1
|
Magnavita N, Meraglia I, Terribile DA. Returning to Work after Breast Cancer: A One-Year Mixed-Methods Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:1057. [PMID: 39200667 PMCID: PMC11353812 DOI: 10.3390/ijerph21081057] [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: 06/23/2024] [Revised: 08/10/2024] [Accepted: 08/12/2024] [Indexed: 09/02/2024]
Abstract
Breast cancer (BC) is the most common invasive neoplasm and affects many women of working age. The return to work (RTW) of female survivors (BCSs) is associated with a better quality of life and longer survival. A tailored intervention to promote RTW was launched in 2022. A year later, the women were contacted to find out if RTW had occurred regularly and what their health conditions were compared to the baseline. BCSs reported excessive fatigue, poor sleep quality, anxiety, depression and reduced work ability; these parameters had not improved significantly compared to the baseline. Thematic analysis of the interviews confirmed the presence of personal, company, and societal factors that could hinder or favor RTW. The interviews demonstrated that, even in an economically developed country that has provided numerous benefits for BCSs, protection is not always effective. Personalized intervention seems necessary to complete the process of reintegrating BCSs into their future working careers.
Collapse
Affiliation(s)
- Nicola Magnavita
- Post-Graduate School of Occupational Health, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
| | - Igor Meraglia
- Post-Graduate School of Occupational Health, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
| | - Daniela Andreina Terribile
- Multidisciplinary Breast Center, Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy;
| |
Collapse
|
2
|
Coupe K, Block A, Mark S, Cooper BA, Paul SM, Dunn LB, Hammer MJ, Conley YP, Levine JD, Miaskowski C. Increases in stress and adverse childhood experiences are associated with the co-occurrence of anxiety and depression in oncology patients. J Psychosoc Oncol 2024:1-24. [PMID: 38528755 PMCID: PMC11422520 DOI: 10.1080/07347332.2024.2326146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
PURPOSE Identify subgroups of patients with distinct joint anxiety AND depression profiles and evaluate for differences in demographic and clinical characteristics, as well as stress, resilience, and coping. DESIGN Longitudinal study. PARTICIPANTS Patients (n = 1328) receiving chemotherapy. METHODS Measures of state anxiety and depression were done six times over two cycles of chemotherapy. All of the other measures were completed prior to second or third cycle of chemotherapy. Latent profile analysis was used to identify the distinct joint anxiety and depression profiles. FINDINGS Three classes were identified (i.e. Low Anxiety and Low Depression (57.5%); Moderate Anxiety and Moderate Depression (33.7%), High Anxiety and High Depression (8.8%)). For all of the stress measures, a dose response effect was seen among the profiles. Two worst profiles reported higher occurrence rates for a number of adverse childhood experiences. IMPLICATIONS FOR PROVIDERS Patients need referrals for stress reduction techniques and mental health and social services.
Collapse
Affiliation(s)
- Katie Coupe
- School of Nursing, University of California, San Francisco, CA
| | - Astrid Block
- School of Nursing, University of California, San Francisco, CA
| | - Sueann Mark
- School of Nursing, University of California, San Francisco, CA
| | - Bruce A. Cooper
- School of Nursing, University of California, San Francisco, CA
| | - Steven M. Paul
- School of Nursing, University of California, San Francisco, CA
| | - Laura B. Dunn
- School of Medicine, University of Arkansas, Little Rock, AK
| | | | | | - Jon D. Levine
- School of Medicine, University of California, San Francisco, CA
| | - Christine Miaskowski
- School of Nursing, University of California, San Francisco, CA
- School of Medicine, University of California, San Francisco, CA
| |
Collapse
|
3
|
Trojnar A, Knetki-Wróblewska M, Sobieraj P, Domagała-Kulawik J. Lung Cancer in Women-Sociodemographic, Clinical and Psychological Characteristics with Comparison to Men. J Clin Med 2024; 13:1450. [PMID: 38592288 PMCID: PMC10934020 DOI: 10.3390/jcm13051450] [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: 01/30/2024] [Revised: 02/25/2024] [Accepted: 02/29/2024] [Indexed: 04/10/2024] Open
Abstract
(1) Background: There is a difference in the course of lung cancer between women and men. Therefore, there is a need to evaluate various factors in the patient population treated in daily practice. The purpose of this study was to analyze the clinical, sociodemographic and psychological aspects of female lung cancer. To better express the results, we compared women and men. (2) Methods: Consecutive patients with a history of lung cancer treatment admitted to the outpatient oncology clinic (Department of Lung Cancer and Chest Tumours, Maria Skłodowska-Curie National Research Institute of Oncology in Warsaw) and the Department of Internal Medicine, Pulmonary Diseases and Allergy, were enrolled. We conducted analyses of the clinical, psychological and socioeconomic factors of women with lung cancer treated in everyday practice, including a comparison with a group of men. Demographic data were collected from a self-administered questionnaire. We used the Perceived Stress Scale (PSS-10) and Acceptance of Illness Scale (AIS) questionnaires for psychological evaluation. (3) Results: A total of 100 patients with confirmed primary lung cancer with a history of treatment were enrolled in the study (50 women and 50 men). We found a significantly shorter history of smoking in the group of women; at the same time, there were no differences in the reported incidence of COPD. Despite comparable results to men on the psychological questionnaire (PSS-10, AIS), women more often reported a willingness to be supported by a psychologist or psychiatrist due to lung cancer. However, they did not decide to consult them more often than men. Immunotherapy was a significantly less frequently used method in women. (4) Conclusions: We should be more active in finding out the willingness to consult a psychologist or psychiatrist among women with lung cancer. The diagnosis of COPD should be considered more often among women due to the lack of differences in the reported incidence of COPD between men and women, despite a clear contrast in the number of pack-years.
Collapse
Affiliation(s)
- Anna Trojnar
- Department of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw, 02-091 Warsaw, Poland;
| | - Magdalena Knetki-Wróblewska
- Department of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw, 02-091 Warsaw, Poland;
- Department of Lung Cancer and Chest Tumors, Maria Skłodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland
| | - Piotr Sobieraj
- Department of Internal Medicine, Hypertension and Vascular Diseases, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Joanna Domagała-Kulawik
- Maria Skłodowska-Curie Medical Academy, Institute of Clinical Sciences, 00-136 Warsaw, Poland;
| |
Collapse
|
4
|
McLouth LE, Shelton BJ, Bursac V, Burris JL, Cheavens JS, Weyman K, Peterman AH, Corum L, Studts JL, Arnold SM. "Pathways": A hope-enhancing intervention for patients undergoing treatment for advanced lung cancer. Psychooncology 2024; 33:e6316. [PMID: 38446540 PMCID: PMC11157457 DOI: 10.1002/pon.6316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 02/14/2024] [Accepted: 02/22/2024] [Indexed: 03/07/2024]
Abstract
OBJECTIVE Observational data suggest hope is associated with the quality of life and survival of people with cancer. This trial examined the feasibility, acceptability, and preliminary outcomes of "Pathways," a hope intervention for people in treatment for advanced lung cancer. METHODS Between 2020 and 2022, we conducted a single-arm trial of Pathways among participants who were 3-12 weeks into systemic treatment. Pathways consisted of two individual sessions delivered during infusions and three phone calls in which participants discussed their values, goals, and goal strategies with a nurse or occupational therapist. Participants completed standardized measures of hope and goal interference pre- and post-intervention. Feasibility was defined as ≥60% of eligible patients enrolling, ≥70% of participants completing three or more sessions, ≥70% of participants completing post-assessments, and mean acceptability ratings ≥7 out of 10 on intervention relevance, helpfulness, and convenience. Linear regression fixed effects models with covariates modeled pre-post changes in complete case analysis and multiple imputation models. RESULTS Fifty two participants enrolled: female (59.6%), non-Hispanic White (84.6%), rural (75.0%), and with low educational attainment (51.9% high school degree or less). Except for enrollment (54%), feasibility and acceptability markers were surpassed (77% adherence, 77% retention, acceptability ratings ≥8/10). There was moderate improvement in hope and goal interference from pre-to post-intervention (d = 0.51, p < 0.05 for hope; d = -0.70, p < 0.005 for goal interference). CONCLUSIONS Strong feasibility, acceptability, and patient-reported outcome data suggest Pathways is a promising intervention to increase hope and reduce cancer-related goal interference during advanced lung cancer treatment.
Collapse
Affiliation(s)
- Laurie E McLouth
- Department of Behavioral Science, Center for Health Equity Transformation, University of Kentucky College of Medicine, Lexington, Kentucky, USA
- Markey Cancer Center, University of Kentucky, Lexington, Kentucky, USA
| | - Brent J Shelton
- Markey Cancer Center, University of Kentucky, Lexington, Kentucky, USA
- Division of Cancer Biostatistics, Department of Internal Medicine, University of Kentucky College of Medicine, Lexington, Kentucky, USA
| | - Vilma Bursac
- Department of Behavioral Science, Center for Health Equity Transformation, University of Kentucky College of Medicine, Lexington, Kentucky, USA
| | - Jessica L Burris
- Markey Cancer Center, University of Kentucky, Lexington, Kentucky, USA
- Department of Psychology, University of Kentucky College of Arts and Sciences, Lexington, Kentucky, USA
| | | | - Kaitlyn Weyman
- Medical College of Wisconsin Affiliated Hospitals, Madison, Wisconsin, USA
| | - Amy H Peterman
- Department of Psychological Science, University of North Carolina-Charlotte, Charlotte, North Carolina, USA
| | - Lauren Corum
- Markey Cancer Center, University of Kentucky, Lexington, Kentucky, USA
| | - Jamie L Studts
- Division of Medical Oncology, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Susanne M Arnold
- Markey Cancer Center, University of Kentucky, Lexington, Kentucky, USA
- Division of Medical Oncology, Department of Internal Medicine, University of Kentucky College of Medicine, Lexington, Kentucky, USA
| |
Collapse
|
5
|
van de Wal D, den Hollander D, Desar IM, Gelderblom H, Oosten AW, Reyners AK, Steeghs N, Husson O, van der Graaf WT. Fear, anxiety and depression in gastrointestinal stromal tumor (GIST) patients in the Netherlands: Data from a cross-sectional multicenter study. Int J Clin Health Psychol 2024; 24:100434. [PMID: 38226006 PMCID: PMC10788803 DOI: 10.1016/j.ijchp.2023.100434] [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: 11/07/2023] [Accepted: 12/28/2023] [Indexed: 01/17/2024] Open
Abstract
Background This study aims to (1) investigate the prevalence of anxiety, depression and severe fear of cancer recurrence or progression in gastrointestinal stromal tumor (GIST) patients treated in a curative or palliative setting, (2) compare their prevalence with a norm population, (3) identify factors associated with anxiety, depression and severe fear, and (4) study the impact of these psychological symptoms on health-related quality of life (HRQoL). Methods In a cross-sectional study, GIST patients completed the Hospital Anxiety and Depression Scale, Cancer Worry Scale, and EORTC QLQ-C30. Results Of the 328 patients, 15% reported anxiety, 13% depression, and 43% had severe fear. Anxiety and depression levels were comparable between the norm population and patients in the curative setting, but significantly higher for patients in the palliative setting. Having other psychological symptoms was associated with anxiety, while current TKI treatment and anxiety were associated with depression. Severe fear was associated with age, female sex, palliative treatment setting, anxiety, and GIST-related concerns. Conclusion GIST patients treated in a palliative setting are more prone to experience psychological symptoms, which can significantly impair their HRQoL. These symptoms deserve more attention in clinical practice, in which regular screening can be helpful, and appropriate interventions should be offered.
Collapse
Affiliation(s)
- Deborah van de Wal
- Department of Medical Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, the Netherlands
| | - Dide den Hollander
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Ingrid M.E. Desar
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Hans Gelderblom
- Department of Medical Oncology, Leiden University Medical Center, Leiden, the Netherlands
| | - Astrid W. Oosten
- Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Anna K.L. Reyners
- Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Neeltje Steeghs
- Department of Medical Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, the Netherlands
| | - Olga Husson
- Department of Medical Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, the Netherlands
- Department of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
- Department of Surgical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, the Netherlands
| | - Winette T.A. van der Graaf
- Department of Medical Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, the Netherlands
- Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, the Netherlands
| |
Collapse
|
6
|
Liu JY, Zheng JQ, Yin CL, Tang WP, Zhang JN. Hotspots and frontiers of the relationship between gastric cancer and depression: A bibliometric study. World J Gastroenterol 2023; 29:6076-6088. [PMID: 38130743 PMCID: PMC10731158 DOI: 10.3748/wjg.v29.i46.6076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 11/02/2023] [Accepted: 12/02/2023] [Indexed: 12/13/2023] Open
Abstract
BACKGROUND A significant relationship between gastric cancer (GC) and depression has been found in the last 20 years. However, there is no comprehensive information that helps researchers find popular and potential research directions on GC and depression. AIM To determine the research status and hotspots by bibliometric analysis of relevant publications on the relationship between GC and depression. METHODS We used the Web of Science Core Collection to search and collate the literature on GC and depression from 2000 to 2022 on 31 May, 2023. Then, visualization analysis was performed using VOSviewer software (version 1.6.19) and the Bibliometrix package in R software. RESULTS We retrieved 153 pertinent publications from 2000 to 2022. The annual publication count showed an overall upward trend. China had the most prominent publications and significant contributions to this field (n = 64, 41.83%). Before 2020, most studies focused on "the effect of GC on the development and progression of depression in patients." The latest research trends indicate that "the effect of depression on the occurrence and development of GC and its mechanism" will receive more attention in the future. CONCLUSION The study of "the effect of depression on the occurrence and development of GC and its mechanism" has emerged as a novel research theme over the past two years, which may become a research hotspot in this field. This study provides new insights into the hotpots and frontiers of the relationship between GC and depression, potentially guiding researchers toward hot research topics in the future.
Collapse
Affiliation(s)
- Jia-Yu Liu
- Department of Neurosurgery, The First Medical Centre, Chinese PLA General Hospital, Beijing 100853, China
| | - Ji-Qi Zheng
- School of Health Humanities, Peking University, Beijing 100191, China
| | - Cheng-Liang Yin
- Medical Big Data Research Center, Medical Innovation Research Division of Chinese PLA General Hospital, Beijing 100853, China
- National Engineering Research Center for Medical Big Data Application Technology, Chinese PLA General Hospital, Beijing 100853, China
| | - Wen-Pei Tang
- School of Health Humanities, Peking University, Beijing 100191, China
| | - Jian-Ning Zhang
- Department of Neurosurgery, The First Medical Centre, Chinese PLA General Hospital, Beijing 100853, China
| |
Collapse
|
7
|
Zamani M, Alizadeh-Tabari S. Anxiety and depression prevalence in digestive cancers: a systematic review and meta-analysis. BMJ Support Palliat Care 2023; 13:e235-e243. [PMID: 34417285 DOI: 10.1136/bmjspcare-2021-003275] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 08/12/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Cancers of the digestive system can be associated with disturbing and disabling symptoms, which can contribute to a negative psychological pressure on patients. AIM To investigate the reported prevalence of symptoms of anxiety and depression in patients with major digestive cancers, including oesophageal, gastric, colorectal, pancreatic or hepatic cancers. METHODS We searched Embase, PubMed, Scopus and Web of Science for articles published from inception to December 2020. We included studies reporting the prevalence of anxiety or depression symptoms using validated questionnaires in adult patients (≥18 years). RESULTS In total, 51 eligible papers were finally included. Overall, the pooled prevalence of anxiety symptoms was 20.4% (95% CI 17% to 23.8%). The estimate in patients with gastrointestinal (GI) cancers was 19.1% and in patients with hepatic cancer was 29.1%. Among GI cancers, the highest pooled prevalence of anxiety symptoms related to oesophageal cancer (20.6%), while the lowest pooled prevalence pertained to gastric cancer (18.7%). Regarding depression symptoms, the overall pooled prevalence was 30.2% (95% CI 24.3% to 36.1%). The estimate in patients with GI cancers was 31% and in patients with hepatic cancer was 21.5%. Among GI cancers, the highest pooled prevalence of depression symptoms related to oesophageal cancer (45.2%), while the lowest pooled prevalence pertained to colorectal cancer (22.9%). CONCLUSION A considerable prevalence of anxiety and depression symptoms is observed in patients with digestive cancers. Screening and preventive measures with early management of these psychological problems by clinicians could possibly improve outcomes for these patients. PROSPERO REGISTRATION NUMBER CRD42020210079.
Collapse
Affiliation(s)
- Mohammad Zamani
- Digestive Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Student Research Committee, Babol University of Medical Science, Babol, Iran
| | | |
Collapse
|
8
|
Allen JM, Awunti M, Guo Y, Bian J, Rogers SC, Scarton L, DeRemer DL, Wilkie DJ. Unraveling Racial Disparities in Supportive Care Medication Use among End-of-Life Pancreatic Cancer Patients: Focus on Pain Management and Psychiatric Therapies. Cancer Epidemiol Biomarkers Prev 2023; 32:1675-1682. [PMID: 37788369 PMCID: PMC10690138 DOI: 10.1158/1055-9965.epi-23-0251] [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: 04/05/2023] [Revised: 06/06/2023] [Accepted: 09/11/2023] [Indexed: 10/05/2023] Open
Abstract
BACKGROUND Supportive care medication use differences may contribute to racial disparities observed in health-related quality of life in patients with pancreatic cancer. METHODS In this observation study using the Surveillance, Epidemiology, and End Results-Medicare linked database, we sought to examine supportive care medication use disparities in patients with pancreatic cancer from 2005 to 2017 by race and ethnicity. RESULTS Among 74,309 patients included in the final analysis, racial and ethnic disparities in the use of supportive care medications were identified. After adjustment for confounding factors and compared with non-Hispanic Whites, minorities had significantly less use of opioids [Black: adjusted OR (aOR), 0.84; 95% confidence interval (CI), 0.79-0.88; Asian: aOR, 0.84; 95% CI, 0.79-0.90), and skeletomuscular relaxants (Black: aOR, 0.90; 95% CI, 0.82-0.99; Hispanic: aOR, 0.82; 95% CI, 0.74-0.91; Asian: aOR, 0.59; 95% CI, 0.51-0.68), and increased use of non-opioid analgesics (Hispanic: aOR, 1.16; 95% CI, 1.01-1.14; Asian: aOR, 1.37; 95% CI, 1.26-1.49). Racial and ethnic minorities had less use of antidepressants (Black: aOR, 0.56; 95% CI, 0.53-0.59; Hispanic: aOR, 0.77; 95% CI, 0.73-0.82; Asian: aOR, 0.47; 95% CI, 0.44-0.51), anxiolytics (Black: aOR, 0.78; 95% CI, 0.74-0.82; Hispanic: aOR, 0.66; 95% CI, 0.62-0.71; Asian: aOR, 0.52; 95% CI, 0.48-0.57), and antipsychotics (Hispanic: aOR, 0.90; 95% CI, 0.82-0.99; Asian: aOR, 0.84; 95% CI, 0.74-0.95). CONCLUSIONS Racial and ethnic disparities in the use of supportive care medications among patients with pancreatic cancer were observed, with the differences unexplained by sociodemographic factors. IMPACT Future studies should identify strategies to promote equitable use of supportive care medications among racial minorities and explore factors that may influence their use in these populations.
Collapse
Affiliation(s)
- John M. Allen
- Department of Pharmacotherapy and Translational Research, University of Florida College of Pharmacy, Orlando, Florida
| | - MegCholack Awunti
- Department of Pharmacotherapy and Translational Research, University of Florida College of Pharmacy, Orlando, Florida
| | - Yi Guo
- Department of Health Outcomes & Biomedical Informatics, University of Florida College of Medicine, Gainesville, Florida
| | - Jiang Bian
- Department of Health Outcomes & Biomedical Informatics, University of Florida College of Medicine, Gainesville, Florida
| | - Sherise C. Rogers
- Division of Hematology & Oncology, University of Florida College of Medicine, Gainesville, Florida
| | - Lisa Scarton
- Department of Family, Community, and Health Systems Science, University of Florida College of Nursing, Gainesville, Florida
| | - David L. DeRemer
- Department of Pharmacotherapy and Translational Research, University of Florida College of Pharmacy, Gainesville, Florida
| | - Diana J. Wilkie
- Department of Biobehavioral Nursing Science, University of Florida College of Nursing, Gainesville, Florida
| |
Collapse
|
9
|
Chew NM, Ting EL, Kerr L, Brewster DJ, Russo PL. Psychosocial Interventions at the End-of-Life: A Scoping Review. Cancer Nurs 2023; 46:432-446. [PMID: 35786585 DOI: 10.1097/ncc.0000000000001136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The integration of holistic and effective end-of-life (EOL) care into cancer management has increasingly become a recognized field. People living with terminal cancer and their caregivers face a unique set of emotional, spiritual, and social stressors, which may be managed by psychosocial interventions. OBJECTIVES This study aimed to explore the types and characteristics of psychosocial interventions at the EOL for adult cancer patients and their caregivers and to identify gaps in the current literature. METHODS A systematic search was conducted through MEDLINE (Ovid) and CINAHL from January 1, 2011, to January 31, 2021, retrieving 2453 results. A final 15 articles fulfilled the inclusion criteria, reviewed by 2 independent reviewers. Ten percent of the original articles were cross-checked against study eligibility at every stage by 2 experienced researchers. RESULTS Most interventions reported were psychotherapies, with a predominance of meaning or legacy-related psychotherapies. Most interventions were brief, with significant caregiver involvement. Most studies were conducted in high-income, English-speaking populations. CONCLUSION There is robust, although heterogeneous, literature on a range of psychosocial interventions at the EOL. However, inconsistencies in the terminology used surrounding EOL and means of outcome assessment made the comparison of interventions challenging. IMPLICATION FOR PRACTICE Future studies will benefit from increased standardization of study design, EOL terminology, and outcome assessment to allow for a better comparison of intervention efficacy. There is a need for increased research in psychosocial interventions among middle- to low-income populations exploring social aspects, intimacy, and the impact of COVID-19.
Collapse
Affiliation(s)
- Nicolle Marie Chew
- Author Affiliations: School of Medicine, Monash University (Drs Chew and Ting); Cabrini Monash University Department of Nursing Research, Cabrini Health (Drs Chew, Ting, Russo, and Kerr); School of Nursing and Midwifery, Monash University (Drs Russo and Kerr); Intensive Care Unit, Cabrini Hospital (Dr Brewster); and Central Clinical School, Monash University (Dr Brewster), Victoria, Australia
| | | | | | | | | |
Collapse
|
10
|
Choudhury A, Shahsavar Y. Exploring the determinants influencing suicidal ideation and depression in gastrointestinal cancer patients. Sci Rep 2023; 13:18236. [PMID: 37880295 PMCID: PMC10600149 DOI: 10.1038/s41598-023-45634-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 10/21/2023] [Indexed: 10/27/2023] Open
Abstract
Studies have shown a heightened prevalence of depression and suicidal ideation among patients with Gastrointestinal Cancer (GIC). GIC patients are at a 1.5- to threefold increased risk of suicide and depression compared to other cancer patients. This study investigates the interplay of internet use, family burden, and emotional support on mental health (depression) and suicidal ideation among patients with GIC. The study involves 202 respondents of which 78 were undergoing GIC treatment during this study. Using structural equation modeling, our findings indicate a substantial negative correlation between mental health and suicidal ideation. Overall, suicidal ideation (median score) was noticeably lower in patient who completed their treatment with noticeable individuals with exceptionally high SI even after completing the treatment. Notably, participants who had completed their treatment demonstrated a significantly stronger correlation between emotional support and mental health compared to those who were still undergoing treatment. Age was found to moderate the mental health-suicidal ideation link significantly. Internet usage for health-related information was also inversely correlated with mental health (directly) and suicidal ideation (indirectly). We noted that the influence of emotional support on mental health was significantly higher among individuals who completed their treatment compared to those who were undergoing their GIC treatment. Family burden emerged as significant negative influences on mental health, while emotional support positively impacted mental health. The findings of this study contribute towards a deeper understanding of suicide risk factors in GIC patients, potentially shaping more effective preventive strategies.
Collapse
Affiliation(s)
- Avishek Choudhury
- Industrial and Management Systems Engineering, Benjamin M. Statler College of Engineering and Mineral Resources, West Virginia University, 1306 Evansdale Drive, Morgantown, WV, 26506, USA.
| | - Yeganeh Shahsavar
- Industrial and Management Systems Engineering, Benjamin M. Statler College of Engineering and Mineral Resources, West Virginia University, 1306 Evansdale Drive, Morgantown, WV, 26506, USA
| |
Collapse
|
11
|
Rohan EA, Boehm JE, Samarasinha R, Stachon K, Gallaway MS, Huang G, Ng D, Manian N. Diving deeper into distress screening implementation in oncology care. J Psychosoc Oncol 2023; 41:645-660. [PMID: 37655693 PMCID: PMC10964759 DOI: 10.1080/07347332.2023.2250774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
BACKGROUND Responding to calls for additional research that identifies effective distress screening (DS) processes, including referral practices subsequent to screening and receipt of recommended care, we engaged in qualitative research as part of a larger (mixed methods) study of distress screening. This qualitative inquiry of oncology professionals across different facilities in the United States examined routine DS implementation, facilitators and challenges staff encounter with DS processes, and staff members' perceived value of DS. PARTICIPANTS AND METHODS We conducted key informant interviews and focus groups with staff in 4 Commission on Cancer (CoC)-accredited oncology facilities (a total of 18 participants) to understand implementation of routine DS within oncology care. We used a rigorous data analysis design, including inductive and deductive approaches. RESULTS Respondents believe DS enhances patient care and described ways to improve DS processes, including administering DS at multiple points throughout oncology care, using patient-administrated DS methods, and enhancing electronic health records infrastructure to better collect, record, and retrieve DS data. Respondents also identified the need for additional psychosocial staff at their facilities to provide timely psychosocial care. CONCLUSIONS Results reinforce the value of DS in cancer care, including the importance of follow-up to screening with psychosocial oncology providers. Understanding and resolving the barriers and facilitators to implementing DS are important to ensure appropriate psychosocial care for people with cancer. Insights from oncology staff may be used to enhance the quality of DS and subsequent psychosocial care, which is an essential component of oncology care.
Collapse
Affiliation(s)
- Elizabeth A. Rohan
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jennifer E. Boehm
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ruvini Samarasinha
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Karen Stachon
- American College of Surgeons, Commission on Cancer, Chicago, IL
| | - M. Shayne Gallaway
- Arizona Department of Public Health, Phoenix, AZ, USA
- Division of Population Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Grace Huang
- Public Health, Westat Inc., Rockville, MD, USA
| | - Diane Ng
- Public Health, Westat Inc., Rockville, MD, USA
| | | |
Collapse
|
12
|
Magnavita N, Di Prinzio RR, Meraglia I, Vacca ME, Arnesano G, Merella M, Mauro I, Iuliano A, Terribile DA. Supporting Return to Work after Breast Cancer: A Mixed Method Study. Healthcare (Basel) 2023; 11:2343. [PMID: 37628540 PMCID: PMC10454012 DOI: 10.3390/healthcare11162343] [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: 07/21/2023] [Revised: 08/14/2023] [Accepted: 08/17/2023] [Indexed: 08/27/2023] Open
Abstract
Breast cancer (BC) is the most common invasive cancer in the world. Most BC survivors (BCSs) continue working while dealing with cancer-related disabilities. BCSs' return-to-work (RTW) after cancer treatment is an important stage of their recovery and is associated with a higher survival rate. In this study, we addressed the RTW of BCSs with the intention of facilitating this process through direct action in the workplace. Thirty-two women who requested assistance from January to December 2022 were enrolled in the study. Semi-structured interviews and medical examinations were conducted by a team of three physicians. Interviews were analyzed using Thematic Analysis. Moreover, a quantitative cross-sectional study was conducted to compare the health status of BCSs with that of a control group of 160 working women, using standardized questionnaires on work ability, fatigue, sleep problems, anxiety, depression, and happiness. BCSs were also asked to rate the level of organizational justice they perceived at work prior to their illness. From the qualitative analysis emerged three facilitating/hindering themes: (1) person-related factors, (2) company-related factors, and (3) society-related factors. In the quantitative analysis, BCSs had significantly higher scores for anxiety, depression, sleep problems and fatigue, and lower levels of happiness than controls. The RTW of BCSs entails adapting working conditions and providing adequate support. The work-related analysis of each case made it possible to highlight the measures that need to be taken in the workplace to promote RTW. The treatment of cancer should be paired with advice on the best way to regain the ability to work.
Collapse
Affiliation(s)
- Nicola Magnavita
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (N.M.); (I.M.); (M.E.V.); (G.A.); (M.M.); (I.M.); (A.I.); (D.A.T.)
- Department of Woman, Child and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Reparata Rosa Di Prinzio
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (N.M.); (I.M.); (M.E.V.); (G.A.); (M.M.); (I.M.); (A.I.); (D.A.T.)
- Alta Scuola di Economia e Management dei Sistemi Sanitari (ALTEMS), Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Igor Meraglia
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (N.M.); (I.M.); (M.E.V.); (G.A.); (M.M.); (I.M.); (A.I.); (D.A.T.)
| | - Maria Eugenia Vacca
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (N.M.); (I.M.); (M.E.V.); (G.A.); (M.M.); (I.M.); (A.I.); (D.A.T.)
| | - Gabriele Arnesano
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (N.M.); (I.M.); (M.E.V.); (G.A.); (M.M.); (I.M.); (A.I.); (D.A.T.)
| | - Marco Merella
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (N.M.); (I.M.); (M.E.V.); (G.A.); (M.M.); (I.M.); (A.I.); (D.A.T.)
| | - Igor Mauro
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (N.M.); (I.M.); (M.E.V.); (G.A.); (M.M.); (I.M.); (A.I.); (D.A.T.)
| | - Angela Iuliano
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (N.M.); (I.M.); (M.E.V.); (G.A.); (M.M.); (I.M.); (A.I.); (D.A.T.)
| | - Daniela Andreina Terribile
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (N.M.); (I.M.); (M.E.V.); (G.A.); (M.M.); (I.M.); (A.I.); (D.A.T.)
- Department of Woman, Child and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| |
Collapse
|
13
|
Hohmann L, Merx K, Weingaertner S, Schreiber A, Hetjens S, Hofmann WK, Hofheinz RD, Gencer D. Assessment and Evaluation of Psychosocial Distress in Outpatients with Cancer at a University Hospital in Germany. Oncol Res Treat 2023; 46:424-432. [PMID: 37473735 DOI: 10.1159/000531888] [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: 09/16/2022] [Accepted: 06/23/2023] [Indexed: 07/22/2023]
Abstract
INTRODUCTION Cancer patients (pts) suffer from a significant amount of psychosocial distress related to tumor disease itself or straining treatments. Despite recommendations on how to screen for and to deal with psychosocial distress in cancer pts, data about implementation of psycho-oncological interventions (poi) in outpatient settings of cancer pts are scarce. The aim of this study was to identify outpatients with cancer in need of poi and to evaluate different assessment instruments. METHODS N = 200 outpatients with hemat-/oncological malignancies were interviewed between October 2015 and December 2017 at the University Hospital Mannheim using the Basic Documentation for Psycho-Oncology (PO-Bado) and the Hornheider Screening Instrument (HSI) - both clinician-administered assessment tools - followed by descriptive, univariate, and agreement analysis. RESULTS N = 61 cancer pts (31%) were identified to be in need for poi considering the results of both questionnaires. The number of identified pts in need of poi was lower when analyzing the results of the PO-Bado (n = 42, 21%) and the HSI (n = 39, 20%) separately. The degree of agreement between the results of PO-Bado and HSI was low (kappa = 0.3655). Several factors like gender, age and diagnosis were identified to have significant impact on the need for poi (p ≤ 0.05). CONCLUSION Our study underlines that different screening instruments for psychosocial distress may identify disparate populations of cancer pts. The study data also revealed significant characteristics that might be associated with elevated levels of psychosocial distress and a clear indication for poi. However, further analyses on larger populations of cancer pts are needed to provide information how to transfer positive screening to poi in clinical routine.
Collapse
Affiliation(s)
- Laura Hohmann
- 3rd Department of Medicine, Medical Faculty Mannheim, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
| | - Kirsten Merx
- 3rd Department of Medicine, Medical Faculty Mannheim, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
| | - Simone Weingaertner
- 3rd Department of Medicine, Medical Faculty Mannheim, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
| | - Annette Schreiber
- 3rd Department of Medicine, Medical Faculty Mannheim, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
| | - Svetlana Hetjens
- Department of Medical Statistics, Biomathematics and Information Processing, University Medical Center Mannheim, Heidelberg University, Heidelberg, Germany
| | - Wolf-Karsten Hofmann
- 3rd Department of Medicine, Medical Faculty Mannheim, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
| | - Ralf-Dieter Hofheinz
- 3rd Department of Medicine, Medical Faculty Mannheim, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
| | - Deniz Gencer
- 3rd Department of Medicine, Medical Faculty Mannheim, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
| |
Collapse
|
14
|
Bovero A, Pesce S, Botto R, Tesio V, Ghiggia A. Self-Transcendence: Association with Spirituality in an Italian Sample of Terminal Cancer Patients. Behav Sci (Basel) 2023; 13:559. [PMID: 37504006 PMCID: PMC10376349 DOI: 10.3390/bs13070559] [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: 06/06/2023] [Revised: 06/30/2023] [Accepted: 07/02/2023] [Indexed: 07/29/2023] Open
Abstract
Terminally ill cancer patients often experience demoralization and loss of dignity, which undermines their spiritual wellbeing, which could, however, be supported by the presence of other factors such as self-transcendence and religious coping strategies. To assess self-transcendence and religious coping strategies and how they influence spirituality, we studied 141 end-stage cancer patients (64.3% male; mean age 68.6 ± 14.6) with a Karnofsky Performance Status ≤ 50 and a life expectancy ≤ 4 months using the Self-Transcendence Scale, the Demoralization Scale, the Functional Assessment of Chronic Illness Therapy-Spiritual Wellbeing (FACIT-Sp-12), the Brief Religious COPE, and the Patient Dignity Inventory. To understand the effects of these variables on spirituality, hierarchical multiple regression was performed on FACIT-Sp-12. The final model predicted 67% of the variance in spiritual wellbeing. Demoralization was the strongest influencing factor (β = -0.727, p < 0.001), followed by self-transcendence (β = 0.256, p < 0.001), and positive religious coping (β = 0.148, p < 0.05). This study suggests that self-transcendence and positive religious coping may be protective factors for spirituality in terminal cancer patients. These factors should be considered in treatment to promote spiritual wellbeing and improve patients' quality of life at the end of life.
Collapse
Affiliation(s)
- Andrea Bovero
- Clinical Psychology Unit, AOU Città della Salute e della Scienza, Corso Bramante 88, 10126 Turin, Italy
| | - Sara Pesce
- Clinical Psychology Unit, AOU Città della Salute e della Scienza, Corso Bramante 88, 10126 Turin, Italy
| | - Rossana Botto
- Clinical Psychology Unit, AOU Città della Salute e della Scienza, Corso Bramante 88, 10126 Turin, Italy
- Department of Neuroscience, University of Turin, AOU Città della Salute e della Scienza, Corso Bramante 88, 10126 Turin, Italy
| | - Valentina Tesio
- Department of Psychology, University of Turin, Via Verdi 10, 10124 Turin, Italy
| | - Ada Ghiggia
- Department of Life Sciences, University of Trieste, Via Edoardo Weiss 21, 34128 Trieste, Italy
| |
Collapse
|
15
|
Karibayeva I, Turdaliyeva B, Zainal NZ, Bagiyarova F, Kussainova D. Kazakh version of the beck depression inventory: Validation study in female cancer patients. Heliyon 2023; 9:e18146. [PMID: 37519682 PMCID: PMC10372230 DOI: 10.1016/j.heliyon.2023.e18146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 06/20/2023] [Accepted: 07/10/2023] [Indexed: 08/01/2023] Open
Abstract
This study aimed to evaluate the validity of the Beck Depression Inventory (BDI-II) as a screening tool for depression among Kazakh-speaking female cancer patients. A cross-sectional study design with random sampling was used to collect and analyze data from 115 female cancer patients. Means, sensitivity, specificity, and positive and negative predictive values were calculated. An analysis of receiver operating characteristic (ROC) curves was conducted to determine the optimal cut-off score for the BDI-II in this population as a screening tool for depression. Test-retest reliability and internal consistency were also tested. Results showed that using a BDI-II cut score of 15 retained high sensitivity (82.7%), increased specificity (75.0%), and improved positive (86.1%) and negative predictive values (69.8%) of the BDI-II compared to a cut score of 14. Kazakh BDI-II indicated excellent consistency (Cronbach's alpha of 0.86) and reliability (intraclass correlation coefficient (ICC) of 0.92 (95% CI [0.89-0.94])). The use of this valid screening tool can facilitate the diagnosis of depression in female cancer patients.
Collapse
Affiliation(s)
- Indira Karibayeva
- Department of Public Health, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
| | - Botagoz Turdaliyeva
- Department of Epidemiology, Evidence-Based Medicine and Biostatistics, Kazakhstan's Medical University “KSPH” Almaty, Kazakhstan
| | - Nor Zuraida Zainal
- Department of Psychological Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Fatima Bagiyarova
- Department of Communicative Skills, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
| | - Dinara Kussainova
- Department of Public Health, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
- Department of Psycho-Social Help, Kazakh Scientific Research Institute of Oncology and Radiology, Almaty, Kazakhstan
| |
Collapse
|
16
|
Hansen JM, Kjaer TK, Mellemgård A, Stensøe Oksen M, Andersen I, Dalton SO. Association between anxiety and depression symptoms and completion of first-line treatment in newly diagnosed lung cancer patients. Acta Oncol 2023; 62:820-824. [PMID: 37162449 DOI: 10.1080/0284186x.2023.2207745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 04/23/2023] [Indexed: 05/11/2023]
Affiliation(s)
- Josephine Maffait Hansen
- Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Trille Kristina Kjaer
- Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Anders Mellemgård
- Department of Oncology, Herlev Hospital, University of Copenhagen, Herlev, Denmark
| | | | - Ingelise Andersen
- Department of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Susanne Oksbjerg Dalton
- Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
- Danish Research Center for Equality in Cancer, Department of Clinical Oncology and Palliative Care, Zealand University Hospital, Næstved, Denmark
| |
Collapse
|
17
|
Caliandro M, Carbonara R, Surgo A, Ciliberti MP, Di Guglielmo FC, Bonaparte I, Paulicelli E, Gregucci F, Turchiano A, Fiorentino A. The Role of Telemedicine for Psychological Support for Oncological Patients Who Have Received Radiotherapy. Curr Oncol 2023; 30:5158-5167. [PMID: 37232848 DOI: 10.3390/curroncol30050390] [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: 04/24/2023] [Revised: 05/15/2023] [Accepted: 05/17/2023] [Indexed: 05/27/2023] Open
Abstract
AIM In our radiation departments, all patients received psycho-oncological support during RT and during follow-up. Based on the latter, the aim of this retrospective analysis was to evaluate the role of tele-visits and in-person psychological support for cancer patients after RT, and to report a descriptive analysis pointing out the needs of psychosocial intervention in a radiation department during radiation treatment. METHODS According to our institutional care management, all patients receiving RT were prospectively enrolled to receive charge-free assessment of their cognitive, emotional and physical states and psycho-oncological support during treatment. For the whole population who accepted the psychological support during RT, a descriptive analysis was reported. For all patients who agreed to be followed up by a psycho-oncologist, at the end of RT, a retrospective analysis was conducted to evaluate the differences between tele-consultations (video-call or telephone) and on-site psychological visits. Patients were followed up by on-site psychological visit (Group-OS) or tele-consult (Group-TC) visit. For each group, to evaluate anxiety, depression and distress, the Hospital Anxiety Depression Scale (HADS), Distress Thermometer and Brief COPE (BC) were used. RESULTS From July 2019 to June 2022, 1145 cases were evaluated during RT with structured psycho-oncological interviews for a median of 3 sessions (range 2-5). During their first psycho-oncological interview, all the 1145 patients experienced the assessment of anxiety, depression and distress levels with the following results: concerning the HADS-A scale, 50% of cases (574 patients) reported a pathological score ≥8; concerning the HADS-D scale, 30% of cases (340 patients) reported a pathological score ≥8, concerning the DT scale, 60% (687 patients) reported a pathological score ≥4. Eighty-two patients were evaluated after RT: 30 in the Group-OS and 52 in the Group-TC. During follow-up, a median of 8 meetings (range 4-28) were performed. Comparing psychological data at baseline (beginning of RT) and at the last follow-up, in the entire population, a significant improvement in terms of HADS-A, global HADS and BC was shown (p 0.04; p 0.05; and p 0.0008, respectively). Compared to baseline, statistically significant differences were observed between the two groups in terms of anxiety in favor of on-site visit: Group-OS reported a better anxiety score compared with Group-TC. In each group, a statistical improvement was observed in BC (p 0.01). CONCLUSION The study revealed optimal compliance to tele-visit psychological support, even if the anxiety could be better controlled when patients were followed up on-site. However, rigorous research on this topic is needed.
Collapse
Affiliation(s)
- Morena Caliandro
- Radiation Oncology Department, General Regional Hospital F. Miulli, Strada Provinciale 127, Acquaviva delle Fonti, 70021 Bari, Italy
| | - Roberta Carbonara
- Radiation Oncology Department, General Regional Hospital F. Miulli, Strada Provinciale 127, Acquaviva delle Fonti, 70021 Bari, Italy
| | - Alessia Surgo
- Radiation Oncology Department, General Regional Hospital F. Miulli, Strada Provinciale 127, Acquaviva delle Fonti, 70021 Bari, Italy
| | - Maria Paola Ciliberti
- Radiation Oncology Department, General Regional Hospital F. Miulli, Strada Provinciale 127, Acquaviva delle Fonti, 70021 Bari, Italy
| | - Fiorella Cristina Di Guglielmo
- Radiation Oncology Department, General Regional Hospital F. Miulli, Strada Provinciale 127, Acquaviva delle Fonti, 70021 Bari, Italy
| | - Ilaria Bonaparte
- Radiation Oncology Department, General Regional Hospital F. Miulli, Strada Provinciale 127, Acquaviva delle Fonti, 70021 Bari, Italy
| | - Eleonora Paulicelli
- Radiation Oncology Department, General Regional Hospital F. Miulli, Strada Provinciale 127, Acquaviva delle Fonti, 70021 Bari, Italy
| | - Fabiana Gregucci
- Radiation Oncology Department, General Regional Hospital F. Miulli, Strada Provinciale 127, Acquaviva delle Fonti, 70021 Bari, Italy
| | - Angela Turchiano
- Radiation Oncology Department, General Regional Hospital F. Miulli, Strada Provinciale 127, Acquaviva delle Fonti, 70021 Bari, Italy
| | - Alba Fiorentino
- Radiation Oncology Department, General Regional Hospital F. Miulli, Strada Provinciale 127, Acquaviva delle Fonti, 70021 Bari, Italy
- Department of Medicine and Surgery, LUM University, Casamassima, 70010 Bari, Italy
| |
Collapse
|
18
|
Liou KT, McConnell KM, Currier MB, Baser RE, MacLeod J, Walker D, Casaw C, Wong G, Piulson L, Popkin K, Lopez AM, Panageas K, Bradt J, Mao JJ. Telehealth-Based Music Therapy Versus Cognitive Behavioral Therapy for Anxiety in Cancer Survivors: Rationale and Protocol for a Comparative Effectiveness Trial. JMIR Res Protoc 2023; 12:e46281. [PMID: 37103999 PMCID: PMC10176150 DOI: 10.2196/46281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 02/19/2023] [Indexed: 02/21/2023] Open
Abstract
BACKGROUND Cancer survivors represent one of the fastest growing populations in the United States. Unfortunately, nearly 1 in 3 survivors experience anxiety symptoms as a long-term consequence of cancer and its treatment. Characterized by restlessness, muscle tension, and worry, anxiety worsens the quality of life; impairs daily functioning; and is associated with poor sleep, depressed mood, and fatigue. Although pharmacological treatment options are available, polypharmacy has become a growing concern for cancer survivors. Music therapy (MT) and cognitive behavioral therapy (CBT) are evidence-based, nonpharmacological treatments that have demonstrated effectiveness in treating anxiety symptoms in cancer populations and can be adapted for remote delivery to increase access to mental health treatments. However, the comparative effectiveness of these 2 interventions delivered via telehealth is unknown. OBJECTIVE The aims of the Music Therapy Versus Cognitive Behavioral Therapy for Cancer-related Anxiety (MELODY) study are to determine the comparative effectiveness of telehealth-based MT versus telehealth-based CBT for anxiety and comorbid symptoms in cancer survivors and to identify patient-level factors associated with greater anxiety symptom reduction for MT and CBT. METHODS The MELODY study is a 2-arm, parallel-group randomized clinical trial that aims to compare the effectiveness of MT versus CBT for anxiety and comorbid symptoms. The trial will enroll 300 English- or Spanish-speaking survivors of any cancer type or stage who have experienced anxiety symptoms for at least 1 month. Participants will receive 7 weekly sessions of MT or CBT delivered remotely via Zoom (Zoom Video Communications, Inc) over 7 weeks. Validated instruments to assess anxiety (primary outcome), comorbid symptoms (fatigue, depression, insomnia, pain, and cognitive dysfunction), and health-related quality of life will be administered at baseline and at weeks 4, 8 (end of treatment), 16, and 26. Semistructured interviews will be conducted at week 8 with a subsample of 60 participants (30 per treatment arm) to understand individual experiences with the treatment sessions and their impact. RESULTS The first study participant was enrolled in February 2022. As of January 2023, 151 participants have been enrolled. The trial is expected to be completed by September 2024. CONCLUSIONS This study is the first and largest randomized clinical trial to compare the short- and long-term effectiveness of remotely delivered MT and CBT for anxiety in cancer survivors. Limitations include the lack of usual care or placebo control groups and the lack of formal diagnostic assessments for psychiatric disorders among trial participants. The study findings will help guide treatment decisions for 2 evidence-based, scalable, and accessible interventions to promote mental well-being during cancer survivorship. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/46281.
Collapse
Affiliation(s)
- Kevin T Liou
- Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | | | | | - Raymond E Baser
- Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Jodi MacLeod
- Society for Integrative Oncology, Washington, DC, United States
| | | | - Camila Casaw
- Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Greta Wong
- Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Lauren Piulson
- Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Karen Popkin
- Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Ana Maria Lopez
- Thomas Jefferson University, Philadelphia, PA, United States
| | | | - Joke Bradt
- Drexel University, Philadelphia, PA, United States
| | - Jun J Mao
- Memorial Sloan Kettering Cancer Center, New York, NY, United States
| |
Collapse
|
19
|
Grassi L, Caruso R, Riba MB, Lloyd-Williams M, Kissane D, Rodin G, McFarland D, Campos-Ródenas R, Zachariae R, Santini D, Ripamonti CI. Anxiety and depression in adult cancer patients: ESMO Clinical Practice Guideline. ESMO Open 2023; 8:101155. [PMID: 37087199 PMCID: PMC10163167 DOI: 10.1016/j.esmoop.2023.101155] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/27/2023] [Accepted: 01/29/2023] [Indexed: 03/15/2023] Open
Abstract
•Anxiety and depressive disorders are common in patients with cancer. •A higher prevalence seen in patients with cancer than the general population is often underrecognised. •Psychotherapy, cognitive behavioural therapy and mindfulness-based therapies are effective treatments. •Psychopharmacological treatments have been shown to be effective treatments of anxiety and depressive disorders.
Collapse
Affiliation(s)
- L Grassi
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - R Caruso
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - M B Riba
- Department of Psychiatry, University of Michigan, Ann Arbor; University of Michigan Rogel Cancer Center, University of Michigan, Ann Arbor, USA
| | - M Lloyd-Williams
- Academic Palliative and Supportive Care Studies Group (APSCSG), Primary Care and Mental Health, University of Liverpool, Liverpool; Department of Supportive and Palliative Care, Liverpool John Moores University, Liverpool, UK
| | - D Kissane
- Department of Psychiatry, Monash University and Monash Medical Centre, Monash Health, Clayton, Australia
| | - G Rodin
- Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Canada
| | - D McFarland
- Department of Psychiatry, University of Rochester, Rochester; Wilmont Cancer Institute, University of Rochester Medical Center, Rochester, USA
| | - R Campos-Ródenas
- Department of Psychiatry, Hospital Clínico Universitario Lozano Blesa, University of Zaragoza, Zaragoza, Spain
| | - R Zachariae
- Unit for Psychooncology and Health Psychology, Department of Oncology, Aarhus University Hospital, Aarhus; Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | - D Santini
- UOC Medical Oncology, AUSL Latina, Sapienza University of Rome, Aprilia
| | - C I Ripamonti
- Oncology-Supportive Care in Cancer, Department of Oncology & Haematology Fondazione IRCCS, Istituto Nazionale dei Tumori di Milano, Milan, Italy
| |
Collapse
|
20
|
Goerling U, Hinz A, Koch-Gromus U, Hufeld JM, Esser P, Mehnert-Theuerkauf A. Prevalence and severity of anxiety in cancer patients: results from a multi-center cohort study in Germany. J Cancer Res Clin Oncol 2023:10.1007/s00432-023-04600-w. [PMID: 36757620 PMCID: PMC10356888 DOI: 10.1007/s00432-023-04600-w] [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: 12/09/2022] [Accepted: 01/25/2023] [Indexed: 02/10/2023]
Abstract
PURPOSE Anxiety is an accompanying symptom in cancer patients that can have a negative impact on patients. The aim of the present analyses is to determine the prevalence of anxiety, taking into account sociodemographic and medical variables, and to determine the odds ratio for the occurrence of anxiety in cancer patients compared to general population. METHODS In this secondary analyses, we included 4,020 adult cancer patients during and after treatment from a multi-center epidemiological study from 5 regions in Germany in different treatment settings and a comparison group consisting of 10,000 people from the general population in Germany. Anxiety was measured with the Generalized Anxiety Disorder (GAD-7) questionnaire. In multivariate analyses adjusted for age and sex, we calculated the odds of being anxious. RESULTS The prevalence of anxiety was observed to be 13.8% (GAD-7 ≥ 10). The level of anxiety was significant higher for patients in rehabilitation, compared to patients during inpatient and outpatient treatment (p = .013). Comparison with the general population yielded a 2.7-fold increased risk for anxiety among cancer patients (95% CI 2.4-3.1; p < .001). Patients with bladder cancer (OR, 5.3; 95% CI 3.0-9.4) and testicular cancer (OR, 5.0; 95% CI 2.1-12.1) showed the highest risk of having high levels of anxiety. CONCLUSION The results highlight the importance of identifying anxiety in cancer patients.
Collapse
Affiliation(s)
- Ute Goerling
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charité Comprehensive Cancer Center, Charitéplatz 1, 10117, Berlin, Germany.
| | - Andreas Hinz
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
| | - Uwe Koch-Gromus
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Julia Marie Hufeld
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
| | - Peter Esser
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
| | - Anja Mehnert-Theuerkauf
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
| |
Collapse
|
21
|
Pinheiro LC, Cho J, Rothman J, Zeng C, Wilson M, Kern LM, Tamimi RM, Safford MM. Diabetes and cancer co-management: patient-reported challenges, needs, and priorities. Support Care Cancer 2023; 31:145. [PMID: 36729259 PMCID: PMC9892662 DOI: 10.1007/s00520-023-07604-x] [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: 09/30/2022] [Accepted: 01/20/2023] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Twenty percent of breast cancer survivors have co-occurring diabetes and face a 50% greater risk of 10-year mortality compared to survivors without diabetes. Individuals with cancer are often overwhelmed during cancer treatment and have less time for their diabetes, contributing to worse outcomes. We elicited perspectives of breast cancer survivors with diabetes regarding their specific needs for diabetes and cancer co-management. METHODS We conducted semi-structured interviews with women with breast cancer aged 40 + years at three New York City hospitals from May 2021 to March 2022. Eligible participants had type 2 diabetes or pre-diabetes. Interviews were audio-recorded, professionally transcribed, and coded by two independent reviewers. RESULTS We conducted interviews with 15 females with breast cancer of mean age 61.5 years (SD 7.2); 70% were Black, Hispanic, or Asian/Pacific Islander, and 20% had only a high school education. Most (73%) patients were insured by Medicaid or Medicare, and 73% underwent chemotherapy as part of their cancer care. Of the 15 participants, 60% reported that their glucose levels were of control during cancer treatment and nearly 50% reported glucose levels > 200 mg/dL. We identified distinct themes that reflect patient-reported challenges (worse glucose control after initiation of cancer treatment, lack of information on co-managing diabetes, negative psychosocial effects, burden of diabetes management during cancer care) and needs/priorities (designated provider to help, educational resources specific to diabetes and cancer, and individualized care plans). CONCLUSIONS Patients co-managing diabetes and cancer face challenges and have unmet needs that should be addressed to improve diabetes control during cancer treatment. Our findings can directly inform interventions aimed at improving glucose control in this population.
Collapse
Affiliation(s)
- Laura C. Pinheiro
- grid.5386.8000000041936877XDivision of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, 420 East 70th Street, Box 331, New York, NY USA ,grid.5386.8000000041936877XDivision of Epidemiology, Department of Population Health Science, Weill Cornell Medicine, New York, NY USA
| | - Jacklyn Cho
- grid.36425.360000 0001 2216 9681Renaissance School of Medicine at Stony Brook University, NY Stony Brook, USA
| | - Julia Rothman
- grid.5386.8000000041936877XCornell University, Ithaca, NY USA
| | - Caroline Zeng
- grid.5386.8000000041936877XDivision of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, 420 East 70th Street, Box 331, New York, NY USA
| | - Micayla Wilson
- grid.266093.80000 0001 0668 7243University of California Irvine, Irvine, CA USA
| | - Lisa M. Kern
- grid.5386.8000000041936877XDivision of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, 420 East 70th Street, Box 331, New York, NY USA
| | - Rulla M. Tamimi
- grid.5386.8000000041936877XDivision of Epidemiology, Department of Population Health Science, Weill Cornell Medicine, New York, NY USA
| | - Monika M. Safford
- grid.5386.8000000041936877XDivision of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, 420 East 70th Street, Box 331, New York, NY USA
| |
Collapse
|
22
|
Onyeka TC, Onu JU, Agom DA. Psychosocial aspects of adult cancer patients: A scoping review of sub-Saharan Africa. Psychooncology 2023; 32:86-106. [PMID: 36250212 DOI: 10.1002/pon.6052] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 10/06/2022] [Accepted: 10/09/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Psychosocial aspects of adult cancer patients in sub-Saharan Africa (SSA) have been described in silos of research articles. Integrative analysis of regional evidence is lacking. This review aimed to describe the scope of existing research on mental health problems, identify research gaps and make informed research, policy and practice recommendations. METHODS Search was conducted for original peer-reviewed research articles, irrespective of their quality, on psychosocial aspects of cancer in all SSA countries using PubMed, Google Scholar, Google search, African Index Medicus and direct searches of reference list of pertinent journal articles. Publications in English or translated to English were included. Case reports, dissertations, abstracts, publications without primary focus on psychosocial issues, psychosocial issues in children and studies conducted with SSA populations living outside the sub-region were excluded. The methodological framework described by Arksey and O'Malley was used to synthesize and present the results. Inductive approach was used to arrive at the thematic areas. Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guideline was used to describe the review. RESULTS Eighty-three studies conducted across 15 countries were identified. Six thematic areas emerged namely; psychosocial needs, psychiatric disorders, coping strategies, suicidality, psychometrics and psychosocial interventions. Fifteen of 46 countries had at least one study with the majority of articles emanating from Nigeria. Research articles on psychosocial needs, psychiatric morbidities and coping strategies appears adequate for systematic review in SSA region. Despite the overwhelming evidence of high unmet psychosocial needs, a huge gap exists regarding psychosocial interventions. CONCLUSION Further research is needed into identified gaps in the region and quality of evidence of these studies need to be improved upon. Comprehensive policies and action plan development are sin qua non for addressing psychosocial problems of adults with cancer in SSA.
Collapse
Affiliation(s)
- Tonia C Onyeka
- Department of Anaesthesia/Pain and Palliative Care Unit, College of Medicine, University of Nigeria Ituku-Ozalla Campus, Enugu, Enugu State, Nigeria.,Center for Translation and Implementation Research (CTAIR), College of Medicine, University of Nigeria, Enugu, Nigeria
| | - Justus U Onu
- Center for Translation and Implementation Research (CTAIR), College of Medicine, University of Nigeria, Enugu, Nigeria.,Department of Mental Health, College of Health Sciences, Nnamdi Azikiwe University, Awka, Anambra State, Nigeria
| | - David A Agom
- Center for Translation and Implementation Research (CTAIR), College of Medicine, University of Nigeria, Enugu, Nigeria.,School of Nursing and Health Education, University of Bedfordshire, Luton, UK
| |
Collapse
|
23
|
Forbes E, Clover K, Baker AL, McCarter KL, Oultram S, Kumar M, Wratten C, Tieu MT, Nixon J, Britton B. Biofeedback Enabled CALM (BeCALM)-the feasibility of biofeedback on procedural anxiety during radiation therapy: study protocol for a pilot randomised controlled trial. BMJ Open 2022; 12:e062467. [PMID: 36600369 PMCID: PMC9730381 DOI: 10.1136/bmjopen-2022-062467] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Patients undergoing treatment for cancer who require radiation therapy (RT) report anxiety specifically relating to the RT procedure. Procedural anxiety can be detrimental to treatment delivery, causing disruptions to treatment sessions, or treatment avoidance. Acute procedural anxiety is most commonly managed with anxiolytic medication. There is a need for effective, non-pharmacological interventions for patients not suitable for, or who prefer to avoid, anxiolytic medication. The primary objectives of this pilot trial are to evaluate the: (1) feasibility of conducting the Biofeedback Enabled CALM (BeCALM) intervention during RT treatment sessions; (2) acceptability of the BeCALM intervention among patients; and (3) acceptability of the BeCALM intervention among radiation therapists. The secondary objective of this pilot trial is to examine the potential effectiveness of the BeCALM intervention delivered by radiation therapists to reduce procedural anxiety during RT. METHODS AND ANALYSIS This is a pilot randomised controlled trial. A researcher will recruit adult patients with cancer (3-month recruitment period) scheduled to undergo RT and meeting eligibility criteria for procedural anxiety at the Calvary Mater Hospital, Newcastle (NSW), Australia. Participants will be randomly assigned to receive treatment as usual or the BeCALM intervention (biofeedback plus brief breathing techniques). The primary outcomes are feasibility (measured by recruitment, retention rates and percentage of treatment sessions in which the intervention was successfully delivered); radiation therapists perceived feasibility and acceptability (survey responses); and patient perceived acceptability (survey responses). Secondary outcome is potential effectiveness of the intervention (as measured by the State Trait Anxiety Inventory-State subscale; the Distress Thermometer; and an analysis of treatment duration). ETHICS AND DISSEMINATION The study protocol has received approval from Hunter New England Health Human Research Ethics Committee (2021/ETH11356). The results will be disseminated via peer-reviewed publications, as well as presentation at relevant conferences. TRIAL REGISTRATION NUMBER ACTRN12621001742864.
Collapse
Affiliation(s)
- Erin Forbes
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Kerrie Clover
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia
- PsychoOncology Service, Department of Consultation Liaison Psychiatry, Calvary Mater Newcastle, Waratah, New South Wales, Australia
| | - Amanda L Baker
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Kristen Louise McCarter
- School of Psychological Sciences, College of Science, Engineering and Environment, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Sharon Oultram
- Radiation Oncology Department, Calvary Mater Newcastle, Waratah, New South Wales, Australia
| | - Mahesh Kumar
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia
- Radiation Oncology Department, Calvary Mater Newcastle, Waratah, New South Wales, Australia
| | - Chris Wratten
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia
- Radiation Oncology Department, Calvary Mater Newcastle, Waratah, New South Wales, Australia
| | - Minh Thi Tieu
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia
- Radiation Oncology Department, Calvary Mater Newcastle, Waratah, New South Wales, Australia
| | - Jodie Nixon
- School of Health and Rehabilitation Sciences, The University of Queensland, Saint Lucia, Queensland, Australia
- Occupational Therapy Department, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
| | - Ben Britton
- Mental Health Services, Hunter New England Health, New Lambton, New South Wales, Australia
| |
Collapse
|
24
|
Clover K, Lambert SD, Oldmeadow C, Britton B, Mitchell AJ, Carter G, King MT. Convergent and criterion validity of PROMIS anxiety measures relative to six legacy measures and a structured diagnostic interview for anxiety in cancer patients. J Patient Rep Outcomes 2022; 6:80. [PMID: 35857151 PMCID: PMC9300804 DOI: 10.1186/s41687-022-00477-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 06/05/2022] [Indexed: 12/03/2022] Open
Abstract
Background Detecting anxiety in oncology patients is important, requiring valid yet brief measures. One increasingly popular approach is the Patient Reported Outcomes Measurement Information System (PROMIS); however, its validity is not well established in oncology. We assessed the convergent and criterion validity of PROMIS anxiety measures in an oncology sample.
Methods 132 oncology/haematology outpatients completed the PROMIS Anxiety Computer Adaptive Test (PROMIS-A-CAT) and the 7 item (original) PROMIS Anxiety Short Form (PROMIS-A-SF) along with six well-established measures: Hospital Anxiety and Depression Scale-Anxiety (HADS-A); Generalised Anxiety Disorder-7 (GAD-7); Depression, Anxiety and Stress Scale-Anxiety (DASS-A) and Stress (DASS-S); Distress Thermometer (DT) and PSYCH-6. Correlations, area under the curve (AUC) and diagnostic accuracy statistics were calculated with Structured Clinical Interview as the reference standard.
Results Both PROMIS measures correlated with all legacy measures at p < .001 (Rho = .56–.83). AUCs (> .80) were good for both PROMIS measures and comparable to or better than all legacy measures. At the recommended mild cut-point (55), PROMIS-A-SF had sensitivity (.67) comparable to or better than all the legacy measures, whereas PROMIS-A-CAT sensitivity (.59) was lower than GAD-7 (.67) and HADS-A (.62), but comparable to PSYCH-6 and higher than DASS-A, DASS-S and DT. Sensitivity for both was .79. A reduced cut-point of 51 on both PROMIS measures improved sensitivity (.83–.84) although specificity was only adequate (.61–.62). Conclusions The convergent and criterion validity of the PROMIS anxiety measures in cancer populations was confirmed as equivalent, but not superior to, established measures (GAD-7 and HADS-A). The PROMIS-A-CAT did not demonstrate clear advantages over PROMIS-A-SF.
Collapse
|
25
|
Liu T, Xu J, Cheng H, Zhang Y, Wang S, Lin L, Tian L. Effects of internet-based cognitive behavioral therapy on anxiety and depression symptoms in cancer patients: A meta-analysis. Gen Hosp Psychiatry 2022; 79:135-145. [PMID: 36375342 DOI: 10.1016/j.genhosppsych.2022.09.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/17/2022] [Accepted: 09/19/2022] [Indexed: 11/04/2022]
Abstract
PURPOSE This meta-analysis was to critically evaluate the effects of Internet-based cognitive behavioral therapy (ICBT) on the symptoms of anxiety and depression in cancer patients. METHODS Eight Chinese and English databases (CNKI, Wanfang, VIP, CBM, Cochrane Library, PubMed, Embase, and PsycINFO) were systematically searched from the inception of databases to May 2022 for relevant randomized controlled trials (RCTs). According to the Cochrane Collaboration criteria, two reviewers independently assessed the risk of bias and extract data from included studies. All analyses were performed with Review Manager 5.4. RESULTS Thirteen qualified studies were included in the meta-analysis, twelve of which reported the effect of ICBT on anxiety in 2079 cancer patients; thirteen of the studies reported the effect of ICBT on depression in 2179 patients. The meta-analysis indicated that ICBT was effective in improving anxiety [SMD = -0.37, 95%CI (-0.62, -0.12), P < 0.01, I2 = 86%] and depression [SMD = -0.27, 95%CI (-0.44, -0.09), P < 0.01, I2 = 72%] symptoms in cancer patients, especially those undergoing anti-cancer treatment. Therapist-guided ICBT was more effective than self-directed ICBT. ICBT lasting for ≤12 weeks could relieve anxiety and depressive symptoms of cancer patients. ICBT with number of modules ≥5 had a small effect on anxiety and depression relief while ICBT with number of modules <5 was found to be ineffective. CONCLUSIONS ICBT lasting for ≤12 weeks, especially therapist-directed, helps relieve the anxiety and depressive symptoms of cancer patients. The ideal number of modules for ICBT and its long-term efficacy need to be validated by more studies of higher-quality.
Collapse
Affiliation(s)
- Tingting Liu
- The First Affiliated Hospital of Soochow University, Suzhou 215006, People's Republic of China; School of Nursing, Medical College of Soochow University, Suzhou 215006, People's Republic of China
| | - Juan Xu
- The First Affiliated Hospital of Soochow University, Suzhou 215006, People's Republic of China
| | - Hui Cheng
- School of Nursing, Medical College of Soochow University, Suzhou 215006, People's Republic of China
| | - Yueyue Zhang
- School of Nursing, Medical College of Soochow University, Suzhou 215006, People's Republic of China
| | - Shaotong Wang
- School of Nursing, Medical College of Soochow University, Suzhou 215006, People's Republic of China
| | - Lu Lin
- The First Affiliated Hospital of Soochow University, Suzhou 215006, People's Republic of China; School of Nursing, Medical College of Soochow University, Suzhou 215006, People's Republic of China.
| | - Li Tian
- The First Affiliated Hospital of Soochow University, Suzhou 215006, People's Republic of China; School of Nursing, Medical College of Soochow University, Suzhou 215006, People's Republic of China.
| |
Collapse
|
26
|
Rohan EA, Gallaway MS, Huang GC, Ng D, Boehm JE, Samarasinha R, Stachon K. Disparities in Psychosocial Distress Screening and Management of Lung and Ovarian Cancer Survivors. JCO Oncol Pract 2022; 18:e1704-e1715. [PMID: 35939778 PMCID: PMC9835932 DOI: 10.1200/op.22.00078] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 05/26/2022] [Accepted: 06/17/2022] [Indexed: 01/16/2023] Open
Abstract
PURPOSE Since 2016, the American College of Surgeons' Commission on Cancer (CoC) has required routine distress screening (DS) of cancer survivors treated in their accredited facilities to facilitate early identification of survivors with psychosocial concerns. Lung and ovarian cancer survivors have relatively low 5-year survival rates and may experience high levels of distress. We examined the extent to which ovarian and lung cancer survivors received CoC-mandated DS and whether DS disparities exist on the basis of diagnosis, sociodemographic factors, or facility geography (urban/rural). METHODS This study included a quantitative review of DS documentation and follow-up services provided using existing electronic health records (EHRs). We worked with 21 CoC-accredited facilities across the United States and examined EHRs of 2,258 survivors from these facilities (1,618 lung cancer survivors and 640 ovarian cancer survivors) diagnosed in 2016 or 2017. RESULTS Documentation of DS was found in half (54.8%) of the EHRs reviewed. Disparities existed across race/ethnicity, cancer type and stage, and facility characteristics. Hispanic/Latino and Asian/Pacific Islander survivors were screened at lower percentages than other survivors. Patients with ovarian cancer, those diagnosed at earlier stages, and survivors in urban facilities had relatively low percentages of DS. Non-Hispanic Black survivors were more likely than non-Hispanic White survivors to decline further psychosocial services. CONCLUSION Despite the mandate for routine DS in CoC-accredited oncology programs, gaps remain in how many and which survivors are screened for distress. Improvements in DS processes to enhance access to DS and appropriate psychosocial care could benefit cancer survivors. Collaboration with CoC during this study led to improvement of their processes for collecting DS data for measuring standard adherence.
Collapse
Affiliation(s)
- Elizabeth A. Rohan
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA
| | - M. Shayne Gallaway
- Arizona Department of Public Health, Phoenix, AZ
- Division of Population Health, Centers for Disease Control and Prevention, Atlanta, GA
| | | | | | - Jennifer E. Boehm
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA
| | - Ruvini Samarasinha
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA
| | - Karen Stachon
- American College of Surgeons, Commission on Cancer, Chicago, IL
| |
Collapse
|
27
|
Monoamine Neurotransmitters Control Basic Emotions and Affect Major Depressive Disorders. Pharmaceuticals (Basel) 2022; 15:ph15101203. [PMID: 36297314 PMCID: PMC9611768 DOI: 10.3390/ph15101203] [Citation(s) in RCA: 49] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 09/16/2022] [Accepted: 09/20/2022] [Indexed: 11/17/2022] Open
Abstract
Major depressive disorder (MDD) is a common and complex mental disorder, that adversely impacts an individual’s quality of life, but its diagnosis and treatment are not accurately executed and a symptom-based approach is utilized in most cases, due to the lack of precise knowledge regarding the pathophysiology. So far, the first-line treatments are still based on monoamine neurotransmitters. Even though there is a lot of progress in this field, the mechanisms seem to get more and more confusing, and the treatment is also getting more and more controversial. In this study, we try to review the broad advances of monoamine neurotransmitters in the field of MDD, and update its effects in many advanced neuroscience studies. We still propose the monoamine hypothesis but paid special attention to their effects on the new pathways for MDD, such as inflammation, oxidative stress, neurotrophins, and neurogenesis, especially in the glial cells, which have recently been found to play an important role in many neurodegenerative disorders, including MDD. In addition, we will extend the monoamine hypothesis to basic emotions; as suggested in our previous reports, the three monoamine neurotransmitters play different roles in emotions: dopamine—joy, norepinephrine—fear (anger), serotonins—disgust (sadness). Above all, this paper tries to give a full picture of the relationship between the MDD and the monoamine neurotransmitters such as DA, NE, and 5-HT, as well as their contributions to the Three Primary Color Model of Basic Emotions (joy, fear, and disgust). This is done by explaining the contribution of the monoamine from many sides for MDD, such the digestive tract, astrocytes, microglial, and others, and very briefly addressing the potential of monoamine neurotransmitters as a therapeutic approach for MDD patients and also the reasons for its limited clinical efficacy, side effects, and delayed onset of action. We hope this review might offer new pharmacological management of MDD.
Collapse
|
28
|
Zhang F, Zhai M, Yang J, Zhao L, Lin Z, Wang J, Zhang T, Yu D. 'FLARE' of tumor marker in advanced gastric cancer treated with first-line systemic therapy. Therap Adv Gastroenterol 2022; 15:17562848221124029. [PMID: 36187367 PMCID: PMC9523829 DOI: 10.1177/17562848221124029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 08/16/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Transient tumor marker elevations caused by chemotherapy were defined as 'Flare' and have been demonstrated in some solid tumors. In clinical practice, we observed that some patients were accompanied by elevated tumor markers during treatment, but subsequent imaging proved that the treatment they received was effective. OBJECTIVES We aimed to study the Flare and the prognosis in advanced gastric cancer. DESIGN This is an observational retrospective study. A total of 167 patients were enrolled in this study. Carcinoembryonic antigen (CEA), carbohydrate antigen (CA) 19-9 and CA125 values were obtained before the first, second, third, fourth, fifth and sixth cycles of treatment, respectively. METHODS Imaging for the first efficacy assessment was reviewed according to the Response Evaluation Criteria in Solid Tumors 1.1 (RECIST 1.1) criteria. Kaplan-Meier analyses and log-rank tests were performed for overall survival (OS) analyses. Univariate and multivariate Cox analyses were used to determine the prognostic factor for OS and progression-free survival (PFS). RESULTS 37.1% of patients were accompanied with at least one tumor marker Flare during the course of treatment. The median time to tumor marker peak was 24-30 days and the Flare duration lasted 49-53 days. Patients with tumor markers Flare had a worse OS. Flare may be associated with the use of 5-fluorouracil. Baseline CEA and CA125 levels were the independent prognostic factors for OS and baseline CA125 level was the independent prognostic factor for PFS. CONCLUSION Initial elevation of tumor markers during treatment is not an indication of tumor progression. Patients with tumor markers 'Flare' may had a worse OS.
Collapse
Affiliation(s)
- Fangyuan Zhang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China,Institute of Radiation Oncology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Menglan Zhai
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China,Institute of Radiation Oncology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jinru Yang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China,Institute of Radiation Oncology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lei Zhao
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China,Institute of Radiation Oncology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhenyu Lin
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China,Institute of Radiation Oncology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jing Wang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China,Institute of Radiation Oncology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tao Zhang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China,Institute of Radiation Oncology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | | |
Collapse
|
29
|
Tsehay M, Belete A, Necho M. Epidemiology and associated factors of depression among cancer patients in Ethiopia: protocol for systematic review and meta-analysis. Int J Ment Health Syst 2022; 16:46. [PMID: 36056363 PMCID: PMC9438069 DOI: 10.1186/s13033-022-00556-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 08/25/2022] [Indexed: 11/25/2022] Open
Abstract
Background There is no pooled evidence regarding the prevalence and potential associated factors of depression among cancer patients in Ethiopian community. Hence, the current review aimed to examine the prevalence and associated factors of depression among cancer patients in Ethiopia. Method A computerized systematic literature search was made in MEDLINE, Scopus, PubMed, Science Direct, and Google Scholar. Each database was searched from its start date to June 2020. More over we will also add scholars and gray literature consultations. All articles will be included if they were published in English, which evaluated the prevalence and associated factors of depression among cancer patients in Ethiopia. Pooled estimations with a 95% confidence interval (CI) were calculated with DerSimonian-Laird random-effects model. Publication bias was evaluated by using inspection of funnel plots and statistical tests. Discussion Since we are using existing anonymized data, ethical approval is not required for this study. Our results can be used to guide clinical decisions about the most efficient way to prevent and treat depression among cancer patients. Systematic review registration Submitted to Prospero.
Collapse
Affiliation(s)
- Mekonnen Tsehay
- College of Medicine and Health Sciences, Department of Psychiatry, Wollo University, Dessie, Ethiopia.
| | - Asmare Belete
- College of Medicine and Health Sciences, Department of Psychiatry, Wollo University, Dessie, Ethiopia
| | - Mogesie Necho
- College of Medicine and Health Sciences, Department of Psychiatry, Wollo University, Dessie, Ethiopia
| |
Collapse
|
30
|
Zhang L, Liu X, Tong F, Zhou R, Peng W, Yang H, Liu F, Yang D, Huang X, Wen M, Jiang L, Yi L. The prevalence of psychological disorders among cancer patients during the COVID-19 pandemic A meta-analysis. Psychooncology 2022; 31:1972-1987. [PMID: 35950545 PMCID: PMC9538248 DOI: 10.1002/pon.6012] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 06/07/2022] [Accepted: 08/05/2022] [Indexed: 11/11/2022]
Abstract
Purpose We aimed to assess the prevalence rate (PR) of depression, anxiety, posttraumatic stress disorder (PTSD), insomnia, distress, and fear of cancer progression/recurrence among patients with cancer during the COVID‐19 pandemic. Methods Studies that reported the PR of six psychological disorders among cancer patients during the COVID‐19 pandemic were searched in PubMed, Embase, PsycINFO, and Web of Science databases, from January 2020 up to 31 January 2022. Meta‐analysis results were merged using PR and 95% confidence intervals, and heterogeneity among studies was evaluated using I2 and Cochran's Q test. Publication bias was examined using funnel plots and Egger's tests. All data analyses were performed using Stata14.0 software. Results Forty studies with 27,590 participants were included. Pooled results showed that the PR of clinically significant depression, anxiety, PTSD, distress, insomnia, and fear of cancer progression/recurrence among cancer patients were 32.5%, 31.3%, 28.2%, 53.9%, 23.2%, and 67.4%, respectively. Subgroup analysis revealed that patients with head and neck cancer had the highest PR of clinically significant depression (74.6%) and anxiety (92.3%) symptoms. Stratified analysis revealed that patients with higher education levels had higher levels of clinically significant depression (37.2%). A higher level of clinically significant PTSD was observed in employed patients (47.4%) or female with cancer (27.9%). Conclusion This meta‐analysis evaluated the psychological disorders of cancer patients during the COVID‐19 outbreak. Therefore, it is necessary to develop psychological interventions to improve the mental health of cancer patients during the pandemic.
Collapse
Affiliation(s)
- Lemeng Zhang
- Thoracic Medicine Department 1, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan Province, P.R. China, 410013
| | - Xiaohong Liu
- Department of Clinical Spiritual Care, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan Province, P.R. China, 410013
| | - Fei Tong
- Department of Clinical Spiritual Care, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan Province, P.R. China, 410013
| | - Ran Zhou
- Department of Clinical Spiritual Care, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan Province, P.R. China, 410013
| | - Wanglian Peng
- Department of Clinical Spiritual Care, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan Province, P.R. China, 410013
| | - Hui Yang
- Department of Clinical Spiritual Care, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan Province, P.R. China, 410013
| | - Feng Liu
- Department of Radiation Oncology, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan Province, P.R. China, 410013
| | - Desong Yang
- The Second Department of Thoracic Surgery, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan Province, P.R. China, 410013
| | - Xufen Huang
- Department of Clinical Spiritual Care, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan Province, P.R. China, 410013
| | - Minni Wen
- Department of Clinical Spiritual Care, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan Province, P.R. China, 410013
| | - Ling Jiang
- Department of Clinical Spiritual Care, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan Province, P.R. China, 410013
| | - Lili Yi
- Department of Clinical Spiritual Care, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan Province, P.R. China, 410013
| |
Collapse
|
31
|
Clover K, Lambert SD, Oldmeadow C, Britton B, King MT, Mitchell AJ, Carter GL. Apples to apples? Comparison of the measurement properties of hospital anxiety and depression-anxiety subscale (HADS-A), depression, anxiety and stress scale-anxiety subscale (DASS-A), and generalised anxiety disorder (GAD-7) scale in an oncology setting using Rasch analysis and diagnostic accuracy statistics. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-020-00906-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
|
32
|
Riccetti N, Blettner M, Taylor K, Wehler B, Gohrbandt B, Nestle U, Bals R, Stockinger M, Wehler T, Singer S, Eichler M. Quality of life in lung cancer survivors treated with tyrosine-kinase inhibitors (TKI): results from the multi-centre cross-sectional German study LARIS. J Cancer Res Clin Oncol 2022; 148:1943-1953. [PMID: 35608689 PMCID: PMC9293811 DOI: 10.1007/s00432-022-03975-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 02/28/2022] [Indexed: 11/26/2022]
Abstract
Purpose We aimed at exploring the quality of life (QOL) of lung cancer survivors with proven tyrosine-kinase receptor (RTK) genetic alterations and targeted tyrosine-kinase inhibitors (TKI) therapy, compared to lung cancer survivors with no-RTK alterations and no-TKI therapy. Methods Data were collected in a cross-sectional multi-centre study. Primary lung cancer survivors were asked about their socio-demographic and clinical information, QOL, symptom burden, and distress. QOL and symptom burden were assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30), and distress with the Patient Health Questionnaire-4 (PHQ-4). Demographic and clinical characteristics were reported in absolute and relative frequencies, QOL, and symptom burden using mean scores. Differences in mean scores with relative 95% confidence intervals were used for comparison. Results Three groups of survivors were defined: group A with proven RTK alterations, TKI therapy at any time during therapy, and stage IV lung cancer at diagnosis (n = 49); group B: non-TKI therapy and stage IV lung cancer (n = 121); group C: non-TKI therapy and stage I–III lung cancer (n = 495). Survivors in group A reported lower QOL (mean score difference = -11.7 vs. group B) and symptom burden for dyspnoea (difference = -11.5 vs. group C), and higher symptom burden for appetite loss (difference = + 11.4 vs. group C), diarrhoea and rash (differences = + 25.6, + 19.6 and + 13.2, + 13.0, respectively, vs. both groups). Conclusions Our results suggest that the specific side effects of TKI therapy can impair QOL among lung cancer survivors. Therefore, specific focus towards the optimal management of these side effects should be considered.
Collapse
Affiliation(s)
- Nicola Riccetti
- University Medical Center, Johannes Gutenberg University, Langenbeckstraße 1, 55131, Mainz, Germany.
- University Cancer Center Mainz, Langenbeckstraße 1, 55131, Mainz, Germany.
- Institute of Medical Biostatistics, Epidemiology, and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University, Obere Zahlbacher Straße 69, 55131, Mainz, Germany.
| | - Maria Blettner
- University Medical Center, Johannes Gutenberg University, Langenbeckstraße 1, 55131, Mainz, Germany
- Institute of Medical Biostatistics, Epidemiology, and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University, Obere Zahlbacher Straße 69, 55131, Mainz, Germany
| | - Katherine Taylor
- University Medical Center, Johannes Gutenberg University, Langenbeckstraße 1, 55131, Mainz, Germany
- University Cancer Center Mainz, Langenbeckstraße 1, 55131, Mainz, Germany
- Institute of Medical Biostatistics, Epidemiology, and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University, Obere Zahlbacher Straße 69, 55131, Mainz, Germany
| | - Beatrice Wehler
- Universitätsklinikum Gießen Marburg GmbH Standort Gießen, Medizinische Klinik IV/V, Klinikstr. 33, 35392, Gießen, Germany
| | | | - Ursula Nestle
- University Medical Center Freiburg, Albert-Ludwig-University, Hugstetter Str. 55, 79106, Freiburg im Breisgau, Germany
- Boehringer-Ingelheim, Binger Str. 173, 55216, Ingelheim am Rhein, Germany
| | - Robert Bals
- Department of Internal Medicine V, Saarland University Medical Center, Kirrberger Str. 100, 66421, Homburg, Germany
| | - Marcus Stockinger
- University Medical Center, Johannes Gutenberg University, Langenbeckstraße 1, 55131, Mainz, Germany
| | - Thomas Wehler
- Universitätsklinikum Gießen Marburg GmbH Standort Gießen, Medizinische Klinik IV/V, Klinikstr. 33, 35392, Gießen, Germany
| | - Susanne Singer
- University Medical Center, Johannes Gutenberg University, Langenbeckstraße 1, 55131, Mainz, Germany
- University Cancer Center Mainz, Langenbeckstraße 1, 55131, Mainz, Germany
- Institute of Medical Biostatistics, Epidemiology, and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University, Obere Zahlbacher Straße 69, 55131, Mainz, Germany
| | - Martin Eichler
- University Medical Center, Johannes Gutenberg University, Langenbeckstraße 1, 55131, Mainz, Germany
- University Hospital Carl Gustav Carus, Fetscherstraße 74, 01307, Dresden, Germany
| |
Collapse
|
33
|
Weng Hong C, Ajit Singh V, Amar Singh AK. Psychological disorders in patients with orthopaedic oncological diseases and their coping strategies. J Orthop Surg (Hong Kong) 2022; 30:10225536221093431. [PMID: 35410527 DOI: 10.1177/10225536221093431] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND This study aimed to determine the prevalence and risk factors of anxiety and depression among orthopaedic oncology patients, their quality of life and coping strategies. METHODS This cross-sectional study recruited patients from the outpatient orthopaedic oncology clinic at a tertiary institution. Data were collected from self-report questionnaires: Hospital Anxiety and Depression Scale Hospital Anxiety Depression Scale, World Health Organization Quality of Life (WHOQOL-BREF) and Brief Coping with Problems Experienced (Brief COPE). Risk factors were analyzed with multiple logistic regression. RESULTS 191 patients were recruited. The median age was 39.4 years old (IQR 35.0). 29.8% had anxiety, 16.2% had depression, and 15.2% had mixed anxiety and depression. Quality of life median scores differed significantly between patients with anxiety and no anxiety and patients with depression and no depression (p < 0.001). Patients with mixed anxiety and depression had a more inferior quality of life (p < 0.001). Age, psychological health and radiotherapy were inversely associated with anxiety. Physical and psychological health were significantly associated with less depression. Ongoing chemotherapy was significantly associated with anxiety and depression. The commonest coping strategies were denial, behavioural disengagement, venting and self-blame. CONCLUSION Anxiety and depression are prevalent among orthopaedic oncology patients. Patients with mixed anxiety and depression had a more inferior quality of life. Patients with ongoing chemotherapy had higher risks of anxiety and depression. The commonest coping strategies were denial, behavioural disengagement, venting and self-blame. Psychosocial evaluation followed by appropriate psychiatric referrals and consultations could be established to facilitate orthopaedic oncology patients during their course of treatment.
Collapse
Affiliation(s)
- Chung Weng Hong
- Department of Orthopaedic Surgery (NOCERAL), Faculty of Medicine, 37447University of Malaya, Kuala Lumpur, Malaysia
| | - Vivek Ajit Singh
- Department of Orthopaedic Surgery (NOCERAL), Faculty of Medicine, 37447University of Malaya, Kuala Lumpur, Malaysia
| | | |
Collapse
|
34
|
Venkataramu VN, Ghotra HK, Chaturvedi SK. Management of psychiatric disorders in patients with cancer. Indian J Psychiatry 2022; 64:S458-S472. [PMID: 35602367 PMCID: PMC9122176 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_15_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 01/10/2022] [Accepted: 01/12/2022] [Indexed: 11/05/2022] Open
Affiliation(s)
| | | | - Santosh K Chaturvedi
- Department of Psychiatry, NIMHANS, Bengaluru, Karnataka, India.,Leicestershire Partnership NHS Trust, Thurmaston, Leicestershire, UK E-mail:
| |
Collapse
|
35
|
Khan H, Nazir S, Farooq RK, Khan IN, Javed A. Fabrication and Assessment of Diosgenin Encapsulated Stearic Acid Solid Lipid Nanoparticles for Its Anticancer and Antidepressant Effects Using in vitro and in vivo Models. Front Neurosci 2022; 15:806713. [PMID: 35221890 PMCID: PMC8866708 DOI: 10.3389/fnins.2021.806713] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 12/29/2021] [Indexed: 11/17/2022] Open
Abstract
Inflammatory cascade plays a pivotal role in the onset and progression of major depressive disorder (MDD) and glioblastoma multiforme (GBM). Therefore, questing natural compounds with anti-inflammatory activity such as diosgenin can act as a double-edged sword targeting cancer and cancer-induced inflammation simultaneously. The blood–brain barrier limits the therapeutic efficiency of the drugs against intracranial pathologies including depression and brain cancers. Encapsulating a drug molecule in lipid nanoparticles can overcome this obstacle. The current study has thus investigated the anticancer and antidepressant effect of Tween 80 (P80) coated stearic acid solid lipid nanoparticles (SLNPs) encapsulating the diosgenin. Physio-chemical characterizations of SLNPs were performed to assess their stability, monodispersity, and entrapment efficiency. In vitro cytotoxic analysis of naked and drug encapsulated SLNPs on U-87 cell line indicated diosgenin IC50 value to be 194.4 μM, while diosgenin encapsulation in nanoparticles slightly decreases the toxicity. Antidepressant effects of encapsulated and non-encapsulated diosgenin were comprehensively evaluated in the concanavalin-A–induced sickness behavior mouse model. Behavior test results indicate that diosgenin and diosgenin encapsulated nanoparticles significantly alleviated anxiety-like and depressive behavior. Diosgenin incorporated SLNPs also improved grooming behavior and social interaction as well as showed normal levels of neutrophils and leukocytes with no toxicity indication. In conclusion, diosgenin and diosgenin encapsulated solid lipid nanoparticles proved successful in decreasing in vitro cancer cell proliferation and improving sickness behavioral phenotype and thus merit further exploration.
Collapse
Affiliation(s)
- Hina Khan
- Atta-ur-Rahman School of Applied Biosciences, National University of Sciences and Technology, Islamabad, Pakistan
| | - Sadia Nazir
- Atta-ur-Rahman School of Applied Biosciences, National University of Sciences and Technology, Islamabad, Pakistan
| | - Rai Khalid Farooq
- Department of Neuroscience Research, Institute for Research and Medical Consultations (IRMC), Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Ishaq N. Khan
- Department of Molecular Biology and Genetics, Institute of Basic Medical Sciences (IBMS), Khyber Medical University, Peshawar, Pakistan
| | - Aneela Javed
- Atta-ur-Rahman School of Applied Biosciences, National University of Sciences and Technology, Islamabad, Pakistan
- Healthcare Biotechnology, Atta-ur-Rahman School of Applied Biosciences (ASAB), National University of Science and Technology (NUST), Islamabad, Pakistan
- *Correspondence: Aneela Javed,
| |
Collapse
|
36
|
O’Brien K. Cannabidiol (CBD) in Cancer Management. Cancers (Basel) 2022; 14:cancers14040885. [PMID: 35205633 PMCID: PMC8869992 DOI: 10.3390/cancers14040885] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 01/28/2022] [Accepted: 02/05/2022] [Indexed: 12/23/2022] Open
Abstract
Simple Summary Cannabidiol (CBD) is one of the main constituents of the plant Cannabis sativa. Surveys suggest that medicinal cannabis is popular amongst people diagnosed with cancer. CBD is one of the key constituents of cannabis, and does not have the potentially intoxicating effects that tetrahydrocannabinol (THC), the other key phytocannabinoid has. Research indicates the CBD may have potential for the treatment of cancer, including the symptoms and signs associated with cancer and its treatment. Preclinical research suggests CBD may address many of the pathways involved in the pathogenesis of cancers. Preclinical and clinical research also suggests some evidence of efficacy, alone or in some cases in conjunction with tetrahydrocannabinol (THC, the other key phytocannabinoid in cannabis), in treating cancer-associated pain, anxiety and depression, sleep problems, nausea and vomiting, and oral mucositis that are associated with cancer and/or its treatment. Studies also suggest that CBD may enhance orthodox treatments with chemotherapeutic agents and radiation therapy and protect against neural and organ damage. CBD shows promise as part of an integrative approach to the management of cancer. Abstract The plant Cannabis sativa has been in use medicinally for several thousand years. It has over 540 metabolites thought to be responsible for its therapeutic effects. Two of the key phytocannabinoids are cannabidiol (CBD) and tetrahydrocannabinol (THC). Unlike THC, CBD does not have potentially intoxicating effects. Preclinical and clinical research indicates that CBD has a wide range of therapeutic effects, and many of them are relevant to the management of cancer. In this article, we explore some of the potential mechanisms of action of CBD in cancer, and evidence of its efficacy in the integrative management of cancer including the side effects associated with its treatment, demonstrating its potential for integration with orthodox cancer care.
Collapse
Affiliation(s)
- Kylie O’Brien
- Adelaide Campus, Torrens University, Adelaide, SA 5000, Australia;
- NICM Health Research Centre, Western Sydney University, Westmead, Sydney, NSW 2145, Australia
- Releaf Group Ltd., St Kilda, VIC 3182, Australia
- International College of Cannabinoid Medicine, iccm.co, London N1 7GU, UK
| |
Collapse
|
37
|
Seib C, McCarthy A, McGuire A, Porter-Steele J, Balaam S, McDonald N, Bailey T, Anderson D. Determining the psychometric properties of the Greene Climacteric Scale (GCS) in women previously treated for breast cancer: A pooled analysis of data from the Women's Wellness after Cancer Programs. Maturitas 2022; 161:65-71. [DOI: 10.1016/j.maturitas.2022.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 02/06/2022] [Accepted: 02/11/2022] [Indexed: 11/17/2022]
|
38
|
Andersen BL, McElroy JP, Carbone DP, Presley CJ, Smith RM, Shields PG, Brock GN. Psychological Symptom Trajectories and Non-Small Cell Lung Cancer Survival: A Joint Model Analysis. Psychosom Med 2022; 84:215-223. [PMID: 34629425 PMCID: PMC8831460 DOI: 10.1097/psy.0000000000001027] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Lung cancer remains the number one cause of cancer-related mortality worldwide, but less known is that lung cancer patients are among the most psychologically disabled of all cancer groups. Patients with stage IV non-small cell lung cancer (NSCLC) were studied to test the hypothesis that trajectories of depression and/or anxiety symptoms after diagnosis would show an adverse relationship with survival, beyond relevant controls. METHODS Patients with stage IV NSCLC (n = 157) were enrolled (ClinicalTrials.gov Identifier: NCT03199651) at diagnosis and completed validated measures for depressive symptoms (Patient Health Questionnaire-9) and anxiety symptoms (Generalized Anxiety Disorder-7). Patients were reassessed every 1 to 2 months through 24 months (16 assessments; 80% average completion rate) and survival monitored. Joint statistical models provided simultaneous modeling of longitudinal (psychological) and time-to-event (survival) processes. Control variables were age, sex, marital status, education, smoking status, cancer type, and treatment received. RESULTS Depression and anxiety symptoms significantly decreased with time since diagnosis. The 2-year trajectory of depressive symptoms was significantly associated with cancer survival after adjustment for covariates (hazard ratio = 1.09 per unit increase in the Patient Health Questionnaire-9, 95% confidence interval = 1.03-1.15, p = .002). Anxiety was marginally significant in the unadjusted (p = .053) but not the adjusted (p = .39) model. CONCLUSIONS For the first time, joint model analyses test the interaction of a longitudinal trajectory of psychological symptoms, assessed from diagnosis to 24 months, and cancer survival. New data show the continuation of depressive and anxiety symptoms through treatment and thereafter. Immunotherapy and targeted therapies have dramatically improved survival for patients with advanced NSCLC; however, novel data suggest their benefit may be constrained by depressive symptoms.
Collapse
Affiliation(s)
| | - Joseph P. McElroy
- Department of Biomedical Informatics and Center for Biostatistics, College of Medicine, The Ohio State University
| | - David P. Carbone
- Department of Internal Medicine, Division of Medical Oncology, College of Medicine, The Ohio State University
| | - Carolyn J. Presley
- Department of Internal Medicine, Division of Medical Oncology, College of Medicine, The Ohio State University
| | - Rachel M. Smith
- Department of Biomedical Informatics and Center for Biostatistics, College of Medicine, The Ohio State University
| | - Peter G. Shields
- Department of Internal Medicine, Division of Medical Oncology, College of Medicine, The Ohio State University
| | - Guy N. Brock
- Department of Biomedical Informatics and Center for Biostatistics, College of Medicine, The Ohio State University
| |
Collapse
|
39
|
Relationship between Breast Cancer Surgical Treatment and Psychiatric Symptomatology: Which Sociodemographic and Clinical Factors Could Influence It? A Preliminary Study. Behav Sci (Basel) 2022; 12:bs12010009. [PMID: 35049620 PMCID: PMC8772987 DOI: 10.3390/bs12010009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 12/29/2021] [Accepted: 01/02/2022] [Indexed: 02/05/2023] Open
Abstract
This study aimed to investigate psychiatric symptomatology in a sample of patients affected by breast cancer undergoing surgery, evaluating the potential mediators on perceived stress levels, depression and hopelessness. The study was conducted on eighty-five patients with breast cancer, admitted consecutively to the Breast Unit of the IRCCS Ospedale Policlinico San Martino, between May 2018 and December 2019. Sociodemographic (age of diagnosis, gender, marital and occupational status, educational level, having children) and clinical (type and side of surgery, previous breast surgery, neoadjuvant chemotherapy and axillary dissection) characteristics were investigated through a semi-structured interview. The following rating scales were administered: Beck Depression Inventory, Beck Hopelessness Scale, and Perceived Stress Scale. Our findings indicate that the presence of children and of a partner was associated with a lower total score on the clinical dimensions evaluated. Furthermore, we found demolitive surgery to be a mediator between perceived stress and hopelessness, while history of previous breast surgery was found to be a mediator between demolitive surgery and perceived stress. In conclusion, patients affected by breast cancer undergoing more complex and demolitive surgery or with history of previous breast surgery should be mostly monitored from a psychological and psychiatric point of view from the beginning of treatments to evaluate the first manifestations of psychiatric symptomatology.
Collapse
|
40
|
Massa E, Donisi C, Liscia N, Madeddu C, Impera V, Mariani S, Scartozzi M, Lai E. The Difficult Task of Diagnosing Depression in Elderly People with Cancer: A Systematic Review. Clin Pract Epidemiol Ment Health 2021; 17:295-306. [PMID: 35444712 PMCID: PMC8985471 DOI: 10.2174/1745017902117010295] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 09/08/2021] [Accepted: 11/17/2021] [Indexed: 11/22/2022]
Abstract
Background:
Depression is a common psychiatric problem in the elderly and oncology patients. In elderly people with cancer, depression has a peculiar phenomenology. It has a significant impact on the quality of life. Moreover, it is associated with poor adherence to treatments, increased risk of suicide, and mortality. Nevertheless, the topic of depression in elderly people with cancer remains unexplored.
Objective:
The main goal of this article is to review the literature from the past 20 years on the relationships between depression, cancer, and aging.
Methods:
The methods followed the Prisma model for eligibility of studies. The articles in which the keywords “depression”, “cancer”, “ elderly, aging, or geriatric” were present, either in the text or in the abstract, were selected. 8.056 articles, by matching the keywords “depression and elderly and cancer,” were identified. Only 532 papers met the eligibility criteria of search limits and selection process. Out of 532 papers, 467 were considered irrelevant, leaving 65 relevant studies. Out of 65 suitable studies, 39 (60.0%) met our quality criteria and were included.
Results:
The risk factors associated with depression in elderly people with cancer can be divided into 4 groups: 1) tumor-related; 2) anticancer treatment-related; 3) patients-related; 4) number and type of comorbidity. The main obstacles in diagnosing depression in elderly patients with cancer are the overlap of the symptoms of cancer and side effects of treatment with the symptoms of depression but also the different ways of reporting depressive symptoms of elderly people and the different clinical types of depression. There is a lack of data regarding validated scales to assess depression in geriatric patients with cancer. Any mental illness, specifically co-occurring anxiety and depression, increases the risk of diagnosis delay and anticancer treatment adherence. Cancer and the diagnosis of mental disorders prior to cancer diagnosis correlate with an increased risk for suicide. A non-pharmacological therapeutic approach, pharmacological treatment and/or a combination of both can be used to treat elderly patients with cancer, but a detailed analysis of comorbidities and the assessment of polypharmacy is mandatory in order to avoid potential side-effects and interactions between antidepressants and the other drugs taken by the patients.
Conclusion:
Future research should be conducted with the aim of developing a modified and adapted assessment method for the diagnosis and treatment of depression in elderly people with cancer in order to improve their clinical outcomes and quality of life.
Collapse
|
41
|
Li ZF, Liu MJ. The Application and Influence of Hospice Care Among Patients with Advanced Esophageal Cancer. Int J Gen Med 2021; 14:6839-6845. [PMID: 34703288 PMCID: PMC8526510 DOI: 10.2147/ijgm.s326589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 08/24/2021] [Indexed: 11/23/2022] Open
Abstract
Objective To investigate the application effect of hospice care in patients with advanced esophageal cancer (EC), provide a practical basis for improving sleep quality, dignity, and subjective well-being, and relieving depression and anxiety in patients with advanced EC. Methods A randomized cluster sampling method was used to select 60 patients with advanced EC who received routine intervention (control group) and 64 patients with advanced EC who received hospice care (study group). The intervention time was three months, and the self-rated anxiety scale (SAS) before and after the interventions was compared between the two groups. The Hamilton Depression Scale (HAMD), the Pittsburgh Sleep Quality Index (PSQI), the General Well-being Scale (GWB), the Patient Dignity Scale (PDI), and patients' physical pain state were recorded. Results No significant differences were found in the HAMD, SAS, PSQI, GWB, or PDI scores between the two groups before the interventions (P > 0.05); after the interventions, the HAMD, SAS, PSQI, and PDI scores of the two groups were significantly decreased, and the HAMD, SAS, PSQI, and PDI scores of the study group were lower compared with the control group. The GWB scores of the two groups were significantly increased, and those of the study group were significantly higher compared with the control group; the difference was statistically significant (P < 0.05). After the interventions, pain grades of III and above decreased in both groups to grade II, and pain sensation in the study group was lower compared with the control group; the difference was statistically significant (P < 0.05). Conclusion Hospice care can reduce the level of pain related to depression and anxiety in patients with advanced EC and improve their sleep quality, as well as their sense of dignity and subjective well-being.
Collapse
Affiliation(s)
- Zheng-Fang Li
- School of Nursing, Southwest Medical University, Luzhou, Sichuan, 646000, People's Republic of China.,Chest Cancer Center, Chongqing University Cancer Hospital, Chongqing, 400030, People's Republic of China
| | - Meng-Jie Liu
- School of Nursing, Southwest Medical University, Luzhou, Sichuan, 646000, People's Republic of China.,Department of Nursing, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, 646000, People's Republic of China
| |
Collapse
|
42
|
Relationship between malnutrition and the presence of symptoms of anxiety and depression in hospitalized cancer patients. Support Care Cancer 2021; 30:1607-1613. [PMID: 34549348 PMCID: PMC8727429 DOI: 10.1007/s00520-021-06532-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 08/30/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND Anxiety and depression are a common issue in patients with cancer, yet understudied among hospitalized patients. The aim of this study was to estimate the prevalence of anxiety and depression symptomatology in cancer inpatients and its relationship with malnutrition. METHODS Cross-sectional study in hospitalized cancer patients. A nutritional assessment was done using the Global Leadership Initiative on Malnutrition (GLIM) criteria to diagnose malnutrition. Data regarding anxiety and depression symptomatology was obtained with the Hospital Anxiety and Depression Scale (HADS). RESULTS A total of 282 inpatients were assessed. GLIM criteria found 20% (66) of well-nourished and 80% (216) with malnutrition. HADS presented an average score of 8.3 ± 4.4 with respect to anxiety and an average score of 7.7 ± 4.6 with respect to depression. Up to 54% of the patients showed a possible presence of anxiety, and 45.3% of them showed a possible presence of depression. In malnourished patients, HADS score was non-significantly higher with respect to anxiety (8.5 ± 4.3 in malnourished vs 7.1 ± 4.6 in well-nourished; p = 0.06) and was significantly higher with respect to depression (8.2 ± 4.6 in malnourished vs 5.3 ± 4.0 in well-nourished; p < 0.001). After controlling for potential confounders, malnourished patients were 1.98 times more likely to present anxious symptomatology (95% CI 1.01-3.98; p = 0.049) and 6.29 times more likely to present depressive symptomatology (95% CI 1.73-20.47; p = 0.005). CONCLUSIONS The presence of anxiety and depression symptomatology in oncological inpatients is high. There is an association between malnutrition and presenting anxious and depressive symptomatology in hospitalized cancer patients.
Collapse
|
43
|
Puzia ME, Huberty J, Eckert R, Larkey L, Mesa R. Associations Between Global Mental Health and Response to an App-Based Meditation Intervention in Myeloproliferative Neoplasm Patients. Integr Cancer Ther 2021; 19:1534735420927780. [PMID: 32564631 PMCID: PMC7307391 DOI: 10.1177/1534735420927780] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background: Depression, anxiety, and sleep disturbance are common
problems that greatly affect quality of life for many myeloproliferative
neoplasm (MPN) patients. App-based mindfulness meditation is a feasible
nonpharmacologic approach for managing symptoms. However, previous research has
not considered how patients’ overall mental health may influence their
responsiveness to these interventions. Objective: The purpose of
this study was to conduct an exploratory, secondary analysis of the effects of a
smartphone meditation app, Calm, on depression, anxiety, and sleep disturbance
in MPN patients based on patients’ baseline levels of Global Mental Health
(GMH). Methods: Participants (N = 80) were a subset of MPN patients
from a larger feasibility study. Patients were enrolled into an intervention
(use Calm for 10 minutes daily for 4 weeks) or educational control group.
Results: In multilevel models, there were significant 3-way
interactions between time, group, and baseline GMH for depression and anxiety
symptoms, with participants in the meditation intervention who reported the
poorest baseline GMH experiencing the greatest reduction in symptoms over time.
For both intervention and control participants, poorer initial GMH was
associated with increases in sleep disturbance symptoms over time.
Conclusions: Mindfulness meditation apps, such as Calm, may be
effective in reducing depression and anxiety symptoms in MPN patients,
particularly for those experiencing mental health difficulties. Given the need
for accessible tools to self-manage chronic cancer–related symptoms, especially
strong negative emotions, these findings warrant larger efficacy studies to
determine the effects of app-based meditation for alleviating depression and
anxiety in cancer populations.
Collapse
Affiliation(s)
- Megan E Puzia
- Behavioral Research and Analytics, LLC, Salt Lake City, UT, USA
| | | | - Ryan Eckert
- UT Health San Antonio MD Anderson, San Antonio, TX, USA
| | | | - Ruben Mesa
- UT Health San Antonio MD Anderson, San Antonio, TX, USA
| |
Collapse
|
44
|
Yim J, Shaw J, Viney R, Arora S, Ezendam N, Pearce A. Investigating the Association Between Self-Reported Comorbid Anxiety and Depression and Health Service Use in Cancer Survivors. PHARMACOECONOMICS 2021; 39:681-690. [PMID: 33818744 DOI: 10.1007/s40273-021-01016-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/06/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Anxiety and depression have a higher prevalence in cancer survivors than in the general population and are associated with lower quality of life, poorer survival and an increased risk of suicide. Anxiety and depression are also highly comorbid among cancer survivors and associated with increased health service use. As such, it is important to consider both anxiety and depression and health service use in cancer survivors. OBJECTIVE Our objective was to explore the association between anxiety and depression and health service utilisation, both cancer-specific and general doctor visits, in cancer survivors. METHODS Data from a Dutch cancer registry were analysed to determine the association between anxiety and depression (measured using the Hospital Anxiety and Depression Scale) and health service use. Negative binomial regression models, controlling for patient demographics, comorbidities and cancer-related variables were estimated. RESULTS Cancer survivors (n = 2538), with a mean age of 61.1 years and between 0.7 and 10.9 years since diagnosis, were included in the analysis. Increasing levels of anxiety and depression were associated with increased health service use. Having severe levels of anxiety was associated with more frequent visits to the general practitioner (p < 0.001). Severe depression in cancer survivors was associated with more frequent visits to the specialist (p < 0.001). CONCLUSION Anxiety and depression in cancer survivors, particularly severe anxiety and depression, were associated with increased health service use. Treatment of anxiety and depression in cancer survivors has the potential to reduce overall health service use and associated costs and improve health outcomes for cancer survivors.
Collapse
Affiliation(s)
- Jackie Yim
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Haymarket, NSW, Australia.
| | - Joanne Shaw
- Psycho-Oncology Co-operative Research Group, Faculty of Science, School of Psychology, The University of Sydney, Camperdown, NSW, Australia
| | - Rosalie Viney
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Haymarket, NSW, Australia
| | - Sheena Arora
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Haymarket, NSW, Australia
| | - Nicole Ezendam
- Department of Medical and Clinical Psychology, Center of Research on Psychological and Somatic Disorders (CoRPS), Tilburg University, Tilburg, The Netherlands
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands
| | - Alison Pearce
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Haymarket, NSW, Australia
- Sydney School of Public Health, University of Sydney, Camperdown, NSW, Australia
| |
Collapse
|
45
|
Housman B, Flores R, Lee DS. Narrative review of anxiety and depression in patients with esophageal cancer: underappreciated and undertreated. J Thorac Dis 2021; 13:3160-3170. [PMID: 34164206 PMCID: PMC8182527 DOI: 10.21037/jtd-20-3529] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Depression and anxiety are emotional disorders that commonly affect patients with esophageal cancer. As a result of its high morbidity, mortality, and complication rates, this population is at particularly high risk for developing or exacerbating affective disorders; even when compared to patients with other forms of cancer. Many of the medical conditions and social behaviors that predispose patients to this disease are also independently associated with affective disorders, and likely compound their effects. Unfortunately, in the existing literature, there is wide variability in study design and diagnostic criteria. There is no standard method of evaluation, many studies are limited to written surveys, and widespread mental health screening is not included as a part of routine care. As a result, the prevalence of these illnesses remains elusive. Additionally, psychiatric and psychosocial illness can affect compliance with surveillance and treatment, and gaps in knowledge may ultimately influence patient outcomes and survival. This review will discuss the existing literature on depression and anxiety in patients with esophageal cancer. It will highlight current methods of psychological evaluation, the prevalence of affective disorders in this population, and their effects on treatment, compliance, and outcomes. It will also discuss possible screening tools, treatments and interventions for these comorbid illnesses that may improve oncologic outcomes as well as quality of life.
Collapse
Affiliation(s)
- Brian Housman
- Department of Thoracic Surgery, Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, NY, USA
| | - Raja Flores
- Department of Thoracic Surgery, Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, NY, USA
| | - Dong-Seok Lee
- Department of Thoracic Surgery, Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, NY, USA
| |
Collapse
|
46
|
Partelli S, Sclafani F, Barbu ST, Beishon M, Bonomo P, Braz G, de Braud F, Brunner T, Cavestro GM, Crul M, Trill MD, Ferollà P, Herrmann K, Karamitopoulou E, Neuzillet C, Orsi F, Seppänen H, Torchio M, Valenti D, Zamboni G, Zins M, Costa A, Poortmans P. European Cancer Organisation Essential Requirements for Quality Cancer Care (ERQCC): Pancreatic Cancer. Cancer Treat Rev 2021; 99:102208. [PMID: 34238640 DOI: 10.1016/j.ctrv.2021.102208] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 04/07/2021] [Accepted: 04/09/2021] [Indexed: 12/14/2022]
Abstract
European Cancer Organisation Essential Requirements for Quality Cancer Care (ERQCC) are written by experts representing all disciplines involved in cancer care in Europe. They give patients, health professionals, managers and policymakers a guide to essential care throughout the patient journey. Pancreatic cancer is an increasing cause of cancer mortality and has wide variation in treatment and care in Europe. It is a major healthcare burden and has complex diagnosis and treatment challenges. Care must be carried out only in pancreatic cancer units or centres that have a core multidisciplinary team (MDT) and an extended team of health professionals detailed here. Such units are far from universal in European countries. To meet European aspirations for comprehensive cancer control, healthcare organisations must consider the requirements in this paper, paying particular attention to multidisciplinarity and patient-centred pathways from diagnosis, to treatment, to survivorship.
Collapse
Affiliation(s)
- Stefano Partelli
- European Society of Surgical Oncology (ESSO); IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Francesco Sclafani
- European Organisation for Research and Treatment of Cancer (EORTC); Institut Jules Bordet, Brussels, Belgium
| | - Sorin Traian Barbu
- Pancreatic Cancer Europe (PCE); Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Marc Beishon
- Cancer World, European School of Oncology (ESO), Milan, Italy
| | - Pierluigi Bonomo
- Flims Alumni Club (FAC); Careggi University Hospital, Florence, Italy
| | - Graça Braz
- European Oncology Nursing Society (EONS); Portuguese Oncology Institute, Porto, Portugal
| | - Filippo de Braud
- Organisation of European Cancer Institutes (OECI); IRCCS Foundation National Cancer Institute of Milan, Milan, Italy
| | - Thomas Brunner
- European Society for Radiotherapy and Oncology (ESTRO); Otto von Guericke University, Magdeburg, Germany
| | - Giulia Martina Cavestro
- European Hereditary Tumour Group (EHTG); IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Mirjam Crul
- European Society of Oncology Pharmacy (ESOP); Amsterdam University Medical Centre, Netherlands
| | - Maria Die Trill
- International Psycho-Oncology Society (IPOS); ATRIUM: Psycho-Oncology & Clinical Psychology, Madrid, Spain
| | - Piero Ferollà
- International Neuroendocrine Cancer Alliance (INCA); Umbria Regional Cancer Network, Perugia, Italy
| | - Ken Herrmann
- European Association of Nuclear Medicine (EANM); University Hospital Essen, Essen, Germany
| | - Eva Karamitopoulou
- European Society of Pathology (ESP); Institute of Pathology, University of Bern, Bern, Switzerland
| | - Cindy Neuzillet
- International Society of Geriatric Oncology (SIOG), Institut Curie, Saint-Cloud, France
| | - Franco Orsi
- Cardiovascular and Interventional Radiological Society of Europe (CIRSE); European Institute of Oncology, Milan, Italy
| | - Hanna Seppänen
- Association of European Cancer Leagues (ECL); Helsinki University Hospital, Helsinki, Finland
| | - Martina Torchio
- Organisation of European Cancer Institutes (OECI); IRCCS Foundation National Cancer Institute of Milan, Milan, Italy
| | - Danila Valenti
- European Association for Palliative Care (EAPC); Palliative Care Network, AUSL Bologna, Bologna, Italy
| | - Giulia Zamboni
- European Society of Oncologic Imaging (ESOI); University Hospital Verona, Verona, Italy
| | - Marc Zins
- European Society of Radiology (ESR); Groupe hospitalier Paris Saint-Joseph, Paris, France
| | | | - Philip Poortmans
- European Cancer Organisation (ECCO); Iridium Kankernetwerk and University of Antwerp, Wilrijk-Antwerp, Belgium
| |
Collapse
|
47
|
Bergerot CD, Razavi M, Clark KL, Philip EJ, Pal SK, Loscalzo M, Dale W. Emotional problem-related distress screening and its prevalence by cancer type: Assessment by patients' characteristics and level of assistance requested. Psychooncology 2021; 30:1332-1338. [PMID: 33797817 DOI: 10.1002/pon.5685] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 03/09/2021] [Accepted: 03/24/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Emotional problem-related distress is a common issue faced by patients with cancer. However, patients suffering with this emotional burden do not typically seek assistance. This study sought to determine the prevalence of emotional problem-related distress by cancer type, and identify factors correlated with the level of assistance requested. METHODS Using the SupportScreen®, patients were screened for emotional problem-related distress at their first or second visit to an NCI designated Comprehensive Cancer Center. General Linear Model was used to test the association between emotional problem-related distress and type of cancer, and the relationship between level of assistance requested and patients' characteristics. RESULTS A total of 2,421 patients were included in this analysis. Patients were mostly female (62%), diagnosed with breast (24%), gynecological (16%) or gastrointestinal (15%) cancers. Highest levels of emotional problem-related distress were reported by patients diagnosed with lung, gynecological, breast and gastrointestinal cancers. Level of assistance requested were significantly associated with problem-related distress scores (p < 0.001), which were higher among patients with lower household incomes (p < 0.001) and Spanish as primary language (p = 0.001). CONCLUSION Our study found an association between Level of assistance requested and emotional problem-related distress, which were heightened by lower income and Spanish-speaking. Intervention strategies should be considered to increase access to psychosocial support services.
Collapse
Affiliation(s)
- Cristiane Decat Bergerot
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Marianne Razavi
- Department of Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Karen Lynn Clark
- Department of Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Errol J Philip
- Medical School, University of California San Francisco, San Francisco, California, USA
| | - Sumanta Kumar Pal
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Matthew Loscalzo
- Department of Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - William Dale
- Department of Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| |
Collapse
|
48
|
Maurício S, Rebêlo I, Madeira C, Resende F, Esteves S. Validation of the Portuguese version of Amsterdam Preoperative Anxiety and Information Scale (APAIS). Health Qual Life Outcomes 2021; 19:95. [PMID: 33741005 PMCID: PMC7976695 DOI: 10.1186/s12955-021-01736-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 03/08/2021] [Indexed: 11/10/2022] Open
Abstract
Background Preoperative anxiety is common among the oncological surgical population. Due to its psychological and physiological detrimental effects, identifying and addressing it is of uttermost importance to improve anesthetic management and patient’s outcomes. The aim of this study is to validate the Portuguese version of Amsterdam Preoperative Anxiety and Information Scale (APAIS) in the oncological population. Methods Following forward and backward translation of the original APAIS scale, further adaptation was obtained through cognitive interviewing. The resulting instrument was tested on the day before surgery on a sample of adult cancer surgical patients from a Portuguese oncology centre. Psychometric evaluation was derived from inter-item correlation, confirmatory factor analysis, Cronbach’s alpha, correlation with comparative scales, receiver operating characteristic curve and Youden index.
Results 109 patients (58 males, 51 females) were included. A three-dimensional model—anxiety about anesthesia, anxiety about surgery and desire for information, showed the best fit to the data. The questionnaire revealed high internal consistency (Cronbach alpha 0.81) and good inter-item correlation. Also, Portuguese APAIS correlated well with the gold standard anxiety scale. Therefore, the psychometric properties of this scale version make it a valid and reliable instrument. The optimal cutoff to maximize both sensitivity and specificity was 12 for the APAIS global anxiety score. Conclusions Portuguese APAIS version is an accurate tool to identify preoperative anxiety among cancer patients and might impact its management, from premedication choice to provision of information and reassurance about either anesthesia or surgery.
Collapse
Affiliation(s)
- Sandra Maurício
- Serviço de Anestesiologia, Instituto Português de Oncologia de Lisboa, Lisbon, Portugal.
| | - Isabel Rebêlo
- Serviço de Anestesiologia, Instituto Português de Oncologia de Lisboa, Lisbon, Portugal
| | - Catarina Madeira
- Serviço de Anestesiologia, Instituto Português de Oncologia de Lisboa, Lisbon, Portugal
| | - Filipa Resende
- Serviço de Anestesiologia, Instituto Português de Oncologia de Lisboa, Lisbon, Portugal
| | - Susana Esteves
- Unidade de Investigação Clínica, Instituto Português de Oncologia de Lisboa, Lisbon, Portugal
| |
Collapse
|
49
|
Hildenbrand GM, Benedict BC. Examining Variation in Emotional Distress among Individuals with a Cancer Diagnosis. West J Nurs Res 2021; 44:151-158. [PMID: 33666126 DOI: 10.1177/0193945921994118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study examined whether emotional distress among U.S. adults diagnosed with cancer was influenced by death rates, survival rates, and new cases based on cancer type and individual-level variables (health efficacy, perceived health, and use of information and communication technologies and social media for health-related reasons). Health Information National Trends Survey 5 data from cycle 1 and cycle 2 were used to examine emotional distress among individuals who had experienced 1 of 17 different types of cancer diagnoses. A multilevel model and follow-up one-way ANOVA indicated a small statistically significant difference in emotional distress across cancer types. To investigate the influence of individual-level variables on emotional distress, a hierarchical regression analysis indicated that, after controlling for perceived health and health efficacy, using social media in a greater number of health-related ways significantly predicted greater emotional distress, while using information and communication technologies in a greater number of health-related ways did not.
Collapse
Affiliation(s)
- Grace M Hildenbrand
- Brian Lamb School of Communication, Purdue University, West Lafayette, IN, USA
| | - Bailey C Benedict
- Brian Lamb School of Communication, Purdue University, West Lafayette, IN, USA
| |
Collapse
|
50
|
Jendoubi F, Severino-Freire M, Negretto M, Arbus C, Paul C, Bulai Livideanu C. Neuropsychiatric, cognitive and sexual impairment in mastocytosis patients. Orphanet J Rare Dis 2021; 16:118. [PMID: 33673856 PMCID: PMC7934538 DOI: 10.1186/s13023-021-01747-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 02/16/2021] [Indexed: 11/15/2022] Open
Abstract
Background Mastocytosis is a rare disease characterised by the accumulation and/or proliferation of abnormal mast cells (MCs) in one or several organs. It may present with a number of different symptoms that involve various organ systems. The current study aims to assess the prevalence of MC mediator-related symptoms in a cohort of mastocytosis patients with a specific focus on neurological, psychiatric, cognitive and sexual symptoms. We also assessed the impact of the disease on patients’ professional lives. Patients were administered a validated multidimensional questionnaire to collect information on patients’ perception of the severity of their symptoms. From the questionnaires we extracted the neurological, cognitive, psychiatric and sexual symptoms and the impact of the disease on patients’ professional lives as well as their grading. The affective status was assessed using the 17-item version of the Hamilton Depression Rating Scale. Results We included 139 patients. Mastocytosis was classified as systemic in 113 patients and cutaneous in 26 patients. The prevalence of MC mediator-related systemic symptoms was as follows: cutaneous (71%), gastro-intestinal (48%), cardio-vascular (36%), musculoskeletal (26.6%), fatigue (24%), urinary (14.4%) and respiratory (10%). Headaches and vertigo were noted in respectively 55% and 32% of patients. Irritability, episodes of memory loss and difficulty concentrating were reported in 54%, 52% and 40% of cases, respectively. Sexual impairment was noted in 24% of patients. No associations were found between neuropsychiatric/cognitive impairment and age, gender, diagnostic delay, disease form, the presence of cutaneous lesions, the level of serum and bone marrow tryptase and the presence of KIT mutation in bone marrow and/or skin. Depression was noted in 49% of patients. One in four patients reported a negative impact of the disease on their professional lives. Conclusion This current study provides some insights regarding symptoms related to mastocytosis and their impact on patients’ professional lives.
Collapse
Affiliation(s)
- Fatma Jendoubi
- Mastocytosis National Expert Centre (CEREMAST), Department of Dermatology, Toulouse University Hospital, 24 Chemin de Pouvourville, 31059, Toulouse, France
| | - Maella Severino-Freire
- Mastocytosis National Expert Centre (CEREMAST), Department of Dermatology, Toulouse University Hospital, 24 Chemin de Pouvourville, 31059, Toulouse, France
| | - Mathilde Negretto
- Mastocytosis National Expert Centre (CEREMAST), Department of Dermatology, Toulouse University Hospital, 24 Chemin de Pouvourville, 31059, Toulouse, France
| | - Christophe Arbus
- Department of Psychiatry, Toulouse University Hospital, Tonic Inserm 1214, Toulouse, France
| | - Carle Paul
- Mastocytosis National Expert Centre (CEREMAST), Department of Dermatology, Toulouse University Hospital, 24 Chemin de Pouvourville, 31059, Toulouse, France
| | - Cristina Bulai Livideanu
- Mastocytosis National Expert Centre (CEREMAST), Department of Dermatology, Toulouse University Hospital, 24 Chemin de Pouvourville, 31059, Toulouse, France.
| |
Collapse
|