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Faris MM, Dhillon HM, Campbell R, Halkett GKB, Miller A, Chan RJ, Haydon HM, Sansom-Daly UM, Koh ES, Ownsworth T, Nowak AK, Kelly B, Leonard R, Pike KE, Legge DM, Pinkham MB, Agar MR. Unmet needs in people with high-grade glioma: defining criteria for stepped care intervention. JNCI Cancer Spectr 2024; 8:pkae034. [PMID: 38730547 PMCID: PMC11218915 DOI: 10.1093/jncics/pkae034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 04/03/2024] [Accepted: 04/27/2024] [Indexed: 05/13/2024] Open
Abstract
BACKGROUND We aimed to define levels of unmet supportive care needs in people with primary brain tumor and to reach expert consensus on feasibility of addressing patients' needs in clinical practice. METHODS We conducted secondary analysis of a prospective cohort study of people diagnosed with high-grade glioma (n = 116) who completed the Supportive Care Needs Survey-Short Form during adjuvant chemoradiation therapy. Participants were allocated to 1 of 3 categories: no need ("no need" for help on all items), low need ("low need" for help on at least 1 item, but no "moderate" or "high" need), or moderate/high need (at least 1 "moderate" or "high" need indicated). Clinical capacity to respond to the proportion of patients needing to be prioritized was assessed. RESULTS Overall, 13% (n = 5) were categorized as no need, 23% (n = 27) low need, and 64% (n = 74) moderate/high need. At least 1 moderate/high need was reported in the physical and daily living domain (42%) and the psychological (34%) domain. In recognition of health system capacity, the moderate/high need category was modified to distinguish between moderate need ("moderate" need indicated for at least 1 item but "high" need was not selected for any item) and high need (at least 1 "high" need indicated). Results revealed 24% (n = 28) moderate need and 40% (n = 46) high need. Those categorized as high need indicated needing assistance navigating the health system and information. CONCLUSIONS Using four step allocations resulted in 40% of patients indicating high need. Categories may facilitate appropriate triaging and guide stepped models of healthcare delivery.
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Affiliation(s)
- Mona M Faris
- Psycho-Oncology Cooperative Research Group, School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
| | - Haryana M Dhillon
- Psycho-Oncology Cooperative Research Group, School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
- Centre for Medical Psychology & Evidence-Based Decision-Making, School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
| | - Rachel Campbell
- Psycho-Oncology Cooperative Research Group, School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
| | - Georgia K B Halkett
- Curtin School of Nursing/Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Bentley, WA, Australia
| | - Annie Miller
- Community advisory group, Psycho-Oncology Cooperative Research Group, The University of Sydney, Sydney, NSW, Australia
| | - Raymond J Chan
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Helen M Haydon
- Centre for Online Health, The University of Queensland, Brisbane, QLD, Australia
- Centre for Health Services Research, The University of Queensland, Brisbane, QLD, Australia
| | - Ursula M Sansom-Daly
- School of Clinical Medicine, UNSW Medicine and Health, University of New South Wales, Kensington, NSW, Australia
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW, Australia
- Sydney Youth Cancer Service, Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Randwick, NSW, Australia
| | - Eng-Siew Koh
- South West Sydney Clinical School, UNSW Medicine, University of New South Wales, Liverpool, NSW, Australia
- Liverpool and Macarthur Cancer Therapy Centres, Liverpool, NSW, Australia
- Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
| | - Tamara Ownsworth
- School of Applied Psychology & Menzies Health Institute of Queensland, Brisbane, QLD, Australia
| | - Anna K Nowak
- Medical School, University of Western Australia, Crawley, WA, Australia
| | - Brian Kelly
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
| | - Robyn Leonard
- Brain Cancer Collective, NHMRC Clinical Trials Centre, University of Sydney, Sydney, NSW, Australia
| | - Kerryn E Pike
- School of Applied Psychology & Menzies Health Institute of Queensland, Brisbane, QLD, Australia
- Griffith Centre for Mental Health, Griffith University, Queensland, Australia
- School of Psychology & Public Health and John Richards Centre for Rural Ageing Research, La Trobe University, Victoria, Australia
| | - Dianne M Legge
- Curtin School of Nursing/Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Bentley, WA, Australia
- Olivia Newton-John Cancer and Wellness Centre, Austin Hospital, Heidelberg, VIC, Australia
| | - Mark B Pinkham
- Division of Cancer Services, Princess Alexandra Hospital, Woolloongabba, QLD, Australia
- School of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Meera R Agar
- Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT) Research Centre, Faculty of Health, University of Technology, Sydney, NSW, Australia
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Okami T, Toshishige Y, Kondo M, Okazaki J, Mizushima H, Akechi T. Interpersonal psychotherapy for comorbid prolonged grief disorder and persistent depressive disorder in a Japanese patient: A case report. PCN REPORTS : PSYCHIATRY AND CLINICAL NEUROSCIENCES 2023; 2:e161. [PMID: 38868732 PMCID: PMC11114255 DOI: 10.1002/pcn5.161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 11/05/2023] [Accepted: 11/17/2023] [Indexed: 06/14/2024]
Abstract
Background Prolonged grief disorder (PGD) is a new diagnostic entity. However, treatment for PGD is not yet available. Interpersonal psychotherapy (IPT) may be effective for PGD. Case Presentation A single 27-year-old Japanese woman lost her brother to suicide. However, she did not express her grief to anyone or visit a psychiatric clinic. After experiencing strong depressive symptoms triggered by work stress, she visited a psychiatric clinic, where she was diagnosed with depression as well as PGD. Through pharmacotherapy, her depressive symptoms improved, but no improvement was noted in her PGD symptoms. She therefore began IPT for PGD at our hospital, 5 years after her brother's suicide and after 4 years of PGD symptoms. In the introductory phase of IPT, she was diagnosed with comorbid persistent depressive disorder (PDD). After this diagnosis, through psychoeducation on PDD, she could identify the symptoms that reflected her personality traits as "PDD symptoms." Furthermore, she could affirm her positive and negative feelings and share them with others. Consequently, the grieving process was facilitated, and her interests and relationships were re-established. Her PGD and PDD symptoms improved. Conclusion IPT may be effective for PGD comorbid with PDD among Japanese.
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Affiliation(s)
- Takuya Okami
- Department of Psychiatry and Cognitive‐Behavioral MedicineNagoya City University Graduate School of Medical SciencesNagoyaJapan
| | - Yuko Toshishige
- Department of Psychiatry and Cognitive‐Behavioral MedicineNagoya City University Graduate School of Medical SciencesNagoyaJapan
| | - Masaki Kondo
- Department of Psychiatry and Cognitive‐Behavioral MedicineNagoya City University Graduate School of Medical SciencesNagoyaJapan
| | | | | | - Tatsuo Akechi
- Department of Psychiatry and Cognitive‐Behavioral MedicineNagoya City University Graduate School of Medical SciencesNagoyaJapan
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Uneno Y, Kotera Y, Fujisawa D, Kataoka Y, Kosugi K, Murata N, Kessoku T, Ozaki A, Miyatake H, Muto M. Development of a novel COMPAssion focused online psyChoTherapy for bereaved informal caregivers: the COMPACT feasibility trial protocol. BMJ Open 2022; 12:e067187. [PMID: 36549732 PMCID: PMC9772635 DOI: 10.1136/bmjopen-2022-067187] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION An easy-to-access and effective psychotherapy for bereaved informal caregivers has not been established. People with higher self-compassion status tend to have lower bereavement related grief, psychotherapy focused on self-compassion can be promising for this population. This study aimed to examine the feasibility of online self-compassion focused psychotherapy for bereaved informal caregivers. METHOD AND ANALYSIS A total of 60 study participants will undergo an intervention programme comprising online sessions of 2 hours per week for five consecutive weeks and undertake postsession work. The intervention personnel will comprise psychologists who have received more than 10 hours of structured training. The primary endpoint will be assessed on the intervention completion rate, with secondary endpoints consisting of the Complicated Grief Questionnaire, Patient Health Questionnaire-9, Generalised Anxiety Disorder-7, Brief Resilience Scale and Self-Compassion Scale. Evaluations will be conducted preintervention, immediately after intervention, and 4 and 12 weeks after intervention. ETHICS AND DISSEMINATION This study has been reviewed and approved by the Ethics Committee of the Kyoto University Graduate School and Faculty of Medicine, Kyoto University Hospital, Japan (Approved ID: C1565). The results of this study will be disseminated through publication in a peer-reviewed journal and conference presentations. TRIAL REGISTRATION NUMBER UMIN000048554.
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Affiliation(s)
- Yu Uneno
- Department of Therapeutic Oncology, Kyoto University, Graduate School of Medicine, Kyoto, Japan
| | - Yasuhiro Kotera
- Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
| | - Daisuke Fujisawa
- Department of Neuropsychiatry and Palliative Care Center, Keio University School of Medicine, Tokyo, Japan
| | - Yuki Kataoka
- Department of Internal Medicine, Kyoto Min-Iren Asukai Hospital, Kyoto, Japan
- Scientific Research Works Peer Support Group (SRWS-PSG), Osaka, Japan
- Section of Clinical Epidemiology, Department of Community Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
- Department of Healthcare Epidemiology, Kyoto University Graduate School of Medicine / School of Public Health, Kyoto, Japan
| | - Kazuhiro Kosugi
- Department of Palliative Medicine, National Cancer Center Hospital East, Kashiwa, Japan
| | - Nanami Murata
- Medical School, Wakayama Medical University, Wakayama, Japan
| | - Takaomi Kessoku
- Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine Graduate School of Medicine, Yokohama, Japan
- Department of Palliative Medicine, Yokohama City University Hospital, Yokohama, Japan
| | - Akihiko Ozaki
- Department of Breast Surgery, Jyoban Hospital of Tokiwa Foundation, Fukushima, Japan
| | | | - Manabu Muto
- Department of Therapeutic Oncology, Kyoto University, Graduate School of Medicine, Kyoto, Japan
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Interpersonal Psychotherapy for Bereavement-Related Major Depressive Disorder in Japan: A Systematic Case Report. Case Rep Psychiatry 2022; 2022:9921103. [PMID: 36247224 PMCID: PMC9553710 DOI: 10.1155/2022/9921103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 08/10/2022] [Accepted: 09/02/2022] [Indexed: 12/05/2022] Open
Abstract
Bereavement-related major depressive disorder (MDD) is a common disorder with both mental and physical effects. Specific psychotherapies for bereavement-related MDD remain unavailable in Japan despite its relatively high prevalence. Interpersonal psychotherapy (IPT) is a treatment with established efficacy for MDD, including bereavement-related MDD. There are, however, few studies of IPT for MDD and none at all for bereavement-related MDD in Japan. The efficacy of IPT for bereavement-related MDD needs confirmation in Japanese culture because the expression of emotions during the grieving and mourning process varies across cultures, and the Japanese-specific cultural custom exists of maintaining a relationship with the deceased in the afterlife mainly via a Buddhist memorial tablet, altar, and grave. We present a case study describing the therapist's adaptation of IPT to Japanese culture to treat bereavement-related MDD in a Japanese man with insufficient response to pharmacotherapy who had suddenly lost his mother to heart disease. His mother's death and a dispute with his father both appeared to have contributed to his sustained bereavement-related MDD. The 16-session treatment course for depressive symptoms was monitored using the Beck Depression Inventory-II. Treatment was scheduled weekly, but some sessions unavoidably took place fortnightly because they were conducted in person during the COVID-19 pandemic. The patient's MDD severity continually decreased, functional disability gradually recovered from the beginning until the 3-month follow-up, and the interpersonal relationships with his deceased mother, his wife, colleague, and father changed after IPT. Case studies are inherently limited, but IPT, in consideration of Japanese cultural characteristics for bereavement-related MDD, can be potentially effective in Japan.
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Bereavement care provision and its associated factors among nurses in cancer care settings: a cross-sectional study. Support Care Cancer 2022; 30:7625-7633. [PMID: 35676344 DOI: 10.1007/s00520-022-07180-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 05/25/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE The goals of this study were to (1) investigate bereavement care provision in practical settings, (2) examine the difference in care by nurses' affiliation (general hospital, hospice, or homecare setting), and (3) identify institutional and personal barriers associated with bereavement care provision. METHODS A cross-sectional survey was conducted using an online questionnaire. Nurses (n = 309) who had an experience of cancer patient care before death at least once in a previous year were included in the analysis. Kruskal-Wallis test and Mann-Whitney test were conducted to compare bereavement care provision by nurses' affiliation, and hierarchical logistic regression analysis was conducted to investigate the correlation between bereavement care provision and its associated factors. RESULTS Less than 30% of nurses reported providing bereavement care in structured settings such as home visits, counseling at a hospital, or phone calls. The differences in bereavement care provision by nurses' affiliation were significant, and the nurses working in a hospital were less likely to provide bereavement care than those working in a hospice or homecare setting. Working in a palliative care setting (OR = 2.35, 95%CI 1.09-5.07, p < 0.05) and greater confidence (OR = 2.18, 95%CI 1.07-4.42, p < 0.05) and knowledge regarding bereavement care (OR = 12.46, 95%CI 5.69-27.29, p < 0.001) were significantly associated factors of bereavement care provision. CONCLUSION This study indicated a lack of bereavement care provision, especially in general hospitals. Improving nurses' confidence and knowledge may encourage them to provide bereavement care provision.
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