancer in a Middle-Income Setting. Diagnostics (Basel) 2023; 13:674. [PMID: 36832162 PMCID: PMC9955895 DOI: 10.3390/diagnostics13040674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/25/2023] [Accepted: 02/03/2023] [Indexed: 02/15/2023] Open
Abstract
(1) Background: Differences in access to biomarker testing and cancer treatment in resource-limited settings may affect the clinical utility of the AJCC8 staging system compared to the anatomical AJCC7 system. (2) Methods: A total of 4151 Malaysian women who were newly diagnosed with breast cancer from 2010 to 2020 were followed-up until December 2021. All patients were staged using the AJCC7 and AJCC8 systems. Overall survival (OS) and relative survival (RS) were determined. Concordance-index was used to compare the discriminatory ability between the two systems. (3) Results: Migration from the AJCC7 to AJCC8 staging system resulted in the downstaging of 1494 (36.0%) patients and the upstaging of 289 (7.0%) patients. Approximately 5% of patients could not be staged using the AJCC8 classification. Five-year OS varied between 97% (Stage IA) and 66% (Stage IIIC) for AJCC7, and 96% (Stage IA) and 60% (Stage IIIC) for AJCC8. Concordance-indexes for predicting OS using the AJCC7 and AJCC8 models were 0.720 (0.694-0.747) and 0.745 (0.716-0.774), and for predicting RS they were 0.692 (0.658-0.728) and 0.710 (0.674-0.748), respectively. (4) Conclusions: Given the comparable discriminatory ability between the two staging systems in predicting the stage-specific survival of women with breast cancer in the current study, the continued use of the AJCC7 staging system in resource-limited settings seems pragmatic and justifiable.
Collapse
Affiliation(s)
- Chin-Vern Song
- Julius Center for Health Sciences and Primary Care, UMC Utrecht, Heidelberglaan 100, 3508 GA Utrecht, The Netherlands
| | - Carla H. van Gils
- Julius Center for Health Sciences and Primary Care, UMC Utrecht, Heidelberglaan 100, 3508 GA Utrecht, The Netherlands
| | - Cheng-Har Yip
- Ramsay Sime Darby Health Care, Jalan SS12, Subang Jaya 47500, Malaysia
| | - Isabelle Soerjomataram
- Cancer Surveillance Branch, International Agency for Research on Cancer, 150 Cr Albert Thomas, 69008 Lyon, France
| | - Nur Aishah Mohd Taib
- Department of Surgery, University of Malaya Medical Centre, Jalan Professor Diraja Ungku Aziz, Lembah Pantai, Kuala Lumpur 59100, Malaysia
| | - Mee-Hoong See
- Department of Surgery, University of Malaya Medical Centre, Jalan Professor Diraja Ungku Aziz, Lembah Pantai, Kuala Lumpur 59100, Malaysia
| | - Alexander Lim
- Hospital Seberang Jaya, Jalan Tun Hussein Onn, Seberang Jaya, Permatang Pauh, Pulau Pinang 13700, Malaysia
| | - Nur Fadhlina Abdul Satar
- Department of Clinical Oncology, University of Malaya Medical Centre, Jalan Professor Diraja Ungku Aziz, Lembah Pantai, Kuala Lumpur 59100, Malaysia
| | - Nirmala Bhoo-Pathy
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
| |
Collapse
|
50
|
Social functioning, depression, and quality of life among breast cancer patients: A path analysis. Eur J Oncol Nurs 2023; 62:102237. [PMID: 36455513 DOI: 10.1016/j.ejon.2022.102237] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 10/22/2022] [Accepted: 11/07/2022] [Indexed: 11/13/2022]
Abstract
PURPOSE To identify associations among social functioning, depression, and quality of life in breast cancer patients. METHOD A cross-sectional study was conducted. A total of 180 breast cancer patients were recruited from the surgical units in southern Taiwan hospital in 2021. Path analysis was employed to analyze the relationships between background information and social functioning, depression, and quality of life. Structural equation modeling (SEM) was used for examining the path analysis in this study. RESULTS The path model showed that respondents with a religious belief (ß = 0.18, p < .000) and less severe disease (ß = -0.29, p < .01) showed better social functioning. Income did not affect social functioning directly but was directly related to the social interaction dimension (ß = 0.30, p < .000). Moreover, younger age (ß = -0.29, p < .000, lower income (ß = -0.10, p < .05) and more severe disease (ß = 0.35, p < .000) increased the level of depression. Less severe disease would also result in a better quality of life (ß = -0.45, p < .000). Breast cancer patients with better social function levels have low levels of depression (ß = -0.82, p < .000) and better quality of life (ß = 0.76, p < .000). CONCLUSION Age, religion, income, and severity are crucial predictors of social functioning, depression, and quality of life. Furthermore, severity variables which combined clinical variables to make this variable a stronger predictor for SF, depression, and QOL.
Collapse
|