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Li N, Wang G, Duan G, Li Z, Zheng Y, Wang Z, Li G. Clinical observation of transcatheter arterial chemoembolization in super-aged patients with advanced gastric cancer. Support Care Cancer 2021; 30:1441-1450. [PMID: 34529138 DOI: 10.1007/s00520-021-06565-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 09/08/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE To retrospectively analyze the safety and efficacy of transcatheter arterial chemoembolization (TACE) in super-aged patients with advanced gastric cancer (AGC), as well as the effects of TACE on quality of life (QOL) and anxiety state. METHODS In this study, 32 AGC patients aged over 80 years old were enrolled and treated with TACE. Complications of TACE and total effective rate of symptom relief after TACE were observed. Changes of the maximum diameter of solid tumors before and after TACE were compared by reexamination of abdominal computerized tomography. QOL, Eastern Cooperative Oncology Group (ECOG), and Hamilton anxiety scale (HAMA) scores of tumor patients were performed before TACE and 3d, 28d, and 90d after TACE. RESULTS No serious complications occurred during or after TACE in any patient. The total effective rate of symptom relief was 56.25% at 28d after TACE and 71.88% at 90d after TACE. Compared with before TACE, the maximum diameter of tumor was significantly decreased after TACE; ECOG was increased at 3d after TACE, while was decreased at 28d and 90d after TACE (P < 0.05); QOL and HAMA had no significant change at 3d after TACE, while increased significantly at 28d and 90d after TACE (all P < 0.05). CONCLUSION TACE was safe and effective, could shrink tumors, and improve the QOL and anxiety for super-aged patients with AGC.
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Affiliation(s)
- Na Li
- Department of Oncology, the First Affiliated Hospital of Henan University, 357 Ximen Street, Kaifeng, Henan, China.
| | - Gang Wang
- Department of Radiation Oncology, the Third People's Hospital of Zhengzhou, Zhengzhou, Henan, China
| | - Guolong Duan
- Department of Oncology, Queshan County People's Hospital, Zhumadian, Henan, China
| | - Zongmin Li
- Department of Radiation Oncology, Huanghe Sanmenxia Hospital, Sanmenxia, Henan, China
| | - Yu Zheng
- Department of Interventional Diagnosis and Treatment, Inner Mongolia People's Hospital, Hohhot, Inner Mongolia, China
| | - Zhiwei Wang
- Department of Oncology, the First Affiliated Hospital of Henan University, 357 Ximen Street, Kaifeng, Henan, China
| | - Guowen Li
- Radiotherapy Inpatient Ward II, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
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Validity and Reliability of the Persian Version of Emotion Thermometers in Iranian Advanced Cancer Patients. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT 2019. [DOI: 10.5812/ijcm.90504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Harju E, Michel G, Roser K. A systematic review on the use of the emotion thermometer in individuals diagnosed with cancer. Psychooncology 2019; 28:1803-1818. [DOI: 10.1002/pon.5172] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2018] [Revised: 07/02/2019] [Accepted: 07/08/2019] [Indexed: 01/06/2023]
Affiliation(s)
- Erika Harju
- Department of Health Sciences and Health PolicyUniversity of Lucerne Lucerne Switzerland
| | - Gisela Michel
- Department of Health Sciences and Health PolicyUniversity of Lucerne Lucerne Switzerland
| | - Katharina Roser
- Department of Health Sciences and Health PolicyUniversity of Lucerne Lucerne Switzerland
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Brief emotional screening in oncology: Specificity and sensitivity of the emotion thermometers in the Portuguese cancer population. Palliat Support Care 2019; 18:39-46. [DOI: 10.1017/s1478951519000208] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
AbstractObjectiveThis study aimed to determine the cutoff and the specificity and sensitivity of the Emotion Thermometers (ET) in a Portuguese sample of cancer patients.MethodA total of 147 patients (mean age = 49.2; SD = 12.6) completed the ET, the Brief Symptom Inventory (BSI), and the Subjective Experiences of Illness Suffering Inventory. Data were collected in a cancer support institution and in a major hospital in the North of Portugal.ResultThe optimal cutoff for the Anxiety Thermometer was 5v6 (until 5 and 6 or more), which identified 74% of the BSI-anxiety cases and 70% of noncases. The Depression Thermometer cutoff was 4v5 (until 4 and 5 or more), which identified 85% of BSI-depression cases and 82% of noncases. Cutoff for the Anger Thermometer was 4v5 (until 4 and 5 or more), which identified 83% of BSI-hostility cases and 73% of noncases; for the Distress Thermometer, the optimal cutoff was 4v5 (until 4 and 5 or more), which identified 84% of the suffering cases and 73% of noncases. Finally, for the Help Thermometer, it was 3v4 (until 3 and 4 or more), which helped to identify 93% of the suffering cases and 64% of noncases.Significance of resultsResults supported the Portuguese version of the ET as an important screening tool for identifying the emotional distress in cancer patients.
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Normative values for the distress thermometer (DT) and the emotion thermometers (ET), derived from a German general population sample. Qual Life Res 2018; 28:277-282. [PMID: 30284181 DOI: 10.1007/s11136-018-2014-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE The distress thermometer (DT) and the emotion thermometers (ET) are short screening instruments for use in oncological practice. The aim of this study was to provide normative values and to analyze the correlational structure of the ET. METHODS A representative sample of the adult German general population (N = 2437) completed the ET, the PHQ-4, the FACIT-fatigue scale, and the demoralization scale. RESULTS The percentages of people above the cutoff (≥ 4) and the mean scores of the five ET scales were as follows: distress: 39.0%, M = 3.15 ± 2.62, anxiety: 12.3%, M = 1.36 ± 1.93, depression: 16.1%, M = 1.65 ± 2.11, anger: 24.5%, M = 2.33 ± 2.16, and need for help: 10.7%, M = 1.18 ± 1.90. Women reported significantly higher levels of burden than men, with effect sizes between 0.07 (anger) and 0.36 (anxiety). All ET dimensions were interrelated (r between 0.44 and 0.69) and significantly correlated with the other scales (r between 0.36 and 0.68). CONCLUSIONS The normative scores can help qualify assessments of groups of patients. The new four dimensions of the ET provide relevant additional information that is not already covered by the DT.
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Westenberg RF, Zale EL, Heinhuis TJ, Özkan S, Nazzal A, Lee SG, Chen NC, Vranceanu AM. Does a Brief Mindfulness Exercise Improve Outcomes in Upper Extremity Patients? A Randomized Controlled Trial. Clin Orthop Relat Res 2018; 476:790-798. [PMID: 29480886 PMCID: PMC6260083 DOI: 10.1007/s11999.0000000000000086] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Mindfulness-based interventions are useful in reducing psychologic distress and pain intensity in patients with chronic pain. However, most mindfulness-based interventions are resource-intensive, lengthy, and not feasible for busy orthopaedic surgical practices. QUESTIONS/PURPOSES The purpose of this study was to determine if a 60-second personalized mindfulness-based video exercise is (1) associated with improved pain intensity, emotional distress, and state anxiety compared with an attention placebo control (a time-matched educational pamphlet about pain and stress); and (2) feasible and acceptable for patients with upper extremity injury in an orthopaedic practice. METHODS This was a single-center, single-blind randomized controlled trial of the mindfulness-based video exercise (60 seconds duration, free online) versus an attention placebo control (an educational pamphlet about pain and stress presented to patients to read over 60 seconds). One hundred forty-nine patients presenting for a new or followup appointment at the office of one of two orthopaedic hand and upper extremity outpatient surgical practices at an urban academic hospital were invited to participate between September 2016 and December 2016. Of 149 patients screened, 125 patients were randomized and completed a demographic questionnaire, the Numeric Rating Scale to assess pain intensity, the State Anxiety subscale of the State Trait Anxiety Inventory to assess state anxiety, and Emotion Thermometers to assess anxiety, anger, and depression before and after the interventions. Postintervention, patients also completed the Client Satisfaction Questionnaire Scale-3 to assess the acceptability. A mean score of 21 or higher is considered acceptable. Feasibility was determined based on number of patients approached who refused participation. The intervention was defined as feasible if refusal rate was lower than 25%. Analysis of covariance was used to test comparative improved pain intensity on the NRS, psychologic distress on the Emotion Thermometers, and state anxiety on the State Anxiety Subscale of the State Trait Anxiety Index after controlling for respective baseline scores. A 1-point minimal clinically important difference (MCID) was used on the NRS for pain intensity. RESULTS Adjusted for the baseline means, compared with patients who received the attention placebo control, patients who participated in the mindfulness-based video exercise demonstrated improved pain intensity (mindfulness-based video exercise: 3.03 ± 0.12; control: 3.49 ± 0.12; mean difference: 0.46 [0.12-0.80]; p = 0.008); state anxiety (mindfulness-based video exercise: 32.35 ± 0.59; control: 35.29 ± 0.59; mean difference: 2.94 [1.29-4.59]; p = 0.001); anxiety symptoms (mindfulness-based video exercise: 1.49 ± 0.19; control: 2.10 ± 0.19; mean difference: 0.61 [0.08-1.14]; p = 0.024); depression (mindfulness-based video exercise: 1.03 ± 0.10; control: 1.47 ± 0.11; mean difference: 0.44 [0.15-0.73]; p = 0.004); and anger (mindfulness-based video exercise: 0.76 ± 0.12; control: 1.36 ± 0.12; mean difference: 0.60 [0.26-0.94]; p = 0.001). However, the observed differences in pain intensity were below 1 point on the NRS, which is the MCID established in patients with chronic pain. No MCID is available for the other measures. The mindfulness-based video exercise was feasible based on a dropout rate of 0%, and acceptability reached the medium range with similar scores in both groups (mindfulness-based video exercise: 20.70 ± 5.48; control: 20.52 ± 6.42). CONCLUSIONS A 60-second mindfulness-based video exercise is feasible to implement and acceptable to patients in busy orthopaedic practices. This video exercise is also effective in improving momentary pain, anxiety, depression, and anger in this population, but it is unclear whether these improved pain and distress levels are meaningful to patients who present with low levels of pain and psychologic distress. Future studies should seek to discern whether the improved pain and distress levels we observed are clinically important or whether the intervention delivers larger effects in subgroups of patients experiencing greater pain intensity and if the improved pain and distress levels are durable. Such studies might also assess cost-effectiveness, because this mindfulness-based tool takes little time and few resources to use, and the effects and durability of multiple sessions of a mindfulness-based video exercise. LEVEL OF EVIDENCE Level II, therapeutic study.
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Affiliation(s)
- Ritsaart F Westenberg
- R. F. Westenberg, S. Özkan, A. Nazzal, S.-G. Lee, N. C. Chen, Hand and Upper Extremity Service, Department of Orthopedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA E. L. Zale, T. J. Heinhuis, A.-M. Vranceanu, Integrated Brain Health Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA E. L. Zale, Department of Psychology, Syracuse University, Syracuse, NY, USA S. Özkan, Department of Trauma Surgery, VU University Medical Center, Amsterdam, The Netherlands
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Ames N, Shuford R, Yang L, Moriyama B, Frey M, Wilson F, Sundaramurthi T, Gori D, Mannes A, Ranucci A, Koziol D, Wallen GR. Music Listening Among Postoperative Patients in the Intensive Care Unit: A Randomized Controlled Trial with Mixed-Methods Analysis. INTEGRATIVE MEDICINE INSIGHTS 2017; 12:1178633717716455. [PMID: 28904523 PMCID: PMC5588801 DOI: 10.1177/1178633717716455] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 05/25/2017] [Indexed: 11/17/2022]
Abstract
Background: Music listening may reduce the physiological, emotional, and mental effects of distress and anxiety. It is unclear whether music listening may reduce the amount of opioids used for pain management in critical care, postoperative patients or whether music may improve patient experience in the intensive care unit (ICU). Methods: A total of 41 surgical patients were randomized to either music listening or controlled non-music listening groups on ICU admission. Approximately 50-minute music listening interventions were offered 4 times per day (every 4-6 hours) during the 48 hours of patients’ ICU stays. Pain, distress, and anxiety scores were measured immediately before and after music listening or controlled resting periods. Total opioid intake was recorded every 24 hours and during each intervention. Results: There was no significant difference in pain, opioid intake, distress, or anxiety scores between the control and music listening groups during the first 4 time points of the study. However, a mixed modeling analysis examining the pre- and post-intervention scores at the first time point revealed a significant interaction in the Numeric Rating Scale (NRS) for pain between the music and the control groups (P = .037). The Numeric Rating Score decreased in the music group but remained stable in the control group. Following discharge from the ICU, the music group’s interviews were analyzed for themes. Conclusions: Despite the limited sample size, this study identified music listening as an appropriate intervention that improved patients’ post-intervention experience, according to patients’ self-report. Future mixed methods studies are needed to examine both qualitative patient perspectives and methodology to improve music listening in critical care units.
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Affiliation(s)
- Nancy Ames
- Nursing Department, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Rebecca Shuford
- Nursing Department, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Li Yang
- Nursing Department, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Brad Moriyama
- Pharmacy Department, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Meredith Frey
- Nursing Department, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Florencia Wilson
- Nursing Department, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | | | - Danelle Gori
- Nursing Department, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Andrew Mannes
- Department of Perioperative Medicine, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Alexandra Ranucci
- Nursing Department, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Deloris Koziol
- Biostatistics and Clinical Epidemiology Service, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Gwenyth R Wallen
- Nursing Department, Clinical Center, National Institutes of Health, Bethesda, MD, USA
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Differences in distress severity among oncology patients treated by a consultation–liaison service. A five-year survey in Germany. THE EUROPEAN JOURNAL OF PSYCHIATRY 2017. [DOI: 10.1016/j.ejpsy.2017.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Twig G, Gerstein HC, Fruchter E, Shina A, Afek A, Derazne E, Tzur D, Cukierman-Yaffe T, Amital D, Amital H, Tirosh A. Self-Perceived Emotional Distress and Diabetes Risk Among Young Men. Am J Prev Med 2016; 50:737-745. [PMID: 26810356 DOI: 10.1016/j.amepre.2015.12.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Revised: 10/29/2015] [Accepted: 12/14/2015] [Indexed: 02/09/2023]
Abstract
INTRODUCTION There are mixed data regarding the effect of emotional distress on diabetes risk, especially among young adults. This study assessed the effect of self-perceived emotional distress on diabetes incidence among young men. METHODS Incident diabetes during a mean follow-up of 6.3 (4.3) years was assessed among 32,586 men (mean age, 31.0 [5.6] years) of the Metabolic, Lifestyle, and Nutrition Assessment in Young Adults cohort with no history of diabetes between 1995 and 2011. Emotional distress was assessed by asking participants as part of a computerized questionnaire: Are you preoccupied by worries or concerns that affect your overall wellbeing? Time-dependent Cox models were applied. Data analysis took place between 2014 and 2015. RESULTS There were 723 cases of diabetes during 206,382 person-years. The presence of distress was associated with a 53% higher incidence of diabetes (95% CI=1.08, 2.18, p=0.017) after adjustment for age, BMI, fasting plasma glucose, family history of diabetes, triglyceride and high-density lipoprotein cholesterol levels, education, cognitive performance, white blood cell count, physical activity, and sleep quality. These results persisted when distress, BMI, physical activity, and smoking status were treated as time-dependent variables (hazard ratio=1.66, 95% CI=1.21, 2.17, p=0.002). An adjusted hazard ratio of 2.14 (95% CI=1.04, 4.47, p=0.041) for incident diabetes was observed among participants persistently reporting emotional distress compared with those persistently denying it. CONCLUSIONS Sustained emotional distress contributes to the development of diabetes among young and apparently healthy men in a time-dependent manner. These findings warrant awareness by primary caregivers when stratifying diabetes risk.
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Affiliation(s)
- Gilad Twig
- Department of Medicine B, Sheba Medical Center, Tel Hashomer, Israel; The Dr. Pinchas Bornstein Talpiot Medical Leadership Program, Sheba Medical Center, Tel Hashomer, Israel; The Israel Defense Forces Medical Corps, Israel; The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Hertzel C Gerstein
- Division of Endocrinology and Metabolism, and Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | | | - Avi Shina
- The Dr. Pinchas Bornstein Talpiot Medical Leadership Program, Sheba Medical Center, Tel Hashomer, Israel; The Israel Defense Forces Medical Corps, Israel; Department of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Israel
| | - Arnon Afek
- The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Israel Ministry of Health, Jerusalem, Israel
| | - Estela Derazne
- The Israel Defense Forces Medical Corps, Israel; The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dorit Tzur
- The Israel Defense Forces Medical Corps, Israel
| | - Tali Cukierman-Yaffe
- The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Endocrinology, Sheba Medical Center, Tel Hashomer, Israel
| | - Daniela Amital
- The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Psychiatry B, Ness Ziona Mental Health Center, Ness Ziona, Israel
| | - Howard Amital
- Department of Medicine B, Sheba Medical Center, Tel Hashomer, Israel; The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Amir Tirosh
- The Dr. Pinchas Bornstein Talpiot Medical Leadership Program, Sheba Medical Center, Tel Hashomer, Israel; Department of Endocrinology, Sheba Medical Center, Tel Hashomer, Israel; Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
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