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Derbes R, Hakun J, Elbich D, Master L, Berenbaum S, Huang X, Buxton OM, Chang AM, Truica CI, Sturgeon KM. Design and methods of the mobile assessment of cognition, environment, and sleep (MACES) feasibility study in newly diagnosed breast cancer patients. Sci Rep 2024; 14:8338. [PMID: 38594369 PMCID: PMC11004176 DOI: 10.1038/s41598-024-58724-1] [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: 02/21/2023] [Accepted: 04/02/2024] [Indexed: 04/11/2024] Open
Abstract
Endocrine therapy (ET) for breast cancer treatment is associated with cognitive complaints, but their etiology is poorly understood. To address this, we developed and implemented an ambulatory assessment protocol consisting of wearable activity monitors, brief surveys of affect, context, and perceived impairments, and ultra-brief performance-based measures of cognition. Newly diagnosed, ER/PR+, stage 0-III, female breast cancer patients, were recruited. Ambulatory assessments were conducted on smart phones and wearable activity monitors were used to monitor sleep and physical activity. Participants were asked to complete five 7-day measurement bursts (one before starting ET and one each month for 4 consecutive months while on ET). We observed a consent rate of 36%, 27 women completed the study. Of the women that withdrew, 91% dropped prior to the midpoint of follow up. There were no significant differences in demographics, clinical breast cancer characteristics, sleep or physical activity patterns, or measures of cognition between women who completed versus withdrew. Women who did not complete the study provided fewer valid days of baseline data. In conclusion, while some women may be overwhelmed with their cancer diagnosis, we did not identify any predictive characteristics of women whom did not complete the study. This novel method enables the prospective study of psychological changes associated with cancer treatment, capturing a wide array of information about behavior, experience, and cognition, thus providing a picture of the lived experiences of cancer patients before and during exposure to ET.
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Affiliation(s)
- Rebecca Derbes
- Department of Public Health Sciences, College of Medicine, Pennsylvania State University, Hershey, PA, USA
| | - Jonathan Hakun
- Penn State Milton S. Hershey Medical Center, Department of Neurology, H5508, College of Medicine, Pennsylvania State University, 500 University Drive, Hershey, PA, H03717033, USA.
- Department of Psychology, College of Liberal Arts, Pennsylvania State University, University Park, PA, USA.
- Center for Healthy Aging, The Pennsylvania State University, University Park, PA, 16802, USA.
- College of Medicine, Translational Brain Research Center, Pennsylvania State University, Hershey, PA, 17033, USA.
| | - Daniel Elbich
- Penn State Milton S. Hershey Medical Center, Department of Neurology, H5508, College of Medicine, Pennsylvania State University, 500 University Drive, Hershey, PA, H03717033, USA
- College of Medicine, Translational Brain Research Center, Pennsylvania State University, Hershey, PA, 17033, USA
| | - Lindsay Master
- Department of Biobehavioral Health, College of Health and Human Development, Pennsylvania State University, University Park, PA, USA
| | - Sheri Berenbaum
- Department of Psychology, College of Liberal Arts, Pennsylvania State University, University Park, PA, USA
| | - Xuemei Huang
- Penn State Milton S. Hershey Medical Center, Department of Neurology, H5508, College of Medicine, Pennsylvania State University, 500 University Drive, Hershey, PA, H03717033, USA
- College of Medicine, Translational Brain Research Center, Pennsylvania State University, Hershey, PA, 17033, USA
| | - Orfeu M Buxton
- Center for Healthy Aging, The Pennsylvania State University, University Park, PA, 16802, USA
- Department of Biobehavioral Health, College of Health and Human Development, Pennsylvania State University, University Park, PA, USA
| | - Anne-Marie Chang
- Department of Biobehavioral Health, College of Health and Human Development, Pennsylvania State University, University Park, PA, USA
| | - Cristina I Truica
- Division of Hematology and Oncology, Department of Medicine, Pennsylvania State University, Hershey, PA, USA
| | - Kathleen M Sturgeon
- Department of Public Health Sciences, College of Medicine, Pennsylvania State University, Hershey, PA, USA
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Kim U, Lee JY. Impact of post-treatment symptoms on supportive care needs among breast cancer survivors in South Korea. Asia Pac J Oncol Nurs 2023; 10:100295. [PMID: 37780397 PMCID: PMC10541476 DOI: 10.1016/j.apjon.2023.100295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 08/15/2023] [Indexed: 10/03/2023] Open
Abstract
Objective The aim of this study is to investigate the factors influencing the supportive care needs of survivors of breast cancer who have completed major treatment. Methods A total of 121 survivors of breast cancer from an online community in South Korea participated in this study. The study variables were supportive care needs, physical symptoms, anxiety, and depression. Independent t-tests, one-way Analysis of Variance (ANOVA), Pearson's correlation, and hierarchical regression analyses were performed. Results The highest rankings of supportive care needs of survivors of breast cancer were medical system and information needs, patient care and support needs, psychological needs, sexual needs, and physical and daily life needs. Hierarchical regression analysis revealed that the participants' supportive care needs were explained by physical symptoms (P < 0.001) and anxiety (P < 0.001), accounting for 52.1% of the variance. Conclusions Supportive care needs of survivors of breast cancer have a high level of medical system and information needs, and posttreatment conditions are related to high physical symptoms and anxiety. In the future, it will be necessary to identify supportive care needs and apply interventions to reduce their physical symptoms and anxiety.
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Affiliation(s)
- Unhee Kim
- College of Nursing, The Catholic University of Korea, Seoul, South Korea
| | - Ju-Young Lee
- College of Nursing, The Catholic University of Korea, Seoul, South Korea
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Taub CJ, Diaz A, Blomberg BB, Jutagir DR, Fisher HM, Gudenkauf LM, Lippman ME, Hudson BI, Antoni MH. Relationships Between Serum Cortisol, RAGE-Associated s100A8/A9 Levels, and Self-Reported Cancer-Related Distress in Women With Nonmetastatic Breast Cancer. Psychosom Med 2022; 84:803-807. [PMID: 35980780 PMCID: PMC9437114 DOI: 10.1097/psy.0000000000001109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Elevated inflammation and psychological distress in patients with breast cancer (BCa) have been related to poorer health outcomes. Regulation of the hypothalamic-pituitary-adrenal axis and signaling of the receptor for advanced glycation end products (RAGE) are important in the inflammatory response and have been associated with increased stress and poorer health outcomes in patients with cancer. This study examined relationships among circulating cortisol, a measure of hypothalamic-pituitary-adrenal axis activity and physiological stress; s100A8/A9, a RAGE ligand and emerging cancer-related biological measure; and self-reported cancer-related distress. METHODS Patients with BCa ( N = 183, stages 0-IIIb) were recruited 2 to 10 weeks after surgery but before receiving adjuvant therapies. Participants provided blood samples, from which serum cortisol and s100A8/A9 levels were determined, and completed a psychosocial questionnaire. Regression analyses, adjusting for age, cancer stage, time since surgery, race, and menopausal status, were conducted examining the relationships between cortisol, s100A8/A9, and cancer-related distress (Impact of Event Scale [IES]-Revised). RESULTS Cortisol and s100A8/A9 levels were positively related ( β = 0.218, t (112) = 2.332, p = .021), although the overall model was not significant. Cortisol levels were also positively associated with IES-Intrusions ( β = 0.192, t (163) = 2.659, p = .009) and IES-Hyperarousal subscale scores ( β = 0.171, t (163) = 2.304, p = .022). CONCLUSIONS Patients with higher cortisol levels also reported higher s100A8/A9 levels and more cancer-related distress. The relationship between cortisol and s100A8/A9 supports a link between the stress response and proinflammatory physiological processes known to predict a greater metastatic risk in BCa. Stress processes implicated in cancer biology are complex, and replication and extension of these initial findings are important.
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Affiliation(s)
- Chloe J Taub
- Department of Medical Social Science, Northwestern University Feinberg School of Medicine
| | - Alain Diaz
- Department of Microbiology and Immunology, University of Miami Miller School of Medicine
| | - Bonnie B Blomberg
- Department of Microbiology and Immunology, University of Miami Miller School of Medicine
| | - Devika R Jutagir
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center
| | - Hannah M Fisher
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine
| | - Lisa M Gudenkauf
- Department of Health Outcomes and Behavior, Moffitt Cancer Center
| | - Marc E Lippman
- Department of Oncology and Medicine, Georgetown Lombardi Comprehensive Cancer Center
| | - Barry I Hudson
- Oncology Academic Department, Georgetown University School of Medicine
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Kim HK, Yoo YS. [Effects of the Advanced Practice Nurse-Led Psychoeducational Program for Colorectal Cancer Survivors]. J Korean Acad Nurs 2022; 52:245-260. [PMID: 35818875 DOI: 10.4040/jkan.21207] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 03/08/2022] [Accepted: 04/14/2022] [Indexed: 01/12/2023]
Abstract
PURPOSE This study aimed to investigate the effects of an advanced practice nurse-led psychoeducational program on distress, anxiety, depression, coping with cancer (CWC), health promotion behavior (HPB), and quality of life (QOL) among colorectal cancer survivors. METHODS This study was designed as a quasi-experimental study with a non-equivalent control group pretest-posttest. The participants were survivors of colorectal cancer who underwent follow-up care. There were 39 survivors: 19 in the experimental group and 20 in the control group. The experimental group performed a psychoeducational program for 120 minutes per session, once a week for a total of six weeks, while the control group received routine education and counseling. Distress, anxiety, depression, CWC, HPB, and QOL were investigated before, immediately after, and 4 weeks after the intervention. The data were analyzed with SPSS/WIN ver. 24.0, using repeated measures ANOVA. RESULTS There were significant interactions between time and group for distress and anxiety. In addition, CWC interacted with the total of CWC and interpersonal coping, and QOL interacted with the total of QOL and functional status. However, there were no significant differences in the depression or HPB scores. CONCLUSION Based on the results of this study, we expect that this program can be used as an effective intervention for colorectal cancer survivors.
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Affiliation(s)
- Hye Kyung Kim
- Cancer Center, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Yang-Sook Yoo
- College of Nursing, The Catholic University of Korea, Seoul, Korea.
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Longitudinal Analysis of Sleep Disturbance in Breast Cancer Survivors. Nurs Res 2022; 71:177-188. [PMID: 35026802 PMCID: PMC9038645 DOI: 10.1097/nnr.0000000000000578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND Breast cancer survivors (BCS) often report poor sleep quality and wakefulness throughout the night as the greatest challenges experienced during and posttreatment. OBJECTIVES This study aimed to elucidate characteristics of sleep disturbances and determine potential predictors that affect sleep disturbances in BCS for 2 years postchemotherapy. METHODS This is a secondary analysis of data from the EPIGEN study, which longitudinally examined sociodemographic and cancer-related factors, lifestyle, symptom characteristics, and epigenetic factors at baseline prior to chemotherapy (T1), the midpoint (T2), 6-month (T3), 1-year (T4), and 2-year (T5) time points postchemotherapy. Temporal lifestyle changes, symptom characteristics, and epigenetic factors were explored using linear mixed-effects models with a random intercept. A linear regression model was fitted to identify significant predictors of sleep disturbances at each time point. RESULTS In 74 BCS with an average age of 51 years and 70% non-Hispanic White, BCS experienced severe sleep disturbances at T2, which gradually improved over time. Significant temporal changes in midsleep awakenings, early awakenings, and fatigue at work were observed, with disturbances being elevated at T2. Anxiety (T1, T2, and T4), fatigue (T3 and T4), and perceived stress (T3) were significant predictors after adjusting for radiation therapy, surgery, and adjuvant endocrine therapy. DISCUSSION This study highlights that predictors of sleep disturbances change over time, with anxiety being a factor earlier in the treatment trajectory (prechemotherapy) and continuing over time with fatigue and perceived stress being involved later in the treatment trajectory. Our results indicate that symptom management strategies to address sleep disturbances should be tailored to the temporal factors that may change in severity during active treatment and early survivorship period. Findings gained from this study on sleep disturbance patterns and the potential risk factors can be incorporated into clinical practice in planning education and developing interventions.
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Molinaro J, Banerjee A, Lyndon S, Slocum S, Danhieux-Poole C, Restivo-Pritzl C, Uselmann AM, Wallace L, Knight JM. Reducing distress and depression in cancer patients during survivorship. Psychooncology 2021; 30:962-969. [PMID: 33797112 DOI: 10.1002/pon.5683] [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: 01/15/2021] [Accepted: 02/19/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Distress and depression are prevalent in cancer patients throughout survivorship and are associated with adverse outcomes. This study examines the association between outpatient psycho-oncology treatment and distress and depression in cancer patients. METHODS This is a prospective observational study of adult patients with a primary diagnosis of cancer referred for psycho-oncology services. Patients were seen for two psycho-oncology visits in a single clinical setting with various qualified providers. Patients completed the distress thermometer and problem checklist (DT + PL) and the Patient Health Questionnaire (PHQ-9) at the beginning of their first and second visits and repeated the DT at the end of these visits. RESULTS The analysis included 174 patients seen once and 69 patients seen twice. Patients were seen on average 2.5 years after diagnosis. Both visits were associated with significant reductions in distress (5.56 before and 3.85 after for visit 1, p < 0.001; 4.92 before and 3.43 after for visit 2, p < 0.001). There was a significant reduction in distress from baseline to after visit 2 (p < 0.001). Depression scores significantly decreased from the first to second visits (8.79-7.57; p = 0.002). CONCLUSIONS Psycho-oncology services were associated with significant reductions in distress and depression, with scores after services no longer meeting criteria for clinically significant distress (DT scores ≥ 4) and depression (PHQ-9 scores ≥ 8) as they did at baseline. Reductions in distress and depression were not significantly associated with provider type, intervention or timing of diagnosis. These findings support the use of psycho-oncology services in cancer patients throughout survivorship.
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Affiliation(s)
- Jessica Molinaro
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Anjishnu Banerjee
- Division of Biostatistics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Stanley Lyndon
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Sarah Slocum
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | | | - Christine Restivo-Pritzl
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | | | - Lyndsey Wallace
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Jennifer M Knight
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.,Departments of Medicine and Microbiology and Immunology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
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“Life Isn't as Carefree as It Used to Be”: A Mixed-Methods Evaluation of the Experiences of Women With Fear of Falling During Cancer Survivorship. REHABILITATION ONCOLOGY 2021. [DOI: 10.1097/01.reo.0000000000000217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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8
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McFarland DC, Nelson C, Miller AH. Early childhood adversity in adult patients with metastatic lung cancer: Cross-sectional analysis of symptom burden and inflammation. Brain Behav Immun 2020; 90:167-173. [PMID: 32791210 PMCID: PMC7544656 DOI: 10.1016/j.bbi.2020.08.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 07/24/2020] [Accepted: 08/07/2020] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE Psychological and physical symptoms commonly occur in patients with metastatic lung cancer and are associated with reduced quality of life and decreased survival. Previous work has associated these symptoms with inflammation. The experience of Early Childhood Adversity (ECA) is linked to chronic inflammation and may identify adult cancer patients who are at-risk for psychological and physical symptoms. We thus hypothesized that ECA in lung cancer patients would be associated with increased psychological symptoms (distress, anxiety, and depression) and physical symptoms and that this relationship would be explained by inflammation. METHODS Patients with metastatic lung cancer (n = 92) were evaluated for ECA using the Risky Families Questionnaire. Concomitant assessments were made of distress (Distress Thermometer and Problem List [DT&PL]), anxiety (Generalized Anxiety Disorder-7), depression (Patient Hospital Questionniare-9), physical symptoms (DT&PL), and inflammation (C-reactive protein [CRP]). Multivariate models were created to explain associations of ECA with depression, anxiety, distress, number of physical problems, and inflammation. RESULTS ECA was associated with distress (r = 0.24, p = .03), anxiety (r = 0.30, p = .004), depression (r = 0.35, p = .001), greater physical problems (r = 0.25, p = .03), younger age (r = -0.29, p = .006), and elevated CRP (r = 0.22, p = .04). Multivariate analyses of outcomes found that depression severity was independently explained by both ECA and inflammation (β = 0.37, p = .001) but not distress or anxiety, while controlling for age and sex. Number of physical problems were also associated with ECA (β = 0.35, p = .004) but not inflammation. The association between ECA and physical problems was not significant after controlling for depression. CONCLUSION ECA is associated with increased depression and physical symptoms independent of inflammation. Moreover, depression appears to mediate the impact of ECA on physical symptoms. ECA may identify patients at risk for psychological and physical symptoms.
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Affiliation(s)
- Daniel C. McFarland
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, United States,Corresponding author at: Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 641 Lexington Ave, New York, NY 10024, United States, (D.C. McFarland)
| | - Christian Nelson
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Andrew H. Miller
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States
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Winters L, Post K, Flanagan J. A Web-Streamed Yoga Intervention for Breast Cancer Survivors. Creat Nurs 2020; 26:e70-e76. [PMID: 32883829 DOI: 10.1891/crnr-d-19-00005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Current research indicates that structured yoga practice may improve physical and emotional symptoms related to cancer treatment. Yoga is recommended for patients with cancer, yet there are barriers to participation in community- and hospital-based classes. Wellness interventions such as yoga are easy to access via the internet, but information can be overwhelming and not tailored to people with cancer. PURPOSE The purpose of this study was to develop a nurse-led, breast cancer-specific, web-based gentle yoga video for home use, and to understand the feasibility, utilization, and safety of the video in a sample of breast cancer survivors. METHOD Data was collected via open-ended telephone interviews three times over a 4-week period. RESULTS The 14 women participating in the study reported that the web-based video was safe in that it resulted in no injury, and was easy to use, and convenient to access. However, most did not continue to practice the video for the full 4 weeks of the study. A knowledge deficit about gentle yoga as a structured mindful movement-based practice rather than a vigorous exercise was identified. IMPLICATIONS Nurses can provide tailored wellness interventions for cancer survivors via video stream. Future work should include instruction that yoga is a mindfulness-based self-care activity requiring regular practice.
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Abstract
BACKGROUND Patient engagement (PE) is a key factor for early-stage breast cancer survivors during survivorship, yet little is known about what factors may contribute to PE. OBJECTIVES The aims of this study were to describe the relationship between sociodemographic factors, survivorship variables, and PE and explore how variations in these variables might contribute to PE in breast cancer survivors. METHODS A cross-sectional, web-based self-report national survey was conducted to assess sociodemographic factors and survivorship variables: health-related quality of life (HRQOL) as measured by 7-item Functional Assessment of Cancer Therapy-General, fear of cancer recurrence, cancer health literacy, and 2 measures of PE (Patient Activation and Knowing Participation in Change) in breast cancer survivors. One open-ended question assessed additional survivorship concerns. Data were analyzed via bivariate associations and backward linear regression modeling in SPSS. RESULTS The sample (N = 303), equally dispersed across the United States, was predominantly middle-aged (mean, 50.70 [SD, 14.01]), white, non-Hispanic women. Knowing Participation in Change and Patient Activation regression models indicate HRQOL was significantly associated with PE (P ≤ .001), whereas findings related to fear of cancer recurrence lacked significance. In the Knowing Participation in Change regression model, HRQOL, social support, and level of education were all significantly associated with PE (P ≤ .001). CONCLUSIONS Breast cancer survivors with higher HRQOL, greater social support, and higher levels of education were more likely to have higher levels of PE. IMPLICATIONS FOR PRACTICE Findings may provide insight as to which survivors may be ready to engage in SC and those who may need more specific tailoring of resources and support.
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Admiraal JM, Hoekstra-Weebers JEHM, Schröder CP, Tuinier W, Hospers GAP, Reyners AKL. Distress, problems, referral wish, and supportive health care use in breast cancer survivors beyond the first year after chemotherapy completion. Support Care Cancer 2020; 28:3023-3032. [PMID: 31511981 PMCID: PMC7256025 DOI: 10.1007/s00520-019-05030-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 08/06/2019] [Indexed: 12/21/2022]
Abstract
PURPOSE We examined distress levels, problems, referral wish, and supportive health care use in a cross-sectional group of breast cancer survivors at two-time points with a 1-year time interval. Also, factors related to continuing elevated distress were explored. METHODS Breast cancer survivors, 1-5 years after chemotherapy completion, filled in the Dutch Distress Thermometer/Problem List (DT/PL) and questions on background characteristics at study inclusion (T1). DT/PL responses and health care use were discussed during semi-structured interviews. One year later, re-assessment took place (T2). The data were analyzed by descriptive and univariate analyses. Continuing elevated distress was defined as a DT score ≥ 5 at T1 and T2. RESULTS Seventy-three survivors completed all questionnaires (response = 84.6%). Eighteen (25%) experienced continuing elevated distress. Fatigue (T1 N = 48 (66%); T2 N = 41 (56%)) and lack of physical fitness (T1 N = 44 (60%); T2 N = 36 (49%)) were most often reported. Time since diagnosis, health care use, and practical, social, emotional and physical problems were significantly associated with continuing elevated distress. Between diagnosis and T1, N = 49(67%) used supportive healthcare services, mostly a psychologist and/or a physical/lymphedema therapist, and between T1 and T2, 39 (53%) did. At T1, 8 (11%) expressed a referral wish and at T2, 11 (16%) did. CONCLUSIONS Screening and management of distress, problems, and referral wish are important, even years after chemotherapy completion as a substantial proportion of breast cancer survivors continue to report elevated distress and problems. Special attention should be paid to survivors reporting physical problems, especially fatigue and lack of physical fitness, since these problems are most strongly related to continuing elevated distress.
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Affiliation(s)
- J M Admiraal
- University of Groningen, University Medical Center Groningen, Department of Medical Oncology, Groningen, The Netherlands
| | - J E H M Hoekstra-Weebers
- University of Groningen, University Medical Center Groningen, Wenckebach Institute, Groningen, The Netherlands
| | - C P Schröder
- University of Groningen, University Medical Center Groningen, Department of Medical Oncology, Groningen, The Netherlands
| | - W Tuinier
- University of Groningen, University Medical Center Groningen, Department of Medical Oncology, Groningen, The Netherlands
| | - G A P Hospers
- University of Groningen, University Medical Center Groningen, Department of Medical Oncology, Groningen, The Netherlands
| | - Anna K L Reyners
- University of Groningen, University Medical Center Groningen, Department of Medical Oncology, Groningen, The Netherlands.
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Álvaro Sanz E, Abilés J, Garrido Siles M, Pérez Ruíz E, Alcaide García J, Rueda Domínguez A. Impact of weight loss on cancer patients' quality of life at the beginning of the chemotherapy. Support Care Cancer 2020; 29:627-634. [PMID: 32424642 DOI: 10.1007/s00520-020-05496-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 04/23/2020] [Indexed: 01/06/2023]
Abstract
PURPOSE Among the prognostic factors relevant to the condition of oncological patients, nutritional status (NS) has the greatest single impact on quality of life (QL). The goals of our study were to evaluate the influence of NS, weight loss (WL), and the presence of cachexia, prior to the initiation of chemotherapy, on the patient's QL. METHODS Adult patients (aged ≥ 18 years) diagnosed with solid tumours for whom chemotherapy was started between April 2016 and June 2017 were eligible for inclusion in the study. They were asked to complete a QL questionnaire (Functional Assessment of Cancer Treatment (FACT-G)) at the beginning. The presence or absence of cachexia was evaluated at the outset, following the definition proposed by Fearon and nutritional assessment by the Patient-Generated Subjective Global Assessment (PG-SGA) scale. RESULTS A total of 177 patients completed the FACT-G, the 60% receiving curative therapy. At the start of the treatment, 58.2% of patients had experienced WL, with an average of 4.4 ± 7.4%, and 19% were at risk of malnutrition. Patient who presented cachexia at diagnosis, were treated with palliative intention, had a Nutriscore ≥ 5 points or presented malnutrition in accordance with PG-SGA had a poorer QL (p < 0.05). Greater WL was associated with a worsened QL (p = 0.001). Breast cancer patients presented an inverse correlation between the %WL and the initial score in the FACT-G (r = - 0.304, p = 0.023), whereas no such correlation was observed for the other types of tumour (r = - 0.012, p = 0.892). CONCLUSIONS These results underline the relation of NS before starting chemotherapy and QL. Greater WL was associated with a worsened QL, especially in women with breast cancer.
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Affiliation(s)
- Elena Álvaro Sanz
- Área de Farmacia y Nutrición, Hospital Costa del Sol, Agencia Sanitaria Costa del Sol, A7, km. 187, 29603, Marbella, Málaga, Spain
| | - Jimena Abilés
- Área de Farmacia y Nutrición, Hospital Costa del Sol, Agencia Sanitaria Costa del Sol, A7, km. 187, 29603, Marbella, Málaga, Spain
| | - Margarita Garrido Siles
- Área de Farmacia y Nutrición, Hospital Costa del Sol, Agencia Sanitaria Costa del Sol, A7, km. 187, 29603, Marbella, Málaga, Spain.
| | - Elísabeth Pérez Ruíz
- Oncology service, Hospital Costa del Sol, A7, km 187, 29603, Marbella, Málaga, Spain
| | - Julia Alcaide García
- Oncology service, Hospital Costa del Sol, A7, km 187, 29603, Marbella, Málaga, Spain
| | - Antonio Rueda Domínguez
- UGCI Oncología Médica, Hospitales Universitarios Regional y Virgen de la Victoria, IBIMA, P° Limonar, 2, Bq3, 5°A, Málaga, Spain
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Relationships Between Weight Change and Physical and Psychological Distress in Early-Stage Breast Cancer Survivors. Cancer Nurs 2020; 42:E43-E50. [PMID: 29847347 DOI: 10.1097/ncc.0000000000000612] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Weight gain and unfavorable changes in body composition are common in a growing population of breast cancer survivors, but the etiology of these changes is poorly understood. OBJECTIVE The aim of this study was to investigate relationships between weight change and symptoms of physical and psychological distress in the first 12 months of completing treatment in women who had completed treatment for breast cancer. METHODS Physical distress and psychological distress were assessed using the Rotterdam Symptom Checklist, the Distress Thermometer, and the Fatigue Symptom Inventory. RESULTS Weight change in 28 women since the completion of treatment (mean, 6.4 ± 4.4 months) ranged from -6.0 kg to +5.2 kg (mean, -0.4 ± 3.2), with 6 women gaining and 7 women losing an average of 3.5 ± 1.0 and 5.1 ± 0.8 kg, respectively. Rotterdam mean scores for physical (17.5 ± 9.0) and psychological distress (27.1 ± 16.9) were similar to previous findings for patients with early-stage breast cancer in active treatment and appear to be markedly higher than distress levels previously reported in cancer-free adults. Distress levels, based on the Distress Thermometer, were moderate to severe in 35% of women. Fatigue was common and associated with interference in daily living for some women. Fatigue duration was negatively correlated with weight change (P = -0.46, P < .05). CONCLUSIONS Symptoms of physical and psychological distress persist for some women in the first year after completing treatment and may associate with weight change. IMPLICATIONS These findings underscore a need for ongoing assessment and supportive care across the breast cancer trajectory and may guide dietary counseling aimed at promoting healthy body weight and overall health in early survivorship.
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Lantheaume S, Fernandez L, Moták L, Blois Da Conceição S. Cancer du sein non métastasé et dessin de l’arbre. PSYCHO-ONCOLOGIE 2020. [DOI: 10.3166/pson-2019-0108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Cette recherche porte sur l’évolution des tracés du dessin de l’arbre (DA) au cours du temps chez 30 patientes atteintes de cancer du sein, de l’annonce diagnostique à la fin des traitements. Les patientes ont été réparties en deux groupes : le premier est composé de femmes ayant reçu de la chimiothérapie, le second de femmes n’ayant pas reçu de chimiothérapie. Les résultats mettent en évidence que les constellations de tracés au test de l’arbre n’évoluent pas au cours du temps, mais en fonction de la présence/absence de chimiothérapie. Les profils psychologiques des patientes restent stables entre l’annonce diagnostique et un délai de six mois après la fin des traitements. L’arbre dessiné semble en revanche porter les stigmates des traitements subis.
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Kitajima M, Mikami K, Noto Y, Itaki C, Fukushi Y, Hirota Y, Mariya Y, Tsushima M, Kattou K, Osanai T. Quantitative assessment of radiodermatitis through a non-invasive objective procedure in patients with breast cancer. Mol Clin Oncol 2019; 12:89-93. [PMID: 31814981 DOI: 10.3892/mco.2019.1948] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Accepted: 09/19/2019] [Indexed: 11/06/2022] Open
Abstract
Assessment of skin condition is necessary for providing advice regarding skin self-care to patients with breast cancer who have undergone radiation therapy. Acute and chronic phases of radiodermatitis were analyzed in patients using objective assessment tools in the present study. A total of 18 women who received radiation therapy for breast cancer were enrolled in the present study and their skin surface temperature (SST), hydration level of the skin surface (HL), melanin intensity (MI) and erythema intensity (EI) were measured prior to radiation therapy and six months thereafter. Furthermore, skin condition was assessed using the Common Terminology Criteria for Adverse Events (CTCAE). EI and MI levels at the irradiated site peaked upon the completion of radiation therapy and declined to baseline at 6 months. In contrast, SST levels were elevated at the irradiated site during radiation therapy (P<0.05) and plateaued after its completion. The same parameters in non-irradiated control sites remained unchanged during the study period. HL reached the minimum in irradiated and non-irradiated sites upon completion of radiation therapy. Although HL returned to baseline in the non-irradiated site 6 months after radiation therapy, it remained low in the irradiated site. No relationship between the CTCAE and EI level was observed. In conclusion, the present study demonstrated that objective assessment tools, including SST and EI levels, were useful for assessing skin condition during radiodermatitis. The combination of the CTCAE and objective assessment tools will enable a more accurate assessment of radiodermatitis.
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Affiliation(s)
- Maiko Kitajima
- Department of Nursing Science, Hirosaki University Graduate School of Health Science, Hirosaki, Aomori 036-8564, Japan
| | - Kasumi Mikami
- Department of Nursing Science, Hirosaki University Graduate School of Health Science, Hirosaki, Aomori 036-8564, Japan
| | - Yuka Noto
- Department of Nursing Science, Hirosaki University Graduate School of Health Science, Hirosaki, Aomori 036-8564, Japan
| | - Chieko Itaki
- Department of Nursing Science, Hirosaki University Graduate School of Health Science, Hirosaki, Aomori 036-8564, Japan
| | - Yasuyo Fukushi
- Department of Radiology, Mutsu General Hospital, Mutsu, Aomori 035-8601, Japan
| | - Yoshiko Hirota
- Hirosaki Central Hospital, Hirosaki, Aomori 036-8188, Japan
| | - Yasushi Mariya
- Department of Radiology, Mutsu General Hospital, Mutsu, Aomori 035-8601, Japan
| | - Megumi Tsushima
- Department of Nursing Science, Hirosaki University Graduate School of Health Science, Hirosaki, Aomori 036-8564, Japan
| | - Keiichi Kattou
- Hirosaki Central Hospital, Hirosaki, Aomori 036-8188, Japan
| | - Tomohiro Osanai
- Department of Nursing Science, Hirosaki University Graduate School of Health Science, Hirosaki, Aomori 036-8564, Japan
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Escalera C, Santoyo‐Olsson J, Stewart AL, Ortiz C, Nápoles AM. Social support as a moderator in the relationship between intrusive thoughts and anxiety among Spanish-speaking Latinas with breast cancer. Psychooncology 2019; 28:1819-1828. [PMID: 31216604 PMCID: PMC6771841 DOI: 10.1002/pon.5154] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 05/31/2019] [Accepted: 06/11/2019] [Indexed: 12/02/2022]
Abstract
OBJECTIVE Intrusive thoughts, defined as unwanted and recurrent thoughts about a stressful experience, are associated with psychological distress in women with breast cancer. This study assessed moderating effects of various social support dimensions on associations between intrusive thoughts and psychological distress among Latina breast cancer survivors. METHODS We used baseline data from a randomized controlled trial of a stress management intervention delivered to 151 Spanish-speaking Latinas with nonmetastatic breast cancer within 1 year of diagnosis. Intrusive thoughts, four dimensions of social support (emotional/informational, tangible, affectionate, and positive social interaction), and symptoms of anxiety and depression were assessed through in-person interviews. Information on age, time since diagnosis, breast cancer variables, history of depression, and marital status served as covariates. Generalized linear models were used to investigate bivariate and multivariate associations and to explore moderation effects of the four dimensions of social support. RESULTS In bivariate models, intrusive thoughts were associated positively with depression (β = .024, .001) and anxiety (β = .047, P < .001) symptoms. Adjusting for other factors, intrusive thoughts remained associated with depression symptoms (β = .022, .008), regardless of level of social support (for all support dimensions). For anxiety, there were significant interactions of tangible (β = -.013, .034) and affectionate (β = -.022, .005) support with intrusive thoughts. Intrusive thoughts were associated more strongly with anxiety symptoms among women reporting less tangible and affectionate support than those with higher levels of these types of support. CONCLUSIONS Tangible and affectionate support have protective effects on anxiety symptoms among Spanish-speaking Latina breast cancer survivors experiencing intrusive thoughts, but not depression symptoms.
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Affiliation(s)
- Cristian Escalera
- National Institute on Minority Health and Health DisparitiesNational Institutes of HealthBethesdaMaryland
| | - Jasmine Santoyo‐Olsson
- Division of General Internal Medicine, Department of MedicineUniversity of California San FranciscoSan FranciscoCalifornia
| | - Anita L. Stewart
- Center for Aging in Diverse CommunitiesUniversity of California San FranciscoSan FranciscoCalifornia
- Institute for Health and AgingUniversity of California San FranciscoSan FranciscoCalifornia
| | - Carmen Ortiz
- Círculo de Vida Cancer Support and Resource CenterSan FranciscoCalifornia
| | - Anna Maria Nápoles
- National Institute on Minority Health and Health DisparitiesNational Institutes of HealthBethesdaMaryland
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Jha S, Wyld L, Krishnaswamy PH. The Impact of Vaginal Laser Treatment for Genitourinary Syndrome of Menopause in Breast Cancer Survivors: A Systematic Review and Meta-analysis. Clin Breast Cancer 2019; 19:e556-e562. [DOI: 10.1016/j.clbc.2019.04.007] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Revised: 03/16/2019] [Accepted: 04/07/2019] [Indexed: 01/23/2023]
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Pituskin E, Perri M, Cox-Kennett N, Andrews E, Dimitry R, McNeely M, Paterson I. Personalized Care in the Prevention of Treatment-Related Cardiac Dysfunction in Female Cancer Survivors. J Womens Health (Larchmt) 2019; 28:1384-1390. [PMID: 31314650 DOI: 10.1089/jwh.2018.6979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: The American Cancer Society projects the number of U.S. cancer survivors to exceed 20 million individuals by 2026. However, approximately one in four cancer survivors report decreased quality of life due to physical dysfunction and disabling symptoms. Many effective anticancer treatments are now understood to be associated with cardiotoxicity, such that, for many survivors, the risk of death from cardiovascular disease now exceeds that of recurrent cancer. Materials and Methods: We undertook a Clinical Review of cancer treatment-related cardiac dysfunction (CTRCD) associated with standard treatment regimens with attention to risks experienced by female cancer patients and survivors. Results: Risks of standard (chemotherapy, radiotherapy) and targeted (antibodies, kinase inhibitors) in development of CTCRD in females are discussed. Multidisciplinary approaches in prevention are reviewed. Conclusions: Female cancer survivors with CTRCD represent an entirely new population at high risk of morbidity and mortality. Increased awareness of the short- and long-term effects of anti-cancer treatments is necessary for the community health care provider for early detection and CTRCD risk reduction.
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Affiliation(s)
- Edith Pituskin
- Faculty of Nursing, University of Alberta, Edmonton, Canada
| | | | | | | | | | - Margaret McNeely
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | - Ian Paterson
- Department of Cardiology, Faculty of Medicine, University of Alberta, Edmonton, Canada
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The Relationships Among Symptom Distress, Posttraumatic Stress Symptoms, and Depression in Patients With Female-specific Cancers. Cancer Nurs 2019; 41:181-188. [PMID: 28151832 DOI: 10.1097/ncc.0000000000000479] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Previous studies have demonstrated that posttraumatic stress symptoms (PTSS) affect women with breast cancer. However, few studies have explored the relationships among PTSS, symptom distress, and depression in association with cancers specific to women in Taiwan. OBJECTIVE The aim of this study was to explore the relationships among symptom distress, PTSS, and depression in women given a diagnosis of female-specific cancers. METHODS A cross-sectional design was used, and 220 women given a diagnosis of female-specific cancer were recruited from a general hospital in southern Taiwan. The outcome measures included the subjects' scores on a symptom distress scale, the Chinese Davidson Trauma Scale, and the Center for Epidemiologic Studies-Depressive Scale; their personal characteristics; and disease-related variables. RESULTS There were significant positive relationships among the frequency of PTSS, the severity of PTSS, symptom distress, and depressive symptoms. Logistic regression analysis demonstrated that educational level, symptom distress, and the frequency of PTSS were significant predictors of depression. CONCLUSIONS The study demonstrated a high prevalence of depression in women with female-specific cancer, and the results confirm the relationship between PTSS and depression. In addition, educational level and physical distress were also found to be predictors of depression. IMPLICATIONS FOR PRACTICE Screening for depressive symptoms should be a component of routine screening in women with female-specific cancer. Oncology nurses should be aware of the distress symptoms experienced by these women and recognize PTSS in patients who are given a diagnosis of female-specific cancer. Awareness will reduce the multiple risks of posttraumatic stress disorder and depression and decrease the depressive symptoms of women after surviving cancer.
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Schreier AM, Johnson LA, Vohra NA, Muzaffar M, Kyle B. Post-Treatment Symptoms of Pain, Anxiety, Sleep Disturbance, and Fatigue in Breast Cancer Survivors. Pain Manag Nurs 2018; 20:146-151. [PMID: 30527856 DOI: 10.1016/j.pmn.2018.09.005] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Revised: 09/05/2018] [Accepted: 09/12/2018] [Indexed: 01/06/2023]
Abstract
BACKGROUND In part because of improvements in early detection and treatment, the number of breast cancer survivors is increasing. After treatment, however, breast cancer survivors often experience distressing symptoms, including pain, sleep disturbance, anxiety, and fatigue; at the same time, they have less frequent contact with health care providers. Pain commonly co-occurs with other symptoms and the combination of symptoms contribute to the amount of distress experienced by survivors. Previous studies of post-treatment symptoms include primarily urban and white women. AIMS The purpose of this study was to describe the post-treatment cluster of symptoms, to examine the correlations among these symptoms, and to examine the role pain intensity may play in understanding the variation in sleep disturbance, fatigue, and anxiety in a racially diverse sample of rural breast cancer survivors. DESIGN The theoretical framework for this descriptive correlational study was the theory of unpleasant symptoms. SETTINGS Outpatient university-affiliated cancer clinic. PARTICIPANTS/SUBJECTS Forty women who were between 6 months and 5 years post breast cancer diagnosis. METHODS Participants completed the following self-report instruments: Patient Reported Outcomes Measurement Information System of pain intensity, pain interference, anxiety, and sleep disturbance and the Piper Fatigue Short Form 12. RESULTS The average age of participants was 58 years, and 57.5% were black. Most women reported sleep disturbance (78%), pain interference (68%), and pain intensity (63%) above the national average for an American adult. Black women reported higher pain intensity than whites. There were moderate to strong correlations among the symptoms (range r = 0.35-0.89). CONCLUSIONS Nurses and health care providers in primary care settings need to screen for symptoms, and nursing interventions are needed to assist breast cancer survivors to manage distressing symptoms.
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Affiliation(s)
- Ann M Schreier
- Department of Nursing Science, College of Nursing, East Carolina University, Greenville, North Carolina.
| | - Lee Ann Johnson
- Department of Nursing Science, College of Nursing, East Carolina University, Greenville, North Carolina
| | - Nasreen A Vohra
- Division of Surgical Oncology, Department of Surgery, Brody School of Medicine, East Carolina University, Greenville, North Carolina
| | - Mahvish Muzaffar
- Division of Hematology Oncology, Department of Internal Medicine, Brody School of Medicine, East Carolina University, Greenville, North Carolina
| | - Brandon Kyle
- Department of Psychiatry & Behavioral Medicine, Brody School of Medicine, East Carolina University, Greenville, North Carolina
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Di Giacomo D, Ranieri J, Donatucci E, Perilli E, Cannita K, Passafiume D, Ficorella C. Emotional "Patient-Oriented" Support in Young Patients With I-II Stage Breast Cancer: Pilot Study. Front Psychol 2018; 9:2487. [PMID: 30568627 PMCID: PMC6290028 DOI: 10.3389/fpsyg.2018.02487] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 11/22/2018] [Indexed: 11/13/2022] Open
Abstract
Objective: The recent increased survival rate after breast cancer (BC) diagnosis and treatment is mostly related to early screening in younger age. Evidence gained from newly detected assessed psychological needs as well as certain emotional regulatory patterns in younger survivors has been related in the literature to an extremely low rate of adherence to the psychological therapies offered. Tailored psychological support is necessary. The aim of the present study was to verify the preliminary efficacy of supportive psychological intervention with an innovative orientation: the Early BC Psychological Intervention (EBC-Psy). Methods: A controlled study design was used to investigate the efficacy of EBC-Psy intervention. Preliminary data involved twenty-four patients in the age range of 35–50 years, diagnosed with cancer at the early stage (I–II), who were exposed to the EBC-Psy intervention. To address the effect of intervention, emotional variables were tested before the treatment (Time 1) and then again after 6 months of the treatment (Time 2); evaluated emotional dimensions were anxiety, anger, depression, and psychological distress. Results: EBC-Psy intervention appears to be effective on both depression (p = 0.02) and psychological distress (p = 0.01), even in a short time, highlighting the strength of a reinforced positive psychological conceptual approach to deal with the “disease condition” in younger patients; on the contrary, the control group evidenced an increase in the same emotional variables in timing. Conclusion: Our findings, even if limited by this small-scale protocol, seemed to confirm the role of positive psychotherapy after BC diagnosis and treatment through the impact of cognitive processes, coping strategies, and psychological resilience. Future theoretical framework could boost the intervention to design an innovative survivorship model.
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Affiliation(s)
- D Di Giacomo
- Department of MeSVA, University of L'Aquila, L'Aquila, Italy
| | - J Ranieri
- Department of MeSVA, University of L'Aquila, L'Aquila, Italy
| | - E Donatucci
- Department of MeSVA, University of L'Aquila, L'Aquila, Italy
| | - E Perilli
- Department of MeSVA, University of L'Aquila, L'Aquila, Italy
| | - K Cannita
- San Salvatore Hospital, L'Aquila, Italy
| | - D Passafiume
- Department of MeSVA, University of L'Aquila, L'Aquila, Italy
| | - C Ficorella
- San Salvatore Hospital, L'Aquila, Italy.,Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, L'Aquila, Italy
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Yuan L, Guo LH, Yuan CA, Zhang YH, Han K, Nandi A, Honig B, Huang DS. Integration of Multi-omics Data for Gene Regulatory Network Inference and Application to Breast Cancer. IEEE/ACM TRANSACTIONS ON COMPUTATIONAL BIOLOGY AND BIOINFORMATICS 2018; 16:782-791. [PMID: 30137012 DOI: 10.1109/tcbb.2018.2866836] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Underlying a cancer phenotype is a specific gene regulatory network that represents the complex regulatory relationships between genes. However, it remains a challenge to find cancer-related gene regulatory network because of insufficient sample sizes and complex regulatory mechanisms in which gene is influenced by not only other genes but also other biological factors. With the development of high-throughput technologies and the unprecedented wealth of multi-omics data give us a new opportunity to design machine learning method to investigate underlying gene regulatory network. In this paper, we propose an approach, which use biweight midcorrelation to measure the correlation between factors and make use of nonconvex penalty based sparse regression for gene regulatory network inference (BMNPGRN). BMNCGRN incorporates multi-omics data (including DNA methylation and copy number variation) and their interactions in gene regulatory network model. The experimental results on synthetic datasets show that BMNPGRN outperforms popular and state-of-the-art methods (including DCGRN, ARACNE and CLR) under false positive control. Furthermore, we applied BMNPGRN on breast cancer (BRCA) data from The Cancer Genome Atlas database and provided gene regulatory network.
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van der Meulen IC, May AM, Koole R, Ros WJG. A Distress Thermometer Intervention for Patients With Head and Neck Cancer
. Oncol Nurs Forum 2018; 45:E14-E32. [PMID: 29251296 DOI: 10.1188/18.onf.e14-e32] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To investigate the feasibility of an intervention using the National Comprehensive Cancer Network Distress Thermometer and Problem List with nurse-guided follow-up and the effect on depressive symptoms, health-related quality of life, and worry of cancer in patients with head and neck cancer.
. SAMPLE & SETTING 110 patients with head and neck cancer in a two-arm randomized, controlled trial in an outpatient clinic of a university hospital.
. METHODS & VARIABLES Patients were randomized to usual care (n = 57) or the intervention group (n = 53), which consisted of screening with the Distress Thermometer and Problem List plus nurse-guided follow-up lasting about 20 minutes three to four times during 12 months. Intention-to-treat analysis was performed using linear mixed models with outcomes at 6 and 12 months and baseline adjustment.
. RESULTS The intervention showed moderate compliance and acceptable session duration. Intervention participants were satisfied with nurses' care. Depressive symptoms, health-related quality of life, and worry of cancer were not significantly different in the two treatment groups. The intervention seemed feasible in clinical practice, but no effects on patient outcomes were seen.
. IMPLICATIONS FOR NURSING Patients with head and neck cancer appreciated the opportunity to discuss their problems and challenges with a nurse. Nurses supported patients with basic psychosocial care, minor interventions, and referral possibilities.
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Robbeson C, Hugenholtz-Wamsteker W, Meeus M, Devoogdt N, Nijs J, De Groef A. Screening of physical distress in breast cancer survivors: Concurrent validity of the Distress Thermometer and Problem List. Eur J Cancer Care (Engl) 2018; 28:e12880. [DOI: 10.1111/ecc.12880] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 01/15/2018] [Accepted: 06/08/2018] [Indexed: 12/01/2022]
Affiliation(s)
- Conny Robbeson
- Department of Physiotherapy, Physiology & Anatomy; Faculty of Physical Education and Physiotherapy; Vrije Universiteit Brussel; Brussels Belgium
- European College for Lymphology & Oncology; De Berekuyl/CSI-the Netherlands; Harderwijk The Netherlands
- WillU Fysio; Dinteloord The Netherlands
| | - Willemijn Hugenholtz-Wamsteker
- Department of Physiotherapy, Physiology & Anatomy; Faculty of Physical Education and Physiotherapy; Vrije Universiteit Brussel; Brussels Belgium
- European College for Lymphology & Oncology; De Berekuyl/CSI-the Netherlands; Harderwijk The Netherlands
- Procare Fysiotherapie & Trainingscentrum; Gorinchem The Netherlands
| | - Mira Meeus
- European College for Lymphology & Oncology; De Berekuyl/CSI-the Netherlands; Harderwijk The Netherlands
- Pain in Motion International Research Group, www.paininmotion.be
- Department of Rehabilitation Sciences and Physiotherapy; Faculty of Medicine & Health Sciences; Ghent University; Ghent Belgium
- Department of Rehabilitation Sciences and Physiotherapy; Faculty of Medicine & Health Sciences; University of Antwerp; Antwerp Belgium
| | - Nele Devoogdt
- Department of Rehabilitation Sciences; Lymphoedema Centre; University Hospitals Leuven; KU Leuven - University of Leuven; Leuven Belgium
| | - Jo Nijs
- Department of Physiotherapy, Physiology & Anatomy; Faculty of Physical Education and Physiotherapy; Vrije Universiteit Brussel; Brussels Belgium
- European College for Lymphology & Oncology; De Berekuyl/CSI-the Netherlands; Harderwijk The Netherlands
- Pain in Motion International Research Group, www.paininmotion.be
- Department of Physical Medicine and Rehabilitation/Physiotherapy; University Hospital Brussels; Brussels Belgium
| | - An De Groef
- Department of Rehabilitation Sciences; KU Leuven - University of Leuven; Leuven Belgium
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Lacourt TE, Heijnen CJ. Mechanisms of Neurotoxic Symptoms as a Result of Breast Cancer and Its Treatment: Considerations on the Contribution of Stress, Inflammation, and Cellular Bioenergetics. CURRENT BREAST CANCER REPORTS 2017; 9:70-81. [PMID: 28616125 PMCID: PMC5445149 DOI: 10.1007/s12609-017-0245-8] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE OF REVIEW Breast cancer and its treatment are associated with a range of neurotoxic symptoms, such as fatigue, cognitive impairment, and pain. Although these symptoms generally subside after treatment completion, they become chronic in a significant subset of patients. We here summarize recent findings on neuroinflammation, stress, and mitochondrial dysfunction as mechanistic pathways leading to neurotoxic symptom experience in breast cancer patients and survivors. RECENT FINDINGS Neuroinflammation related to stress or cancer treatment and stress resulting from diagnosis, treatment, or (cancer-related) worrying are important predictors of a neurotoxic symptom experience, both during and after treatment for breast cancer. Both inflammation and stress hormones, as well as cancer treatment, can induce mitochondrial dysfunction resulting in reduced cellular energy. SUMMARY We propose reduced cellular energy (mitochondrial dysfunction) induced by inflammation, oxygen radical production, and stress as a result of cancer and/or cancer treatment as a final mechanism underlying neurotoxic symptoms.
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Affiliation(s)
- Tamara E. Lacourt
- Department of Symptom Research, Neuroimmunology Laboratory, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 384, Houston, TX 77030 USA
| | - Cobi J. Heijnen
- Department of Symptom Research, Neuroimmunology Laboratory, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 384, Houston, TX 77030 USA
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Lester J, Stout R, Crosthwaite K, Andersen B. Self-Reported Distress: Adult Acute Leukemia Survivors During and After Induction Therapy. Clin J Oncol Nurs 2017; 21:211-218. [DOI: 10.1188/17.cjon.211-218] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Predictors of psychological distress among cancer patients receiving care at a safety-net institution: the role of younger age and psychosocial problems. Support Care Cancer 2017; 25:2305-2312. [DOI: 10.1007/s00520-017-3641-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 02/10/2017] [Indexed: 01/30/2023]
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Kamen C, Jabson JM, Mustian KM, Boehmer U. Minority stress, psychosocial resources, and psychological distress among sexual minority breast cancer survivors. Health Psychol 2017; 36:529-537. [PMID: 28165265 DOI: 10.1037/hea0000465] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Few studies have examined unique factors predicting psychological distress among sexual minority (i.e., lesbian and bisexual) women postbreast cancer diagnosis. The present study assessed the association of minority stress and psychosocial resource factors with depression and anxiety symptoms among sexual minority breast cancer survivors. METHOD Two hundred one sexual minority women who had ductal carcinoma in situ or Stage I-IV breast cancer participated in this study through the Love/Avon Army of Women. Self-report questionnaires were used to assess demographic and clinical factors, minority stress factors (discrimination, minority identity development, outness), psychosocial resources (resilience, social support), and psychological distress (anxiety and depression). These factors were included in a structural equation model, testing psychosocial resources as mediators between minority stress and psychological distress. RESULTS There were no significant differences noted between lesbian and bisexual women. The final structural equation model demonstrated acceptable fit across all sexual minority women, χ2 = 27.83, p > .05; confirmatory fit index = 0.97, root-mean-square error of approximation = 0.04, Tucker-Lewis index = 0.93. The model accounted for significant variance in psychological distress (56%). Examination of indirect effects confirmed that exposure to discrimination was associated with distress via association with resilience. CONCLUSIONS Factors unique to sexual minority populations, such as minority stress, may be associated with higher rates of psychological distress among sexual minority breast cancer survivors. However, presence of psychosocial resources may mediate relationships with distress in this population; enhancement of resilience, in particular, could be an aim of psychological intervention. (PsycINFO Database Record
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Affiliation(s)
| | | | | | - Ulrike Boehmer
- Department of Community Health Sciences, Boston University
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Di Blasio A, Morano T, Cianchetti E, Gallina S, Bucci I, Di Santo S, Tinari C, Di Donato F, Izzicupo P, Di Baldassarre A, Cimini A, Napolitano G. Psychophysical health status of breast cancer survivors and effects of 12 weeks of aerobic training. Complement Ther Clin Pract 2017; 27:19-26. [PMID: 28438275 DOI: 10.1016/j.ctcp.2017.01.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 01/26/2017] [Indexed: 02/03/2023]
Abstract
The aim of this study was to analyse the health status of breast cancer survivors and the effects of 12 weeks of aerobic training. Twenty-three breast cancer survivors (51.71 ± 3.17 years) and 23 healthy women (50.73 ± 2.97 years) were investigated for body composition, daily physical activity, quality of life, salivary cortisol, and DHEA-S. Breast cancer survivors were then aerobically trained for 12 weeks. Breast cancer survivors have a worse psychophysical health than healthy women. Aerobic training increased salivary DHEA-S, aerobic fitness, self-reported health, and nocturnal sleeping time and reduced salivary cortisol in breast cancer survivors. Salivary cortisol variation correlated with change of sleeping time and self-reported health. Salivary DHEA-S correlated with change of self-reported physical pain and general health as well. Breast cancer survivors can live in a situation of continuous distress, requiring a multidisciplinary approach. Twelve weeks of aerobic training improve the psychophysical health of breast cancer survivors.
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Affiliation(s)
- Andrea Di Blasio
- Department of Medicine and Ageing Sciences, 'G. d'Annunzio' University of Chieti-Pescara, Italy.
| | - Teresa Morano
- Department of Medicine and Ageing Sciences, 'G. d'Annunzio' University of Chieti-Pescara, Italy
| | - Ettore Cianchetti
- Department of Medical, Oral and Biotechnological Sciences, 'G. d'Annunzio' University of Chieti-Pescara, Italy; Department of General Surgery Specialised in Senology of the 'G. Bernabeo' Hospital, Ortona, Italy
| | - Sabina Gallina
- Department of Neuroscience and Imaging, 'G. d'Annunzio' University of Chieti-Pescara, Italy
| | - Ines Bucci
- Department of Medicine and Ageing Sciences, 'G. d'Annunzio' University of Chieti-Pescara, Italy
| | - Serena Di Santo
- Department of Medicine and Ageing Sciences, 'G. d'Annunzio' University of Chieti-Pescara, Italy
| | - Camilla Tinari
- Department of Medicine and Ageing Sciences, 'G. d'Annunzio' University of Chieti-Pescara, Italy
| | | | - Pascal Izzicupo
- Department of Medicine and Ageing Sciences, 'G. d'Annunzio' University of Chieti-Pescara, Italy
| | - Angela Di Baldassarre
- Department of Medicine and Ageing Sciences, 'G. d'Annunzio' University of Chieti-Pescara, Italy
| | - Alessandra Cimini
- Department of General Surgery Specialised in Senology of the 'G. Bernabeo' Hospital, Ortona, Italy
| | - Giorgio Napolitano
- Department of Medicine and Ageing Sciences, 'G. d'Annunzio' University of Chieti-Pescara, Italy
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Psychological Manifestations of Early Childhood Adversity in the Context of Chronic Hematologic Malignancy. PSYCHOSOMATICS 2016; 58:46-55. [PMID: 28010748 DOI: 10.1016/j.psym.2016.10.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Accepted: 10/04/2016] [Indexed: 12/25/2022]
Abstract
BACKGROUND Myeloproliferative neoplasms (MPNs), a group of chronic hematologic malignancies, carry significant physical and psychological symptom burdens that significantly affect patients' quality of life. OBJECTIVES We sought to identify the relationship between early childhood adversity (ECA) and psychological distress in patients with MPNs, as ECA may compound symptom burden. METHODS Patients with MPNs were assessed for ECA (i.e., the Risky Families Questionnaire-subscales include abuse/neglect/chaotic home environment), distress (i.e., Distress Thermometer and Problem List), anxiety (i.e., Hospital Anxiety and Depression Scale-Anxiety [HADS-A]), depression (i.e., Hospital Anxiety and Depression Scale-Depression [HADS-D]), meeting standardized cutoff thresholds for distress (i.e., Distress Thermometer and Problem List≥ 4 or ≥ 7)/anxiety (HADS-A ≥8)/depression (HADS-D ≥ 8), and demographic factors. RESULTS A total of 117 participants completed the study (78% response rate). ECA was associated with depression (p < 0.000), anxiety (p < 0.000), and distress (p < 0.000) and problem list variables emotional (p < 0.000), physical (p = 0.004), family (p = 0.01), and spiritual (p = 0.01) by bivariate analysis and only with distress (HADS) (p = 0.038) on multivariate analysis. ECA was associated with meeting cutoff threshold criteria for distress (p = 0.007), anxiety (p = 0.001), and depression (p = 0.02). ECA subscale variables abuse and chaotic home environment were associated with psychological outcomes. ECA was higher based on disease subtypes with greater symptom burden (other > polycythemia vera > myelofibrosis > essential thrombocythemia) (p = 0.047) and taking an antidepressant (p = 0.011). CONCLUSION ECA is associated with psychological distress and meets screening criteria for anxiety and depression in patients with MPNs. ECA may help to explain individual patient trajectories, and further understanding may enhance patient-centered care among patients with MPNs.
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Lo-Fo-Wong DNN, de Haes HCJM, Aaronson NK, van Abbema DL, den Boer MD, van Hezewijk M, Immink M, Kaptein AA, Menke-Pluijmers MBE, Reyners AKL, Russell NS, Schriek M, Sijtsema S, van Tienhoven G, Sprangers MAG. Predictors of enduring clinical distress in women with breast cancer. Breast Cancer Res Treat 2016; 158:563-72. [PMID: 27417105 PMCID: PMC4963436 DOI: 10.1007/s10549-016-3896-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Accepted: 07/02/2016] [Indexed: 10/25/2022]
Abstract
To date, little is known about enduring clinical distress as measured with the commonly used distress thermometer. We therefore used the distress thermometer to examine: (a) the prevalence of enduring clinical distress, distress-related problems, and subsequent wish for referral of women with breast cancer, and (b) sociodemographic, clinical, and psychosocial predictors of enduring clinical distress. The study had a multicenter, prospective, observational design. Patients with primary breast cancer completed a questionnaire at 6 and 15 months postdiagnosis. Medical data were retrieved from chart reviews. Enduring clinical distress was defined as heightened distress levels over time. The prevalence of enduring clinical distress, problems, and wish for referral was examined with descriptive analyses. Associations between predictors and enduring clinical distress were examined with multivariate analyses. One hundred sixty-four of 746 patients (22 %) reported having enduring clinical distress at 6 and 15 months postdiagnosis. Of these, 10 % wanted to be referred for care. Fatigue was the most frequently reported problem by patients with and without clinical distress, at both time points. Lack of muscle strength (OR = 1.82, 95 % CI 1.12-2.98), experience of a low level of life satisfaction (OR = 0.77, 95 % CI 0.67-0.89), more frequent cancer worry (OR = 1.40, 95 % CI 1.05-1.89), and neuroticism (OR = 1.09, 95 % CI 1.00-1.18) were predictors of enduring clinical distress. In conclusion, one in five women with breast cancer develops enduring clinical distress. Oncologists, nurse practitioners, and cancer nurses are advised to use single-item questions about distress and distress-related problems to ensure timely detection of high-risk patients. Providers should also routinely assess fatigue and its causes, as fatigue is the most frequently reported distress-related problem over time.
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Affiliation(s)
- Deborah N N Lo-Fo-Wong
- Department of Medical Psychology, Academic Medical Center, Meibergdreef 15, Amsterdam, 1105 AZ, The Netherlands.
| | - Hanneke C J M de Haes
- Department of Medical Psychology, Academic Medical Center, Meibergdreef 15, Amsterdam, 1105 AZ, The Netherlands
| | - Neil K Aaronson
- The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - Doris L van Abbema
- GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands
| | - Mathilda D den Boer
- Erasmus MC - Cancer Institute, Groene Hilledijk 301, 3075 EA, Rotterdam, The Netherlands
| | - Marjan van Hezewijk
- Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
| | - Marcelle Immink
- Reinier de Graaf Hospital, Reinier de Graafweg 3-11, 2625 AD, Delft, The Netherlands
| | - Ad A Kaptein
- Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
| | | | - Anna K L Reyners
- University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| | - Nicola S Russell
- The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - Manon Schriek
- St. Elisabeth Hospital, Hilvarenbeekseweg 60, 5022 GC, Tilburg, The Netherlands
| | - Sieta Sijtsema
- University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Geertjan van Tienhoven
- Department of Medical Psychology, Academic Medical Center, Meibergdreef 15, Amsterdam, 1105 AZ, The Netherlands
| | - Mirjam A G Sprangers
- Department of Medical Psychology, Academic Medical Center, Meibergdreef 15, Amsterdam, 1105 AZ, The Netherlands
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Gesselman AN, Bigatti SM, Garcia JR, Coe K, Cella D, Champion VL. Spirituality, emotional distress, and post-traumatic growth in breast cancer survivors and their partners: an actor-partner interdependence modeling approach. Psychooncology 2016; 26:1691-1699. [PMID: 27280320 DOI: 10.1002/pon.4192] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 05/18/2016] [Accepted: 06/06/2016] [Indexed: 12/24/2022]
Abstract
BACKGROUND The association between spirituality and emotional health has been well documented in healthy individuals. A small literature has shown that spirituality plays a role in well-being for some breast cancer (BC) survivors; however, this link is virtually unexplored in partners/spouses of survivors. The current study aimed to assess the relationship between spirituality, emotional distress, and post-traumatic growth for BC survivors and their partners using a dyadic analyses approach. METHODS A total of 498 couples who were 3-8 years post-BC diagnosis were recruited from the Eastern Oncology Group database. RESULTS For BC survivors and their partners, greater levels of spirituality were associated with increases in their own post-traumatic growth. There was no relation between BC and partner spirituality and their own emotional distress, but partner's spirituality was associated with reduced occurrence of intrusive thoughts in the BC survivor. In contrast, BC survivors' spirituality was found to be wholly unrelated to partner's mental health and adjustment. CONCLUSIONS Following diagnosis and treatment, spirituality appears to associate with positive growth in BC survivors and their partners. However, BC survivor and partner spirituality seem to be ineffective at impacting the other's post-traumatic growth or emotional distress, with the exception of intrusive thoughts. Dyadic analysis takes into account the reciprocal influence of close relationships on health and is an important and under-utilized methodology in behavioral oncology research and clinical practice. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Amanda N Gesselman
- The Kinsey Institute, Indiana University, Bloomington, IN, USA.,IU Richard M. Fairbanks School of Public Health at IUPUI, Indianapolis, IN, USA
| | - Silvia M Bigatti
- IU Richard M. Fairbanks School of Public Health at IUPUI, Indianapolis, IN, USA
| | - Justin R Garcia
- The Kinsey Institute, Indiana University, Bloomington, IN, USA.,Department of Gender Studies, Indiana University, Bloomington, IN, USA
| | - Kathryn Coe
- IU Richard M. Fairbanks School of Public Health at IUPUI, Indianapolis, IN, USA
| | - David Cella
- Northwestern University, Chicago, IL, USA.,NorthShore University, Evanston, IL, USA
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McFarland DC, Andreotti C, Harris K, Mandeli J, Tiersten A, Holland J. Early Childhood Adversity and its Associations With Anxiety, Depression, and Distress in Women With Breast Cancer. PSYCHOSOMATICS 2015; 57:174-84. [PMID: 26876888 DOI: 10.1016/j.psym.2015.11.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2015] [Revised: 11/25/2015] [Accepted: 11/25/2015] [Indexed: 01/06/2023]
Abstract
BACKGROUND Certain vulnerability factors have been found to place patients at risk for depression and anxiety, especially within the context of medical illness. OBJECTIVES We sought to describe the relationships among early childhood adversity (ECA) and anxiety, depression and distress in patients with breast cancer. METHODS Patients with breast cancer (stages 0-IV) were assessed for ECA (i.e., the Risky Families Questionnaire subscales include Abuse/Neglect/Chaotic Home Environment), distress (i.e., Distress Thermometer and Problem List), anxiety (Hospital Anxiety and Depression Scale-Anxiety), depression (Hospital Anxiety and Depression Scale-Depression), meeting standardized cut-off thresholds for distress (Distress Thermometer and Problem List ≥4 or ≥7)/anxiety (Hospital Anxiety and Depression Scale-Anxiety ≥8)/depression (Hospital Anxiety and Depression Scale-Depression ≥8) and demographic factors. RESULTS A total of 125 participants completed the study (78% response rate). ECA was associated with depression (p <0.001), anxiety (p = 0.001), and distress (p = 0.006), meeting cut-off threshold criteria for distress (p = 0.024), anxiety (p = 0.048), and depression (p = 0.001). On multivariate analysis, only depression (p = 0.04) and emotional issues (i.e., component of Distress Thermometer and Problem List) (p = 0.001) were associated with ECA. Neglect, but not Abuse and Chaotic Home Environment, was associated with depression (β = 0.442, p < 0.001), anxiety (β = 0.342, p = 0.002), and self-identified problems with family (β = 0.288, p = 0.022), emotion (β = 0.345, p = 0.004), and physical issues (β = 0.408, p < 0.001). CONCLUSION ECA and neglect are associated with multiple psychologic symptoms, but most specifically depression in the setting of breast cancer. ECA contributes to psychologic burden as a vulnerability factor. ECA may help to explain individual patient trajectories and influence the provision of patient-centered care for psychologic symptoms in patients with breast cancer.
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Affiliation(s)
- Daniel C McFarland
- Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY.
| | - Charissa Andreotti
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Kirk Harris
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL
| | - John Mandeli
- Department of Preventative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Amy Tiersten
- Department of Medicine, Division of Hematology/Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai Hospital, New York, NY
| | - Jimmie Holland
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY
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Torres-Lacomba M, Sánchez-Sánchez B, Prieto-Gómez V, Pacheco-da-Costa S, Yuste-Sánchez MJ, Navarro-Brazález B, Gutiérrez-Ortega C. Spanish cultural adaptation and validation of the shoulder pain and disability index, and the oxford shoulder score after breast cancer surgery. Health Qual Life Outcomes 2015; 13:63. [PMID: 26001890 PMCID: PMC4489002 DOI: 10.1186/s12955-015-0256-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2015] [Accepted: 04/30/2015] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND The Oxford Shoulder Score (OSS) and the Shoulder Pain and Disability Index (SPADI) are patient-based outcome scores with valid psychometric properties which are widely used for shoulder interventions. OBJECTIVE The purpose of the study is to adapt both questionnaires cross-culturally to Spanish, and to test their reliability, validity, responsiveness, and feasibility. DESIGN Cultural adaptation and psychometric validation study. METHODS Consecutive patients who had undergone breast cancer surgery referred to an outpatient clinic at the University of Alcalá de Henares, Spain. One hundred and twenty women who had undergone breast cancer surgery, with pain and shoulder dysfunction. Cross-cultural adaptation was performed according to the international guidelines. Reliability was analysed by test-retest reliability and internal consistency. Content and convergent construct validity were measured by the Expert Committee's and Spearman coefficient respectively. Responsiveness, feasibility, floor and ceiling effects were also tested. RESULTS One hundred and twenty women aged 54.2 (±11) years took part in the study. The reliability was excellent; test-retest reliability was 0.974 (p < 0.001) for OSS, and 0.992 (p < 0.001) for SPADI; and Cronbach's alpha value was 0.947 for OSS, and 0.965 for SPADI. High construct validity was found between the OSS and SPADI questionnaires (r = -0.674). The effect size (ES) and standardized response mean (SRM) was moderate in OSS (ES = 0.50 and SRM = 0.70 (p < 0.001)), and moderate to good in SPADI (ES = 0.59 and SRM = 0.82 (p < 0.001)). LIMITATIONS This study has some limitations, such as the group of participants is composed only of women following breast cancer treatment; the measurement took place in a single centre; and all the questionnaires administered were always provided to the participants in the same order. CONCLUSIONS The OSS and SPADI Spanish versions are applicable, reliable, valid, and responsive to assess shoulder symptoms and quality of life in Spanish women with shoulder pain and disability after breast cancer treatment.
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Affiliation(s)
- María Torres-Lacomba
- Physiotherapy Department, Physiotherapy in Women's Health Research Group, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain.
- Faculty of Medicine and Health Sciences-University of Alcalá, Campus Externo, Ctra. Madrid-Barcelona km 33.600, Alcalá de Henares, Madrid, 28071, Spain.
| | - Beatriz Sánchez-Sánchez
- Physiotherapy Department, Physiotherapy in Women's Health Research Group, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain.
| | - Virginia Prieto-Gómez
- Physiotherapy Department, Physiotherapy in Women's Health Research Group, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain.
| | - Soraya Pacheco-da-Costa
- Physiotherapy Department, Physiotherapy in Women's Health Research Group, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain.
| | - María José Yuste-Sánchez
- Physiotherapy Department, Physiotherapy in Women's Health Research Group, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain.
| | - Beatriz Navarro-Brazález
- Physiotherapy Department, Physiotherapy in Women's Health Research Group, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain.
| | - Carlos Gutiérrez-Ortega
- Department of Epidemiology, Medical Statistics Unit, Central de la Defensa Hospital, Madrid, Madrid, Spain.
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Park JH, Bae SH, Chun M, Jung YS, Jung YM. Factors Influencing Elevated Distress Scores at the End of Primary Treatment of Breast Cancer. ASIAN ONCOLOGY NURSING 2015. [DOI: 10.5388/aon.2015.15.3.132] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Jin-Hee Park
- College of Nursing·Nursing Research Institute, Ajou University, Suwon, Korea
| | - Sun Hyoung Bae
- College of Nursing·Nursing Research Institute, Ajou University, Suwon, Korea
| | - Mison Chun
- School of Medicine, Ajou University, Suwon, Korea
| | | | - Young-Mi Jung
- College of Nursing·Nursing Research Institute, Ajou University, Suwon, Korea
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Vila Sánchez L, Font Guiteras A, Caba Vela L. Estado emocional en mujeres con cáncer de mama: variación experimentada después de una sesión psico-oncológica basada en el counselling y la psicología positiva. PSICOONCOLOGIA 1970. [DOI: 10.5209/psic.54433] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Objetivo: La mayoría de estudios sobre los beneficios de la intervención psicológica en pacientes de cáncer de mama se han centrado en los efectos acumulados después de varias sesiones terapéuticas. El objetivo de la presente investigación ha sido describir el estado emocional de las pacientes antes de la sesión y constatar el posible efecto emocional inmediato de la misma.Método: Se evaluó el estado emocional de 30 mujeres diagnosticadas de cáncer de mama, mediante un instrumento ad hoc que incluía ítems del Distress Thermometer for Patients, antes y después de una sesión de apoyo psicológico. Durante la sesión se abordaban aquellos aspectos que preocupaban a las pacientes desde un enfoque terapéutico basado en el counselling y la psicología positiva.Resultados: La media de malestar emocional experimentado durante la semana previa a la sesión era de 6,4 puntos (sobre 10) en el termómetro emocional y más de la mitad de las mujeres habían experimentado varios problemas emocionales durante ese período. Después de la sesión se redujo significativamente la intensidad de las emociones negativas con respecto al inicio de la visita y, también, el malestar emocional en comparación con la última semana. Así mismo, más de la mitad de la muestra experimentaban estados emocionales positivos. Las mejoras no se relacionaron con la situación médica ni con el número de visitas psico-oncológicas previas.Conclusiones: Ante la constatación de alivio inmediato del malestar emocional, se concluye que es adecuado derivar a todos los pacientes al servicio de psico-oncología al menos para una vista de control.
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