Gender Differences in the Use of Engagement and Disengagement Coping Strategies in Patients With Cancer Receiving Chemotherapy

The Landscape of Care for Women Veterans with Cancer: An Evidence Map

BACKGROUND

Women are the fastest growing veteran group in the US and the number of women veterans (WVs) with cancer is rising; however, little is known about this population. Cancer care for WVs is complex and it is essential to understand their unique needs and care coordination challenges to provide evidence-based care. The purpose of this review is to map the quantity, distribution, and characteristics of literature describing cancer and its treatment among WVs.

METHODS

We searched MEDLINE (via PubMed), Embase (Elsevier), and Web of Science Core Collection (Clarivate) from inception through January, 2024. Publications were eligible that reported gender-specific data on any aspect of cancer care among WVs. Data was abstracted by a single investigator with over-reading.

RESULTS

Forty-six reports were included; 44 were observational and 19 had a women-only sample. There were no interventional reports and no qualitative reports had a patient sample. Breast cancer was the most commonly addressed (n = 19). There were six additional reports on sex-specific cancers. Many reports used large VA databases or previous trial data, creating the potential for patient overlap between reports. Among VA-specific areas of interest, only three reports evaluated the potential implications of racial differences and only two included a transgender population. No reports examined the effects of toxic exposures on cancer. Within the NCI Cancer Control Continuum, crosscutting areas were more commonly represented; over half (25) of the reports addressed epidemiology. There were few reports on focus areas and little overlap between focus and crosscutting areas.

DISCUSSION

Existing literature provides an inadequate understanding of the population of WVs with cancer. There is scant information regarding the population of WVs with cancer, their care preferences or experiences, or how to best identify and address unmet healthcare needs. It is imperative to expand research to provide evidence-based care for this population.

The effectiveness of social prescribing in the management of long-term conditions in community-based adults: A systematic review and meta-analysis

OBJECTIVE

The objective of this systematic review and meta-analysis was to evaluate the effectiveness of social prescribing interventions in the management of long-term conditions in adults.

DATA SOURCES

Eleven electronic databases were searched for randomised and quasi-randomised controlled trials.

REVIEW METHODS

Outcomes of interest were quality of life, physical activity, psychological well-being and disease-specific measures. Bias was assessed with the Cochrane Risk of Bias 2 tool. A narrative synthesis and meta-analysis were performed.

RESULTS

Twelve studies (n = 3566) were included in this review. Social prescribing interventions were heterogeneous and the most common risks of bias were poor blinding and high attrition. Social prescribing interventions designed to target specific long-term conditions i.e., cancer and diabetes demonstrated significant improvements in quality of life (n = 2 studies) and disease-specific psychological outcomes respectively (n = 3 studies). There was some evidence for improvement in physical activity (n = 2 studies) but most changes were within group only (n = 4 studies). Social prescribing interventions did not demonstrate any significant changes in general psychological well-being.

CONCLUSION

Social prescribing interventions demonstrated some improvements across a range of outcomes although the quality of evidence remains poor.

Usability and Acceptability of a Videoconference Program for the Treatment of Depression in Adults With Peripheral Neuropathy

Peripheral neuropathy is a debilitating neurological disorder affecting 13% to 14% of the US population. Estimates for co-occurring mood disorders in individuals with neuropathy range from 30% to 47%, but sparse evidence exists regarding depression treatment for adults with neuropathy. A cognitive-behavioral treatment, Acceptance and commitment therapy, is known to reduce depression in people with chronic pain, but little is known about its effectiveness in adults with neuropathy, particularly when the treatment is provided via videoconference. Acceptability and usability of this therapeutic treatment provided via videoconference was assessed in participants with peripheral neuropathy and symptoms of depression. Participants completed pre- and post-self-report outcome measures: the nine-item depression scale of the Patient Health Questionnaire and the 36-item Short-Form Health Survey. They also completed the Acceptability e-Scale and Post-Study System Usability Questionnaire after treatment. Depression decreased significantly, with scores declining from an average of 9.2 to 5.1 on the Patient Health Questionnaire ( P < .05). The Short-Form Health Survey indicated significant improvement post-treatment on the "Energy/Fatigue" and "Emotional Well Being" subscales. The intervention was rated by participants as acceptable and demonstrated high usability. This initial therapeutic treatment via videoconference offers promise to treat depression in older adults with neuropathy.

Role of sex on psychological distress, quality of life, and coping of patients with advanced colorectal and non-colorectal cancer

BACKGROUND

Patients with advanced gastrointestinal cancer must cope with the negative effects of cancer and complications.

AIM

To evaluate psychological distress, quality of life, and coping strategies in patients with advanced colorectal cancer compared to non-colorectal cancer based on sex.

METHODS

A prospective, transversal, multicenter study was conducted in 203 patients; 101 (50%) had a colorectal and 102 (50%) had digestive, non-colorectal advanced cancer. Participants completed questionnaires evaluating psychological distress (Brief Symptom Inventory-18), quality of life (EORTC QLQ-C30), and coping strategies (Mini-Mental Adjustment to Cancer) before starting systemic cancer treatment.

RESULTS

The study included 42.4% women. Women exhibited more depressive symptoms, anxiety, functional limitations, and anxious preoccupation than men. Patients with non-colorectal digestive cancer and women showed more somatization and physical symptoms than subjects with colorectal cancer and men. Men with colorectal cancer reported the best health status.

CONCLUSION

The degree of disease acceptance in gastrointestinal malignancies may depend on sex and location of the primary digestive neoplasm. Future interventions should specifically address sex and tumor site differences in individuals with advanced digestive cancer.

Gender Differences in Coping, Depression, and Anxiety in Patients with Non-Metastatic Lung Cancer

Background

Depression and anxiety are prevalent issues amongst individuals suffering from thoracic cancer. Gender differences in coping with thoracic cancer have a serious impact upon the management of emotional distress. The purpose of our study has been to assess sex variations in handling anxiety and depression, including the use of coping mechanisms and their relationship with respect to anxiety and depression.

Methods

This cross-sectional study registered 18 women and 22 men with non-metastatic lung cancer and operated upon. Pre-operatively and at one month post-operatively, the patients were assessed by means of scales (COPE, GAD-7 and PHQ-9).

Results

Post-operatively, the intensity of depression and anxiety was substantially greater in males than in females (p = 0.049, p = 0.042). Male individuals tended to use coping mechanisms of humour (p = 0.009) and restraint (p = 0.029) significantly more frequently than women. Moreover, in women, depression correlated significantly with denial and behavioural deactivation (rho = 0.465, p = 0.029, respectively, rho = 0.562, p = 0.006); whilst anxiety, similarly, correlated with positive interpretation, behavioural deactivation, and use of social-emotional support (rho = 0.484, p = 0.022, respectively, rho = 0.590, p = 0.004 and rho = 0.502, p = 0.017). Furthermore, in males, depression correlated significantly with mental deactivation, use of social-instrumental and social-emotional support (rho = 0.702, p = 0.001, respectively, rho = 0.505, p=0.033, and rho = 0.773 with p < 0.001), whilst anxiety correlated significantly with mental deactivation, denial, and use of social-emotional support (rho = 0.597, p = 0.009, respectively, rho = 0.553 with p = 0.017 and rho = 0.755, p < 0.001).

Conclusion

There were gender divergences in the use of coping mechanisms and the level of post-surgical anxiety and depression. We found significant positive relationships between some coping mechanisms and depression/anxiety. The patient’s gender governs the coping style, which in turn has bearing upon the post-operative evolution.

Psychological variables associated with quality of life in patients with head and neck cancer: the role of body image distress

OBJECTIVE

The aim of this cross-sectional study was to explore the relationship between quality of life (QoL) and body image distress in patients with head and neck cancer (HNC), considering relevant psychological variables (i.e., coping strategies, social anxiety symptoms, self-esteem, intolerance of uncertainty, pain, and distress). We also aimed to explore gender differences in patients with HNC in terms of relevant psychological variables in HNC.

METHODS

Fifty-one HNC patients (37 males and 14 females) completed self-report questionnaires to assess body image distress, physical and mental QoL, and relevant psychological variables in HNC (coping strategies, social anxiety symptoms, self-esteem, intolerance of uncertainty, pain, and distress) before undergoing treatment. Pearson's correlations and four-step hierarchical regressions were performed to assess the relationship between body image distress, QoL, and the abovementioned psychological variables, while one-way analyses of variance and one-way analysis of covariance were employed to assess gender differences.

RESULTS

Physical QoL was associated with body image distress above and beyond disease duration, distress, coping strategies, pain, mental QoL, and self-esteem, while mental QoL was associated with pain above and beyond distress, coping strategies, physical QoL, self-esteem, and body image distress. Concerning gender differences, females scored higher than males on most of the explored psychological variables, except for physical QoL and intolerance of uncertainty, and showed lower mental QoL and self-esteem than males.

CONCLUSION

Body image distress and pain emerged as negatively associated with QoL, and almost all the explored psychological variables differed among genders. Psychological interventions targeting body image distress and pain should be promoted in patients with HNC to increase their QoL, while keeping gender differences in mind.

Will I or my loved one die? Concordant awareness between terminal cancer patients and their caregivers is associated with lower patient anxiety and caregiver burden

OBJECTIVE

The aims of this study were to investigate the association between patients' awareness of their terminal illness and the levels of anxiety and depression, whether the concordance between the patients' and caregivers' belief about the patient's terminal illness was associated with patient's anxiety and depression, and with the caregiver burden.

METHOD

The study recruited 31 terminally ill patients with cancer along with their caregivers from a Palliative Care Unit. All data about patients and caregivers' awareness of the illness, patients' depression and anxiety, and caregiver burden were collected.

RESULTS

Patients aware of their short-term prognosis of death showed lower levels of anxiety than the unaware ones, especially women. Aware patients with concordant caregivers showed lower levels of anxiety but not of depression. Caregivers concordant with the patients' awareness presented lower levels of strain and burden. Finally, terminal patients who had an adult child caregiver were less likely to be aware of their terminal condition.

CONCLUSIONS

It appears that illness awareness and the caregiver's concordance with the patient's belief on the terminal condition are associated with lower anxiety, especially in women, and a reduced burden for caregivers.