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Nuttall P, Fothergill A, Hemington-Gorse SJ, Dobbs TD, Tree JJ. Letter to the Editor: Confronting the psychological challenges of skin cancer: A qualitative study investigating patient's experience of a skin cancer diagnosis and support received. J Plast Reconstr Aesthet Surg 2023; 83:301-304. [PMID: 37295153 DOI: 10.1016/j.bjps.2023.05.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 05/14/2023] [Indexed: 06/12/2023]
Affiliation(s)
- Penny Nuttall
- School of Psychology, Faculty of Medicine, Health, and Life Sciences, Swansea University, United Kingdom.
| | - Alexandra Fothergill
- School of Psychology, Faculty of Medicine, Health, and Life Sciences, Swansea University, United Kingdom
| | | | - Thomas D Dobbs
- School of Psychology, Faculty of Medicine, Health, and Life Sciences, Swansea University, United Kingdom; The Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea, United Kingdom
| | - Jeremy J Tree
- School of Psychology, Faculty of Medicine, Health, and Life Sciences, Swansea University, United Kingdom
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Ebob-Anya BA, Bassah N. Psychosocial distress and the quality of life of cancer patients in two health facilities in Cameroon. Palliat Care 2022; 21:96. [PMID: 35650571 PMCID: PMC9158288 DOI: 10.1186/s12904-022-00981-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 04/14/2022] [Indexed: 11/30/2022] Open
Abstract
Background Psychosocial distress interferes with the ability to cope effectively with cancer, its physical symptoms and treatment. This in turn leads to poor outcomes in patients. Objective The aim of this study was to assess the level of psychosocial distress, emotional distress and the quality of life of cancer patients in two health facilities in Cameroon. Methods This study used a cross-sectional hospital-based design. The study was carried out over a period of three months from July–September 2020. The sample size was 120 cancer patients. A consecutive sampling technique was used to select participants. Three validated questionnaires were used: DT, HADS and EORTC QLQ-C30 to assess, psychosocial distress, emotional distress and quality of life respectively. Results were presented using descriptive (frequency, percentage, mean) and inferential statistics (Chi square, Pearson’s correlation, ANOVA). Data were analysed with SPSS version 21. All statistics were considered significant at an alpha value set at 0.05 level. Results The majority of patients 83 (69.2%) presented with clinically significant distress, with financial difficulties 87 (72.5%), fatigue 83 (69.2%), transportation 73 (60.8%) and difficulties with work/school 69(57.5%) being the most reported problems. Fifty nine (50.0%) and 56(47.5%) had moderate to severe anxiety and depression symptoms respectively. Overall on HADS, 67 patients (56.8%) presented with emotional distress. The quality of life was fair, with a mean of 52.4 ± 21.3.There was a statistically significant negative relationship (P < 0.0001), between psychosocial distress and quality of life of patients. Conclusion Cancer patients suffer from psychosocial distress, which has a negative relationship on their quality of life. It is important that healthcare professionals working in these settings, assess psychosocial distress early in patients with cancer to improve the quality of care and enhance quality of life. Supplementary Information The online version contains supplementary material available at 10.1186/s12904-022-00981-w.
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Affiliation(s)
- Bachi-Ayukokang Ebob-Anya
- Department of Nursing, Faculty of Health Sciences, University of Buea, P.O Box 63, Buea, South-West Region, Cameroon. .,Buea Regional Hospital Annex, Buea, South-West Region, Cameroon.
| | - Nahyeni Bassah
- Department of Nursing, Faculty of Health Sciences, University of Buea, P.O Box 63, Buea, South-West Region, Cameroon
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Marte C, George LS, Rutherford SC, Ouyang DJ, Martin P, Leonard JP, Trevino KM. Unmet mental health needs in patients with advanced B-cell lymphomas. Palliat Support Care 2022; 20:328-333. [PMID: 35713350 PMCID: PMC9843817 DOI: 10.1017/s1478951521001164] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
CONTEXT Existing research on psychological distress and mental health service utilization has focused on common types of solid tumor cancers, leaving significant gaps in our understanding of patients experiencing rare forms of hematologic cancers. OBJECTIVE To examine distress, quality of life, and mental health service utilization among patients with aggressive, refractory B-cell lymphomas. METHOD Patients (n = 26) with B-cell lymphomas that relapsed after first- or second-line treatment completed self-report measures of distress (Hospital Anxiety and Depression Scale) and quality of life (Short-Form Health Survey, SF-12). Patients also reported whether they had utilized mental health treatment since their cancer diagnosis. RESULTS Approximately 42% (n = 11) of patients reported elevated levels of psychological distress. Of patients with elevated distress, only one quarter (27.2%; n = 3) received mental health treatment, while more than half did not receive mental health treatment (54.5%; n = 6), and 18.1% (n = 2) did not want treatment. Patients with elevated distress reported lower mental quality of life than patients without elevated distress [F (1, 25) = 15.32, p = 0.001]. SIGNIFICANCE OF THE RESULTS A significant proportion of patients with advanced, progressive, B-cell lymphomas may experience elevated levels of distress. Yet, few of these distressed patients receive mental health treatment. Findings highlight the need to better identify and address barriers to mental health service utilization among patients with B-cell lymphoma, including among distressed patients who decline treatment.
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Affiliation(s)
| | | | | | | | - Peter Martin
- Weill Cornell Medicine, New York, NY
- New York Presbyterian, New York, NY
| | - John P Leonard
- Weill Cornell Medicine, New York, NY
- New York Presbyterian, New York, NY
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Early stage melanoma diagnosis and mental health-related: emotional influence of body self-perception. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021. [DOI: 10.1016/j.jadr.2021.100188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Wiens L, Schäffeler N, Eigentler T, Garbe C, Forschner A. Psychological Distress of Metastatic Melanoma Patients during Treatment with Immune Checkpoint Inhibitors: Results of a Prospective Study. Cancers (Basel) 2021; 13:2642. [PMID: 34072206 PMCID: PMC8198252 DOI: 10.3390/cancers13112642] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 05/19/2021] [Accepted: 05/25/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Immune checkpoint inhibitors (ICI) provide effective treatment options for advanced melanoma patients. However, they are associated with high rates of immune-related side effects. There are no data on the distress of melanoma patients during their ICI treatment. We, therefore, conducted a prospective longitudinal study to assess distress and the need for psycho-oncological support in these patients. METHODS Questionnaires were completed before initiation of ICI (T0), after 6-8 weeks (T1), and after 12-14 weeks (T2). We furthermore included the Hornheide Screening Instrument (HSI), distress thermometer (DT), and patients' self-assessment. Binary logistic regression was performed to identify factors indicating a need for psychooncological support. RESULTS 36.3%/55.8% (HSI / DT) of the patients were above the threshold, indicating a need for psychooncological support at T0, and 7.8% of the patients reported practical problems. In contrast, at T2, the distress values had decreased to 29.0%/40.2% (HSI/DT), respectively. Female gender and occurrence of side effects significantly correlated to values above the threshold. The strongest factor was the patient's self-assessment. CONCLUSION With the beginning of ICI, psychooncological support should be offered. Furthermore, practical problems should be considered, e.g., transport to therapy. Female patients and patients with side effects should be given special attention, as well as the patient self-assessment.
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Affiliation(s)
- Lisa Wiens
- Department of Dermatology, University Hospital Tübingen, 72076 Tübingen, Germany; (L.W.); (T.E.); (C.G.)
| | - Norbert Schäffeler
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, 72076 Tübingen, Germany;
| | - Thomas Eigentler
- Department of Dermatology, University Hospital Tübingen, 72076 Tübingen, Germany; (L.W.); (T.E.); (C.G.)
| | - Claus Garbe
- Department of Dermatology, University Hospital Tübingen, 72076 Tübingen, Germany; (L.W.); (T.E.); (C.G.)
| | - Andrea Forschner
- Department of Dermatology, University Hospital Tübingen, 72076 Tübingen, Germany; (L.W.); (T.E.); (C.G.)
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El Abbadi S, Susok L, Stockfleth E, Bechara FG, Gambichler T, Herbrandt S, Goldschmidtböing L, Sand M. Comparison of the Skin Cancer Quality of Life Impact Tool and the Skin Cancer Index Questionnaire in Measurement of Health-Related Quality of Life and the Effect of Patient Education Brochures in Patients with Actinic Keratosis, Non-melanoma Skin Cancer, and Cutaneous Melanoma. Dermatol Ther (Heidelb) 2021; 11:929-940. [PMID: 33847880 PMCID: PMC8163937 DOI: 10.1007/s13555-021-00522-y] [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: 12/07/2020] [Accepted: 03/26/2021] [Indexed: 12/03/2022] Open
Abstract
Introduction Few studies have evaluated patient-reported outcome measures and the effect of patient educational materials in German patients with skin cancer. We conducted a prospective study to measure the impact of treatment on health-related quality of life in German patients with skin cancer, identify variables that may contribute to changes in health-related quality of life, and evaluate the effect of providing additional information through a patient education brochure. Methods A total of 461 patients diagnosed with actinic keratosis, nonmetastatic nonmelanoma skin cancer, melanoma in situ, or nonmetastatic cutaneous melanoma treated between August 2018 and July 2020 were included. Ninety-seven patients were randomly selected to receive an additional patient education brochure (“Hautkrebs”). The patients completed a Skin Cancer Quality of Life Index Tool (n = 324) or a Skin Cancer Index Questionnaire (n = 137) 1 week after surgical treatment. Results Ninety-seven patients were provided an additional patient education brochure. We found statistical correlation between sociodemographic factors (young age and female gender) and the location of the skin cancer (head and face) and impairment of health-related quality of life in patients with skin cancer (p < 0.05). Moreover, we found that patients who were presented a brochure showed significantly higher awareness concerning direct sun exposure (p < 0.05). Conclusion Impaired health-related quality of life is correlated with a patient with skin cancer’s age, gender, and the location of the lesion. Physicians should consider these factors in clinical practice and advocate the use of patient education brochures as effective assets in preventing the reoccurrence of skin cancer.
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Affiliation(s)
- Sam El Abbadi
- Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital OWL, Campus Klinikum Bielefeld Center, Bielefeld, Germany
| | - Laura Susok
- Department of Dermatology, Venereology and Allergology, Ruhr-University Bochum, Bochum, Germany
| | - Egger Stockfleth
- Department of Dermatology, Venereology and Allergology, Ruhr-University Bochum, Bochum, Germany
| | - Falk Georges Bechara
- Department of Dermatology, Venereology and Allergology, Ruhr-University Bochum, Bochum, Germany
| | - Thilo Gambichler
- Department of Dermatology, Venereology and Allergology, Ruhr-University Bochum, Bochum, Germany
| | - Swetlana Herbrandt
- Department for Statistical Consulting and Analysis, Center for Higher Education, Technical University of Dortmund, Dortmund, Germany
| | - Lisa Goldschmidtböing
- Department for Statistical Consulting and Analysis, Center for Higher Education, Technical University of Dortmund, Dortmund, Germany
| | - Michael Sand
- Department of Dermatology, Venereology and Allergology, Ruhr-University Bochum, Bochum, Germany. .,Department of Plastic, Reconstructive and Aesthetic Surgery, St. Josef Hospital, Essen, Germany.
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Fu H, Teleni L, Crichton M, Chan RJ. Supportive care and unmet needs in patients with melanoma: a mixed-methods systematic review. Support Care Cancer 2020; 28:3489-3501. [DOI: 10.1007/s00520-020-05464-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 04/08/2020] [Indexed: 12/12/2022]
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Mori S, Blank NR, Connolly KL, Dusza SW, Nehal KS, Rossi AM, Lee EH. Association of Quality of Life With Surgical Excision of Early-Stage Melanoma of the Head and Neck. JAMA Dermatol 2019; 155:85-89. [PMID: 30422228 DOI: 10.1001/jamadermatol.2018.3409] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Importance Surgical excision is the standard-of-care treatment for Tis and T1a melanomas of the head and neck. Currently, however, the association of diagnosis and surgical treatment of these typically slowly progressive and nonfatal melanomas with a patient's health-related quality of life (HRQoL) is unknown. Objective To characterize and assess HRQoL in patients with Tis and T1a head and neck melanoma, evaluate changes in HRQoL over the surgical treatment course, and identify patient characteristics associated with lower HRQoL. Design, Setting, and Participants This longitudinal, prospective cohort study involved patients with Tis or T1a melanoma of the head and neck who underwent staged excision at a single tertiary care center (Memorial Sloan Kettering Cancer Center, New York, New York) and were recruited from June 1, 2016, to February 28, 2017. Patients were followed up for 1 year after their surgical procedure. Participants were asked to complete 2 patient-reported outcome measure questionnaires, Skindex-16 and Skin Cancer Index (SCI), at 4 time points: baseline, perioperative (1 to 2 weeks after surgery), and 6-month and 1-year follow-up. Main Outcomes and Measures Scores on the Skindex-16 and SCI questionnaires. Results In total, 56 patients were included in the study, among whom 24 (43%) were female and 32 (57%) were male, with a mean (range) age of 67.2 (32-88) years; all patients self-identified as white. Forty-one (73%) questionnaires at perioperative, 49 (88%) at 6-month postoperative, and 41 (73%) at 1-year postoperative time points were completed. At baseline, female patients and those younger than 65 years had statistically significantly worse HRQoL on the Skindex-16 questionnaire (mean score, 14.2 [95% CI, 9.1-21.9] and 16.1 [95% CI, 9.8-26.4]) and on the SCI questionnaire (mean score, 57.2 [95% CI, 48.3-67.6] and 53.2 [95% CI, 44.1-64.3]) compared with males (mean Skindex-16 score, 7.0 [95% CI, 4.8-10.3]; mean SCI score, 73.5 [95% CI, 66.0-81.7]) and those aged 65 years or older (mean Skindex-16 score 7.1 [95% CI, 5.0-10.0]; mean SCI score, 74.3 [95% CI, 67.7-81.6]). Questions that demonstrated the worst scores at baseline were worry about skin condition (Skindex-16) and worry about future skin cancers (SCI). The emotions subscale scores on the Skindex-16 questionnaire showed the greatest improvement from baseline to 1-year follow-up levels (26.6 vs 15.3; P < .001) and so did the appearance subscale scores on the SCI questionnaire (64.0 vs 84.6; P < .001). The score difference in HRQoL by sex diminished over time, whereas the score difference by age persisted through the first year. Conclusions and Relevance Improvement in HRQoL at the 6-month and 1-year follow-up was associated with surgical excision in patients with early-stage head and neck melanoma, and younger and female patients experienced worse HRQoL. These results may be used in tailoring counseling for this patient population.
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Affiliation(s)
- Shoko Mori
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, New York.,State University of New York Downstate College of Medicine, Brooklyn, New York
| | - Nina R Blank
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Karen L Connolly
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Stephen W Dusza
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Kishwer S Nehal
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Anthony M Rossi
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Erica H Lee
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, New York
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Abstract
BACKGROUND Psycho-oncological care is a main component of comprehensive oncological care as stated in the National Cancer Plan of the German Federal Government. Correspondingly this goal has been adopted in the strategy of the German Skin Cancer Council. In certified skin cancer centers structural requirements for psycho-oncological care are established. Nevertheless, a large proportion of skin cancer patients are treated in dermatological practices. Up to now data on psycho-oncological care in dermatological practices are missing. MATERIALS UND METHODS We conducted a descriptive cross-sectional written survey on psycho-oncological care in dermatological practices from October 2016 to February 2017. RESULTS In all, 171 practices completed the questionnaire; 19.4% of these practices have an oncological focus. The mean number of treated skin cancer patients was 554.3 ± 659.1 and 62.4 ± 73.6 for melanoma patients. Dermatologists estimated a low proportion (≤5%) of patients with need for psycho-oncological care; however, 21.9% of practices actively offer information on psycho-oncological programs and 26.1% cooperate with psycho-oncological care providers. Interest in psycho-oncological care concepts was stated by 29.3%. CONCLUSIONS Psycho-oncological care is only occasionally and partly deficiently provided in dermatological practices including referral to psycho-oncological care professionals. The results emphasize the necessity to raise awareness regarding psycho-oncological needs of skin cancer patients and to integrate psycho-oncological counselling into clinical routine in dermatological practices.
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Meiss F, Loquai C, Weis J, Giesler JM, Reuter K, Nashan D. Psycho-oncological care of melanoma patients in certified skin cancer centers. J Dtsch Dermatol Ges 2019; 16:576-582. [PMID: 29750461 DOI: 10.1111/ddg.13521] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 11/02/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND The establishment und certification of skin cancer centers (SCCs) in compliance with requirements issued by the German Cancer Society play a key role for quality-assured treatment of skin cancer patients. These requirements also call for the implementation of a qualified psycho-oncology program. When planning the present study, we assumed site-specific differences in the way such programs were implemented at various SCCs. METHODS In 2014, we conducted a cross-sectional survey of all SCCs certified at the time (n = 43), in which these institutions were asked to provide information on the structural and process quality of their psycho-oncology programs. RESULTS Overall, 81.4 % of certified SCCs (n = 35) participated in the survey. Thirty-seven percent of SCCs directly employed personnel trained in psycho-oncology. Nearly all facilities offered information/counseling, crisis intervention, one-on-one discussions, and palliative/end-of-life care as part of their psycho-oncology program. Standardized screening tools were commonly used to evaluate patients' need for psycho-oncological support. Eighty-three percent of psycho-oncology programs primarily focused on inpatients. On average, 25.2 % of melanoma patients received psycho-oncological support. Ninety-seven percent of SCCs stated that the certification requirements had actually improved the psycho-oncological care of their patients. Seventy-one percent of SCCs reported to be satisfied with the implementation of the requirements. CONCLUSIONS The certification of institutions as SCCs has led to the implementation of personnel, structural, and content requirements relating to psycho-oncological care. The majority of SCCs surveyed reported to be satisfied with the quality of care thus achieved.
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Affiliation(s)
- Frank Meiss
- Department of Dermatology and Venereology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Carmen Loquai
- Department of Dermatology, University Medical Center Mainz, Mainz, Germany
| | - Joachim Weis
- Chair of Selfhelp Research, Comprehensive Cancer Center, University Medical Center Freiburg, Medical Faculty, University Freiburg, Freiburg, Germany
| | - Jürgen M Giesler
- Institute of Medical Biometry and Statistics, Section for Health Care Research and Rehabilitation Research, University Medical Center Freiburg, University of Freiburg, Freiburg, Germany
| | - Katrin Reuter
- Group Practice for Psychotherapy and Psychooncology (PPPO), Stadtstraße 11, Freiburg, Germany
| | - Dorothée Nashan
- Medical Center Dortmund, Department of Dermatology, Dortmund, Germany
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Tibubos AN, Ernst M, Brähler E, Fischbeck S, Hinz A, Blettner M, Zeissig SR, Weyer V, Imruck BH, Binder H, Beutel ME. Fatigue in survivors of malignant melanoma and its determinants: a register-based cohort study. Support Care Cancer 2019; 27:2809-2818. [PMID: 30539313 DOI: 10.1007/s00520-018-4587-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 12/05/2018] [Indexed: 10/27/2022]
Abstract
PURPOSE Fatigue has found increasing attention as a debilitating and lasting condition of cancer patients. However, it has remained unclear to what degree long-term survivors of malignant melanoma suffer from fatigue. Therefore, this study aimed to determine fatigue and its link with quality of life, aftercare behavior, and mental and physical symptoms among melanoma survivors. METHODS A register-based sample of 684 long-term survivors an average of 8.4 (SD = 1.72; range 5.67-12.17) years after diagnosis was compared to 2049 participants from a representative survey by the Multidimensional Fatigue Inventory. In a hierarchical linear regression, statistical predictors for fatigue were ascertained. RESULTS Overall fatigue was not increased in melanoma survivors except for younger melanoma survivors under 40 years. As in the general population, fatigue increased with age, and it was higher in women compared to men. Fatigue was associated with decreased quality of life, reduced functioning, and increased physical and mental symptoms. Substantial predictors (30% explained variance) were higher age, additional chronic illness, self-blame, detrimental interactions and lack of social support, and also fear of recurrence. There was neither an effect of medical parameters (clinical stage, time since diagnosis) nor of participation in follow-up care. CONCLUSIONS Fatigue needs to be taken seriously in the aftercare of melanoma survivors as it is associated with multiple functional and quality of life impairments and heightened distress. Reduction of fatigue in melanoma patients should address younger survivors (under 40 years) and older survivors (over 60 years) with additional chronic illness and focus on illness coping and social support.
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Affiliation(s)
- Ana Nanette Tibubos
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Untere Zahlbacher Str. 8, 55131, Mainz, Germany.
| | - Mareike Ernst
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Untere Zahlbacher Str. 8, 55131, Mainz, Germany
| | - Elmar Brähler
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Untere Zahlbacher Str. 8, 55131, Mainz, Germany
| | - Sabine Fischbeck
- Department of Psychosomatic Medicine and Psychotherapy, Medical Psychology and Medical Sociology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Andreas Hinz
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Maria Blettner
- Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg-University, Institute for Medical Biostatistics, Mainz, Germany
- Cancer Registry of Rhineland Palatinate, Mainz, Germany
| | - Sylke R Zeissig
- Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg-University, Institute for Medical Biostatistics, Mainz, Germany
- Cancer Registry of Rhineland Palatinate, Mainz, Germany
| | - Veronika Weyer
- Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg-University, Institute for Medical Biostatistics, Mainz, Germany
| | - Barbara H Imruck
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Untere Zahlbacher Str. 8, 55131, Mainz, Germany
| | - Harald Binder
- Faculty of Medicine and Medical Center - University of Freiburg, Institute of Medical Biometry and Statistics (IMBI), Freiburg im Breisgau, Germany
| | - Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Untere Zahlbacher Str. 8, 55131, Mainz, Germany
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Long-Term Survival, Quality of Life, and Psychosocial Outcomes in Advanced Melanoma Patients Treated with Immune Checkpoint Inhibitors. JOURNAL OF ONCOLOGY 2019; 2019:5269062. [PMID: 31182961 PMCID: PMC6512024 DOI: 10.1155/2019/5269062] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Accepted: 03/25/2019] [Indexed: 12/17/2022]
Abstract
Immune checkpoint inhibitors have become a standard of care option for the treatment of patients with advanced melanoma. Since the approval of the first immune checkpoint (CTLA-4) inhibitor ipilimumab in 2011 and programmed death-1 (PD-1) blocking monoclonal antibodies pembrolizumab and nivolumab thereafter, an increasing proportion of patients with unresectable advanced melanoma achieved long-term overall survival. Little is known about the psychosocial wellbeing, neurocognitive function, and quality of life (QOL) of these survivors. Knowledge about the long term side-effects of these novel treatments is scarce as long-term survivorship is a novel issue in the field of immunotherapy. The purpose of this review is to summarize our current knowledge regarding the survival and safety results of pivotal clinical trials in the field of advanced melanoma and to highlight potential long-term consequences that are likely to impact psychosocial wellbeing, neurocognitive functioning, and QOL. The issues raised substantiate the need for clinical investigation of these issues with the aim of optimizing comprehensive health care for advanced melanoma survivors.
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Russell L, Ugalde A, Orellana L, Milne D, Krishnasamy M, Chambers R, Austin DW, Livingston PM. A pilot randomised controlled trial of an online mindfulness-based program for people diagnosed with melanoma. Support Care Cancer 2018; 27:2735-2746. [DOI: 10.1007/s00520-018-4574-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 11/22/2018] [Indexed: 11/30/2022]
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Krajewski C, Benson S, Elsenbruch S, Schadendorf D, Livingstone E. Predictors of quality of life in melanoma patients 4 years after diagnosis: Results of a nationwide cohort study in Germany. J Psychosoc Oncol 2018; 36:734-753. [PMID: 30321123 DOI: 10.1080/07347332.2018.1499691] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
In this multicenter, cross-sectional study, 561 melanoma patients completed a questionnaire battery 4 years after primary diagnosis. The proportion of melanoma patients with clinically relevant anxiety (p < .001) or depression (p = .001) symptoms was significantly greater compared to the general population. Lower QoL was predicted by higher depression (ß = -.329, p < .001) and anxiety (ß = -.257, p < .001), older age (ß = -.147, p = .002), and body mass index (ß = -.093, p = .036). Clinical parameters including tumor stage and comorbidity index did not enter the model. Overall, the model explained 32.2% of total variance (F = 43.66, p < .001, corrected R2 = .322). The proportion of patients with clinically relevant anxiety symptoms requires attention. Anxiety and depression symptoms contribute to impaired QoL, calling for appropriate screening.
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Affiliation(s)
- Christin Krajewski
- a Institute of Medical Psychology and Behavioral Immunobiology , University Hospital Essen, University of Duisburg-Essen , Essen , Germany
| | - Sven Benson
- a Institute of Medical Psychology and Behavioral Immunobiology , University Hospital Essen, University of Duisburg-Essen , Essen , Germany
| | - Sigrid Elsenbruch
- a Institute of Medical Psychology and Behavioral Immunobiology , University Hospital Essen, University of Duisburg-Essen , Essen , Germany
| | - Dirk Schadendorf
- b Department of Dermatology , University Hospital Essen, University of Duisburg-Essen , Essen , Germany
| | - Elisabeth Livingstone
- b Department of Dermatology , University Hospital Essen, University of Duisburg-Essen , Essen , Germany
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15
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Buchhold B, Arnold A, Lutze S, Jülich A, Winkler M, Bahlmann J, Eggert C, Jünger M, Hannich HJ. Psychosocial distress and desire for support among inpatients with skin cancer. J Dtsch Dermatol Ges 2018; 15:791-799. [PMID: 28763595 DOI: 10.1111/ddg.13294] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Accepted: 03/23/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND Regular assessment of psychosocial distress is an important component of adequate psycho-oncological and social support in cancer patients. To date, relevant studies on skin cancer patients have primarily included individuals with melanoma. OBJECTIVES (1) Does the need for psychosocial support vary with the type of skin cancer? (2) Do mentally distressed patients desire support? (3) From the various individuals in the treatment team, whom do patients choose as potential contact person? PATIENTS UND METHODS Inpatients with skin cancer were asked to self-assess their psychosocial situation using the Hornheide questionnaire. In addition, they were asked about their desire for psychosocial support and the preferred potential contact person. RESULTS The need for support among the 116 patients surveyed varied significantly depending on the diagnosis (p = 0.007). However, the direct comparison between patients with melanoma (n = 38; 32.8 %) and squamous cell carcinoma (n = 9; 7.8 %) (p = 0.724) or other types of skin cancer (n = 20; 17.2 %) (p = 0.366) revealed no such difference. The prevalence of psychosocial distress (n = 49; 42.2 %) and the desire for support (n = 20; 17.4 %) showed considerable differences. Patients primarily chose a physician (n = 14/35) or a psychologist (n = 13/35) as potential "go-to" person for their mental distress. CONCLUSIONS Apart from psychosocial distress, the desire for support should be assessed, and patients should be provided access to additional psychosocial care options. With respect to the need for psychosocial support, it does not seem to be justified to preferentially - or even exclusively - consider melanoma patients in clinical practice and research.
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Affiliation(s)
- Britta Buchhold
- Institute of Medical Psychology, Greifswald University School of Medicine
| | - Andreas Arnold
- Department of Dermatology, Greifswald University School of Medicine
| | - Stine Lutze
- Department of Dermatology, Greifswald University School of Medicine
| | - Andreas Jülich
- Department of Internal Medicine (C), Greifswald University School of Medicine
| | | | - Johannes Bahlmann
- Department of Psychiatry and Psychotherapy, HELIOS Hanse-Klinikum Stralsund
| | - Claudia Eggert
- Department of Dermatology, Greifswald University School of Medicine
| | - Michael Jünger
- Department of Dermatology, Greifswald University School of Medicine
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16
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Buchhold B, Lutze S, Arnold A, Jülich A, Daeschlein G, Wendler M, Jünger M, Hannich HJ. Psychosoziale Belastung und Unterstützungswunsch von Hauttumorpatienten - Einfluss des Behandlungs-Settings. J Dtsch Dermatol Ges 2018; 16:861-872. [PMID: 29989378 DOI: 10.1111/ddg.13578_g] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 12/29/2017] [Indexed: 11/27/2022]
Affiliation(s)
- Britta Buchhold
- Universitätsmedizin Greifswald, Institut für Medizinische Psychologie
| | - Stine Lutze
- Universitätsmedizin Greifswald, Klinik und Poliklinik für Hautkrankheiten
| | - Andreas Arnold
- Universitätsmedizin Greifswald, Klinik und Poliklinik für Hautkrankheiten
| | - Andreas Jülich
- Universitätsmedizin Greifswald, Klinik und Poliklinik für Innere Medizin C
| | - Georg Daeschlein
- Universitätsmedizin Greifswald, Klinik und Poliklinik für Hautkrankheiten
| | - Martin Wendler
- Universitätsmedizin Greifswald, Institut für Mathematik und Informatik
| | - Michael Jünger
- Universitätsmedizin Greifswald, Klinik und Poliklinik für Hautkrankheiten
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17
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Buchhold B, Lutze S, Arnold A, Jülich A, Daeschlein G, Wendler M, Juenger M, Hannich HJ. Psychosocial distress and desire for support among skin cancer patients - impact of treatment setting. J Dtsch Dermatol Ges 2018; 16:861-871. [DOI: 10.1111/ddg.13578] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 12/29/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Britta Buchhold
- Institute of Medical Psychology; University Medical Center; Greifswald Germany
| | - Stine Lutze
- Department of Dermatology; University Medical Center; Greifswald Germany
| | - Andreas Arnold
- Department of Dermatology; University Medical Center; Greifswald Germany
| | - Andreas Jülich
- Department of Internal Medicine C; University Medical Center; Greifswald Germany
| | - Georg Daeschlein
- Department of Dermatology; University Medical Center; Greifswald Germany
| | - Martin Wendler
- Institute of Mathematics and Computer Science; University Medical Center; Greifswald Germany
| | - Michael Juenger
- Department of Dermatology; University Medical Center; Greifswald Germany
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18
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Meiss F, Loquai C, Weis J, Giesler JM, Reuter K, Nashan D. Psychoonkologische Versorgung von Melanompatienten in zertifizierten Hautkrebszentren. J Dtsch Dermatol Ges 2018; 16:577-584. [PMID: 29750470 DOI: 10.1111/ddg.13521_g] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 11/02/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Frank Meiss
- Klinik für Dermatologie und Venerologie, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Freiburg im Breisgau
| | - Carmen Loquai
- Hautklinik und Poliklinik, Universitätsmedizin Mainz, Mainz
| | - Joachim Weis
- Professur Selbsthilfeforschung, Comprehensive Cancer Center, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert Ludwigs Universität Freiburg im Breisgau
| | - Jürgen M Giesler
- Institut für Medizinische Biometrie und Statistik, Sektion Versorgungsforschung und Rehabilitationsforschung, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Freiburg im Breisgau
| | - Katrin Reuter
- Praxengemeinschaft für Psychotherapie und Psychoonkologie (PPPO), Stadtstraße 11, Freiburg im Breisgau
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19
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Stonelake-French H, Moos BE, Brueggen CM, Gravemann EL, Hansen AL, Voll JM, Dose AM. Understanding Distress in the Hospital: A Qualitative Study Examining Adults With Cancer. Oncol Nurs Forum 2018; 45:206-216. [PMID: 29466351 DOI: 10.1188/18.onf.206-216] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To measure the distress of hospitalized adults with cancer and identify strategies and behaviors to manage distress.
. PARTICIPANTS & SETTING 185 adults with cancer hospitalized in a large tertiary hospital in the Midwest.
. METHODOLOGIC APPROACH This study involved a one-time assessment using the National Comprehensive Cancer Network's (NCCN's) Distress Thermometer and two open-ended questions. Demographic data were reviewed, and responses to open-ended questions were analyzed by content analysis. A team approach was used to develop and validate themes.
. FINDINGS Strategies used by patients to manage distress were categorized as taking charge and embracing help. Helpful strategies were related to quality of life and relationship with care teams.
. IMPLICATIONS FOR NURSING Understanding of distress in hospitalized adults with cancer is limited, which warrants the attention of healthcare professionals. Study results have implications to enhance patient care and to address nationally established psychosocial care objectives and NCCN distress screening standards.
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20
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Dieng M, Kasparian NA, Mireskandari S, Butow P, Costa D, Morton R, Mann G, Menzies S, Cust A. Psychoeducational intervention for people at high risk of developing another melanoma: a pilot randomised controlled trial. BMJ Open 2017; 7:e015195. [PMID: 29018064 PMCID: PMC5652456 DOI: 10.1136/bmjopen-2016-015195] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Information and psychological needs have been reported as one of the greatest areas of unmet needs for patients with melanoma. To respond to these needs, we developed the Melanoma Care Intervention, a developed psychoeducational intervention for people at high risk of developing another melanoma comprising of a newly developed melanoma educational booklet and individually tailored telephone support sessions provided by trained psychologists. The purpose of this study was to investigate the acceptability and feasibility of the Melanoma Care Intervention. METHODS Twenty-four adults (14 men, 10 women, mean age: 58 years, SD: 12.2) at high risk of developing a subsequent primary melanoma were recruited and randomly assigned 1:1 to the intervention (a psychoeducational booklet, a Cancer Council booklet on melanoma and up to five telephone-based sessions with a psychologist) or usual care (Cancer Council booklet only). Acceptability, feasibility, fear of cancer recurrence and secondary psychosocial outcomes were assessed at baseline, 1 and 6 months. RESULTS Satisfaction and perceived benefits were rated highly for all intervention components, particularly the telephone-based psychology sessions (mean satisfaction and benefits: both 9.27 out of 10, SD=2.41). The quality of information and support provided throughout the trial was rated as 'high' by the intervention group, with a mean score of 4.6 out of a possible 5 (SD=0.9) and 4.2 (SD=1.2) for the control group. CONCLUSIONS The intervention was feasible and acceptable for improving psychological adjustment. Timely access to effective, evidence-based, psychological care is a recognised need for people with melanoma. The intervention is designed to directly address this need in a way that is feasible in a clinical setting, acceptable to patients and health professionals. TRIAL REGISTRATION NUMBER The trial was registered with the Australian and New Zealand Clinical Trials Registry on 19/03/2013 (Registration Number: ACTRN12613000304730).
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Affiliation(s)
- Mbathio Dieng
- Cancer Epidemiology and Prevention Research, Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
- NHMRC Clinical Trials Centre, University of Sydney, Camperdown, Australia
| | - N A Kasparian
- Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, The University of New South Wales, Sydney, Australia
| | - Shab Mireskandari
- Centre for Medical Psychology & Evidence-based Decision-making, The University of Sydney, Sydney, New South Wales, Australia
| | - Phyllis Butow
- Psycho-oncology Co-operative Research Group, School of Psychology, The University of Sydney, Sydney, New South Wales, Australia
| | - Daniel Costa
- Pain Management Research Institute, University of Sydney at Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | - Rachael Morton
- NHMRC Clinical Trials Centre, University of Sydney, Camperdown, Australia
| | - Graham Mann
- Centre for Cancer Research, Westmead Institute for Medical Research, The University of Sydney, Westmead, Australia
- Melanoma Institute Australia, The University of Sydney, North Sydney, Australia
| | - Scott Menzies
- Discipline of Dermatology, Sydney Medical School, The University of Sydney, Camperdown, Australia
- The Sydney Melanoma Diagnostic Centre, Royal Prince Alfred Hospital, Camperdown, Australia
| | - Anne Cust
- Cancer Epidemiology and Prevention Research, Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
- Centre for Cancer Research, Westmead Institute for Medical Research, The University of Sydney, Westmead, Australia
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21
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Mayer S, Teufel M, Schaeffeler N, Keim U, Garbe C, Eigentler TK, Zipfel S, Forschner A. The need for psycho-oncological support for melanoma patients: Central role of patients' self-evaluation. Medicine (Baltimore) 2017; 96:e7987. [PMID: 28906378 PMCID: PMC5604647 DOI: 10.1097/md.0000000000007987] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Despite an increasing number of promising treatment options, only a limited number of studies concerning melanoma patients' psycho-oncological distress have been carried out. However, multiple screening tools are in use to assess the need for psycho-oncological support. This study aimed first to identify parameters in melanoma patients that are associated with a higher risk for being psycho-oncologically distressed and second to compare patients' self-evaluation concerning the need for psycho-oncological support with the results of established screening tools.We performed a cross-sectional study including 254 melanoma patients from the Center for Dermatooncology at the University of Tuebingen. The study was performed between June 2010 and February 2013. Several screening instruments were included: the Distress Thermometer (DT), Hospital Anxiety and Depression Scale and the patients' subjective evaluation concerning psycho-oncological support. Binary logistic regression was performed to identify factors that indicate the need for psycho-oncological support.Patients' subjective evaluation concerning the need for psycho-oncological support, female gender, and psychotherapeutic or psychiatric treatment at present or in the past had the highest impact on values above threshold in the DT. The odds ratio of patients' self-evaluation (9.89) was even higher than somatic factors like female gender (1.85), duration of illness (0.99), or increasing age (0.97). Patients' self-evaluation concerning the need for psycho-oncological support indicated a moderate correlation with the results of the screening tools included.In addition to the results obtained by screening tools like the DT, we could demonstrate that patients' self-evaluation is an important instrument to identify patients who need psycho-oncological support.
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Affiliation(s)
- Simone Mayer
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital, Tuebingen
| | - Martin Teufel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital, Tuebingen
- Department of Psychosomatic Medicine and Psychotherapy, LVR-University-Hospital, University Duisburg-Essen, Essen
| | - Norbert Schaeffeler
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital, Tuebingen
| | - Ulrike Keim
- Department of Dermatology, University Hospital, Tuebingen, Germany
| | - Claus Garbe
- Department of Dermatology, University Hospital, Tuebingen, Germany
| | | | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital, Tuebingen
| | - Andrea Forschner
- Department of Dermatology, University Hospital, Tuebingen, Germany
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22
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Buchhold B, Arnold A, Lutze S, Jülich A, Winkler M, Bahlmann J, Eggert C, Jünger M, Hannich HJ. Stationäre Hauttumorpatienten - Psychosoziale Belastung und Unterstützungswunsch. J Dtsch Dermatol Ges 2017; 15:791-800. [PMID: 28763602 DOI: 10.1111/ddg.13294_g] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Accepted: 03/23/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Britta Buchhold
- Institut für Medizinische Psychologie, Universitätsmedizin Greifswald
| | - Andreas Arnold
- Klinik und Poliklinik für Hautkrankheiten, Universitätsmedizin Greifswald
| | - Stine Lutze
- Klinik und Poliklinik für Hautkrankheiten, Universitätsmedizin Greifswald
| | - Andreas Jülich
- Klinik und Poliklinik für Innere Medizin C, Universitätsmedizin Greifswald
| | | | - Johannes Bahlmann
- Klinik für Psychiatrie und Psychotherapie, HELIOS Hanse-Klinikum Stralsund
| | - Claudia Eggert
- Klinik und Poliklinik für Hautkrankheiten, Universitätsmedizin Greifswald
| | - Michael Jünger
- Klinik und Poliklinik für Hautkrankheiten, Universitätsmedizin Greifswald
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23
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Psychological characteristics of early-stage melanoma patients: a cross-sectional study on 204 patients. Melanoma Res 2017; 27:277-280. [DOI: 10.1097/cmr.0000000000000348] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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24
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Rocque GB, Taylor RA, Acemgil A, Li X, Pisu M, Kenzik K, Jackson BE, Halilova KI, Demark-Wahnefried W, Meneses K, Li Y, Martin MY, Chambless C, Lisovicz N, Fouad M, Partridge EE, Kvale EA. Guiding Lay Navigation in Geriatric Patients With Cancer Using a Distress Assessment Tool. J Natl Compr Canc Netw 2016; 14:407-14. [PMID: 27059189 DOI: 10.6004/jnccn.2016.0047] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 01/27/2016] [Indexed: 12/30/2022]
Abstract
BACKGROUND There is growing interest in psychosocial care and evaluating distress in patients with cancer. As of 2015, the Commission on Cancer requires cancer centers to screen patients for distress, but the optimal approach to implementation remains unclear. METHODS We assessed the feasibility and impact of using distress assessments to frame lay navigator interactions with geriatric patients with cancer who were enrolled in navigation between January 1, 2014, and December 31, 2014. RESULTS Of the 5,121 patients enrolled in our lay patient navigation program, 4,520 (88%) completed at least one assessment using a standardized distress tool (DT). Navigators used the tool to structure both formal and informal distress assessments. Of all patients, 24% reported distress scores of 4 or greater and 5.5% reported distress scores of 8 or greater. The most common sources of distress at initial assessment were pain, balance/mobility difficulties, and fatigue. Minority patients reported similar sources of distress as the overall program population, with increased relative distress related to logistical issues, such as transportation and financial/insurance questions. Patients were more likely to ask for help with questions about insurance/financial needs (79%), transportation (76%), and knowledge deficits about diet/nutrition (76%) and diagnosis (66%) when these items contributed to distress. CONCLUSIONS Lay navigators were able to routinely screen for patient distress at a high degree of penetration using a structured distress assessment.
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Affiliation(s)
- Gabrielle B Rocque
- University of Alabama at Birmingham Comprehensive Cancer Center,Hematology and Oncology, University of Alabama at Birmingham School of Medicine
| | - Richard A Taylor
- University of Alabama at Birmingham Comprehensive Cancer Center,Preventive Medicine, University of Alabama at Birmingham School of Medicine
| | - Aras Acemgil
- University of Alabama at Birmingham Comprehensive Cancer Center,University of Alabama at Birmingham School of Nursing
| | - Xuelin Li
- University of Alabama at Birmingham School of Nursing
| | - Maria Pisu
- University of Alabama at Birmingham Comprehensive Cancer Center,University of Alabama at Birmingham School of Nursing
| | - Kelly Kenzik
- University of Alabama at Birmingham School of Nursing
| | - Bradford E Jackson
- Preventive Medicine, University of Alabama at Birmingham School of Medicine
| | | | | | - Karen Meneses
- University of Alabama at Birmingham Comprehensive Cancer Center,Preventive Medicine, University of Alabama at Birmingham School of Medicine
| | - Yufeng Li
- University of Alabama at Birmingham Comprehensive Cancer Center,University of Alabama at Birmingham School of Nursing
| | | | - Carol Chambless
- University of Alabama at Birmingham Comprehensive Cancer Center
| | - Nedra Lisovicz
- University of Alabama at Birmingham Comprehensive Cancer Center,University of Alabama at Birmingham School of Nursing
| | - Mona Fouad
- University of Alabama at Birmingham Comprehensive Cancer Center,University of Alabama at Birmingham School of Nursing
| | | | - Elizabeth A Kvale
- University of Alabama at Birmingham Comprehensive Cancer Center,Birmingham VA Medical Center, Birmingham, Alabama
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Dieng M, Butow PN, Costa DS, Morton RL, Menzies SW, Mireskandari S, Tesson S, Mann GJ, Cust AE, Kasparian NA. Psychoeducational Intervention to Reduce Fear of Cancer Recurrence in People at High Risk of Developing Another Primary Melanoma: Results of a Randomized Controlled Trial. J Clin Oncol 2016; 34:4405-4414. [DOI: 10.1200/jco.2016.68.2278] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose People with a history of melanoma commonly report a fear of cancer recurrence (FCR), yet psychologic support is not routinely offered as part of ongoing melanoma care. This randomized controlled trial examined the efficacy of a psychoeducational intervention to reduce FCR and improve psychologic adjustment in this patient group compared with usual care. Methods The intervention comprised a newly developed psychoeducational resource and three telephone-based psychotherapeutic sessions over a 1-month period timed in accordance with dermatologic appointments. Participants were randomly assigned to intervention (n = 80) or usual care (n = 84). Assessments were completed at baseline, 1 month, and 6 months after dermatologic appointments. Linear mixed models were used to examine differences between treatment and control groups for patient-reported outcomes, including FCR, anxiety, stress, depression, melanoma-related knowledge, health behaviors, satisfaction with melanoma care, unmet needs, and health-related quality of life. Results At 6 months, the intervention group reported lower FCR severity, trigger, and distress scores than the control group in the baseline-adjusted models; the between-group mean difference was −1.9 for FCR severity (95% CI, −3.1 to −0.7; P = .002), −2.0 for FCR triggers (95% CI, −3.3 to −0.7; P = .003), and −0.7 for FCR distress (95% CI, −1.3 to −0.1; P = .03). The decrease in FCR severity (but not triggers or distress) remained statistically significant after adjustment for other covariates ( P = .04). At 6 months, the intervention group also reported lower stress (−1.6; 95% CI, −3.1 to −0.2; P = .03) and improved melanoma-related knowledge (1.7; 95% CI, 0.8 to 2.6; P < .001) compared with the control group. No differences were found between groups for other secondary outcomes. Conclusion This newly developed evidence-based psychoeducational intervention was effective in reducing FCR and stress and increasing melanoma-related knowledge in people at high risk for another melanoma.
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Affiliation(s)
- Mbathio Dieng
- Mbathio Dieng and Anne E. Cust, Sydney School of Public Health, The University of Sydney; Anne E. Cust, Rachael L. Morton, and Graham J. Mann, The Melanoma Institute Australia, The University of Sydney; Phyllis N. Butow and Stephanie Tesson, School of Psychology, The University of Sydney; Daniel S.J. Costa, Pain Management Research Institute, The University of Sydney; Rachael L. Morton, NHMRC Clinical Trials Centre, The University of Sydney; Scott W. Menzies, Sydney Medical School, The University of
| | - Phyllis N. Butow
- Mbathio Dieng and Anne E. Cust, Sydney School of Public Health, The University of Sydney; Anne E. Cust, Rachael L. Morton, and Graham J. Mann, The Melanoma Institute Australia, The University of Sydney; Phyllis N. Butow and Stephanie Tesson, School of Psychology, The University of Sydney; Daniel S.J. Costa, Pain Management Research Institute, The University of Sydney; Rachael L. Morton, NHMRC Clinical Trials Centre, The University of Sydney; Scott W. Menzies, Sydney Medical School, The University of
| | - Daniel S.J. Costa
- Mbathio Dieng and Anne E. Cust, Sydney School of Public Health, The University of Sydney; Anne E. Cust, Rachael L. Morton, and Graham J. Mann, The Melanoma Institute Australia, The University of Sydney; Phyllis N. Butow and Stephanie Tesson, School of Psychology, The University of Sydney; Daniel S.J. Costa, Pain Management Research Institute, The University of Sydney; Rachael L. Morton, NHMRC Clinical Trials Centre, The University of Sydney; Scott W. Menzies, Sydney Medical School, The University of
| | - Rachael L. Morton
- Mbathio Dieng and Anne E. Cust, Sydney School of Public Health, The University of Sydney; Anne E. Cust, Rachael L. Morton, and Graham J. Mann, The Melanoma Institute Australia, The University of Sydney; Phyllis N. Butow and Stephanie Tesson, School of Psychology, The University of Sydney; Daniel S.J. Costa, Pain Management Research Institute, The University of Sydney; Rachael L. Morton, NHMRC Clinical Trials Centre, The University of Sydney; Scott W. Menzies, Sydney Medical School, The University of
| | - Scott W. Menzies
- Mbathio Dieng and Anne E. Cust, Sydney School of Public Health, The University of Sydney; Anne E. Cust, Rachael L. Morton, and Graham J. Mann, The Melanoma Institute Australia, The University of Sydney; Phyllis N. Butow and Stephanie Tesson, School of Psychology, The University of Sydney; Daniel S.J. Costa, Pain Management Research Institute, The University of Sydney; Rachael L. Morton, NHMRC Clinical Trials Centre, The University of Sydney; Scott W. Menzies, Sydney Medical School, The University of
| | - Shab Mireskandari
- Mbathio Dieng and Anne E. Cust, Sydney School of Public Health, The University of Sydney; Anne E. Cust, Rachael L. Morton, and Graham J. Mann, The Melanoma Institute Australia, The University of Sydney; Phyllis N. Butow and Stephanie Tesson, School of Psychology, The University of Sydney; Daniel S.J. Costa, Pain Management Research Institute, The University of Sydney; Rachael L. Morton, NHMRC Clinical Trials Centre, The University of Sydney; Scott W. Menzies, Sydney Medical School, The University of
| | - Stephanie Tesson
- Mbathio Dieng and Anne E. Cust, Sydney School of Public Health, The University of Sydney; Anne E. Cust, Rachael L. Morton, and Graham J. Mann, The Melanoma Institute Australia, The University of Sydney; Phyllis N. Butow and Stephanie Tesson, School of Psychology, The University of Sydney; Daniel S.J. Costa, Pain Management Research Institute, The University of Sydney; Rachael L. Morton, NHMRC Clinical Trials Centre, The University of Sydney; Scott W. Menzies, Sydney Medical School, The University of
| | - Graham J. Mann
- Mbathio Dieng and Anne E. Cust, Sydney School of Public Health, The University of Sydney; Anne E. Cust, Rachael L. Morton, and Graham J. Mann, The Melanoma Institute Australia, The University of Sydney; Phyllis N. Butow and Stephanie Tesson, School of Psychology, The University of Sydney; Daniel S.J. Costa, Pain Management Research Institute, The University of Sydney; Rachael L. Morton, NHMRC Clinical Trials Centre, The University of Sydney; Scott W. Menzies, Sydney Medical School, The University of
| | - Anne E. Cust
- Mbathio Dieng and Anne E. Cust, Sydney School of Public Health, The University of Sydney; Anne E. Cust, Rachael L. Morton, and Graham J. Mann, The Melanoma Institute Australia, The University of Sydney; Phyllis N. Butow and Stephanie Tesson, School of Psychology, The University of Sydney; Daniel S.J. Costa, Pain Management Research Institute, The University of Sydney; Rachael L. Morton, NHMRC Clinical Trials Centre, The University of Sydney; Scott W. Menzies, Sydney Medical School, The University of
| | - Nadine A. Kasparian
- Mbathio Dieng and Anne E. Cust, Sydney School of Public Health, The University of Sydney; Anne E. Cust, Rachael L. Morton, and Graham J. Mann, The Melanoma Institute Australia, The University of Sydney; Phyllis N. Butow and Stephanie Tesson, School of Psychology, The University of Sydney; Daniel S.J. Costa, Pain Management Research Institute, The University of Sydney; Rachael L. Morton, NHMRC Clinical Trials Centre, The University of Sydney; Scott W. Menzies, Sydney Medical School, The University of
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Dunn J, Watson M, Aitken JF, Hyde MK. Systematic review of psychosocial outcomes for patients with advanced melanoma. Psychooncology 2016; 26:1722-1731. [PMID: 27696578 DOI: 10.1002/pon.4290] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Revised: 09/19/2016] [Accepted: 09/29/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND New advanced melanoma therapies are associated with improved survival; however, quality of survivorship, particularly psychosocial outcomes, for patients overall and those treated with newer therapies is unclear. OBJECTIVE Synthesize qualitative and quantitative evidence about psychosocial outcomes for advanced (stage III/IV) melanoma patients. METHODS Five databases were searched (01/01/1980 to 31/01/2016). Inclusion criteria were as follows: advanced melanoma patients or sub-group analysis; assessed psychosocial outcomes; and English language. RESULTS Fifty-two studies met review criteria (4 qualitative, 48 quantitative). Trials comprise mostly medical not psychosocial interventions, with psychosocial outcomes assessed within broader quality of life measures. Patients receiving chemotherapy or IFN-alpha showed decreased emotional and social function and increased distress. Five trials of newer therapies appeared to show improvements in emotional and social function. Descriptive studies suggest that patients with advanced, versus localized disease, had decreased emotional and social function and increased distress. Contributors to distress were largely unexplored, and no clear framework described coping/adjustment trajectories. Patients with advanced versus localized disease had more supportive care needs, particularly amount, quality, and timing of melanoma-related information, communication with and emotional support from clinicians. Limitations included: lack of theoretical underpinnings guiding study design; inconsistent measurement approaches; small sample sizes; non-representative sampling; and cross-sectional design. CONCLUSIONS Quality trial evidence is needed to clarify the impact of treatment innovations for advanced melanoma on patients' psychosocial well-being. Survivorship research and subsequent translation of that knowledge into programs and services currently lags behind gains in the medical treatment of advanced melanoma, a troubling circumstance that requires immediate and focused attention.
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Affiliation(s)
- Jeff Dunn
- Cancer Council Queensland, Brisbane, Queensland, Australia.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia.,School of Social Science, The University of Queensland, St Lucia, Queensland, Australia.,Institute for Resilient Regions, University of Southern Queensland, Toowoomba, Australia
| | - Maggie Watson
- Pastoral and Psychological Care, Royal Marsden Hospital, Sutton, Surrey, UK
| | - Joanne F Aitken
- Cancer Council Queensland, Brisbane, Queensland, Australia.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia.,Institute for Resilient Regions, University of Southern Queensland, Toowoomba, Australia.,School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Melissa K Hyde
- Cancer Council Queensland, Brisbane, Queensland, Australia.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
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27
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Rogers Z, Elliott F, Kasparian NA, Bishop DT, Barrett JH, Newton-Bishop J. Psychosocial, clinical and demographic features related to worry in patients with melanoma. Melanoma Res 2016; 26:497-504. [PMID: 27196629 PMCID: PMC5010282 DOI: 10.1097/cmr.0000000000000266] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 03/27/2016] [Indexed: 01/11/2023]
Abstract
The aim of this study was to investigate clinical, demographic and psychosocial predictors of melanoma-related worry. A questionnaire-based study in a population-ascertained cohort of individuals diagnosed with melanoma in the previous 3-6 months was carried out to identify factors associated with worry about melanoma shortly after diagnosis. A total of 520 patients felt worried about their future with respect to melanoma and 1568 patients felt confident about their future with respect to melanoma. Worry was less likely in men with partners than women with partners [adjusted odds ratio (OR)=0.51, 95% confidence interval (CI) (0.39-0.67)], and increasing age was protective against worry [adjusted OR=0.96 per year, 95% CI (0.95-0.97)]. Worry was more likely for patients with stage III/IV melanoma [adjusted OR=1.90, 95% CI (1.41-2.56) compared with stages IB-IIC], melanoma arising in sun-protected sites (compared with a limb), no occupation (compared with workers), those who reported insufficient emotional support from healthcare providers [adjusted OR=2.20, 95% CI (1.56-3.09) compared with sufficient support], lower knowledge of melanoma [adjusted OR=4.50, 95% CI (2.82-7.18) compared with well informed], perceived financial hardship compared with no financial hardship and over three previous negative life events compared with none/one. Worry about melanoma outcomes after diagnosis is multifactorial in origin.
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Affiliation(s)
- Zoe Rogers
- Section of Epidemiology and Biostatistics, Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK
| | - Faye Elliott
- Section of Epidemiology and Biostatistics, Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK
| | - Nadine A. Kasparian
- Discipline of Paediatrics, School of Women’s and Children’s Health, UNSW Medicine, The University of New South Wales, Sydney, New South Wales, Australia
| | - D. Timothy Bishop
- Section of Epidemiology and Biostatistics, Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK
| | - Jennifer H. Barrett
- Section of Epidemiology and Biostatistics, Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK
| | - Julia Newton-Bishop
- Section of Epidemiology and Biostatistics, Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK
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28
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Lang MJ, David V, Giese-Davis J. The Age Conundrum: A Scoping Review of Younger Age or Adolescent and Young Adult as a Risk Factor for Clinical Distress, Depression, or Anxiety in Cancer. J Adolesc Young Adult Oncol 2016; 4:157-73. [PMID: 26697266 DOI: 10.1089/jayao.2015.0005] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
This scoping review was conducted to understand the extent, range, and nature of current research on adolescents and young adults (AYA) with cancer and distress, depression, and anxiety (DDA). This information is necessary to find and aggregate valuable data on the AYA population embedded in generalized studies of DDA. Keyword searches of six relevant electronic databases identified 2156 articles, with 316 selected for abstract review and 40 for full text review. Full-text reviews and data extraction resulted in 34 studies being included, which ranged widely in design, sample size, age-range categorization, analysis methods, DDA measurement tool, overall study rigor, and quality of evidence. Studies very seldom reported using theory to guide their age categorization, with only four studies giving any rationale for their age-group definitions. All 34 studies found a significant association between at least one DDA construct and the younger age group relative to the older age groups at some point along the cancer trajectory. However, age as an independent risk factor for DDA is still unclear, as the relationship could be confounded by other age-related factors. Despite the wide range of definitions and effect sizes in the studies included in this review, one thing is clear: adolescents and young adults, however defined, are a distinct group within the cancer population with an elevated risk of DDA. Widespread adoption of a standard AYA age-range definition will be essential to any future meta-analytical psycho-oncology research in this population.
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Affiliation(s)
- Michael J Lang
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary , Alberta, Canada . ; Provincial Integrated Survivorship Program, Provincial Practices, Alberta Health Services-Cancer Control , Alberta, Canada
| | - Victoria David
- Undergraduate Medical Education, Cumming School of Medicine, University of Calgary , Alberta, Canada
| | - Janine Giese-Davis
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary , Alberta, Canada . ; Psychosocial Resources, Tom Baker Cancer Centre, Alberta Health Services-Cancer Control , Alberta, Canada . ; Division of Psychosocial Oncology, Department of Oncology, Cumming School of Medicine, University of Calgary , Alberta, Canada
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29
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“Melanoma: Questions and Answers.” Development and evaluation of a psycho-educational resource for people with a history of melanoma. Support Care Cancer 2016; 24:4849-4859. [DOI: 10.1007/s00520-016-3339-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 07/10/2016] [Indexed: 10/21/2022]
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30
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Nolte S, van der Mei SH, Strehl-Schwarz K, Köster J, Bender A, Rose M, Kruse J, Peters EMJ. Comparison of patient-reported need of psycho-oncologic support and the doctor's perspective: how do they relate to disease severity in melanoma patients? Psychooncology 2015; 25:1271-1277. [DOI: 10.1002/pon.4050] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Revised: 10/19/2015] [Accepted: 11/12/2015] [Indexed: 12/30/2022]
Affiliation(s)
- Sandra Nolte
- Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology; Charité - Universitätsmedizin Berlin; Berlin Germany
- Population Health Strategic Research Centre, School of Health and Social Development; Deakin University; Burwood VIC 3125 Australia
| | - Sicco H. van der Mei
- Department of Psychosomatic Medicine; Justus Liebig University (JLU); Giessen Germany
| | - Kerstin Strehl-Schwarz
- Department of Psychosomatic Medicine; Philipps University Marburg; Marburg Germany
- Psychoneuroimmunology Laboratory, Department of Psychosomatic Medicine; Justus Liebig University (JLU); Giessen Germany
| | - Johanna Köster
- Psychoneuroimmunology Laboratory, Department of Psychosomatic Medicine; Justus Liebig University (JLU); Giessen Germany
| | - Armin Bender
- Department of Dermatology; Philipps University Marburg; Marburg Germany
| | - Matthias Rose
- Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology; Charité - Universitätsmedizin Berlin; Berlin Germany
- Quantitative Health Sciences, Outcomes Measurement Science; University of Massachusetts Medical School; Worcester MA USA
| | - Johannes Kruse
- Department of Psychosomatic Medicine; Justus Liebig University (JLU); Giessen Germany
- Department of Psychosomatic Medicine; Philipps University Marburg; Marburg Germany
| | - Eva M. J. Peters
- Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology; Charité - Universitätsmedizin Berlin; Berlin Germany
- Psychoneuroimmunology Laboratory, Department of Psychosomatic Medicine; Justus Liebig University (JLU); Giessen Germany
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31
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Fischbeck S, Imruck BH, Blettner M, Weyer V, Binder H, Zeissig SR, Emrich K, Friedrich-Mai P, Beutel ME. Psychosocial Care Needs of Melanoma Survivors: Are They Being Met? PLoS One 2015; 10:e0132754. [PMID: 26296089 PMCID: PMC4546620 DOI: 10.1371/journal.pone.0132754] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Accepted: 06/17/2015] [Indexed: 11/24/2022] Open
Abstract
Patients who have survived malignant melanoma for more than five years may lack the opportunity to talk about their burden. As a consequence their psychosocial care needs remain undetected and available supportive interventions may not be utilised. Therefore, the psychosocial burden of this patient group needs to be assessed using specific screening instruments. The aim of this study was to investigate the psychosocial burden of long-term melanoma survivors, their psychosocial care needs and the determinants of these needs. We wanted to find out if the use of professional support corresponds to the care needs defined by experts. Using the cancer registry of Rhineland-Palatinate, melanoma patients diagnosed at least 5 years before the survey were contacted by physicians. N = 689 former patients completed the Hornheide Questionnaire (short form HQ-S) to identify psychosocial support need (scale cut off ≥ 16 or item-based cut-off score) and the potential psychosocial determinants of these needs. Additionally, they were asked about their utilisation of the professional support system. More than one third (36%) of them was in need for professional psychosocial support. The highest burden scores concerned worry about tumour progression. Younger age (< 50), higher general fatigue, higher symptom burden, lower general health, negative social interactions and unfulfilled information needs were significant predictors of the need for psychosocial intervention. Related to the percentage of survivors identified as 'in need', the professional support system was underused. Further studies should investigate whether using the HQ-S to routinely identify burdened melanoma patients could lead to better fulfilment of their intervention needs, ultimately enhancing health-related quality of life.
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Affiliation(s)
- Sabine Fischbeck
- Department of Psychosomatic Medicine and Psychotherapy, Medical Psychology and Medical Sociology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Barbara H. Imruck
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Maria Blettner
- Institute for Medical Biometrics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Veronika Weyer
- Institute for Medical Biometrics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Harald Binder
- Institute for Medical Biometrics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Sylke R. Zeissig
- Institute for Medical Biometrics, Epidemiology and Informatics (IMBEI), Cancer Registry, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Katharina Emrich
- Institute for Medical Biometrics, Epidemiology and Informatics (IMBEI), Cancer Registry, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Peter Friedrich-Mai
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Manfred E. Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
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32
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Barry V, Lynch ME, Tran DQ, Antun A, Cohen HG, DeBalsi A, Hicks D, Mattis S, Ribeiro MJA, Stein SF, Truss CL, Tyson K, Kempton CL. Distress in patients with bleeding disorders: a single institutional cross-sectional study. Haemophilia 2015; 21:e456-64. [DOI: 10.1111/hae.12748] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2015] [Indexed: 11/26/2022]
Affiliation(s)
- V. Barry
- Division of Hematology/Oncology; Department of Pediatrics; Emory University School of Medicine; Atlanta Georgia USA
- Aflac Cancer and Blood Disorders Center; Children's Healthcare of Atlanta; Atlanta Georgia USA
| | - M. E. Lynch
- Department of Psychiatry and Behavioral Services; Emory University School of Medicine; Atlanta Georgia USA
| | - D. Q. Tran
- Department of Hematology and Medical Oncology; Emory University School of Medicine; Atlanta Georgia USA
| | - A. Antun
- Department of Hematology and Medical Oncology; Emory University School of Medicine; Atlanta Georgia USA
| | - H. G. Cohen
- Winship Cancer Institute of Emory University; Atlanta Georgia USA
| | - A. DeBalsi
- Division of Hematology/Oncology; Department of Pediatrics; Emory University School of Medicine; Atlanta Georgia USA
- Aflac Cancer and Blood Disorders Center; Children's Healthcare of Atlanta; Atlanta Georgia USA
| | - D. Hicks
- Division of Hematology/Oncology; Department of Pediatrics; Emory University School of Medicine; Atlanta Georgia USA
- Aflac Cancer and Blood Disorders Center; Children's Healthcare of Atlanta; Atlanta Georgia USA
| | - S. Mattis
- Division of Hematology/Oncology; Department of Pediatrics; Emory University School of Medicine; Atlanta Georgia USA
- Aflac Cancer and Blood Disorders Center; Children's Healthcare of Atlanta; Atlanta Georgia USA
| | - M. J. A. Ribeiro
- Department of Hematology and Medical Oncology; Emory University School of Medicine; Atlanta Georgia USA
| | - S. F. Stein
- Department of Hematology and Medical Oncology; Emory University School of Medicine; Atlanta Georgia USA
| | - C. L. Truss
- Division of Hematology/Oncology; Department of Pediatrics; Emory University School of Medicine; Atlanta Georgia USA
- Aflac Cancer and Blood Disorders Center; Children's Healthcare of Atlanta; Atlanta Georgia USA
| | - K. Tyson
- Aflac Cancer and Blood Disorders Center; Children's Healthcare of Atlanta; Atlanta Georgia USA
| | - C. L. Kempton
- Division of Hematology/Oncology; Department of Pediatrics; Emory University School of Medicine; Atlanta Georgia USA
- Aflac Cancer and Blood Disorders Center; Children's Healthcare of Atlanta; Atlanta Georgia USA
- Department of Hematology and Medical Oncology; Emory University School of Medicine; Atlanta Georgia USA
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33
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Schaeffeler N, Pfeiffer K, Ringwald J, Brucker S, Wallwiener M, Zipfel S, Teufel M. Assessing the need for psychooncological support: screening instruments in combination with patients' subjective evaluation may define psychooncological pathways. Psychooncology 2015; 24:1784-91. [PMID: 26042392 DOI: 10.1002/pon.3855] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 03/05/2015] [Accepted: 04/28/2015] [Indexed: 11/12/2022]
Abstract
BACKGROUND Cancer patients suffer from severe distress. About one third show mental comorbidities. Nevertheless, there is no common agreement on how to measure distress or identify patients in need for psychooncological services using screening questionnaires. PATIENTS AND METHODS A sample of N = 206 patients with confirmed breast cancer, being inpatient for surgical treatment, filled in distress assessment instruments: Distress Thermometer, Hospital Anxiety and Depression Scale, Patient Health Questionnaire 2, Hornheider Screening Instrument and parts of the EORTC-QLQ-C30. Additionally, they were asked for their subjective need for psychooncological counselling. RESULTS The correlation between the assessment instruments is low to medium. The number of patients above the cut-off criteria varies quite a lot according to the instrument (10% to 66%). Therefore, the congruence between the instruments' indications is quite low. Patients with and without subjective need do not differ in personal data but in distress scores. CONCLUSIONS Recommended instruments for distress assessment in psychooncology measure different areas of distress. They do not sufficiently agree in indicating a patient's need for psychooncological treatment. Hence, one should neither compare results of studies using different assessment instruments nor implement a screening without reflecting the used instrument's characteristics compared to the others. The subjective need seems to provide additional information to the assessment. At present, the combination of an assessment instrument and patients' subjective need is seen as a best practice for identifying patients in need of psychooncological treatment.
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Affiliation(s)
- N Schaeffeler
- Department of Psychosomatic Medicine and Psychotherapy, Tuebingen University Hospital, Tuebingen, Germany.,Comprehensive Cancer Centre, Tuebingen University Hospital, Tuebingen, Germany
| | - K Pfeiffer
- Department of Psychosomatic Medicine and Psychotherapy, Tuebingen University Hospital, Tuebingen, Germany
| | - J Ringwald
- Department of Psychosomatic Medicine and Psychotherapy, Tuebingen University Hospital, Tuebingen, Germany.,Comprehensive Cancer Centre, Tuebingen University Hospital, Tuebingen, Germany
| | - S Brucker
- Department of Obstetrics and Gynaecology, Tuebingen University Hospital, Tuebingen, Germany
| | - M Wallwiener
- Department of Obstetrics and Gynaecology, Heidelberg University Hospital, Heidelberg, Germany
| | - S Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, Tuebingen University Hospital, Tuebingen, Germany
| | - M Teufel
- Department of Psychosomatic Medicine and Psychotherapy, Tuebingen University Hospital, Tuebingen, Germany.,Comprehensive Cancer Centre, Tuebingen University Hospital, Tuebingen, Germany
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34
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Depression, anxiety and quality of life in long-term survivors of malignant melanoma: a register-based cohort study. PLoS One 2015; 10:e0116440. [PMID: 25615573 PMCID: PMC4304781 DOI: 10.1371/journal.pone.0116440] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2014] [Accepted: 12/08/2014] [Indexed: 12/21/2022] Open
Abstract
AIM The purpose of the study was to determine anxiety and depression, quality of life, and their determinants in long-term survivors of malignant melanoma. METHODS In a state cancer registry a cohort of survivors of malignant melanoma was contacted via the physician registered. Of 1302 contactable patients, 689 (52.2%) completed a questionnaire including the Patient Health Questionnaire with generalized anxiety (GAD-7) and depression (PHQ-9) and the EORTC Quality of Life Questionnaire (EORTC QLQ 30). Based on multiple regression analysis, predictors of quality of life and distress were identified. Comparison data were assessed in two waves of representative face-to-face household surveys of the adult German population. RESULTS An average of 8.4 (5.7 to 12.2) years after diagnosis, distress was higher in women compared to men and in middle adulthood (vs. older patients). Symptoms were higher in women than in men, and there was a decline of functioning and increase of symptoms across the age range of both genders. Compared to the general population, there were slightly increased depression and anxiety (only women), but no impaired global quality of life. Yet, survivors evidenced functional decline and more physical symptoms. Distress and reduced quality of life were consistently predicted by lack of social support, fear of recurrence, pessimism and self-blame. Distress was increased by a family history of melanoma, and additional mental and somatic diseases. CONCLUSION Overall, long-term survivors have adjusted well achieving a global quality of life comparable to the general population. Yet, compromised functional dimensions, physical symptoms and distress indicate the need for integrating psychooncological screening into oncological follow-up, which might be guided by predictors such as family history or social support. Further prospective study is needed to determine the course of adaptation to the disease and corroborate the risk factors identified.
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35
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Loquai C, Scheurich V, Syring N, Schmidtmann I, Müller-Brenne T, Werner A, Grabbe S, Beutel M. Characterizing psychosocial distress in melanoma patients using the expert rating instrument PO-Bado SF. J Eur Acad Dermatol Venereol 2014; 28:1676-84. [DOI: 10.1111/jdv.12361] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Accepted: 12/09/2013] [Indexed: 11/29/2022]
Affiliation(s)
- C. Loquai
- Department of Dermatology; University of Mainz; Mainz Germany
| | - V. Scheurich
- Department of Psychosomatic Medicine and Psychotherapy; University of Mainz; Mainz Germany
| | - N. Syring
- Department of Dermatology; University of Mainz; Mainz Germany
| | - I. Schmidtmann
- Institute of Medical Biostatistics; Epidemiology and Informatics; University of Mainz; Mainz Germany
| | | | - A. Werner
- Tumor Center Rhineland-Palatinate; Mainz Germany
| | - S. Grabbe
- Department of Dermatology; University of Mainz; Mainz Germany
| | - M.E. Beutel
- Department of Psychosomatic Medicine and Psychotherapy; University of Mainz; Mainz Germany
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36
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Albrecht K, Meiss F, Zeiss T, Nashan D, Reuter K. [Psycho-oncological care for melanoma patients: conception and implementation]. DER HAUTARZT 2013; 64:927-30. [PMID: 24132612 DOI: 10.1007/s00105-013-2681-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Offering psycho-oncological care is an essential, guideline-based component of comprehensive care in skin cancer centers. This paper describes the development, implementation and utilization of a specific psycho-oncologic care concept for melanoma patients in the University Dermatology Clinic Freiburg. Based on the stepped-care principle, the concept is composed of interdisciplinary group sessions for patients and their relatives offered every 4-6 weeks addressing medical and psycho-oncological topics related to treatment of malignant melanoma and then individual psycho-oncological sessions modified for the patient's treatment needs. Between April 2010 and July 2012, 67 % of the melanoma patients treated in the Freiburg Skin Cancer Center were reached by the program. A stepped-care concept with a routinely initiated first contact and low-threshold patient education group sessions is a reliable approach to reach patients and inform them about further psycho-oncological care. The advantages justify the allocation of resources and the approach proved successful for routine clinical practice.
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Affiliation(s)
- K Albrecht
- Klinik für Dermatologie und Venerologie, Hauttumorzentrum Freiburg, Universitätsklinikum Freiburg, Hauptstr. 7, 79104, Freiburg, Deutschland,
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