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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.
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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
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Onyedibe MCC, Ugwu LE, Nnadozie EE, Onu DU. Cancer coping self-efficacy mediates the relationship between mental adjustment to cancer and health-related quality of life in persons with cancer. SOUTH AFRICAN JOURNAL OF PSYCHOLOGY 2021. [DOI: 10.1177/00812463211061071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Individuals with cancer experience significant levels of distress. Improving health-related quality of life of persons with cancer is a major focus in cancer treatment. This study investigated the mediating role of self-efficacy for coping with cancer in the relationship between mental adjustment to cancer and health-related quality of life among individuals with cancer. Two hundred and fourteen persons with cancer (male = 74, female = 140, mean age = 50.57) were recruited from a University Teaching Hospital, in South-West Nigeria. Participants responded to the measures of psychological responses to cancer (mental adjustment to cancer), self-efficacy for coping with cancer (Cancer Behaviour Inventory [CBI]), and health-related quality of life (Functional Assessment of Cancer Therapy–General). Mediation analysis and structural equation modelling were carried out using IBM AMOS software version 23. Domains of mental adjustment to cancer significantly predicted health-related quality of life, helplessness/hopelessness, and anxious preoccupation had a negative association with health-related quality of life; whereas fighting spirit, cognitive avoidance, and fatalism were positively associated with health-related quality of life. Self-efficacy had a positive association with health-related quality of life. Mediation analysis showed that self-efficacy for coping with cancer partially mediated the association between four domains of mental adjustment to cancer (helplessness/hopelessness, fighting spirit, cognitive avoidance, and fatalism) and health-related quality of life. The findings demonstrated the need for improved coping mechanisms while undergoing cancer treatment. The study has important clinical implications for psycho-oncology practice, particularly with respect to self-efficacy for coping with cancer. Psychosocial therapies aimed at enhancing the self-efficacy of persons with cancer should be incorporated as part of cancer treatment to improve their health-related quality of life.
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Affiliation(s)
| | | | | | - Desmond U Onu
- Department of Psychology, University of Nigeria, Nigeria
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3
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Toquero P, Blanco Fernández C, López Martí MP, Hernández Marín B, Vera Cea EB, Garrido García A, Méndez Carrascosa E, Bañón Torres D, Donnay Candil O, Ballesteros García AI, Sánchez-Torres JM, Costas Rojo P, Mondéjar R, Colomer R, Romero-Laorden N. Emotional Distress in Cancer Patients During the First Wave of the COVID-19 Pandemic. Front Psychol 2021; 12:755965. [PMID: 34803837 PMCID: PMC8602105 DOI: 10.3389/fpsyg.2021.755965] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 10/11/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The COVID-19 pandemic has caused mental health problems worldwide. The psychopathological implications of COVID-19 in cancer patients have rarely been addressed. Considering the increased vulnerability of oncology patients, this issue needs to be addressed to improve the long-term mental health status of these patients. Methods: We conducted a prospective study in outpatients under active cancer treatment during the first wave of the COVID-19 pandemic. A semi-structured 24-question survey was designed to measure baseline sociodemographic, psychosocial and COVID-19 exposure characteristics. The Hospital Anxiety and Depression Scale was used to measure psychological symptoms. A descriptive and analytical univariate analysis of the variables studied was performed. We used the Z-score to compare different populations (experimental and historical control cohort). Results: 104 patients were included, the majority of which were women (64.4%), were above 65 years of age (57.7%), had either lung and breast cancer (56.7%), had advanced disease (64%) and were undergoing chemotherapy (63.5%). 51% of them expressed greater fear of cancer than of COVID-19 infection or both. In relation to HADS, 52.8% of emotional distress, 42.3% of anxiety and 58.6% of depression rates were detected. The main factors related with higher rates of psychological symptomatology were history of previous psychotropic drug consumption and the adoption of additional infection prevention measures because they considered themselves at risk of severe COVID-19 infection (p = 0.008; p = 0.003 for emotional distress, p = 0.026; p = 0.004 for anxiety, and p = 0.013; p = 0.008 for depression). Tumor type, stage, oncologic treatment or rescheduling of cancer treatments were not related to higher levels of psychological symptomatology. Comparison of our results with another population of similar characteristics was not significant (Z score = -1.88; p = 0.060). Conclusions: We detected high rates of emotional distress during the first wave of the COVID-19 pandemic among cancer patients in active treatment (52.8%). This was higher and clinically relevant than observed in a comparable population (42.5%), although not significant. Cancer itself is the main factor of concern for cancer patients, above and beyond the emotional distress generated by COVID-19 pandemic.
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Affiliation(s)
- Patricia Toquero
- Department of Medical Oncology, Hospital Universitario de La Princesa, Madrid, Spain
| | - Carmen Blanco Fernández
- Spanish Association Against Cancer (Asociación Española Contra el Cáncer, or “AECC”), Madrid, Spain
| | | | - Berta Hernández Marín
- Department of Medical Oncology, Hospital Universitario de La Princesa, Madrid, Spain
| | - E. Beatriz Vera Cea
- Department of Medical Oncology, Hospital General Nuestra Sra. Del Prado, Talavera de la Reina, Spain
| | - Ana Garrido García
- Department of Medical Oncology, Hospital Universitario de La Princesa, Madrid, Spain
| | | | - Dulce Bañón Torres
- Department of Medical Oncology, Hospital Universitario de La Princesa, Madrid, Spain
| | - Olga Donnay Candil
- Department of Medical Oncology, Hospital Universitario de La Princesa, Madrid, Spain
| | | | | | - Pablo Costas Rojo
- Department of Medical Oncology, Hospital Universitario de La Princesa, Madrid, Spain
| | - Rebeca Mondéjar
- Department of Medical Oncology, Hospital Universitario de La Princesa, Madrid, Spain
| | - Ramon Colomer
- Department of Medical Oncology, Hospital Universitario de La Princesa, Madrid, Spain
| | - Nuria Romero-Laorden
- Department of Medical Oncology, Hospital Universitario de La Princesa, Madrid, Spain
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Maté-Méndez J, L. Gil Moncayo F, Ochoa Arnedo C, Casellas-Grau A, Trelis Navarro J, Calle Rodríguez C. Consenso sobre el estándar de atención psicooncológica, complejidad psicosocial y actividad asistencial en el Instituto Catalán de Oncología. PSICOONCOLOGIA 2021. [DOI: 10.5209/psic.74530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Introducción: La atención psicosocial de las personas con enfermedad oncológica y la familia debe formar parte de todo modelo integral de atención que pretenda reducir el impacto vital del cáncer. Las intervenciones psicosociales han probado su eficacia en la ayuda a pacientes y familiares para afrontar las situaciones de alta complejidad psicosocial emergentes a consecuencia de un diagnóstico de cáncer. Objetivo: Definir y explicar el modelo de Atención Psicosocial del Comité Psicosocial del Instituto Catalán de Oncología (ICO) utilizando criterios de vulnerabilidad, complejidad y derivación; enmarcado y basado en los valores del ICO (centrados en las necesidades de pacientes con cáncer y sus familias). Método: El modelo que se presenta en este documento consta de cinco pilares: 1) Principios de la Práctica Psicosocial en Oncología; 2) Áreas de actuación en la Atención Psicosocial del paciente con cáncer y la familia; 3) Cribado de malestar emocional y derivación del paciente con cáncer y la familia para una atención psicooncológica específica; 4) Comité Psicosocial: (objetivos; funciones; organización; composición; disciplinas participantes; criterios de derivación y niveles de complejidad; y procedimiento); y 5) Índice de productividad. Resultados: Pacientes y familiares atendidos por el CPS mostraron mejoría estadísticamente significativa en los niveles del malestar emocional, pasando de una media inicial de 8,12/10 (EVA/ ENV) a una media 6,27/10 (EVA/ENV). Asimismo, se constata que las intervenciones derivadas del comité psicosocial redujeron el porcentaje de casos iniciales de alta complejidad, pasando de un 69,3% a un 49,3%. Conclusiones: El abordaje de la complejidad psicosocial mediante un modelo basado en criterios multi e interdisciplinarios consensuados ayuda en la toma de decisiones sobre las acciones a seguir y en la mejora del malestar emocional y complejidad de los pacientes y la familia.
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Petrova D, Redondo-Sánchez D, Rodríguez-Barranco M, Romero Ruiz A, Catena A, Garcia-Retamero R, Sánchez MJ. Physical comorbidities as a marker for high risk of psychological distress in cancer patients. Psychooncology 2021; 30:1160-1166. [PMID: 33599019 DOI: 10.1002/pon.5632] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 01/15/2021] [Indexed: 02/06/2023]
Abstract
AIMS Physical and psychiatric comorbidities are common in cancer patients and could impact their treatment and prognosis. However, the evidence base regarding the influence of comorbidities in the management and health service use of patients is still scant. In this research we investigated how physical comorbidities are related to the mental health and help-seeking of cancer patients. METHODS Data were obtained from the representative National Health Survey of Spain (2017). Participants were respondents who reported a cancer diagnosis (n = 484). These were also matched with controls without cancer history (n = 484) based on age, gender, and region. Four alternative physical comorbidities indices were created based on information regarding 28 chronic conditions. Outcomes of interest were psychological distress and having consulted a mental healthcare professional in the year before the survey. RESULTS Thirty percent of cancer patients reported significant psychological distress but only 10% had consulted a professional. After adjusting for sociodemographic variables, among cancer patients each additional comorbidity was associated with 9% higher odds of reporting high psychological distress (odds ratio [OR] = 1.09, 95% confidence interval [CI]: 1.01-1.16) and 21% higher odds of having consulted a mental healthcare professional (OR = 1.21, 95% CI: 1.09-1.34). The effects of comorbidities depended on the type of index and were different in controls without cancer history. CONCLUSION Physical comorbidities in cancer patients are associated with higher risk of psychological distress and higher demand for mental health services. We encourage further research on this issue as it could improve mental health screening and management in oncologic care.
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Affiliation(s)
- Dafina Petrova
- Epidemiology and Control of Chronic Diseases, CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Cancer Registry of Granada, Escuela Andaluza de Salud Pública, Granada, Spain.,Cancer Epidemiology Group, Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.,Department of Experimental Psychology, Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain
| | - Daniel Redondo-Sánchez
- Epidemiology and Control of Chronic Diseases, CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Cancer Registry of Granada, Escuela Andaluza de Salud Pública, Granada, Spain.,Cancer Epidemiology Group, Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Miguel Rodríguez-Barranco
- Epidemiology and Control of Chronic Diseases, CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Cancer Registry of Granada, Escuela Andaluza de Salud Pública, Granada, Spain.,Cancer Epidemiology Group, Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Antonio Romero Ruiz
- Cancer Registry of Granada, Escuela Andaluza de Salud Pública, Granada, Spain
| | - Andrés Catena
- Department of Experimental Psychology, Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain
| | - Rocio Garcia-Retamero
- Department of Experimental Psychology, Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain.,Harding Center for Risk Literacy, Max Planck Institute for Human Development, Berlin, Germany
| | - María-José Sánchez
- Epidemiology and Control of Chronic Diseases, CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Cancer Registry of Granada, Escuela Andaluza de Salud Pública, Granada, Spain.,Cancer Epidemiology Group, Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.,Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
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Zayat CG, Azevedo IM, De Domenico EBL, Bergerot CD. Fatores Preditores de Sintomas Emocionais e Físicos Reportados por Pacientes Oncológicos. PSICOLOGIA: TEORIA E PESQUISA 2021. [DOI: 10.1590/0102.3772e37441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Neste estudo, avaliou-se a associação entre ansiedade/depressão (AD) e sintomas físicos reportados por pacientes oncológicos em quimioterapia. Pacientes foram avaliados quanto ao distress (Termômetro de Distress), AD (Escala de Ansiedade e Depressão), qualidade de vida (Functional Assessment of Chronic Illness Therapy-General) e sintomas (Escala de Avaliação dos Sintomas de Edmonton). Utilizou-se a regressão linear para identificação dos fatores associados a AD. Setenta e três pacientes (65,8% feminino, 58,9% baixa escolaridade e 83,6% estádio avançado) foram incluídos. Sono, respiração, dor, fadiga, bem-estar físico e emocional foram preditores de AD. A prevalência de ansiedade (20,5%) foi inferior à descrita na literatura e a de depressão (17,8%), equivalente. Os resultados ressaltam a importância de um planejamento terapêutico para direcionamento desses fatores de risco.
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Grassi L, Belvederi Murri M, Riba M, de Padova S, Bertelli T, Sabato S, Nanni MG, Caruso R, Ounalli H, Zerbinati L. Hostility in cancer patients as an underexplored facet of distress. Psychooncology 2020; 30:493-503. [PMID: 33205480 DOI: 10.1002/pon.5594] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 11/10/2020] [Accepted: 11/10/2020] [Indexed: 11/10/2022]
Abstract
OBJECTIVE In the present study, we aimed to assess hostility and to examine its association with formal psychiatric diagnosis, coping, cancer worries, and quality of life in cancer patients. METHODS The World Health Organization (WHO) Composite International Diagnostic Interview (CIDI) to make an ICD-10 (International Classification of Disease) psychiatric diagnosis was applied to 516 cancer outpatients. The patients also completed the Brief Symptom Inventory-53 to assess hostility (BSI-HOS), and the Mini-Mental Adjustment to cancer scale (Mini-MAC). A subset of patients completed the Cancer Worries Inventory (CWI), the Openness Scale, and the Quality of Life Index. RESULTS By analyzing the distribution of the responses 25% of the patients had moderate and 11% high levels of hostility, with about 20% being BSI-HOS "cases." Hostility was higher in patients with a formal ICD-10 psychiatric diagnosis (mainly major depression, other depressive disorders, anxiety disorders) than patients without ICD-10 diagnosis. However, about 25% of ICD-10-non cases also had moderate-to-high hostility levels. Hostility was associated with Mini-MAC hopelessness and anxious preoccupation, poorer quality of life, worries (mainly problems sin interpersonal relationships), and inability to openly discuss these problems within the family. CONCLUSIONS Hostility and its components should be considered as dimensions to be more carefully explored in screening for distress in cancer clinical settings for its implications in negatively impacting on quality of life, coping and relationships with the family, and possibly the health care system.
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Affiliation(s)
- Luigi Grassi
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy.,Department of Mental Health, University Unit of Hospital Psychiatry, S. Anna University Hospital and Ferarra Health Trust, Ferrara, Italy
| | - Martino Belvederi Murri
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy.,Department of Mental Health, University Unit of Hospital Psychiatry, S. Anna University Hospital and Ferarra Health Trust, Ferrara, Italy
| | - Michelle Riba
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA.,Department of Psychiatry, University of Michigan Depression Center, Ann Arbor, Michigan, USA.,University of Michigan Rogel Cancer Center, Psycho-oncology Program, Ann Arbor, Michigan, USA
| | - Silvia de Padova
- Psycho-Oncology Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), IRCCS, Meldola, Italy
| | - Tatiana Bertelli
- Psycho-Oncology Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), IRCCS, Meldola, Italy
| | - Silvana Sabato
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy
| | - Maria Giulia Nanni
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy.,Department of Mental Health, University Unit of Hospital Psychiatry, S. Anna University Hospital and Ferarra Health Trust, Ferrara, Italy
| | - Rosangela Caruso
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy.,Department of Mental Health, University Unit of Hospital Psychiatry, S. Anna University Hospital and Ferarra Health Trust, Ferrara, Italy
| | - Heifa Ounalli
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy
| | - Luigi Zerbinati
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy.,Department of Mental Health, University Unit of Hospital Psychiatry, S. Anna University Hospital and Ferarra Health Trust, Ferrara, Italy
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8
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Caruso R, Nanni MG, Rodin G, Hales S, Malfitano C, De Padova S, Bertelli T, Murri MB, Bovero A, Miniotti M, Leombruni P, Zerbinati L, Sabato S, Grassi L. Effectiveness of a brief manualized intervention, Managing Cancer and Living Meaningfully (CALM), adapted to the Italian cancer care setting: Study protocol for a single-blinded randomized controlled trial. Contemp Clin Trials Commun 2020; 20:100661. [PMID: 33089003 PMCID: PMC7566943 DOI: 10.1016/j.conctc.2020.100661] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 08/29/2020] [Accepted: 10/03/2020] [Indexed: 12/19/2022] Open
Abstract
Patients with advanced cancer suffer from psychosocial distress that may impair quality of life and that may be ameliorated by psychotherapeutic treatment. We describe here the methodology of a randomized controlled trial (RCT) to assess the effectiveness of a novel, brief, semi-structured psychotherapeutic intervention to reduce distress and increase well-being in patients with advanced or metastatic cancer. The intervention, called Managing Cancer and Living Meaningfully (CALM), was originally developed in Canada and we are now testing its Italian adaptation (CALM-IT). The study is a single-blinded phase III RCT with assessment at baseline, 3 and 6 months with two conditions: CALM-IT versus a nonspecific supportive intervention (SPI). Eligibility criteria include: ≥ 18 years of age; fluency in the Italian language; no cognitive deficit, and diagnosis of advanced or metastatic cancer with an expected survival of 12–18 months. CALM-IT includes up to 12 sessions, delivered over 6 months and covers 4 domains: i) Symptom Management and Communication with Health Care Providers; ii) Changes in Self and Relations with Close Others; iii) Sense of Meaning and Purpose; and iv) the Future and Mortality. The primary outcome is difference in severity of depressive symptoms between treatment arm and the primary endpoint is 6 months. The secondary endpoint is 3 months and secondary outcomes are: generalized anxiety, distress about dying and death, demoralization, spiritual well-being, attachment security, posttraumatic growth, communication with partners, quality of life, and satisfaction with clinical care. If shown to be effective, CALM-IT can be implemented nationally to relieve distress and to promote psychological well-being in patients with advanced cancer.
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Affiliation(s)
- Rosangela Caruso
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy.,University Hospital Psychiatry Unit, Program on Psycho-Oncology and Psychiatry in Palliative Care, Integrated Department of Mental Health and Addictive Disorders, Health Trust and University S. Anna Hospital, Ferrara, Italy
| | - Maria Giulia Nanni
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy.,University Hospital Psychiatry Unit, Program on Psycho-Oncology and Psychiatry in Palliative Care, Integrated Department of Mental Health and Addictive Disorders, Health Trust and University S. Anna Hospital, Ferrara, Italy
| | - Gary Rodin
- Department of Supportive Care, Princess Margaret Cancer Center, University Health Network, 16th Floor, 610 University Avenue, Toronto, ON M5G 2M9, Canada.,Department of Psychiatry, University of Toronto, 8th Floor, 250 College Street, Toronto, ON M5T 1R8, Canada
| | - Sarah Hales
- Department of Supportive Care, Princess Margaret Cancer Center, University Health Network, 16th Floor, 610 University Avenue, Toronto, ON M5G 2M9, Canada.,Department of Psychiatry, University of Toronto, 8th Floor, 250 College Street, Toronto, ON M5T 1R8, Canada
| | - Carmine Malfitano
- Department of Supportive Care, Princess Margaret Cancer Center, University Health Network, 16th Floor, 610 University Avenue, Toronto, ON M5G 2M9, Canada.,Department of Psychiatry, University of Toronto, 8th Floor, 250 College Street, Toronto, ON M5T 1R8, Canada
| | - Silvia De Padova
- Psycho-Oncology Unit, Istituto Scientifico Romagnolo per Lo Studio e La Cura Dei Tumori (IRST), IRCCS, Meldola, Italy
| | - Tatiana Bertelli
- Psycho-Oncology Unit, Istituto Scientifico Romagnolo per Lo Studio e La Cura Dei Tumori (IRST), IRCCS, Meldola, Italy
| | - Martino Belvederi Murri
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy.,University Hospital Psychiatry Unit, Program on Psycho-Oncology and Psychiatry in Palliative Care, Integrated Department of Mental Health and Addictive Disorders, Health Trust and University S. Anna Hospital, Ferrara, Italy
| | - Andrea Bovero
- Clinical Psychology Unit, Department of Neuroscience, University of Turin, "Città Della Salute e Della Scienza" Hospital, Turin, Italy
| | - Marco Miniotti
- Clinical Psychology Unit, Department of Neuroscience, University of Turin, "Città Della Salute e Della Scienza" Hospital, Turin, Italy
| | - Paolo Leombruni
- Clinical Psychology Unit, Department of Neuroscience, University of Turin, "Città Della Salute e Della Scienza" Hospital, Turin, Italy
| | - Luigi Zerbinati
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy
| | - Silvana Sabato
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy
| | - Luigi Grassi
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy.,University Hospital Psychiatry Unit, Program on Psycho-Oncology and Psychiatry in Palliative Care, Integrated Department of Mental Health and Addictive Disorders, Health Trust and University S. Anna Hospital, Ferrara, Italy
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9
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The use of the Distress Thermometer and the Hospital Anxiety and Depression Scale for screening of anxiety and depression in Italian women newly diagnosed with breast cancer. Support Care Cancer 2020; 28:4997-5004. [DOI: 10.1007/s00520-020-05343-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 02/02/2020] [Indexed: 11/25/2022]
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10
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García-García T, Carmona-Bayonas A, Jimenez-Fonseca P, Jara C, Beato C, Castelo B, Mangas M, de Castro EM, Ramchandani A, Gomez D, Calderón C. Biopsychosocial and clinical characteristics in patients with resected breast and colon cancer at the beginning and end of adjuvant treatment. BMC Cancer 2019; 19:1143. [PMID: 31771533 PMCID: PMC6880341 DOI: 10.1186/s12885-019-6358-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 11/12/2019] [Indexed: 01/05/2023] Open
Abstract
Background The aim of this study was to analyze biopsychosocial factors affecting how patients cope with cancer and adjuvant treatment and to appraise psychological distress, coping, perceived social support, quality of life and SDM before and after adjuvant treatment in breast cancer patients compared to colon cancer patients. Methods NEOcoping is a national, multicenter, cross-sectional, prospective study. The sample comprised 266 patients with colon cancer and 231 with breast cancer. The instruments used were the Brief Symptom Inventory (BSI), Mini-Mental Adjustment to Cancer (Mini-MAC), Multidimensional Scale of Perceived Social Support (MSPSS), Shared Decision-Making Questionnaire-Patient (SDM-Q-9) and Physician’s (SDM-Q-Doc), and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ). Results Breast cancer patients reacted worse to the diagnosis of cancer with more symptoms of anxiety, depression, and somatization, and were less satisfied with their involvement than those with colon cancer (p = 0.003). Participants with colon cancer were older and had more physical symptoms and functional limitations at the beginning of adjuvant treatment, while there were scarcely any differences between the two groups at the end of adjuvancy, at which time both groups suffered greater psychological and physical effects and scored lower on coping strategies, except for anxious preoccupation. Conclusions Breast cancer patients need more information and involvement of the oncologist in shared decision-making, as well as and more medical and psychological support when beginning adjuvant treatment. Both breast and colon cancer patients may require additional psychological care at the end of adjuvancy.
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Affiliation(s)
| | | | - Paula Jimenez-Fonseca
- Department of Medical Oncology, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Carlos Jara
- Department of Medical Oncology, Hospital Universitario Fundación Alcorcón- Universidad Rey Juan Carlos, Madrid, Spain
| | - Carmen Beato
- Department of Medical Oncology, Hospital Universitario Virgen de la Macarena, Sevilla, Spain
| | - Beatriz Castelo
- Department of Medical Oncology, Hospital Universitario La Paz, Madrid, Spain
| | - Montserrat Mangas
- Department of Medical Oncology, Hospital Galdakao-Usansolo, Galdakao-Usansolo, Spain
| | - Eva Martínez de Castro
- Department of Medical Oncology, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Avinash Ramchandani
- Department of Medical Oncology, Hospital Universitario Insular de Gran Canaria, Las Palmas, Spain
| | - David Gomez
- Department of Medical Oncology, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Caterina Calderón
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Barcelona, Spain.
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Hernández R, Calderon C, Carmona-Bayonas A, Rodríguez Capote A, Jara C, Padilla Álvarez A, Gómez-Camacho MDLN, Beato C, Castelo B, Majem M, Muñoz MDM, Ivars A, Mangas-Izquierdo M, Rogado-Revuelta J, Jimenez-Fonseca P. Differences in coping strategies among young adults and the elderly with cancer. Psychogeriatrics 2019; 19:426-434. [PMID: 30723983 DOI: 10.1111/psyg.12420] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 11/06/2018] [Accepted: 12/31/2018] [Indexed: 01/10/2023]
Abstract
BACKGROUND Coping with cancer and the oncologist-patient relationship can vary depending on the patient's age. Our aim is to examine and compare young and elderly adults with non-metastatic, resected cancer. METHODS Two groups of patients were selected, young (< 40 years) and elderly (> 70) with a diagnosis of non-metastatic, resected cancer requiring adjuvant chemotherapy from a pre-exiting, national database (NEOCOPING Study). Epidemiological variables were collected and subjects' emotional responses, perceptions of the physician-patient relationship, support network, fears, and regret about the decision to receive chemotherapy were assessed with questionnaires validated in previous studies: Mini-Mental Adjustment to Cancer, Brief Summary Inventory (18 items), European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire-C30, Shared Decision-Making Questionnaire-Physician's version, Shared Decision-Making Questionnaire-Patient's version, and Informed Risk (physician and patient versions). RESULTS Data from 46 young and 46 elderly participants were collected. The most common neoplasms in both groups were breast (50%) and colorectal (22%). The younger adults had a higher level of education and were actively employed (72% vs. 7%). The leading coping strategy in the younger cohort was hope, and resignation among the elderly. Young adults sought more social support and the impact of diagnosis was more negative for them than for older individuals. No significant differences were detected in quality of life; both age groups demanded more time at their first visit with the doctor, while the older group exhibited greater satisfaction with shared decision-making. At the end of adjuvant chemotherapy, neither age group regretted their decision to receive said treatment. CONCLUSION Higher levels of education, greater demands of the labour market, and the advent of the age of information have entailed drastic changes in the physician-patient relationship paradigm. This is especially true in the younger cancer patient population, who require more information and active participation in decision-making, can display more anxiety about their diagnosis, but also greater capacity to fight.
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Affiliation(s)
- Raquel Hernández
- Department of Medical Oncology, University Hospital of the Canary Islands, Tenerife, Spain
| | - Caterina Calderon
- Department of Clinical Psychology and Psychobiology. Faculty of Psychology, University of Barcelona, Barcelona, Spain
| | | | | | - Carlos Jara
- Department of Medical Oncology, University Hospital Fundación Alcorcón, Universidad Rey Juan Carlos, Madrid, Spain
| | - Airam Padilla Álvarez
- Department of Medical Oncology, University Hospital of the Canary Islands, Tenerife, Spain
| | | | - Carmen Beato
- Department of Medical Oncology, Hospital Grupo Quirón, Sevilla, Spain
| | - Beatriz Castelo
- Department of Medical Oncology, University Hospital La Paz, Madrid, Spain
| | - Margarita Majem
- Department of Medical Oncology, University Hospital Santa Creu and Sant Pau, Barcelona, Spain
| | | | - Alejandra Ivars
- Department of Medical Oncology, Morales Meseguer University Hospital, Murcia, Spain
| | | | | | - Paula Jimenez-Fonseca
- Department of Medical Oncology, University Hospital Central of Asturias, Oviedo, Spain
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12
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Coping strategies and depressive symptoms in cancer patients. Clin Transl Oncol 2019; 22:330-336. [DOI: 10.1007/s12094-019-02123-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 04/19/2019] [Indexed: 10/26/2022]
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13
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Ryu JS, Choi SW, Yun SS, Koo BH, Choi IS, Kim SJ, Park JS, Seok JH, Yoon DS. Preliminary Findings on the Effectiveness of Meaning-Centered Psychotherapy in Patients with Pancreatobiliary Cancer. Yonsei Med J 2018; 59:1107-1114. [PMID: 30328326 PMCID: PMC6192895 DOI: 10.3349/ymj.2018.59.9.1107] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 09/05/2018] [Accepted: 09/06/2018] [Indexed: 11/27/2022] Open
Abstract
PURPOSE This study investigated the effectiveness of meaning-centered psychotherapy (MCP), which is known to be a helpful psychotherapeutic intervention in distressing conditions, for patients with pancreatobiliary cancer. MATERIALS AND METHODS We recruited 37 patients with pancreatobiliary cancer from three university general hospitals and assessed their psychological characteristics. Patients who reported clinically significant emotional distress were recommended to undergo MCP. Patients who consented to MCP were provided four sessions of the therapy. Patient psychological characteristics were assessed again 2 months after MCP. For statistical comparison, outcome variables included anxiety, depression, mental adjustment to cancer, and quality of life (QoL), as well as the degree of stress and physical symptoms. RESULTS Sixteen patients completed the MCP and the final assessment 2 months later. In the initial assessment, the patients receiving MCP showed higher levels of anxiety and depression than those not receiving MCP, and QoL was also lower in terms of role function, emotional function, social function, and global QoL. At the 2-month follow-up, the MCP group showed a significant improvement in anxiety (p=0.007), depression (p=0.010), and anxious preoccupation (p<0.001). In addition, QoL significantly improved in the MCP group, while there was no significant change in the non-MCP group. CONCLUSION In this study, MCP showed potential therapeutic benefits against emotional distress in patients with pancreatobiliary cancer, improving their QoL.
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Affiliation(s)
- Jin Sun Ryu
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Korea
| | - Sun Woo Choi
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Korea
| | - Sung Su Yun
- Department of Surgery, Yeungnam University College of Medicine, Daegu, Korea
| | - Bon Hoon Koo
- Department of Psychiatry, Yeungnam University College of Medicine, Daegu, Korea
| | - In Seok Choi
- Department of Surgery, Konyang University College of Medicine, Daejeon, Korea
| | - Seung Jun Kim
- Department of Psychiatry, Konyang University College of Medicine, Daejeon, Korea
| | - Joon Seong Park
- Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Jeong Ho Seok
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Korea.
| | - Dong Sup Yoon
- Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.
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Andreu Vaillo Y, Murgui Pérez S, Martínez López P, Romero Retes R. Mini-Mental Adjustment to Cancer Scale: Construct validation in Spanish breast cancer patients. J Psychosom Res 2018; 114:38-44. [PMID: 30314577 DOI: 10.1016/j.jpsychores.2018.09.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 08/07/2018] [Accepted: 09/07/2018] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The Mini-Mental Adjustment to Cancer Scale (MiniMAC) is widely used to evaluate cancer patients' psychological responses to diagnosis and treatment. Validation studies of the scale have shown inconsistency in the obtained factor structures. The aim of this study was to explore the factor structure, using Confirmatory Factor Analysis (CFA), and other psychometric properties of the MiniMAC in Spanish breast cancer patients. METHODS A sample of 368 women with breast cancer completed the MiniMAC and the 18 items version of the Brief Symptom Inventory (BSI-18). RESULTS The original pentafactorial model and three additional models derived from the empirical research -two first-order structures with four and three factors, and a second-order bifactorial structure- were tested. The five-factor model showed the best model fit and largely replicated the original MiniMAC's subscales. Five factors had acceptable reliability and showed modest correlations with emotional distress in the expected direction. CONCLUSIONS The Spanish version of the MiniMAC has a satisfactory overall performance and serves as a brief, reliable and valid tool measuring cognitive appraisals and ensuing reactions to cancer.
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Affiliation(s)
- Yolanda Andreu Vaillo
- Department of Personality, Evaluation, and Psychological Treatment, University of Valencia, Spain.
| | | | - Paula Martínez López
- Department of Personality, Evaluation, and Psychological Treatment, University of Valencia, Spain
| | - Rocío Romero Retes
- Psychology Unit, Fundación Instituto Valenciano de Oncologia - FIVO, Valencia, Spain
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15
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Nanni MG, Caruso R, Travado L, Ventura C, Palma A, Berardi AM, Meggiolaro E, Ruffilli F, Martins C, Kissane D, Grassi L. Relationship of demoralization with anxiety, depression, and quality of life: A Southern European study of Italian and Portuguese cancer patients. Psychooncology 2018; 27:2616-2622. [PMID: 29943491 DOI: 10.1002/pon.4824] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 06/08/2018] [Accepted: 06/14/2018] [Indexed: 11/06/2022]
Abstract
BACKGROUND Demoralization syndrome is a significant condition that has not been greatly studied in Southern European countries. AIMS To extend the knowledge of demoralization in Southern Europe by examining its prevalence according to different methods of assessment, its relationship with anxiety and depression, and its impact on quality of life (QoL) among cancer patients. METHODS A convenience sample of 195 cancer outpatients from two oncology centers (102 from Lisbon, Portugal, and 93 from Ferrara, Italy) participated in an observational, cross-sectional study using the Diagnostic Criteria of Psychosomatic Research-Demoralization interview (DCPR/D) and psychometric tools (Demoralization scale-DS; Patient Health Questionnaire-9/PHQ-9; Hospital Anxiety Depression Scale-HADS; and European Quality of Life-5-EQ-5D). RESULTS A 25.1% prevalence (CI 95%, 0.19-0.31) of clinically relevant demoralization was reported on the DCPR/D interview. A total demoralization score cutoff score ≥ 25 maximized sensitivity (81.6%), and specificity (72.6%) in identifying DCPR/D demoralized patients. The DCPR/D and DS were associated with poorer levels of QoL. About half of the patients who were demoralized were not clinically depressed (PHQ-9). Self-reported suicidal ideation (PHQ-9 item 9) was found in a minority of patients (8.2%), most of whom (77%) were cases of depression (PHQ-9), but one-quarter (23%) were not depressed, yet moderately/severely demoralized (DCPR/D and DS). CONCLUSIONS This Southern European study confirms the importance of demoralization in cancer patients as a different condition with respect to depression and its relationship with poor QoL and suicidal ideation.
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Affiliation(s)
- Maria Giulia Nanni
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy
| | - Rosangela Caruso
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy
| | - Luzia Travado
- Psycho-oncology Service, Champalimaud Clinical Center, Champalimaud Foundation, Lisbon, Portugal
| | - Cidalia Ventura
- Unidade de Psicologia Clínica, Centro Hospitalar de Lisboa Central, Lisbon, Portugal
| | | | - Alejandra M Berardi
- Psycho-Oncology Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Elena Meggiolaro
- Psycho-Oncology Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Federica Ruffilli
- Psycho-Oncology Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Cristina Martins
- Unidade de Psicologia Clínica, Centro Hospitalar de Lisboa Central, Lisbon, Portugal
| | - David Kissane
- Department of Psychiatry, Monash University and Szalmuk Family Research Unit at Cabrini Health, Victoria, Australia
| | - Luigi Grassi
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy
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16
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Jimenez-Fonseca P, Calderon C, Carmona-Bayonas A, Muñoz MM, Hernández R, Mut Lloret M, Ghanem I, Beato C, Cacho Lavín D, Ivars Rubio A, Carrión R, Jara C. The relationship between physician and cancer patient when initiating adjuvant treatment and its association with sociodemographic and clinical variables. Clin Transl Oncol 2018; 20:1392-1399. [DOI: 10.1007/s12094-018-1870-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Accepted: 03/26/2018] [Indexed: 10/17/2022]
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17
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Micheli A, Sanz N, Mwangi-Powell F, Coleman MP, Neal C, Ullrich A, Travado L, Santini LA, Grassi L, De Lorenzo F, Costa A, Dangou JM, Bisanti L, Costantini AS, Abu-Rmeileh N, Kamal M, Federico M, Saracci R, Rennert G, Stefanini A, Cavalli F, Cazap E, Redmond K, O?Reilly S, Muti P, Casali P, Gatta G, Ferrari A, Koifman S, Bah E, Pastore G, Barr R, Lombardo C, Frazzingaro C, Ciampichini R, Baili P. International collaborations in cancer control and the Third International Cancer Control Congress. TUMORI JOURNAL 2018; 95:579-96. [DOI: 10.1177/030089160909500502] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Over the past few decades, there has been growing support for the idea that cancer needs an interdisciplinary approach. Therefore, the international cancer community has developed several strategies as outlined in the WHO non-communicable diseases Action Plan (which includes cancer control) as the World Health Assembly and the UICC World Cancer Declaration, which both include primary prevention, early diagnosis, treatment, and palliative care. This paper highlights experiences/ideas in cancer control for international collaborations between low, middle, and high income countries, including collaborations between the European Union (EU) and African Union (AU) Member States, the Latin-American and Caribbean countries, and the Eastern Mediterranean countries. These proposals are presented within the context of the global vision on cancer control set forth by WHO in partnership with the International Union Against Cancer (UICC), in addition to issues that should be considered for collaborations at the global level: cancer survival (similar to the project CONCORD), cancer control for youth and adaptation of Clinical Practice Guidelines. Since cancer control is given lower priority on the health agenda of low and middle income countries and is less represented in global health efforts in those countries, EU and AU cancer stakeholders are working to put cancer control on the agenda of the EU-AU treaty for collaborations, and are proposing to consider palliative care, population-based cancer registration, and training and education focusing on primary prevention as core tools. A Community of Practice, such as the Third International Cancer Control Congress (ICCC-3), is an ideal place to share new proposals, learn from other experiences, and formulate new ideas. The aim of the ICCC-3 is to foster new international collaborations to promote cancer control actions in low and middle income countries. The development of supranational collaborations has been hindered by the fact that cancer control is not part of the objectives of the Millennium Development Goals (MGGs). As a consequence, less resources of development aids are allocated to control NCDs including cancer.
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Affiliation(s)
- Andrea Micheli
- Descriptive studies and health planning unit, Fondazione IRCCS “Istituto Nazionale dei Tumori”, Milan, Italy
| | - Natalia Sanz
- Descriptive studies and health planning unit, Fondazione IRCCS “Istituto Nazionale dei Tumori”, Milan, Italy
| | | | - Michel P Coleman
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | - Andreas Ullrich
- Diseases and Health Promotion, World Health Organization (WHO), Geneva, Switzerland
| | - Luzia Travado
- National Coordination for Oncology Diseases, High Commission for Health, Lisbon, Portugal
| | | | - Luigi Grassi
- Section of Psychiatry, University of Ferrara, Italy
| | | | | | | | - Luigi Bisanti
- Epidemiology Unit, Local Health Authority of Milan, Milan, Italy
| | - Adele Seniori Costantini
- Occupational and Environmental Epidemiology Unit, ISPO Cancer Prevention and Research Institute, Florence, Italy
| | - Niveen Abu-Rmeileh
- Institute of Community and Public Health, Birzeit University West Bank, Palestinian Authority
| | - Mostafa Kamal
- Egyptian Smoking Prevention Research Institute, Cairo, Egypt
| | | | | | - Gad Rennert
- National Israeli Breast and Colorectal Cancer Detection Programs Ministry of Health and Israel Cancer Association, Department of Community Medicine and Epidemiology Carmel Medical Center and B. Rappaport Faculty of Medicine, Technion, Israel
| | - Angelo Stefanini
- Office of Development Cooperation, Consulate General of Italy, Jerusalem (on leave from the University of Bologna, Italy), Jerusalem, Israel
| | - Franco Cavalli
- International Union Against Cancer (UICC), Geneva, Switzerland
| | - Eduardo Cazap
- Latino American and Caribbean Society of Medical Oncology (SLACOM), Buenos Aires, Argentina
| | - Kathy Redmond
- Cancer World Magazine and Media Program, European School of Oncology, Milan, Italy
| | - Susan O?Reilly
- British Columbia Cancer Agency, Division of Medical Oncology Department of Medicine at the University of British Columbia, Vancouver, Canada
| | - Paola Muti
- Italian National Cancer Institute “Regina Elena”, Rome, Italy
| | - Paolo Casali
- Oncology Medicine Unit, Fondazione IRCCS “Istituto Nazionale dei Tumori”, Milan, Italy
| | - Gemma Gatta
- Evaluation Epidemiology Unit, Fondazione IRCCS “Istituto Nazionale dei Tumori”, Milan, Italy
| | - Andrea Ferrari
- Paedriatic Oncology Unit, Fondazione IRCCS “Istituto Nazionale dei Tumori”, Milan, Italy
| | | | - Ebrima Bah
- International Agency for Cancer Research (IARC), Banjul, Gambia
| | | | | | - Claudio Lombardo
- National Institute for Cancer Research of Genoa, Genoa, and Alleanza Contro il Cancro, Rome
| | - Cristina Frazzingaro
- Descriptive studies and health planning unit, Fondazione IRCCS “Istituto Nazionale dei Tumori”, Milan, Italy
| | - Roberta Ciampichini
- Descriptive studies and health planning unit, Fondazione IRCCS “Istituto Nazionale dei Tumori”, Milan, Italy
| | - Paolo Baili
- Descriptive studies and health planning unit, Fondazione IRCCS “Istituto Nazionale dei Tumori”, Milan, Italy
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Illness cognitions and the associated socio-demographic and clinical factors in Chinese women with breast cancer. Eur J Oncol Nurs 2017; 32:33-39. [PMID: 29353630 DOI: 10.1016/j.ejon.2017.11.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 11/19/2017] [Accepted: 11/22/2017] [Indexed: 12/22/2022]
Abstract
PURPOSE Illness cognitions are important mediators between disease and psychological adjustment. Evidence related to illness cognitions among patients with breast cancer remains limited. The purpose of this study was to examine illness cognitions among Chinese women with breast cancer and associations with socio-demographic and clinical factors. METHODS A cross-sectional study was carried out involving 313 women with breast cancer recruited from a general hospital and a social cancer support club in Beijing from October 2016 to May 2017. Data were collected using the Illness Cognition Questionnaire. RESULTS Participants reported positive overall cognition regarding breast cancer (helplessness, 13.70 ± 4.24; acceptance, 16.86 ± 4.30; perceived benefits, 17.93 ± 3.86). A multiple regression model indicated that six factors were associated with illness cognitions: treatment phase of disease, having no children, not returning to work (positive associations with helplessness, negative associations with acceptance; age (negative associations with helplessness, positive associations with acceptance); treatment phase of disease, having no medical insurance (negative associations with perceived benefit); and disease duration (positive associations with acceptance). CONCLUSIONS This study reports on the presence of different illness cognitions in Chinese women with breast cancer and the associated factors, and the results could help oncology medical and nursing staff identify risk factors for poor emotional adjustment to breast cancer and the patients who may benefit from interventions aimed at improving the presence of positive illness cognitions.
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Prevalence, correlates, and impact of depressive and anxiety disorder in cancer: Findings from a multicenter study. Palliat Support Care 2017; 16:552-565. [DOI: 10.1017/s1478951517000736] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
ABSTRACTObjective:Our aim was to examine the prevalence, correlates, and association of depressive and anxiety disorders with quality of life (QoL) and such other outcomes as the need for psychosocial services in cancer patients.Method:A total of 400 patients participated in a multicenter survey involving five cancer centers located throughout Korea. The Short-Form Health Survey, the MD Anderson Symptom Inventory, the Mini-Mental Adjustment to Cancer (MINI-MAC), and Mini-International Neuropsychiatric Interview were administered.Results:The prevalence rates for depressive and anxiety disorders were 16 and 17.1%, respectively. Younger age and poor Eastern Cooperative Oncology Group performance status, and all physical symptoms, as well as helplessness/hopelessness, anxious preoccupation (AP), and cognitive avoidance (CA) on the MINI-MAC were found to be significantly related to depressive disorder (DD) in a univariate logistic regression analysis. Metastases, the symptoms of disturbed sleep, dry mouth, and numbness or tingling, as well as AP and CA were significantly correlated with anxiety disorder (AD) in the univariate analysis. In the multivariate analyses, only AP was significant for AD (odds ratio = 2.94,p< 0.001), while none reached statistical significance for DD. Psychiatric comorbidity status had a detrimental effect on various dimensions of QoL. Patients with DD or AD reported a significantly higher need for professional psychosocial services.Significance of results:Given the substantial prevalence and pervasive impact of DD and AD on various aspects of QoL, its assessment and care should be integrated as a regular part of oncological care throughout the cancer continuum.
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Mental disorder screening on cancer patients before and after radiotherapy and at the 1-month follow-up. Support Care Cancer 2017; 26:813-821. [DOI: 10.1007/s00520-017-3894-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 09/11/2017] [Indexed: 10/18/2022]
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Effect of the patient-to-patient communication model on dysphagia caused by total laryngectomy. The Journal of Laryngology & Otology 2017; 131:253-258. [PMID: 28095938 DOI: 10.1017/s0022215116009968] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The study aimed to evaluate the effect of a patient-to-patient communication model on dysphagia in laryngeal cancer patients after total laryngectomy. METHODS Sixty-five patients who had undergone total laryngectomy were randomly divided into three groups: a routine communication group, a patient communication group (that received the patient-to-patient communication model) and a physician communication group. Questionnaires were used to compare quality of life and swallowing problems among all patient groups. RESULTS The main factors causing dysphagia in total laryngectomy patients were related to fear and mental health. The patient communication group had improved visual analogue scale scores at one week after starting to eat. Quality of life in swallowing disorders questionnaire scores were significantly higher in the patient communication and physician communication groups than in the routine communication group. In addition, swallowing problems were much more severe in patients educated to high school level and above than in others. CONCLUSION The patient-to-patient communication model can be used to resolve swallowing problems caused by psychological factors in total laryngectomy patients.
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Arnaboldi P, Riva S, Vadilonga V, Tadini L, Magon G, Pravettoni G. Distress and Psychosocial Needs in Patients Accessing a Cancer Day Surgery Division: Implications for Clinical Decision Making. Front Psychol 2016; 7:2040. [PMID: 28082946 PMCID: PMC5186802 DOI: 10.3389/fpsyg.2016.02040] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Accepted: 12/16/2016] [Indexed: 01/30/2023] Open
Abstract
Introduction: The Distress Thermometer (DT) was built and validated for screening cancer patients for distress, as suggested by the National Comprehensive Cancer Network. The current work was designed to measure the rates of distress in a sample of patients being hospitalized in a multidisciplinary outpatient surgery clinic. OBJECTIVE To measure the rates of distress in a sample of patients referring to a multidisciplinary day surgery division in a comprehensive cancer center based in Northern Italy. Methods: A total of 177 patients were asked to fill in the (DT) before surgery. Results: Out of 177 patients, 154 (87%) patients completed the DT. While 13% of the patients indicated a total absence of distress, more than half of the sample declared a moderate or high distress. A total of 55% of patients presented at least three difficulties in the Problem List Checklist. Distress was not correlated with age or other medical and clinical variables. Number of emotional problems was the best predictor of distress at admission (β = 0.655, p = 0.000). Conclusion: Screening for distress in a day surgery multidisciplinary oncology division is feasible and a relevant percentage of patients can be identified as clinically distressed. Outcomes also highlight the impact of age and precise physical and psycho-social signs as prognostic indicators of clinically significant distress. Measurement of distress and associated problems list represent the preliminary endpoint toward adequate recommendations that contribute to taking care of distress in cancer patients in cost-effective clinical setting.
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Affiliation(s)
- Paola Arnaboldi
- Applied Research Division for Cognitive and Psychological Science, European Institute of OncologyMilan, Italy
| | - Silvia Riva
- Applied Research Division for Cognitive and Psychological Science, European Institute of OncologyMilan, Italy
- Department of Oncology and Hemato-oncology, Faculty of Medicine, University of MilanMilan, Italy
| | - Valeria Vadilonga
- Applied Research Division for Cognitive and Psychological Science, European Institute of OncologyMilan, Italy
| | - Liliana Tadini
- Day Surgery Division, European Institute of OncologyMilan, Italy
| | - Giorgio Magon
- Service for Nursing, Technical and Rehabilitation Staff, European Institute of OncologyMilan, Italy
| | - Gabriella Pravettoni
- Applied Research Division for Cognitive and Psychological Science, European Institute of OncologyMilan, Italy
- Department of Oncology and Hemato-oncology, Faculty of Medicine, University of MilanMilan, Italy
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Li J, Humphreys K, Eriksson M, Dar H, Brandberg Y, Hall P, Czene K. Worse quality of life in young and recently diagnosed breast cancer survivors compared with female survivors of other cancers: A cross-sectional study. Int J Cancer 2016; 139:2415-25. [PMID: 27486698 DOI: 10.1002/ijc.30370] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Revised: 06/28/2016] [Accepted: 07/29/2016] [Indexed: 12/16/2022]
Abstract
Literature focusing on health-related quality of life (HRQoL) by cancer site among women only is scarce. This study examines HRQoL of breast cancer (BC) survivors compared with female survivors of other cancers, and to understand which subgroups of BC survivors were particularly at risk of reduced HRQoL. We placed emphasis on young (<50 years) and recently diagnosed (≤5 years) survivors, where the deficits in HRQoL were most pronounced. The cross-sectional study consisted of 2,224 BC survivors, 8,504 non-cancer controls and 2,205 other cancer survivors in the Karma study. We examined HRQoL differences using linear regression analyses in the whole cohort and in a subset of young and recently diagnosed BC survivors (n = 242) and female survivors of other cancers (n = 140) with comparable ages at diagnosis (43.6 vs 43.6, p = 0.917) and time since diagnosis (2.3 vs 2.8 years, p < 0.001). HRQoL was assessed using the EORTC QLQ-C30 questionnaire. While only cognitive functioning was significantly compromised in BC survivors compared with survivors of other cancers when women of all ages were included, young BC survivors reported significantly lower HRQoL on multiple functional scales (global quality of life, emotional, role, social and cognitive functioning) and experienced more fatigue and insomnia. BC survivors with any prior medical history of mental disorders reported poorer HRQoL than those without such a history. We also observed a close-knit relationship between tumor and treatment characteristics. BC survivors perform poorly in HRQoL in comparison with female survivors of other cancers. Our results emphasize the importance of age- and gender-appropriate comparison groups.
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Affiliation(s)
- Jingmei Li
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, 171 77, Sweden.
| | - Keith Humphreys
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, 171 77, Sweden
| | - Mikael Eriksson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, 171 77, Sweden
| | - Huma Dar
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, 171 77, Sweden
| | - Yvonne Brandberg
- Department of Oncology and Pathology, Karolinska Institutet, Stockholm, 171 77, Sweden
| | - Per Hall
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, 171 77, Sweden
| | - Kamila Czene
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, 171 77, Sweden
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Amadi KU, Uwakwe R, Odinka PC, Ndukuba AC, Muomah CR, Ohaeri JU. Religion, coping and outcome in out-patients with depression or diabetes mellitus. Acta Psychiatr Scand 2016; 133:489-96. [PMID: 26667095 DOI: 10.1111/acps.12537] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/16/2015] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The study assesses the association between religiosity and coping style with the outcome of depression and diabetes. METHOD Using a simple random sampling, we recruited 112 participants with diabetes and an equal number with depression consecutively, matching for gender. Religiosity was determined using Religious Orientation Scale (revised) (ROS-R), coping styles with Brief Religious Coping (Brief RCOPE) scale and Mental Adjustment to Cancer (MAC) scale (adapted). Primary and secondary outcomes were evaluated using Sheehan's Disability Scale (SDS) and Becks Depression Inventory-II (BDI-II) respectively. RESULTS Among participants with diabetes, BDI-II total scores correlated negatively with ROS-R Extrinsic Social (r = -0.2, P < 0.05) and Fighting Spirit (r = -0.3, P < 0.05) but correlated positively with Helplessness/Hopelessness (r = 0.3, P < 0.05) and Brief RCOPE Negative (r = 0.4, P < 0.05). SDS global scores correlated positively with Helplessness/Hopelessness (r = 0.3, P < 0.05) and Brief RCOPE Negative (r = 0.4, P < 0.05). Among participants with depression, BDI-II total scores correlated negatively with Intrinsic religiosity (r = -0.2, P < 0.05) and Fighting Spirit (r = -0.4, P < 0.05) but correlated positively with Helplessness/Hopelessness (r = 0.6, P < 0.05) and Brief RCOPE Negative (r = 0.7, P < 0.05). SDS global scores correlated negatively with Intrinsic religiosity (r = -0.2, P < 0.05) and Fighting Spirit (r = -0.3, P < 0.05) but correlated positively with Helplessness/Hopelessness (r = 0.5, P < 0.05) and Brief RCOPE Negative (r = 0.4, P < 0.05). CONCLUSION High intrinsic and extrinsic religiosities are likely to be associated with positive coping skills and better treatment outcome in patients with depression or diabetes.
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Affiliation(s)
- K U Amadi
- Department of Psychological Medicine, College of Medicine, University of Nigeria, Enugu, Nigeria
| | - R Uwakwe
- Faculty of Medicine, Nnamdi Azikiwe University, Nnewi, Nigeria
| | - P C Odinka
- Department of Psychological Medicine, College of Medicine, University of Nigeria, Enugu, Nigeria
| | - A C Ndukuba
- Department of Psychological Medicine, College of Medicine, University of Nigeria, Enugu, Nigeria
| | - C R Muomah
- Department of Psychological Medicine, College of Medicine, University of Nigeria, Enugu, Nigeria
| | - J U Ohaeri
- Department of Psychological Medicine, College of Medicine, University of Nigeria, Enugu, Nigeria
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Cardoso G, Graca J, Klut C, Trancas B, Papoila A. Depression and anxiety symptoms following cancer diagnosis: a cross-sectional study. PSYCHOL HEALTH MED 2015; 21:562-70. [DOI: 10.1080/13548506.2015.1125006] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Cancer patients' emotional distress, coping styles and perception of doctor-patient interaction in European cancer settings. Palliat Support Care 2015; 14:204-11. [PMID: 26155817 DOI: 10.1017/s1478951515000760] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE As a part of a European study, we cross-culturally examined the rate of emotional distress and maladaptive coping and their association with cancer patients' satisfaction with their interactions with the physician responsible for their care. METHODS Cancer patients (n = 302) from one Middle European (Austria) and two Southern European (Italy, Spain) countries completed the NCCN Distress Thermometer (DT), the Mini-Mental Adjustment to Cancer (Mini-MAC) Anxious Preoccupation (AP) and Hopelessness (H) sub-scales, and the Physician Patient Satisfaction with Doctors Questionnaire (PSQ). RESULTS The prevalence of emotional distress (DT caseness) was 60% (26.1% mild, 18.8% moderate, and 14.9% severe distress). Maladaptive coping (Mini-MAC cases) was found in 22.8% (hopeless cases), and 22.5% (anxious preoccupation cases). PSQ-MD was significantly correlated with Mini-MAC/H and Mini-Mac/AP, while PSQ-PS was negatively correlated with Mini-MAC/H. DT cases and those with higher levels of hopelessness reported higher scores on PSQ-MD and lower on PSQ-PS than non-cases. Some differences were found between countries both as far as patients' coping and perception of the interaction with doctors. In hierarchical multiple regression analysis, after adjusting for socio-demographic and medical variables, Mini-MAC/H significantly predicted the scores on PSQ-MD (positive direction) and PSQ-PS (negative direction). SIGNIFICANCE OF RESULTS The study confirms that about one out of three cancer patients have moderate to high level of emotional distress and about one out of four, clinically significant maladaptive coping. Also, patients showing hopelessness and distress tended to perceive their doctors as both disengaged and less supportive. These results highlights the need for physicians to monitor their patient's level of distress and coping mechanisms and to adjust their own relational and communication style according to patients' psychological condition. Also, cross-cultural issues should be taken into account when exploring psychosocial variables and cancer patients' perception of and satisfaction with the interaction with their doctors.
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Chan CMH, Wan Ahmad WA, Yusof MMD, Ho GF, Krupat E. Effects of depression and anxiety on mortality in a mixed cancer group: a longitudinal approach using standardised diagnostic interviews. Psychooncology 2014; 24:718-25. [PMID: 25345781 DOI: 10.1002/pon.3714] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Revised: 09/25/2014] [Accepted: 09/29/2014] [Indexed: 01/06/2023]
Abstract
BACKGROUND Distress and psychiatric morbidity in cancer patients are associated with poorer outcomes including mortality. In this study, we examined the prevalence of psychiatric morbidity and its association with cancer survival over time. METHODS Participants were 467 consecutive adult cancer patients attending oncology follow-ups at a single academic medical centre. Assessment consisted of the Hospital Anxiety and Depression Scale and Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision. Comparison between co-morbid psychiatric cases and non-cases was made in follow-ups of up to 24 months. RESULTS Of the 467 patients, 217 of 220 patients with elevated total Hospital Anxiety and Depression Scale scores (≥16) met the criteria for an Axis I disorder at 6 months follow-up, with 102 of the follow-up sample having a persistent diagnosable psychiatric disorder after 1 year. The most frequent initial diagnoses were minor depression (17.6%), major depressive disorder (15.8%) and adjustment disorder (15.8%). Cancer patients without psychiatric morbidity had a survival benefit of 2.24 months or 67 days. Mean survival at 24 months was 20.87 months (95% CI 20.06-21.69) for cancer patients with psychiatric morbidity versus 23.11 months (95% CI 22.78-23.43) for those without (p < 0.001 for log rank). After adjusting for demographics and cancer stage on a Cox proportional hazards model, psychiatric morbidity remained associated with worse survival (hazard ratio 4.13, 95% CI 1.32-12.92, p = 0.015). CONCLUSIONS This study contributes to the growing body of evidence linking psychiatric morbidity to cancer mortality. Treating underlying psychiatric conditions in cancer may therefore improve not just quality of life but also survival.
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Affiliation(s)
- Caryn Mei Hsien Chan
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Wan Azman Wan Ahmad
- Department of Medicine, University Malaya Medical Center, Kuala Lumpur, Malaysia
| | - Mastura M D Yusof
- Department of Clinical Oncology, University Malaya Medical Center, Kuala Lumpur, Malaysia
| | - Gwo-Fuang Ho
- Department of Clinical Oncology, University Malaya Medical Center, Kuala Lumpur, Malaysia
| | - Edward Krupat
- Center for Evaluation, Harvard Medical School, Boston, MA, USA
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Renom-Guiteras A, Planas J, Farriols C, Mojal S, Miralles R, Silvent MA, Ruiz-Ripoll AI. Insomnia among patients with advanced disease during admission in a Palliative Care Unit: a prospective observational study on its frequency and association with psychological, physical and environmental factors. BMC Palliat Care 2014; 13:40. [PMID: 25136263 PMCID: PMC4135052 DOI: 10.1186/1472-684x-13-40] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Accepted: 08/04/2014] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND THE AIMS OF THIS STUDY WERE 1) to assess the frequency of insomnia among patients during admission in a Palliative Care Unit (PCU); 2) to study the association between emotional distress and insomnia, taking physical, environmental and other psychological factors into account. METHODS Prospective observational study including patients consecutively admitted to a PCU during eight months, excluding those with severe cognitive problems or too low performance status. Insomnia was assessed by asking a single question and by using the Sleep Disturbance Scale (SDS), and emotional distress using the Hospital Anxiety and Depression Scale (HADS). Physical, environmental and other psychological factors potentially interfering with sleep quality were evaluated. Association between insomnia and the factors evaluated was studied using univariate and multivariate regression analyses. RESULTS 61 patients were included (mean age 71.5 years; 95% with oncological disease); 38 (62%) answered "yes" to the insomnia single question and 29 (47%) showed moderate to severe insomnia according to the SDS. 65% showed clinically significant emotional distress and 79% had nocturnal rumination. The physical symptoms most often mentioned as interfering with sleep quality were pain (69%) and dyspnoea (36%). 77% reported at least one environmental disturbance. In the univariate analysis, answering "yes" to the insomnia single question was significantly associated with higher HADS score, anxiety, nocturnal rumination, clear knowledge of the diagnosis, higher performance status and dyspnoea; moderate to severe insomnia was significantly associated with nocturnal rumination, higher performance status, environmental disturbances and daytime sleepiness. In the multivariate regression analysis, answering "yes" to the single question was associated with dyspnoea (OR 7.2 [1.65-31.27]; p = 0.009), nocturnal rumination (OR 5.5 [1.05-28.49]; p = 0.04) and higher performance status (OR 14.3 [1.62-125.43]; p = 0.017), and moderate to severe insomnia with nocturnal rumination (OR 5.6 [1.1-29.1]; p = 0.041), and inversely associated with daytime sleepiness (OR 0.25 [0.07-0.9]; p = 0.043). CONCLUSIONS Insomnia was highly frequent. Several physical, psychological and environmental factors seemed to influence insomnia. Within the multimodal management of insomnia, the assessment of nocturnal rumination may be of particular interest, irrespective of emotional distress. Further studies with larger sample sizes could confirm this result.
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Affiliation(s)
- Anna Renom-Guiteras
- School of Nursing Science and Institute of General Practice and Family Medicine, Faculty of Health, University of Witten/Herdecke, 50 Alfred-Herrhausen-Str, 58448 Witten, Germany ; Geriatric Service, Hospital de l'Esperança, Centre Fòrum, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
| | - José Planas
- Palliative Care Unit, Department of Medical Oncology, Hospital de l'Esperança, Parc de Salut Mar, Barcelona, Spain ; Universitat Autònoma de Barcelona, Barcelona, Spain ; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Cristina Farriols
- Palliative Care Unit, Department of Medical Oncology, Hospital de l'Esperança, Parc de Salut Mar, Barcelona, Spain ; Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Sergi Mojal
- Scientific and Technical Services, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Ramón Miralles
- Geriatric Service, Hospital de l'Esperança, Centre Fòrum, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain ; Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Maria A Silvent
- Palliative Care Unit, Department of Medical Oncology, Hospital de l'Esperança, Parc de Salut Mar, Barcelona, Spain
| | - Ada I Ruiz-Ripoll
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain ; Department of Psychiatry, Institute of Neuropsychiatry and Addiction, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
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Zheng Y, Liu M, Li M, Zhang J, Ge J, Sun Y, Tian L. The Influence of the ‘Patient-to-Patient Model' on Swallowing Problems in Patients with Supraglottic Laryngeal Cancer. ORL J Otorhinolaryngol Relat Spec 2014; 76:171-7. [DOI: 10.1159/000365092] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Accepted: 06/03/2014] [Indexed: 11/19/2022]
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Koh MJ, Jeung HC, Namkoong K, Chung HC, Kang JI. Influence of the BDNF Val66Met polymorphism on coping response to stress in patients with advanced gastric cancer. J Psychosom Res 2014; 77:76-80. [PMID: 24913346 DOI: 10.1016/j.jpsychores.2014.04.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Revised: 04/25/2014] [Accepted: 04/25/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Coping with cancer is an important determinant of psychological morbidity, quality of life, and treatment adherence in cancer patients. The aim of this study was to elucidate the association between the brain-derived neurotrophic factor (BDNF) Val66Met polymorphism and coping response to stress in patients diagnosed with advanced gastric cancer. METHODS Ninety-one subjects (60 males, 31 females) recently diagnosed with advanced gastric cancer were recruited. Coping style and distress level were examined using the Mini-Mental Adjustment to Cancer (Mini-MAC) scale and Hospital Anxiety and Depression Scale, and genotyping was evaluated. To examine the temporal stability of the Mini-MAC scores, a 6-week follow-up evaluation was conducted in 72 patients, after completion of two chemotherapy cycles. RESULTS Coping style to cancer significantly differed between the Met carriers of BDNF Val66Met and the Val/Val homozygotes. The Met carriers were significantly more anxious than the Val/Val homozygotes. CONCLUSION The present findings suggest that the BDNF Val66Met polymorphism may be involved in individual coping responses to cancer. The Met allele of BDNF Val66Met may be predictive of an anxious coping style in patients with advanced cancer.
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Affiliation(s)
- Min Jung Koh
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, South Korea; The Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea.
| | - Hei-Cheul Jeung
- Division of Oncology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei Cancer Center, Yonsei Cancer Research Institute, Yonsei University College of Medicine, Seoul, South Korea.
| | - Kee Namkoong
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, South Korea; The Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea.
| | - Hyun Cheol Chung
- Division of Oncology, Department of Internal Medicine, Severance Hospital, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea.
| | - Jee In Kang
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, South Korea; The Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea.
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Porcelli P, Guidi J, Sirri L, Grandi S, Grassi L, Ottolini F, Pasquini P, Picardi A, Rafanelli C, Rigatelli M, Sonino N, Fava GA. Alexithymia in the medically ill. Analysis of 1190 patients in gastroenterology, cardiology, oncology and dermatology. Gen Hosp Psychiatry 2013; 35:521-7. [PMID: 23664571 DOI: 10.1016/j.genhosppsych.2013.04.005] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Revised: 04/04/2013] [Accepted: 04/08/2013] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To use the Diagnostic Criteria for Psychosomatic Research (DCPR) for characterizing alexithymia in a large and heterogeneous medical population, in conjunction with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) and other DCPR criteria. METHOD Of 1305 patients recruited from 4 medical centers in the Italian Health System, 1190 agreed to participate. They all underwent an assessment with DSM-IV and DCPR structured interviews. A total of 188 patients (15.8%) were defined as alexithymic by using the DCPR criteria. Data were submitted to cluster analysis. RESULTS Five clusters of patients with alexithymia were identified: (1) alexithymia with no psychiatric comorbidity (29.3% of cases); (2) depressed somatization with alexithymic features (23.4%); (3) alexithymic illness behavior (17.6%); (4) alexithymic somatization (17%) and (5) alexithymic anxiety (12.8%). CONCLUSIONS The results indicate that DCPR alexithymia is associated with a comorbid mood or anxiety disorder in about one third of cases; it is related to various forms of somatization and abnormal illness behavior in another third and may occur without psychiatric comorbidity in another subgroup. Identification of alexithymic features may entail major prognostic and therapeutic differences among medical patients who otherwise seem to be deceptively similar since they share the same psychiatric and/or medical diagnosis.
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Affiliation(s)
- Piero Porcelli
- Psychosomatic Unit, IRCCS De Bellis Hospital, Castellana Grotte, Italy.
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Hernández M, Antonio Cruzado J. La atención psicológica a pacientes con cáncer: de la evaluación al tratamiento. CLÍNICA Y SALUD 2013. [DOI: 10.5093/cl2013a1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Grassi L, Johansen C, Annunziata MA, Capovilla E, Costantini A, Gritti P, Torta R, Bellani M. Screening for distress in cancer patients. Cancer 2013; 119:1714-21. [DOI: 10.1002/cncr.27902] [Citation(s) in RCA: 91] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2012] [Revised: 10/14/2012] [Accepted: 10/16/2012] [Indexed: 11/07/2022]
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Gil F, Costa G, Hilker I, Benito L. First anxiety, afterwards depression: psychological distress in cancer patients at diagnosis and after medical treatment. Stress Health 2012; 28:362-7. [PMID: 22972767 DOI: 10.1002/smi.2445] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2012] [Revised: 06/14/2012] [Accepted: 07/20/2012] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The purpose of this study was to assess psychosocial changes at two particular moments: at cancer diagnosis and 2-4 weeks after having finished treatment. MATERIAL AND METHODS A total of 67 cancer outpatients were assessed in this study. The inclusion/exclusion criteria were as follows: ambulatory cancer patients aged 18 years or older and receiving medical treatment. Patients with a performance status <50 or with cognitive impairment (≥3 errors in the Pfeiffer Questionnaire) were excluded. The inclusion period ranged from 1 April 2005 to 30 April 2007. The scales used were the 14-item Hospital Anxiety and Depression Scale (HADS), which has two subscales for anxiety (seven items) and for depression (seven items), the Quality of Life Short Form 36 Questionnaire, the Mental Adjustment Scale and the Medical Outcomes Study Questionnaire for measuring social support. All data were compared with sociodemographic and medical characteristics. RESULTS Patients had higher levels of pre-treatment versus post-treatment anxiety (HADS-Anxiety mean, 7.41 versus 6.69), whereas depression scores were higher post-treatment versus pre-treatment (HADS-Depression mean, 3.14 versus 3.89). After medical treatment, patients were more fatigued, with lower performance status (Karnofsky Index), less social support and less quality of life, but no differences in coping styles were found. Women had higher levels of anxiety than men. Patients with psychiatric antecedents had higher levels of distress, but these differences were only observed after diagnosis and not after the treatment. In general, head and neck cancer patients had higher levels of distress, worse coping and worse social functioning. CONCLUSIONS Cancer patients require special consideration before and after treatment. Anxiety is the symptom that characterizes diagnosis, whereas depression is more common after medical treatment. The head and neck cancer patients were the group with the highest complexity.
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Affiliation(s)
- Francisco Gil
- Psycho-oncology Unit, Duran i Reynals Hospital, Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain.
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5-HTTLPR polymorphism and anxious preoccupation in early breast cancer patients. Radiol Oncol 2012; 46:321-7. [PMID: 23411667 PMCID: PMC3572887 DOI: 10.2478/v10019-012-0024-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2011] [Accepted: 02/02/2012] [Indexed: 12/31/2022] Open
Abstract
Background Difficulties in coping with cancer, and the accompanying anxious and depressive symptoms, have been shown to affect the mood and the quality of life in breast cancer patients. 5-Hydroxytryptamine Transporter Gene-linked Polymorphic Region (5-HTTLPR) functional polymorphism of serotonin transporter has been shown to influence the adaptation to stressful life events. The aim of this prospective study was therefore to examine the association of 5-HTTLPR with the mental adaptation to cancer diagnosis and treatment. Patients and methods Forty eight consecutive patients with early mammary carcinoma were evaluated at enrolment and at follow up after one and three months. The patients were characterized psychometrically using the Hospital Anxiety and Depression Scale (HADS) and the Mini-Mental Adjustment to Cancer Scale (Mini-MAC); 5-HTTLPR allelic variants were determined using PCR-based techniques. Results In women with early breast cancer, the mental adaptation to the disease was associated with high scores of avoidance and anxious preoccupation of Mini-MAC, which decreased with time at follow up. Anxious preoccupation decreased with time less in patients with the S/S and S/L genetic variant of 5-HTTLPR as compared with the L/L carriers (p=0.023), indicating gene - environment interactions. Conclusions These results indicate that the characterization of 5-HTTLPR allows the identification of breast cancer patients in greater risk of mental suffering, for which specific intervention may be focused; in case of drug therapy, they provide indications for the choice of most appropriate agent in a pharmacogenetic perspective.
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Association of APC and REEP5 gene polymorphisms with major depression disorder and treatment response to antidepressants in a Han Chinese population. Gen Hosp Psychiatry 2012; 34:571-7. [PMID: 22795047 DOI: 10.1016/j.genhosppsych.2012.05.015] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2011] [Revised: 05/29/2012] [Accepted: 05/29/2012] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Despite the high prevalence of depression and its considerable impact on the population, knowledge about the pathogenesis of the illness and the antidepressant treatment response is still unknown. METHODS A total of 397 patients with major depression disorder (MDD) and 473 normal controls were employed in the present research. Twelve single nucleotide polymorphisms (SNPs) within the adenomatous polyposis coli (APC) and receptor accessory protein (REEP5) genes were selected for genotyping using the GoldenGate genotyping assay. A total of 165 MDD patients completed a 6-week antidepressant treatment. Responders were defined as patients with at least a 50% reduction in Hamilton Rating Scale for Depression total scores posttreatment. RESULTS Two SNPs (rs2464805 and rs563556) within the APC gene exhibited a statistically significant association with MDD when analyzed by genotype and allele frequencies. Three SNPs (rs495794, rs153549 and rs153560) in the REEP5 gene showed significant statistical differences between the responders and nonresponders. CONCLUSIONS The APC gene may be one of the susceptibility genes for MDD as well as a genetic link between psychiatric disease and cancer. REEP5 gene polymorphisms may influence antidepressant treatment response in MDD.
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Johansson M, Rydén A, Ahlberg K, Finizia C. “Setting boundaries” – Mental adjustment to cancer in laryngeal cancer patients: An interview study. Eur J Oncol Nurs 2012; 16:419-25. [DOI: 10.1016/j.ejon.2011.09.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2011] [Revised: 09/28/2011] [Accepted: 09/30/2011] [Indexed: 10/15/2022]
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Costa-Requena G, Rodríguez A, Fernández-Ortega P. Longitudinal assessment of distress and quality of life in the early stages of breast cancer treatment. Scand J Caring Sci 2012; 27:77-83. [DOI: 10.1111/j.1471-6712.2012.01003.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Ng CG, Boks MPM, Smeets HM, Zainal NZ, de Wit NJ. Prescription patterns for psychotropic drugs in cancer patients; a large population study in the Netherlands. Psychooncology 2012; 22:762-7. [DOI: 10.1002/pon.3056] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2011] [Revised: 02/01/2012] [Accepted: 02/01/2012] [Indexed: 11/09/2022]
Affiliation(s)
| | | | - Hugo Matthias Smeets
- Julius Centre for Health Sciences and Primary Care; University Medical Centre; Utrecht; The Netherlands
| | - Nor Zuraida Zainal
- Department of Psychological Medicine; Faculty of Medicine; University of Malaya; Kuala Lumpur; Malaysia
| | - Niek J. de Wit
- Julius Centre for Health Sciences and Primary Care; University Medical Centre; Utrecht; The Netherlands
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Porcelli P, Tulipani C, Di Micco C, Spedicato MR, Maiello E. Temporal stability of alexithymia in cancer patients following a psychological intervention. J Clin Psychol 2011; 67:1177-87. [PMID: 22052601 DOI: 10.1002/jclp.20839] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE The state-trait nature of alexithymia is not fully resolved. The aim of this article was to evaluate the temporal stability of alexithymia in cancer patients after psychological intervention. DESIGN Absolute and relative stability of alexithymia was evaluated in 104 cancer patients who received multicomponent psychological treatment or usual medical care. RESULTS Alexithymia scores significantly decreased in treated patients and increased in the control group, thus showing that the lack of absolute stability (i.e., the change of personality scores over time) likely was because of the effect of the treatment versus the control condition. The relative stability (i.e., the extent to which the inter-individual differences remain the same over time) of alexithymia after 6 months was, however, demonstrated with multiple regressions, after controlling for anxiety, depression, and cancer-related pain. CONCLUSIONS This study confirms the relative stability of alexithymia and that the lack of absolute stability of the construct is influenced by psychological intervention in cancer patients.
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Affiliation(s)
- Piero Porcelli
- Department of Medical Oncology, IRCCS Casa Sollievo della Sofferenza Hospital, S.Giovanni Rotondo, Italy.
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Johansson M, Rydén A, Finizia C. Mental adjustment to cancer and its relation to anxiety, depression, HRQL and survival in patients with laryngeal cancer - a longitudinal study. BMC Cancer 2011; 11:283. [PMID: 21718478 PMCID: PMC3136424 DOI: 10.1186/1471-2407-11-283] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2010] [Accepted: 06/30/2011] [Indexed: 11/12/2022] Open
Abstract
Background Using a longitudinal design, aim of this study was to investigate the relation between mental adjustment to cancer and anxiety, depression, health-related quality of life (HRQL) and survival in patients treated for laryngeal cancer. Methods 95 patients with Tis-T4 laryngeal cancer were assessed at one and 12 months after start of treatment, respectively, using the Mini-Mental Adjustment to Cancer Scale (Mini-MAC), the European Organisation for Research and Treatment of Cancer (EORTC) Study Group on Quality of Life core questionnaire (EORTC QLQ-C30) supplemented with the Head and Neck cancer module (QLQ-H&N35) and the Hospital Anxiety and Depression (HAD) Scale. For survival analyses patients were followed up for a median time of 4.22 years from inclusion. Results The most commonly used adjustment response at both occasions was Fighting Spirit. The use of adjustment responses was relatively stable over time. Correlation analyses showed that patients using Helpless-Hopeless and Anxious Preoccupation responses reported more anxiety and depression, as well as decreased HRQL. Tumour site and stage showed no effect on adjustment response. Survival analysis indicated that use of a Helpless-Hopeless response was related to poorer survival (HR 1.17, p 0.001). Conclusion The relation between adjustment responses Helpless-Hopeless and Anxious Preoccupation and anxiety, depression, HRQL and possibly poorer survival indicate that assessment of mental adjustment should be considered when planning treatment and rehabilitation in laryngeal cancer patients.
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Affiliation(s)
- Mia Johansson
- Department of Otolaryngology, Sahlgrenska University Hospital, SE 431 80 Mölndal, Sweden.
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Andreu Y, Galdón MJ, Durá E, Martínez P, Pérez S, Murgui S. A longitudinal study of psychosocial distress in breast cancer: prevalence and risk factors. Psychol Health 2011; 27:72-87. [PMID: 21678180 DOI: 10.1080/08870446.2010.542814] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
This longitudinal study was conducted among 102 women with non-metastasic breast cancer to identify the time evolution and prevalence of distress at specific times through diagnosis and treatment of disease: preliminary diagnosis, surgery, definitive diagnosis and chemotherapy. Additionally, the study aimed to examine the role of demographic, medical and psychosocial factors on distress. The results indicated that prevalence of distress was higher at initial diagnosis (25%) than the following time points (approximately 17%). The differences inter-individuals in the levels of distress were observed over the four assessments. No relation between distress and demographic and medical factors was found. However, psychosocial aspects were significant risk factors. Patterns of emotional suppression and specific coping responses like helplessness/hopelessness, anxious preoccupation, cognitive avoidance and fatalism were positively related to distress, whereas fighting spirit and perceived social support showed a protective role. Moreover, helplessness/hopelessness and anxious preoccupation jointly predicted 75% of cases and 98% non-cases of distress. Finally, a mediational model between emotional suppression and distress through helplessness/hopelessness was tested. Results support the necessity of routine distress screening all through the illness. Implications of data for psychosocial interventions with breast cancer patients are highlighted.
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Affiliation(s)
- Yolanda Andreu
- Department of Personality, Assessment and Psychological Treatment, University of Valencia, Valencia, Spain
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Le Corroller-Soriano AG, Bouhnik AD, Preau M, Malavolti L, Julian-Reynier C, Auquier P, Moatti JP. Does cancer survivors' health-related quality of life depend on cancer type? Findings from a large French national sample 2 years after cancer diagnosis. Eur J Cancer Care (Engl) 2011; 20:132-40. [PMID: 20345457 DOI: 10.1111/j.1365-2354.2009.01160.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
We investigated whether health-related quality of life (HRQL) depends on cancer type, after adjustment for demographic and medical variables. A French national population-based survey was conducted between November and December 2004 to assess surviving cancer patients' HRQL 2 years after diagnosis. HRQL was measured by the 36-Item Short Form Survey scale. The sample included 3900 persons. All cancer diagnoses were entered in the study. We demonstrated that medical and treatment variables have an impact on patients' physical HRQL but not on mental HRQL. Cancer type impacted on physical HRQL, with those suffering from upper aerodigestive tract /lung cancers and haematological malignancies being affected to a greater degree. Disturbing side effects impacted both HRQL domains. Socio-demographic variables had statistically significant effects but not clinically meaningful ones. Socio-economic variables led to potentially clinically meaningful differences for cancer patients' HRQL and represented a socio-economic gradient in HRQL among cancer survivors. From our results, we may assert that cancer survivors, 2 years after cancer diagnosis, share a similar pattern of psychological morbidity, independent of cancer type. Patients disproportionately affected by cancer, such as those with lower educational levels and income, need to be identified and targeted and interventions which address their unique needs and concerns need to be developed.
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[Psychological comorbidity in patients with cancer]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2011; 54:46-51. [PMID: 21246328 DOI: 10.1007/s00103-010-1184-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
In western industrial nations, cancer is one of the most frequent somatic diseases showing increasing incidence rates. Although the options for medical treatment and the survival rates for most cancer diagnoses have improved over the last few decades, cancer is still a life-threatening illness associated with psychosocial issues, suffering, and distress. Depending on the severity and duration of symptoms, psychosocial distress due to cancer ranges from normal reactions to psychological comorbidity based on ICD classification criteria. In cancer patients, the most frequent psychological diagnoses are adjustment disorders, anxiety, and depression; prevalence rates in the literature show high variations depending on the tumor type studied and the assessment instrument used. Today, standardized and validated screening instruments and diagnostic interviews are available for the screening and assessment of psychosocial distress and psychiatric comorbidity. The screening of psychosocial distress in cancer patients and the assessment of psychiatric disorders are important tasks of modern cancer treatment in order to determine the need for psychosocial counseling and psychooncological treatment.
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Blalock JA, Lam C, Minnix JA, Karam-Hage M, Gritz ER, Robinson JD, Cinciripini PM. The Effect of Mood, Anxiety, and Alcohol Use Disorders on Smoking Cessation in Cancer Patients. J Cogn Psychother 2011; 25:82-96. [DOI: 10.1891/0889-8391.25.1.82] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Smoking is highly prevalent in individuals with psychiatric disorders. The relationship between smoking and anxiety disorders has received less attention than that of depression and substance use disorders, despite the fact that anxiety disorders are the most common of mental illnesses across the globe. In this study, we investigated the relationship between psychiatric disorders, including anxiety, depression, alcohol abuse, and comorbid combinations of these primary Axis I disorders and smoking cessation, in a cohort of 1,425 cancer patients who were participating in a smoking cessation clinical program. Patients were followed prospectively and assessed for abstinence status at the end of treatment and at 6-month posttreatment. Treatment involved six to eight behavioral smoking cessation counseling sessions over a 12- to 16-week period, and up to 12 weeks of smoking cessation pharmacotherapy. We hypothesized that patients with current anxiety disorders as well as other psychiatric disorders would have lower smoking cessation rates than those with no psychiatric disorders. There were no differences in abstinence rates between patients with anxiety disorders and those with no psychiatric disorders at end of treatment or 6 months. Patients with major depression or alcohol abuse had lower cessation rates than patients with no psychiatric disorders at 6 months. Findings suggest that both major depression and alcohol abuse may adversely affect treatment outcome in cancer patients. However, these findings should be considered within the limitations of observational studies that involve comparisons between nonrandomly assigned groups.
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Abstract
AbstractObjective:The purpose of this study was to assess the psychological care needs of cancer patients throughout the healthcare process: after diagnosis, after medical treatment (surgery, chemotherapy, radiotherapy) and during follow-up.Method:A total of 703 ambulatory cancer patients were assessed in this study. The inclusion period was from April 1, 2005 to April 30, 2007. The first psychological scales used were the 14-item Hospital Anxiety and Depression Scales (HADS), which has two sub-scales for anxiety (7 items) and for depression (7 items). All patients with a score ≥14 were assessed through the Structured Clinical Interview for Psychiatric Disorder (SCID-I) of the DSM-IV. All data were compared with sociodemographic and medical characteristics.Results:Of the 703 cancer patients in the study, 349 were men and 354 women, with a mean age of 53 years. The median time between the cancer diagnosis and our clinical interview was 6 months (range, 12 days to 190 months). Overall, the screening tools indicated that one in four patients needed psychological care. The most common psychiatric diagnosis was adjustment disorder (129 cases), whereas 10 patients were diagnosed with major depression. Using a HADS cut-off score of >7 for anxiety and depression, 28% and 17% of patients, respectively, were classified as “possible clinical cases.” Risk factors for distress included age <65 years, asthenia, constipation, and a low performance status. However, chemotherapy treatment was found to be a protector against distress in cancer patients.Significance of Results:Chemotherapy treatment is interpreted by the patients as a protector against cancer, thereby reducing distress levels.
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Do spirituality and faith make a difference? Report from the Southern European Psycho-Oncology Study Group. Palliat Support Care 2010; 8:405-13. [DOI: 10.1017/s147895151000026x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjective:In the last decade, some attention has been given to spirituality and faith and their role in cancer patients' coping. Few data are available about spirituality among cancer patients in Southern European countries, which have a big tradition of spirituality, namely, the Catholic religion. As part of a more general investigation (Southern European Psycho-Oncology Study – SEPOS), the aim of this study was to examine the effect of spirituality in molding psychosocial implications in Southern European cancer patients.Method:A convenience sample of 323 outpatients with a diagnosis of cancer between 6 to 18 months, a good performance status (Karnofsky Performance Status > 80), and no cognitive deficits or central nervous system (CNS) involvement by disease were approached in university and affiliated cancer centers in Italy, Spain, Portugal, and Switzerland (Italian speaking area). Each patient was evaluated for spirituality (Visual Analog Scale 0-10), psychological morbidity (Hospital Anxiety and Depression Scale— HADS), coping strategies (Mini-Mental Adjustment to Cancer — Mini-MAC) and concerns about illness (Cancer Worries Inventory — CWI).Results. The majority of patients (79.3%) referred to being supported by their spirituality/faith throughout their illness. Significant differences were found between the spirituality and non-spirituality groups (p ≤ 0.01) in terms of education, coping styles, and psychological morbidity. Spirituality was significantly correlated with fighting spirit (r = −0.27), fatalism (r = 0.50), and avoidance (r = 0.23) coping styles and negatively correlated with education (r = −0.25), depression (r = −0.22) and HAD total (r = −0.17).Significance of results:Spirituality is frequent among Southern European cancer patients with lower education and seems to play some protective role towards psychological morbidity, specifically depression. Further studies should examine this trend in Southern European cancer patients.
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Grassi L, Nanni M, Caruso R. Emotional distress in cancer: screening policy, clinical limitations and educational needs. ACTA ACUST UNITED AC 2010. [DOI: 10.1007/s12682-010-0047-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Grassi L, Travado L, Gil F, Sabato S, Rossi E, Tomamichel M, Marmai L, Biancosino B, Nanni MG. Hopelessness and Related Variables Among Cancer Patients in the Southern European Psycho-Oncology Study (SEPOS). PSYCHOSOMATICS 2010. [DOI: 10.1016/s0033-3182(10)70686-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Harandy TF, Ghofranipour F, Montazeri A, Anoosheh M, Bazargan M, Mohammadi E, Ahmadi F, Niknami S. Muslim breast cancer survivor spirituality: coping strategy or health seeking behavior hindrance? Health Care Women Int 2010; 31:88-98. [PMID: 20390638 DOI: 10.1080/07399330903104516] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
We explored the role of religiosity and spirituality on (i) feelings and attitudes about breast cancer, (ii) strategies for coping with breast cancer, and (iii) health care seeking behaviors among breast cancer survivors in Iran. We conducted in-depth semistructured interviews with 39 breast cancer survivors. We found that spirituality is the primary source of psychological support among participants. Almost all participants attributed their cancer to the will of God. Despite this, they actively have been engaged with their medical treatment. This is in surprising contrast to Western cultures in which a belief in an external health locus of control diminishes participation in cancer screening, detection, and treatment. These findings can help researchers to provide a framework for the development of appropriate and effective culturally sensitive health interventions.
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