Association of resilience with health-related quality of life and depression in multiple myeloma and its precursors: results of a German cross-sectional study

Depression in patients with hematologic malignancies: The current landscape and future directions

Patients with hematologic malignancies experience high rates of depression. These patients are vulnerable to depression throughout the disease trajectory, from diagnosis to survivorship, and at the end of life. In addition to the distressing nature of depression, it has substantial downstream effects including poor quality of life, increased risk of treatment complications, and worse survival. Therefore, systematic screening for depression and integration of robust psychological interventions for affected patients is crucial. Although depression has been historically studied mostly in patients with solid malignancies, research focusing on patients with hematologic malignancies is growing. In this article, we describe what is known about depression in patients with hematologic malignancies, including its assessment, prevalence, risk factors, and implications. We also describe interventions to ameliorate depression in this population. Future research is needed to test effective and scalable interventions to reduce the burden of depression among patients with blood cancers.

The impact of divergent forms of social support on health-related quality of life in patients with multiple myeloma and its precursor states

PURPOSE

Multiple myeloma is a largely incurable disease. Patients suffer from the cancer, therapeutic side effects, and often psychological symptoms. Not only multiple myeloma patients but also patients with precursor diseases show high psychological distress. Today, treatment option evaluations are increasingly performed in combination with health-related quality of life (HRQoL) assessments. One factor that is positively associated with HRQoL is social support.

METHODS

Our recent study used questionnaires (EORTC QLQ-C30, EORTC QLQ-MY20, Illness-specific Social Support Scale) to investigate the influence of positive and negative aspects of social support on HRQoL in patients with multiple myeloma and its precursors.

RESULTS

Multiple linear regression analyses with sex, age, treatment line, hemoglobin level, and number of comorbidities as control variables show that positive social support had a significant beneficial association with emotional function (β = 0.323) and social function (β = 0.251). Detrimental interactions had a significant negative association with social function (β =  - 0.209) and a significant positive association with side effects of treatment (β = 0.266).

CONCLUSION

Therefore, screening for social support and, if needed, psycho-oncological care can be an important resource and should be implemented in routine care.

CLINICAL TRIAL REGISTRATION

This study was registered with clinicaltrials.gov (NCT04328038).

A Focus on Relapsed Multiple Myeloma

Multiple myeloma (MM) is a relapsing disease for many patients with multiple myeloma. At relapse, patients have many options for treatment once disease has progressed. Advanced practitioners are well suited to set expectations for ongoing therapy and underscore the importance of continued disease monitoring. Criteria for relapsed myeloma rely on biomarker and radiologic imaging, as well as physical exam and awareness of new bone pain or changes in physiologic function. The treatment of patients with relapsed MM requires a personalized approach and considers patient desires in regard to aggressiveness of therapy and willingness to participate in a clinical trial. The prognosis of patients with relapsed MM depends upon disease characteristics at baseline or throughout, as patients may acquire adverse cytogenetic abnormalities through various lines of treatment. Empowering patients to understand their diagnosis, interpret labs, and take an active role in treatment selection through shared decision-making can improve patients' quality of life and enhance adherence.

Higher fasting C-peptide is associated with post-stroke depression: a multicenter prospective cohort study

BACKGROUND

Fasting C-peptide (FCP) has been shown to play an important role in the pathophysiology of mood disorders including depression and schizophrenia, but it is unknown whether it also predicts post-stroke depression (PSD). This study examined the association between FCP and PSD at 6 months after acute ischemic-stroke onset among Chinese subjects.

METHODS

A total of 656 stroke patients were consecutively recruited from three hospitals of Wuhan city, Hubei province. Clinical and laboratory data were collected on admission. PSD status was evaluated by DSM-V criteria and 17-item Hamilton Rating Scale for Depression (HAMD-17) at 6 months after acute ischemic stroke. The χ2-test, Mann-Whitney U-test, and t-test were used to check for statistical significance. Multivariate logistic regression model was used to explore independent predictor of PSD.

RESULTS

In the univariate analysis, significant differences were found between the PSD and non-PSD groups in terms of FCP level (p = 0.009). After multivariate adjustments, FCP remained a significant independent predictor of PSD, with an adjusted odds ratio of 1.179 (95%CI: 1.040-1.337, p = 0.010).

CONCLUSIONS

Higher FCP levels on admission were found to be associated with PSD at 6 months after acute ischemic-stroke onset. For stroke patients, doctors should pay attention to the baseline FCP for screening high-risk PSD in clinical practice.

The Effects of a Tripod Approach for Cancer Patients on Illness Stress, Health-Promoting Lifestyle, Hope, and Resilience

BACKGROUND

Health-related exercise and education program for cancer patients are necessary to provide physical and emotional support to enable efficient and appropriate self-management at home.

OBJECTIVE

This study aimed to investigate the effects of a tripod approach including physical exercise, education, and emotional support program on illness stress, health promotion lifestyle, hope, and resilience in cancer patients.

INTERVENTIONS/METHODS

This was a quasi-experimental repeated-measures study using a pre-post design with a nonhomogeneous control group. A total of 72 cancer patients (experimental group = 37, control group = 35) who were currently receiving treatment and staying at home were enrolled.

RESULTS

The experimental group showed significantly lower illness stress scores (F = 17.35, P < .001) and increase in health promotion lifestyle scores (F = 4.05, P = .048) compared with the control group, especially social relationships (t = 1.85, P = .073) and stress management (t = 2.30, P = .027). However, there were no effects on hope and resilience. Also, illness stress showed significant changes after 6 weeks (t = -3.35, P = .001) and after 10 weeks (t = -5.04, P < .001). Overall health promotion lifestyle showed changes after 10 weeks (t = 2.25, P = .030), with meaning of life (t = 2.57, P = .014), stress management (t = 2.30, P = .027), and medical behaviors (t = 2.46, P = .019) especially showing significant changes.

CONCLUSIONS

The results showed that the tripod approach had positive effects on illness stress and health promotion lifestyle of cancer patients staying at home. Further study to improve positive emotions such as hope and resilience is needed.

IMPLICATIONS FOR PRACTICE

Based on our findings, combining nursing intervention with physical exercise, education, and emotional support could be incorporated into cancer patients in community and early survivorship care plans in clinical practice.

Dynamics and predictors of resilience in Chinese rural children: a follow-up study

The present study attempted to investigate dynamics and predictors of resilience amongst Chinese children using prospective data. Totally 816 children completed the resilience measurement at baseline and one-year follow-up. Multivariate logistic regression was used to examine associations between high resilience and predictor variables. Mean resilience scores increased during the one-year follow-up (t = -2.35, P = 0.019). Although the proportions of high and low resilience were relatively stable, whereas 28% of children had inconsistent resilience level during the follow-up. Multivariable logistic regression analysis showed that participants' parents having secondary school (adjusted OR (aOR) = 1.67, 95%CI = 1.14-2.44) or higher (aOR = 2.53, 95%CI = 1.51-4.24) education level, and high quality of life (aOR = 1.81, 95%CI = 1.20-2.73) were positively associated with high resilience, whereas moderate family function obstacles (aOR = 0.47, 95%CI = 0.34-0.67), abuse experience (aOR = 0.68, 95%CI = 0.50-0.92), and significant depression symptoms (aOR = 0.47, 95%CI = 0.28-0.77) were negatively associated with high resilience. Results highlight that resilience levels were not merely static trait and improved over one year among Chinese children. Findings would deepen understanding of resilience change and provide potential targets of resilience-focused intervention in children.