1
|
van Buchem MM, de Hond AAH, Fanconi C, Shah V, Schuessler M, Kant IMJ, Steyerberg EW, Hernandez-Boussard T. Applying natural language processing to patient messages to identify depression concerns in cancer patients. J Am Med Inform Assoc 2024; 31:2255-2262. [PMID: 39018490 DOI: 10.1093/jamia/ocae188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 06/03/2024] [Accepted: 07/09/2024] [Indexed: 07/19/2024] Open
Abstract
OBJECTIVE This study aims to explore and develop tools for early identification of depression concerns among cancer patients by leveraging the novel data source of messages sent through a secure patient portal. MATERIALS AND METHODS We developed classifiers based on logistic regression (LR), support vector machines (SVMs), and 2 Bidirectional Encoder Representations from Transformers (BERT) models (original and Reddit-pretrained) on 6600 patient messages from a cancer center (2009-2022), annotated by a panel of healthcare professionals. Performance was compared using AUROC scores, and model fairness and explainability were examined. We also examined correlations between model predictions and depression diagnosis and treatment. RESULTS BERT and RedditBERT attained AUROC scores of 0.88 and 0.86, respectively, compared to 0.79 for LR and 0.83 for SVM. BERT showed bigger differences in performance across sex, race, and ethnicity than RedditBERT. Patients who sent messages classified as concerning had a higher chance of receiving a depression diagnosis, a prescription for antidepressants, or a referral to the psycho-oncologist. Explanations from BERT and RedditBERT differed, with no clear preference from annotators. DISCUSSION We show the potential of BERT and RedditBERT in identifying depression concerns in messages from cancer patients. Performance disparities across demographic groups highlight the need for careful consideration of potential biases. Further research is needed to address biases, evaluate real-world impacts, and ensure responsible integration into clinical settings. CONCLUSION This work represents a significant methodological advancement in the early identification of depression concerns among cancer patients. Our work contributes to a route to reduce clinical burden while enhancing overall patient care, leveraging BERT-based models.
Collapse
Affiliation(s)
- Marieke M van Buchem
- Department of Medicine (Biomedical Informatics), Stanford University, Stanford, CA 94305, United States
- Clinical Artificial Intelligence Implementation and Research Lab (CAIRELab), Leiden University Medical Center, Leiden 2333ZN, The Netherlands
| | - Anne A H de Hond
- Department of Medicine (Biomedical Informatics), Stanford University, Stanford, CA 94305, United States
- Julius Centre for Health Sciences and Primary Care, University Medical Center, Utrecht 3584CX, The Netherlands
| | - Claudio Fanconi
- Department of Medicine (Biomedical Informatics), Stanford University, Stanford, CA 94305, United States
- Department of Information Technology and Electrical Engineering, ETH Zürich, Zürich 8092, Switzerland
| | - Vaibhavi Shah
- Department of Medicine (Biomedical Informatics), Stanford University, Stanford, CA 94305, United States
| | - Max Schuessler
- Department of Biomedical Data Science, Stanford University, Stanford, CA 94305, United States
| | - Ilse M J Kant
- Department of Digital Health, University Medical Center Utrecht, Utrecht 3584CX, The Netherlands
| | - Ewout W Steyerberg
- Clinical Artificial Intelligence Implementation and Research Lab (CAIRELab), Leiden University Medical Center, Leiden 2333ZN, The Netherlands
- Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden 2333ZN, The Netherlands
| | - Tina Hernandez-Boussard
- Department of Medicine (Biomedical Informatics), Stanford University, Stanford, CA 94305, United States
- Department of Biomedical Data Science, Stanford University, Stanford, CA 94305, United States
| |
Collapse
|
2
|
Akechi T, Furukawa TA, Noma H, Iwata H, Toyama T, Higaki K, Matsuoka H, Zenda S, Iwatani T, Akahane K, Inoue A, Sagara Y, Uchida M, Imai F, Momino K, Imaizumi G, Yamaguchi T, Mashiko T, Miyaji T, Horikoshi M, Sakurai N, Onishi T, Kanemitsu Y, Murata T, Wanifuchi-Endo Y, Kuroda H, Nishikawa R, Miyashita M, Abe M, Uchitomi Y. Optimizing smartphone psychotherapy for depressive symptoms in patients with cancer: Multiphase optimization strategy using a decentralized multicenter randomized clinical trial (J-SUPPORT 2001 Study). Psychiatry Clin Neurosci 2024; 78:353-361. [PMID: 38468404 DOI: 10.1111/pcn.13657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 01/28/2024] [Accepted: 02/08/2024] [Indexed: 03/13/2024]
Abstract
AIM Patients with cancer experience various forms of psychological distress, including depressive symptoms, which can impact quality of life, elevate morbidity risk, and increase medical costs. Psychotherapy and pharmacotherapy are effective for reducing depressive symptoms among patients with cancer, but most patients prefer psychotherapy. This study aimed to develop an efficient and effective smartphone psychotherapy component to address depressive symptom. METHODS This was a decentralized, parallel-group, multicenter, open, individually randomized, fully factorial trial. Patients aged ≥20 years with cancer were randomized by the presence/absence of three cognitive-behavioral therapy (CBT) skills (behavioral activation [BA], assertiveness training [AT], and problem-solving [PS]) on a smartphone app. All participants received psychoeducation (PE). The primary outcome was change in the patient health questionnaire-9 (PHQ-9) total score between baseline and week 8. Secondary outcomes included anxiety. RESULTS In total, 359 participants were randomized. Primary outcome data at week 8 were obtained for 355 participants (99%). The week 8 PHQ-9 total score was significantly reduced from baseline for all participants by -1.41 points (95% confidence interval [CI] -1.89, -0.92), but between-group differences in change scores were not significant (BA: -0.04, 95% CI -0.75, 0.67; AT: -0.16, 95% CI -0.87, 0.55; PS: -0.19, 95% CI -0.90, 0.52). CONCLUSION As the presence of any of the three intervention components did not contribute to a significant additive reduction of depressive symptoms, we cannot make evidence-based recommendations regarding the use of specific smartphone psychotherapy.
Collapse
Affiliation(s)
- Tatsuo Akechi
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
- Center for Palliative Care and Psycho-oncology, Nagoya City University Hospital, Nagoya, Japan
| | - Toshiaki A Furukawa
- Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan
| | - Hisashi Noma
- Department of Data Science, The Institute of Statistical Mathematics, Tokyo, Japan
| | - Hiroji Iwata
- Department of Breast Oncology, Aichi Cancer Center, Nagoya, Japan
| | - Tatsuya Toyama
- Department of Breast Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | | | - Hiromichi Matsuoka
- Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Sadamoto Zenda
- Division of Radiation Oncology, National Cancer Center Hospital East, Chiba, Japan
| | - Tsuguo Iwatani
- Department of Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan
| | | | - Akira Inoue
- Department of Palliative Medicine, Tohoku University School of Medicine, Sendai, Japan
| | - Yasuaki Sagara
- Department of Breast and Thyroid Surgical Oncology, Hakuaikai Medical Corporation, Sagara Hospital, Kagoshima, Japan
| | - Megumi Uchida
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
- Center for Palliative Care and Psycho-oncology, Nagoya City University Hospital, Nagoya, Japan
| | - Fuminobu Imai
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Kanae Momino
- Department of Nursing Administration and Management, Nagoya City University Graduate School of Nursing, Nagoya, Japan
| | - Gen Imaizumi
- Department of Psychiatric and Mental Health Nursing, Nagoya City University Graduate School of Nursing, Nagoya, Japan
| | - Takuhiro Yamaguchi
- Division of Biostatistics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Tomoe Mashiko
- Division of Survivorship, Institute for Cancer Control, National Cancer Center, Tokyo, Japan
| | - Tempei Miyaji
- Division of Survivorship, Institute for Cancer Control, National Cancer Center, Tokyo, Japan
| | - Masaru Horikoshi
- National Center for Cognitive Behavior Therapy and Research, National Center of Neurology and Psychiatry, Tokyo, Japan
| | | | - Tatsuya Onishi
- Department of Breast Surgery, National Cancer Center Hospital East, Chiba, Japan
| | - Yukihide Kanemitsu
- Department of Colorectal Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Takeshi Murata
- Department of Breast Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Yumi Wanifuchi-Endo
- Department of Breast Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Hiroaki Kuroda
- Department of Thoracic Surgery, Aichi Cancer Center, Nagoya, Japan
| | - Ryutaro Nishikawa
- Department of Obstetrics and Gynecology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Minoru Miyashita
- Department of Breast and Endocrine Surgical Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Masakazu Abe
- Department of Obstetrics and Gynecology, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Yosuke Uchitomi
- Division of Survivorship, Institute for Cancer Control, National Cancer Center, Tokyo, Japan
| |
Collapse
|
3
|
de Hond A, van Buchem M, Fanconi C, Roy M, Blayney D, Kant I, Steyerberg E, Hernandez-Boussard T. Predicting Depression Risk in Patients With Cancer Using Multimodal Data: Algorithm Development Study. JMIR Med Inform 2024; 12:e51925. [PMID: 38236635 PMCID: PMC10835583 DOI: 10.2196/51925] [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: 08/17/2023] [Revised: 11/11/2023] [Accepted: 12/08/2023] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND Patients with cancer starting systemic treatment programs, such as chemotherapy, often develop depression. A prediction model may assist physicians and health care workers in the early identification of these vulnerable patients. OBJECTIVE This study aimed to develop a prediction model for depression risk within the first month of cancer treatment. METHODS We included 16,159 patients diagnosed with cancer starting chemo- or radiotherapy treatment between 2008 and 2021. Machine learning models (eg, least absolute shrinkage and selection operator [LASSO] logistic regression) and natural language processing models (Bidirectional Encoder Representations from Transformers [BERT]) were used to develop multimodal prediction models using both electronic health record data and unstructured text (patient emails and clinician notes). Model performance was assessed in an independent test set (n=5387, 33%) using area under the receiver operating characteristic curve (AUROC), calibration curves, and decision curve analysis to assess initial clinical impact use. RESULTS Among 16,159 patients, 437 (2.7%) received a depression diagnosis within the first month of treatment. The LASSO logistic regression models based on the structured data (AUROC 0.74, 95% CI 0.71-0.78) and structured data with email classification scores (AUROC 0.74, 95% CI 0.71-0.78) had the best discriminative performance. The BERT models based on clinician notes and structured data with email classification scores had AUROCs around 0.71. The logistic regression model based on email classification scores alone performed poorly (AUROC 0.54, 95% CI 0.52-0.56), and the model based solely on clinician notes had the worst performance (AUROC 0.50, 95% CI 0.49-0.52). Calibration was good for the logistic regression models, whereas the BERT models produced overly extreme risk estimates even after recalibration. There was a small range of decision thresholds for which the best-performing model showed promising clinical effectiveness use. The risks were underestimated for female and Black patients. CONCLUSIONS The results demonstrated the potential and limitations of machine learning and multimodal models for predicting depression risk in patients with cancer. Future research is needed to further validate these models, refine the outcome label and predictors related to mental health, and address biases across subgroups.
Collapse
Affiliation(s)
- Anne de Hond
- Clinical AI Implementation and Research Lab, Leiden University Medical Centre, Leiden, Netherlands
- Department of Biomedical Data Sciences, Leiden University Medical Centre, Leiden, Netherlands
- Department of Medicine (Biomedical Informatics), Stanford Medicine, Stanford University, Stanford, CA, United States
| | - Marieke van Buchem
- Clinical AI Implementation and Research Lab, Leiden University Medical Centre, Leiden, Netherlands
- Department of Biomedical Data Sciences, Leiden University Medical Centre, Leiden, Netherlands
- Department of Medicine (Biomedical Informatics), Stanford Medicine, Stanford University, Stanford, CA, United States
| | - Claudio Fanconi
- Department of Medicine (Biomedical Informatics), Stanford Medicine, Stanford University, Stanford, CA, United States
- Department of Electrical Engineering and Information Technology, ETH Zürich, Zürich, Switzerland
| | - Mohana Roy
- Department of Medical Oncology, Stanford Medicine, Stanford University, Stanford, CA, United States
| | - Douglas Blayney
- Department of Medical Oncology, Stanford Medicine, Stanford University, Stanford, CA, United States
| | - Ilse Kant
- Clinical AI Implementation and Research Lab, Leiden University Medical Centre, Leiden, Netherlands
- Department of Digital Health, University Medical Centre Utrecht, Utrecht, Netherlands
| | - Ewout Steyerberg
- Clinical AI Implementation and Research Lab, Leiden University Medical Centre, Leiden, Netherlands
- Department of Biomedical Data Sciences, Leiden University Medical Centre, Leiden, Netherlands
| | - Tina Hernandez-Boussard
- Department of Medicine (Biomedical Informatics), Stanford Medicine, Stanford University, Stanford, CA, United States
- Department of Biomedical Data Science, Stanford University, Stanford, CA, United States
- Department of Epidemiology & Population Health (by courtesy), Stanford University, Stanford, CA, United States
| |
Collapse
|
4
|
Battat MMK, Marie M. Rehabilitation interventions for depression symptoms among cancer patients in Palestine: A systematic review. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:978844. [PMID: 36545130 PMCID: PMC9760909 DOI: 10.3389/fresc.2022.978844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 10/31/2022] [Indexed: 12/12/2022]
Abstract
Background Depression enhances the disease burden in patients with cancer. Psychological interventions and the rehabilitation of depression are required as a part of palliative care for cancer patients to improve their quality of life and mental health.The aim of the study was to review the literature about depression rehabilitation interventions among patients with cancer in Palestine. Method The electronic databases used: PubMed, Science Direct, Research Gate, and Google Scholar to search for systematic review articles for the review study. Results A total of 23 articles were reviewed, including five from Palestine and five from Arab and Islamic nations. Pharmacological and non-pharmacological interventions used to decrease symptoms of depression and enhance mental health among cancer patients represent the majority of interventions for depression rehabilitation in cancer patients. Interventions for depression rehabilitation among cancer patients in Palestine are only available from the perspective of palliative care, which also involves family education, managing the symptoms of cancer patients, and providing psychological support. Conclusion In Palestine, non-pharmacological interventions, such as psychological interventions, are the primary options for treating and recovering from symptoms of depression. The management of symptoms in cancer patients also has a favorable impact on mental health and recovery from depression. In Palestine, there is a need for improvement in palliative care, particularly interventions for depressive symptoms. The main reason Palestinian patients with cancer have such limited treatment and recovery options are because of Israeli occupation.
Collapse
Affiliation(s)
- Maher Mohammad Khalil Battat
- Head Nurse of Bone Marrow Transplant and Leukemia Unit, An-Najah National University Hospital, Nablus, Palestine,Correspondence: Maher Mohammad Khalil Battat
| | - Mohammad Marie
- Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| |
Collapse
|
5
|
Chronister BNC, Wu T, Santella RM, Neugut AI, Wolff MS, Chen J, Teitelbaum SL, Parada H. Dietary Acid Load, Serum Polychlorinated Biphenyl Levels, and Mortality Following Breast Cancer in the Long Island Breast Cancer Study Project. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:ijerph19010374. [PMID: 35010632 PMCID: PMC8751127 DOI: 10.3390/ijerph19010374] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 12/17/2021] [Accepted: 12/23/2021] [Indexed: 12/14/2022]
Abstract
Dietary acid load (DAL) may be associated with all-cause mortality (ACM) and breast cancer-specific mortality (BCM), and these associations may be modified by serum polychlorinated biphenyl (PCB) levels. Participants included 519 women diagnosed with first primary in situ or invasive breast cancer in 1996/1997 with available lipid-corrected PCB data. After a median of 17 years, there were 217 deaths (73 BCM). Potential renal acid load (PRAL) and net endogenous acid production (NEAP) scores calculated from a baseline food frequency questionnaire estimated DAL. Cox regression estimated covariate-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for associations between PRAL and NEAP with mortality. We evaluated effect measure modification by total serum PCB levels (>median vs. ≤median). PRAL quartile 4 versus quartile 1 was associated with an ACM HR of 1.31 (95%CI = 0.90-1.92). In the upper median of PCBs, ACM HRs were 1.43 (95%CI = 0.96-2.11) and 1.40 (95%CI = 0.94-2.07) for PRAL and NEAP upper medians, respectively. In the lower median of PCBs, the upper median of NEAP was inversely associated with BCM (HR = 0.40, 95%CI = 0.19-0.85). DAL may be associated with increased risk of all-cause mortality following breast cancer among women with high total serum PCB levels, but inversely associated with breast cancer mortality among women with low PCB levels.
Collapse
Affiliation(s)
- Briana N. C. Chronister
- Herbert Wertheim School of Public Health, University of California, San Diego, CA 92093, USA;
- School of Public Health, San Diego State University, San Diego, CA 92182, USA;
| | - Tianying Wu
- School of Public Health, San Diego State University, San Diego, CA 92182, USA;
| | - Regina M. Santella
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY 10027, USA;
| | - Alfred I. Neugut
- Department of Medicine, Vagelos College of Physicians and Surgeons and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10027, USA;
| | - Mary S. Wolff
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (M.S.W.); (J.C.); (S.L.T.)
| | - Jia Chen
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (M.S.W.); (J.C.); (S.L.T.)
| | - Susan L. Teitelbaum
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (M.S.W.); (J.C.); (S.L.T.)
| | - Humberto Parada
- School of Public Health, San Diego State University, San Diego, CA 92182, USA;
- UC San Diego Moores Cancer Center, San Diego, CA 92037, USA
- Department of Radiation Medicine & Applied Science, University of California, San Diego, CA 92037, USA
- Correspondence: ; Tel.: +1-619-594-0980
| |
Collapse
|
6
|
Fear of Cancer Recurrence and Death Anxiety: Unaddressed Concerns for Adult Neuro-oncology Patients. J Clin Psychol Med Settings 2021; 28:16-30. [PMID: 31848927 DOI: 10.1007/s10880-019-09690-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Primary brain tumor (PBT) patients may experience existential distress; however, few studies have examined this issue. The objectives of this study were to (1) systematically review PBT representation in psycho-oncology literature regarding fear/anxiety related to progression, recurrence, and death and (2) preliminarily assess the prevalence of fear of dying in a sample of PBT patients. Systematic searching of three databases yielded 1555 articles for review. Of these, 327 studies met inclusion criteria (patient sample N = 132,951). Only eight studies (0.18% of the participants) included patients with a PBT diagnosis, potentially due to exclusion criteria such as cognitive impairment or specific treatment parameters which may prohibit PBT patient participation. Review of the results from the eight included studies revealed mixed methods and limited demographic analyses; existential distress was correlated with heightened depression and anxiety, and overall worsened quality of life. From the original data collection, approximately one-third of PBT patients endorsed fear of dying, which was positively related to depression severity. Taken together, results suggest that PBT patients are considerably underrepresented in existential psycho-oncology literature, despite preliminary findings suggesting prevalence of these concerns. Future research on existential distress in neuro-oncology is warranted.
Collapse
|
7
|
Meggiolaro E, De Padova S, Ruffilli F, Bertelli T, Bragagni M, Prati S, Pisotti L, Massa I, Foca F, Tamberi S, De Giorgi U, Zerbinati L, Tiberto E, Grassi L. From Distress Screening to Uptake: An Italian Multicenter Study of Cancer Patients. Cancers (Basel) 2021; 13:cancers13153761. [PMID: 34359662 PMCID: PMC8345103 DOI: 10.3390/cancers13153761] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 07/22/2021] [Accepted: 07/23/2021] [Indexed: 01/30/2023] Open
Abstract
INTRODUCTION Little consideration is given to the referral and uptake of available supportive services after distress screening. However, identifying the reasons for accepting or refusing help is mandatory for implementing a screening policy. The present study explored the practical usefulness of and potential barriers to the application of distress management. METHODS 406 cancer patients were consecutively selected and asked to complete the Distress Thermometer (DT) and Problem Check List (PL). All patients with a DT score ≥6 were invited for a post-DT telephone interview with a trained psychologist. RESULTS The 112 patients who refused to take part were more often older, retired, at a more advanced stage of illness, and with no previous experience of psychological intervention with respect to those who accepted. Of the 78 patients with a score ≥6 who were referred to the Psycho-Oncology Service, 65.4% accepted the telephone interview. Twenty-two patients rejected the initial invitation immediately for various reasons including logistic difficulties, physical problems, and feeling embarrassed about opening up to a psychologist. CONCLUSIONS Our study confirms that screening per sé is insufficient to deal with the problem of distress and that more emphasis should be placed on implementing referral and treatment.
Collapse
Affiliation(s)
- Elena Meggiolaro
- Psycho-Oncology Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, Italy; (S.D.P.); (F.R.); (T.B.)
- Correspondence: ; Tel.: +39-0543-739260; Fax: +39-0543-739151
| | - Silvia De Padova
- Psycho-Oncology Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, Italy; (S.D.P.); (F.R.); (T.B.)
| | - Federica Ruffilli
- Psycho-Oncology Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, Italy; (S.D.P.); (F.R.); (T.B.)
| | - Tatiana Bertelli
- Psycho-Oncology Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, Italy; (S.D.P.); (F.R.); (T.B.)
| | - Marina Bragagni
- Nursing and Technical Administration, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, Italy; (M.B.); (S.P.); (L.P.)
| | - Sabrina Prati
- Nursing and Technical Administration, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, Italy; (M.B.); (S.P.); (L.P.)
| | - Lidia Pisotti
- Nursing and Technical Administration, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, Italy; (M.B.); (S.P.); (L.P.)
| | - Ilaria Massa
- Healthcare Administration, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, Italy;
| | - Flavia Foca
- Unit of Biostatistics and Clinical Trials, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, Italy;
| | - Stefano Tamberi
- Medical Oncology Unit, Ospedale degli Infermi, 48018 Faenza, Italy;
| | - Ugo De Giorgi
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, Italy;
| | - Luigi Zerbinati
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, 44121 Ferrara, Italy; (L.Z.); (E.T.); (L.G.)
| | - Elisa Tiberto
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, 44121 Ferrara, Italy; (L.Z.); (E.T.); (L.G.)
| | - Luigi Grassi
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, 44121 Ferrara, Italy; (L.Z.); (E.T.); (L.G.)
| |
Collapse
|
8
|
Acid-Producing Diet and Depressive Symptoms among Breast Cancer Survivors: A Longitudinal Study. Cancers (Basel) 2020; 12:cancers12113183. [PMID: 33138152 PMCID: PMC7692146 DOI: 10.3390/cancers12113183] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 10/21/2020] [Accepted: 10/27/2020] [Indexed: 12/22/2022] Open
Abstract
Simple Summary Depressive symptoms, which are highly prevalent among breast cancer survivors, can significantly influence quality of life and increase total mortality. The aim of our prospective study was to determine whether acid-producing diets have an adverse impact on depression. Our study demonstrated that a higher consumption of acid-producing diets was significantly associated with depressive symptoms among breast cancer survivors, especially among those who were younger than 55 and had a sedentary lifestyle. Abstract The incidence of depression is two-to-three times higher in cancer survivors than the general population. Acid-producing diets may play important roles in the development of depression. Cancer survivors are more susceptible to acid-producing diets, yet few prospective studies have investigated the association of acid-producing diets with depression among breast cancer survivors. We leveraged a large cohort of 2975 early stage breast cancer survivors, which collected detailed dietary data via 24-h recalls. Potential renal acid load (PRAL) and net endogenous acid production (NEAP), two commonly used dietary acid load scores, were used to estimate acid-producing diets. Intakes of PRAL and NEAP were assessed at baseline and years one and four. Increased PRAL and NEAP were each independently associated with increased depression in the longitudinal analyses, after adjusting for covariates. The magnitude of the associations was stronger for PRAL than NEAP. Women with the highest quartile intakes of PRAL had 1.34 (95% CI 1.11–1.62) times the risk of depression compared to women with the lowest quartile. Furthermore, we also observed a joint impact of PRAL and younger age on depression, as well as a joint impact of PRAL and physical activity on depression. Decreasing the consumption of acid-producing diets may be a novel and practical strategy for reducing depressive symptoms among breast cancer survivors, especially those who are younger and have a sedentary lifestyle.
Collapse
|
9
|
Loughan AR, Aslanzadeh FJ, Brechbiel J, Rodin G, Husain M, Braun SE, Willis KD, Lanoye A. Death-related distress in adult primary brain tumor patients. Neurooncol Pract 2020; 7:498-506. [PMID: 33014390 DOI: 10.1093/nop/npaa015] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Background A diagnosis of cancer may increase mortality salience and provoke death-related distress. Primary brain tumor (PBT) patients may be at particular risk for such distress given the certainty of tumor progression, lack of curative treatments, and poor survival rates. This study is the first to examine the prevalence of death-related distress and its correlates in PBT patients. Methods Adult PBT patients (N = 105) enrolled in this cross-sectional study and completed the Death Distress Scale (subscales: Death Depression, Death Anxiety, Death Obsession), Generalized Anxiety Disorder-7, and Patient Health Questionnaire-9. Prevalence and predictors of death-related distress, and the relationships of demographic variables to clusters of distress, were explored. Results The majority of PBT patients endorsed clinically significant death-related distress in at least one domain. Death anxiety was endorsed by 81%, death depression by 12.5%, and death obsession by 10.5%. Generalized anxiety was the only factor associated with global death-related distress. Cluster analysis yielded 4 profiles: global distress, emotional distress, resilience, and existential distress. Participants in the resilience cluster were significantly further out from diagnosis than those in the existential distress cluster. There were no differences in cluster membership based on age, sex, or tumor grade. Conclusions PBT patients appear to have a high prevalence of death-related distress, particularly death anxiety. Further, 4 distinct profiles of distress were identified, supporting the need for tailored approaches to addressing death-related distress. A shift in clusters of distress based on time since diagnosis also suggest the need for future longitudinal assessment.
Collapse
Affiliation(s)
- Ashlee R Loughan
- Virginia Commonwealth University, Department of Neurology, Division of Neuro-Oncology, Richmond, Virginia.,Massey Cancer Center, Richmond, Virginia.,Virginia Commonwealth University, School of Medicine, Richmond, Virginia
| | - Farah J Aslanzadeh
- Virginia Commonwealth University, Department of Psychology, Richmond, Virginia
| | - Julia Brechbiel
- Virginia Commonwealth University, Department of Psychology, Richmond, Virginia
| | - Gary Rodin
- Princess Margaret Cancer Centre, University Health Network, Department of Supportive Care, Toronto, Ontario, Canada.,University of Toronto, Department of Psychiatry, Toronto, Ontario, Canada
| | - Mariya Husain
- Virginia Commonwealth University, School of Medicine, Richmond, Virginia
| | - Sarah E Braun
- Virginia Commonwealth University, Department of Psychology, Richmond, Virginia.,Medical University of South Carolina, Department of Psychiatry & Behavioral Sciences, Charleston, South Carolina
| | - Kelcie D Willis
- Virginia Commonwealth University, Department of Psychology, Richmond, Virginia
| | - Autumn Lanoye
- Virginia Commonwealth University, School of Medicine Department of Health Behavior and Policy, Richmond, Virginia
| |
Collapse
|
10
|
Shoval G, Balicer RD, Feldman B, Hoshen M, Eger G, Weizman A, Zalsman G, Stubbs B, Golubchik P, Gordon B, Krivoy A. Adherence to antidepressant medications is associated with reduced premature mortality in patients with cancer: A nationwide cohort study. Depress Anxiety 2019; 36:921-929. [PMID: 31332883 DOI: 10.1002/da.22938] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 03/24/2019] [Accepted: 05/25/2019] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Depression and anxiety are common in cancer and antidepressants (AD) are efficacious treatment. The relationship between AD adherence and mortality in cancer is unclear. This study aimed to evaluate the association between adherence to AD and all-cause mortality in a population-based cohort of patients with cancer. MATERIALS AND METHODS We conducted a 4-year historical prospective cohort study including 42,075 patients with cancer who purchased AD at least once during the study period. Adherence to AD was modeled as nonadherence (<20%), poor (20-50%), moderate (50-80%), and good (>80%) adherence. We conducted multivariable survival analyses adjusted for demographic and clinical variables that may affect mortality. RESULTS During 1,051,489 person-years at risk follow-up, the adjusted hazard ratios (HR) for mortality were 0.89 (95% confidence interval [CI]: 0.83-0.95), 0.77 (95% CI: 0.66-0.72), and 0.80 (95% CI: 0.76-0.85) for the poor, moderate, and good adherence groups, respectively, compared to the nonadherent group. Analysis of the entire sample and a subgroup with depression, for cancer subtypes, revealed similar patterns for breast, colon, lung, and prostate cancers, but not for melanoma patients. Multivariate predictors of premature mortality included male gender (HR 1.48 [95% CI: 1.42-1.55]), current/past smoking status (HR 1.1, [95% CI: 1.04-1.15]; P < .0001), low socioeconomic status (HR 1.1, [95% CI: 1.03-1.17]; P < .0001) and more physical comorbidities. CONCLUSIONS The present study is the first to demonstrate that higher adherence to AD is associated with a decrease of all-cause mortality in a large nationwide cohort of cancer patients. Our data add to the pressing need to encourage adherence to AD among cancer patients.
Collapse
Affiliation(s)
- Gal Shoval
- Chief Physician Office, Clalit Health Services, Clalit Research Institute, Tel Aviv, Israel.,Child and Adolescent Division, Geha Mental Health Center, Petah Tiqva, Israel.,Department of Psychiatry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ran D Balicer
- Chief Physician Office, Clalit Health Services, Clalit Research Institute, Tel Aviv, Israel.,Public Health Department, Faculty of Health Sciences, Ben-Gurion University, Beer-Sheva, Israel
| | - Becca Feldman
- Chief Physician Office, Clalit Health Services, Clalit Research Institute, Tel Aviv, Israel
| | - Moshe Hoshen
- Chief Physician Office, Clalit Health Services, Clalit Research Institute, Tel Aviv, Israel
| | - Gilad Eger
- Child and Adolescent Division, Geha Mental Health Center, Petah Tiqva, Israel.,Department of Psychiatry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Abraham Weizman
- Child and Adolescent Division, Geha Mental Health Center, Petah Tiqva, Israel.,Department of Psychiatry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Division of Molecular Imaging and Neuropathology, Department of Psychiatry, Columbia University, New York, New York
| | - Gil Zalsman
- Child and Adolescent Division, Geha Mental Health Center, Petah Tiqva, Israel.,Department of Psychiatry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Division of Molecular Imaging and Neuropathology, Department of Psychiatry, Columbia University, New York, New York.,Felsenstein Medical Research Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Brendon Stubbs
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Pavel Golubchik
- Child and Adolescent Division, Geha Mental Health Center, Petah Tiqva, Israel.,Department of Psychiatry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Barak Gordon
- Medical Corps, Israel Defense Forces, Tel Aviv, Israel.,Department of Family Medicine, Faculty of Medicine, Hebrew University, Jerusalem, Israel
| | - Amir Krivoy
- Chief Physician Office, Clalit Health Services, Clalit Research Institute, Tel Aviv, Israel.,Child and Adolescent Division, Geha Mental Health Center, Petah Tiqva, Israel.,Department of Psychiatry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| |
Collapse
|
11
|
Xia S, Sun M, Liu X. Major depression but not minor to intermediate depression correlates with unfavorable prognosis in surgical colorectal cancer patients underwent adjuvant chemotherapy. PSYCHOL HEALTH MED 2019; 25:309-318. [PMID: 31397608 DOI: 10.1080/13548506.2019.1643032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- Shuli Xia
- Department of General Surgery 10, The 2nd Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Meiling Sun
- Department of Nursing, The 2nd Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Xuesong Liu
- Department of Nursing, The 2nd Affiliated Hospital of Harbin Medical University, Harbin, China
| |
Collapse
|
12
|
The Relationship Between Emotional Functioning of the EORTC QLQ-C30 and A Measure of Anxiety and Depression (HADS) in Cancer Patients. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT 2019. [DOI: 10.5812/ijcm.94568] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
13
|
Sudarisan SSP, Abraham B, George C. Prevalence, correlates of depression, and its impact on quality of life of cancer patients attending a palliative care setting in South India. Psychooncology 2019; 28:1308-1313. [DOI: 10.1002/pon.5083] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2018] [Revised: 03/23/2019] [Accepted: 03/27/2019] [Indexed: 11/06/2022]
Affiliation(s)
| | - Bennet Abraham
- Department of AnesthesiaDr. SMCSI Medical College and Hospital Trivandrum India
| | - Christina George
- Department of PsychiatryDr. SMCSI Medical College and Hospital Trivandrum India
| |
Collapse
|
14
|
Mccorkle R, Hughes L, Robinson L, Levine B, Nuamah I. Nursing Interventions for Newly Diagnosed Older Cancer Patients Facing Terminal Illness. J Palliat Care 2019. [DOI: 10.1177/082585979801400308] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Ruth Mccorkle
- Center for Excellence in Chronic Illness Management, Yale University, School of Nursing, New Haven, Connecticut
| | - Linda Hughes
- Department of Adult Nursing, University of Texas School of Nursing, Medical Branch at Galveston, Galveston, Texas
| | - Linda Robinson
- University of San Diego, School of Nursing, San Diego, California
| | - Barbara Levine
- Center for Advancing Care in Serious Illness, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
| | - Isaac Nuamah
- Center for Advancing Care in Serious Illness, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
| |
Collapse
|
15
|
Miwata K, Masuda T, Yamaguchi K, Sakamoto S, Horimasu Y, Miyamoto S, Nakashima T, Iwamoto H, Fujitaka K, Hamada H, Hattori N. Performance Status Is a Risk Factor for Depression before the Diagnosis of Lung Cancer Patients. Intern Med 2019; 58:915-920. [PMID: 30568143 PMCID: PMC6478988 DOI: 10.2169/internalmedicine.1812-18] [Citation(s) in RCA: 5] [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] [Indexed: 01/10/2023] Open
Abstract
Objective Previous studies have shown that lung cancer patients experience depression before their diagnosis. However, the patient characteristics that are risk factors for depression before the diagnosis of lung cancer are unclear. We therefore performed this study to identify the characteristics that are risk factors for depression in lung cancer patients. Methods We performed a prospective observational study that included 183 patients who visited our department for suspected lung cancer between August 2014 and March 2017. These patients completed a Quick Inventory of Depressive Symptomatology-Self Report questionnaire. Ten patients with a history of depression were excluded. Results Among the remaining 173 patients, 110 were diagnosed with lung cancer. Among these 110 patients, 57 had depression. A poor performance status (PS) was significantly more prevalent in patients with depression than in those without. Furthermore, a multivariate analysis revealed that a poor PS was the only independent risk factor for depression before the diagnosis of lung cancer. Conclusion Physicians can use this information to evaluate whether patients have depression before the diagnosis of lung cancer.
Collapse
Affiliation(s)
- Kei Miwata
- Department of Respiratory Internal Medicine, Hiroshima University Hospital, Japan
| | - Takeshi Masuda
- Department of Respiratory Internal Medicine, Hiroshima University Hospital, Japan
| | - Kakuhiro Yamaguchi
- Department of Respiratory Internal Medicine, Hiroshima University Hospital, Japan
| | - Shinjiro Sakamoto
- Department of Respiratory Internal Medicine, Hiroshima University Hospital, Japan
| | - Yasushi Horimasu
- Department of Respiratory Internal Medicine, Hiroshima University Hospital, Japan
| | - Shintaro Miyamoto
- Department of Respiratory Internal Medicine, Hiroshima University Hospital, Japan
| | - Taku Nakashima
- Department of Respiratory Internal Medicine, Hiroshima University Hospital, Japan
| | - Hiroshi Iwamoto
- Department of Respiratory Internal Medicine, Hiroshima University Hospital, Japan
| | - Kazunori Fujitaka
- Department of Respiratory Internal Medicine, Hiroshima University Hospital, Japan
| | - Hironobu Hamada
- Department of Respiratory Internal Medicine, Hiroshima University Hospital, Japan
| | - Noboru Hattori
- Department of Respiratory Internal Medicine, Hiroshima University Hospital, Japan
| |
Collapse
|
16
|
Li Q, Lin Y, Xu Y, Zhou H. The impact of depression and anxiety on quality of life in Chinese cancer patient-family caregiver dyads, a cross-sectional study. Health Qual Life Outcomes 2018; 16:230. [PMID: 30545383 PMCID: PMC6293618 DOI: 10.1186/s12955-018-1051-3] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 11/25/2018] [Indexed: 12/15/2022] Open
Abstract
Background Cancer and its treatment can result in psychological distress in both adults with cancer and in their family caregivers. This psychological distress acts as a significant adverse factor in patient-caregiver dyads. The study purposes included: (i) to assess anxiety and depression in adults with cancer and their family caregivers, and examine the dyadic relationship of anxiety and depression in patient-caregiver dyads; (ii) to investigate factors that may modify these relationships; and (iii) to explore the impact of anxiety and depression on patient-caregiver dyad quality of life (QOL). Methods This was a secondary analysis of a cross-sectional study. Participants consisted of 641 patient-caregiver dyads. Participants completed a survey assessing adults with cancer-related, family caregiver-related, and family-related variables using a demographic/clinical information sheet. In addition, anxiety/depression and QOL were assessed by using the Chinese version of the Hospital Anxiety and Depression Scale and SF-12 respectively. Data were analyzed by using descriptive statistics, Pearson correlations, subgroup analysis, and the Actor-Partner Interdependence Model. Results Nearly one-third of participants had experienced anxiety and depression. Adults with cancer and family caregivers experienced a similar degree of anxiety and depression. Correlations (r) of anxiety and depression between patient-caregiver dyads ranged from 0.25 to 0.32. Various factors influencing the anxiety and depression relationship between patient-caregiver dyads were identified, including adults with cancer-related (e.g., age, gender, marital status, level of being informed about the disease, different types of cancer and treatment), family caregiver-related (e.g., being the spouse of a patient, duration in their role as a family caregiver, and amount of time spent on caregiving each day), and family-related (family relationship pre- and post-cancer, financial burden on the family due to cancer treatment) variables. To some extent, both actor and partner effects were identified for anxiety and depression on the QOL of patient-caregiver dyads. Conclusions Study findings call attention to anxiety and depression, as well as related factors, in patient-caregiver dyads. The underlined essential components and focus of intervention, which will be developed to decrease psychological distress and improve QOL in patient-caregiver dyads, included individual characteristics of patient-caregiver dyads, family relationship, and anxiety and depression in their counterparts. Electronic supplementary material The online version of this article (10.1186/s12955-018-1051-3) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Qiuping Li
- Wuxi Medical School, Jiangnan University, Wuxi, Jiangsu Province, China.
| | - Yi Lin
- Wuxi Medical School, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Yinghua Xu
- Wuxi People's Hospital, Wuxi, Jiangsu Province, China
| | - Huiya Zhou
- Wuxi People's Hospital, Wuxi, Jiangsu Province, China
| |
Collapse
|
17
|
Akechi T, Okuyama T, Onishi J, Morita T, Furukawa TA. WITHDRAWN: Psychotherapy for depression among incurable cancer patients. Cochrane Database Syst Rev 2018; 11:CD005537. [PMID: 30480780 PMCID: PMC6517274 DOI: 10.1002/14651858.cd005537.pub3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND The most common psychiatric diagnosis among cancer patients is depression; this diagnosis is even more common among patients with advanced cancer. Psychotherapy is a patient-preferred and promising strategy for treating depression among cancer patients. Several systematic reviews have investigated the effectiveness of psychological treatment for depression among cancer patients. However, the findings are conflicting, and no review has focused on depression among patients with incurable cancer. OBJECTIVES To investigate the effects of psychotherapy for treating depression among patients with advanced cancer by conducting a systematic review of randomized controlled trials (RCTs). SEARCH METHODS We searched the Cochrane Pain, Palliative and Supportive Care Group Register, The Cochrane Controlled Trials Register, MEDLINE, EMBASE, CINAHL, and PsycINFO databases in September 2005. SELECTION CRITERIA All relevant RCTs comparing any kind of psychotherapy with conventional treatment for adult patients with advanced cancer were eligible for inclusion. Two independent review authors identified relevant studies. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data from the original reports using standardized data extraction forms. Two independent review authors also assessed the methodological quality of the selected studies according to the recommendations of a previous systematic review of psychological therapies for cancer patients that utilized ten internal validity indicators. The primary outcome was the standardized mean difference (SMD) of change between the baseline and immediate post-treatment scores. MAIN RESULTS We identified a total of ten RCTs (total of 780 participants); data from six studies were used for meta-analyses (292 patients in the psychotherapy arm and 225 patients in the control arm). Among these six studies, four studies used supportive psychotherapy, one adopted cognitive behavioural therapy, and one adopted problem-solving therapy. When compared with treatment as usual, psychotherapy was associated with a significant decrease in depression score (SMD = -0.44, 95% confidence interval [CI] = -0.08 to -0.80). None of the studies focused on patients with clinically diagnosed depression. AUTHORS' CONCLUSIONS Evidence from RCTs of moderate quality suggest that psychotherapy is useful for treating depressive states in advanced cancer patients. However, no evidence supports the effectiveness of psychotherapy for patients with clinically diagnosed depression.
Collapse
Affiliation(s)
- Tatsuo Akechi
- Nagoya City University Graduate School of Medical SciencesDepartment of Psychiatry & Cognitive‐Behavioral MedicineMizuho‐cho, Mizuho‐kuNagoyaAichiJapan467 8601
| | - Toru Okuyama
- Nagoya City University Graduate School of Medical SciencesDepartment of Psychiatry & Cognitive‐Behavioral MedicineMizuho‐cho, Mizuho‐kuNagoyaAichiJapan467 8601
| | - Joji Onishi
- Nagoya University Graduate School of MedicineDepartment of Geriatrics65 Tsurumai‐cho, Schowa‐kuNagoyaAichiJapan466‐8550
| | - Tatsuya Morita
- Seirei Mikatabara HospitalSeirei HospicePalliative care team and Seirei Hospice3453 Mikatabara‐choHamamatsuShizuokaJapan433 8558
| | - Toshi A Furukawa
- Kyoto University Graduate School of Medicine/School of Public HealthDepartment of Health Promotion and Human BehaviorYoshida Konoe‐cho, Sakyo‐ku,KyotoJapan606‐8501
| | | |
Collapse
|
18
|
Zhou J, Han X, Fan J, Feng P, Song J, Jiang G, Zheng Y. Bad Healthy State Compress Temporal Extension Both in Past and Future Orientations. Front Psychol 2018; 9:1703. [PMID: 30254598 PMCID: PMC6141731 DOI: 10.3389/fpsyg.2018.01703] [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: 08/27/2017] [Accepted: 08/23/2018] [Indexed: 11/26/2022] Open
Abstract
We examined how different health states and cancer-related depression influence time perception in temporal extension (TE) regarding the past and the future over individuals' entire lives. We used the magnitude estimation method to investigate TE (past and future) and long duration (20 years), and directly measured patients with cancer and their subjective feelings about their lives. In Experiment 1, we investigated whether there were differences in perceptions of TE between patients with cancer (n = 144) compared to a healthy control group (n = 208). Results indicated that the patients with cancer group evaluated longer TE in healthy states (imagination condition) than in unhealthy states (objectivity condition), and the healthy control group evaluated longer TE in healthy states (objectivity condition) than in unhealthy states (imagination condition). Moreover, the patients with cancer group evaluated longer past-oriented TE than future-oriented TE, whereas the healthy control group evaluated longer future-oriented TE than past-oriented TE. Experiment 2 was conducted to further examine the unexplained findings of Experiment 1. Results indicated that because of the impact of depression on the cancer group, their embodied time system slowed down, and explicit behavior indicated an over-evaluation of time, resulting in group differences. In conclusion, TE could be affected by different health states. Moreover, healthy and unhealthy states may be more associated with future and past orientation, respectively. Lastly, individuals' time perception can be influenced by depression.
Collapse
Affiliation(s)
- Jia Zhou
- Center for Studies of Education and Psychology of Ethnic Minorities in Southwest China, Southwest University, Chongqing, China
- School of Humanities and Management Science, Southwest Medical University, Luzhou, China
| | - Xingping Han
- Department of Oncology, Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Juan Fan
- Department of Oncology, Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Pan Feng
- Faculty of Psychology, Southwest University, Chongqing, China
| | - Jingjing Song
- Faculty of Psychology, Southwest University, Chongqing, China
| | - Guangyu Jiang
- Faculty of Psychology, Southwest University, Chongqing, China
| | - Yong Zheng
- Center for Studies of Education and Psychology of Ethnic Minorities in Southwest China, Southwest University, Chongqing, China
- Faculty of Psychology, Southwest University, Chongqing, China
| |
Collapse
|
19
|
Smyth JA, Dempster M, Warwick I, Wilkinson P, McCorry NK. A Systematic Review of the Patient- and Carer-Related Factors Affecting the Experience of Pain for Advanced Cancer Patients Cared for at Home. J Pain Symptom Manage 2018; 55:496-507. [PMID: 28843458 DOI: 10.1016/j.jpainsymman.2017.08.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 08/15/2017] [Accepted: 08/15/2017] [Indexed: 11/25/2022]
Abstract
CONTEXT Effective pain management is a priority in the palliative care of advanced cancer patients. A body of research is emerging examining the factors that influence the management and experience of pain for such individuals. Identifying such factors should allow for the development of targeted interventions to improve pain management in the home while ultimately reducing unnecessary suffering for the patient. OBJECTIVES The objective of this study was to identify relevant patient- and carer-related factors which have an effect on the pain experienced by advanced cancer patients cared for at home. METHOD This is a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) statement guidelines. Studies were retrieved from the CINAHL, MEDLINE, and Web of Science and assessed independently by two reviewers with discrepancies assessed by a third before quality assessment and data extraction. A narrative synthesis was produced. RESULTS Our search strategy produced 720 hits, of which 10 studies were retained for the final analysis. The factors identified included carer knowledge of cancer pain management, carer burden, carer and patient distress, pain rating disparity, patient well-being, patient depression, patient affective experience, patient body image, and satisfaction with palliative/medical care. All factors identified are supported by only some evidence with many having only been explored in single studies. CONCLUSIONS There is a lack of quantitative research in the area of factors influencing the experience of pain for advanced cancer patients cared for at home. Such findings would be useful in developing theories of change that would underpin interventions aimed at improving pain outcomes for this population.
Collapse
Affiliation(s)
- John A Smyth
- School of Psychology, Queen's University, Belfast, UK
| | | | | | | | - Noleen K McCorry
- Centre of Excellence for Public Health Northern Ireland, Queen's University, Belfast, UK
| |
Collapse
|
20
|
Grossman CH, Brooker J, Michael N, Kissane D. Death anxiety interventions in patients with advanced cancer: A systematic review. Palliat Med 2018; 32:172-184. [PMID: 28786328 DOI: 10.1177/0269216317722123] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Death anxiety is a common issue in adult patients with advanced cancer and can have a large impact on quality of life and end-of-life care. Interventions are available to assist but are scarcely used in everyday practice. AIM To assess quantitative studies on interventions for adult patients with advanced cancer suffering from death anxiety. DATA SOURCES MEDLINE, PsycINFO, Embase and CINAHL were searched to identify quantitative or mixed studies on death anxiety or relatable existential intervention studies in advanced cancer patients published from 1990 to December 2016. Two reviewers independently screened titles and abstracts and assessed relevant studies for eligibility. Data were then extracted from included studies for analysis. RESULTS Nine unique quantitative studies were identified, including five randomised controlled trials, involving a total overall of 1179 advanced cancer patients. All studies were psychotherapeutic in nature and centred on existential themes such as meaning, dignity, relationships and spiritual well-being. The therapies investigated shared overlapping themes but varied in duration, therapist experience, training required and burden on patient. Heterogeneity of studies and measures prevented determination of an overall effect size. CONCLUSION Interventions were identified for this clinical scenario of death anxiety in patients with advanced cancer. Therapies of short duration incorporating spiritual well-being and those evoking a sense of meaning were claimed to be the most beneficial, despite lacking rigorous statistical analysis. More high-quality studies with tailored outcome measures are required to fully evaluate the most effective interventions for death anxiety in patients with advanced cancer.
Collapse
Affiliation(s)
- Christopher H Grossman
- 1 Palliative Care Research Department, Cabrini Institute, Cabrini Health, Melbourne, VIC, Australia.,2 Palliative Care Service, Cabrini Health, Prahran, VIC, Australia
| | - Joanne Brooker
- 3 Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia.,4 Szalmuk Family Psycho-Oncology Research Unit, Cabrini Health, Malvern, VIC, Australia
| | - Natasha Michael
- 1 Palliative Care Research Department, Cabrini Institute, Cabrini Health, Melbourne, VIC, Australia.,2 Palliative Care Service, Cabrini Health, Prahran, VIC, Australia.,5 School of Medicine, Sydney, University of Notre Dame, Sydney, NSW, Australia.,6 Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC, Australia
| | - David Kissane
- 1 Palliative Care Research Department, Cabrini Institute, Cabrini Health, Melbourne, VIC, Australia.,3 Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia.,4 Szalmuk Family Psycho-Oncology Research Unit, Cabrini Health, Malvern, VIC, Australia.,7 Supportive and Palliative Care Unit, Monash Health, Clayton, VIC, Australia
| |
Collapse
|
21
|
Bužgová R, Sikorová L, Kozáková R, Jarošová D. Predictors of Change in Quality of Life in Patients With End-Stage Disease During Hospitalization. J Palliat Care 2017; 32:69-76. [PMID: 28884618 DOI: 10.1177/0825859717724687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Currently, there are no studies aimed at evaluating the quality of life (QoL) of patients with end-stage disease during hospitalization and the factors that influence it. AIM The aim of the research was to identify predictors of change in the QoL of patients hospitalized due to advanced stage of disease. METHODS The sample consisted of 140 patients with end-stage disease who were hospitalized on this account. For evaluation of QoL, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) was used. The Hospital Anxiety and Depression Scale and Karnofsky Performance Status questionnaires were used for the assessment of mental and functional status. For the evaluation of predictors of negative change in QoL, a logistic regression analysis was used. RESULTS During hospitalization, there was a significant deterioration in the scores given for all domains of the functional QLQ-C30 scale, but not the symptomatic scale. Predictors of change in overall QoL detected were marital status, improved functional status, and depression detected on admission to hospital. Gender and age were found to be protective factors against deterioration in overall QoL. CONCLUSION Sociodemographic characteristics and mental and functional status may be associated with change in QoL of patients with end-stage disease during hospitalization.
Collapse
Affiliation(s)
- Radka Bužgová
- 1 Department of Nursing and Midwifery, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Lucie Sikorová
- 1 Department of Nursing and Midwifery, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Radka Kozáková
- 1 Department of Nursing and Midwifery, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Darja Jarošová
- 1 Department of Nursing and Midwifery, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| |
Collapse
|
22
|
Aminisani N, Nikbakht H, Asghari Jafarabadi M, Shamshirgaran SM. Depression, anxiety, and health related quality of life among colorectal cancer survivors. J Gastrointest Oncol 2017; 8:81-88. [PMID: 28280612 DOI: 10.21037/jgo.2017.01.12] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The aim of this study was to examine the relationship between psychological distress and quality of life (QOL) dimensions in colorectal cancer (CRC) patients. METHODS This cross-sectional study was conducted in the North of Iran. A total of 157 CRC survivors were selected from the registry database and included in this study. Psychological distress was measured using the Hospital Anxiety and Depression Scale (HADS) and QOL was estimated using the European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire C30 (EORTC QLQ C-30). The association between the patients' emotional functioning (EF) score on EORTC QLQ-C30 and their HADS scores was analysed through multiple linear regression. RESULTS In statistical terms, there were significantly negative relationships between EF and HADS-A (anxiety), and between HADS-D (depression) and HADS-T (total score). However, compared with HADS-A, the correlation between HADS-D and other QOL dimensions was significantly higher. By the same token, depression rather than anxiety was more strongly associated with reduced QOL. CONCLUSIONS The EF dimension of the EORTC QLQ-C30 predominantly assesses anxiety; however, depression has a stronger impact on the global QOL of patients than anxiety. Therefore, the use of an additional instrument is recommended for the assessment of depression in outpatients with CRC.
Collapse
Affiliation(s)
- Nayyereh Aminisani
- Epidemiology and Statistics Department, Faculty of Health Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hosseinali Nikbakht
- Social Determinants of Health Research Centre, Babol University of Medical Sciences and Epidemiology Department, Faculty of Health Sciences, Shiraz University of Medical Sciences, Iran
| | | | - Seyed Morteza Shamshirgaran
- Epidemiology and Statistics Department, Faculty of Health Sciences, Tabriz University of Medical Sciences, Tabriz, Iran;; Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| |
Collapse
|
23
|
Li M, Kennedy EB, Byrne N, Gérin-Lajoie C, Katz MR, Keshavarz H, Sellick S, Green E. Systematic review and meta-analysis of collaborative care interventions for depression in patients with cancer. Psychooncology 2016; 26:573-587. [PMID: 27643388 DOI: 10.1002/pon.4286] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 08/17/2016] [Accepted: 09/15/2016] [Indexed: 01/06/2023]
Abstract
BACKGROUND Previous systematic reviews have found limited evidence for the effectiveness of pharmacological and psychological interventions for the management of depression in patients with cancer. This paper provides the first meta-analysis of newer collaborative care interventions, which may include both types of treatment, as well as integrated delivery and follow-up. Meta-analyses of pharmacological and psychological interventions are included as a comparison. METHODS A search of MEDLINE, EMBASE, PsycINFO, and the Cochrane Library from July 2005 to January 2015 for randomized controlled trials of depression treatments for cancer patients diagnosed with a major depressive disorder, or who met a threshold on a validated depression rating scale was conducted. Meta-analyses were conducted using summary data. RESULTS Key findings included eight reports of four collaborative care interventions, eight pharmacological, and nine psychological trials. A meta-analysis demonstrated that collaborative care interventions were significantly more effective than usual care (standardized mean difference = -0.49, p = 0.003), and depression reduction was maintained at 12 months. By comparison, short-term (up to 12 weeks), but not longer-term effectiveness was demonstrated for both pharmacological and psychological interventions. CONCLUSIONS Collaborative care interventions have newly emerged as multidisciplinary care delivery models, which may result in more long-term depression remission. This review also updates previous findings of modest evidence for the effectiveness of both pharmacological and psychological interventions for threshold depression in cancer patients. Research designs focusing on combined treatments and delivery systems may best further the limited evidence-base for the management of depression in cancer.
Collapse
Affiliation(s)
- Madeline Li
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Erin B Kennedy
- Cancer Care Ontario, Program in Evidence-based Care/McMaster University, Hamilton, Ontario, Canada
| | - Nelson Byrne
- Trillium Health Partners, Mississauga Halton-Central West Regional Cancer Program, Mississauga, Ontario, Canada
| | | | - Mark R Katz
- Stronach Regional Cancer Centre, Southlake Regional Health Centre, Ontario, Canada
| | - Homa Keshavarz
- Cancer Care Ontario, Program in Evidence-based Care/McMaster University, Hamilton, Ontario, Canada
| | - Scott Sellick
- Thunder Bay Regional Health Sciences Centre, Thunder Bay, Ontario, Canada
| | - Esther Green
- Nursing and Psychosocial Oncology, Cancer Care Ontario, Toronto, Ontario, Canada
| |
Collapse
|
24
|
Li Q, Lin Y, Hu C, Xu Y, Zhou H, Yang L, Xu Y. The Chinese version of hospital anxiety and depression scale: Psychometric properties in Chinese cancer patients and their family caregivers. Eur J Oncol Nurs 2016; 25:16-23. [PMID: 27865248 DOI: 10.1016/j.ejon.2016.09.004] [Citation(s) in RCA: 113] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2016] [Revised: 08/29/2016] [Accepted: 09/09/2016] [Indexed: 12/13/2022]
Abstract
PURPOSE The Hospital Anxiety and Depression Scale (HADS) acts as one of the most frequently used self-reported measures in cancer practice. The evidence for construct validity of HADS, however, remains inconclusive. The objective of this study is to evaluate the psychometric properties of the Chinese version HADS (C-HADS) in terms of construct validity, internal consistency reliability, and concurrent validity in dyads of Chinese cancer patients and their family caregivers. METHODS This was a cross-sectional study, conducted in multiple centers: one hospital in each of the seven different administrative regions in China from October 2014 to May 2015. A total of 641 dyads, consisting of cancer patients and family caregivers, completed a survey assessing their demographic and background information, anxiety and depression using C-HADS, and quality of life (QOL) using Chinese version SF-12. Data analysis methods included descriptive statistics, confirmatory factor analysis (CFA), and Pearson correlations. RESULTS Both the two-factor and one-factor models offered the best and adequate fit to the data in cancer patients and family caregivers respectively. The comparison of the two-factor and single-factor models supports the basic assumption of two-factor construct of C-HADS. The overall and two subscales of C-HADS in both cancer patients and family caregivers had good internal consistency and acceptable concurrent validity. CONCLUSIONS The Chinese version of the HADS may be a reliable and valid screening tool, as indicated by its original two-factor structure. The finding supports the basic assumption of two-factor construct of HADS.
Collapse
Affiliation(s)
- Qiuping Li
- Wuxi Medical School, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Yi Lin
- Wuxi Medical School, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Caiping Hu
- Shanxi Provincial Tomor Hospital, Taiyuan, Shanxi Province, China
| | - Yinghua Xu
- Wuxi People's Hospital, Wuxi, Jiangsu Province, China.
| | - Huiya Zhou
- Wuxi People's Hospital, Wuxi, Jiangsu Province, China
| | - Liping Yang
- Xijing Hospital, Xi'an, Shaanxi Province, China
| | - Yongyong Xu
- Department of Health Statistics, Fourth Military Medical University, Xi'an, Shaanxi Province, China.
| |
Collapse
|
25
|
Itani Y, Arakawa A, Tsubamoto H, Ito K, Nishikawa R, Inoue K, Yamamoto S, Miyagi Y, Hori K, Furukawa N. Validation of the distress and impact thermometer and the changes of mood during the first 6 months of treatment in gynecological cancer patients: a Kansai Clinical Oncology Group (KCOG)-G1103 prospective study. Arch Gynecol Obstet 2016; 294:1273-1281. [PMID: 27488702 DOI: 10.1007/s00404-016-4166-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 07/28/2016] [Indexed: 12/30/2022]
Abstract
PURPOSE To verify distress and impact thermometer (DIT) for screening emotional distress in gynecological cancer patients by Hospital Anxiety and Depression Scale total (HADS-T) as gold standard and to assess emotional changes by DIT and HADS-T. METHODS A prospective study was conducted in newly diagnosed gynecological cancer patients during the peri-treatment period after the cancer diagnosis followed by 6-month. We defined a HADS-T score of ≥11 as being indicative of emotional distress. RESULTS 117 patients were enrolled between May 1, 2011 and March 31, 2012, and 95 were eligible. The median age was 54 years (range 31-77). (1) From the baseline to 3-month, distress (DIT-D) ≥4 with Impact (DIT-I) ≥2 exhibited sensitivity, specificity, positive predictive value (PPV), and negative predictive values (NPV) of 0.776 [95 % confidential interval (CI) 0.688, 0.850], 0.889 (95 % CI 0.824, 0.954), 0.868 (95 % CI 0.792, 0.949), and 0.808 (95 % CI 0.731, 0.886), respectively. (2) At 6-month, DIT-D ≥2 with DIT-I ≥1 exhibited sensitivity, specificity, PPV and NPV of 0.893 (95 % CI 0.778, 1), 0.825 (95 % CI 0.707, 0.942), 0.781 (95 % CI 0.638, 0.928), and 0.917 (95 % CI 0.826, 1). (3) At 6-month, the HADS-T, DIT-D, and DIT-I scores in individual patients were significantly reduced by a mean of 4.57 (p < 0.0001), 2.34 (p < 0.0001), and 1.10 (p = 0.0031), respectively, compared with those scores of baseline (Student's paired t test), but still remained high. CONCLUSIONS (1) On acute phase within 3-month setting, DIT; DIT-D ≥4 with DIT-I ≥2, is a reliable cut-off to screen emotional distress among gynecological cancer patients. (2) The patients' moods had improved, but not completely recovered at 6-month after the diagnosis.
Collapse
Affiliation(s)
- Y Itani
- Department of Obstetrics and Gynecology, Nara Prefecture General Medical Center, Nara, Japan.
| | - A Arakawa
- Department of Obstetrics and Gynecology, Nagoya City University Graduate School of Medicine, Nagoya, Japan
| | - H Tsubamoto
- Department of Obstetrics and Gynecology, Hyogo College of Medicine, Nishinomiya, Japan
| | - K Ito
- Department of Obstetrics and Gynecology, Kansai Rosai Hospital, Amagasaki, Japan
| | - R Nishikawa
- Department of Obstetrics and Gynecology, Nagoya City University Graduate School of Medicine, Nagoya, Japan
| | - K Inoue
- Department of Obstetrics and Gynecology, Meiwa General Hospital, Amagasaki, Japan
| | - S Yamamoto
- Department of Obstetrics and Gynecology, Kansai Rosai Hospital, Amagasaki, Japan
| | - Y Miyagi
- Department of Gynecology Okayama, Ohfuku Clinic, Okayama, Japan
| | - K Hori
- Department of Obstetrics and Gynecology, Kansai Rosai Hospital, Amagasaki, Japan
| | - N Furukawa
- Department of Obstetrics and Gynecology, Nara Prefectural Seiwa Medical Center, Ikomagun-Sangocho, Japan
| |
Collapse
|
26
|
Li M, Kennedy EB, Byrne N, Gérin-Lajoie C, Katz MR, Keshavarz H, Sellick S, Green E. Management of Depression in Patients With Cancer: A Clinical Practice Guideline. J Oncol Pract 2016; 12:747-56. [PMID: 27382000 DOI: 10.1200/jop.2016.011072] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
PURPOSE This report updates the Cancer Care Ontario Program in Evidence-Based Care guideline for the management of depression in adult patients with cancer. This guideline covers pharmacologic, psychological, and collaborative care interventions, with a focus on integrating practical management tools to assist clinicians in delivering appropriate treatments for depression in patients with cancer. METHODS Recommendations were developed by synthesizing information from extant guidelines and reviews and searching for randomized controlled trials from the date of database inception (1964 for MEDLINE and 1974 for EMBASE) to January 2015. Quality assessment of guidelines and systematic reviews were conducted by using the Appraisal of Guidelines for Research and Evaluation II (AGREE II), Assessment of Multiple Systematic Reviews (AMSTAR), and Cochrane Risk of Bias tools. Final recommendations were developed through a standardized Program in Evidence-Based Care multidisciplinary expert and knowledge user review process. RESULTS Two high-quality relevant clinical practice guidelines, eight pharmacologic trials, nine psychological trials, and eight collaborative care intervention trials composed the evidence base upon which the recommendations were developed. Eight specific recommendations were made to establish a standard of care for the management of depression in patients with cancer. The recommendations and practical management tools were reviewed as being well organized and helpful, although systemic barriers to implementation were identified. CONCLUSION This updated guideline supports the previous general recommendation that patients with cancer who have depression may benefit from psychological and/or pharmacologic interventions, without evidence for the superiority of any specific treatment over another. New recommendations for a collaborative care model that incorporates a stepped care approach suggest that multidisciplinary mental health care restructuring may be required for optimal management of depression.
Collapse
Affiliation(s)
- Madeline Li
- Princess Margaret Cancer Centre, University Health Network; Cancer Care Ontario; and University of Toronto, Toronto; Cancer Care Ontario Program in Evidence-Based Care, McMaster University, Hamilton; Trillium Health Partners, Mississauga Halton-Central West Regional Cancer Program, Mississauga; Ottawa Hospital Cancer Centre, Ottawa; Stronach Regional Cancer Centre and Southlake Regional Health Centre, Newmarket; and Thunder Bay Regional Health Sciences Centre, Thunder Bay, Ontario, Canada
| | - Erin B Kennedy
- Princess Margaret Cancer Centre, University Health Network; Cancer Care Ontario; and University of Toronto, Toronto; Cancer Care Ontario Program in Evidence-Based Care, McMaster University, Hamilton; Trillium Health Partners, Mississauga Halton-Central West Regional Cancer Program, Mississauga; Ottawa Hospital Cancer Centre, Ottawa; Stronach Regional Cancer Centre and Southlake Regional Health Centre, Newmarket; and Thunder Bay Regional Health Sciences Centre, Thunder Bay, Ontario, Canada
| | - Nelson Byrne
- Princess Margaret Cancer Centre, University Health Network; Cancer Care Ontario; and University of Toronto, Toronto; Cancer Care Ontario Program in Evidence-Based Care, McMaster University, Hamilton; Trillium Health Partners, Mississauga Halton-Central West Regional Cancer Program, Mississauga; Ottawa Hospital Cancer Centre, Ottawa; Stronach Regional Cancer Centre and Southlake Regional Health Centre, Newmarket; and Thunder Bay Regional Health Sciences Centre, Thunder Bay, Ontario, Canada
| | - Caroline Gérin-Lajoie
- Princess Margaret Cancer Centre, University Health Network; Cancer Care Ontario; and University of Toronto, Toronto; Cancer Care Ontario Program in Evidence-Based Care, McMaster University, Hamilton; Trillium Health Partners, Mississauga Halton-Central West Regional Cancer Program, Mississauga; Ottawa Hospital Cancer Centre, Ottawa; Stronach Regional Cancer Centre and Southlake Regional Health Centre, Newmarket; and Thunder Bay Regional Health Sciences Centre, Thunder Bay, Ontario, Canada
| | - Mark R Katz
- Princess Margaret Cancer Centre, University Health Network; Cancer Care Ontario; and University of Toronto, Toronto; Cancer Care Ontario Program in Evidence-Based Care, McMaster University, Hamilton; Trillium Health Partners, Mississauga Halton-Central West Regional Cancer Program, Mississauga; Ottawa Hospital Cancer Centre, Ottawa; Stronach Regional Cancer Centre and Southlake Regional Health Centre, Newmarket; and Thunder Bay Regional Health Sciences Centre, Thunder Bay, Ontario, Canada
| | - Homa Keshavarz
- Princess Margaret Cancer Centre, University Health Network; Cancer Care Ontario; and University of Toronto, Toronto; Cancer Care Ontario Program in Evidence-Based Care, McMaster University, Hamilton; Trillium Health Partners, Mississauga Halton-Central West Regional Cancer Program, Mississauga; Ottawa Hospital Cancer Centre, Ottawa; Stronach Regional Cancer Centre and Southlake Regional Health Centre, Newmarket; and Thunder Bay Regional Health Sciences Centre, Thunder Bay, Ontario, Canada
| | - Scott Sellick
- Princess Margaret Cancer Centre, University Health Network; Cancer Care Ontario; and University of Toronto, Toronto; Cancer Care Ontario Program in Evidence-Based Care, McMaster University, Hamilton; Trillium Health Partners, Mississauga Halton-Central West Regional Cancer Program, Mississauga; Ottawa Hospital Cancer Centre, Ottawa; Stronach Regional Cancer Centre and Southlake Regional Health Centre, Newmarket; and Thunder Bay Regional Health Sciences Centre, Thunder Bay, Ontario, Canada
| | - Esther Green
- Princess Margaret Cancer Centre, University Health Network; Cancer Care Ontario; and University of Toronto, Toronto; Cancer Care Ontario Program in Evidence-Based Care, McMaster University, Hamilton; Trillium Health Partners, Mississauga Halton-Central West Regional Cancer Program, Mississauga; Ottawa Hospital Cancer Centre, Ottawa; Stronach Regional Cancer Centre and Southlake Regional Health Centre, Newmarket; and Thunder Bay Regional Health Sciences Centre, Thunder Bay, Ontario, Canada
| |
Collapse
|
27
|
The OECI model: the experience of INT Milan with a focus on the integration of psycho-oncology support. TUMORI JOURNAL 2016; 101 Suppl 1:S25-32. [PMID: 27096269 DOI: 10.5301/tj.5000469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2015] [Indexed: 11/20/2022]
Abstract
The procedure for Organisation of European Cancer Institutes (OECI) accreditation identified the formation of MDTs for the diagnosis and scheduling of primary treatment with integration of supportive care as a key strength at Istituto Nazionale Tumori (INT). The opportunities for improvement highlighted by the OECI peer review inspired a study on the evaluation of psychological distress, with a view to integrating this evaluation into global patient management and to defining standardized criteria for the provision of psychological services. This article describes the OECI accreditation experience at INT and the study conducted between January and May 2015 on the evaluation of patients' distress levels during cancer treatment, defining a score-based cutoff point that triggers the intervention of a psychologist. The Distress Thermometer was used as a tool for evaluating psychological distress, performed by nurses on admitting the patient. A total of 261 questionnaires were completed by patients admitted to the medical oncology and hematology departments, with an average distress value of 4.1, and 60% of patients experiencing clinically detectable emotional distress. Emotion-related problems had a significant association with a greater level of distress, while there were few reports of relationship issues as a cause of distress. As a result of the improvement initiative supported by the psychological distress evaluation study, we validated the screening questionnaire to be included at the initial patient evaluation stage with a cutoff point triggering the intervention by a psychologist at a score of ≥7.
Collapse
|
28
|
Pergolizzi JV, Zampogna G, Taylor R, Gonima E, Posada J, Raffa RB. A Guide for Pain Management in Low and Middle Income Communities. Managing the Risk of Opioid Abuse in Patients with Cancer Pain. Front Pharmacol 2016; 7:42. [PMID: 26973529 PMCID: PMC4771925 DOI: 10.3389/fphar.2016.00042] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 02/15/2016] [Indexed: 11/18/2022] Open
Abstract
Most patients who present with cancer have advanced disease and often suffer moderate to severe pain. Opioid therapy can be safe and effective for use in cancer patients with pain, but there are rightful concerns about inappropriate opioid use even in the cancer population. Since cancer patients live longer than ever before in history (and survivors may have long exposure times to opioid therapy), opioid misuse among cancer patients is an important topic worthy of deeper investigation. Cancer patients with pain must be evaluated for risk factors for potential opioid misuse and aberrant drug-taking behaviors assessed. A variety of validated screening tools should be used. Of particular importance is the fact that pain in cancer patients changes frequently, whether it is related to their underlying disease (progression or remission), pain related to treatment (such as painful chemotherapy-induced peripheral neuropathy), and concomitant pain unrelated to cancer (such as osteoarthritis, headache, or back pain). Fortunately, clinicians can use universal precautions to help reduce the risk of opioid misuse while still assuring that cancer patients get the pain therapy they need. Another important new “tool” in this regard is the emergence of abuse-deterrent opioid formulations.
Collapse
Affiliation(s)
- Joseph V Pergolizzi
- Department of Medicine, Johns Hopkins University School of MedicineBaltimore, MD, USA; Department of Anesthesiology, Georgetown University School of MedicineWashington, DC, USA; Department of Pharmacology, Temple University School of MedicinePhiladelphia, PA, USA
| | | | | | - Edmundo Gonima
- Anesthesiologist, Pain and Palliative Care, Pain Specialist in Hospital Militar Bogota, Colombia
| | - Jose Posada
- Psychiatry, Colombian National Board of Narcotics Bogota, Colombia
| | - Robert B Raffa
- Department of Pharmaceutical Sciences, Temple University School of Pharmacy Philadelphia, PA, USA
| |
Collapse
|
29
|
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]
|
30
|
Assessing anxiety and depression with respect to the quality of life in cancer inpatients receiving palliative care. Eur J Oncol Nurs 2015; 19:667-72. [DOI: 10.1016/j.ejon.2015.04.006] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Revised: 04/24/2015] [Accepted: 04/28/2015] [Indexed: 11/19/2022]
|
31
|
Ristevska-Dimitrovska G, Stefanovski P, Smichkoska S, Raleva M, Dejanova B. Depression and Resilience in Breast Cancer Patients. Open Access Maced J Med Sci 2015; 3:661-5. [PMID: 27275304 PMCID: PMC4877904 DOI: 10.3889/oamjms.2015.119] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 11/10/2015] [Accepted: 11/11/2015] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE: A significant number of breast cancer patients, during their life with the diagnosis, experience emotional distress in the form of depression and anxiety. Psychological resilience is the ability of a person to protect his/her mental health when faced with adverse circumstances such as the cancer diagnosis. This study aims to assess the resilience in breast cancer patients and to explore whether depression affects the resilience. MATERIAL AND METHODS: Two hundred eighteen (218) women, treated for early breast cancer responded to Connor - Davidson Resilience Scale and Hospital Depression and Anxiety Scale, in order to assess the level of psychological resilience and the level of depression. RESULTS: There is a significant negative correlation between depression and resilience in our sample (r = - 0.562, p < 0.001). Individuals with higher levels of depression have lower levels of psychological resilience. There is no statistically significant correlation between the ages of the participants; time passed since diagnosis, cancer stage and resilience levels. CONCLUSION: This study shows that patients who are less depressed have higher levels of resilience and that psychological resilience may independently contribute to lower levels of depression among breast cancer patients. The level of psychological resilience may be a protective factor for depression and psychological distress.
Collapse
Affiliation(s)
| | - Petar Stefanovski
- Clinical Hospital Dr. Trifun Panovski, Department of Oncology, Bitola, Republic of Macedonia
| | - Snezhana Smichkoska
- University Clinic for Radiotherapy and Oncology, Medical Faculty, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
| | - Marija Raleva
- University Clinic of Psychiatry, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
| | - Beti Dejanova
- Department of Medical and Experimental Physiology with Anthropology, Medical Faculty, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
| |
Collapse
|
32
|
Tang MH, Castle DJ, Choong PFM. Identifying the prevalence, trajectory, and determinants of psychological distress in extremity sarcoma. Sarcoma 2015; 2015:745163. [PMID: 25767410 PMCID: PMC4342175 DOI: 10.1155/2015/745163] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Revised: 12/31/2014] [Accepted: 01/05/2015] [Indexed: 01/07/2023] Open
Abstract
Objective. Extremity sarcoma (ES) is a rare cancer that presents with unique challenges. This study was performed to identify the prevalence, trajectory, and determinants of distress and characterise sources of stress in this cohort. Methods. Consecutive patients with ES were prospectively recruited between May 2011 and December 2012. Questionnaires were administered during initial diagnosis and then six months and one year after surgery. Results. Distress was reported by about a third of our cohort and associated with poorer physical function, poorer quality of life, and pain. In addition to fears regarding mortality and life role changes, the most common sources of stress were centered on dissatisfaction with the healthcare system, such as frustrations with a lack of communication with the hospital regarding appointments and lack of education regarding management and outcomes. Conclusions. Psychological distress presents early in the cancer journey and persists up to one year after surgery. Distress is associated with negative outcomes. Active screening and effective interventions are necessary to improve outcomes. Sources of stress have been identified that may be amenable to targeted interventions.
Collapse
Affiliation(s)
- Melissa H. Tang
- St. Vincent's Hospital Melbourne, 35 Victoria Parade, Fitzroy, VIC 3065, Australia
| | - David J. Castle
- St. Vincent's Hospital Melbourne, 35 Victoria Parade, Fitzroy, VIC 3065, Australia
| | - Peter F. M. Choong
- St. Vincent's Hospital Melbourne, 35 Victoria Parade, Fitzroy, VIC 3065, Australia
| |
Collapse
|
33
|
Kepple AL, Azzam PN, Gopalan P, Arnold RM. Decision-making capacity at the end of life. PROGRESS IN PALLIATIVE CARE 2014. [DOI: 10.1179/1743291x14y.0000000109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
|
34
|
Indicators of psychiatric disorders in different oncology specialties: a prevalence study. JOURNAL OF ONCOLOGY 2014; 2014:350262. [PMID: 24829578 PMCID: PMC4009332 DOI: 10.1155/2014/350262] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/21/2013] [Revised: 02/28/2014] [Accepted: 03/20/2014] [Indexed: 01/06/2023]
Abstract
Objective. This study evaluated the prevalence of various indicators of psychiatric disorders in Brazilian outpatients with cancer and assessed possible associations with sociodemographic indicators. Materials and Methods. A total of 1,385 patients were evaluated using the following instruments: Patient Health Questionnaire-4 (PHQ-4), Generalized Anxiety Disorder (GAD-7), Fagerström Test for Nicotine Dependence (FTND), and Fast Alcohol Screening Test (FAST). Results. The sample was composed of both genders with a slight predominance of women (55.8%), subjects with incomplete/completed elementary school (59%), married (67.4%), with children (94%), not active from a labor viewpoint (61.6%), and following some type of religion (79.5%). The prevalence of anxiety for the total sample varied between 21.5 and 27.4%. The prevalence of depression was 21.1%, tobacco abuse/dependence was 40.2%, and alcohol was 20.3%. Women had significantly higher levels of anxiety and depression than men. Men had higher levels of substance abuse/dependence indicators than women. Conclusion. These results are consistent with the literature, which attests to the high prevalence of psychiatric disorder indicators in cancer patients, especially compared to the general population.
Collapse
|
35
|
Lo C, Hales S, Jung J, Chiu A, Panday T, Rydall A, Nissim R, Malfitano C, Petricone-Westwood D, Zimmermann C, Rodin G. Managing Cancer And Living Meaningfully (CALM): phase 2 trial of a brief individual psychotherapy for patients with advanced cancer. Palliat Med 2014; 28:234-42. [PMID: 24170718 DOI: 10.1177/0269216313507757] [Citation(s) in RCA: 95] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Advanced cancer brings substantial physical and psychosocial challenges that may contribute to emotional distress and diminish well-being. In this study, we present preliminary data concerning the effectiveness of a new brief individual psychotherapy, Managing Cancer And Living Meaningfully (CALM), designed to help individuals cope with this circumstance. AIM To test the feasibility and preliminary effectiveness of CALM to reduce emotional distress and promote psychological well-being and growth. DESIGN CALM is a brief, manualized, semi-structured individual psychotherapy for patients with advanced cancer. This study employed a phase 2 intervention-only design. The primary outcome was depressive symptoms and the secondary outcomes were death anxiety, attachment security, spiritual well-being and psychological growth. These were assessed at 3 months (t1) and 6 months (t2). Multilevel regression was used to model change over time. SETTING/PARTICIPANTS A total of 50 patients with advanced or metastatic cancer were recruited from the Princess Margaret Cancer Centre, Toronto, Canada. RESULTS A total of 39 patients (78%) were assessed at baseline, 24 (48%) at t1, and 16 (32%) at t2. Analyses revealed reductions over time in depressive symptoms: beta = -0.13, confidence interval (CI.95) = (-0.23, -0.022) and death anxiety: beta = -0.23, CI.95 (-0.40, -0.061); and an increase in spiritual well-being: beta = 0.14, CI.95 (0.026, 0.26). CONCLUSIONS CALM may be a feasible intervention to benefit patients with advanced cancer. The results are encouraging, despite attrition and small effect sizes, and support further study.
Collapse
Affiliation(s)
- Chris Lo
- 1Department of Psychosocial Oncology and Palliative Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
36
|
Barrera I, Spiegel D. Review of psychotherapeutic interventions on depression in cancer patients and their impact on disease progression. Int Rev Psychiatry 2014; 26:31-43. [PMID: 24716499 DOI: 10.3109/09540261.2013.864259] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Depression, ranging from mild to severe, is the most frequently found psychological symptom among individuals with cancer. Depression in cancer patients has been known to mitigate emotional distress, quality of life, adherence to medical treatment, and overall health outcomes. Specifically, depression has been associated with impaired immune response and with poorer survival in patients with cancer. Various studies have found that psychotherapeutic interventions are effective in reducing symptoms of depression, which in turn could affect disease progression and mortality. This paper provides updated information on psychotherapeutic interventions geared towards cancer patients suffering from depressive disorders, and its impact on disease progression. PubMed, Cochrane Library database, PsycINFO and PsycARTICLES databases were searched from January 1980 through August 2013 using key words: psychotherapy, treatment, oncology, cancer, psycho-oncology, psychosocial issues, psychosocial stress, depression, mood disorder, and psychoneuroimmunology.
Collapse
Affiliation(s)
- Ingrid Barrera
- Department of Psychiatry and Behavioral Science, Miller School of Medicine, University of Miami , Miami, Florida , USA
| | | |
Collapse
|
37
|
FitzHenry F, Wells N, Slater V, Dietrich MS, Wisawatapnimit P, Chakravarthy AB. A randomized placebo-controlled pilot study of the impact of healing touch on fatigue in breast cancer patients undergoing radiation therapy. Integr Cancer Ther 2013; 13:105-13. [PMID: 24105358 DOI: 10.1177/1534735413503545] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
PURPOSE This is a pilot study investigating the effect of healing touch (HT) on fatigue in breast cancer patients undergoing radiation therapy (RT). METHODS/DESIGN This study presents the results of a within-subjects design randomized clinical trial where the treatment group was treated with HT, whereas the control group experienced sham therapy. The setting was a university RT clinic. The participants were breast cancer patients treated with lumpectomy or mastectomy, 21 to 75 years old with an Eastern Cooperative Oncology Group (ECOG) score of 0 to 2. The intervention was a 45-minute session of HT or sham therapy once a week during RT. Outcome measures included fatigue, quality of life (QOL), and anxiety/depression. RESULT A total of 70 patients were approached, with 41 completing the study. At completion, the HT participants tended to report higher levels of fatigue, statistically significant for interference ( : = .010) and usual fatigue ( : = .024). The control group tended to report greater reductions in fatigue relative to their own means than the HT group (Cohen's : = 0.30 to 0.49 vs 0.06 to 0.18, respectively). There were no statistically significant differences between the groups for QOL. CONCLUSION Our enrollment and retention indicate that HT is feasible for women during RT. Our pilot findings do not support a beneficial effect of HT on fatigue or QOL. Future research may explore increasing dose and teasing out therapist effect.
Collapse
|
38
|
Archie P, Bruera E, Cohen L. Music-based interventions in palliative cancer care: a review of quantitative studies and neurobiological literature. Support Care Cancer 2013; 21:2609-24. [PMID: 23715815 PMCID: PMC3728458 DOI: 10.1007/s00520-013-1841-4] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2012] [Accepted: 04/21/2013] [Indexed: 12/23/2022]
Abstract
PURPOSE This study aimed to review quantitative literature pertaining to studies of music-based interventions in palliative cancer care and to review the neurobiological literature that may bare relevance to the findings from these studies. METHODS A narrative review was performed, with particular emphasis on RCTs, meta-analyses, and systematic reviews. The Cochrane Library, Ovid, PubMed, CINAHL Plus, PsycINFO, and ProQuest were searched for the subject headings music, music therapy, cancer, oncology, palliative care, pain, anxiety, depression, mood, quality of life, prevalence, neuroscience, functional imaging, endogenous opioids, GABA, 5HT, dopamine, and permutations of these same search terms. Data for the review were comprised of articles published between 1970 and 2012. References of all the cited articles were also reviewed. RESULTS Available evidence suggests that music-based interventions may have a positive impact on pain, anxiety, mood disturbance, and quality of life in cancer patients. Advances in neurobiology may provide insight into the potential mechanisms by which music impacts these outcomes. CONCLUSIONS More research is needed to determine what subpopulation of cancer patients is most likely to respond to music-based interventions, what interventions are most effective for individual outcomes, and what measurement parameters best gauge their effectiveness.
Collapse
Affiliation(s)
- Patrick Archie
- Celilo Cancer Center, Mid-Columbia Medical Center, 1800 East 19th Street, The Dalles, OR 97058, USA.
| | | | | |
Collapse
|
39
|
Associations of interleukin-6 with vegetative but not affective depressive symptoms in terminally ill cancer patients. Support Care Cancer 2013; 21:2097-106. [DOI: 10.1007/s00520-013-1767-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2012] [Accepted: 02/15/2013] [Indexed: 10/27/2022]
|
40
|
Cooke L, Grant M, Gemmill R. Discharge needs of allogeneic transplantation recipients. Clin J Oncol Nurs 2013; 16:E142-9. [PMID: 22842699 DOI: 10.1188/12.cjon.e142-e149] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Hematopoietic cell transplantation (HCT) recipients are one of the most complex patient populations to teach at the time of discharge. The purpose of this article is to discuss the qualitative themes that emerged at the time of discharge for 141 transplantation recipients who were enrolled in an advanced practice nurse (APN) intervention study. The APN intervention consisted of six teaching sessions, and the qualitative data for this article involved the first session at the time of discharge. Content analysis was conducted on the patient-initiated narrative content and structured into three groups: content scheduled to be covered at Session 1, content scheduled to be covered at a later session, and content that was not part of the scripted intervention. All topics were organized into the quality-of-life framework (physical, psychological, social, and spiritual or survivorship). Most of the patient-initiated topics, which were not part of the scripted intervention, were psychosocial in nature. Nurses need to be aware of the complex teaching needs that encompass not only physical issues but also psychosocial issues at discharge. That teaching awareness needs to be coupled with flexibility, competence, and comfort with challenging psychosocial issues.
Collapse
Affiliation(s)
- Liz Cooke
- Department of Nursing Research and Education, City of Hope, Duarte, CA, USA.
| | | | | |
Collapse
|
41
|
Dégi CL. In search of the sixth vital sign: cancer care in Romania. Support Care Cancer 2012; 21:1273-80. [PMID: 23151651 DOI: 10.1007/s00520-012-1657-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2012] [Accepted: 10/29/2012] [Indexed: 10/27/2022]
Abstract
PURPOSE Romania still has to adapt and develop psychosocial assessment protocols which would allow standardized screening for the sixth vital sign in cancer patients, namely distress and quality of life. The present study screens for the psychosocial and communication needs of cancer outpatients in palliative care and in rehabilitation. These data are also compared with those obtained from a sample of cancer inpatients. METHODS Subjects for this study were recruited from cancer care services from the Transylvania region in Romania. A total of 203 persons with cancer were included in the screening. Of this number, 68 were in the hospitalized group, 71 were from the rehabilitation group, and 64 were palliative care cases. FACT-G 4.0 and BDI screening instruments were used in these clinical samples. Statistical analysis performed was: associational and comparative statistics, one-way analysis of variance. RESULTS Statistically and clinically significant results were found in relation to symptoms of depression, physical and functional well-being, and overall quality of life. However, with regard to psychosocial well-being, there were no clinically relevant or significant differences among cancer patients under hospital treatment, or in rehabilitation and palliative care programs. More than 40 % of the cancer patients included in our pilot screening were not open to talk about their illness and their related needs. CONCLUSIONS Cancer is an unmet psychosocial challenge to patients and to the specialized services, regardless of care type. The urgency of psychosocial screening in the Romanian cancer care system is revealed. Based on these findings, there is a need for psychosocial screening and related supportive care services that need to be integrated into Romania's cancer care programs. A recommendation is to pilot psychosocial and supportive care model within the four regional cancer care institutions.
Collapse
Affiliation(s)
- Csaba L Dégi
- Faculty of Sociology and Social Work, Babeş-Bolyai University, Bd. 21 Decembrie 1989, nr. 128-130, 400604, Cluj-Napoca, Romania.
| |
Collapse
|
42
|
Abstract
Prognosis is poor and quantity of life is compromised for individuals with advanced cancer. Quality of life is impacted, for some, by psychological distress. According to Acceptance and Commitment Therapy (ACT), psychological distress is associated with emotional avoidance and lack of valued living. ACT aims to increase psychological health via acceptance of one’s “minding,” a focus on present-moment living, and a commitment to value-driven life. In this article, we introduce the advanced cancer patient, the theory behind ACT, and how ACT may be delivered. We present the hypothetical case of J.B., a 56-year-old woman with recurrent Stage III ovarian cancer who reports thoughts of hopelessness and worthlessness, and how ACT might be applied to help J.B. experience a rich and meaningful life irrespective of her time remaining.
Collapse
|
43
|
Akechi T, Okuyama T, Uchida M, Nakaguchi T, Sugano K, Kubota Y, Ito Y, Kizawa Y, Komatsu H. Clinical Indicators of Depression among Ambulatory Cancer Patients Undergoing Chemotherapy. Jpn J Clin Oncol 2012; 42:1175-80. [DOI: 10.1093/jjco/hys162] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
44
|
Abu-Saad Huijer H, Abboud S, Doumit M. Symptom prevalence and management of cancer patients in Lebanon. J Pain Symptom Manage 2012; 44:386-99. [PMID: 22727948 DOI: 10.1016/j.jpainsymman.2011.10.019] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2011] [Revised: 10/04/2011] [Accepted: 10/10/2011] [Indexed: 12/22/2022]
Abstract
CONTEXT Cancer patients experience a great number of distressing physical and psychological symptoms. In Lebanon, there are no available data on symptom prevalence and symptom management in adults with cancer. OBJECTIVES The aim of this study was to determine the prevalence of symptoms and the effectiveness of treatment received as reported by patients. METHODS The study used a cross-sectional, descriptive survey design. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and the Memorial Symptom Assessment Scale were translated to Arabic and used; data were collected from adult Lebanese cancer patients at the American University of Beirut Medical Center. RESULTS A total of 200 cancer patients participated in the study; the majority were female with breast cancer and mean age was 54 years. The cognitive functioning domain of the EORTC QLQ-C30 scale was found to have the highest score and social functioning the lowest. The most prevalent symptom was lack of energy. Nausea and pain were the symptoms most treated. Males reported better quality of life (QoL), physical functioning, and role functioning than females; females reported more fatigue, pain, and appetite loss than males. Higher physical and psychological symptoms were correlated with lower health status, QoL, and functioning. CONCLUSION Although this sample reported a fair QoL and social functioning, many symptoms were highly prevalent and inadequately treated. Symptoms were found to negatively affect QoL and functioning. Based on these results, providing adequate symptom management and social support to Lebanese cancer patients is highly recommended.
Collapse
|
45
|
Shimizu K, Nakaya N, Saito-Nakaya K, Akechi T, Yamada Y, Fujimori M, Ogawa A, Fujisawa D, Goto K, Iwasaki M, Tsugane S, Uchitomi Y. Clinical biopsychosocial risk factors for depression in lung cancer patients: a comprehensive analysis using data from the Lung Cancer Database Project. Ann Oncol 2012; 23:1973-1979. [PMID: 22473594 DOI: 10.1093/annonc/mds061] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Various risk factors for depression in lung cancer patients have been suggested but have been examined separately in studies with relatively small sample sizes. The present study examined the biopsychosocial risk factors of depression in lung cancer patients, focusing on psychological factors in the largest patient sample reported to date. PATIENTS AND METHODS A total of 1334 consecutively recruited lung cancer patients were selected, and data on cancer-related variables, personal characteristics, health behaviors, physical symptoms, and psychological factors were obtained. The participants were divided into groups with or without depression using the Hospital Anxiety and Depression Scale. RESULTS Among the recruited patients, 165 (12.4%) manifested depression. The results of a binary logistic regression analysis were significant (overall R2, 36.5%), and a greater risk for depression was strongly associated with psychological factors, such as personality characteristics (neuroticism) and coping style (low fighting spirit, helplessness/hopelessness, and anxious preoccupation). Although the contributions of cancer-related variables, personal characteristics, health behaviors, and clinical state were relatively low, cancer stage, cancer type, sex, and age correlated significantly with depression. CONCLUSION Depression was most strongly linked with personality traits and coping style, and using screening instruments to identify these factors may be useful for preventive interventions.
Collapse
Affiliation(s)
- K Shimizu
- Psycho-Oncology Division, National Cancer Center Hospital, Tokyo.
| | - N Nakaya
- Department of Nutrition and Dietetics, Faculty of Family and Consumer Sciences, Kamakura Women's University, Kamakura; Departments of Epidemiology; Behavioral Medicine, Tohoku University Graduate School of Medicine, Sendai
| | - K Saito-Nakaya
- Departments of Epidemiology; Behavioral Medicine, Tohoku University Graduate School of Medicine, Sendai
| | - T Akechi
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya
| | - Y Yamada
- Psycho-Oncology Division, National Cancer Center Hospital, Tokyo
| | - M Fujimori
- Psycho-Oncology Division, National Cancer Center Hospital, Tokyo; Psycho-Oncology Division, Research Center for Innovative Oncology, National Cancer Center Hospital East, Kashiwa
| | - A Ogawa
- Psycho-Oncology Division, Research Center for Innovative Oncology, National Cancer Center Hospital East, Kashiwa; Psycho-Oncology Division, National Cancer Center Hospital East, Kashiwa
| | - D Fujisawa
- Psycho-Oncology Division, Research Center for Innovative Oncology, National Cancer Center Hospital East, Kashiwa; Psycho-Oncology Division, National Cancer Center Hospital East, Kashiwa
| | - K Goto
- Division of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa
| | - M Iwasaki
- Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center Research Institute, Tokyo
| | - S Tsugane
- Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center Research Institute, Tokyo
| | - Y Uchitomi
- Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| |
Collapse
|
46
|
CHENG K, YEUNG R. Impact of mood disturbance, sleep disturbance, fatigue and pain among patients receiving cancer therapy. Eur J Cancer Care (Engl) 2012; 22:70-8. [DOI: 10.1111/j.1365-2354.2012.01372.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
47
|
Ryan D, Gallagher P, Wright S, Cassidy E. Methodological challenges in researching psychological distress and psychiatric morbidity among patients with advanced cancer: what does the literature (not) tell us? Palliat Med 2012; 26:162-77. [PMID: 21562030 DOI: 10.1177/0269216311399663] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Patients with advanced cancer experience multiple demands and losses that place them at risk for experiencing psychological distress. Researchers can face challenges in conducting research among this population because of their poor levels of physical and cognitive functioning. This paper aims to develop our understanding of these challenges. A systematic literature review was conducted of papers describing surveys in which a stated aim was to measure rates of psychological distress or psychiatric morbidity among patients with advanced cancer. We also included papers that focused on the development of assessment tools. Studies were identified through computerized (MEDLINE and PsycINFO) and manual searches for the years 1995-2009. Twenty-eight papers met the inclusion criteria. They describe findings in relation to a total of 3942 patients. The sample sizes ranged from 25 to 422 (median = 87). The main methodological challenge identified is the recruitment of large and representative samples. Significant portions of the advanced cancer population are excluded from distress studies or are refusing to take part. In conclusion, researchers can enhance the methodological knowledge base by presenting more detailed accounts of the participant recruitment and data collection processes. Future researchers should strive to develop more flexible methods of assessing distress among patients with advanced disease.
Collapse
Affiliation(s)
- Dermot Ryan
- School of Nursing, Dublin City University, Ireland.
| | | | | | | |
Collapse
|
48
|
Yamaguchi T, Morita T, Sakuma Y, Kato A, Kunimoto Y, Shima Y. Longitudinal follow-up study using the distress and impact thermometer in an outpatient chemotherapy setting. J Pain Symptom Manage 2012; 43:236-43. [PMID: 21665422 DOI: 10.1016/j.jpainsymman.2011.03.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2010] [Revised: 03/09/2011] [Accepted: 03/15/2011] [Indexed: 10/18/2022]
Abstract
CONTEXT Although the combined use of the Impact Thermometer (IT) with the Distress Thermometer (DT), DIT, is reported to be a validated screening tool for clinically significant psychological distress in cancer patients, its longitudinal changes in the outpatient chemotherapy setting have not been examined. OBJECTIVES The objective was to clarify the longitudinal changes in distress evaluated by the DIT and effects of coexisting physical symptoms in an outpatient chemotherapy setting. METHODS A total of 297 patients who underwent chemotherapy for any malignancy on an outpatient basis were included. All the participants completed a questionnaire that included the DIT and intensities of seven physical symptoms (pain, somnolence, fatigue, dyspnea, appetite loss, abdominal distention, and nausea) at the initial and follow-up visit. RESULTS Although 109 patients had moderate or severe distress (the DT ≥4 and IT ≥3) at the initial visit, 46.8% of these patients improved their distress (DIT score below the cutoff of moderate distress) at their follow-up visit. Also, 85 patients had severe distress (DT ≥5 and IT ≥4) at the initial visit, and 43.5% of these patients improved their distress (DIT score below the cutoff of severe distress) at their follow-up visit. In a subgroup of patients who had no severe physical symptoms at the initial visit, 69.0% and 68.4% of the patients with moderate or severe distress and severe distress at the initial visit, respectively, improved their distress (DIT scores below the cutoff of moderate and severe distress) at the follow-up visit. CONCLUSION The distress evaluated by DIT can change on sequential measurements within short time intervals. Further study is needed to determine the appropriate use of the DIT for the screening and monitoring of psychological distress in an outpatient chemotherapy setting.
Collapse
Affiliation(s)
- Takashi Yamaguchi
- Department of Palliative Medicine, Tsukuba Medical Center Hospital, Tsukuba, Japan.
| | | | | | | | | | | |
Collapse
|
49
|
Turriff A, Levy HP, Biesecker B. Prevalence and psychosocial correlates of depressive symptoms among adolescents and adults with Klinefelter syndrome. Genet Med 2011; 13:966-72. [PMID: 21799429 PMCID: PMC3208082 DOI: 10.1097/gim.0b013e3182227576] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To determine the prevalence and psychosocial correlates of depressive symptoms among adolescents and adults with Klinefelter syndrome. METHODS Individuals (n = 310) aged 14-75 years with self-reported Klinefelter syndrome were recruited from regional and national support networks to complete a web-based survey. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale. Perceived consequences (Illness Perceptions Questionnaire), perceived stigma (Perceived Social Stigmatization Scale), and coping (Ways of Coping Checklist-Revised) were also measured and evaluated as correlates of depressive symptoms. RESULTS Overall, 68.8% of the study participants reported clinically significant levels of depressive symptoms as indicated by a Center for Epidemiologic Studies Depression Scale score ≥16. The use of emotion-focused coping strategies (P < 0.01), perceptions of stigmatization (P < 0.01), perceived negative consequences of Klinefelter syndrome (P < 0.01), and the importance of having children in the future (P < 0.05) were all significantly associated with depressive symptoms. CONCLUSIONS Individuals with Klinefelter syndrome may be at increased risk for depression. Routine screening for depressive symptoms and appropriate referral and evaluation may be warranted.
Collapse
Affiliation(s)
- Amy Turriff
- Social and Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892, USA.
| | | | | |
Collapse
|
50
|
Akechi T, Okuyama T, Endo C, Sagawa R, Uchida M, Nakaguchi T, Akazawa T, Yamashita H, Toyama T, Furukawa TA. Patient's perceived need and psychological distress and/or quality of life in ambulatory breast cancer patients in Japan. Psychooncology 2011; 20:497-505. [PMID: 20878850 DOI: 10.1002/pon.1757] [Citation(s) in RCA: 104] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Tatsuo Akechi
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, Japan.
| | | | | | | | | | | | | | | | | | | |
Collapse
|