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Simon JDHP, Schepers SA, van Gorp M, Michiels EMC, Fiocco M, Grootenhuis MA, Tissing WJE. Pain monitoring app leads to less pain in children with cancer at home: Results of a randomized controlled trial. Cancer 2024; 130:2339-2350. [PMID: 37947136 DOI: 10.1002/cncr.35100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 10/17/2023] [Accepted: 10/18/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND The authors developed a pain monitoring app offering educational information, and real-time health care professional feedback on clinically significant pain (>4 numeric rating scale [NRS]-11) for children with cancer to reduce pain at home. METHODS This monocenter, nonblinded randomized controlled trial enrolled Dutch children (0-18 years old) receiving cancer treatment (≥3 months after diagnosis, ≥2 months treatment remaining). Children were randomly assigned to use the app or receive usual care (two parallel groups). We assessed whether use of the app yielded less clinically significant pain (aim 1) and whether it affected pain severity, duration, interference, pain management strategies, and parental emotional well-being (aim 2). The app was also evaluated by families (aim 3). RESULTS A total of 94 children were randomized to use the app (15 drop-outs), and 90 were to receive care as usual (11 drop-outs). The app group (n = 79, mean age: 7.5 [5.1] years, 48% girls, 63% hemato-oncology diagnosis) reported significantly less clinically significant pain compared to usual care (n = 79, mean age: 7.5 [5.4] years, 52% girls, 65% hemato-oncology diagnosis) (odds ratio [OR], 0.38; 95% confidence interval [CI], 0.198-0.734]) (aim 1), as well as significantly lower pain severity (β = -0.27; 95% CI, -0.407 to -0.142). No differences were found for duration, interference, or management strategies. Parents in the app group reported significantly less distress compared to usual care (β = -0.84; 95% CI, -1.61 to -0.03]) (aim 2). Families generally evaluated the app positively (aim 3). CONCLUSIONS Use of the app resulted in less clinically significant pain at home. The exact working mechanisms of the app should be further elucidated.
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Affiliation(s)
- Julia D H P Simon
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Sasja A Schepers
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Marloes van Gorp
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Erna M C Michiels
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Marta Fiocco
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Mathematical Institute, Leiden University, Leiden, The Netherlands
| | | | - Wim J E Tissing
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Department of Pediatric Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Silva S, Paredes T, Teixeira RJ, Brandão T, Dimitrovová K, Marques D, Sousa J, Leal M, Dias A, Neves C, Marques G, Amaral N. Emotional Distress in Portuguese Cancer Patients: The Use of the Emotion Thermometers (ET) Screening Tool. Healthcare (Basel) 2023; 11:2689. [PMID: 37830726 PMCID: PMC10572115 DOI: 10.3390/healthcare11192689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 09/27/2023] [Accepted: 09/27/2023] [Indexed: 10/14/2023] Open
Abstract
Cancer patients may experience significant distress. The "Emotion Thermometers" (ETs) are a short visual analogue scale used to screen patients for psychosocial risk. This study aimed to assess emotional distress in a large sample of cancer patients attending psychological services at an non-governmental organization (NGO), and to explore factors that may contribute to it. The ETs were answered by 899 cancer patients. They were, on average, 59.9 years old, the majority were female, had breast cancer, were under treatment or were disease-free survivors, and reported high levels of emotional distress, above the cut-off (≥5). A Generalized Linear Model was used to measure the association between the level of distress, age, gender, disease phase and 33 items of the problem list. Four items-sadness, depression, sleep and breathing-were found to be significantly related to a higher level of distress. Additionally, women and patients who were in the palliative phase also had significantly higher levels of distress. The results confirm the need for early emotional screening in cancer patients, as well as attending to the characteristics of each patient. Additionally, they highlight the utility of the ETs for the clinical practice, allowing to optimize the referral to specialized psychosocial services.
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Affiliation(s)
- Sónia Silva
- Portuguese Cancer League (Central Branch), Rua Dr. António José de Almeida, nº 329—2º Sl 56, 3000-045 Coimbra, Portugal; (T.P.); (N.A.)
| | - Tiago Paredes
- Portuguese Cancer League (Central Branch), Rua Dr. António José de Almeida, nº 329—2º Sl 56, 3000-045 Coimbra, Portugal; (T.P.); (N.A.)
| | - Ricardo João Teixeira
- REACH—Mental Health Clinic, 4000-138 Porto, Portugal;
- CINEICC, Faculty of Psychology and Educational Sciences, University of Coimbra, 3004-531 Coimbra, Portugal
| | - Tânia Brandão
- William James Center for Research, ISPA—Instituto Universitário, 1149-041 Lisboa, Portugal;
| | - Klára Dimitrovová
- Comprehensive Health Research Center, CHRC, NOVA University Lisboa, 1150-082 Lisboa, Portugal;
- MOAI Consulting, 1350-346 Lisboa, Portugal; (D.M.); (J.S.)
| | - Diogo Marques
- MOAI Consulting, 1350-346 Lisboa, Portugal; (D.M.); (J.S.)
| | - Joana Sousa
- MOAI Consulting, 1350-346 Lisboa, Portugal; (D.M.); (J.S.)
| | - Monick Leal
- Portuguese Cancer League (North Branch), 4200-172 Porto, Portugal;
| | - Albina Dias
- Portuguese Cancer League (South Branch), 1099-023 Lisboa, Portugal;
| | - Carole Neves
- Portuguese Cancer League (Madeira Branch), 9050-023 Funchal, Portugal;
| | - Graciete Marques
- Portuguese Cancer League (Azores Branch), 9700-171 Angra do Heroísmo, Açores, Portugal;
| | - Natália Amaral
- Portuguese Cancer League (Central Branch), Rua Dr. António José de Almeida, nº 329—2º Sl 56, 3000-045 Coimbra, Portugal; (T.P.); (N.A.)
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3
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Le Grande MR, Murphy BM, Rogerson MC, Ski CF, Amerena J, Smith JA, Hoover V, Alvarenga ME, Higgins RO, Thompson DR, Jackson AC. Development of a short form of the Cardiac Distress Inventory. BMC Cardiovasc Disord 2023; 23:408. [PMID: 37596516 PMCID: PMC10439557 DOI: 10.1186/s12872-023-03439-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 08/08/2023] [Indexed: 08/20/2023] Open
Abstract
BACKGROUND Cardiac distress may be viewed as a persistent negative emotional state that spans multiple psychosocial domains and challenges a patient's capacity to cope with living with their heart condition. The Cardiac Distress Inventory (CDI) is a disease-specific clinical assessment tool that captures the complexity of this distress. In busy settings such as primary care, cardiac rehabilitation, and counselling services, however, there is a need to administer briefer tools to aid in identification and screening. The aim of the present study was to develop a short, valid screening version of the CDI. METHODS A total of 405 participants reporting an acute coronary event in the previous 12 months was recruited from three hospitals, through social media and by direct enrolment on the study website. Participants completed an online survey which included the full version of the CDI and general distress measures including the Kessler K6, Patient Health Questionnaire-4, and Emotion Thermometers. Relationship of the CDI with these instruments, Rasch analysis model fit and clinical expertise were all used to select items for the short form (CDI-SF). Construct validity and receiver operating characteristics in relation to the Kessler K6 were examined. RESULTS The final 12 item CDI-SF exhibited excellent internal consistency indicative of unidimensionality and good convergent and discriminant validity in comparison to clinical status measures, all indicative of good construct validity. Using the K6 validated cutoff of ≥ 18 as the reference variable, the CDI-SF had a very high Area Under the Curve (AUC) (AUC = 0.913 (95% CI: 0.88 to 0.94). A CDI-SF score of ≥ 13 was found to indicate general cardiac distress which may warrant further investigation using the original CDI. CONCLUSION The psychometric findings detailed here indicate that the CDI-SF provides a brief psychometrically sound screening measure indicative of general cardiac distress, that can be used in both clinical and research settings.
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Affiliation(s)
- Michael R Le Grande
- Australian Centre for Heart Health, Melbourne, VIC, Australia
- Melbourne Centre for Behaviour Change, School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Barbara M Murphy
- Australian Centre for Heart Health, Melbourne, VIC, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC, Australia
| | | | - Chantal F Ski
- Australian Centre for Heart Health, Melbourne, VIC, Australia
- Integrated Care Academy, University of Suffolk, Ipswich, UK
- Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia
| | - John Amerena
- Barwon Health, Geelong, VIC, Australia
- Deakin School of Medicine, University Hospital Geelong, Geelong, VIC, Australia
| | - Julian A Smith
- Department of Cardiothoracic Surgery, Monash Health, Clayton, VIC, Australia
- Department of Surgery, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia
- Victorian Heart Institute, Clayton, VIC, Australia
| | - Valerie Hoover
- Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Marlies E Alvarenga
- Australian Centre for Heart Health, Melbourne, VIC, Australia
- Victorian Heart Institute, Clayton, VIC, Australia
- Institute of Health and Wellbeing, Federation University, Berwick, VIC, Australia
- Monash Health & Department of Medicine, Monash University, Clayton, VIC, Australia
| | - Rosemary O Higgins
- Australian Centre for Heart Health, Melbourne, VIC, Australia
- Department of Physiotherapy, University of Melbourne, Parkville, VIC, Australia
| | - David R Thompson
- Australian Centre for Heart Health, Melbourne, VIC, Australia
- Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Alun C Jackson
- Australian Centre for Heart Health, Melbourne, VIC, Australia.
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC, Australia.
- Centre on Behavioral Health, University of Hong Kong, Hong Kong, China.
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4
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Jackson AC, Grande MRL, Rogerson MC, Ski CF, Amerena J, Smith JA, Hoover V, Alvarenga ME, Higgins RO, Thompson DR, Murphy BM. The cardiac distress inventory: A new measure of psychosocial distress associated with an acute cardiac event. BMC Cardiovasc Disord 2022; 22:460. [PMID: 36329396 PMCID: PMC9633013 DOI: 10.1186/s12872-022-02897-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 10/10/2022] [Indexed: 11/06/2022] Open
Abstract
Background Many challenges are posed by the experience of a heart attack or heart surgery which can be characterised as ‘cardiac distress’. It spans multiple psychosocial domains incorporating patients’ responses to physical, affective, cognitive, behavioural and social symptoms and experiences related to their cardiac event and their recovery. Although some measures of the psychological and emotional impacts of a cardiac event exist, none provides a comprehensive assessment of cardiac distress. To address this gap, the study aimed to develop a Cardiac Distress Inventory (CDI) using best practice in instrument design. Method An item pool was generated through analysis of cognate measures, mostly in relation to other health conditions and through focus group and individual review by a multidisciplinary development team, cardiac patients, and end-users including cardiac rehabilitation co-ordinators. The resulting 144 items were reduced through further reviews to 74 for testing. The testing was carried out with 405 people recruited from three hospitals, through social media and by direct enrolment on the study website. A two-stage psychometric evaluation of the 74 items used exploratory factor analysis to extract the factors followed by Rasch analysis to confirm dimensionality within factors. Results Psychometric analysis resulted in the identification of 55 items comprising eight subscales, to form the CDI. The subscales assess fear and uncertainty, disconnection and hopelessness, changes to roles and relationships, overwhelm and depletion, cognitive challenges, physical challenges, health system challenges, and death concerns. Validation against the Kessler 6 supports the criterion validity of the CDI. Conclusion The CDI reflects a nuanced understanding of cardiac distress and should prove to be a useful clinical assessment tool, as well as a research instrument. Individual subscales or the complete CDI could be used to assess or monitor specific areas of distress in clinical practice. Development of a short form screening version for use in primary care, cardiac rehabilitation and counselling services is warranted. Supplementary Information The online version contains supplementary material available at 10.1186/s12872-022-02897-y.
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Affiliation(s)
- Alun C Jackson
- Australian Centre for Heart Health, Melbourne, VIC, Australia. .,Centre on Behavioral Health, University of Hong Kong, Hong Kong SAR, China.
| | - Michael R Le Grande
- Australian Centre for Heart Health, Melbourne, VIC, Australia.,Melbourne Centre for Behaviour Change, School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
| | | | - Chantal F Ski
- Australian Centre for Heart Health, Melbourne, VIC, Australia.,Integrated Care Academy, University of Suffolk, Ipswich, UK.,Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia
| | - John Amerena
- Barwon Health, Geelong, VIC, Australia.,Deakin School of Medicine, University Hospital Geelong, Geelong, VIC, Australia
| | - Julian A Smith
- Department of Cardiothoracic Surgery, Monash Health, Clayton, VIC, Australia.,Department of Surgery, School of Clinical Sciences at Monash Health), Monash University, Clayton, VIC, Australia
| | - Valerie Hoover
- Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Marlies E Alvarenga
- Australian Centre for Heart Health, Melbourne, VIC, Australia.,Institute of Health and Wellbeing, Federation University, Berwick, VIC, Australia.,Victorian Heart Institute, Clayton, VIC, Australia.,Monash Health & Department of Medicine, Monash University, Clayton, VIC, Australia
| | - Rosemary O Higgins
- Australian Centre for Heart Health, Melbourne, VIC, Australia.,Department of Physiotherapy, University of Melbourne, Parkville, VIC, Australia
| | - David R Thompson
- Australian Centre for Heart Health, Melbourne, VIC, Australia.,Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia.,School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Barbara M Murphy
- Australian Centre for Heart Health, Melbourne, VIC, Australia.,Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC, Australia
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5
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Ceccato E, Roveran C. Effects of Music Therapy in the Reduction of Pre-Meal Anxiety in Patients Suffering from Anorexia Nervosa. Brain Sci 2022; 12:brainsci12060801. [PMID: 35741686 PMCID: PMC9221392 DOI: 10.3390/brainsci12060801] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 06/17/2022] [Accepted: 06/17/2022] [Indexed: 11/16/2022] Open
Abstract
Literature reviews appear to indicate that Music Therapy (MT) may instil a sense of empowerment and generate feelings of renewed self-confidence, distracting subjects who follow this type of intervention from negative thoughts and, generally, helping patients suffering from Anorexia Nervosa (AN) to redevelop or rediscover their identity. The purpose of the study reported in this paper is to investigate whether MT proposed before an evening meal is capable of decreasing pre-meal anxiety in adolescents suffering from AN who follow the Day-hospital Treatment Programme at the San Bortolo Hospital of Vicenza (Italy). A total of 24 patients participated voluntarily in once-weekly sessions of group-based MT conducted by a qualified music therapist over a period of six months. Before evening meals on Monday, Tuesday and Wednesday, pre-meal anxiety was measured using a self-report scale, and the MT group session occurred every Wednesday before the evening meal was consumed. MT activities were both active and receptive. It has been found that with respect to Mondays and Tuesdays, pre-meal anxiety was significantly lower on Wednesdays following participation in the MT group. MT is evidently capable of reducing pre-meal anxiety and may be adopted as a supportive element in treatment plans relating to patients with AN in a day-hospital treatment programme.
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Affiliation(s)
- Enrico Ceccato
- Department of Mental Health, San Bortolo Hospital, 36100 Vicenza, Italy
- The Giovanni Ferrari Music Therapy School, 35100 Padua, Italy;
- Correspondence:
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Ganz FD, Raanan O, Shafir G, Levy D, Klempfner R, Beigel R, Iakobishvili Z. Distress among hospitalized patients with acute coronary syndrome. Nurs Crit Care 2021; 27:165-171. [PMID: 34766409 DOI: 10.1111/nicc.12730] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 10/28/2021] [Accepted: 10/29/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Previous studies have demonstrated that those suffering from acute coronary syndrome (ACS) experience various physical and psychological symptoms. Few studies have investigated the multi-factorial, holistic, unpleasant experience of distress that includes physical, psychological, social, and spiritual factors among this patient population while still hospitalized. AIM To describe the level of distress among patients hospitalized with ACS and its association with demographic and clinical factors and mortality. STUDY DESIGN The study conducted a descriptive, cross-sectional survey. METHODS The Acute Coronary Syndrome Israel Study is a national, biennial registry, enrolling all patients with ACS admitted to cardiac intensive care or cardiology wards in Israel within a 2-month period. Demographic and clinical data were retrieved from an electronic database. Distress was measured by the Distress Thermometer. Nurses collected distress data directly from patients before discharge. RESULTS Nine hundred ninety participants (50.6% response rate) were surveyed. Mean age was 62.8 (SD = 12.5). Mean distress level was 4.8 (SD = 3.45) out of 10. The most frequently reported area of distress was physical, followed by emotional. Practical and family problems were less frequent. Emotional distress was found to differ based on educational level, marital status, smoking history, and previous medical history. Distress did not predict 7- or 30-day mortality. CONCLUSIONS Respondents with ACS were in moderate distress. It is recommended that those at increased risk receive increased monitoring of emotional distress while still in hospital. Further studies should investigate this holistic view of distress among the ACS population using a variety of methods and methodologies.
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Affiliation(s)
- Freda DeKeyser Ganz
- Faculty of Life and Health Sciences, Jerusalem College of Technology, Jerusalem, Israel.,Hadassah-Hebrew University School of Nursing, Jerusalem, Israel
| | - Ofra Raanan
- Sheba Medical Center School of Nursing, Tel Hashomer, Israel
| | - Gennady Shafir
- Cardiac Intensive Care Unit, Haemek Medical Center, Afula, Israel
| | - Dassy Levy
- Division of Cardiology, Rambam Medical Center, Haifa, Israel
| | - Robert Klempfner
- Department of Cardiology, Sheba Medical Center, Cardiac Rehabilitation Institute, Tel Hashomer, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Roy Beigel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Cardiology, Sheba Medical Center, Tel Hashomer, Israel
| | - Zaza Iakobishvili
- Department of Community Cardiology, Clalit Health Services, Tel Aviv, Israel.,Department of Cardiology, Samson Assuta Ashdod University Hospital, Ashdod, Israel
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7
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Licková K, Čoček A, Ambruš M, Soumarová R, Vránová J, Klézl P, Mitchell AJ, Raudenská J, Javůrková A. Rapid screening of depression and anxiety in cancer patients: Interview validation of emotion thermometers. Asian J Psychiatr 2021; 65:102827. [PMID: 34560569 DOI: 10.1016/j.ajp.2021.102827] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 08/19/2021] [Accepted: 08/26/2021] [Indexed: 01/06/2023]
Abstract
BACKGROUND AND OBJECTIVE This study aimed to determine the degree of depression and anxiety in cancer patients using the Emotion Thermometers (ET) and confirming their clinical usefulness compared to the gold standard interview, as well as determining optimal cut-off values for the appropriate identification of cancer patients' distress. METHODS We included 238 cancer patients and we used ET (Emotion Thermometers) to screen depression and anxiety and the Beck depression inventory for adults (BDI-II), the Generalized Anxiety Disorder 7-item scale (GAD-7) and the Mini-International Neuropsychiatric Interview (M.I.N.I) was used as the criterial validity standard. RESULTS The prevalence of anxiety on the M.I.N.I. was 24% and depression was 11%. The optimal value for diagnosis of depression from ET (Dep ET) appears to be > 4.5 (AUC 0.928) against M.I.N.I. Optimal score for anxiety from ET (AnxT ET) compared to GAD according to M.I.N.I. we determined the value of 3.5 (AUC 0.899). To determine the cut off score for distress using from ET (DT), we compared against GAD-7 and BDI-II RS (raw total score) and the most optimal was 4.5 (AUC 0.953). For analysis of the cut off score for quality of life (QoL) against the total sums of all parts of the ET, the value of 14.5 (AUC 0.892) forms the cut off between the negative and the positive clinical finding. CONCLUSIONS The results of the study support the use of ET as a rapid screening tool for the detection of depression, anxiety and distress in cancer patients.
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Affiliation(s)
- K Licková
- Radiotherapy and Oncology Department, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czechia
| | - A Čoček
- Department of Ear, Nose and Throat, Thomayer Hospital, Prague, Czechia
| | - M Ambruš
- Radiotherapy and Oncology Department, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czechia
| | - R Soumarová
- Radiotherapy and Oncology Department, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czechia
| | - J Vránová
- Institute of Medical Biophysics and Medical Informatics, Third Faculty of Medicine, Charles University, Prague, Czechia
| | - P Klézl
- Department of Urology, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czechia
| | - A J Mitchell
- Department of Psycho-oncology, University of Leicester, Leicester LE1 5WW, UK
| | - J Raudenská
- Department of Nursing, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czechia
| | - A Javůrková
- Department of Nursing, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czechia; Department of Clinical Psychology, University Hospital Kralovske Vinohrady, Prague, Czechia.
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Grund S, Kilb M, Breitinger E, Hundsdörfer W, Schäfer HG, Schols JMGA, Gordon AL, Bauer JM, Alpers GW. Evaluation of a new screening instrument for psychological distress in postacute rehabilitation in older person. Eur Geriatr Med 2021; 13:243-251. [PMID: 34510385 DOI: 10.1007/s41999-021-00554-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 08/11/2021] [Indexed: 05/31/2023]
Abstract
PURPOSE Although psychological distress has a negative impact on functional recovery, institutionalisation and mortality rates, there is typically no established procedure to screen for psychological distress in geriatric rehabilitation. The aim of the study was to evaluate a brief single-item Verbal Numerical Rating Scale (VNRS-PD) as a screening tool for psychological distress in multimorbid geriatric rehabilitation patients. METHODS In this cross-sectional study, N = 132 geriatric rehabilitation in-patients (M = 82 years old; 70.5% female) completed a verbal numerical rating scale (VNRS-PD) on satisfaction with their mood as well as the Hospital Anxiety and Depression Scale (HADS) and the short-form of the Geriatric Depression Scale (GDS). Based on the questionnaire data, the rehabilitation patients were classified as high or low in psychopathology. Using receiver-operating characteristic (ROC) curve analysis, optimal cutoff scores of the VNRS-PD were calculated for each questionnaire to detect significant psychological distress. RESULTS Between 28.8% (HADS ≥ 18) and 43.9% (GDS ≥ 6) of the sample had above-cutoff questionnaire scores. The area under the curve (AUC) of the VNRS-PD varied from 0.785 (95%-CI 0.709-0.861) (GDS ≥ 6) and 0.790 (95%-CI 0.716-0.864) (HADS ≥ 18) to 0.807 (95%-CI 0.734-0.880) (GDS ≥ 7). A score of ≤ 5 in the VNRS-PD proved to be the cutoff with an optimal trade-off between sensitivity (0.776-0.867) and specificity (0.638-0.703). CONCLUSION The VNRS-PD may be a suitable screening instrument to detect patients with psychological distress in inpatient geriatric rehabilitation for and to initiate further diagnostics within a graduated psychodiagnostic scheme. This first step may help to identify older patients with psychological distress and mental disorders, to initiate targeted interventions. Further research is needed to replicate these findings in a larger sample.
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Affiliation(s)
- Stefan Grund
- Department of Geriatrics and Geriatric Rehabilitation, Center for Geriatric Medicine, Agaplesion Bethanien Krankenhaus Heidelberg, University of Heidelberg, Heidelberg, Germany.
| | - Michael Kilb
- Department of Psychology, School of Social Sciences, University of Mannheim, Mannheim, Germany
| | - Eva Breitinger
- Department of Psychology, School of Social Sciences, University of Mannheim, Mannheim, Germany
| | - Wilfried Hundsdörfer
- Diakonissen Hospital Mannheim Department of Geriatric Rehabilitation, Mannheim, Germany
| | - Hans G Schäfer
- Diakonissen Hospital Mannheim Department of Geriatric Rehabilitation, Mannheim, Germany
| | - Jos M G A Schols
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.,Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Adam L Gordon
- Division of Medical Sciences and Graduate Entry Medicine, School of Medicine, University of Nottingham, Nottingham, UK.,School of Health Sciences, City University of London, London, UK
| | - Jürgen M Bauer
- Department of Geriatrics and Geriatric Rehabilitation, Center for Geriatric Medicine, Agaplesion Bethanien Krankenhaus Heidelberg, University of Heidelberg, Heidelberg, Germany
| | - Georg W Alpers
- Department of Psychology, School of Social Sciences, University of Mannheim, Mannheim, Germany
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Grimmett C, Bates A, West M, Leggett S, Varkonyi-Sepp J, Campbell A, Davis J, Wootton S, Shaw C, Barlow R, Ashcroft J, Scott A, Moyes H, Hawkins L, Levett DZH, Williams F, Grocott MPW, Jack S. SafeFit Trial: virtual clinics to deliver a multimodal intervention to improve psychological and physical well-being in people with cancer. Protocol of a COVID-19 targeted non-randomised phase III trial. BMJ Open 2021; 11:e048175. [PMID: 34446487 PMCID: PMC8392740 DOI: 10.1136/bmjopen-2020-048175] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION The impact of the COVID-19 pandemic (caused by the SARS-CoV-2 virus) on individuals with cancer has been profound. It has led to increased anxiety, distress and deconditioning due to reduced physical activity. We aim to investigate whether SafeFit, a multimodal intervention of physical activity, nutrition and psychological support delivered virtually by cancer exercise specialists (CES), can improve physical and emotional functionings during the COVID-19 pandemic. METHODS AND ANALYSIS A phase III non-randomised intervention trial, target recruitment of 1050 adults with suspected or confirmed diagnosis of cancer. All recruited participants will receive the multimodal intervention delivered by CES for 6 months. Sessions will be delivered 1-to-1 using telephone/video conferencing consultations. CES will work with each participant to devise a personalised programme of (1) physical activity, (2) basic dietary advice and (3) psychological support, all underpinned by behaviour change support. PRIMARY OUTCOME Physical and emotional functioning as measured by the European Organisation for Research and Treatment of Cancer-Quality of Life Questionnaire (EORTC-QLQ-C30). SECONDARY OUTCOMES overall quality of life measured by EORTC-QLQ-C30 and EQ-5D-5L, health economics, patient activation, self-efficacy to self-manage chronic disease, distress, impact of COVID-19 on emotional functioning, self-reported physical activity, functional capacity and nutrition. Adherence to the intervention will also be measured and a process evaluation conducted. ETHICS AND DISSEMINATION Ethical approval was obtained from the Health Research Authority (reference number 20/NW/0254). Results of this trial will be disseminated through publication of peer-reviewed articles, presentations at scientific conferences, and to the public and people with cancer in collaboration with our patient and public involvement representatives and partners. TRIAL REGISTRATION NUMBER NCT04425616.
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Affiliation(s)
- Chloe Grimmett
- School of Health Sciences, University of Southampton, Southampton, UK
| | - Andrew Bates
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Malcolm West
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
- School of Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Samantha Leggett
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Judit Varkonyi-Sepp
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Anna Campbell
- School of Applied Science, Edinburgh Napier University, Edinburgh, UK
| | | | - Stephen Wootton
- School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
- NIHR Cancer and Nutrition Collaboration, Southampton, UK
| | - Clare Shaw
- NIHR Biomedical Research Centre, Royal Marsden NHS Foundation Trust, London, UK
| | - Rachael Barlow
- Cardiff and Vale University Health Board, University Hospital of Wales, Cardiff, UK
| | - Joanna Ashcroft
- St George's University Hospitals NHS Foundation Trust, London, UK
| | - Andrew Scott
- School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, UK
| | - Helen Moyes
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Lesley Hawkins
- Critical Care/Anaesthesia and Perioperative Medicine Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Denny Z H Levett
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
- School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | | | - Michael P W Grocott
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
- School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Sandy Jack
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
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Quintero Garzón L, Hinz A, Koranyi S, Mehnert-Theuerkauf A. Norm Values and Psychometric Properties of the 24-Item Demoralization Scale (DS-I) in a Representative Sample of the German General Population. Front Psychol 2021; 12:681977. [PMID: 34194373 PMCID: PMC8236510 DOI: 10.3389/fpsyg.2021.681977] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 05/18/2021] [Indexed: 11/16/2022] Open
Abstract
Purpose: The Demoralization scale (DS-I) is a validated and frequently used instrument to assess existential distress in patients with cancer and other severe medical illness. The purpose of this study was to provide normative values derived from a representative German general population sample and to analyze the correlational structure of the DS-I. Methods: A representative sample of the adult German general population completed the DS-I (24 Items), the Emotion Thermometers (ET) measuring distress, anxiety, depression, anger, need for help, and the Functional Assessment of Chronic Illness Therapy Fatigue Scale (FACIT-fatigue). Results: The sample consists of N = 2,407 adults (mean age = 49.8; range = 18–94 years), 55.7% women). The percentages of participants above the DS-I cutoff (≥30) was 13.5%. The mean scores of the DS-I dimensions were as follows: (1) loss of meaning and purpose: M = 2.78 SD = 4.49; (2) disheartenment: M = 3.19 SD = 4.03; (3) dysphoria M = 4.51 SD = 3.20; (4) sense of failure: M = 6.24 SD = 3.40; and for the DS-I total score: M = 16.72 SD = 12.74. Women reported significantly higher levels of demoralization than men, with effect sizes between d = 0.09 (Loss of Meaning) and d = 0.21 (Dysphoria). Age was not associated with demoralization in our sample. DS-I reliability was excellent (α = 0.94) and DS-I subscales were interrelated (r between 0.31 and 0.87) and significantly correlated with ET, especially depression, anxiety, and need for help and fatigue (r between 0.14 and 0.69). Conclusions: In order to use the DS-I as a screening tool in clinical practice and research the normative values are essential for comparing the symptom burden of groups of patients within the health care system to the general population. Age and sex differences between groups of patients can be accounted for using the presented normative scores of the DS-I.
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Affiliation(s)
- Leonhard Quintero Garzón
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
| | - Andreas Hinz
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
| | - Susan Koranyi
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
| | - Anja Mehnert-Theuerkauf
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
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Abstract
BACKGROUND Understanding the impact of the COVID-19 pandemic on paediatric non-COVID-19-related care, as well as patient and caregiver concerns and stressors, is critical for informing healthcare delivery. It was hypothesised that high care disruptions and psychological stress would be observed among paediatric and adult CHD patients in the early phase of the pandemic. METHODS A cross-sectional, international, electronic survey study was completed. Eligible participants included parents of children with acquired or CHD, adults with CHD, or caregivers of adults with CHD. RESULTS A total of 1220 participants from 25 countries completed the survey from 16 April to 4 May, 2020. Cardiac care disruption was significant with 38% reporting delays in pre-pandemic scheduled cardiac surgeries and 46% experiencing postponed cardiac clinic visits. The majority of respondents (75%) endorsed moderate to high concern about the patient with heart disease becoming ill from COVID-19. Worry about returning for in-person care was significantly greater than worry of harm to patient due to postponed care. Clinically significant psychological stress was high across the sample including children (50%), adults with CHD (42%), and caregivers (42%). CONCLUSIONS The early phase of the COVID-19 pandemic contributed to considerable disruptions in cardiac care for patients with paediatric and adult CHD. COVID-19-related fears are notable with potential to impact willingness to return to in-person care. Psychological stress is also very high necessitating intervention. Further study of the impact of delays in care on clinical outcomes is warranted.
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12
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Sousa H, Oliveira J, Figueiredo D, Ribeiro O. The clinical utility of the Distress Thermometer in non-oncological contexts: A scoping review. J Clin Nurs 2021; 30:2131-2150. [PMID: 33555631 DOI: 10.1111/jocn.15698] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 01/18/2021] [Accepted: 01/29/2021] [Indexed: 12/22/2022]
Abstract
AIMS To assess the clinical utility of the Distress Thermometer (DT) in non-cancer populations. METHODS The search was performed between the 6th and the 18th of April 2020, on the following databases: Web of Science (all databases included), Scopus and Science Direct. One last update was performed on 5 June 2020. The findings were reported using the PRISMA-ScR. RESULTS Fifty-three studies were included. Overall results indicated that this tool has been used in several contexts and populations (clinical and non-clinical). The DT is highly accessible, suitable and relevant for health professionals and/or researchers who aim to use it as a distress screening tool, particularly in patients with chronic physical conditions. Assumptions about its practicality and acceptability in non-oncology care should be made with caution since few studies have explored the psychometric qualities of this instrument, the completers' perceptions about completing the DT and the perceptions of health professionals who administer the tool. CONCLUSIONS This lack of information undermines conclusions about the overall clinical utility of the DT as a screening tool for distress in individuals who do not have cancer. IMPLICATIONS FOR PRACTICE Future research should aim to fill this gap and investigate the psychometric qualities of the DT through validation studies and, thus, increase the rigour of its application and clinical utility in non-oncological contexts.
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Affiliation(s)
- Helena Sousa
- Center for Health Technology and Services Research (CINTESIS.UA), School of Health Sciences, University of Aveiro (Campus Universitário de Santiago), Aveiro, Portugal
| | - Jaime Oliveira
- Department of Education and Psychology, Center for Health Technology and Services Research (CINTESIS.UA), University of Aveiro (Campus Universitário de Santiago), Aveiro, Portugal
| | - Daniela Figueiredo
- Center for Health Technology and Services Research (CINTESIS.UA), School of Health Sciences, University of Aveiro (Campus Universitário de Santiago), Aveiro, Portugal
| | - Oscar Ribeiro
- Department of Education and Psychology, Center for Health Technology and Services Research (CINTESIS.UA), University of Aveiro (Campus Universitário de Santiago), Aveiro, Portugal
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Jackson A, Rogerson M, Le Grande M, Thompson D, Ski C, Alvarenga M, Amerena J, Higgins R, Raciti M, Murphy BM. Protocol for the development and validation of a measure of persistent psychological and emotional distress in cardiac patients: the Cardiac Distress Inventory. BMJ Open 2020; 10:e034946. [PMID: 32532770 PMCID: PMC7295398 DOI: 10.1136/bmjopen-2019-034946] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Revised: 04/21/2020] [Accepted: 04/22/2020] [Indexed: 01/09/2023] Open
Abstract
INTRODUCTION Distress is experienced by the majority of cardiac patients, yet no cardiac-specific measure of distress exists. The aim of this project is to develop and validate the Cardiac Distress Inventory (CDI). Using the CDI, health professionals will be able to identify key clusters of psychological, emotional and social concern to address with patients, postcardiac event. METHODS AND ANALYSIS An item pool will be generated through: identification of items by a multidisciplinary group of clinician researchers; review of generic and condition-specific distress measures; focus group testing with cardiac rehabilitation professionals; feedback from patients. The COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments) criteria will be used to inform the development of the methodology for determining the CDI's psychometric properties. The item pool will be tested with 400 cardiac patients and responses subjected to exploratory factor analysis, Rasch analysis, construct validity testing and latent class analysis. Receiver operating characteristic analysis will be used to identify the optimal CDI cut-off score for distinguishing whether a person experiences clinically significant distress. ETHICS AND DISSEMINATION Approved by the Monash Health Human Research Ethics Committee (approval number-RES-19-0000631L-559790). The CDI will be made available to clinicians and researchers without charge. The CDI will be translated for use internationally. Study findings will be shared with cardiac patient support groups; academic and medical communities via publications and presentations; in the training of cardiac secondary prevention professionals; and in reports to funders. Authorship for publications will follow the uniform requirements for manuscripts submitted to biomedical journals.
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Affiliation(s)
- Alun Jackson
- Australian Centre for Heart Health, North Melbourne, Victoria, Australia
- Deakin University Faculty of Health, Burwood, Victoria, Australia
| | - Michelle Rogerson
- Australian Centre for Heart Health, North Melbourne, Victoria, Australia
| | - Michael Le Grande
- Australian Centre for Heart Health, North Melbourne, Victoria, Australia
- Centre for Behaviour Change, Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - David Thompson
- Australian Centre for Heart Health, North Melbourne, Victoria, Australia
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Chantal Ski
- Australian Centre for Heart Health, North Melbourne, Victoria, Australia
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Marlies Alvarenga
- School of Health and Life Sciences, Federation University Australia - Berwick Campus, Berwick, Victoria, Australia
- Monash Cardiovascular Research Centre, MonashHeart, Melbourne, Victoria, Australia
| | - John Amerena
- Cardiac Services, Barwon Health, Geelong, Victoria, Australia
- Deakin School of Medicine, Geelong, Victoria, Australia
| | - Rosemary Higgins
- Australian Centre for Heart Health, North Melbourne, Victoria, Australia
- Deakin University Faculty of Health, Burwood, Victoria, Australia
| | - Michela Raciti
- Australian Centre for Heart Health, North Melbourne, Victoria, Australia
| | - Barbara M Murphy
- Australian Centre for Heart Health, North Melbourne, Victoria, Australia
- Deakin University Faculty of Health, Burwood, Victoria, Australia
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Cell Phone Application to Monitor Pain and Quality of Life in Neurogenic Pain Patients. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2020; 8:e2732. [PMID: 32440405 PMCID: PMC7209850 DOI: 10.1097/gox.0000000000002732] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 02/04/2020] [Indexed: 11/25/2022]
Abstract
Supplemental Digital Content is available in the text. Management of postoperative pain is a challenge for healthcare providers in all surgical fields, especially in the context of the current opioid epidemic. We developed a cell phone application to monitor pain, medication use, and relevant quality of life domains (eg, mood, mobility, return to work, and sleep) in patients with neurogenic pain, including those with limb loss. A literature review was conducted to define application length and design parameters. The final application includes 12 questions for patients with limb loss and 8 for patients with neurogenic pain without limb loss. Pilot testing with 21 participants demonstrates acceptable time to complete the application (mean = 158 seconds, SD = 81 seconds) and usability, based on the mHealth App Usability Questionnaire. We aim for our application to serve as an outcome measure for evaluation of an evolving group of peripheral nerve procedures, including targeted muscle reinnervation. In addition, the application could be adapted for clinical use in patients undergoing these procedures for neurogenic pain and thus serve as a tool to monitor and manage pain medication use.
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Validity and Reliability of the Persian Version of Emotion Thermometers in Iranian Advanced Cancer Patients. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT 2019. [DOI: 10.5812/ijcm.90504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Areia NP, Mitchell A, Fonseca G, Major S, Relvas AP. A Visual-Analogue Screening Tool for Assessing Mood and Quality of Daily Life Complications in Family Members of People Living With Cancer: Portuguese Version of the Emotion Thermometers: Burden Version. Eval Health Prof 2019; 43:264-269. [PMID: 31203658 DOI: 10.1177/0163278719857456] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Cancer is a disease that impacts not only the patient but also affects the entire family. Family members experience high levels of distress. Therefore, screening for cancer-specific distress among family members of people with cancer is important but relatively unexplored. This cross-sectional study aims to analyze the psychometric properties of a screening tool for family members of people with cancer. We examined the usefulness of the emotional thermometers burden version (ET-BV) in detecting caregiver emotional distress. The ET-BV is a simple multidomain visual analogue scale distributed in two major domains: "emotional upset" and "impact." A total of 364 cancer patients' family members completed the ET-BV and Brief Symptom Inventory. Analyses were aimed to examine the diagnostic accuracy (receiver operating characteristic) of the ET-BV. A fair to good diagnostic accuracy was achieved for ET-BV. For emotional upset thermometers, a cutoff of ≥5 was determined and for impact thermometers, a cutoff of ≥4 was established. ET-BV seems to be a useful, quick, and simple tool for distress screening in family members of people with cancer. A revision of a specific thermometer is discussed in order to increase ET screening performance and clinical utility.
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Affiliation(s)
- Neide P Areia
- Centre for Social Studies, University of Coimbra, Coimbra, Portugal
| | - Alex Mitchell
- Leicester Cancer Research Centre, University of Leicester, Leicester, United Kingdom
| | - Gabriela Fonseca
- Faculty of Psychology and Education Science, University of Coimbra, Coimbra, Portugal
| | - Sofia Major
- Faculty of Social Sciences and Humanities, University of Azores, Ponta Delgada, Portugal
| | - Ana P Relvas
- Faculty of Psychology and Education Science, University of Coimbra, Coimbra, Portugal
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Brief emotional screening in oncology: Specificity and sensitivity of the emotion thermometers in the Portuguese cancer population. Palliat Support Care 2019; 18:39-46. [DOI: 10.1017/s1478951519000208] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
AbstractObjectiveThis study aimed to determine the cutoff and the specificity and sensitivity of the Emotion Thermometers (ET) in a Portuguese sample of cancer patients.MethodA total of 147 patients (mean age = 49.2; SD = 12.6) completed the ET, the Brief Symptom Inventory (BSI), and the Subjective Experiences of Illness Suffering Inventory. Data were collected in a cancer support institution and in a major hospital in the North of Portugal.ResultThe optimal cutoff for the Anxiety Thermometer was 5v6 (until 5 and 6 or more), which identified 74% of the BSI-anxiety cases and 70% of noncases. The Depression Thermometer cutoff was 4v5 (until 4 and 5 or more), which identified 85% of BSI-depression cases and 82% of noncases. Cutoff for the Anger Thermometer was 4v5 (until 4 and 5 or more), which identified 83% of BSI-hostility cases and 73% of noncases; for the Distress Thermometer, the optimal cutoff was 4v5 (until 4 and 5 or more), which identified 84% of the suffering cases and 73% of noncases. Finally, for the Help Thermometer, it was 3v4 (until 3 and 4 or more), which helped to identify 93% of the suffering cases and 64% of noncases.Significance of resultsResults supported the Portuguese version of the ET as an important screening tool for identifying the emotional distress in cancer patients.
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18
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Lay S, Moody N, Johnsen S, Petersen D, Radovich P. Home Care Program Increases the Engagement in Patients With Heart Failure. HOME HEALTH CARE MANAGEMENT AND PRACTICE 2019. [DOI: 10.1177/1084822318815439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Heart failure patients seen in the outpatient home care setting and in cardiology clinics have repeated emergency department visits, hospital admissions, and readmissions despite receiving education about their medications diet and self-care interventions such as daily weights. The objective of this evidence-based practice change was to determine, in home care patients, whether the use of standardized teach-back methodology educational materials would improve their knowledge and confidence in the self-care of their chronic disease. Of the 22 patients enrolled, 15 were not readmitted to the hospital within 9 months of home care admission. The Self-Care of Heart Failure Index revealed an improvement in patient and caregiver contributions to heart failure self-care maintenance (daily adherence and symptom monitoring). The findings suggest that engaging patients by increasing their knowledge of their disease and their self-confidence can reduce hospitalizations and subsequent readmissions.
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Affiliation(s)
| | | | | | | | - Patricia Radovich
- Loma Linda University Health, CA, USA
- Loma Linda University, CA, USA
- Azusa Pacific University, CA, USA
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19
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Yoowannakul S, Tangvoraphonkchai K, Davenport A. Patient-reported intra-dialytic symptoms and post-dialysis recovery times are influenced by psychological distress rather than dialysis prescription. RENAL REPLACEMENT THERAPY 2019. [DOI: 10.1186/s41100-019-0211-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
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20
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Hoeppner BB, Schick MR, Carlon H, Hoeppner SS. Do self-administered positive psychology exercises work in persons in recovery from problematic substance use? An online randomized survey. J Subst Abuse Treat 2019; 99:16-23. [DOI: 10.1016/j.jsat.2019.01.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 01/05/2019] [Accepted: 01/07/2019] [Indexed: 01/07/2023]
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Normative values for the distress thermometer (DT) and the emotion thermometers (ET), derived from a German general population sample. Qual Life Res 2018; 28:277-282. [PMID: 30284181 DOI: 10.1007/s11136-018-2014-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE The distress thermometer (DT) and the emotion thermometers (ET) are short screening instruments for use in oncological practice. The aim of this study was to provide normative values and to analyze the correlational structure of the ET. METHODS A representative sample of the adult German general population (N = 2437) completed the ET, the PHQ-4, the FACIT-fatigue scale, and the demoralization scale. RESULTS The percentages of people above the cutoff (≥ 4) and the mean scores of the five ET scales were as follows: distress: 39.0%, M = 3.15 ± 2.62, anxiety: 12.3%, M = 1.36 ± 1.93, depression: 16.1%, M = 1.65 ± 2.11, anger: 24.5%, M = 2.33 ± 2.16, and need for help: 10.7%, M = 1.18 ± 1.90. Women reported significantly higher levels of burden than men, with effect sizes between 0.07 (anger) and 0.36 (anxiety). All ET dimensions were interrelated (r between 0.44 and 0.69) and significantly correlated with the other scales (r between 0.36 and 0.68). CONCLUSIONS The normative scores can help qualify assessments of groups of patients. The new four dimensions of the ET provide relevant additional information that is not already covered by the DT.
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Ripamonti CI, Buonaccorso L, Maruelli A, Bandieri E, Boldini S, Pessi MA, Chiesi F, Miccinesi G. Hope Herth Index (HHI): A Validation Study in Italian Patients with Solid and Hematological Malignancies on Active Cancer Treatment. TUMORI JOURNAL 2018; 98:385-92. [DOI: 10.1177/030089161209800317] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Aims and background Although hope is a widely used term, the experience of hope in patients with chronic or even life-threatening diseases is often disregarded due to the scarcity of carefully designed and validated assessment tools. The aim of this study was to validate the Hope Herth Index (HHI) questionnaire in the Italian population of patients with solid or hematological malignancies during active cancer treatment. Methods After the translation procedures, the psychometric properties of the Italian version of HHI were evaluated in 266 patients with non-advanced cancer cared for in four different settings. Summative scores ranged from 12–48, with a higher score denoting greater hope. Confirmative factorial analysis was performed to assess dimensionality. The test-retest reliability was assessed by means of the Lin concordance coefficient (two weeks' interval, 80 patients). Concurrent validity was assessed through the following questionnaires: Hospital Anxiety and Depression Scale (HADS), Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-Sp), Edmonton Symptom Assessment Scale (ESAS), and System Belief Inventory (SBI-15R). Results A total of 266 patients were enrolled. Confirmative factor analysis did not confirm the original three-factor solution, whereas a one-factor solution did perform well. Cronbach's alpha was 0.84 and the test-retest reliability was 0.64 (95% CI 0.51; 0.76). Large convergence was found with spiritual well-being as measured by the FACIT-Sp (0.69) and with anxiety-depression as measured by the HADS (inverse correlation: –0.51). Physical symptoms and religiousness were only slightly correlated, as expected. Conclusions The Italian version of HHI is a valid and reliable assessment tool – useful to initiate conversation with someone who is troubled but finds it difficult to talk – in patients with either solid or hematological malignancies on active cancer treatment during the non-advanced stages of the disease.
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Affiliation(s)
- Carla Ida Ripamonti
- Supportive Care in Cancer Unit,
Fondazione IRCCS Istituto Nazionale dei Tumori, Milan
| | - Loredana Buonaccorso
- AMO, Association of Oncological
Patients from nine towns and villages located in the northern area of Modena
| | - Alice Maruelli
- Psychology Unit, LILT and Center for
Oncological Rehabilitation, CERION, Florence
| | | | - Stefania Boldini
- Supportive Care in Cancer Unit,
Fondazione IRCCS Istituto Nazionale dei Tumori, Milan
| | - Maria Adelaide Pessi
- Supportive Care in Cancer Unit,
Fondazione IRCCS Istituto Nazionale dei Tumori, Milan
| | | | - Guido Miccinesi
- Clinical Epidemiology Unit,
ISPO-Institute for the Study and Prevention of Cancer, Florence, Italy
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Camilleri S, Chong S, Tangvoraphonkchai K, Yoowannakul S, Davenport A. Effect of Self-Reported Distress Thermometer Score on the Maximal Handgrip and Pinch Strength Measurements in Hemodialysis Patients. Nutr Clin Pract 2017; 32:682-686. [DOI: 10.1177/0884533617697936] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Affiliation(s)
- Stephanie Camilleri
- UCL Centre for Nephrology, Royal Free Hospital, University College London, London, UK
| | - Stephanie Chong
- UCL Centre for Nephrology, Royal Free Hospital, University College London, London, UK
| | | | - Suree Yoowannakul
- UCL Centre for Nephrology, Royal Free Hospital, University College London, London, UK
| | - Andrew Davenport
- UCL Centre for Nephrology, Royal Free Hospital, University College London, London, UK
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Effects of stress, health competence, and social support on depressive symptoms after cardiac hospitalization. J Behav Med 2015; 39:441-52. [PMID: 26660867 DOI: 10.1007/s10865-015-9702-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 11/25/2015] [Indexed: 12/23/2022]
Abstract
Little is known about the role of stress on the psychological well-being of patients after cardiac hospitalization or about factors that protect against or exacerbate the effects of stress. We use prospective data from 1542 patients to investigate the relationship between post-discharge stress and changes in depressive symptoms, and whether the level of prior depressive symptoms, health competence, and perceived social support moderate this relationship. Net of depressive symptoms in the 2 weeks prior to hospitalization, higher levels of post-discharge stress significantly increase depressive symptoms 30 days after discharge. The level of prior depressive symptoms moderates the effect of stress. On the other hand, perceived health competence and social support buffer the negative effects of post-discharge stress. Knowing which patients are particularly vulnerable to experiencing stress and a subsequent increase in depressive symptoms can help trigger interventions prior to discharge and possibly ameliorate the prevalence of depression.
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Drinovac M, Wagner H, Agrawal N, Cock HR, Mitchell AJ, von Oertzen TJ. Screening for depression in epilepsy: a model of an enhanced screening tool. Epilepsy Behav 2015; 44:67-72. [PMID: 25625533 DOI: 10.1016/j.yebeh.2014.12.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Revised: 12/03/2014] [Accepted: 12/13/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Depression is common but frequently underdiagnosed in people with epilepsy. Screening tools help to identify depression in an outpatient setting. We have published validation of the NDDI-E and Emotional Thermometers (ET) as screening tools for depression (Rampling et al., 2012). In the current study, we describe a model of an optimized screening tool with higher accuracy. METHODS Data from 250 consecutive patients in a busy UK outpatient epilepsy clinic were prospectively collected. Logistic regression models and recursive partitioning techniques (classification trees, random forests) were applied to identify an optimal subset from 13 items (NDDI-E and ET) and provide a framework for the prediction of class membership probabilities for the DSM-IV-based depression classification. RESULTS Both logistic regression models and classification trees (random forests) suggested the same choice of items for classification (NDDI-E item 4, NDDI-E item 5, ET-Distress, ET-Anxiety, ET-Depression). The most useful regression model includes all 5 mentioned variables and outperforms the NDDI-E as well as the ET with respect to AUC (NDDI-E: 0.903; ET7: 0.889; logistic regression: 0.943). A model developed using random forests, grown by restricting the possible splitting of variables to these 5 items using only subsets of the original data for single classification, performed similarly (AUC: 0.949). CONCLUSIONS For the first time, we have created a model of a screening tool for depression containing both verbal and visual analog scales, with characteristics supporting that this will be more precise than previous tools. Collection of a new data sample to assess out-of-sample performance is necessary for confirmation of the predictive performance.
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Affiliation(s)
- Mihael Drinovac
- Institute of Applied Statistics, Johannes Kepler University, Linz, Austria
| | - Helga Wagner
- Institute of Applied Statistics, Johannes Kepler University, Linz, Austria
| | - Niruj Agrawal
- Department of Neuropsychiatry, St George's Hospital, London, UK; Epilepsy Group, Atkinson Morley Regional Neurosciences Centre, St George's Hospital, London, UK; St George's University of London, London, UK
| | - Hannah R Cock
- Epilepsy Group, Atkinson Morley Regional Neurosciences Centre, St George's Hospital, London, UK; St George's University of London, London, UK
| | - Alex J Mitchell
- Department of Cancer Studies and Molecular Medicine, University of Leicester, Leicester, UK; Department of Psycho-oncology, Leicestershire Partnership NHS Trust, Leicester, UK
| | - Tim J von Oertzen
- St George's University of London, London, UK; Department of Neurology, Wagner-Jauregg Neuroscience Centre, Kepler University Hospital, Linz, Austria.
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van Rijsbergen GD, Burger H, Hollon SD, Elgersma HJ, Kok GD, Dekker J, de Jong PJ, Bockting CLH. How do you feel? Detection of recurrent Major Depressive Disorder using a single-item screening tool. Psychiatry Res 2014; 220:287-93. [PMID: 25070177 DOI: 10.1016/j.psychres.2014.06.052] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2014] [Revised: 06/21/2014] [Accepted: 06/30/2014] [Indexed: 10/25/2022]
Abstract
Mood is a key element of Major Depressive Disorder (MDD), and is perceived as a highly dynamic construct. The aim of the current study was to examine whether a single-item mood scale can be used for mood monitoring. One hundred thirty remitted out-patients were assessed using the Structured Clinical Interview for DSM-IV Axis-I Disorders (SCID-I), Visual Analogue Mood Scale (VAMS), 17-item Hamilton Depression Rating Scale (HAM-D17), and Inventory of Depressive Symptomatology-Self Report (IDS-SR). Of all patients, 13.8% relapsed during follow-up assessments. Area under the curves (AUCs) for the VAMS, HAM-D17 and IDS-SR were 0.94, 0.91, and, 0.86, respectively. The VAMS had the highest positive predictive value (PPV) without any false negatives at score 55 (PPV=0.53; NPV=1.0) and was the best predictor of current relapse status (variance explained for VAMS: 60%; for HAM-D17: 49%; for IDS-SR: 34%). Only the HAM-D17 added significant variance to the model (7%). Assessing sad mood with a single-item mood scale seems to be a straightforward and patient-friendly avenue for life-long mood monitoring. Using a diagnostic interview (e.g., the SCID) in case of a positive screen is warranted. Repeated assessment of the VAMS using Ecological Momentary Assessment (EMA) might reduce false positives.
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Affiliation(s)
- Gerard D van Rijsbergen
- Department of Clinical Psychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS Groningen, The Netherlands
| | - Huibert Burger
- Department of General Practice, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Steven D Hollon
- Vanderbilt University, Department of Psychology, Nashville, TN, United States
| | - Hermien J Elgersma
- Department of Clinical Psychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS Groningen, The Netherlands
| | - Gemma D Kok
- Department of Clinical Psychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS Groningen, The Netherlands
| | - Jack Dekker
- Research Department, Arkin Mental Health Care, Amsterdam, The Netherlands; Department of Clinical Psychology, VU University, Amsterdam, The Netherlands
| | - Peter J de Jong
- Department of Clinical Psychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS Groningen, The Netherlands
| | - Claudi L H Bockting
- Department of Clinical Psychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS Groningen, The Netherlands.
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Perez-Cornago A, Zulet MA, Martinez JA. Association between mood and diet quality in subjects with metabolic syndrome participating in a behavioural weight-loss programme: a cross-sectional assessment. Nutr Neurosci 2014; 18:137-44. [PMID: 24627977 DOI: 10.1179/1476830514y.0000000116] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
BACKGROUND/OBJECTIVE The interplay between individual's mood fluctuations and nutrition has important health implications. However, little information is available on the relationship between dietary intake and mood state in a population with metabolic syndrome (MetS). The aim of the present study was to evaluate the association between dietary intake and mood state in subjects with MetS. METHODS This cross-sectional study was based on the baseline data of 84 volunteers (mean age 49 ± 1 years) recruited into the Metabolic Syndrome Reduction in Navarra-Spain (RESMENA-S) study. Mood state was determined using a mood thermometer visual analogue scale. The dietary intake was assessed with a 48-hours weighted food record, from which a Healthy Eating Index (HEI) score was obtained. Anthropometrical measurements and biochemical parameters were also analysed. RESULTS At baseline, a positive association between mood thermometer and HEI was observed. Among the 10 HEI components, vegetables, fruits, calories from lipids, saturated fatty acids, and dietary variety were related with higher mood. Moreover, those participants who consumed more water, fibre, vitamin B6, ascorbic acid, tryptophan, magnesium, and selenium have higher mood. DISCUSSION In conclusion, an association between both the overall dietary pattern and isolated nutrients with mood state was observed. The analyses of both dietary patterns and specific nutrients are important to determine the association between mental disorders and dietary intake.
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Music therapy and emotional expression during chemotherapy. How do breast cancer patients feel? Eur J Integr Med 2013. [DOI: 10.1016/j.eujim.2013.04.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Rampling J, Mitchell AJ, Von Oertzen T, Docker J, Jackson J, Cock H, Agrawal N. Screening for depression in epilepsy clinics. A comparison of conventional and visual-analog methods. Epilepsia 2012; 53:1713-21. [DOI: 10.1111/j.1528-1167.2012.03571.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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