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Manne SL, Hudson SV, O'Malley D, Devine KA, Matasar M, Peram J, Solleder J, Handorf E, Evens AM. Survivorship preparedness and activation among survivors of lymphoma. J Cancer Surviv 2024:10.1007/s11764-024-01664-6. [PMID: 39190132 DOI: 10.1007/s11764-024-01664-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Accepted: 08/15/2024] [Indexed: 08/28/2024]
Abstract
OBJECTIVES Taking an active role in managing post-treatment care has emerged as a key aspect of promoting a successful transition into survivorship and is associated with better patient outcomes. In this study, we focus on two key aspects of active self-management, activation and preparedness. Activation was defined as understanding one's role in the care process and having the knowledge, skill, and confidence to take on a role in managing self-care. Preparedness was defined as the extent to which individuals perceived they had sufficient information about what to expect after cancer treatments are completed. The study goal was to characterize survivorship preparedness and activation among lymphoma survivors within 5 years of treatment completion in New Jersey and examine the association of sociodemographic, medical, care transition experiences, practical concerns, and psychosocial factors with activation and preparedness. METHODS One hundred and one Hodgkin lymphoma or non-Hodgkin lymphoma survivors who had completed treatment within 5 years completed a survey of survivorship care experiences (response rate = 34.12%). RESULTS Approximately 60% of survivors reported high activation, with similar percentages for higher preparedness. Less activated survivors were significantly (p < .05) younger, married, resided in a more deprived geographic area, and reported more fatigue and information needs. Less activated survivors reported recalling that their providers were significantly (p < .05) less likely to discuss long-term side effects, psychosocial needs, risk-reducing lifestyle recommendations, and how to manage other medical concerns. Fewer care transition practices were most strongly associated with lower preparedness. CONCLUSIONS A significant proportion were not activated for survivorship, and both activation and preparedness were strongly associated with providers' survivorship transition practices. IMPLICATIONS FOR CANCER SURVIVORS Implementing programs to foster more activation and preparedness for lymphoma survivorship care would benefit from education about recommended follow-up care and healthy lifestyle practices. Providers should routinely ask about their patients' confidence and preparedness for survivorship and provide referrals for appropriate care as needed.
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Affiliation(s)
- Sharon L Manne
- Rutgers Cancer Institute of New Jersey, 120 Albany Street, Tower 2 Floor 8, New Brunswick, NJ, 08901, USA.
| | - Shawna V Hudson
- Dept Family Medicine and Community Health, Rutgers RWJ Medical School, 303 George Street, Rm 309, New Brunswick, NJ, 08901, USA
| | - Dena O'Malley
- Dept Family Medicine and Community Health, Rutgers RWJ Medical School, 303 George Street, Rm 309, New Brunswick, NJ, 08901, USA
| | - Katie A Devine
- Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, New Brunswick, NJ, 08901, USA
| | - Matthew Matasar
- Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, New Brunswick, NJ, 08901, USA
| | - Jacintha Peram
- Rutgers Cancer Institute of New Jersey, 120 Albany Street, Tower 2 Floor 8, New Brunswick, NJ, 08901, USA
| | - Justin Solleder
- Rutgers Cancer Institute of New Jersey, 120 Albany Street, Tower 2 Floor 8, New Brunswick, NJ, 08901, USA
| | - Elizabeth Handorf
- Rutgers School of Public Health, 120 Albany Street, Tower 2 Floor 5, New Brunswick, NJ, 08901, USA
| | - Andrew M Evens
- Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, New Brunswick, NJ, 08901, USA
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Wasse SK, Mounier M, Assogba E, Rossi C, Adnet J, Gauthier S, Girard S, Atsou KM, Dabakuyo-Yonli TS, Maynadie M. Factors Affecting Health-Related Quality of Life among Survivors of Non-Hodgkin Lymphoma: A Population-Based Study. Cancers (Basel) 2023; 15:3885. [PMID: 37568701 PMCID: PMC10417301 DOI: 10.3390/cancers15153885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 07/24/2023] [Accepted: 07/27/2023] [Indexed: 08/13/2023] Open
Abstract
PURPOSE To describe Health-Related Quality of Life (HRQoL) and to identify the association between sociodemographic, clinical and psychosocial factors, and self-reported HRQoL among NHL survivors. METHODS The data of the cancer registry specialized in hematological malignancies in Côte d'Or (France) were used to identify all patients diagnosed with follicular lymphoma (FL) and diffuse large B-cell lymphoma (DLBCL) from 2010 to 2017. Patients were invited to complete SF-12 and other questionnaires. RESULTS The HRQoL of NHL survivors was poorer than that of the French general population (p < 0.05) in vitality (48 vs. 56), general health (56 vs. 63), role physical scores (60 vs. 70), role emotional scores (64 vs. 72) and the Mental Component Scale (45 vs. 49). The mean difference in physical functioning decreased per unit increase in age (β = -1.1 (0.3); p < 0.001). Men had better vitality than women (β = 12.4 (6.1); p = 0.04) and the high education level was associated with greater role emotional scores (β = 14.1 (5.4); p = 0.01). Symptoms of anxiety and depression were associated with poorer HRQoL. The satisfaction of social support was associated with significantly greater scores on mental health (β = 17.3 (5.1); p = 0.001) and social functioning (β = 15.7 (7.8); p = 0.04). Socioeconomic deprivation was associated with poorer general health (β = -12.8 (5.2); p = 0.01). CONCLUSIONS From 3 to 11 years post-diagnosis, the main factors found to be associated with poor HRQoL of NHL survivors were age, sex, presence of anxiety, depression and economic problems. These findings suggest the need for supportive care to improve HRQOL and the consideration of these problems when developing care plans for NHL survivors.
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Affiliation(s)
- Stephane Kroudia Wasse
- Registry of Hematological Malignancies of Côte d’Or, Dijon-Bourgogne University Hospital, F-21000 Dijon, France; (M.M.); (S.G.); (S.G.); (K.M.A.)
- INSERM, UMR1231, Bourgogne Franche-Comté University, F-21000 Dijon, France;
| | - Morgane Mounier
- Registry of Hematological Malignancies of Côte d’Or, Dijon-Bourgogne University Hospital, F-21000 Dijon, France; (M.M.); (S.G.); (S.G.); (K.M.A.)
- INSERM, UMR1231, Bourgogne Franche-Comté University, F-21000 Dijon, France;
| | - Emerline Assogba
- INSERM, UMR1231, Bourgogne Franche-Comté University, F-21000 Dijon, France;
- Breast and Gynaecologic Cancer Registry of Côte d’Or, Georges François Leclerc Comprehensive Cancer Centre, F-21000 Dijon, France
| | - Cédric Rossi
- Clinical Hematology Unit, Dijon Bourgogne University Hospital, F-21000 Dijon, France;
| | - Johan Adnet
- Methodology Biostatistics and Data-Management Unit, Georges François Leclerc Comprehensive Cancer Centre, F-21000 Dijon, France;
| | - Sophie Gauthier
- Registry of Hematological Malignancies of Côte d’Or, Dijon-Bourgogne University Hospital, F-21000 Dijon, France; (M.M.); (S.G.); (S.G.); (K.M.A.)
- INSERM, UMR1231, Bourgogne Franche-Comté University, F-21000 Dijon, France;
| | - Stephanie Girard
- Registry of Hematological Malignancies of Côte d’Or, Dijon-Bourgogne University Hospital, F-21000 Dijon, France; (M.M.); (S.G.); (S.G.); (K.M.A.)
- INSERM, UMR1231, Bourgogne Franche-Comté University, F-21000 Dijon, France;
| | - Kueshivi Midodji Atsou
- Registry of Hematological Malignancies of Côte d’Or, Dijon-Bourgogne University Hospital, F-21000 Dijon, France; (M.M.); (S.G.); (S.G.); (K.M.A.)
- INSERM, UMR1231, Bourgogne Franche-Comté University, F-21000 Dijon, France;
| | - Tienhan Sandrine Dabakuyo-Yonli
- Breast and Gynaecologic Cancer Registry of Côte d’Or, Georges François Leclerc Comprehensive Cancer Centre, F-21000 Dijon, France
- National Quality of Life and Cancer Clinical Research Platform, F-21000 Dijon, France
| | - Marc Maynadie
- Registry of Hematological Malignancies of Côte d’Or, Dijon-Bourgogne University Hospital, F-21000 Dijon, France; (M.M.); (S.G.); (S.G.); (K.M.A.)
- INSERM, UMR1231, Bourgogne Franche-Comté University, F-21000 Dijon, France;
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Della Rocca F, Maremmani AGI, Bacciardi S, Pacini M, Lamanna F, Tripodi B, Miccoli M, Maremmani I. Characteristics of Stress Sensitivity in Heroin Use Disorder Patients during Their Opioid Agonist Treatment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4566. [PMID: 36901575 PMCID: PMC10002439 DOI: 10.3390/ijerph20054566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 02/22/2023] [Accepted: 03/02/2023] [Indexed: 06/18/2023]
Abstract
In the present study, performed on a sample of Heroin Use Disorder (HUD) patients undergoing Opioid Agonist Treatment (OAT), we attempted to explore the relationships between stress sensitivity and heroin addiction-related clinical aspects. HUD patients' stress sensitivity was evaluated with the Heroin/PTSD-Spectrum questionnaire (H/PSTD-S). The Drug Addiction History Questionnaire (DAH-Q), the Symptomatological Check List-90 (SCL-90), and The Behavioural Covariate of Heroin Craving inventory (CRAV-HERO) were all used, as were the Deltito Subjective Wellness Scale (D-SWS), a self-report scale evaluating subjective well-being; the Cocaine Problem Severity Index (CPSI), a questionnaire determining the extent of a cocaine problem; and the Marijuana Craving Questionnaire (MC-Q), an instrument assessing craving for cannabinoids. We checked correlations between stress sensitivity and the extent of HUD clinical features and compared patients with and without problematic stress sensitivity. H/PTSD-S was positively correlated with patients' income, altered mental status, legal problems, the lifetime different treatments index, the current treatment load index, and all SCL-90 indexes and factors. Regarding subjective well-being, stress sensitivity negatively correlated with the contrast best week (last five years) index. Patients with high-stress sensitivity were females with a low income. They exhibited a more severe mental status at treatment entry, greater difficulty in working adaptation, and legal problems during treatment. Additionally, these patients showed a higher level of psychopathology, more impairment in well-being, and more risky behaviours during treatment. Stress sensitivity, as H/PTSD-S, must be considered an outcome of HUD. HUD's addiction history and clinical features are significant risk factors for H/PTSD-S. Therefore, social and behavioural impairment in HUD patients could be considered the clinical expression of the H/PTSD spectrum. In summary, the long-term outcome of HUD is not represented by drug-taking behaviours. Rather, the inability to cope with the contingent environmental conditions is the key feature of such a disorder. H/PTSD-S, therefore, should be seen as a syndrome caused by an acquired inability (increased salience) concerning regular (daily) life events.
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Affiliation(s)
- Filippo Della Rocca
- Addiction Research Methods Institute, World Federation for the Treatment of Opioid Dependence, 225 Varick Street, Suite 402, New York, NY 10014, USA
| | - Angelo G. I. Maremmani
- Addiction Research Methods Institute, World Federation for the Treatment of Opioid Dependence, 225 Varick Street, Suite 402, New York, NY 10014, USA
- Department of Psychiatry and Addictions, Section of Psychiatry, North-Western Tuscany Local Health Unit, Tuscany NHS, Versilia Zone, Via Aurelia 335, 55041 Viareggio, Italy
| | - Silvia Bacciardi
- Addiction Research Methods Institute, World Federation for the Treatment of Opioid Dependence, 225 Varick Street, Suite 402, New York, NY 10014, USA
- Department of Psychiatry and Addictions, Section of Psychiatry, North-Western Tuscany Local Health Unit, Tuscany NHS, Versilia Zone, Via Aurelia 335, 55041 Viareggio, Italy
| | - Matteo Pacini
- V.P. Dole Research Group, G. De Lisio Institute of Behavioural Sciences, Via di Pratale 3, 56121 Pisa, Italy
| | - Francesco Lamanna
- Department of Psychiatry and Addictions, Section of Addictions, North-Western Tuscany Local Health Unit, Tuscany NHS, Pisa Zone, Via delle Torri 160, 56124 Pisa, Italy
| | - Beniamino Tripodi
- Department of Mental Health and Addictions, Division of Psychiatry, ASST Crema, Via Largo Dossena 2, 26013 Crema, Italy
| | - Mario Miccoli
- Addiction Research Methods Institute, World Federation for the Treatment of Opioid Dependence, 225 Varick Street, Suite 402, New York, NY 10014, USA
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56100 Pisa, Italy
| | - Icro Maremmani
- Addiction Research Methods Institute, World Federation for the Treatment of Opioid Dependence, 225 Varick Street, Suite 402, New York, NY 10014, USA
- V.P. Dole Research Group, G. De Lisio Institute of Behavioural Sciences, Via di Pratale 3, 56121 Pisa, Italy
- Saint Camillus International University of Health Sciences (UniCamillus), Via di Sant’Alessandro 8, 00131 Rome, Italy
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Psychological challenges and related factors of ordinary residents after "7.20" heavy rainstorm disaster in Zhengzhou: a cross-sectional survey and study. BMC Psychol 2023; 11:3. [PMID: 36609296 PMCID: PMC9824917 DOI: 10.1186/s40359-023-01038-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 01/03/2023] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND In 2021, a once-in-a-century heavy rainstorm suddenly attacked Zhengzhou, an important inland city in northern China. However, there have been no studies on the psychological health of disaster-stricken residents. This study is the first to comprehensively report on the mental health status and related factors of local ordinary residents after the heavy rainstorm. OBJECTIVE The purpose of this study is to investigate the mental health status and related influencing factors of local ordinary residents after the flood disaster, and to provide reference for government departments to formulate disaster psychological intervention countermeasures based on evidence-driven strategies. METHODS The snowball sampling technique was used in this study, and measurement tools of Rainstorm Exposure Questionnaire, Subjective Perception of Rainstorm, Post-Traumatic Stress Disorder Checklist-Civilian version (PCL-C), Depression, Anxiety and Stress Scale-21 (DAS-21) and Chinese version of Social Support Rating Scale (SSRS) were used to evaluate the rainstorm exposure, subjective perception of the rainstorm, psychological symptoms and social support of the disaster-stricken residents within a week after the rainstorm. Logistic regression analysis was used to examine the psychological status and related factors of local residents after the rainstorm disaster. RESULTS A total of 469 valid samples were obtained in this study. All the subjects were in the disaster area and experienced the rainstorm personally, with normal intelligence. The statistical results showed that 25.37% people had experienced at least three rainstorm-related stresses, nearly 20.26% people had post-traumatic stress disorder (PTSD) symptoms, and 39.3%, 53.92% and 65.83% people had depression, anxiety and stress symptoms, respectively. Multivariable logistic regression analyses indicated that female (all p < 0.05), the divorced, agricultural workers/farmers (all p < 0.05), students (all p < 0.05), people experiencing at least three rainstorm-related stresses (p < 0.05 or p < 0.01), people with lower satisfaction at the social flood fighting measures (p < 0.05 or p < 0.01) and people with low social support (p < 0.05 or p < 0.01) were all independent risk factors for poor psychological health, and college education or above (p < 0.05 or p < 0.01), the lower degree of worrying about themselves (all p < 0.01), family members (all p < 0.01) and family property (all p < 0.01) were all related to higher psychological health among flood survivors after the disaster. CONCLUSIONS Rainstorm could cause local residents to have various degrees of psychological symptoms. This study identified factors associated with the psychological health of disaster-stricken residents, which could be used to develop psychological interventions in improving psychological health of local residents.
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Schroeder HS, Israeli A, Liebergall MI, Or O, Andrews CS, Justo D, Zimlichman E. The Suitability of Measuring Patient-Reported Outcomes in Older Adults Following a Hip Fracture Using the Short-Form 36 Questionnaire: A Qualitative Description Approach. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2023; 60:469580231171819. [PMID: 37183709 DOI: 10.1177/00469580231171819] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Hip-fractures (HF) in older adults are associated with poor outcomes and high costs. Measuring quality-of-care of HF patients has focused on clinical definitions rather than on measuring outcomes that are meaningful to the patient. Healthcare systems worldwide are increasingly interested in patient-reported outcome measures (PROs). The Short-form (SF36) questionnaire is a recommended measure among older adults however it's comprehensiveness and uniqueness for specific patients after a HF is not clear. The aims of this study were to: understand the perspective of the older adults experience following HF, to assess the suitability of the SF36 as a PRO for HF and to determine the best timing for questioning. A qualitative description approach was used. This took place in 2 large academic medical-centers in Israel. The inquiry was done in 2 parts by semi-structured interview. A total 15 HF patients were interviewed. Categories and themes emerging from their responses were similar to the 8 domains of the SF36 questionnaire, but the participants added clarity regarding their own needs for setting goals. In the second part, participants agreed that the SF36 reflected common issues and served as an adequate measure for personal-goal setting. The study encourages patient-centered care in older adults recovering from HF, providing evidence that the SF36 is a suitable tool for measuring PROs in HF patients. Healthcare systems focus on clinical-outcome indicators and do not reflect how the patient views his outcomes. This study provides evidence that care should be customized for each person.
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Affiliation(s)
- Hanna S Schroeder
- Braun School of Public Health, the Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Avi Israeli
- Dr. Julien Rozan Professor of Family Medicine and Health Promotion, Hebrew University - Hadassah Medical School
- Department of Health Policy, Health Care Management and Health Economics, Hebrew University - Hadassah Faculty of Medicine
- Chief Scientist, Israel Ministry of Health
| | - Meir Iri Liebergall
- Orthopedic Department of Surgery, Hadassah Medical Center, Hebrew University, Jerusalem Israel
| | - Omer Or
- Orthopedic Department of Surgery, Hadassah Medical Center, Hebrew University, Jerusalem Israel
| | | | - Dan Justo
- Geriatics Department, Sheba Medical Center, Ramat-Gan, Israel
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Eyal Zimlichman
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Central Management,Sheba Medical Center, Ramat-Gan, Israel
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Zhu H, Li F, Chang Y, Sun Y, Wang N, Wang R. Evaluation of the Effects of R-CHOP Chemotherapy on Brain Glucose Metabolism in Patients with Diffuse Large B Cell Lymphoma: A Baseline, Interim, and End-of-Treatment PET/CT Study. Tomography 2022; 8:2565-2573. [PMID: 36287813 PMCID: PMC9607544 DOI: 10.3390/tomography8050214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 10/07/2022] [Accepted: 10/08/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND To investigate the effect of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) chemotherapy on brain glucose metabolism in patients with diffuse large B cell lymphoma (DLBCL). METHODS Seventy-two patients with newly diagnosed DLBCL underwent FDG PET/CT brain and whole-body scans at baseline (PET0), in the interim of chemotherapy (PET2), and at the end (PET6) of chemotherapy. All three brain scans of each patient were analyzed using statistical parametric mapping software. RESULTS Compared with the PET0 scan, the PET2 and PET6 scans revealed a significantly higher glucose metabolism throughout the whole brain, with the PET6 scan revealing a higher metabolism than the PET2 scan. Patients with a complete response (CR) displayed decreased glucose metabolism in the lingual gyrus and increased glucose metabolism in the pons after chemotherapy compared with the findings in patients with partial responses or progressive disease. CONCLUSIONS Brain glucose metabolism was affected by R-CHOP treatment throughout the entire chemotherapy protocol.
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Affiliation(s)
- Haiyan Zhu
- Department of Hematology, The Fifth Medical Center, Beijing 100039, China
| | - Fei Li
- Department of Hematology, The Fifth Medical Center, Beijing 100039, China
| | - Yan Chang
- Department of Nuclear Medicine, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Yabing Sun
- Department of Nuclear Medicine, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Nan Wang
- Department of Hematology, The Fifth Medical Center, Beijing 100039, China
| | - Ruimin Wang
- Department of Nuclear Medicine, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
- Correspondence: ; Tel.: +86-10-669-36793
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Bach A, Knauer K, Graf J, Schäffeler N, Stengel A. Psychiatric comorbidities in cancer survivors across tumor subtypes: A systematic review. World J Psychiatry 2022; 12:623-635. [PMID: 35582337 PMCID: PMC9048448 DOI: 10.5498/wjp.v12.i4.623] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 12/20/2021] [Accepted: 03/07/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Psychiatric disorders are common but underdiagnosed in cancer survivors. Research suggests that tumor type has an effect on the prevalence of clinically relevant depression, anxiety, comorbid anxiety-depression and posttraumatic stress disorder (PTSD).
AIM To identify studies that examined the prevalence of clinically relevant levels of depression, anxiety, comorbid anxiety-depression and PTSD for patients with one or more tumor sites and compare those prevalences between cancer subtypes.
METHODS Four databases (PubMed, PsycInfo, PubPsych and the Cochrane Database) were searched and resulted in a total of 2387 articles to be screened. To be included, a study must have investigated cancer-free and posttreatment survivors using tools to assess clinically relevant levels of the listed psychiatric comorbidities. All articles were screened by two authors with a third author reviewing debated articles.
RESULTS Twenty-six studies on ten different tumor types fulfilled all inclusion criteria and were included in the review. The studies showed heterogeneity regarding the study characteristics, number of participants, time since diagnosis, and assessment tools. Generally, all four comorbidities show higher prevalences in cancer survivors than the general population. Brain tumor survivors were reported to have a relatively high prevalence of both depression and anxiety. Studies with melanoma survivors reported high prevalences of all four psychiatric comorbidities. Regarding comorbidities, a wide range in prevalence existed across the tumor types. Within one cancer site, the prevalence also varied considerably among the studies.
CONCLUSION Psychiatric comorbidities are more frequent in cancer survivors than in the general population, as reflected by the prevalence of depression, anxiety, comorbid anxiety-depression and PTSD across all tumor subtypes. Developing generalized screening tools that examine psychological distress in cancer survivors up to at least ten years after diagnosis could help to understand and address the psychological burden of cancer survivors.
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Affiliation(s)
- Anne Bach
- Section Psychooncology, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen 72076, Germany
| | - Klara Knauer
- Section Psychooncology, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen 72076, Germany
| | - Johanna Graf
- Section Psychooncology, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen 72076, Germany
| | - Norbert Schäffeler
- Section Psychooncology, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen 72076, Germany
| | - Andreas Stengel
- Section Psychooncology, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen 72076, Germany
- Germany & Charité Center for Internal Medicine and Dermatology, Department for Psychosomatic Medicine, Charite-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin 10117, Germany
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Jung A, Crandell JL, Nielsen ME, Smith SK, Bryant AL, Mayer DK. Relationships among uncertainty, post-traumatic stress disorder symptoms, and quality of life in non-muscle-invasive bladder cancer survivors. Support Care Cancer 2022; 30:6175-6185. [PMID: 35437672 DOI: 10.1007/s00520-022-07034-1] [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: 11/17/2021] [Accepted: 04/03/2022] [Indexed: 11/12/2022]
Abstract
PURPOSE The aim of this study was to examine relationships among uncertainty, PTSD symptoms (PTSS), and quality of life (QOL) in non-muscle-invasive bladder cancer (NMIBC) survivors. METHODS Eligible NMIBC survivors were identified through the North Carolina Central Cancer Registry, and 398 survivors participated in a mailed survey that measured survivor's outcomes (uncertainty, PTSS, and QOL). Structural equation modeling was used to examine the mediating effect of uncertainty and PTSS on the association between personal characteristics and QOL in NMIBC survivors. RESULTS NMIBC survivors experienced cancer-related uncertainty; higher uncertainty was associated with male, lower income, lack of cure, and lower cognition-ability. Uncertainty was significantly and negatively associated with QOL. In addition, PTSS completely mediated the effect of uncertainty on QOL, and higher PTSS had a strong association with poorer QOL. Additionally, comorbidities, cognition-general concerns, uncertainty, and PTSS had strong negative effects on QOL. CONCLUSION This study has identified modifiable psychosocial factors which affect QOL in NMIBC survivors. The study findings can be used in the development of interventions to improve QOL for NMIBC survivors.
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Affiliation(s)
- Ahrang Jung
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. .,School of Nursing, University of North Carolina at Greensboro, Greensboro, NC, USA.
| | - Jamie L Crandell
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Matthew E Nielsen
- School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA
| | | | - Ashley Leak Bryant
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA
| | - Deborah K Mayer
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Can the migration process influence the clinical expression of heroin use disorder in migrants to Italy? CNS Spectr 2021; 26:62-70. [PMID: 31969204 DOI: 10.1017/s1092852919001846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND For some time now, there has been a strong consensus that the migration process can influence the onset, course, development, outcome, and clinical aspects of psychiatric pathologies. METHODS In this study, we have analyzed the influence of the migration process on the clinical expression of heroin use disorder (HUD). In a naturalistic case-control study, we compared, both at univariate and multivariate level, 30 migrant HUD (M-HUD) patients with 30 age/gender-matched Italian HUD (IT-HUD) patients. We also analyzed demographic data, drug addiction history, psychopathological symptoms, addictive behavior, and emotional reactivity to life events. RESULTS Compared with IT-HUD pairs, at HUD Agonist Opioid Treatment, M-HUD patients were characterized by inadequate income and the presence of legal problems. They were more frequently at stage 3 of heroin addiction, with a concomitantly less frequent use of stimulants. Their age at the onset of heroin use was greater than that of subjects in the IT-HUD group. HUD post-traumatic stress disorder spectrum was present and was more severe in all M-HUD patients, but grief reactions and maladaptive behavior were the most discriminant traits. No differences were found in terms of addictive behaviors related to heroin craving or with respect to the severity/typology of psychopathology specific to HUD. CONCLUSIONS The migratory process does not seem to be correlated with addictive behaviors or with psychopathology specific to HUD. It partly affects HUD history, and specifically correlates with emotional reactivity to loss and traumatic life events, so suggesting that in M-HUD individuals, the link between the migratory syndrome and HUD is very close.
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Jung A, Crandell JL, Nielsen ME, Mayer DK, Smith SK. Post-traumatic stress disorder symptoms in non-muscle-invasive bladder cancer survivors: A population-based study. Urol Oncol 2020; 39:237.e7-237.e14. [PMID: 33308978 DOI: 10.1016/j.urolonc.2020.11.033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 10/22/2020] [Accepted: 11/21/2020] [Indexed: 12/21/2022]
Abstract
OBJECTIVE This cross-sectional study examined the prevalence of post-traumatic stress disorder (PTSD) and identified the predictive factors associated with PTSD symptoms in a population of non-muscle-invasive bladder cancer (NMIBC) survivors. METHODS A random sample of 2,000 NMIBC survivors, identified through the North Carolina Central Cancer Registry, were sent postal mail survey. PTSD symptoms were measured using the PTSD Checklist for DSM-5 (PCL-5). Descriptive statistics and hierarchical multiple linear regression were used to examine the prevalence of PTSD and to identify the factors associated with PTSD. RESULTS A total of 376 participants were included in the analysis. The average PCL-5 score was 7.1 (standard deviation [SD] = 10.9, range: 0-66), where higher scores represent higher levels of PTSD symptoms. The prevalence of the provisional PTSD diagnosis was 5.3% or 6.9% (after adjusting for nonresponse). In addition, 28.7% of participants met criteria for at least one PTSD symptom cluster. After controlling for other variables, participants who were younger, had active disease or unsure of status, had more comorbidities, had lower social support, and had higher cognitive concerns reported significantly higher PTSD symptoms. CONCLUSION More than one-fourth of NMIBC survivors had PTSD symptoms. Thus, healthcare providers should assess PTSD symptoms and provide supportive care for NMIBC survivors in the survivorship phase of care.
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Affiliation(s)
- Ahrang Jung
- School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, NC.
| | - Jamie L Crandell
- School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Matthew E Nielsen
- Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC; School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Deborah K Mayer
- School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, NC; Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC
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Schoormans D, Jansen M, Mols F, Oerlemans S. Negative illness perceptions are related to more fatigue among haematological cancer survivors: a PROFILES study. Acta Oncol 2020; 59:959-966. [PMID: 32412348 DOI: 10.1080/0284186x.2020.1759823] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objectives: The common sense model provides a theoretical framework for understanding substantial fatigue among (haematological) cancer survivors based on their illness perceptions. We therefore examined the associations between modifiable illness perceptions and substantial fatigue while controlling for sociodemographic, clinical, and psychological factors (symptoms of depression and anxiety) among haematological cancer survivors.Methods: Data from the population-based PROFILES registry were used. Survivors diagnosed between 1999 and 2013 with Hodgkin lymphoma (N = 164), non-Hodgkin lymphoma (N = 655) and chronic lymphocytic leukaemia (N = 174) were included. Survivors completed the Brief Illness Perception Questionnaire (B-IPQ), the Fatigue Assessment Scale (FAS), and Hospital Anxiety and Depression Scale (HADS). Multivariable logistic regressions analyses were performed for the total group and three haematological cancers separately relating illness perceptions to substantial fatigue (>21 FAS).Results: Haematological cancer survivors with illness perceptions that represent more negative consequences (consequences, OR = 1.27; 95%CI = 1.13-1.42); attribute more symptoms to their illness (identity, OR = 1.29; 95%CI = 1.17-1.43); and have a poorer illness understanding (coherence, 1.13; 1.04-1.22) were more often substantially fatigued. For the remaining five illness perceptions, no significant association was found. Non-Hodgkin lymphoma survivors who reported a poor illness understanding (coherence, OR = 1.35; 95% CI = 1.06-1.72) and chronic lymphocytic leukaemia survivors who reported that treatment can control (OR = 1.25; 95%CI = 1.01-1.55) the illness experienced more often substantial fatigue.Conclusion: Those who experience more consequences of their disease, attribute more symptoms to their illness, and have a poorer illness understanding, have a higher risk to experience substantial levels of fatigue even years after diagnosis. Psychological interventions changing these illness perceptions may be beneficial in reducing fatigue among haematological cancer survivors.
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Affiliation(s)
- Dounya Schoormans
- CoRPS - Center of Research on Psychological and Somatic disorders, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Mandy Jansen
- CoRPS - Center of Research on Psychological and Somatic disorders, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Floortje Mols
- CoRPS - Center of Research on Psychological and Somatic disorders, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Simone Oerlemans
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
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12
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Abstract
This literature review differentially describes mental disorders in patients with Hodgkin's lymphoma (HL) with an emphasis on psychotic disorders, affective states and adjustment disorders. Psychotic disorders observed in patients with HL include affective, delusional conditions, delirium. There are different psychogenic states among the adjustment disorders. Attention is drawn to the frequency of anxious, depressive or mixed states. Conversion disorders and behavioral disorders that lead to non-compliance in patients with HL are described as well. In nosologic aspect, mental disorders in HL are classified as somatogenic and adjustement disorders.
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Affiliation(s)
- L V Olexenko
- National Research Center for Hematology, Moscow, Russia
| | - D E Vybornykh
- National Research Center for Hematology, Moscow, Russia
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13
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Dai W, Kaminga AC, Tan H, Wang J, Lai Z, Wu X, Liu A. Long-term psychological outcomes of flood survivors of hard-hit areas of the 1998 Dongting Lake flood in China: Prevalence and risk factors. PLoS One 2017; 12:e0171557. [PMID: 28170427 PMCID: PMC5295691 DOI: 10.1371/journal.pone.0171557] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Accepted: 01/23/2017] [Indexed: 12/11/2022] Open
Abstract
Background Although numerous studies have indicated that exposure to natural disasters may increase survivors’ risk of post-traumatic stress disorder (PTSD) and anxiety, studies focusing on the long-term psychological outcomes of flood survivors are limited. Thus, this study aimed to estimate the prevalence of PTSD and anxiety among flood survivors 17 years after the 1998 Dongting Lake flood and to identify the risk factors for PTSD and anxiety. Methods This cross-sectional study was conducted in December 2015, 17 years after the 1998 Dongting Lake flood. Survivors in hard-hit areas of the flood disaster were enrolled in this study using a stratified, systematic random sampling method. Well qualified investigators conducted face-to-face interviews with participants using the PTSD Checklist-Civilian version, the Zung Self-Rating Anxiety Scale, the Chinese version of the Social Support Rating Scale and the Revised Eysenck Personality Questionnaire-Short Scale for Chinese to assess PTSD, anxiety, social support and personality traits, respectively. Logistic regression analyses were used to identify factors associated with PTSD and anxiety. Results A total of 325 participants were recruited in this study, and the prevalence of PTSD and anxiety was 9.5% and 9.2%, respectively. Multivariable logistic regression analyses indicated that female sex, experiencing at least three flood-related stressors, having a low level of social support, and having the trait of emotional instability were risk factors for long-term adverse psychological outcomes among flood survivors after the disaster. Conclusions PTSD and anxiety were common long-term adverse psychological outcomes among flood survivors. Early and effective psychological interventions for flood survivors are needed to prevent the development of PTSD and anxiety in the long run after a flood, especially for individuals who are female, experience at least three flood-related stressors, have a low level of social support and have the trait of emotional instability.
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Affiliation(s)
- Wenjie Dai
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Atipatsa C. Kaminga
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
- Department of Mathematics, Mzuzu University, Mzuzu, Malawi
| | - Hongzhuan Tan
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Jieru Wang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States of America
| | - Zhiwei Lai
- Immune Planning Division, Hunan Provincial Center for Disease Control and Prevention, Changsha, Hunan, China
| | - Xin Wu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Aizhong Liu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
- * E-mail:
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14
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Drost FM, Mols F, Kaal SEJ, Stevens WBC, van der Graaf WTA, Prins JB, Husson O. Psychological impact of lymphoma on adolescents and young adults: not a matter of black or white. J Cancer Surviv 2016; 10:726-35. [PMID: 26856728 PMCID: PMC4920833 DOI: 10.1007/s11764-016-0518-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Accepted: 01/20/2016] [Indexed: 01/11/2023]
Abstract
PURPOSE The purpose of the study is to examine differences in perceived impact of cancer (IOC) between adolescents and young adults (AYAs; 18-35 years at cancer diagnosis), adults (36-64 years) and elderly (65-84 years) with a history of (non-)Hodgkin lymphoma. Furthermore, to investigate the association of socio-demographic, clinical and psychological characteristics with IOC; and the association between IOC and health-related quality of life (HRQoL) among AYAs only. METHODS This study is part of a population-based PROFILES registry survey among lymphoma patients diagnosed between 1999 and 2009. Patients (n = 1.281) were invited to complete the IOCv1 and EORTC-QLQ-C30 questionnaires. Response rate was 67 % (n = 861). RESULTS AYA lymphoma survivors scored higher on the positive IOC summary scale, compared to adult and elderly patients (p < 0.001), while no significant differences were observed for negative IOC. Among AYAs, females, survivors with a partner, and survivors with elevated psychological distress levels scored significantly higher on the negative IOC summary scale. The negative IOC summary scale was negatively associated with all EORTC QLQ-C30 functioning scales (β ranging from -0.39 to -0.063; p < 0.05). The positive IOC summary scale was negatively associated with the EORTC QLQ-C30 subscale 'Emotional functioning' (β = -0.24; p < 0.05). CONCLUSION AYA, adult and elderly with a history of (non-)Hodgkin lymphoma experienced different types of IOC in terms of positive and negative aspects. IMPLICATIONS FOR CANCER SURVIVORS Although AYAs experience a more positive IOC compared to older survivors, some AYAs experience more negative IOC and may require developmentally appropriate interventions to address their specific concerns.
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Affiliation(s)
- F M Drost
- CoRPS - Centre of Research on Psychology in Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - F Mols
- CoRPS - Centre of Research on Psychology in Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
- Comprehensive Cancer Centre the Netherlands (CCCN), Netherlands Cancer Registry, Eindhoven, The Netherlands
| | - S E J Kaal
- Department of Medical Oncology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - W B C Stevens
- Department of Haematology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - W T A van der Graaf
- Department of Medical Oncology, Radboud University Medical Centre, Nijmegen, The Netherlands
- The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, UK
| | - J B Prins
- Department of Medical Psychology, Radboud University Medical Centre, PO Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - O Husson
- Department of Medical Psychology, Radboud University Medical Centre, PO Box 9101, 6500 HB, Nijmegen, The Netherlands.
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15
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McKnight PE, Monfort SS, Kashdan TB, Blalock DV, Calton JM. Anxiety symptoms and functional impairment: A systematic review of the correlation between the two measures. Clin Psychol Rev 2016; 45:115-30. [DOI: 10.1016/j.cpr.2015.10.005] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Revised: 10/23/2015] [Accepted: 10/29/2015] [Indexed: 01/01/2023]
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Bhuller KS, Zhang Y, Li D, Sehn LH, Goddard K, McBride ML, Rogers PC. Late mortality, secondary malignancy and hospitalisation in teenage and young adult survivors of Hodgkin lymphoma: report of the Childhood/Adolescent/Young Adult Cancer Survivors Research Program and the BC Cancer Agency Centre for Lymphoid Cancer. Br J Haematol 2016; 172:757-68. [PMID: 26727959 DOI: 10.1111/bjh.13903] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Accepted: 10/30/2015] [Indexed: 02/02/2023]
Abstract
Late complications affecting Hodgkin lymphoma (HL) survivors are well described in paediatric and adult-based publications. This study determined the late morbidity and mortality risk for 442 teenage and young adult (TYAs) 5-year HL survivors, diagnosed at 15-24 years of age between 1970 and 1999, identified from the British Columbia Cancer Registry. Treatment details were abstracted from charts. Survivors and a matched comparison cohort were linked to provincial administrative health datasets until December 2006 and regression analysis was performed, providing risk ratios regarding mortality, secondary malignancy and morbidity causing hospitalisation. Sixty (13·6%) survivors experienced late mortality with excess deaths from secondary cancer [standardised mortality ratio (SMR) 18·6; 95% confidence interval (CI) 11-29·4] and non-malignant disease (SMR 3·6; 95% CI 2·2-5·5). Excess secondary cancers (standardised incidence ratio 7·8; 95% CI 5·6-10·5) were associated with radiotherapy [Hazard ratio (HR) 2·7; 95% CI 1-7·7] and female gender (HR 1·8; 95% CI 1-3·4). Of 281 survivors treated between 1981 and 1999, 143 (51%) had morbidity resulting in hospitalisation (relative risk 1·45; 95% CI 1·22-1·73). Hospitalisation significantly increased with combined modality therapy, chemotherapy alone and recent treatment era. TYA HL survivors have excess risk of mortality and secondary malignancy continuing 30 years from diagnosis. Radiotherapy is associated with secondary malignancy and current response-adapted protocols attempt to minimise exposure, but late morbidity causing hospitalisation remains significant.
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Affiliation(s)
- Kaljit S Bhuller
- Paediatric, Teenage & Young Adult (TYA) Haematology, Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust, Leicester, UK.,Division of Hematology, Oncology and Bone Marrow Transplant, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia, Canada
| | - Yang Zhang
- Cancer Control Research Program, British Columbia Cancer Research Centre, British Columbia Cancer Agency, Vancouver, British Columbia, Canada
| | - Dongdong Li
- Cancer Control Research Program, British Columbia Cancer Research Centre, British Columbia Cancer Agency, Vancouver, British Columbia, Canada
| | - Laurie H Sehn
- Division of Medical Oncology and Centre for Lymphoid Cancer, British Columbia Cancer Agency and University of British Columbia, Vancouver, British Columbia, Canada
| | - Karen Goddard
- Division of Radiation Oncology, British Columbia Cancer Agency and University of British Columbia, Vancouver, British Columbia, Canada
| | - Mary L McBride
- Cancer Control Research Program, British Columbia Cancer Research Centre, British Columbia Cancer Agency, Vancouver, British Columbia, Canada.,School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Paul C Rogers
- Division of Hematology, Oncology and Bone Marrow Transplant, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia, Canada
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17
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Liu L, Yang YL, Wang ZY, Wu H, Wang Y, Wang L. Prevalence and Positive Correlates of Posttraumatic Stress Disorder Symptoms among Chinese Patients with Hematological Malignancies: A Cross-Sectional Study. PLoS One 2015; 10:e0145103. [PMID: 26669841 PMCID: PMC4679613 DOI: 10.1371/journal.pone.0145103] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Accepted: 11/28/2015] [Indexed: 12/25/2022] Open
Abstract
PURPOSE Positive psychological constructs have been given increasing attention in research on the coping resources of cancer-related distresses. However, little research is available on posttraumatic stress disorder (PTSD) in patients with hematological malignancies. The purposes of this study were to assess the prevalence of PTSD symptoms and to explore the associations of perceived social support (PSS), hope, optimism and resilience with PTSD symptoms among Chinese patients with hematological malignancies. METHODS A cross-sectional study was conducted during the period from July 2013 through April 2014. A total of 225 inpatients with hematological malignancies, which were eligible for the study, completed the Post-traumatic Stress Checklist-Civilian Version, Multidimensional Scale of Perceived Social Support, Adult Hope Scale, Life Orientation Scale-Revised, and Resilience Scale. Hierarchical regression analysis was performed to explore the correlates of PTSD symptoms. RESULTS Overall, the prevalence of PTSD symptoms was 10.7%. Initially, PSS was negatively associated with PTSD symptoms (β = -0.248, P < 0.01). However, when positive psychological variables were added, optimism was negatively associated with PTSD symptoms (β = -0.452, P < 0.01), and gender had a significant effect on PTSD symptoms. Women were more vulnerable to these symptoms than men (β = 0.123, P < 0.05). When the analysis was performed separately by gender, only optimism showed a significantly negative association with PTSD symptoms in both men (β = -0.389, P < 0.01) and women (β = -0.493, P < 0.01). CONCLUSIONS Some patients with hematological malignancies suffer from PTSD symptoms. The positive effects of PSS and optimism on PTSD symptoms suggest that an integrated approach to psychosocial intervention from both external and internal perspectives could have practical significance. Gender difference should be considered in developing potential interventions in reducing cancer-related PTSD symptoms.
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Affiliation(s)
- Li Liu
- Department of Social Medicine, School of Public Health, China Medical University, Shenyang, Liaoning, People’s Republic of China
| | - Yi-Long Yang
- Department of Social Medicine, School of Public Health, China Medical University, Shenyang, Liaoning, People’s Republic of China
| | - Zi-Yue Wang
- Department of Social Medicine, School of Public Health, China Medical University, Shenyang, Liaoning, People’s Republic of China
| | - Hui Wu
- Department of Social Medicine, School of Public Health, China Medical University, Shenyang, Liaoning, People’s Republic of China
| | - Yang Wang
- Department of Social Medicine, School of Public Health, China Medical University, Shenyang, Liaoning, People’s Republic of China
| | - Lie Wang
- Department of Social Medicine, School of Public Health, China Medical University, Shenyang, Liaoning, People’s Republic of China
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18
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Bryant AL, Smith SK, Zimmer C, Crandell J, Jenerette CM, Bailey DE, Zimmerman S, Mayer DK. An exploratory path model of the relationships between positive and negative adaptation to cancer on quality of life among non-Hodgkin lymphoma survivors. J Psychosoc Oncol 2015; 33:310-31. [PMID: 25751114 DOI: 10.1080/07347332.2015.1020978] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Adaptation is an ongoing, cognitive process with continuous appraisal of the cancer experience by the survivor. This exploratory study tested a path model examining the personal (demographic, disease, and psychosocial) characteristics associated with quality of life (QOL) and whether or not adaptation to living with cancer may mediate these effects. This study employed path analysis to estimate adaptation to cancer. A cross-sectional sample of NHL survivors (N = 750) was used to test the model. Eligible participants were ≥ 18 years, at least 2 years post-diagnosis, and living with or without active disease. Sixty-eight percent of the variance was accounted for in QOL. The strongest effect (-0.596) was direct by negative adaptation, approximately 3 times that of positive adaptation (0.193). The strongest demographic total effects on QOL were age and social support; <65 years of age had better QOL and better adaptation compared to those ≥ 65. Of the disease characteristics, comorbidity score had the strongest direct effect on QOL; each additional comorbidity was associated with a 0.309 standard deviation decline on QOL. There were no fully mediated effects through positive adaptation alone. Our exploratory findings support the coexistence of positive and negative adaptations perception as mediators of personal characteristics of the cancer experience. Negative adaptation can affect QOL in a positive way. Cancer survivorship is simultaneously shaped by both positive and negative adaptation with future research and implications for practice aimed at improving QOL.
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Affiliation(s)
- Ashley Leak Bryant
- a School of Nursing, University of North Carolina at Chapel Hill , Chapel Hill , NC , USA
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19
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Quality of life more impaired in younger than in older diffuse large B cell lymphoma survivors compared to a normative population: a study from the population-based PROFILES registry. Ann Hematol 2013; 93:811-9. [DOI: 10.1007/s00277-013-1980-1] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Accepted: 11/27/2013] [Indexed: 01/04/2023]
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20
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Straus DJ. Long-term survivorship at a price: late-term, therapy-associated toxicities in the adult hodgkin lymphoma patient. Ther Adv Hematol 2013; 2:111-9. [PMID: 23556081 DOI: 10.1177/2040620711402414] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
There have been an increasing number of survivors of successful treatment of Hodgkin lymphoma (HL) over the past 30 years. Although these survivors may be cured of their HL, long-term morbidity and mortality are associated with late toxicities of treatment. Identification of these late complications will lead to strategies to manage them when they occur and hopefully to decrease the risk of their development. Second malignancies followed by cardiovascular disease are the leading causes of late morbidity and mortality. Musculoskeletal difficulties, endocrine abnormalities including sterility and thyroid disease, heart and lung damage, persistent fatigue and psychosocial distress have also been seen. The subjects of this review are the late complications of primary treatment of HL and autologous stem cell transplantation, usually for relapsed disease.
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Cavalcanti-Ribeiro P, Andrade-Nascimento M, Morais-de-Jesus M, de Medeiros GM, Daltro-Oliveira R, Conceição JO, Rocha MF, Miranda-Scippa Â, Koenen KC, Quarantini LC. Post-traumatic stress disorder as a comorbidity: impact on disease outcomes. Expert Rev Neurother 2013; 12:1023-37. [PMID: 23002944 DOI: 10.1586/ern.12.77] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Post-traumatic stress disorder (PTSD) is associated with many psychiatric and nonpsychiatric comorbidities. Growing evidence suggests that PTSD as a comorbidity may impair drug adherence, quality of life and sleep quality, as well as increase rehospitalization rates, disease relapses, intensity of symptoms, morbidity and mortality. The aim of this article is to examine the literature regarding the effects of PTSD comorbidity on physical and mental health.
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22
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Haeck M, Franke S, Wiskemann J, Mathiak K. [Psycho-oncology]. DER NERVENARZT 2012; 83:1468-1476. [PMID: 23069897 DOI: 10.1007/s00115-012-3669-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Psycho-oncology addresses the psychosocial care of patients with cancer. Systematic research on the interactions between biological, psychological and social factors before, during and after cancer has only been carried out for a few decades. All cancer patients, their relatives and the treating medical team should receive low-threshold offers for psychosocial support. The demand for interdisciplinary counselling and therapy detected by clinical diagnosis and by systematic screening, is not satisfactorily covered and is continuously increasing. In collaboration between the involved professional groups, education and professional qualifications for psycho-oncologists are still being developed.
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Affiliation(s)
- M Haeck
- Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Universitätsklinikum Aachen, RWTH Aachen, Pauwelsstr. 30, 52074 Aachen, Deutschland
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23
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Gold JI, Douglas MK, Thomas ML, Elliott JE, Rao SM, Miaskowski C. The relationship between posttraumatic stress disorder, mood states, functional status, and quality of life in oncology outpatients. J Pain Symptom Manage 2012; 44:520-31. [PMID: 22743157 DOI: 10.1016/j.jpainsymman.2011.10.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2011] [Revised: 10/20/2011] [Accepted: 10/27/2011] [Indexed: 10/28/2022]
Abstract
CONTEXT Oncology patients are at risk for developing posttraumatic stress disorder (PTSD) and other comorbid mood states, which are associated with decreases in functional status and quality of life (QOL). However, few studies have investigated the relationship between PTSD, other mood states, functional status, and QOL in oncology outpatients. OBJECTIVES This study had four aims: 1) determine the percentages of patients with PTSD and partial PTSD; 2) evaluate for differences in demographic and clinical characteristics among patients with PTSD, partial PTSD, and no PTSD; 3) evaluate for differences in mood states, functional status, and QOL among the three PTSD groups; and 4) evaluate whether demographic and disease characteristics were predictors of PTSD. METHODS As part of a larger clinical trial that evaluated the effects of a cognitive-behavioral intervention on cancer pain management, 289 adult oncology patients (M(age)=61.3, SD=11.6) completed self-report measures that assessed PTSD, other mood states, functional status, and QOL. RESULTS Forty-five percent of the sample met the diagnostic criteria for PTSD (n=78) and partial PTSD (n=53) and were younger than those with no PTSD. Patients with PTSD had a significantly lower Karnofsky Performance Status, shorter time since diagnosis, higher ratings of mood disturbance, lower ratings of functional status, and lower QOL than patients with no PTSD. A lower Karnofsky Performance Status, fewer months since diagnosis, and presence of bone metastases predicted a higher likelihood of being classified as having PTSD. CONCLUSION Early identification and interventions may mediate the onset of psychological distress and improve health outcomes.
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Affiliation(s)
- Jeffrey I Gold
- Keck School of Medicine, University of Southern California, and Pain Management and Palliative Care Program, Department of Anesthesiology Critical Care Medicine, Children's Hospital Los Angeles, CA 90027, USA.
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24
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Oerlemans S, Mols F, Issa DE, Pruijt JHFM, Peters WG, Lybeert M, Zijlstra W, Coebergh JWW, van de Poll-Franse LV. A high level of fatigue among long-term survivors of non-Hodgkin's lymphoma: results from the longitudinal population-based PROFILES registry in the south of the Netherlands. Haematologica 2012; 98:479-86. [PMID: 22929981 DOI: 10.3324/haematol.2012.064907] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
The course of fatigue and quality of life in survivors of non-Hodgkin's lymphoma is unknown. The aims of this study were, therefore, to assess fatigue and quality of life in patients with non-Hodgkin's lymphoma following primary treatment, compare fatigue and quality of life in these patients with those of an age- and sex matched normative population to assess the severity of concerns and identify associations with fatigue of survivors who remained fatigued. The population-based Eindhoven Cancer Registry was used to select all patients diagnosed with non-Hodgkin's lymphoma from 1999-2009. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire and the Fatigue Assessment Scale were completed once by 824 survivors of non-Hodgkin's lymphoma (80% response rate); 434 survivors completed these questionnaires again 1 year later. Survivors of non-Hodgkin's lymphoma reported more clinically relevant fatigue up till 10 years post-diagnosis compared to a normative population (P<0.001). Mean fatigue scores remained fairly stable over time (T1: x=28, SD=26; T2: x=30, SD=27, P=0.14): 22-28% of survivors reported deterioration, 19-23% reported improvement and 44-54% reported constant fatigue. Survivors who reported constant fatigue were more often diagnosed with stage IV disease and had more comorbid diseases. They were additionally more often female and divorced. Having comorbidities and being without a partner were also associated with constant fatigue in the normative population. In conclusion, six out of every ten responding non-Hodgkin's lymphoma survivors reported a high level of fatigue up till 10 years after diagnosis. Mean fatigue scores remained stable over time and survivors reporting constant fatigue more often had stage IV disease at diagnosis and comorbidities.
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Oerlemans S, Smith SK, Crespi CM, Zimmerman S, van de Poll-Franse LV, Ganz PA. Assessing the impact of cancer among Dutch non-Hodgkin lymphoma survivors compared with their American counterparts: a cross-national study. Psychooncology 2012; 22:1258-65. [PMID: 22833503 DOI: 10.1002/pon.3131] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2012] [Revised: 06/19/2012] [Accepted: 06/20/2012] [Indexed: 01/22/2023]
Abstract
PURPOSE To understand cultural differences in the impact of cancer (IOC) by (i) performing an independent psychometric evaluation of the Dutch version of the Impact of Cancer Scale version 2 (IOCv2) in a non-Hodgkin lymphoma (NHL) sample and (ii) examining differences between Dutch and American NHL survivors in perceived IOC and identifying associations with socio-demographic and clinical characteristics. METHODS Data collected from 491 Dutch and 738 American NHL survivors were used in this study. IOCv2 responses were obtained from all survivors; the Dutch survivors also completed the European Organization for Research and Treatment of Cancer Quality of Life Core questionnaire, which measures quality of life. RESULTS Exploratory factor analysis of the Dutch version yielded a factor solution similar to the American structure but with some subscales merging into single factors. Internal consistency was good; Cronbach's alpha was 0.88 for the Positive and 0.94 for the Negative summary scales. Large differences were observed between survivors, whereby Dutch survivors reported fewer Positive (Δ -0.4, p < 0.001, effect size: 0.27) and more Negative (Δ 0.2, p ≤ 0.001, effect size: 0.13) impacts of cancer independent of socio-demographic and clinical characteristics. CONCLUSION Similar impact domains of the IOCv2 were observed in the Dutch sample, providing evidence that IOCv2 scales measure common and important survivor concerns across two different Western nations. Higher positive impacts for US survivors might be explained by more personal control and availability of supportive services. Future research should focus on determinants of the IOC in both Dutch and American survivors to gain better understanding of the factors that might improve it and suggest how health care may be modified toward that end.
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Smith HAB, Fuchs DC, Pandharipande PP, Barr FE, Ely EW. Delirium: an emerging frontier in the management of critically ill children. Anesthesiol Clin 2011; 29:729-50. [PMID: 22078920 DOI: 10.1016/j.anclin.2011.09.011] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Delirium is a syndrome of acute brain dysfunction that commonly occurs in critically ill adults and most certainly is prevalent in critically ill children all over the world. The dearth of information about the incidence, prevalence, and severity of pediatric delirium stems from the simple fact that there have not been well-validated instruments for routine delirium diagnosis at the bedside. This article reviewed the emerging solutions to this problem, including description of a new pediatric tool called the pCAM-ICU. In adults, delirium is responsible for significant increases in both morbidity and mortality in critically ill patients. The advent of new tools for use in critically ill children will allow the epidemiology of this form of acute brain dysfunction to be studied adequately, will allow clinical management algorithms to be developed and implemented following testing, and will present the necessary incorporation of delirium as an outcome measure for future clinical trials in pediatric critical care medicine.
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Affiliation(s)
- Heidi A B Smith
- Department of Anesthesiology, Vanderbilt University School of Medicine, Nashville, TN 37232, USA.
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Thompson CA, Mauck K, Havyer R, Bhagra A, Kalsi H, Hayes SN. Care of the adult Hodgkin lymphoma survivor. Am J Med 2011; 124:1106-12. [PMID: 22114824 PMCID: PMC3224339 DOI: 10.1016/j.amjmed.2011.05.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2011] [Revised: 05/20/2011] [Accepted: 05/20/2011] [Indexed: 12/18/2022]
Abstract
Of those individuals diagnosed with Hodgkin lymphoma, 85% will survive and may be affected by residual effects of their cancer and its therapy (chemotherapy, radiation therapy, stem cell transplantation). Hodgkin lymphoma survivors are at risk of developing secondary malignancies, cardiovascular disease, pulmonary disease, thyroid disease, infertility, premature menopause, chronic fatigue, and psychosocial issues. These conditions usually have a long latency and therefore present years or decades after Hodgkin lymphoma treatment, when the patient's care is being managed by a primary care provider. This review summarizes these unique potential medical and psychologic sequelae of Hodgkin lymphoma, and provides screening and management recommendations.
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Affiliation(s)
- Carrie A Thompson
- Division of Hematology, Mayo Clinic College of Medicine, Department of Internal Medicine, Rochester, MN 55905, USA.
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Martis N, Gisselbrecht C, Mounier N. Quality of life following treatment for B-cell lymphoma. Expert Rev Pharmacoecon Outcomes Res 2011; 11:523-32. [PMID: 21958097 DOI: 10.1586/erp.11.40] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Clinical outcome for B-cell non-Hodgkin's lymphoma has been greatly improved through the combination of new treatment options, in particular noncytotoxic drugs that specifically target disease mechanisms. Furthermore, in many cases, lymphoma survivors have to cope with long-term toxicity. Therefore, as with survival and remission length, the assessment of quality of life (QoL) is a major consideration when judging therapeutic benefit in patients. The aim of this article is to discuss the impact of widespread treatments on QoL and the relevance of QoL assessment in B-cell non-Hodgkin's lymphoma in day-to-day clinical practice. Additional studies of QoL in the general population, the associations between QoL and treatment strategy, QoL and specific situations (i.e., stem-cell transplantation and aging population) are also considered.
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Affiliation(s)
- Nihal Martis
- Service d'Onco-Hématologie, Hôpital de l'Archet, Nice, France
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Parry C, Morningstar E, Kendall J, Coleman EA. Working without a net: leukemia and lymphoma survivors' perspectives on care delivery at end-of-treatment and beyond. J Psychosoc Oncol 2011; 29:175-98. [PMID: 21391070 DOI: 10.1080/07347332.2010.548444] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This study explored survivors' perspectives on care delivery and supportive care needs during reentry. Fifty-one individual interviews were conducted with adult leukemia and lymphoma survivors, 3 to 48 months from treatment cessation. Survivors reported poor continuity of care across the patient-survivor transition, difficulty finding appropriate information/services, lack of preparation, lack of support for survivorship issues, and inadequate or poorly timed follow-up as factors contributing to adjustment difficulties at end of treatment and beyond. Improved care coordination is needed after active treatment, including use of an exit interview and delivery of services that are more congruent and better timed to meet ongoing and emergent survivorship needs.
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Affiliation(s)
- Carla Parry
- Division of Health Care Policy and Research, University of Colorado Denver School of Medicine, Aurora, CO, USA.
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30
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Oerlemans S, Mols F, Nijziel MR, Lybeert M, van de Poll-Franse LV. The impact of treatment, socio-demographic and clinical characteristics on health-related quality of life among Hodgkin's and non-Hodgkin's lymphoma survivors: a systematic review. Ann Hematol 2011; 90:993-1004. [PMID: 21670973 PMCID: PMC3150657 DOI: 10.1007/s00277-011-1274-4] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2011] [Accepted: 06/05/2011] [Indexed: 12/24/2022]
Abstract
Cancer survivors are at risk of experiencing adverse physical and psychosocial effects of their cancer and its treatment. Both Hodgkin’s lymphoma (HL) and non-Hodgkin’s lymphoma (NHL) survivors face problems that can affect their health-related quality of life (HRQoL). The authors systematically reviewed the literature on HRQoL among HL and NHL survivors. A PubMed and PsychINFO literature search for original articles published until May 2011 was performed. Twenty-four articles, which met the predefined inclusion criteria, were subjected to a quality checklist. HL survivors showed the most problems in (role) physical, social and cognitive functioning, general health, fatigue and financial problems. In addition, HL survivors treated with a combination of therapies, with older age and female sex reported worse HRQoL. NHL survivors showed the most problems in physical functioning, appetite loss, vitality and financial problems. Having had chemotherapy was negatively associated with HRQoL, but no differences in chemotherapy regimens were found. Furthermore, in NHL survivors not meeting public exercise guidelines, HRQoL is low but can be improved with more exercise. More research on the longitudinal comparison between HL and NHL survivors and healthy controls should be performed in order to better understand the long-term (side) effects of treatment on HRQoL and possibilities to alleviate these.
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Affiliation(s)
- Simone Oerlemans
- Research Department, Comprehensive Cancer Centre South, Eindhoven, The Netherlands.
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31
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Leak A, Mayer DK, Smith S. Quality of life domains among non-Hodgkin lymphoma survivors: an integrative literature review. Leuk Lymphoma 2011; 52:972-85. [PMID: 21534866 DOI: 10.3109/10428194.2011.563884] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Survival rates of individuals with non-Hodgkin lymphoma (NHL) have increased in the past several years, as has the prevalence of older adults who are managing late and long-term effects of the disease and its treatment. In this integrative review, the state of the science for determining the quality of life (QOL) among NHL survivors is outlined. An online search of Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, and the Cochrane Library databases was conducted using the following Keywords: non-Hodgkin lymphoma, health-related quality of life, quality of life, and impact of cancer. Eighteen studies published between 2000 and 2010 are reviewed. Of these, 17 were descriptive, cross-sectional designs, and one was a systematic review. The studies included participants of varying ages and years post-diagnosis as reported in several countries. Importantly, many used one or more QOL measures as outcome variables. Future research is needed on older and minority cancer populations and should include longitudinal and interventional studies.
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Affiliation(s)
- Ashley Leak
- School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7460, USA.
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Seides R. Should the current DSM-IV-TR definition for PTSD be expanded to include serial and multiple microtraumas as aetiologies? J Psychiatr Ment Health Nurs 2010; 17:725-31. [PMID: 21050339 DOI: 10.1111/j.1365-2850.2010.01591.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Post-traumatic stress disorder (PTSD) is an anxiety disorder that develops from events that are interpreted as traumatic. It may be secondary to witnessing trauma to someone close, an event that threatens one's life or childhood sexual trauma. Resultant feelings can be fear, helplessness or horror. Thresholds at which traumatic events cause PTSD, the individual's coping ability and support systems help determine occurrence and severity of symptoms. According to DSM-IV-TR (DSM) definition, PTSD can occur after childhood sexual abuse or a single trauma threatening life or safety. However, it is becoming clearer that symptoms of PTSD can arise from multiple less severe traumas ('microtraumas'), which can be a consequence of a history of longstanding emotional neglect, humiliation or inaccurate attribution of blame. The DSM should consider modifying the criteria to include multiple microtraumas that can lead to PTSD symptoms and may even be more destructive to psychological health.
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Affiliation(s)
- R Seides
- College of Nursing, Seton Hall University, South Orange, NJ 07079, USA.
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Arden-Close E, Absolom K, Greenfield DM, Hancock BW, Coleman RE, Eiser C. Gender differences in self-reported late effects, quality of life and satisfaction with clinic in survivors of lymphoma. Psychooncology 2010; 20:1202-10. [DOI: 10.1002/pon.1835] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2010] [Revised: 07/13/2010] [Accepted: 07/15/2010] [Indexed: 12/21/2022]
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Dooley JJ, Wilson JP, Anderson VA. Stress and depression of facing death: Investigation of psychological symptoms in patients with mesothelioma. AUSTRALIAN JOURNAL OF PSYCHOLOGY 2010. [DOI: 10.1080/00049530903510757] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Julian J. Dooley
- Child Health Promotion Research Centre, Edith Cowan University, Mount Lawley, Western Australia
| | - John P. Wilson
- Department of Psychology, Cleveland State University, Cleveland, Ohio, USA
| | - Vicki A. Anderson
- Department of Child Neuropsychology, Murdoch Children's Research Institute
- Department of Psychology, Royal Children's Hospital
- Department of Psychology and Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
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Arden-Close E, Pacey A, Eiser C. Health-related quality of life in survivors of lymphoma: a systematic review and methodological critique. Leuk Lymphoma 2010; 51:628-40. [PMID: 20218810 DOI: 10.3109/10428191003587263] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Survival rates for Hodgkin lymphoma and non-Hodgkin lymphoma have improved in recent years. However, these improvements are associated with various late effects, which can compromise health-related quality of life (HRQoL). Improving HRQoL is a significant goal in oncology, and increasingly one of the primary outcomes in clinical trials, but is dependent on availability of reliable and sensitive measures. This review therefore aimed to: (i) identify and evaluate commonly used HRQoL measures; (ii) compare HRQoL in patients with lymphoma with the general population; and assess the association between (iii) HRQoL and different treatments; and (iv) HRQoL and demographic, medical, and psychological variables. Standardized systematic searches identified 18 eligible studies that included adult survivors of lymphoma and reported quantitative results by histological diagnosis. Information about design, sample, measures and findings was extracted from each study. Survivors of lymphoma experienced worse physical but comparable mental HRQoL to the general population. No conclusions could be drawn about the association between different treatments and HRQoL. Correlates of better HRQoL included younger age, educational level, being employed, male gender, earlier stage disease, not having co-morbid illnesses, and meeting public health exercise guidelines. Limitations of current research relating to research design, sample demographics, and reporting of descriptive statistics were identified. Given the increasing numbers of patients living with lymphoma, controlled studies using appropriate measures are required to determine the HRQoL consequences associated with the condition.
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Affiliation(s)
- Emily Arden-Close
- Department of Psychology, University of Sheffield, Sheffield S10 2TP, UK.
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36
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Is stroke a ‘trigger’? Br J Gen Pract 2010; 60:374-5. [DOI: 10.3399/bjgp10x501949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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37
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Ganz FD, Raz H, Gothelf D, Yaniv I, Buchval I. Post-Traumatic Stress Disorder in Israeli Survivors of Childhood Cancer. Oncol Nurs Forum 2010; 37:160-7. [DOI: 10.1188/10.onf.160-167] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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38
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Smith HAB, Fuchs DC, Pandharipande PP, Barr FE, Ely EW. Delirium: an emerging frontier in the management of critically ill children. Crit Care Clin 2009; 25:593-614, x. [PMID: 19576533 PMCID: PMC2793079 DOI: 10.1016/j.ccc.2009.05.002] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The objectives of this article are (1) to introduce pediatric delirium and provide understanding of acute brain dysfunction with its classification and clinical presentations (2) to understand how delirium is diagnosed and discuss current modes of delirium diagnosis in the critically ill adult population and translation to pediatrics (3) to understand the prevalence and prognostic significance of delirium in the adult and pediatric critically ill population (4) to discuss the pathophysiology of delirium as currently understood, and (5) to provide general management guidelines for delirium.
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Affiliation(s)
- Heidi A B Smith
- Pediatrics and Anesthesiology Division of Critical Care, Department of Pediatrics, 5121 Doctor's Office Tower, 2200 Children's Way, Nashville, TN 37232-9075, USA.
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Frick LR, Rapanelli M, Bussmann UA, Klecha AJ, Arcos MLB, Genaro AM, Cremaschi GA. Involvement of thyroid hormones in the alterations of T-cell immunity and tumor progression induced by chronic stress. Biol Psychiatry 2009; 65:935-42. [PMID: 19167703 DOI: 10.1016/j.biopsych.2008.12.013] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2008] [Revised: 12/04/2008] [Accepted: 12/06/2008] [Indexed: 01/19/2023]
Abstract
BACKGROUND Stress alters the neuroendocrine system, immunity, and cancer. Although the classic stress hormones are glucocorticoids and catecholamines, thyroid hormones have also been related to stress. We recently reported that chronic restraint stress impairs T-cell mediated immunity and enhances tumor growth in mice. METHODS To study the participation of these hormones on the stress-induced alterations of the immune function and lymphoma growth, mice were subjected to acute or chronic stress, with or without thyroxin supplementation. Hormone levels, immune status, and cancer progression were evaluated. RESULTS Differential endocrine alterations were observed in response to acute and chronic stress. Although corticosterone and noradrenaline levels were increased by acute stress, they were restored after prolonged exposure to the stressor. Instead, thyroid hormone levels were only reduced in chronically stressed animals in comparison with control subjects. Correlating, chronic but not acute stress impaired T-cell reactivity. Thyroxin replacement treatment of chronic restraint stress-exposed mice, which restored the euthyroid status, reversed the observed reduction of T-cell lymphoproliferative responses. Moreover, therapeutic thyroid replacement also reversed the alterations of lymphoma growth induced by chronic stress in syngeneic mice bearing tumors as well as Interleukin-2 production and specific cytotoxic response against tumor cells. Finally, we found that the isoforms theta and alpha of the protein kinase C are involved in these events. CONCLUSIONS These results show for the first time that thyroid hormones are important neuroendocrine regulators of tumor evolution, most probably acting through the modulation of T-cell mediated immunity affected by chronic stress.
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Affiliation(s)
- Luciana Romina Frick
- Centro de Estudios Farmacológicos y Botánicos, Consejo Nacional de Investigaciones Científicas y Técnicas, Primera Cátedra de Farmacología, Universidad de Buenos Aires, Paraguay 2155, 1121 Buenos Aires, Argentina.
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Zebrack BJ, Yi J, Petersen L, Ganz PA. The impact of cancer and quality of life for long-term survivors. Psychooncology 2008; 17:891-900. [PMID: 18050153 DOI: 10.1002/pon.1300] [Citation(s) in RCA: 111] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
UNLABELLED This study reports on health status and quality of life (QOL) outcomes in long-term cancer survivors, and potential correlates including cancer type, age at diagnosis, health status, and key sociodemographic variables. METHOD One hundred and ninety-three cancer survivors 5-10 years post-diagnosis completed a mailed survey assessing physical and mental health status, QOL, post-traumatic growth, and impact of cancer (IOC). RESULTS Respondents were comparable to population norms on physical and mental health status. After controlling for sociodemographic and medical status variables, older respondents reported better overall QOL (p=0.004) and mental health (p<0.001), but worse physical health (p=0.04). Survivors reporting low income (p=0.02) and comorbidities (p=0.003) indicated worse physical functioning. A higher negative IOC score was associated with worse physical functioning (p<0.0001), worse mental health (p<0.0001), and lower overall QOL (p<0.0001). A higher positive IOC score was associated with better mental health (p=0.0004) and better overall QOL (p=0.005). CONCLUSION Perceptions of how cancer has affected survivors' lives in both positive and negative ways may influence, or be influenced by, their functional abilities and QOL.
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Affiliation(s)
- Brad J Zebrack
- University of Southern California School of Social Work, Los Angeles, CA 90089-0411, USA.
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Mols F, Aaronson NK, Vingerhoets AJJM, Coebergh JWW, Vreugdenhil G, Lybeert MLM, van de Poll-Franse LV. Quality of life among long-term non-Hodgkin lymphoma survivors. Cancer 2007; 109:1659-67. [PMID: 17330853 DOI: 10.1002/cncr.22581] [Citation(s) in RCA: 82] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND The objective of this population-based study was to document the long-term effects (5-15 years postdiagnosis) of non-Hodgkin lymphoma and its treatment on health-related quality of life (HRQL) and social problems. METHODS The population-based Eindhoven Cancer Registry was used to select all patients who were diagnosed with non-Hodgkin lymphoma from 1989 to 1998. Three hundred sixty patients were invited to complete the 36-item Short Form Health Survey (SF-36) and the Quality of Life-Cancer Survivors questionnaire, and 294 patients (82%) responded. RESULTS Patients who had received chemotherapy reported significantly worse psychological and social well-being and health-related quality of life (HRQL) than patients who had not received chemotherapy. Radiotherapy and watchful waiting were not associated significantly with HRQL outcomes. Patients who were diagnosed from 10 to 15 years earlier reported better social well-being than patients who were diagnosed from 5 to 9 years earlier. Compared with an age-matched, normative sample from the general population, patients reported significantly worse general health and less vitality, but they reported less bodily pain. Practical problems were reported with work (41%), obtaining health care insurance (6%) and life insurance (15%), and obtaining a home mortgage (22%). CONCLUSIONS From 5 to 15 years after diagnosis, the general health perceptions and vitality levels of non-Hodgkin lymphoma survivors remained significantly lower than those of their peers in the of general population. In addition, survivors faced practical problems with work and finances that deserve additional attention during the period of rehabilitation.
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Affiliation(s)
- Floortje Mols
- Comprehensive Cancer Center South, Eindhoven Cancer Registry, Eindhoven, the Netherlands.
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