1
|
Rashwan ZI, Shaheen SR, Rasoul ASAEFAE, Kamel NMF, Darweesh HAM. Empowering mind-body wellness: effect of bundling seated exercises and psychoeducational rehabilitation using the teach-back approach on fatigue and coping of women postmastectomy. BMC Womens Health 2024; 24:443. [PMID: 39107751 PMCID: PMC11302310 DOI: 10.1186/s12905-024-03242-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 07/02/2024] [Indexed: 08/10/2024] Open
Abstract
BACKGROUND Being diagnosed with Breast Cancer (BC) is a crisis that throws the patient's life out of balance. Cancer-related fatigue is a debilitating sign experienced by women during and after BC treatment. Regular physical exercise may help mitigate patients' fatigue, enhance coping abilities, improve their quality of life, and overall well-being. In parallel, psychological interventions are geared toward normalizing the lived painful experiences among oncology patients. OBJECTIVE to examine the effect of bundling seated exercises and psychoeducational rehabilitation using the teach-back approach on fatigue and coping of women postmastectomy. METHODS A quasi-experimental study was conducted in the Oncology Surgical Department and chemotherapy unit at the Alexandria Main University Hospital, Egypt. A total of 60 women were randomly allocated to either to the study or the control groups. Women in the study group practiced seated exercises and psychological rehabilitation interventions, including mindfulness breathing, problem-solving training, cognitive reframing technique, and thought stopping while the control group received the routine care. RESULTS The study revealed a significant decline in the fatigue mean scores among participants in the intervention group from 136.10 ± 27.76 to 98.43 ± 25.99 (p < 0.001). Similarly, there was a significant decrease in the patients' mean scores of maladaptive coping, helplessness/ hopelessness (p = 0.014), and anxious preoccupation (p = 0.008). In contrast, there is a noticeable increment in the scores of adaptive coping, such as fighting spirit (p = 0.012), cognitive avoidance (p = 0.002), and fatalism (p = 0.009). CONCLUSION Bundling seated exercises and psychological rehabilitation interventions using the teach-back approach have been proven to be simple and inexpensive non-pharmacological methods of reducing cancer-related fatigue and improving coping skills among women post-mastectomy. TRIAL REGISTRATION NUMBER NCT06360276, ClinicalTrails.gov, Retrospectively registered (April 8th, 2024), URL of trial registry record: https://clinicaltrials.gov/ct2/show/NCT06360276 .
Collapse
Affiliation(s)
- Zohour Ibrahim Rashwan
- Pediatric Nursing, Faculty of Nursing, Alexandria University, Alexandria, Egypt.
- Department of Nursing, College of Health and Sport Sciences, University of Bahrain, Zallaq, Kingdom of Bahrain.
| | - Samah Ramadan Shaheen
- Medical-Surgical Nursing, Faculty of Nursing, Alexandria University, Alexandria, Egypt
- Department of Nursing Sciences, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Wadi Addawasir, Riyadh, Kingdom of Saudi Arabia
| | | | - Neama Mohamed Fouad Kamel
- Community Nursing Department, College of Nursing, Imam Abdulrahman Bin Faisal University (IAU), Dammam, Kingdom of Saudi Arabia
| | - Hamida Ahmed Mostafa Darweesh
- Nursing Education, Faculty of Nursing, Alexandria University, Alexandria, Egypt
- Nursing Department, Alriyada College for Health Science, Jeddah, Kingdom of Saudi Arabia
| |
Collapse
|
2
|
Velasco-Durantez V, Cruz-Castellanos P, Hernandez R, Rodriguez-Gonzalez A, Fernandez Montes A, Gallego A, Manzano-Fernandez A, Sorribes E, Zafra M, Carmona-Bayonas A, Calderon C, Jiménez-Fonseca P. Prospective study of predictors for anxiety, depression, and somatization in a sample of 1807 cancer patients. Sci Rep 2024; 14:3188. [PMID: 38326426 PMCID: PMC10850144 DOI: 10.1038/s41598-024-53212-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 01/29/2024] [Indexed: 02/09/2024] Open
Abstract
In cancer patients, psychological distress, which encompasses anxiety, depression, and somatization, arises from the complex interplay of emotional and behavioral reactions to the diagnosis and treatment, significantly influencing their functionality and quality of life. The aim was to investigate factors associated with psychological distress in cancer patients. This prospective and multicenter study, conducted by the Spanish Society of Medical Oncology (SEOM), included two cohorts of patients with cancer (localized resected or advanced unresectable). They completed surveys assessing psychological distress (BSI-18) before and after cancer treatment and coping (MINI-MAC) and spirituality (FACIT-sp) prior to therapy. A multivariable logistic regression analysis and a Structural Equation Modeling (SEM) were conducted. Between 2019 and 2022, 1807 patients were evaluated, mostly women (54%), average age 64 years. The most frequent cancers were colorectal (30%), breast (25%) and lung (18%). Men had lower levels of anxiety and depression (OR 0.66, 95% CI 0.52-0.84; OR 0.72, 95% CI 0.56-0.93). Colorectal cancer patients experienced less anxiety (OR 0.63, 95% CI 0.43-0.92), depression (OR 0.55, 95% CI 0.37-0.81), and somatization (OR 0.59, 95% CI 0.42-0.83). Patients with localized cancer and spiritual beliefs had reduced psychological distress, whereas those with anxious preoccupation had higher level. SEM revealed a relationship between psychological distress and coping strategies, emphasizing how baseline anxious preoccupation exacerbates post-treatment distress. This study suggests that age, sex, extension and location of cancer, coping and spirituality influence psychological distress in cancer patients.
Collapse
Affiliation(s)
- Veronica Velasco-Durantez
- Department of Medical Oncology, Hospital Universitario Central de Asturias, ISPA, Avenida Roma sn, 33011, Oviedo, Spain.
- Universidad de Valladolid, Valladolid, Spain.
| | | | - Raquel Hernandez
- Department of Medical Oncology, Hospital Universitario de Canarias, Tenerife, Spain
| | - Adan Rodriguez-Gonzalez
- Department of Medical Oncology, Hospital Universitario Central de Asturias, ISPA, Avenida Roma sn, 33011, Oviedo, Spain
| | - Ana Fernandez Montes
- Department of Medical Oncology, Complejo Hospitalario Universitario de Ourense, Orense, Spain
| | - Alejandro Gallego
- Department of Medical Oncology, Clínica Universidad de Navarra, Madrid, Spain
| | | | - Elena Sorribes
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Barcelona, Spain
| | - Marta Zafra
- Department of Hematology and Medical Oncology, Hospital Universitario Morales Meseguer, Murcia, Spain
| | - Alberto Carmona-Bayonas
- Department of Hematology and Medical Oncology, Hospital Universitario Morales Meseguer, UMU, IMIB, Murcia, Spain
| | - Caterina Calderon
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Barcelona, Spain
| | - Paula Jiménez-Fonseca
- Department of Medical Oncology, Hospital Universitario Central de Asturias, ISPA, Avenida Roma sn, 33011, Oviedo, Spain
| |
Collapse
|
3
|
Ramchandani A, Mihic-Góngora L, Hernández R, Zafra-Poves M, Muñoz MM, Ferreira E, Cruz-Castellanos P, Fernández-Montes A, Pacheco-Barcia V, Jiménez-Fonseca P, Calderon C. Psychological factors and prognostic communication preferences in advanced cancer: multicentre study. BMJ Support Palliat Care 2024; 13:e1342-e1350. [PMID: 37491146 DOI: 10.1136/spcare-2023-004221] [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: 02/14/2023] [Accepted: 07/09/2023] [Indexed: 07/27/2023]
Abstract
OBJECTIVES Communication regarding prognosis to patients with advanced cancer is fundamental for informed medical decision making. Our objective was to analyse (1) the proportion of subjects with advanced cancer who prefer to know their prognosis, (2) the characteristics associated with patients' preference for prognostic information, (3) the psychological factors that impact the preference to know prognosis and 4) the concordance between preference for prognostic information perceived among physicians and patients. METHODS A prospective, cross-sectional design was adopted. Data were collected from 748 participants with advanced cancer at 15 tertiary hospitals in Spain. Participants completed the following questionnaires: Mental Adjustment to Cancer; Trust in the Physician; Uncertainty in Illness Scale Patient's Prognostic Preferences. RESULTS Fifty-two per cent of advanced cancer sufferers preferred to know the prognosis of their disease. Compared with participants who preferred not to know, those who did reported more uncertainty, greater satisfaction with their physician and higher scores on positive attitude (all p=0.001). Thirty-seven per cent of the physicians believed that patients want to know their prognosis, indicating that they underestimate the number of such patients. No significant differences were found regarding preference to know prognosis as a function of sociodemographic and clinical variables. CONCLUSIONS A substantial proportion of individuals with advanced cancer prefer to know the prognosis of their disease. It appears that knowing their prognosis was mainly motivated by a need to maintain a positive attitude, lessen uncertainty and by satisfaction with the physician. It is important to explore patients' preferences for information to offer more personalised communication.
Collapse
Affiliation(s)
- Avinash Ramchandani
- Department of Medical Oncology, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Luka Mihic-Góngora
- Department of Medical Oncology, Hospital Universitario Central de Asturias, Instituto de Investigación del Principado de Asturias, ISPA, Oviedo, Spain
| | - Raquel Hernández
- Department of Medical Oncology, Hospital Universitario de Canarias, La Laguna, Canarias, Spain
| | - Marta Zafra-Poves
- Department of Medical Oncology, Hospital General Universitario José M Morales Meseguer, Murcia, Spain
| | - María M Muñoz
- Department of Medical Oncology, Hospital General Virgen de la Luz, Cuenca, Spain
| | - Estrella Ferreira
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
| | | | - Ana Fernández-Montes
- Department of Medical Oncology, Complejo Hospitalario de Orense, Ourense, Galicia, Spain
| | - Vilma Pacheco-Barcia
- Department of Medical Oncology, Hospital Central de la Defensa Gomez Ulla, Madrid, Spain
| | | | - Caterina Calderon
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
| |
Collapse
|
4
|
Carmona-Bayonas A, Rodriguez-Gonzalez A, García-García T, Velasco-Durantez V, Hernández-San Gil R, Cruz-Castellanos P, Fernandez-Montes A, Castillo-Trujillo A, Ballester I, Rogado J, Calderon C, Jimenez-Fonseca P. Can Oncologists Prompt Patient Prognostic Awareness to Enhance Decision-Making? Data From the NEOetic Study. Oncologist 2023; 28:986-995. [PMID: 37185783 PMCID: PMC10628594 DOI: 10.1093/oncolo/oyad100] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 03/21/2023] [Indexed: 05/17/2023] Open
Abstract
INTRODUCTION Anti-neoplastic therapy improves the prognosis for advanced cancer, albeit it is not curative. An ethical dilemma that often arises during patients' first appointment with the oncologist is to give them only the prognostic information they can tolerate, even at the cost of compromising preference-based decision-making, versus giving them full information to force prompt prognostic awareness, at the risk of causing psychological harm. METHODS We recruited 550 participants with advanced cancer. After the appointment, patients and clinicians completed several questionnaires about preferences, expectations, prognostic awareness, hope, psychological symptoms, and other treatment-related aspects. The aim was to characterize the prevalence, explanatory factors, and consequences of inaccurate prognostic awareness and interest in therapy. RESULTS Inaccurate prognostic awareness affected 74%, conditioned by the administration of vague information without alluding to death (odds ratio [OR] 2.54; 95% CI, 1.47-4.37, adjusted P = .006). A full 68% agreed to low-efficacy therapies. Ethical and psychological factors oriented first-line decision-making, in a trade-off in which some lose quality of life and mood, for others to gain autonomy. Imprecise prognostic awareness was associated with greater interest in low-efficacy treatments (OR 2.27; 95% CI, 1.31-3.84; adjusted P = .017), whereas realistic understanding increased anxiety (OR 1.63; 95% CI, 1.01-2.65; adjusted P = 0.038), depression (OR 1.96; 95% CI, 1.23-3.11; adjusted P = .020), and diminished quality of life (OR 0.47; 95% CI, 0.29-0.75; adjusted P = .011). CONCLUSION In the age of immunotherapy and targeted therapies, many appear not to understand that antineoplastic therapy is not curative. Within the mix of inputs that comprise inaccurate prognostic awareness, many psychosocial factors are as relevant as the physicians' disclosure of information. Thus, the desire for better decision-making can actually harm the patient.
Collapse
Affiliation(s)
- Alberto Carmona-Bayonas
- Department of Medical Oncology, Hospital Universitario Morales Meseguer, University of Murcia, UMU, IMIB, Murcia, Spain
| | - Adán Rodriguez-Gonzalez
- Department of Medical Oncology, Hospital Universitario Central de Asturias, ISPA, Faculty of Medicine, University of Oviedo, Oviedo, Spain
| | - Teresa García-García
- Department of Medical Oncology, Hospital General Universitario Santa Lucia, Cartagena, Spain
| | - Verónica Velasco-Durantez
- Department of Medical Oncology, Hospital Universitario Central de Asturias, ISPA, Oviedo, Faculty of Medicine, University of Valladolid, Valladolid, Spain
| | | | | | - Ana Fernandez-Montes
- Department of Medical Oncology, Complejo Hospitalario Universitario de Ourense, Orense, Spain
| | - Alfredo Castillo-Trujillo
- Department of Medical Oncology, Hospital Universitario Central de Asturias, ISPA, Faculty of Medicine, University of Oviedo, Oviedo, Spain
| | - Inmaculada Ballester
- Department of Medical Oncology, Hospital Universitario Morales Meseguer, University of Murcia, UMU, IMIB, Murcia, Spain
| | - Jacobo Rogado
- Department of Medical Oncology, Hospital Universitario Infanta Leonor, Madrid, Spain
| | - Caterina Calderon
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology. University of Barcelona, Spain
| | - Paula Jimenez-Fonseca
- Department of Medical Oncology, Hospital Universitario Central de Asturias, ISPA, Faculty of Medicine, University of Oviedo, Oviedo, Spain
| |
Collapse
|
5
|
Obispo B, Cruz-Castellanos P, Fernández-Montes A, Coca-Membribes S, Rogado J, Antoñanzas M, Castillo-Trujillo OA, López-Ceballos H, Rodríguez-González A, Jiménez-Fonseca P, Calderon C. Coping strategies as mediators of uncertainty and psychological distress in patients with advanced cancer. Psychooncology 2023; 32:1694-1701. [PMID: 37789602 DOI: 10.1002/pon.6219] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 09/11/2023] [Accepted: 09/14/2023] [Indexed: 10/05/2023]
Abstract
PURPOSE Uncertainty in the context of advanced cancer diagnosis often incurs significant psychological distress. The aims were to evaluate the incidence of psychological distress upon diagnosis of advanced cancer and to analyze whether the relationship between illness uncertainty and psychological distress can be mediated by coping strategies. METHODS A multicenter, prospective, cross-sectional study was conducted in 15 medical oncology departments across Spain. Individuals with unresectable advanced cancer completed questionnaires on uncertainty (Michel Uncertainty of Illness Scale, coping strategies (Mental Adjustment to Cancer, M-MAC), and psychological distress (Brief Symptom Inventory, BSI-18) after the diagnostic and treatment appointment and before beginning systemic cancer treatment. RESULTS 841 patients eligible for systemic treatment with palliative intent were included between February 2020 and April 2022. A total of 71.7% had clinically significant levels of psychological distress. Univariate analyses identified that the groups with less psychological distress were male (ηp2 = 0.016), married (ηp2 = 0.006), and had a better performance status (ηp2 = 0.007). The most widely used coping strategies were positive attitude and cognitive avoidance. A positive relationship was found between uncertainty, coping strategies, and psychological distress (p < 0.05). Participants who responded with anxious preoccupation suffered more helplessness and psychological distress, while those who responded with cognitive avoidance displayed greater positive attitude and lesser psychological distress. CONCLUSION Patients with newly diagnosed unresectable advanced cancer frequently experience psychological distress in the face of uncertainty, potentially influenced by coping strategies like cognitive avoidance.
Collapse
Affiliation(s)
- Berta Obispo
- Department of Medical Oncology, Hospital Universitario Infanta Leonor, Madrid, Spain
| | | | - Ana Fernández-Montes
- Department of Medical Oncology, Complejo Hospitalario Universitario de Ourense - CHUO, Ourense, Spain
| | - Sara Coca-Membribes
- Department of Medical Oncology, Hospital Universitario de Canarias, La Laguna, Spain
| | - Jacobo Rogado
- Department of Medical Oncology, Hospital Universitario Infanta Leonor, Madrid, Spain
| | - Mónica Antoñanzas
- Department of Medical Oncology, Hospital Universitario Clínico San Carlos, Madrid, Spain
| | | | - Helena López-Ceballos
- Department of Medical Oncology, Hospital San Pedro de Alcántara de Caceres, Cáceres, Spain
| | - Adán Rodríguez-González
- Department of Medical Oncology, Hospital Universitario Central de Asturias, ISPA, Oviedo, Spain
| | - Paula Jiménez-Fonseca
- Department of Medical Oncology, Hospital Universitario Central de Asturias, ISPA, Oviedo, Spain
| | - Caterina Calderon
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
| |
Collapse
|
6
|
Pergolizzi J, LeQuang JAK, Coluzzi F, Magnusson P, Lara-Solares A, Varrassi G. Considerations for Pain Assessments in Cancer Patients: A Narrative Review of the Latin American Perspective. Cureus 2023; 15:e40804. [PMID: 37489190 PMCID: PMC10363018 DOI: 10.7759/cureus.40804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 06/21/2023] [Indexed: 07/26/2023] Open
Abstract
Cancer incidence in Latin America is lower than in Europe or the United States but morbidity and mortality rates are disproportionately high. A barrier to adequate pain control is inadequate pain assessment, which is a relatively easy and inexpensive metric. The objective of this narrative review is to describe pain assessment for cancer patients in Latin America. Cultural factors may influence pain perception, including contextualizing pain as noble or natural suffering and aspects of what is now called "spiritual pain." Unlike other painful conditions, cancer pain may be strongly associated with existential fear, psychosocial distress, anxiety, and spiritual concerns. Pain assessment allows not just quantification of pain intensity but may elucidate pain mechanisms involved or psychosocial aspects that may color the pain. Many current pain assessment instruments capture only pain intensity, which is but one aspect of the pain experience; some have expanded to include functional assessments, mental health status evaluations, and quality of life metrics. A quality-of-life assessment may be appropriate for cancer patients since chronic pain can severely impact function, which can in turn create a vicious cycle by exacerbating pain. The incidence of cancer in Latin America is expected to increase in the ensuing years. Better pain assessment and clinician education are needed to help manage pain in this large and growing patient population.
Collapse
Affiliation(s)
| | | | - Flaminia Coluzzi
- Medical and Surgical Sciences, Sapienza University of Rome, Rome, ITA
| | | | - Argelia Lara-Solares
- Pain and Palliative Care, National Institute of Medical and Nutritional Sciences, Mexico City, MEX
| | | |
Collapse
|
7
|
Rodríguez-González A, Velasco-Durántez V, Cruz-Castellanos P, Hernández R, Fernández-Montes A, Jiménez-Fonseca P, Castillo-Trujillo OA, García-Carrasco M, Obispo B, Rogado J, Antoñanzas-Basa M, Calderon C. Mental Adjustment, Functional Status, and Depression in Advanced Cancer Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3015. [PMID: 36833708 PMCID: PMC9964518 DOI: 10.3390/ijerph20043015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 02/06/2023] [Accepted: 02/07/2023] [Indexed: 06/18/2023]
Abstract
Depressive symptoms are common in individuals with advanced cancer. OBJECTIVES This study sought to analyze the relationship between physical and functional status and depressive symptoms, and to assess the role of mental adjustment across these variables in people with advanced cancer. METHODS A prospective, cross-sectional design was adopted. Data were collected from 748 participants with advanced cancer at 15 tertiary hospitals in Spain. Participants completed self-report measures: Brief Symptom Inventory (BSI), Mini-Mental Adjustment to Cancer (Mini-MAC) scale, and the European Organization for Research and Treatment of Cancer (EORTC) questionnaire. RESULTS Depression was present in 44.3% of the participants and was more common among women, patients <65 years old, non-partnered, and those with recurrent cancer. Results revealed a negative correlation with functional status, and functional status was negatively associated with depressive symptoms. Mental adjustment affected functional status and depression. Patients having a positive attitude displayed fewer depressive symptoms, while the presence of negative attitudes increased depressive symptoms in this population. CONCLUSIONS Functional status and mental adjustment are key factors in the presence of depressive symptoms among people with advanced cancer. Assessment of functional status and mental adjustment should be considered when planning treatment and rehabilitation in this population.
Collapse
Affiliation(s)
- Adán Rodríguez-González
- Department of Medical Oncology, Hospital Universitario Central de Asturias, ISPA, 33006 Oviedo, Spain
| | - Verónica Velasco-Durántez
- Department of Medical Oncology, Hospital Universitario Central de Asturias, ISPA, 33006 Oviedo, Spain
| | | | - Raquel Hernández
- Department of Medical Oncology, Hospital Universitario de Canarias, 38320 Tenerife, Spain
| | - Ana Fernández-Montes
- Department of Medical Oncology, Complejo Hospitalario Universitario de Ourense—CHUO, 32005 Ourense, Spain
| | - Paula Jiménez-Fonseca
- Department of Medical Oncology, Hospital Universitario Central de Asturias, ISPA, 33006 Oviedo, Spain
| | | | | | - Berta Obispo
- Department of Medical Oncology, Hospital Universitario Infanta Leonor, 28031 Madrid, Spain
| | - Jacobo Rogado
- Department of Medical Oncology, Hospital Universitario Infanta Leonor, 28031 Madrid, Spain
| | - Mónica Antoñanzas-Basa
- Department of Medical Oncology, Hospital Universitario Clínico San Carlos, 28040 Madrid, Spain
| | - Caterina Calderon
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, 08035 Barcelona, Spain
| |
Collapse
|
8
|
Pacheco-Barcia V, Gomez D, Obispo B, Mihic Gongora L, Hernandez San Gil R, Cruz-Castellanos P, Gil-Raga M, Villalba V, Ghanem I, Jimenez-Fonseca P, Calderon C. Role of sex on psychological distress, quality of life, and coping of patients with advanced colorectal and non-colorectal cancer. World J Gastrointest Oncol 2022; 14:2025-2037. [PMID: 36310711 PMCID: PMC9611434 DOI: 10.4251/wjgo.v14.i10.2025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 05/24/2022] [Accepted: 08/25/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Patients with advanced gastrointestinal cancer must cope with the negative effects of cancer and complications.
AIM To evaluate psychological distress, quality of life, and coping strategies in patients with advanced colorectal cancer compared to non-colorectal cancer based on sex.
METHODS A prospective, transversal, multicenter study was conducted in 203 patients; 101 (50%) had a colorectal and 102 (50%) had digestive, non-colorectal advanced cancer. Participants completed questionnaires evaluating psychological distress (Brief Symptom Inventory-18), quality of life (EORTC QLQ-C30), and coping strategies (Mini-Mental Adjustment to Cancer) before starting systemic cancer treatment.
RESULTS The study included 42.4% women. Women exhibited more depressive symptoms, anxiety, functional limitations, and anxious preoccupation than men. Patients with non-colorectal digestive cancer and women showed more somatization and physical symptoms than subjects with colorectal cancer and men. Men with colorectal cancer reported the best health status.
CONCLUSION The degree of disease acceptance in gastrointestinal malignancies may depend on sex and location of the primary digestive neoplasm. Future interventions should specifically address sex and tumor site differences in individuals with advanced digestive cancer.
Collapse
Affiliation(s)
- Vilma Pacheco-Barcia
- Department of Medical Oncology, School of Medicine, Alcala University (UAH), Hospital Central de la Defensa Gómez Ulla, Madrid 28047, Spain
| | - David Gomez
- Department of Medical Oncology, Hospital Universitario de Navarra, Pamplona 31008, Spain
| | - Berta Obispo
- Department of Medical Oncology, Hospital Universitario Infanta Leonor, Madrid 28031, Spain
| | - Luka Mihic Gongora
- Department of Medical Oncology, Hospital Universitario Central de Asturias, Oviedo 33011, Spain
| | | | | | - Mireia Gil-Raga
- Department of Medical Oncology, Hospital General Universitario de Valencia, CIBERONC, Valencia 46014, Spain
| | - Vicente Villalba
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Barcelona 08007, Spain
| | - Ismael Ghanem
- Department of Medical Oncology, Hospital Universitario La Paz, Madrid 28046, Spain
| | - Paula Jimenez-Fonseca
- Department of Medical Oncology, Hospital Universitario Central de Asturias, ISPA, Oviedo 33007, Spain
| | - Caterina Calderon
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona 08007, Spain
| |
Collapse
|
9
|
Calderon C, Lorenzo-Seva U, Ferrando PJ, Sorribes E, Rodríguez-González A, Obispo BM, Mihic-Góngora L, Corral MJ, Rogado J, Cruz-Castellanos P, Jiménez-Fonseca P. Measurement properties of the Spanish version of the brief resilient coping scale (BRCS) in cancer patients. Int J Clin Health Psychol 2022; 22:100313. [PMID: 35662793 PMCID: PMC9163688 DOI: 10.1016/j.ijchp.2022.100313] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 04/27/2022] [Indexed: 01/07/2023] Open
Abstract
Background/Objective Resilience is the capacity to adaptively confront stress. The aim of this study was to evaluate the psychometric properties, convergent validity, and factorial invariance of the Spanish version of the Brief Resilient Coping Scale (BRCS). Method Exploratory and confirmatory factor analyses based on a cross-validation were conducted to explore the scale's dimensionality and test for strong (scalar) measurement invariance across gender, age, tumor site, and survival, by fitting multiple-group confirmatory solutions. An extended structural equation model was used to assess external validity. Prospective, multicenter cohort study of 636 patients who completed the BRCS, Satisfaction with Life Scale (SWLS), and Spiritual well‐being (FACIT-sp) scales. Results The data supported a unidimensional structure. The BRCS is a very short, narrow bandwidth measure, with items demonstrating high discriminating power. A strong invariance solution demonstrated excellent fit across gender, age, tumor site, and survival. Scores derived from the unidimensional structure exhibited satisfactory degrees of reliability (ω = .86) and determinacy (FDI = .94). BRCS revealed substantial associations with satisfaction with life and spirituality well-being (all p < .001), factors widely related to resilience, particularly in cancer patients. Conclusions The Spanish version of the BRCS is a reliable, valid resilience measure in advanced cancer.
Collapse
Affiliation(s)
- Caterina Calderon
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Spain
- Corresponding author at: Department of Psychology, University of Barcelona, Barcelona, Spain.
| | - Urbano Lorenzo-Seva
- Department of Psychology, Faculty of Psychology, Rovira and Virgili University, Tarragona, Spain
| | - Pere J. Ferrando
- Department of Psychology, Faculty of Psychology, Rovira and Virgili University, Tarragona, Spain
| | - Elena Sorribes
- Department of Social Psychology and Quantitative, Faculty of Psychology, University of Barcelona, Spain
| | | | - Berta M. Obispo
- Department of Medical Oncology, Hospital Universitario Infanta Leonor, Madrid, Spain
| | - Luka Mihic-Góngora
- Department of Medical Oncology, Hospital Universitario Central of Asturias, Oviedo, Spain
| | - María J. Corral
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Spain
| | - Jacobo Rogado
- Department of Medical Oncology, Hospital Universitario Infanta Leonor, Madrid, Spain
| | | | - Paula Jiménez-Fonseca
- Department of Medical Oncology, Hospital Universitario Central of Asturias, Oviedo, Spain
| |
Collapse
|
10
|
Gomez D, Carmona-Bayonas A, Hernandez R, Higuera O, Rogado J, Pacheco-Barcia V, Valero M, Gil-Raga M, Mar Muñoz M, Carrión-Galindo R, Jimenez-Fonseca P, Calderon C. Stoic attitude in patients with cancer from the NEOcoping study: Cross-sectional study. PLoS One 2022; 17:e0269712. [PMID: 35901019 PMCID: PMC9333303 DOI: 10.1371/journal.pone.0269712] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 05/26/2022] [Indexed: 11/20/2022] Open
Abstract
Aim Stoicism has been applied to describe a wide range of behaviors in the face of disease and influences an individual’s use of coping strategies. This study tested the relationship between stoicism and social support, optimism, psychological distress, and coping strategies in patients with cancer. Method NEOcoping is a multicenter, cross-sectional study. Participants’ data were collected using a standardized, self-report form and LSS, MSPSS, Mini-MAC, BSI-18, and LOT-R questionnaires. Linear regression analyses were used to assess the association between stoicism and distress scores in both genders. A total of 932 individuals with non-metastatic, resected cancer were recruited. Results Males perceived a higher risk of recurrence and toxicity with adjuvant chemotherapy and obtained higher stoic attitude scores than females. Women scored higher on somatization, depression, and anxiety. Patients with high stoicism scores were older and experienced more maladaptive coping (helplessness, anxious preoccupation), and depression, while those with lower stoicism scores had greater perceived social support, optimism, and positive attitude. In both males and females, stoicism correlated negatively with perceived social support, optimism, and positive attitude, and positively with helplessness, anxious preoccupation, and depression. In men, stoicism was directly and negatively associated with social support and optimism, and positively with anxious preoccupation. In women, stoicism was positively associated. In women, stoicism was directly and negatively associated with social support and positively with age and optimism. Stoicism was directly and positively associated with helplessness. Discussion A stoic attitude was associated with lower social support, reduced optimism, and passive coping strategies (helplessness and anxious preoccupation) in this series of patients with cancer.
Collapse
Affiliation(s)
- David Gomez
- Department of Medical Oncology, Hospital Universitario Central of Asturias, IPSA, Oviedo, Spain
| | - Alberto Carmona-Bayonas
- Department of Hematology and Medical Oncology, Hospital Universitario Morales Meseguer, Instituto Murciano de Investigación Biosanitaria (IMIB), UMU, Murcia, Spain
| | - Raquel Hernandez
- Department of Medical Oncology, Hospital Universitario de Canarias, Tenerife, Spain
| | - Oliver Higuera
- Department of Medical Oncology, Hospital Universitario La Paz, Madrid, Spain
| | - Jacobo Rogado
- Department of Medical Oncology, Hospital Universitario Infanta Leonor, Madrid, Spain
| | - Vilma Pacheco-Barcia
- Department of Medical Oncology, Hospital Central de la Defensa Gomez Ulla, Madrid, Spain
| | - María Valero
- Department of Medical Oncology, Hospital Quirón salud Sagrado Corazón, Sevilla, Spain
| | - Mireia Gil-Raga
- Department of Medical Oncology, Consorcio Hospital General Universitario de Valencia, Valencia, Spain
| | - Mª Mar Muñoz
- Department of Medical Oncology, Hospital Virgen de La Luz, Cuenca, Spain
| | - Rafael Carrión-Galindo
- Department of Medical Oncology, Hospital Universitario del Sureste, Arganda del Rey-Madrid, Spain
| | | | - Caterina Calderon
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Barcelona, Spain
- * E-mail:
| |
Collapse
|
11
|
Obispo B, Cruz-Castellanos P, Hernandez R, Gil-Raga M, González-Moya M, Rogado J, López-Ceballos H, García-Carrasco M, Jiménez-Fonseca P, Calderon C. Perceived Dignity of Advanced Cancer Patients and Its Relationship to Sociodemographic, Clinical, and Psychological Factors. Front Psychol 2022; 13:855704. [PMID: 35693507 PMCID: PMC9177410 DOI: 10.3389/fpsyg.2022.855704] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 05/09/2022] [Indexed: 11/23/2022] Open
Abstract
Objective Loss of dignity is one of the main reasons for wishing for an early death in patients with incurable diseases such as cancer and is strongly associated with psychological distress and loss of quality of life. The present study aims to analyze the perceived dignity of patients with advanced cancer undergoing systemic treatment and their relationship with sociodemographic, clinical, and psychological factors. Methods A prospective, cross-sectional, multicenter study was conducted in 15 oncology departments in Spain. Patients with locally advanced, unresectable, or metastatic cancer who were candidates for systemic treatment were included. Participants completed demographic information and Palliative Patients’ Dignity Scale, Brief Symptom Inventory, Mental Adjustment to Cancer, Functional Social Support Questionnaire, and Illness Uncertainty. Results A total of 508 patients were recruited between February 2020 and October 2021. Most were male, aged > 65 years, with digestive tumors (41%), and metastatic disease at diagnosis. Subjects were classified as having low (56%, N = 283) or high (44%, N = 225) perceived dignity. Patients ≥ 65 years, with worse baseline status (ECOG ≥ 1), and worse estimated 18-month survival had lower levels of perceived dignity. People with lower perceived dignity scored higher for anxious preoccupation and hopelessness and lower for positive attitude. They also displayed higher levels of anxiety, depression, and somatic symptoms, greater uncertainty, and less social support. Conclusion Self-perceived dignity in advancer cancer patients is significantly associated with psychological factors, psychological distress, uncertainty, less social support. Knowledge of these specific interactions is importance for adequate, comprehensive palliative care.
Collapse
Affiliation(s)
- Berta Obispo
- Department of Medical Oncology, Hospital Universitario Infanta Leonor, Madrid, Spain
| | | | - Raquel Hernandez
- Department of Oncology Medical, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain
| | - Mireia Gil-Raga
- Department of Medical Oncology, Consorci Hospital General Universitario de Valencia, Valencia, Spain
| | | | - Jacobo Rogado
- Department of Medical Oncology, Hospital Universitario Infanta Leonor, Madrid, Spain
| | - Helena López-Ceballos
- Department of Medical Oncology, Hospital San Pedro de Alcántara de Cáceres, Cáceres, Spain
| | | | - Paula Jiménez-Fonseca
- Department of Medical Oncology, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Caterina Calderon
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Barcelona, Spain
- *Correspondence: Caterina Calderon,
| |
Collapse
|
12
|
Velasco-Durantez V, Jimenez-Fonseca P, Martín Abreu CM, Ghanem I, González Moya M, Asensio E, Corral MJ, Rodriguez-Gonzalez A, Gil-Raga M, Carmona-Bayonas A, Calderon C. Resilience, social support, and anxious preoccupation in patients with advanced cancer during COVID-19 pandemic. Cancer Invest 2022; 40:475-482. [PMID: 35468046 DOI: 10.1080/07357907.2022.2067864] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
This study examines the mediating role of social support between anxious preoccupation and resilience in patients with cancer during COVID-19. NEOetic_SEOM is a prospective, multicenter study involving individuals with advanced, unresectable cancer who completed the following scales: Resilience (BCRS), Social Support (Duke-UNC-11), and anxious preoccupation subscale of the Mini-Mental Adjustment to Cancer (M-MAC) before starting antineoplastic treatment. Between March 2020 and July 2021, 507 patients (55% male; mean age, 65) were recruited. No differences in resilience were observed based on sociodemographic or clinical characteristics. Social support in people with advanced, unresectable cancer promotes both decreased anxious preoccupation and greater resilience.
Collapse
Affiliation(s)
| | - Paula Jimenez-Fonseca
- Department of Medical Oncology, Hospital Universitario Central de Asturias, ISPA, Oviedo Spain
| | - Carla M Martín Abreu
- Department of Medical Oncology, Hospital Universitario de Canarias, Tenerife, Spain
| | - Ismael Ghanem
- Department of Medical Oncology, Hospital Universitario La Paz, Madrid, Spain
| | | | - Elena Asensio
- Department of Medical Oncology, Hospital General Universitario de Elche, Elche Spain
| | - María J Corral
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Barcelona, Spain
| | - Adan Rodriguez-Gonzalez
- Department of Medical Oncology, Hospital Universitario Central de Asturias, ISPA, Oviedo Spain
| | - Mireia Gil-Raga
- Department of Medical Oncology, Consorcio Hospital General Universitario de Valencia, Valencia, Spain
| | - Alberto Carmona-Bayonas
- Department of Medical Oncology, Hospital General Universitario Morales Meseguer de Murcia, University of Murcia, IMIB, Murcia, Spain
| | - Caterina Calderon
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Barcelona, Spain
| |
Collapse
|
13
|
Obispo-Portero B, Cruz-Castellanos P, Jiménez-Fonseca P, Rogado J, Hernandez R, Castillo-Trujillo OA, Asensio-Martínez E, González-Moya M, Carmona-Bayonas A, Calderon C. Anxiety and depression in patients with advanced cancer during the COVID-19 pandemic. Support Care Cancer 2022; 30:3363-3370. [PMID: 34993652 PMCID: PMC8735888 DOI: 10.1007/s00520-021-06789-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 12/30/2021] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Cancer patients are at increased risk for psychological difficulties and COVID-19. We sought to analyze anxiety and depression levels during the COVID-19 pandemic and the association between sociodemographic, clinical, and psychological factors in patients with advanced cancer. METHODS A prospective, multicenter cohort of 401 consecutive patients with newly diagnosed, advanced cancer completed the Brief Symptom Inventory, Michel Uncertainty in Illness Scale, Herth Hope Index, and Cancer Worry Scale between February 2020 and May 2021. Linear regression analyses explored the effects of uncertainty, hopelessness, and cancer worry on anxiety and depression, adjusting for sociodemographic and clinical variables. RESULTS The incidence of anxiety and depression was 36% and 35%, respectively. Emotional distress was greater among women, patients < 65 years of age, and those with an estimated survival of > 18 months. Linear regression analysis revealed that being female, preoccupation about cancer, and hopelessness were associated with increased levels of anxiety (p < 0.001) and depression (p < 0.001) and younger age was associated with a higher risk of anxiety. No differences in anxiety or depression levels were found in relation to marital status, children, educational level, cancer type, histology, stage, or type of treatment. CONCLUSIONS Patients with advanced cancer who initiated treatment during the pandemic experienced high levels of depression and anxiety. Early diagnosis and the development of intervention strategies are necessary, especially for specific patient subgroups, such as young women with long survival times.
Collapse
Affiliation(s)
- Berta Obispo-Portero
- Department of Medical Oncology, Hospital Universitario Infanta Leonor, Madrid, Spain.
| | | | - Paula Jiménez-Fonseca
- Department of Medical Oncology, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Jacobo Rogado
- Department of Medical Oncology, Hospital Universitario Infanta Leonor, Madrid, Spain
| | - Raquel Hernandez
- Department of Medical Oncology, Hospital Universitario de Canarias, Tenerife, Spain
| | | | | | | | - Alberto Carmona-Bayonas
- Department of Hematology and Medical Oncology, Hospital Universitario Morales Meseguer, Universidad de Murcia, IMIB, CP13/00126, PI17/0050 (ISCIII & FEDER) Y Fundación Séneca (04515/GERM/06), Murcia, Spain
| | - Caterina Calderon
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Barcelona, Spain
| |
Collapse
|
14
|
Calderon C, Ferrando PJ, Lorenzo-Seva U, Ferreira E, Lee EM, Oporto-Alonso M, Obispo-Portero BM, Mihic-Góngora L, Rodríguez-González A, Jiménez-Fonseca P. Psychometric properties of the Spanish version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). Qual Life Res 2021; 31:1859-1869. [PMID: 34928470 PMCID: PMC9098585 DOI: 10.1007/s11136-021-03068-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2021] [Indexed: 12/15/2022]
Abstract
Purpose The aim of this study was to analyze the internal structure of the EORTC QLQ-C30, to examine the validity and normative data for cancer patients. Method Exploratory and Confirmatory factor analyses were conducted to explore the scale’s dimensionality and test for strong measurement invariance across sex and tumor site. All the analyses were based on a multicenter cohort of 931 patients who completed the Brief Symptom Inventory (BSI-18) and the EORTC QLQ-C30. Results Our findings indicate that the EORTC QLQ-C30 has acceptable psychometric properties and an internal structure that is well accounted for a bifactor model: a general factor that evaluates quality of life and a group factor that would analyze physical health that would be defined by physical function, role function, and fatigue. The result of the multi-group CFA revealed a strong invariance according to sex, tumor, and over time. Reliability of the EORTC exceeding 0.86 and the simple sum of the items of the scale was a good indicator of oncology patients’ quality of life. Both factors correlate closely with depression, anxiety, and psychological distress and are sensitive to change, especially the quality of life, with a significant decrease in the post-test. Conclusion The Spanish version of the EORTC QLQ-C30 proved to be a valid, reliable instrument to appraise quality of life in cancer patients. The normative data collected from this study may be useful for the early detection of initial symptoms of deterioration of quality of life in oncology patients.
Collapse
Affiliation(s)
- Caterina Calderon
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain.
| | - Pere J Ferrando
- Department of Psychology, Faculty of Psychology, Rovira and Virgili University, Tarragona, Spain
| | - Urbano Lorenzo-Seva
- Department of Psychology, Faculty of Psychology, Rovira and Virgili University, Tarragona, Spain
| | - Estrella Ferreira
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain
| | - Eun Mi Lee
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain
| | | | | | - Luka Mihic-Góngora
- Department of Medical Oncology, Hospital Universitario Central of Asturias, Oviedo, Spain
| | | | - Paula Jiménez-Fonseca
- Department of Medical Oncology, Hospital Universitario Central of Asturias, Oviedo, Spain
| |
Collapse
|
15
|
Cerezo MV, Soria-Reyes LM, Alarcón R, Blanca MJ. The Satisfaction with Life Scale in breast cancer patients: Psychometric properties. Int J Clin Health Psychol 2021; 22:100274. [PMID: 34703465 PMCID: PMC8503855 DOI: 10.1016/j.ijchp.2021.100274] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 07/26/2021] [Indexed: 01/07/2023] Open
Abstract
Background/Objective This study aims to analyze the psychometric properties of the Satisfaction with Life Scale (SWLS), examining the reliability of scale scores and providing validity evidence for its use with breast cancer patients. We provide validity evidence based on internal structure and on relationships with positive psychological variables and other variables indicative of psychological adjustment. Method Participants were 222 Spanish women with a diagnosis of breast cancer. They completed the SWLS and a battery of questionnaires measuring positive and negative affect, self-esteem, resilience, emotional intelligence, flourishing, optimism, depression, anxiety, and stress. Results Confirmatory factor analysis supported a single-factor structure for the SWLS, S-B χ2(5) = 7.36, p = .19, CFI = .99, NNFI = .99, RMSEA = .046. The reliability of test scores estimated with McDonald's omega yielded a value of .80. Validity evidence was provided by a positive correlation between SWLS scores and positive affect, self-esteem, resilience, emotional intelligence (specifically, clarity and repair), flourishing, and optimism (range: .24, .69), and by a negative correlation with negative affect, pessimism, depression, anxiety, and stress (range: -.25, -.59). Conclusions The Spanish version of the SWLS showed satisfactory psychometric properties and it is an appropriate measure for use in the breast cancer context.
Collapse
|
16
|
Gomez D, Jimenez-Fonseca P, Fernández AM, Castellanos PC, Arbizu MV, Cabañes RM, Estellés DL, Ferreira E, Del Rio J, García TG, Carmona-Bayonas A, Calderon C. Impact of Obesity on Quality of Life, Psychological Distress, and Coping on Patients with Colon Cancer. Oncologist 2021; 26:e874-e882. [PMID: 33492756 DOI: 10.1002/onco.13687] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 01/12/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Despite the causal relationship between obesity and colon cancer being firmly established, the effect of obesity on the course of cancer calls for further elucidation. The objective of this study was to assess differences in clinical-pathological and psychosocial variables between obese and nonobese individuals with colon cancer. MATERIALS AND METHODS This was a prospective, multicentric, observational study conducted from 2015-2018. The sample comprised patients with stage II-III, resected colon cancer about to initiate adjuvant chemotherapy with fluoropyrimidine in monotherapy or associated with oxaliplatin and grouped into nonobese (body mass index <30 kg/m2 ) or obese (≥30 kg/m2 ). Subjects completed questionnaires appraising quality of life (European Organization for Research and Treatment of Cancer Quality of Life Core questionnaire), coping (Mini-Mental Adjustment to Cancer), psychological distress (Brief Symptom Inventory 18), perceived social support (Multidimensional Scale of Perceived Social Support), personality (Big Five Inventory 10), and pain (Brief Pain Inventory). Toxicity, chemotherapy compliance, 12-month recurrence, and mortality rate data were recorded. RESULTS Seventy-nine of the 402 individuals recruited (19.7%) were obese. Obese subjects exhibited more comorbidities (≥2 comorbidities, 46.8% vs. 30.3%, p = .001) and expressed feeling slightly more postoperative pain (small size-effect). There was more depression, greater helplessness, less perceived social support from friends, and greater extraversion among the obese versus nonobese subjects (all p < .04). The nonobese group treated with fluoropyrimidine and oxaliplatin suffered more grade 3-4 hematological toxicity (p = .035), whereas the obese had higher rates of treatment withdrawal (17.7% vs. 7.7%, p = .033) and more recurrences (10.1% vs. 3.7%, p = .025). No differences in sociodemographic, quality of life, or 12-month survival variables were detected. CONCLUSION Obesity appears to affect how people confront cancer, as well as their tolerance to oncological treatment and relapse. IMPLICATIONS FOR PRACTICE Obesity is a causal factor and affects prognosis in colorectal cancer. Obese patients displayed more comorbidities, more pain after cancer surgery, worse coping, and more depression and perceived less social support than nonobese patients. Severe hematological toxicity was more frequent among nonobese patients, whereas rates of withdrawal from adjuvant chemotherapy were higher in the obese cohort, and during follow-up, obese patients presented greater 12-month recurrence rates. With the growing and maintained increase of obesity and the cancers associated with it, including colorectal cancer, the approach to these more fragile cases that have a worse prognosis must be adapted to improve outcomes.
Collapse
Affiliation(s)
- David Gomez
- Department of Medical Oncology, Hospital Universitario Central de Asturias, ISPA, Oviedo, University of País Vasco, País Vasco, Spain
| | - Paula Jimenez-Fonseca
- Department of Medical Oncology, Hospital Universitario Central de Asturias, ISPA, Oviedo, University of País Vasco, País Vasco, Spain
| | | | | | - Maria Valero Arbizu
- Department of Medical Oncology, Hospital Quirónsalud Sagrado Corazón, Sevilla, Spain
| | - Ruth Martínez Cabañes
- Department of Medical Oncology, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | | | - Estrella Ferreira
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Barcelona
| | - Jorge Del Rio
- Department of Medical Oncology, Hospital Universitario Central de Asturias, ISPA, Oviedo, University of País Vasco, País Vasco, Spain
| | - Teresa García García
- Department of Medical Oncology, Hospital General Universitario Santa Lucia, Cartagena, Spain
| | - Alberto Carmona-Bayonas
- Department of Medical Oncology, Hospital Universitario Morales Meseguer, University of Murcia, IMIB, Murcia, Spain
| | - Caterina Calderon
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Barcelona, University of País Vasco, País Vasco, Spain
| |
Collapse
|