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Asakitogum DA, Nutor JJ, Pozzar R, Hammer M, Miaskowski C. Systematic Review of the Literature on Multiple Co-occurring Symptoms in Patients Receiving Treatment for Gynecologic Cancers. Semin Oncol Nurs 2024; 40:151572. [PMID: 38246840 DOI: 10.1016/j.soncn.2023.151572] [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: 09/09/2023] [Revised: 11/23/2023] [Accepted: 12/07/2023] [Indexed: 01/23/2024]
Abstract
OBJECTIVE Patients with gynecologic cancers experience a very high symptom burden that has a negative impact on their quality of life. This systematic review aims to identify the common co-occurring symptoms, the prevalence of common symptoms, common instruments used to measure symptoms, associated risk factors, and the symptom burden in patients with gynecologic cancers. DATA SOURCES A search of four databases (ie, PubMed, Embase, Web of Science, and CINAHL) was done from January 1, 2012, through September 5, 2022. A qualitative synthesis of the extant literature was performed using Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines (PRISMA 2020). CONCLUSION A total of 118 studies met the prespecified inclusion criteria. Ninety-six symptoms were assessed across these studies. The top six symptoms and their grand mean prevalence rates were lack of energy (64.4%), fatigue (62.1%), abdominal pain (53.3%), depression (52.6%), concentration dysfunction (52.0%), and drowsiness (51.9%). Numerous methodologic challenges were evident across studies. Future research needs to develop a disease-specific symptom assessment measure, evaluate for risk factors associated with a higher symptom burden, and determine the impact of multiple symptoms on patient outcomes. IMPLICATION FOR NURSING PRACTICE The results are relevant for oncology clinicians to assess patients with gynecologic cancers for the presence of common symptoms and risk factors for higher symptom burden in the patients and to offer effective management interventions.
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Affiliation(s)
- David Ayangba Asakitogum
- Doctoral student, Department of Family Health Care Nursing, School of Nursing, University of California, San Francisco, CA.
| | - Jerry John Nutor
- Assistant Professor, Department of Family Health Care Nursing, School of Nursing, University of California, San Francisco, CA
| | - Rachel Pozzar
- Nurse Scientist and Instructor, Phyllis F. Cantor Center for Research in Nursing and Patient Care Services, Dana-Farber Cancer Institute, Boston, MA
| | - Marilyn Hammer
- Nurse Scientist and Instructor, Phyllis F. Cantor Center for Research in Nursing and Patient Care Services, Dana-Farber Cancer Institute, Boston, MA; Director, Phyllis F. Cantor Center for Research in Nursing and Patient Care Services, Dana-Farber Cancer Institute, Boston, MA
| | - Christine Miaskowski
- Professor, Departments of Physiological Nursing and Anesthesia, School of Nursing and Medicine, University of California, San Francisco, CA
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Adamakidou T, Menti K, Charalambous A, Tsiou C, Vlachou E, Govina O. Changes in unmet care needs, social support and distress from initial diagnosis to post-surgery in patients with gynecological cancer: A longitudinal study. Eur J Oncol Nurs 2023; 66:102358. [PMID: 37572628 DOI: 10.1016/j.ejon.2023.102358] [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: 02/25/2023] [Revised: 05/28/2023] [Accepted: 06/05/2023] [Indexed: 08/14/2023]
Abstract
PURPOSE This study aimed to explore the changes in unmet care needs, perceived social support, and levels of distress experienced by newly diagnosed Greek patients with gynecological cancer during the phase after diagnosis and before surgical treatment (T0), and 4 months after surgical treatment at the first postoperative follow-up visit (T1). METHODS This was a prospective, longitudinal, descriptive study based on the framework of stress and coping theory. The Needs Evaluation Questionnaire, Depression, Anxiety and Stress Scale (DASS-21), Multidimensional Scale of Perceived Social Support (MSPSS), and a demographic and clinical data questionnaire were distributed to a convenience sample of 86 patients. RESULTS A convenience sample of 86 patients newly diagnoised with gynecological cancer participated in the study. The mean age of the participants was 60.7 years (SD = 10.9 years) while 57.6% of them were married. Overall, patients' needs and social support had significantly decreased at T1 compared to T0 (p = 0.005 and p = 0.029, respectively). DASS-21 subscale scores did not change significantly at T1, whereas anxiety levels were significantly lower at follow-up (p = 0.048). Changes in anxiety levels were associated with changes in needs related to family (p < 0.001), need for assistance/care (p = 0.013) and support (p = 0.004), and total needs (p = 0.004). CONCLUSION The phase following cancer diagnosis and awaiting surgery is a high-risk period for the mental health of women with gynecological cancer, and one that requires special attention from healthcare professionals. By identifying unmet needs, addressing anxiety and providing appropriate social support, healthcare professional can contribute significantly to improving patients' quality of life throughout their cancer journey.
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Affiliation(s)
- Theodoula Adamakidou
- Nursing Department, Postgraduate Program of Μanagement of Chronic Diseases, University of West Attica, Athens, Greece.
| | - Konstantina Menti
- Nursing Department, Postgraduate Program of Μanagement of Chronic Diseases, University of West Attica, Athens, Greece; Agios Savvas Anticancer Hospital, Athens, Greece.
| | | | - Chrysoula Tsiou
- Nursing Department, Postgraduate Program of Μanagement of Chronic Diseases, University of West Attica, Athens, Greece.
| | - Eugenia Vlachou
- Nursing Department, Postgraduate Program of Μanagement of Chronic Diseases, University of West Attica, Athens, Greece.
| | - Ourania Govina
- Nursing Department, Postgraduate Program of Μanagement of Chronic Diseases, University of West Attica, Athens, Greece.
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Zhang Y, Ding X, Chen J, Liu Y, Wang G, Hu D. Moderating effects of suicide resilience and meaning in life on the association between entrapment and suicidal ideation in Chinese patients with ovarian cancer: a cross-sectional study. BMC Psychiatry 2023; 23:585. [PMID: 37568099 PMCID: PMC10416398 DOI: 10.1186/s12888-023-05057-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 07/27/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND Numerous studies have confirmed that patients with ovarian cancer have a relatively high risk of suicidality. Early identification of psychological factors related to suicidal ideation in patients with ovarian cancer may provide effective information for suicide prevention strategies. This study aimed to investigate whether and how suicide resilience and meaning in life moderate the relationship between entrapment and suicidal ideation in patients with ovarian cancer. METHODS This was a cross-sectional investigation was conducted in 505 Chinese patients with ovarian cancer. Patients completed a battery of self-reported questionnaires that included the General Information Questionnaire, and Chinese versions of the Entrapment Scale, Scale for Suicidal Ideation, Suicide Resilience Inventory-25, and Meaning in Life Scale. Descriptive statistics, Pearson' s chi-square, Pearson' s correlation, and hierarchical multiple linear regression analysis were performed. RESULTS In this study, the prevalence of suicidal ideation reported by patients with ovarian cancer was 32.07%. Patients' suicidal ideation could be explained by the following three predictors: entrapment × suicide resilience × meaning in life (β = -0.169, p < 0.001), entrapment × suicide resilience (β = -0.148, p < 0.001), and entrapment × meaning in life (β = -0.107, p = 0.005). CONCLUSION These findings suggest that ovarian cancer patients are prone to suicidal ideation when they feel a sense of entrapment. Enhancing patients' suicide resilience and meaning in life may be two targeted interventions to reduce suicidal ideation in ovarian cancer patients. In particular, considering both the protective effects of suicide resilience and meaning in life may yield better suicide prevention outcomes than considering only one of these factors.
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Affiliation(s)
- Yinying Zhang
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Xiaoping Ding
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Jie Chen
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Yilan Liu
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Gang Wang
- Wuhan Mental Health Center, Wuhan, 430010, China
| | - Deying Hu
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
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Yang YL, Chang YC, Cheng WF, Chen YL, Lai YH. Factors Predicting the Health Status of Women with Ovarian Cancer During Five Treatment Phases. Semin Oncol Nurs 2023; 39:151464. [PMID: 37400343 DOI: 10.1016/j.soncn.2023.151464] [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: 01/18/2023] [Revised: 04/07/2023] [Accepted: 05/24/2023] [Indexed: 07/05/2023]
Abstract
OBJECTIVE The combined impact of disease status and treatment phase on the quality of life (QoL) of women with ovarian cancer has not been fully considered. Therefore, this clinical, epidemiologic study compared the QoL of patients with ovarian cancer between five different treatment phases and identified the factors predicting their QoL through multivariate modeling. DATA SOURCES This study had a cross-sectional survey design. The participants total of 183 were recruited from the inpatient and outpatient departments of the medical center in northern Taiwan. QoL was measured using the Quality of Life Scales QLQ-C30 and QLQ-OV28 and the Pittsburgh Sleep Quality Index. The patient's clinical characteristics data were obtained from the databank of the Taiwan Gynecologic Cancer Network, a registry of active patients being treated with gynecologic cancer. CONCLUSION Chemotherapeutic agents were the major predictors of poor global health status in patients with ovarian cancer. However, good sleep was beneficial to patients' QoL. The study results can be used as a reference to adjust oncological treatment regimens for more effective symptom management and to promote patient education to improve patients' QoL. IMPLICATIONS FOR NURSING PRACTICE The predicting factors can be considered by physicians and nurses to adjust treatment regimens and enhance patient education.
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Affiliation(s)
- Ya-Ling Yang
- Assistant Professor, School of Nursing, College of Medicine, National Taiwan University and Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan.
| | - Yun-Chen Chang
- Assistant Professor, School of Nursing and Graduate Institute of Nursing, China Medical University and Nursing Department, China Medical University Hospital, Taichung City, Beitun District, Taiwan
| | - Wen-Fang Cheng
- Professor, Department of Obstetrics and Gynecology, Graduate Institute of Oncology & College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yu-Li Chen
- Assistant Professor, Department of Obstetrics and Gynecology, Graduate Institute of Oncology & College of Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yeur-Hur Lai
- Professor, School of Nursing, College of Medicine, National Taiwan University and Department of Nursing, National Taiwan University Cancer Center Taipei, Taiwan
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Pozzar RA, Hammer MJ, Paul SM, Cooper BA, Conley YP, Chen LM, Levine JD, Miaskowski C. Associations Between Distinct State Anxiety Profiles, Exposure to Stressful Life Events, Resilience, and Coping in Patients with Gynecologic Cancers Receiving Chemotherapy. Semin Oncol Nurs 2023; 39:151431. [PMID: 37164885 DOI: 10.1016/j.soncn.2023.151431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 03/20/2023] [Accepted: 03/22/2023] [Indexed: 05/12/2023]
Abstract
OBJECTIVES In a sample of patients with gynecologic cancers who are receiving chemotherapy, subgroups of patients with distinct state anxiety profiles were identified, and differences among the subgroups in demographic and clinical characteristics, stress, exposure to stressful life events, resilience, and coping behaviors were evaluated. DATA SOURCES Patients (n = 230) completed questionnaires six times over two chemotherapy cycles. State anxiety was measured using the Spielberger State Anxiety Inventory. Subgroups of patients with distinct state anxiety profiles were identified using latent profile analysis. Differences among the classes were assessed using parametric and nonparametric tests. CONCLUSION Three distinct state anxiety profiles were identified: low (55.2%), moderate (38.3%), and very high (6.5%). Compared with the low class, persons in the other two classes had lower functional status, more comorbidities, higher perceived stress, and lower resilience and were more likely to report a history of depression and to use disengagement coping strategies. Compared with the low class, the very high class was more likely to report childcare responsibilities; have a history of lung disease, stomach disease, or low back pain; have experienced physical neglect, serious money problems, a serious disaster, or foster care; or were a caregiver for someone with a severe disability. IMPLICATIONS FOR NURSING PRACTICE Nearly 45% of patients reported clinically meaningful levels of state anxiety that persisted over two cycles of chemotherapy. Experiences with a variety of stressors may be risk factors for higher levels of anxiety during chemotherapy. Clinicians need to perform comprehensive social histories and assess for anxiety in patients receiving chemotherapy.
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Affiliation(s)
- Rachel A Pozzar
- Cantor Center for Research in Nursing and Patient Care Services, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Marilyn J Hammer
- Cantor Center for Research in Nursing and Patient Care Services, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Steven M Paul
- Department of Physiological Nursing, School of Nursing, University of California, San Francisco, California, USA
| | - Bruce A Cooper
- Department of Physiological Nursing, School of Nursing, University of California, San Francisco, California, USA
| | - Yvette P Conley
- Department of Health Promotion and Development, School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Lee-May Chen
- Department of Medicine, School of Medicine, University of California, San Francisco, California, USA
| | - Jon D Levine
- Department of Medicine, School of Medicine, University of California, San Francisco, California, USA
| | - Christine Miaskowski
- Departments of Physiological Nursing and Anesthesiology, University of California, San Francisco, California, USA.
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Zeilani RS, Younis WY, Albusoul R, Hasanien A, Hamdan-Mansour A. The buffering role of social support on the severity of physical symptoms among patients living with cancer. Int J Palliat Nurs 2023; 29:204-215. [PMID: 37224097 DOI: 10.12968/ijpn.2023.29.5.204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
BACKGROUND The role of perceived social support (the individual's perception that family, friends and others are available as psychological, social and material support) and its moderating effect on the psychological and physical factors among patients suffering medical problems is still debated. AIM To explore the effect of perceived social support on the relationship between psychological and health-related factors on the severity of physical symptoms among patients with cancer. METHODS A descriptive-correlational, cross-sectional design was used to recruit 459 patients with cancer from three major hospitals in Jordan. Data were collected using a self-administered questionnaire. RESULTS Social support was significantly correlated to the severity of physical symptoms (p>.05) among patients with cancer, while psychological distress, sadness, disturbed body image and anxiety were not (p<.05). The multiple hierarchal regression model showed that social support has no significant moderation effect on the relationship between psychological and health-related factors and the severity of physical symptoms controlling for sociodemographic factors among patients with cancer. CONCLUSION Patients with cancer suffering physical and psychological disturbances do not benefit from social support as a way of controlling the severity of their symptoms. Palliative nurses need to tailor a social support intervention to their patients with cancer, in order to use both professional and family resources.
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Affiliation(s)
| | | | | | - Amer Hasanien
- Assistant Professor, The University of Jordan, Jordan
| | - Aman Hamdan-Mansour
- Professor-Psychiatric and Mental Health Nursing, The University of Jordan, Jordan
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Suskin JA, Paul S, Stuckey AR, Conley YP, Hammer MJ, Miaskowski C, Dunn LB. Anxiety trajectories: An observational study of women undergoing chemotherapy for breast or gynecological cancer. Eur J Oncol Nurs 2022; 61:102227. [DOI: 10.1016/j.ejon.2022.102227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 10/09/2022] [Indexed: 11/17/2022]
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Wu HJ, Chuang CM, Chien CH, Wang TJ, Liang SY. Changes in Depression and Sleep Quality and Associated Factors in Women Receiving Chemotherapy for Ovarian Cancer: An Observational Study. Cancer Nurs 2022; 45:271-279. [PMID: 34310385 DOI: 10.1097/ncc.0000000000000986] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Although women with ovarian cancer experience depression and poor sleep quality, little is known about how various factors, particularly self-efficacy, might be associated with these conditions. OBJECTIVES The aim of this study was to examine the prevalence of and changes in depression and sleep quality and the factors associated with these conditions in a cohort of women with ovarian cancer before, during, and after chemotherapy. METHODS A prospective repeated-measures design was adopted in this study. Participants were women with ovarian cancer who were expected to receive 4 to 6 cycles of chemotherapy and were recruited at a medical center in Taiwan. The participants were asked to complete a questionnaire that included the Symptom Distress Scale, Center for Epidemiologic Studies Depression Scale, General Self-efficacy Scale, and Pittsburgh Sleep Quality Index. The data were collected before, during, and after the course of chemotherapy. RESULTS Overall, 24.6% to 36.9% of women were at risk for depression; 75.4% to 80.0% of women had poor sleep quality. There were no significant changes in depressive symptoms and sleep quality throughout the course of chemotherapy. More severe depressive symptoms were associated with higher levels of symptom distress and lower self-efficacy. Poorer sleep quality was associated with higher levels of symptom distress. CONCLUSIONS Among participants, more depressive symptoms and poorer sleep quality were associated with higher levels of symptom distress or lower self-efficacy. IMPLICATIONS FOR PRACTICE Healthcare providers should continuously assess depression and sleep quality in women with ovarian cancer. These symptoms may be improved by strengthening self-efficacy and relieving symptom distress.
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Affiliation(s)
- Hui-Ju Wu
- Author Affiliations: Department of Obstetrics and Gynecology, Taipei Veterans General Hospital (Ms Wu and Dr Chuang); Faculty of Medicine, School of Medicine, National Yang-Ming University (Dr Chuang); and College of Nursing, National Taipei University of Nursing and Health Sciences, Taipei City, Taiwan (Ms Wu, Dr Chuang, Dr Chien, Dr Wang, and Dr Liang)
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Campbell R, Costa DSJ, Stockler MR, Lee YC, Ledermann JA, Berton D, Sehouli J, Roncolato FT, Connell RO, Okamoto A, Bryce J, Oza AM, Avall-Lundqvist E, Berek JS, Lanceley A, Joly F, Hilpert F, Feeney A, Kaminsky MC, Diamante K, Friedlander ML, King MT. Measure of Ovarian Symptoms and Treatment concerns (MOST) indexes and their associations with health-related quality of life in recurrent ovarian cancer. Gynecol Oncol 2022; 166:254-262. [PMID: 35718565 DOI: 10.1016/j.ygyno.2022.05.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 05/27/2022] [Accepted: 05/31/2022] [Indexed: 11/19/2022]
Abstract
PURPOSE The Measure of Ovarian Symptoms and Treatment (MOST) concerns is a validated patient-reported symptom assessment tool for assessing symptom benefit and adverse effects of palliative chemotherapy in women with recurrent ovarian cancer (ROC). We aimed to examine (i) how symptoms within MOST symptom indexes track together (i.e. co-occur) and (ii) the association between MOST symptom indexes and key aspects of health-related quality of life (HRQL). METHOD A prospective cohort of women with ROC completed the MOST-T35, EORTC QLQ-C30 and EORTC QLQ-OV28 at baseline and before each cycle of chemotherapy. Analyses were conducted on baseline and end-of-treatment data. Exploratory factor analysis and hierarchical cluster analysis identified groups of co-occurring symptoms. Path models examined associations between MOST symptom indexes and HRQL. RESULTS Data from 762 women at baseline and 681 at treatment-end who completed all 22 symptom-specific MOST items and at least one HRQL measure were analysed. Four symptom clusters emerged at baseline and treatment-end: abdominal symptoms, symptoms associated with peripheral neuropathy, nausea and vomiting, and psychological symptoms. Psychological symptoms (MOST-Psych) and symptoms due to disease (ovarian cancer) or treatment (MOST-DorT) were associated with poorer scores on QLQ-C30 and OV28 functioning domains and worse overall health at both time points. CONCLUSION Four MOST symptom clusters were consistent across statistical methods and time points. These findings suggest that routine standardized assessment of psychological and physical symptoms in clinical practice with MOST plus appropriate symptom management referral pathways is an intervention for improving HRQL that warrants further research.
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Affiliation(s)
- Rachel Campbell
- University of Sydney, Faculty of Science, School of Psychology, Australia.
| | - Daniel S J Costa
- University of Sydney, Faculty of Science, School of Psychology, Australia
| | - Martin R Stockler
- University of Sydney, NHMRC Clinical Trials Centre, Sydney, New South Wales, Australia
| | - Yeh Chen Lee
- University of Sydney, NHMRC Clinical Trials Centre, Sydney, New South Wales, Australia; Australia New Zealand Gynaecological Oncology Group (ANZGOG), Australia; Department of Medical Oncology, Prince of Wales Hospital, New South Wales, Australia
| | - Jonathan A Ledermann
- The Cancer Research UK & UCL Cancer Trials Centre, NCRI UK, London, United Kingdom
| | - Dominique Berton
- GINECO-Group d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens, Paris, France; Institut de Cancerologie de l'Ouest (ICO), Centre René Gauducheau, Saint Herblain, France
| | - Jalid Sehouli
- Arbeitsgesmeinschaft Gynäkologische Onkologie Studiengruppe (AGO) und North-Eastern German Society of Gynecologcial Oncology (NOGGO), Berlin, Germany; Department of Gynecology and Oncological Surgery, Charité, University of Berlin, Berlin, Germany
| | - Felicia T Roncolato
- University of Sydney, NHMRC Clinical Trials Centre, Sydney, New South Wales, Australia; Australia New Zealand Gynaecological Oncology Group (ANZGOG), Australia; Department of Medical Oncology, Prince of Wales Hospital, New South Wales, Australia; Macarthur Cancer Therapy Centre, Campbelltown Hospital, NSW, Australia
| | - Rachel O Connell
- University of Sydney, NHMRC Clinical Trials Centre, Sydney, New South Wales, Australia
| | - Aikou Okamoto
- Japanese Gynecologic Oncology Group (JGOG), Tokyo, Japan; Jikei University School of Medicine, Tokyo, Japan
| | - Jane Bryce
- Istituto Nazionale Tumori IRCCS - Fondazione G. Pascale, Multicentre Italian Trials in Ovarian Cancer and Gynecologic Malignancies (MITO), Napoli, Italy; Ascension St. John Clinical Research Institute, Tulsa, USA
| | - Amit M Oza
- Princess Margaret Consortium (PMHC), Toronto, Canada; Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada
| | - Elisabeth Avall-Lundqvist
- Nordic Society of Gynaecological Oncology (NSGO), Copenhagen, Denmark; Department of Oncology and Department of Clinical and Experimental Medicine, Linkoping University, NSGO, Linkoping, Sweden; Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Jonathan S Berek
- Cooperative Gynecologic Oncology Investigators (COGI), Stanford, CA, USA; Stanford Women's Cancer Centre, Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA, USA
| | - Anne Lanceley
- UCL Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, United Kingdom
| | - Florence Joly
- GINECO-Group d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens, Paris, France; Centre Francois Baclesse, Caen, France
| | - Felix Hilpert
- Arbeitsgesmeinschaft Gynäkologische Onkologie Studiengruppe (AGO) und North-Eastern German Society of Gynecologcial Oncology (NOGGO), Berlin, Germany; Onkologisches Therapiezentrum, Krankenhaus Jerusalem, Hamburg, Germany
| | - Amanda Feeney
- The Cancer Research UK & UCL Cancer Trials Centre, NCRI UK, London, United Kingdom
| | - Marie C Kaminsky
- GINECO-Group d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens, Paris, France; Institut de Cancérologie de Lorraine, Alexis Vautrin, Vandoeuvre Les Nancy, France
| | - Katrina Diamante
- University of Sydney, NHMRC Clinical Trials Centre, Sydney, New South Wales, Australia
| | - Michael L Friedlander
- Australia New Zealand Gynaecological Oncology Group (ANZGOG), Australia; Department of Medical Oncology, Prince of Wales Hospital, New South Wales, Australia
| | - Madeleine T King
- University of Sydney, Faculty of Science, School of Psychology, Australia
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Pang X, Li F, Dou L, Tian Y, Zhang Y. Perceived social support and depressive symptoms in Chinese patients with ovarian cancer and the mediating role of resilience:a cross-sectional study. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03155-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Spagnoletti BRM, Bennett LR, Keenan C, Shetty SS, Manderson L, McPake B, Wilopo SA. What factors shape quality of life for women affected by gynaecological cancer in South, South East and East Asian countries? A critical review. Reprod Health 2022; 19:70. [PMID: 35305676 PMCID: PMC8934499 DOI: 10.1186/s12978-022-01369-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 03/02/2022] [Indexed: 12/24/2022] Open
Abstract
Background Gynaecological cancers are among the most prevalent cancers worldwide, with profound effects on the lives of women and their families. In this critical review, we explore the impacts of these cancers on quality of life (QOL) of women in Asian countries, and highlight areas for future inquiry. Methods A systematic search of the literature was conducted in six electronic databases: Web of Science, Scopus, Global Health (CAB Direct), PsycINFO (Ovid), EBMR (Ovid), and Medline (Ovid). Screening resulted in the inclusion of 53 relevant articles reporting on 48 studies. Results Most studies were conducted in high and upper-middle income countries in East Asia and used quantitative approaches. Women had predominantly been diagnosed with cervical or ovarian cancer, and most had completed treatment. Four key interrelated domains emerged as most relevant in shaping QOL of women affected by gynaecological cancer: support, including identified needs, sources and forms; mental health, covering psychological distress associated with cancer, risk and protective factors, and coping strategies; sexual function and sexuality, focused on physiological, emotional and relational changes caused by gynaecological cancers and treatments, and the impacts of these on women’s identities; and physical health, covering the physical conditions associated with gynaecological cancers and their impacts on women’s daily activities. Conclusion QOL of women affected by gynaecological cancer is shaped by their mental and physical health, support, and changes in sexual function and sexuality. The limited number of studies from lower- and middle-income countries in South and Southeast Asia highlights important knowledge gaps requiring future research. Multiple factors shape the quality of life of women affected by gynaecological cancers in Asian countries as elsewhere. We identified 53 articles reporting on 48 studies, most conducted in high- and upper-middle income East Asian countries, with much less attention to women in lower income countries in South and Southeast Asia. Most studies used quantitative research methods to gain an understanding of the impact on women diagnosed with cervical or ovarian cancer who had completed treatment. Women’s quality of life was shaped by their mental and physical health, their support needs, and the changes they experienced in sexual function and sexuality.
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Mokhtari L, Markani AK, Khalkhali HR, Feizi A. The perceived social support by Iranian women with breast cancer: a qualitative study. Support Care Cancer 2021; 30:941-949. [PMID: 34417884 DOI: 10.1007/s00520-021-06478-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 07/28/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Social support has an important role in improving health outcomes and is considered as one of the crucial aspects of the modern care in cancer patients. Therefore, this article aims to explain the perceived experiences of women suffering from breast cancer towards social support. METHODS In this qualitative study, 22 women with breast cancer were selected through purposive sampling from 5 hospitals affiliated to Urmia University of Medical Sciences. The data were collected through semi-structured interviews and were analyzed by the Conventional Qualitative Content Analysis and Graneheim's and Lundman's approach, using MAXQDA software, version 10. RESULTS After completion of the analyzing process, 6 categories were appeared including "creating an empathic atmosphere by family and community," "being in relationship with others," "adaption to disease," "giving meaning to life," "satisfaction with the role of healthcare providers," and "the impact of others support in fighting with the disease." CONCLUSION According to the findings, good social support during the illness can result in the spiritual, mental, and physical well-being of the patients and is one of the most effective factors in fighting the disease and feeling of recovery. The findings of this study can be used to develop plans to help the patients to achieve more support from the family, healthcare providers, and the community and even providing the required supportive care for this group of women.
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Affiliation(s)
- Leila Mokhtari
- Department of Nursing & Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | | | - Hamid Reza Khalkhali
- Patient Safety Research Center, Department of Biostatistics and Epidemiology, Urmia University of Medical Sciences, Urmia, Iran
| | - Aram Feizi
- Patient Safety Research Center, Urmia University of Medical Sciences, Orjhans Street, Resalat Blvd, 571478334, Urmia, Iran.
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13
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Karawekpanyawong N, Kaewkitikul K, Maneeton B, Maneeton N, Siriaree S. The prevalence of depressive disorder and its association in Thai cervical cancer patients. PLoS One 2021; 16:e0252779. [PMID: 34153051 PMCID: PMC8216533 DOI: 10.1371/journal.pone.0252779] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 05/23/2021] [Indexed: 11/17/2022] Open
Abstract
PURPOSE The purpose of this study is to examine the prevalence, associated factors and quality of life associated with depressive disorder in cervical cancer patients. PATIENTS AND METHODS This cross-sectional study was carried out in a gynecologic oncology clinic of a university hospital in Northern Thailand from October 2018 to August 2019. Two-hundred cervical cancer patients were screened for depressive disorder using the nine-item Patient Health Questionnaire (PHQ-9), and psychiatrists interviewed eligible patients to confirm diagnoses. We measured the quality of life using questionnaires from the European Organisation for the Research and Treatment of Cancer: Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) and Cervical Cancer Module 24 (EORTC QLQ-Cx24). Associated factors, including comorbidity, fatigue, and pain, were collected using the Charlson Comorbidity Index (CCI), the eleven-item Chalder Fatigue Scale (CFQ 11), and the visual analog scale (VAS) for pain, respectively. RESULTS Twenty-seven (13.5%) cervical cancer patients were diagnosed with depressive disorder by psychiatrists according to the DSM-5. Depressive disorder was related to a worse quality of life in these patients. A binary logistic regression analysis revealed that depressive disorder among these patients was linked with these factors: high fatigue score (aOR: 1.35; CI: 1.18-1.53), high pain score (aOR: 1.25; CI: 1.02-1.54), no perception of social support, (aOR: 3.12; CI: 1.11-8.81), and no previous surgical treatment for cervical cancer (aOR: 2.99; CI: 1.08-8.29). CONCLUSION The depressive disorder prevalence was 13.5% in Northern Thai cervical cancer patients. In this demographic, cervical cancer patients-who reported high fatigue or pain scores, did not perceive social support, or had no previous cervical cancer surgery- were more likely to have depressive disorder.
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Affiliation(s)
| | - Kewalee Kaewkitikul
- Faculty of Medicine, Department of Psychiatry, Chiang Mai University, Chiang Mai, Thailand
| | - Benchalak Maneeton
- Faculty of Medicine, Department of Psychiatry, Chiang Mai University, Chiang Mai, Thailand
| | - Narong Maneeton
- Faculty of Medicine, Department of Psychiatry, Chiang Mai University, Chiang Mai, Thailand
| | - Sitthicha Siriaree
- Faculty of Medicine, Department of Obstetrics and Gynecology, Chiang Mai University, Chiang Mai, Thailand
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14
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Braga Mendonça A, Ramos Pereira E, Magnago C, Andrade Silva RMCR, das Graças Gazel de Souza M, de Lima Cury Cunha MA. Distress in the context of cancer and chemotherapy: A mixed-method study. Int J Nurs Pract 2021; 28:e12949. [PMID: 34101309 DOI: 10.1111/ijn.12949] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Revised: 03/23/2021] [Accepted: 03/26/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND There are controversial results about the effects of cancer and chemotherapy on the perception of distress. AIMS The purpose to the study is to explore the meaning of the distress experienced by patients with cancer and verify whether the cancer diagnosis, stage and receiving chemotherapy influence this experience. DESIGN This is a mixed-methods study with cancer patients. METHODS Data were collected in 2018 using a phenomenological interview (n = 18) and one suffering inventory (n = 100). Qualitative analysis was performed using the empirical-comprehensive model and quantitative using statistical tests. The results were triangulated. RESULTS Distress originated from difficulties faced in health services, diagnosis confirmation, beginning treatment and interruption of life projects. Patients mobilized resources in the spiritual dimension that allowed them to redefine their distress positively. Chemotherapy brought hope back and promoted healing expectations. Higher average scores for distress were found in patients with advanced stage and receiving palliative chemotherapy. Not having begun chemotherapy and having head and neck cancer were associated with higher average scores for distress. CONCLUSION Distress was greater among patients who had not yet begun chemotherapy; nearness of death and difficulty talking about feelings caused distress; distress was redefined by mobilization of spiritual resources.
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Affiliation(s)
- Angelo Braga Mendonça
- Professional Master's Program in Nursing Care, Aurora de Afonso Costa Nursing School, Fluminense Federal University, Niterói, Brazil
| | - Eliane Ramos Pereira
- Professional Master's Program in Nursing Care, Aurora de Afonso Costa Nursing School, Fluminense Federal University, Niterói, Brazil
| | - Carinne Magnago
- Public Health Faculty, Universidade de São Paulo, SP, Brazil
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15
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Techata A, Muangmool T, Wongpakaran N, Charoenkwan K. Effect of cancer stage on health-related quality of life of patients with epithelial ovarian cancer. J OBSTET GYNAECOL 2021; 42:139-145. [PMID: 33938358 DOI: 10.1080/01443615.2021.1877647] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
We compared the quality of life (QoL) of women with early versus advanced epithelial ovarian cancer and examined predicting factors for the poor QoL. We classified 157 participants into 108 with early disease (stage I-II) and 49 with advanced disease (stage III-IV). They completed two questionnaires: EORTC QLQ-C30 and Chiang Mai University (CMU) ovarian cancer QoL. For EORTC QLQ-C30, the study groups were comparable regarding global health status/QoL, functional scales, and summary scores. The advanced group had worse scores on symptom scales specifically appetite loss and constipation. For CMU Ovarian Cancer QoL, the advanced group had worse scores only in the gastrointestinal domain but not in urinary, lymphatic, and sexual/hormonal domains. These findings remained mostly unchanged after excluding those with recurrence. In multivariable analysis, currently receiving treatment was consistently associated with worse QoL scores. The advanced stage had more adverse impact only on the gastrointestinal domains of QoL, mainly during periods of receiving chemotherapy.IMPACT STATEMENTWhat is already known on this subject? Survival outcome for women with epithelial ovarian cancer varies depending mainly on stage. Those who survive advanced stage disease could expect long-term disease and treatment-related morbidities that significantly affected QoL. However, there has been very limited information regarding QoL of women who have the early disease in comparison to those with more advanced disease especially in the context of Asian culture.What do the results of this study add? Apart from the higher prevalence of gastrointestinal symptoms reported by the patients with advanced disease, the general well-being and other symptom-specific domains of QoL were comparable between women with early and advanced diseases. Receiving treatment is a consistent predictor for poor QoL.What are the implications of these findings for clinical practice and/or further research? In comparison to early-stage epithelial ovarian cancer, the advanced stage had more adverse impact only on the gastrointestinal domains of QoL, mainly during periods of receiving chemotherapy. This information will be useful for patient counselling. Future research should examine the underlying causes of this finding.
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Affiliation(s)
- Apichaya Techata
- Faculty of Medicine, Department of Obstetrics and Gynecology, Chiang Mai University, Chiang Mai, Thailand
| | - Tanarat Muangmool
- Faculty of Medicine, Department of Obstetrics and Gynecology, Chiang Mai University, Chiang Mai, Thailand
| | - Nahathai Wongpakaran
- Faculty of Medicine, Department of Psychiatry, Chiang Mai University, Chiang Mai, Thailand
| | - Kittipat Charoenkwan
- Faculty of Medicine, Department of Obstetrics and Gynecology, Chiang Mai University, Chiang Mai, Thailand
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16
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Mendonça AB, Pereira ER, Magnago C, Medeiros AYBBV, Silva RMCRA, Martins ADO, Meira KC. Suffering experiences of people with cancer undergoing chemotherapy: A meta-ethnographic study. Nurs Health Sci 2021; 23:586-610. [PMID: 33817939 DOI: 10.1111/nhs.12839] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 03/30/2021] [Accepted: 03/31/2021] [Indexed: 12/14/2022]
Abstract
This meta-ethnography had the objectives of identifying, evaluating, and summarizing the findings of qualitative studies regarding the suffering experiences of people undergoing chemotherapy, as well as developing an explanatory conceptual structure regarding what affects these experiences. A systematic literature review was carried out, covering the past 10 years, in the following databases: CINAHL, Embase, Medline, LILACS and Scopus. By using meta-ethnographic synthesis methods, the following themes were found: the pain of loss; evaluating, measuring, and neutralizing the threat; and social contours of suffering. The experience of living with cancer and undergoing chemotherapy was synthesized into a theoretical-explanatory model with a structure that resembles barbed-wire loops. The model expresses people's suffering experiences as marked by the feeling of loss, restraint of emotions, and resilience. While transcendent movements broke the cycle of suffering, resilience emerged as a learning experience that made patients more resistant to the pain of loss. The results indicated a complex and diverse set of factors that influence suffering, which confirmed that experiences are individual, comprehensive, and continuously reinterpreted.
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Affiliation(s)
- Angelo Braga Mendonça
- Healthcare Sciences Program, School of Nursing, Universidade Federal Fluminense, Niterói, Brazil
| | - Eliane Ramos Pereira
- Healthcare Sciences Program, School of Nursing, Universidade Federal Fluminense, Niterói, Brazil
| | - Carinne Magnago
- Public Health Faculty, Universidade de São Paulo, Niterói, Brazil
| | | | | | | | - Karina Cardoso Meira
- Health Sciences School, Universidade Federal do Rio Grande do Norte, Natal, Brazil
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17
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Aquil A, Kherchi OE, Azmaoui NEL, Mouallif M, Guerroumi M, Zaeria H, Jayakumar AR, Benider A, Elgot A. Anxio-depressive symptoms in Moroccan women with gynecological cancer: Relief factors. Bull Cancer 2021; 108:472-480. [PMID: 33752868 DOI: 10.1016/j.bulcan.2020.12.011] [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: 09/29/2020] [Revised: 11/28/2020] [Accepted: 12/14/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Psychosocial determinants can affect the mental health of women who have been diagnosed with gynecological cancer. The aim of this study was to examine how social support and self-esteem are associated with anxiety and depression symptoms in women with gynecological cancer, and who are treated by radical surgery. METHODS A cross-sectional study was performed, within the oncology department of Ibn Rochd University Hospital, Casablanca, on 100 Moroccan women. They all had undergone radical surgery for gynecological cancer, hysterectomy and/or oophorectomy. RESULTS Our results showed that patients with gynecological cancer treated by radical surgery exhibited high prevalence rates of anxiety (66%) and depression symptoms (59%). Associations showed that age, having children, medical coverage system, area of residence, working status and socioeconomic status were significantly related to the prevalence of anxiety and depression symptoms (P<0.05). The general social support, family support and significant other support besides high self-esteem reduce significantly the risk of getting anxiety and depression symptoms (P-values<0.05). DISCUSSION Among patients with gynecological cancer treated by radical surgery, high prevalence of anxiety and depression symptoms was found. Social support and high self-esteem could help improve mental health issues related to this type of cancer.
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Affiliation(s)
- Amina Aquil
- Hassan First University of Settat, Higher Institute of Health Sciences, Laboratory of Sciences and Health Technologies, Epidemiology and biomedical unit, 26000 Settat, Morocco
| | - Ouassil El Kherchi
- Hassan First University of Settat, Higher Institute of Health Sciences, Laboratory of Sciences and Health Technologies, Epidemiology and biomedical unit, 26000 Settat, Morocco
| | - Naoual E L Azmaoui
- Hassan First University of Settat, Higher Institute of Health Sciences, Laboratory of Sciences and Health Technologies, Epidemiology and biomedical unit, 26000 Settat, Morocco
| | - Mustapha Mouallif
- Hassan First University of Settat, Higher Institute of Health Sciences, Laboratory of Sciences and Health Technologies, Epidemiology and biomedical unit, 26000 Settat, Morocco
| | - Maroua Guerroumi
- Hassan First University of Settat, Higher Institute of Health Sciences, Laboratory of Sciences and Health Technologies, Epidemiology and biomedical unit, 26000 Settat, Morocco
| | - Hasna Zaeria
- Hassan First University of Settat, Higher Institute of Health Sciences, Laboratory of Sciences and Health Technologies, Epidemiology and biomedical unit, 26000 Settat, Morocco
| | - Arumugam R Jayakumar
- Gynecology and Reproductive Sciences University of Miami Miller School of Medicine, Miami VA Medical Center and Department of Obstetrics, Neuropathology Research Unit, 33136 Miami, FL, USA
| | - Abdellatif Benider
- Ibn-Rochd University Hospital Center, Mohammed VI Center for the Treatment of Cancers, Casablanca, Morocco
| | - Abdeljalil Elgot
- Hassan First University of Settat, Higher Institute of Health Sciences, Laboratory of Sciences and Health Technologies, Epidemiology and biomedical unit, 26000 Settat, Morocco.
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18
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Scheepers ERM, de Rooij BH, Pijnenborg JMA, van Huis-Tanja LH, Ezendam NPM, Hamaker ME. Perceived social support in patients with endometrial or ovarian cancer: A secondary analysis from the ROGY care study. Gynecol Oncol 2021; 160:811-816. [PMID: 33454131 DOI: 10.1016/j.ygyno.2020.12.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 12/21/2020] [Indexed: 12/09/2022]
Abstract
OBJECTIVE Social support may reduce the amount of psychological distress and increase quality of life. This study assessed whether socio-demographic, personality, and clinical characteristics predict the level of perceived social support in patients with endometrial or ovarian cancer. METHODS Patients with endometrial or ovarian cancer who participated in the ROGY Care study and completed the Multidimensional Scale of Perceived Social Support(MSPSS) 12 months after inclusion were eligible for this study (n=238). Logistic regression analysis was conducted to determine the predictive value of socio-demographic characteristics, personality and clinical characteristics after initial treatment on the perceived level of social support after 12 months. RESULTS Of the 238 patients (mean age 64.8 ± 9.4 years), 139 patients had endometrial cancer (58%) and 99 patients had ovarian cancer (42%). One year after inclusion, the level of perceived social support was high in 79% of all patients (n=189). Patients experiencing low level of perceived social support (n=49) less often had a partner (69% versus 83% in patients with high level of perceived social support; p=0.029), had a higher education level (24% versus 15% respectively; p=0.013) and a distressed (type D) personality was more common (40% versus 16% respectively; p<0.001). In multivariable analysis, a type D personality, characterized by negative affect and social inhibition, was the only independent predictor of a low level of perceived social support (OR 2.96; 95% CI 1.37-6.37; p=0.006). CONCLUSIONS In patients with endometrial or ovarian cancer, the level of perceived social support is mainly associated with a distressed (type D) personality. Those patients can be at risk of experiencing less social support. Future research is needed to assess whether they might benefit from additional support during cancer diagnosis and treatment.
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Affiliation(s)
- E R M Scheepers
- Department of Internal Medicine, Diakonessenhuis, Utrecht, the Netherlands.
| | - B H de Rooij
- Netherlands Comprehensive Cancer Organisation (IKNL), the Netherlands
| | - J M A Pijnenborg
- Department of Gynaecology, Radboud university medical center Nijmegen, the Netherlands
| | - L H van Huis-Tanja
- Department of Internal Medicine, Diakonessenhuis, Utrecht, the Netherlands
| | - N P M Ezendam
- Netherlands Comprehensive Cancer Organisation (IKNL) and Tilburg University, the Netherlands
| | - M E Hamaker
- Department of Geriatric Medicine, Diakonessenhuis, Utrecht, the Netherlands
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19
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Boban S, Downs J, Codde J, Cohen PA, Bulsara C. Women Diagnosed with Ovarian Cancer: Patient and Carer Experiences and Perspectives. PATIENT-RELATED OUTCOME MEASURES 2021; 12:33-43. [PMID: 33623464 PMCID: PMC7896761 DOI: 10.2147/prom.s272688] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Accepted: 12/15/2020] [Indexed: 01/04/2023]
Abstract
Purpose By directly engaging with women diagnosed with ovarian cancer, this study aimed to explore and identify their view of the health symptoms and outcomes that matter most to them as they traverse their disease pathway. Background Patient-reported outcome measures in ovarian cancer have tended to focus on physical symptoms rather than the more complex psychosocial aspects of living with the disease. Using a "ground-up approach", this study sought to comprehensively understand the health concerns that matter most to women with ovarian cancer as a first step in generating items for development into an ovarian cancer-specific patient-reported outcome measure. Patients and Methods Following an extensive literature review, we sought to capture the "patient voice" through a qualitative descriptive approach including a community conversation with ovarian cancer patients, their carers and clinicians, and interviews and focus groups with women with ovarian cancer. Thirteen women were interviewed individually, and two focus groups were conducted. A template thematic analysis was used to analyze the data. Results Key themes included challenges related to clinical diagnosis, treatment phase, altered relationships with family/friends, financial issues, relationships with health professionals and coping strategies. Within each key theme, several sub-themes emerged that were identified as various challenges experienced by participants. Diagnostic delay, chemotherapy and surgery-related challenges, negative impact of sexual well-being on partner relationship, communicational challenges with health professionals were among the few issues identified. In addition, self-empowerment was identified as a coping mechanism among participants. Conclusion By identifying priorities for women diagnosed with ovarian cancer we have highlighted the need for strategies to reduce diagnostic delays and improve quality of life for these women. Data will inform the development of an ovarian cancer-specific patient-reported outcome measure.
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Affiliation(s)
- Sharolin Boban
- School of Health Sciences, University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - Jenny Downs
- Telethon Kids Institute, Centre for Child Health Research, The University of Western Australia, Nedlands, Western Australia, Australia
| | - Jim Codde
- Institute for Health Research, University of Notre Dame Australia, Fremantle, Western Australia, Australia.,Division of Obstetrics and Gynecology, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - Paul A Cohen
- Institute for Health Research, University of Notre Dame Australia, Fremantle, Western Australia, Australia.,Division of Obstetrics and Gynecology, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - Caroline Bulsara
- Institute for Health Research, University of Notre Dame Australia, Fremantle, Western Australia, Australia
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20
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Tsai LY, Tsai JM, Tsay SL. Life experiences and disease trajectories in women coexisting with ovarian cancer. Taiwan J Obstet Gynecol 2020; 59:115-119. [PMID: 32039777 DOI: 10.1016/j.tjog.2019.11.032] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2019] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVE This study investigated the lived experiences of ovarian cancer survivors amid the disease trajectory and psychosocial adaptation. MATERIALS AND METHODS Twenty-one women, all of whom were ovarian cancer survivors, were recruited from medical centers in Taiwan. In-depth, face-to-face, semi-structured interviews were conducted and transcribed verbatim from audio recordings. The sample size was determined by information saturation during data collection. The steps of data process and analysis were performed using Giorgi's phenomenology. RESULTS Three themes and 12 subthemes were extracted: (1) a depressed state, as if facing a fierce enemy: being sentenced to a death penalty like facing an insurmountable challenge; contradictory information and helplessness; turnaround for treatment decision; and facing stigmatization from society; (2) shadow of cancer recurrence: side-effects of cancer treatment; falling into desperation and frustration; worrying about cancer recurrence; and continuing to fight cancer; (3) a change of mindset to move forward: experiencing changes in outlook on life; activating the self-healing process; coexisting with cancer and treating it as a chronic disease; and experiencing physical and mental purification and enhancement. CONCLUSION The conventional models caring for patients with ovarian cancer are based on disease and unable to meet their needs because the lengthy rehabilitation journey. Therefore, medical personnel should emphasize patients' medical autonomy and combine professional care and social resources to help patients developing adjustment strategies and establishing support systems in timely manner for body, mind, and soul of these patients.
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Affiliation(s)
- Li-Yun Tsai
- College of Nursing and Health Sciences, Dayeh University, Changhua, Taiwan
| | - Jung-Mei Tsai
- College of Nursing and Health Sciences, Dayeh University, Changhua, Taiwan; Mackay Memorial Hospital, Taipei City, Taiwan; Department of Nursing, Mackay Junior College of Medicine, Nursing, and Management, Taipei City, Taiwan; Department of Nursing, Mackay Medical College, New Taipei City, Taiwan.
| | - Shiow-Luan Tsay
- College of Nursing and Health Sciences, Dayeh University, Changhua, Taiwan.
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21
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Frey MK, Ellis AE, Zeligs K, Chapman-Davis E, Thomas C, Christos PJ, Kolev V, Prasad-Hayes M, Cohen S, Holcomb K, Blank SV. Impact of the coronavirus disease 2019 pandemic on the quality of life for women with ovarian cancer. Am J Obstet Gynecol 2020; 223:725.e1-725.e9. [PMID: 32598911 PMCID: PMC7318934 DOI: 10.1016/j.ajog.2020.06.049] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 06/12/2020] [Accepted: 06/23/2020] [Indexed: 12/11/2022]
Abstract
Background The coronavirus disease 2019 pandemic has resulted in unprecedented challenges for the oncology community. For people living with cancer, treatments are interrupted, surgeries cancelled, and regular oncology evaluations rescheduled. People with cancer and their physicians must balance plausible fears of coronavirus disease 2019 and cancer treatment with the consequences of delaying cancer care. Objective We aim to evaluate the experience of women with ovarian cancer during the coronavirus disease 2019 pandemic. Study Design Women with a current or previous diagnosis of ovarian cancer completed an online survey focusing on treatment interruptions and quality of life. The quality of life was measured with the Cancer Worry Scale and Hospital Anxiety and Depression Scale. The survey was distributed through survivor networks and social media. Univariate and multivariable linear regression analysis were used to evaluate the effect of participant characteristics on quality of life survey scores. Results A total of 603 women, from 41 states, visited the survey website between March 30, 2020, and April 13, 2020, and 555 (92.0%) completed the survey. The median age was 58 years (range, 20–85). At the time of survey completion, 217 participants (43.3%) were in active treatment. A total of 175 participants (33%) experienced a delay in some component of their cancer care. Ten (26.3%) of the 38 participants scheduled for surgery experienced a delay, as did 18 (8.3%) of the 217 participants scheduled for nonsurgical cancer treatment. A total of 133 participants (24.0%) had a delayed physician appointment, 84 (15.1%) laboratory tests, and 53 (9.6%) cancer-related imaging. Among the cohort, 88.6% (489) reported significant cancer worry, 51.4% (285) borderline or abnormal anxiety, and 26.5% (147) borderline or abnormal depression. On univariate analysis, age less than 65 years, being scheduled for cancer treatment or cancer surgery, delay in oncology care, being self-described as immunocompromised, and use of telemedicine were all associated with higher levels of cancer worry. Higher anxiety scores were associated with age less than 65 years and being self-described as immunocompromised. Higher depression scores were associated with age less than 65 years, being scheduled for cancer surgery, delay in oncology care, being self-described as immunocompromised, and use of telemedicine. On multivariable linear regression analysis, age less than 65 and being self-described as immunocompromised were independently predictive of greater cancer worry, anxiety, and depression, and delay in cancer care was predictive of anxiety and depression. Conclusion The coronavirus disease 2019 crisis is affecting care of patients with ovarian cancer; surgeries, treatments, scheduled physician appointments, laboratory tests, and imaging are cancelled or delayed. Younger age, presumed immunocompromise, and delay in cancer care were associated with significantly higher levels of cancer worry, anxiety, and depression. Providers must work with patients to balance competing risks of coronavirus disease 2019 and cancer, recognizing that communication is a critical clinical tool to improve quality of life in these times.
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Affiliation(s)
| | - Annie E Ellis
- Ovarian Cancer Research Alliance, New York, NY; SHARE, New York, NY
| | | | | | | | | | | | | | | | | | - Stephanie V Blank
- Blavatnik Family Women's Health Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY
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Health-Related Quality of Life in Older Adults: Its Association with Health Literacy, Self-Efficacy, Social Support, and Health-Promoting Behavior. Healthcare (Basel) 2020; 8:healthcare8040407. [PMID: 33081352 PMCID: PMC7712387 DOI: 10.3390/healthcare8040407] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 10/12/2020] [Accepted: 10/13/2020] [Indexed: 12/22/2022] Open
Abstract
This cross-sectional study aimed to explore the relationships among sociodemographics, health literacy, self-efficacy, social support, health-promoting behavior, and health-related quality of life (HRQOL) in older adults. A total of 240 older adults aged >65 years were recruited from three community senior welfare centers in South Korea. Standardized self-administered questionnaires measuring sociodemographic characteristics, health literacy, social support, self-efficacy, health-promoting behavior, and health-related quality of life were distributed to older adults. Multiple regression analyses with stepwise selection was used to determine the factors affecting health-related quality of life. Factors affecting a higher physical component score of HRQOL were a higher comprehension level of and numeracy in health literacy, physical health-promoting behavior, perceived emotional-informational support, and a lesser number of comorbidities. Factors affecting a higher mental component score of HRQOL were a higher comprehension level of and numeracy in health literacy, self-efficacy, physical health-promoting behavior, perceived emotional-informational support, and a lesser number of comorbidities. To improve HRQOL among older adults, nursing interventions are required to measure health literacy, empower physical health-promoting behavior and self-efficacy, and enhance emotional-informational support from family or other resources.
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Beesley VL, Webber K, Nagle CM, DeFazio A, Obermair A, Williams M, Friedlander M, Webb PM. When will I feel normal again? Trajectories and predictors of persistent symptoms and poor wellbeing after primary chemotherapy for ovarian cancer. Gynecol Oncol 2020; 159:179-186. [DOI: 10.1016/j.ygyno.2020.07.029] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 07/19/2020] [Indexed: 12/31/2022]
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De Maria M, Tagliabue S, Ausili D, Vellone E, Matarese M. Perceived social support and health-related quality of life in older adults who have multiple chronic conditions and their caregivers: a dyadic analysis. Soc Sci Med 2020; 262:113193. [PMID: 32777671 DOI: 10.1016/j.socscimed.2020.113193] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 06/08/2020] [Accepted: 07/05/2020] [Indexed: 01/20/2023]
Abstract
RATIONALE Patients who have multiple chronic conditions (MCCs) and their informal caregivers experience poorer health-related quality of life (HRQOL). Perceived social support has been shown to influence HRQOL. OBJECTIVES This study aimed at identifying the differences between patients' and caregivers' physical and mental HRQOL; and determining the association between their perception of social support from different sources, and their own and their dyad partner's HRQOL. METHOD Patients with MCCs and their caregivers (345 dyads) were enrolled in a multicenter cross-sectional study conducted in Italy. The Multidimensional Scale of Perceived Social Support measured perceived social support from family, friends, and significant others, and the 12-Item Short-Form Health Survey measured the physical and mental component of HRQOL in dyads. The dyadic analysis was conducted using the Actor-Partner Interdependence Model through structural equation modelling. RESULTS Family support perceived by each member of the dyad was associated positively with their own mental HRQOL, and that family support perceived by caregivers was also associated positively with patients' mental HRQOL. Greater family support perceived by caregivers was also associated with better physical HRQOL in both caregivers and patients. Moreover, greater friend-support perceived by each member of the dyad was positively associated with own physical HRQOL. CONCLUSIONS The study suggests the reciprocal influence of perceived social support from family and friends on physical and mental HRQOL in MCC dyads. Healthcare professionals should identify those people who are the main sources of support for each member of the dyad, and develop care plans that promote the maintenance and enhancing of this support.
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Affiliation(s)
- Maddalena De Maria
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier, 1, 00133, Rome, Italy.
| | - Semira Tagliabue
- Department of Psychology, Catholic University of the Sacred Heart, Via Trieste, 17, 25121, Brescia, Italy.
| | - Davide Ausili
- Department of Medicine and Surgery, University of Milan-Bicocca, Via Cadore 48, 20900, Monza, Italy.
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier, 1, 00133, Rome, Italy.
| | - Maria Matarese
- Research Unit of Nursing Science, Campus Bio-medico University of Rome, Via Alvaro del Portillo, 21 00128, Rome, Italy.
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Lee K, Zhou J, Norris MK, Chow C, Dieli-Conwright CM. Prehabilitative Exercise for the Enhancement of Physical, Psychosocial, and Biological Outcomes Among Patients Diagnosed with Cancer. Curr Oncol Rep 2020; 22:71. [PMID: 32537699 DOI: 10.1007/s11912-020-00932-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE OF REVIEW This review summarizes the effects of prehabilitative exercise interventions on the physical, psychosocial, and biological outcomes among patients with cancer. Current gaps and future directions in prehabilitative exercise research will be addressed. RECENT FINDINGS Prehabilitative exercise mitigates the detrimental impact of cancer surgery on physical fitness, noted by increases in maximal oxygen consumption and 6-min walk distance. Beneficial effects on psychosocial and biological outcomes remain inconclusive. Aerobic exercise interventions were often prescribed and included low-, moderate-, or high-intensity exercise. Resistance exercise interventions were often performed in conjunction with aerobic exercise. Prehabilitative exercise elicits robust improvements in physical fitness; however, effect on psychosocial and biological outcomes remains inconclusive. Exercise prescription parameters varied greatly by frequency, intensity, time, and type across multiple cancer diagnoses. Future investigations are needed to systematically dose exercise for a wider variety of outcome measures, with an overall goal to set forth pre-operative exercise guidelines.
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Affiliation(s)
- Kyuwan Lee
- Department of Population Sciences, City of Hope, Duarte, CA, 91010, USA
| | - Judy Zhou
- Division of Biokinesiology and Physical Therapy, Ostrow School of Dentistry, University of Southern California (USC), Los Angeles, CA, 90089, USA
| | - Mary K Norris
- Division of Populations Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, 375 Longwood Ave, Boston, MA, 02215, USA
| | - Christina Chow
- Division of Biokinesiology and Physical Therapy, Ostrow School of Dentistry, University of Southern California (USC), Los Angeles, CA, 90089, USA
| | - Christina M Dieli-Conwright
- Division of Populations Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, 375 Longwood Ave, Boston, MA, 02215, USA.
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Maoz A, Ciccone MA, Matsuzaki S, Coleman RL, Matsuo K. Emerging serine-threonine kinase inhibitors for treating ovarian cancer. Expert Opin Emerg Drugs 2020; 24:239-253. [PMID: 31755325 DOI: 10.1080/14728214.2019.1696773] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Introduction: Ovarian cancer is the leading cause of gynecologic cancer death, owing to high rates of incurable, recurrent disease after initial treatment. Serine threonine kinases (STKs) have been proposed as potential therapeutic targets in ovarian cancer because of their role in the initiation and progression of cancers. Experience in non-ovarian cancers suggests that STK inhibitors are active against tumors with specific molecular alterations.Areas covered: This review discusses STK inhibitors in active development in phase II/III clinical trials for ovarian cancer. PubMed and ClinicalTrials.gov were systematically searched to identify STK inhibitor trials for ovarian cancer; active development was confirmed via Pharmaprojects. Available data regarding the efficacy and safety of these compounds are explored.Expert opinion: STK inhibitors currently in development have modest activity as single agents and are unlikely to achieve approval as monotherapy for unselected ovarian cancer patients. Combination trials of STK inhibitors with chemotherapy and/or targeted therapies have suggested an acceptable efficacy/toxicity ratio for certain combinations but confirmatory studies are needed. Carefully designed trials, especially those including somatic molecular analysis, may help identify the subsets of patients most likely to benefit from these therapeutic strategies and determine the role of STK inhibitors in the evolving landscape of precision oncology.
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Affiliation(s)
- Asaf Maoz
- Department of Internal Medicine, Boston University School of Medicine and Boston Medical Center, Boston, MA, USA
| | - Marcia A Ciccone
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA.,Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA
| | - Shinya Matsuzaki
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA
| | - Robert L Coleman
- Department of Gynecologic Oncology, University of Texas, MD-Anderson Cancer Center, Houston, TX, USA
| | - Koji Matsuo
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA.,Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA
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27
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Di Mattei VE, Carnelli L, Taranto P, Mazzetti M, Perego G, Rottoli S, Rancoita PMV, Bergamini A, Petrone M, Rabaiotti E, Candotti G, Candiani M. Chemotherapy-induced nausea in a sample of gynaecological cancer patients: assessment issues and personal risk factors evaluation. Support Care Cancer 2020; 28:5343-5351. [DOI: 10.1007/s00520-020-05377-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 02/24/2020] [Indexed: 11/30/2022]
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28
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Lorusso D, Bologna A, Cecere SC, De Matteis E, Scandurra G, Zamagni C, Arcangeli V, Artioli F, Bella M, Blanco G, Cardalesi C, Casartelli C, De Vivo R, Di Napoli M, Gisone EB, Lauria R, Lissoni AA, Loizzi V, Maccaroni E, Mangili G, Marchetti C, Martella F, Naglieri E, Parolin V, Ricciardi G, Ronzino G, Salutari V, Scarfone G, Secondino S, Spagnoletti I, Tasca G, Tognon G, Guarneri V. Sharing real-world experiences to optimize the management of olaparib toxicities: a practical guidance from an Italian expert panel. Support Care Cancer 2020; 28:2435-2442. [PMID: 32048043 DOI: 10.1007/s00520-020-05320-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 01/17/2020] [Indexed: 11/28/2022]
Abstract
Olaparib is the first poly(ADP-ribose) polymerase inhibitor approved as maintenance therapy of recurrent ovarian cancer (OC) patients with a BRCA mutation. To achieve the maximum clinical benefit, adherence to olaparib must be persistent. However, in clinical practice, this is challenged by the frequent suboptimal management of toxicities. In view of the expanding use of olaparib also in Italy, physicians must learn how to adequately and promptly manage drug toxicities not to unnecessarily interrupt or reduce the dose. The experts agreed that nausea,vomiting, anemia, and fatigue are the most frequent events experienced by OC patients on olaparib, and that these toxicities usually develop early during treatment, are mainly of grade 1-2 and transient and can be managed with simple non-pharmacological interventions. By sharing their real-world experiences, the panel prepared, for each toxicity, an algorithm organized by grade and besides the procedures indicated in the local label, included supportive care interventions based also on nutritional and lifestyle modifications and psycho-oncology consultation. Moreover, in view of the tablet entry into the Italian market, the full and reduced dosages of capsules and tablets were compared. This practical guidance is intended to be a tool to support especially less-experienced physicians in the management of these complex patients, with the aim to help preventing the worsening of patients' conditions and the unnecessary interruption/reduction of olaparib dosage, which may jeopardize treatment efficacy.
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Affiliation(s)
- Domenica Lorusso
- Division of Gynecologic Oncology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy.
| | - Alessandra Bologna
- Oncologia Medica, IRCCS Arcispedale S. Maria Nuova, Viale Risorgimento, 80, 42123, Reggio Emilia, Italy
| | - Sabrina Chiara Cecere
- Oncologia Clinica Sperimentale Uro-Ginecologica, Istituto Nazionale Tumori, IRCCS Fondazione G. Pascale, Via Mariano Semmola, 53, 80131, Naples, Italy
| | | | - Giusy Scandurra
- Multidisciplinary Breast Unit, Azienda Ospedaliera Cannizzaro, Via Messina, 829, 95126, Catania, Italy
| | - Claudio Zamagni
- Medical Oncology Unit, S.Orsola-Malpighi Hospital, Viale Ercolani 4/2, Bologna, Italy
| | - Valentina Arcangeli
- U.O. Oncologia, Ospedale Infermi Rimini, AUSL Romagna, viale Settembrini 2, 47923, Rimini, Italy
| | - Fabrizio Artioli
- Oncology Dept., Carpi and Mirandola Hospitals, Via G. Molinari 2, 41012, Carpi, Italy
| | - Mariangela Bella
- Medical Oncology Unit, University Hospital of Parma, Viale Antonio Gramsci, 14, 43126, Parma, Italy
| | - Giusi Blanco
- Oncology Unit, Ist. Oncologico del Mediterraneo, Via Penninazzo, 7, Viagrande, 95029, Catania, Italy
| | - Cinzia Cardalesi
- Dept. of Clinical and Surgical Medicine, Federico II University Hospital, Via Pansini 5, 80131, Naples, Italy
| | - Clelia Casartelli
- Medical Oncology Unit, Ospedale Valduce, Via Dante Alighieri, 11, 22100, Como, Italy
| | - Rocco De Vivo
- Medical Oncology Unit, AULSS 8 Vicenza, viale Rodolfi, 37, 36100, Vicenza, Italy
| | - Marilena Di Napoli
- Oncologia Clinica Sperimentale Uro-Ginecologica, Istituto Nazionale Tumori, IRCCS Fondazione G. Pascale, Via Mariano Semmola, 53, 80131, Naples, Italy
| | - Emanuele Baldo Gisone
- Dept of Obstetrics and Gynecology, "Filippo Del Ponte" Hospital, University of Insubria, Via del Ponte, 19, 21100, Varese, Italy
| | - Rossella Lauria
- Dept. of Clinical and Surgical Medicine, Federico II University Hospital, Via Pansini 5, 80131, Naples, Italy
| | - Alberto Andrea Lissoni
- Dept of Medicine and Surgery, University of Milano-Bicocca, Via Cadore 48, 20900, Monza, Italy.,Clinic of Obstetrics and Gynecology, San Gerardo Hospital, Via Pergolesi 33, 20900, Monza, Italy
| | - Vera Loizzi
- Dept of Biomedical Sciences and Medical Oncology, University of Bari "Aldo Moro", Piazza Umberto I 1, 70124, Bari, Italy
| | - Elena Maccaroni
- Clinica Oncologica, AOU Ospedali Riuniti Ancona, via Conca 71, , 60020, Ancona, AN, Italy
| | - Giorgia Mangili
- Obstetrics and Gynecology, San Raffaele Hospital, Via Olgettina Milano, 60, 20132, Milan, Italy
| | - Claudia Marchetti
- Division of Gynecologic Oncology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy
| | - Francesca Martella
- Breast Unit, Ospedale S.M. Annunziata, USL Toscana Centro, Via dell'Antella, 58, Bagno a Ripoli, 50012, Florence, Italy
| | - Emanuele Naglieri
- Division of Medical Oncology, IRCCS Istituto Oncologico Giovanni Paolo II, Viale Orazio Flacco, 65, 70124, Bari, Italy
| | - Veronica Parolin
- Breast Uni, Azienda Ospedaliera Universitaria Integrata, Piazzale Aristide Stefani, 1, 37126, Verona, Italy
| | - Giusy Ricciardi
- Medical Oncology, AO Papardo, Contrada Papardo, 98158, Messina, Italy
| | - Graziana Ronzino
- Dept. of Oncology, Vito Fazzi Hospital, Piazzetta Muratore, 73100, Lecce, Italy
| | - Vanda Salutari
- Division of Gynecologic Oncology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy
| | - Giovanna Scarfone
- Dept of Obstetrics, Gynecology and Neonatology, IRCCS Fondazione Cà Granda, Ospedale Maggiore Policlinico, via F. Sforza 28, Milan, Italy
| | - Simona Secondino
- Fondazione IRCCS Policlinico San Matteo, Viale Camillo Golgi, 19, 27100, Pavia, Italy
| | - Ilaria Spagnoletti
- Medical Oncology Unit, Ospedale Sacro Cuore di Gesù, Fatebenefratelli, Viale Principe di Napoli, 14/A, 82100, Benevento, Italy
| | - Giulia Tasca
- Division of Medical Oncology 2, Istituto Oncologico Veneto, Via Gattamelata, 64, 35128, Padua, Italy
| | - Germana Tognon
- UO Ostetricia e Ginecologia-ASST degli Spedali Civili di Brescia, Università degli Studi, Piazzale Spedali Civili 1, 25123, Brescia, Italy
| | - Valentina Guarneri
- Division of Medical Oncology 2, Istituto Oncologico Veneto, Via Gattamelata, 64, 35128, Padua, Italy
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Ilie G, Bradfield J, Moodie L, Lawen T, Ilie A, Lawen Z, Blackman C, Gainer R, Rutledge RDH. The Role of Response-Shift in Studies Assessing Quality of Life Outcomes Among Cancer Patients: A Systematic Review. Front Oncol 2019; 9:783. [PMID: 31482068 PMCID: PMC6710367 DOI: 10.3389/fonc.2019.00783] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 08/02/2019] [Indexed: 12/11/2022] Open
Abstract
Objective: Response-shift has been cited as an important measurement consideration when assessing patient reported quality of life (QoL) outcomes over time among patients with severe chronic conditions. Here we report the results of a systematic review of response shift in studies assessing QoL among cancer patients. Methods: A systematic review using MEDLINE, EMBASE, and PsychINFO along with a manual search of the cited references of the articles selected, was conducted. A quality review was performed using STROBE criteria and reported according to PRISMA guidelines. Results: A systematic review of 1,487 records published between 1,887 and December 2018 revealed 104 potentially eligible studies, and 35 studies met inclusion criteria for content and quality. The most common cancer patient populations investigated in these studies were breast (18 studies), lung (14 studies), prostate (eight studies), and colorectal (eight studies). Response shift was identified among 34 of the 35 studies reviewed. Effect sizes were reported in 17 studies assessing QoL outcomes among cancer patients; 12 of which had negligible to small effect sizes, four reported medium effect sizes which were related to physical, global QoL, pain, and social (role) functioning and one reported a large effect size (fatigue). The most prevalent method for assessing response shift was the then-test, which is prone to recall bias, followed by the pre-test and post-test method. Given the heterogeneity among the characteristics of the samples and designs reviewed, as well as the overall small to negligible effect sizes for the effects reported, conclusions stating that changes due to internal cognitive shifts in perceived QoL should account for changes observed in cancer patients' QoL outcomes should be interpreted with caution. Conclusion: Further work is needed in this area of research. Future studies should control for patient characteristics, time elapsed between diagnosis and baseline assessment and evaluate their contribution to the presence of response shift. Time between assessments should include short and longer periods between assessments and evaluate whether the presence of response shift holds over time. Possible avenues for inquiry for future investigation are discussed.
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Affiliation(s)
- Gabriela Ilie
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax Regional Municipality, NS, Canada.,Department of Urology, Faculty of Medicine, Dalhousie University, Halifax Regional Municipality, NS, Canada.,Department of Psychology and Neuroscience, Dalhousie University, Halifax Regional Municipality, NS, Canada.,Department of Radiation Oncology, Faculty of Medicine, Dalhousie University, Halifax Regional Municipality, NS, Canada
| | - Jillian Bradfield
- Department of Psychology and Neuroscience, Dalhousie University, Halifax Regional Municipality, NS, Canada
| | - Louise Moodie
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax Regional Municipality, NS, Canada
| | - Tarek Lawen
- Department of Urology, Faculty of Medicine, Dalhousie University, Halifax Regional Municipality, NS, Canada.,Urology, Halifax Infirmary-QEII-Nova Scotia Health Authority, Halifax Regional Municipality, NS, Canada
| | - Alzena Ilie
- Department of Psychology and Neuroscience, Dalhousie University, Halifax Regional Municipality, NS, Canada
| | - Zeina Lawen
- Department of Psychology and Neuroscience, Dalhousie University, Halifax Regional Municipality, NS, Canada
| | - Chloe Blackman
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax Regional Municipality, NS, Canada
| | - Ryan Gainer
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax Regional Municipality, NS, Canada
| | - Robert D H Rutledge
- Department of Radiation Oncology, Faculty of Medicine, Dalhousie University, Halifax Regional Municipality, NS, Canada.,Nova Scotia Cancer Centre, Queen Elizabeth II Health Sciences Centre, Halifax Regional Municipality, NS, Canada
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30
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Caring for Survivors of Gynecologic Cancer: Assessment and Management of Long-term and Late Effects. Semin Oncol Nurs 2019; 35:192-201. [DOI: 10.1016/j.soncn.2019.02.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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31
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Telephone-based reminiscence therapy for colorectal cancer patients undergoing postoperative chemotherapy complicated with depression: a three-arm randomised controlled trial. Support Care Cancer 2018; 27:2761-2769. [DOI: 10.1007/s00520-018-4566-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 11/20/2018] [Indexed: 01/08/2023]
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32
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The risk factors for depression in cancer patients undergoing chemotherapy: a systematic review. Support Care Cancer 2018; 27:57-67. [PMID: 30225571 DOI: 10.1007/s00520-018-4466-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 09/10/2018] [Indexed: 12/21/2022]
Abstract
PURPOSE This systematic review aims to identify the risk factors for depression in cancer patients undergoing chemotherapy. METHODS Eight electronic databases were searched from inception of the databases established until August 2017. References for the included studies were retrieved by manual searching. The quality of the eligible studies was appraised by two persons using the 11-item checklist of the Agency for Healthcare Research and Quality (AHRQ). RESULTS Among 5988 potentially relevant articles, 43 studies were eligible, with 17 studies of high quality and 25 studies of moderate quality. A total of 65 factors were extracted, including sociodemographic characteristics (n = 20), physiological condition (n = 20), disease and treatment (n = 12), and psychosocial factors (n = 13). Only social support, anxiety, perceived stress, and self-efficacy were found to be consistently associated with depression in cancer patients. There is not enough evidence to support the link between the other 61 factors and depression in cancer patients undergoing chemotherapy. CONCLUSIONS This review suggests that the development of depression programs should take social support, anxiety, perceived stress, and self-efficacy into account. More original studies with rigorous design are necessary to further confirm those 61 inconclusive risk factors for depression in cancer patients receiving chemotherapy.
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Manne SL, Kashy DA, Virtue S, Criswell KR, Kissane DW, Ozga M, Heckman CJ, Stapleton J, Rodriguez L. Acceptance, social support, benefit-finding, and depression in women with gynecological cancer. Qual Life Res 2018; 27:2991-3002. [PMID: 30128785 DOI: 10.1007/s11136-018-1953-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2018] [Indexed: 02/07/2023]
Abstract
PURPOSE Although studies have demonstrated a protective role for benefit finding in psychological distress, little is known about how benefit finding leads to lower psychological distress. This study's goal was to use a multiple mediator model to evaluate whether the effect of benefit-finding on depression was mediated by acceptance of cancer, acceptance of emotions, and received social support. METHODS One hundred seventy-four women recently diagnosed with gynecological cancer completed measures of perceived benefits from the cancer experience, acceptance-based strategies, social support, and depression. Using a cross-sectional approach, we analyzed a multiple mediator model with benefit-finding as the independent variable, depressive symptom severity as the outcome, and acceptance-based strategies and social support as mediators. RESULTS Acceptance-based strategies and social support significantly mediated the relationship between benefit-finding and depression. Emotional acceptance had the strongest mediational effect, controlling for the other two mediators. CONCLUSIONS Helping women diagnosed with gynecological cancers identify benefits from their cancer experience may reduce depression by paving the way for them to accept their emotional reactions, accept life changes associated with cancer, and facilitate supportive reactions from family and friends. Future longitudinal research is needed to confirm whether gynecological cancer patients who perceive more benefits will feel less depressed later.
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Affiliation(s)
- Sharon L Manne
- Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, New Brunswick, NJ, 08903, USA.
| | - Deborah A Kashy
- Michigan State University, 316 Physics Rd., East Lansing, MI, 48823, USA
| | - Shannon Virtue
- Helen F. Graham Cancer Center, Christiana Care Health System, 4701 Ogletown Stanton 1200, Newark, DE, 19713, USA
| | - Kevin R Criswell
- Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, New Brunswick, NJ, 08903, USA
| | | | - Melissa Ozga
- Memorial Sloan-Kettering Cancer Center, 1440 3rd Ave, New York, NY, 10028, USA
| | - Carolyn J Heckman
- Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, New Brunswick, NJ, 08903, USA
| | - Jerod Stapleton
- Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, New Brunswick, NJ, 08903, USA
| | - Lorna Rodriguez
- Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, New Brunswick, NJ, 08903, USA
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Priede A, Andreu Y, Martínez P, Conchado A, Ruiz-Torres M, González-Blanch C. The factor structure of the Medical Outcomes Study-Social Support Survey: A comparison of different models in a sample of recently diagnosed cancer patients. J Psychosom Res 2018; 108:32-38. [PMID: 29602323 DOI: 10.1016/j.jpsychores.2018.02.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 02/19/2018] [Accepted: 02/20/2018] [Indexed: 01/31/2023]
Abstract
OBJECTIVE To analyse the factor structure and psychometric properties of the original and abbreviated versions of the Medical Outcomes Study-Social Support Survey (MOS-SSS) in recently-diagnosed cancer patients. METHOD A sample of 128 newly-diagnosed cancer patients were assessed with the Spanish versions of the MOS-SSS and the Hospital Anxiety and Depression Scale (HADS). Confirmatory factor analyses were conducted to analyse six different factor structures. Internal consistency and convergent validity indexes were calculated. The models tested included all of the following: 1) the original five-factor model (comprised of the following dimensions: emotional, informational, and tangible support, positive social interaction, and affection); 2) a four-factor empirical solution; 3 & 4) two different three-factor structures obtained in studies conducted in cancer patients; and 5 & 6) a two-factor solution for the abbreviated 8-item form and a one-factor solution for the 6-item form. RESULTS The original five-factor structure showed a better fit index than the three and four factor models. Both the 6- and 8-item versions showed excellent goodness-of-fit, with adequate internal consistency and convergent validity indexes. CONCLUSION The MOS-SSS is a powerful, highly flexible instrument to assess social support in cancer patients. The full 19-item scale allows for a comprehensive assessment of the essential dimensions of social support, while the abbreviated versions permit a quick assessment that minimizes the burden on patients.
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Affiliation(s)
- Amador Priede
- Department of Psychiatry, University Hospital "Marqués de Valdecilla"- IDIVAL, Santander, Spain; Mental Health Centre, Hospital de Laredo, Laredo, Spain.
| | - Yolanda Andreu
- Department of Personality, Assessment and Psychological Treatment, Universidad de Valencia, Valencia, Spain
| | - Paula Martínez
- Department of Personality, Assessment and Psychological Treatment, Universidad de Valencia, Valencia, Spain
| | - Andrea Conchado
- Department of Statistics, Applied Operations Research and Quality, Universidad Politécnica de Valencia, Valencia, Spain
| | - María Ruiz-Torres
- Department of Psychiatry, University Hospital "Marqués de Valdecilla"- IDIVAL, Santander, Spain
| | - César González-Blanch
- Department of Psychiatry, University Hospital "Marqués de Valdecilla"- IDIVAL, Santander, Spain
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Recurrent Cancer Is Associated With Dissatisfaction With Care—A Longitudinal Analysis Among Ovarian and Endometrial Cancer Patients. Int J Gynecol Cancer 2018; 28:614-622. [DOI: 10.1097/igc.0000000000001204] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
ObjectiveThe primary aim of this study was to assess the longitudinal impact of a recurrence of gynecological cancer on satisfaction with information provision and care. The secondary aim was to assess the impact of a recurrence on illness perceptions, anxiety, and depression and health-related quality of life.MethodsThis study is a longitudinal analysis from the ROGY Care trial, conducted between 2011 and 2014, including patients with endometrial (n = 215) and ovarian (n = 149) cancer. Patients were invited to complete questionnaires directly after initial treatment and after 6, 12, and 24 months. Satisfaction with information provision and care, illness perceptions, anxiety, and depression were compared before and after the recurrence. Linear mixed-model analyses were conducted to assess the differences in outcomes of patients with a recurrence compared with patients without a recurrence.ResultsDuring 2-year follow-up, 25 patients with endometrial cancer (12%) and 64 patients with ovarian cancer (43%) had recurrent disease, of whom 9 endometrial and 26 ovarian cancer patients completed at least 1 questionnaire after their recurrence was determined. Patients reported lower satisfaction with care after the diagnosis of a recurrence (doctor interpersonal skills, exchange of information between caregivers, and general satisfaction with care) compared with patients without recurrence. In addition, patients reported lower health-related quality of life, more anxiety and depression, and more threatening illness perceptions after diagnosis of a recurrence.ConclusionsAfter diagnosis of recurrent disease, endometrial and ovarian cancer patients were less satisfied with care compared with patients without a recurrence. Our findings suggest that patients with recurrent cancer are in need of care that is better tailored to their needs.
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36
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Liu CL, Liu L, Zhang Y, Dai XZ, Wu H. Prevalence and its associated psychological variables of symptoms of depression and anxiety among ovarian cancer patients in China: a cross-sectional study. Health Qual Life Outcomes 2017; 15:161. [PMID: 28818112 PMCID: PMC5561632 DOI: 10.1186/s12955-017-0738-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 08/09/2017] [Indexed: 12/18/2022] Open
Abstract
Background It is well known that cancer patients tend to have high levels of perceived stress and symptoms of depression and anxiety. However, there is less study on the association between perceived stress and symptoms of depression and anxiety among ovarian cancer patients in China. And the mediating effect of hope and resilience needs to be further studied. In this study, we aim to examine the prevalence of depression and anxiety symptoms, to analyze the association between perceived stress and symptoms of depression and anxiety, and to test whether hope and resilience mediate the association of perceived stress with symptoms of depression and anxiety among Chinese patients with ovarian cancer. Method A total of 220 questionnaires were distributed and collected from the First Affiliated Hospital of China Medical University and Shengjing Hospital of China Medical University. All participants in this study were ovarian cancer inpatients. After excluding the incomplete questionnaires, 198 questionnaires were valid for the analysis. Qualified patients were asked to response to the questionnaires including Hospital anxiety and depression scale (HADS), perceived stress scale (PSS-10), and the Herth hope scale and the resilience scale. Hierarchical regression analyses were used to test the associations among perceived stress, symptoms of depression and anxiety, and hope and resilience. Bootstrapping method was conducted to examine whether the indirect effect of hope and resilience was significant respectively. Results The prevalence of symptoms of depression and anxiety in ovarian cancer patients was 47.0% and 51.5% respectively. Perceived stress correlated significantly with symptoms of depression (r = 0.709, P < 0.01) and anxiety (r = 0.660, P < 0.01). Hope (a*b = 0.155, BCa 95% CI: 0.094, 0.223) partly mediated the association between perceived stress and symptoms of depression; similarly, hope (a*b = 0.129, BCa 95% CI: 0.048, 0.205) partly mediated the effect of perceived stress on symptoms of anxiety. However, resilience (a*b = 0.004, BCa 95% CI: -0.030, 0.040) did not mediate the association between perceived stress and symptoms of depression. And resilience (a*b = 0.041,BCa 95% CI: -0.013, 0.098) did not mediate the association between perceived stress and symptoms of anxiety. Conclusions The present study suggests that perceived stress might be one of the impact factors of symptoms of depression and anxiety, while hope might ease symptoms of depression and anxiety. In view of the role of hope, medical workers and patient caregivers should pay more attention to hope, and then to intervene perceived stress among patients with ovarian cancer.
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Affiliation(s)
- Chun Li Liu
- Library of China Medical University, Shenyang, Liaoning, China
| | - Li Liu
- Department of Social Medicine, School of Public Health, China Medical University, Shenyang, Liaoning, China
| | - Yi Zhang
- First Affiliated Hospital, China Medical University, Shenyang, Liaoning, China
| | - Xiao Ze Dai
- Department of Social Medicine, School of Public Health, China Medical University, Shenyang, Liaoning, China
| | - Hui Wu
- Department of Social Medicine, School of Public Health, China Medical University, Shenyang, Liaoning, China.
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