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Duan T, Cao Z, Huang X, Wang X, Sun T, Xu C. Association of social health with all-cause mortality and cause-specific mortality: A population-based cohort study. J Affect Disord 2024; 359:49-58. [PMID: 38768818 DOI: 10.1016/j.jad.2024.05.081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 05/13/2024] [Accepted: 05/17/2024] [Indexed: 05/22/2024]
Abstract
BACKGROUND Previous studies only focused on the individual social factors, without considering the overall social health patterns. The present study aimed to develop an integrated social health score (SHS) and investigate its associations with all-cause, cardiovascular disease (CVD), cancer mortality. METHODS A total of 330,716 participants (mean age 56.3 years; 52.4 % female) from UK Biobank was included between 2006 and 2010, and thereafter followed up to 2021. SHS was calculated by using information on social connections, social engagement and social support. Cox proportional hazards models was used to estimate the hazard ratios and 95 % confidence intervals (CIs) of the association between SHS and all-cause and cause-specific mortality and the 4-way decomposition was used to quantify the mediating effect of lifestyle factors. RESULTS During a median follow-up period of 12.4 years, 37,897 death cases were recorded, including 4347 CVD and 10,380 cancer cases. The SHS was inversely associated with the risks of all-cause, CVD and cancer mortality in a dose-dependent manner (P for trend <0.001). The association between SHS with all-cause mortality was mediated by lifestyle factors including diet score, smoking status and alcohol consumption. CONCLUSION Integrated SHS was inversely associated with risks of all-cause, CVD and cancer mortality, and the associations were partially mediated by lifestyle factors. Our study highlights the importance of maintaining high levels of social health by jointly enhancing social involvement, expanding social networks, and cultivating enduring intimate relationships across the life course.
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Affiliation(s)
- Tingshan Duan
- School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Zhi Cao
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Xianhong Huang
- School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Xiaohe Wang
- School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Tao Sun
- School of Public Health, Hangzhou Normal University, Hangzhou, China.
| | - Chenjie Xu
- School of Public Health, Hangzhou Normal University, Hangzhou, China.
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Fauser D, Rimalis-Vogt E, Mattes J, Bethge M. Psychological interventions during breast cancer rehabilitation: a randomized controlled trial comparing structured short-term psychotherapy versus non-specific group discussion. BMC Cancer 2023; 23:1133. [PMID: 37990301 PMCID: PMC10664677 DOI: 10.1186/s12885-023-11576-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 10/27/2023] [Indexed: 11/23/2023] Open
Abstract
PURPOSE Psycho-oncological treatment is recommended in cancer rehabilitation as it improves fatigue, anxiety, depression, and quality of life in breast cancer patients. The aim of our study was to compare a structured short-term psychotherapy and a non-specific group discussion provided during breast cancer rehabilitation. METHODS Breast cancer patients were randomly assigned to structured group short-term psychotherapy or a non-specific group discussion during breast cancer rehabilitation. The patients completed questionnaires at the beginning and end of rehabilitation and three months after rehabilitation. The primary outcome was anxiety. Secondary outcomes were depression, distress, fatigue and health-related quality of life domains. RESULTS In total, 160 patients (80 in both groups) were recruited and included in the analysis. There was no significant difference between both groups in the primary outcome anxiety at the end of rehabilitation (difference = -0.2; 95% CI -1.2 to 0.7) and three months after rehabilitation (difference = 0.2; 95% CI -0.9 to 1.3) and in any secondary outcome. Patients in the short-term psychotherapy group with high anxiety levels at baseline reported fewer depressive symptoms at the end of rehabilitation. CONCLUSIONS Our study showed no difference between structured short-term psychotherapy and a non-specific group discussion. Patients with high baseline anxiety levels were more likely to benefit from short-term structured psychotherapy. Early identification of this subgroup and symptoms of mental illness should occur after initial treatment in breast cancer patients in order to offer a structured treatment for anxiety and depressive symptoms during rehabilitation. TRIAL REGISTRATION German Clinical Trials Register (DRKS00017571; 08/07/2019).
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Affiliation(s)
- David Fauser
- Institute for Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany.
| | | | - Johannes Mattes
- VAMED Rehaklinik Ahrenshoop, Dorfstrasse 55, 18347, Ahrenshoop, Germany
| | - Matthias Bethge
- Institute for Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
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Breast Cancer: How Hippotherapy Bridges the Gap between Healing and Recovery-A Randomized Controlled Clinical Trial. Cancers (Basel) 2023; 15:cancers15041317. [PMID: 36831658 PMCID: PMC9953804 DOI: 10.3390/cancers15041317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 02/16/2023] [Accepted: 02/17/2023] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND Breast cancer is the most diagnosed women's cancer, and has a high survival rate. Despite great progress in detection and treatment, life reconstruction requires comprehensive cross-sectoral approaches between different disciplines and deeper consideration of the patient's challenges. Hippotherapy is an emerging specialized rehabilitation approach, performed by accredited health professionals and equine specialists, on specially trained horses via their movement, activating major paths for physical, mental, psychic and social reinforcement, and is synergistic to rehabilitative and supportive care. METHODS We conducted a randomized open, prospective, two-armed, controlled trial on the effectiveness of hippotherapy versus conventional supportive care on adult women with a diagnosis of breast cancer, after the period of primary treatment (surgery, chemotherapy, radiotherapy). The 6-month program included, in the treated group, an initial 1-week daily hippotherapy session, followed by three short 2-day sessions with an interval of 2 months between each, where the patients received conventional supportive care. The control group received 6 months of conventional supportive care. The primary end point was quality of life. Cognitive performances, fatigue, anxiety, depression, and body image were the secondary end points. Measurements were done through self-reported questionnaires. RESULTS We observed statistical differences in the evolution of the measured parameters over time between the two groups. The hippotherapy group showed a much faster, favorable and continuous improvement until the end of the program for each function assessed. The most striking improvements were observed in global quality of life, and fatigue, while breast cancer-specific quality of life, cognitive performance, anxiety and depression and body image showed a less marked but still statistically significant difference at the final post-treatment evaluation. CONCLUSIONS We demonstrate the therapeutic relevance of hippotherapy, a one-health approach, as a key initial stage after cancer diagnosis and treatment to foster recovery. Furthermore, hippotherapy has a strong impact on cancer treatments' efficiency and reconstruction of patient's life and ecosystem. This work reveals a layer of complexity that needs to be broadly considered. TRIAL REGISTRATION ClincalTrials.gov NCT04350398 accessed on 1 January 2022. Registered 17 April 2020, retrospectively registered; French Clinical Trials in Cancer Register RECF3818. Registered 18 March 2019, retrospectively registered.
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Baussard L, Cousson-Gélie F, Jarlier M, Charbonnier E, Le Vigouroux S, Montalescot L, Janiszewski C, Fourchon M, Coutant L, Guerdoux E, Portales F. Hypnosis and cognitive behavioral therapy with online sessions to reduce fatigue in patients undergoing chemotherapy for a metastatic colorectal cancer: Rational and study protocol for a feasibility study. Front Psychol 2022; 13:953711. [PMID: 35967617 PMCID: PMC9363840 DOI: 10.3389/fpsyg.2022.953711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 07/07/2022] [Indexed: 11/13/2022] Open
Abstract
Background In metastatic colorectal cancer (CRCm), fatigue is pervasive, reduces quality of life, and is negatively associated with survival. Its course is explained in part by psychosocial variables such as emotional distress, coping strategies, or perceived control. Thus, to reduce fatigue, psychosocial interventions appear to be relevant. In some cancers, Cognitive Behavioral Therapies (CBT) reduce fatigue. Hypnosis is also used as a complementary therapy to reduce the side effects of cancer. While CBT requires specific training often reserved for psychologists, hypnosis has the advantage of being increasingly practiced by caregivers and is therefore less expensive (Montgomery et al., 2007). On the other hand, CBT and hypnosis remain understudied in the CRC, do not focus on the symptom of fatigue and in Europe such programs have never been evaluated. Objectives Implementing an intervention in a healthcare setting is complex (e.g., economic and practical aspects) and recruiting participants can be challenging. The primary objective will therefore be to study the feasibility of two standardized interventions (hypnosis and CBT) that aim to reduce fatigue in patients with CRCm treated in a French cancer center. Methods and design A prospective, single-center, randomized interventional feasibility study, using mixed methods (both quantitative and qualitative). A total of 60 patients will be allocated to each intervention group [Hypnosis (n = 30) and CBT (n = 30)]. Participants will be randomized into two parallel groups (ratio 1:1). Both programs will consist of 6 weekly sessions focusing on the CRF management over a period of 6 weeks. Trained therapists will conduct the program combining 3 face-to-face sessions and 3 online sessions. The feasibility and experience of interventions will be evaluated by the outcome variables, including the adhesion rate, the reasons for acceptability, relevance or non-adherence, the satisfaction, the fatigue evolution (with ecological momentary assessments), and the quality of life. All questionnaires will be self-assessment using an online application from the cancer center. Discussion Results will highlight the barriers/facilitators to the implementation of the program and the relevance of the program to the patients, and will be used to generate hypotheses for a randomized control trial. Clinical trial registration ClinicalTrials.gov Identifier: NCT04999306; https://clinicaltrials.gov/ct2/show/NCT04999306.
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Affiliation(s)
- Louise Baussard
- UNIV. NIMES, APSY-V, F-30021 Nîmes Cedex 1, Languedoc-Roussillon, France
- *Correspondence: Louise Baussard
| | - Florence Cousson-Gélie
- Université Paul Valéry Montpellier 3, Laboratoire Epsylon EA4556, Languedoc-Roussillon, France
| | - Marta Jarlier
- Institut du Cancer de Montpellier – Université de Montpellier, Languedoc-Roussillon, France
| | - Elodie Charbonnier
- UNIV. NIMES, APSY-V, F-30021 Nîmes Cedex 1, Languedoc-Roussillon, France
| | - Sarah Le Vigouroux
- UNIV. NIMES, APSY-V, F-30021 Nîmes Cedex 1, Languedoc-Roussillon, France
| | - Lucile Montalescot
- UNIV. NIMES, APSY-V, F-30021 Nîmes Cedex 1, Languedoc-Roussillon, France
| | - Chloé Janiszewski
- Institut du Cancer de Montpellier – Université de Montpellier, Languedoc-Roussillon, France
| | - Michele Fourchon
- UNIV. NIMES, APSY-V, F-30021 Nîmes Cedex 1, Languedoc-Roussillon, France
| | - Louise Coutant
- Institut du Cancer de Montpellier – Université de Montpellier, Languedoc-Roussillon, France
| | - Estelle Guerdoux
- Institut du Cancer de Montpellier – Université de Montpellier, Languedoc-Roussillon, France
- Institut Desbrest d'Epidémiologie et de Santé Publique, INSERM, Université de Montpellier, Languedoc-Roussillon, France
| | - Fabienne Portales
- Institut du Cancer de Montpellier – Université de Montpellier, Languedoc-Roussillon, France
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Xu C, Ganesan K, Liu X, Ye Q, Cheung Y, Liu D, Zhong S, Chen J. Prognostic Value of Negative Emotions on the Incidence of Breast Cancer: A Systematic Review and Meta-Analysis of 129,621 Patients with Breast Cancer. Cancers (Basel) 2022; 14:cancers14030475. [PMID: 35158744 PMCID: PMC8833353 DOI: 10.3390/cancers14030475] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 01/07/2022] [Accepted: 01/11/2022] [Indexed: 02/06/2023] Open
Abstract
Breast cancer (BC) is one of the common malignant tumors in women and affects 1.6 million new cases globally each year. Investigators have recently found that negative emotions (NEs) and their impacts have greatly influenced the incidence and risk of BC. The present study aims to provide an association between NEs and the incidence of BC with possible risk factors. A total of 9343 studies were screened; nine studies met all inclusion criteria that were considered for the meta-analysis. The qualitative studies were measured by the Newcastle-Ottawa Scale; the observational studies were included with relative risks (RR) and corresponding 95% confidence intervals (CI). Besides the NEs and BC, the possible risk factors were evaluated. We analyzed data from 129,621 women diagnosed with NEs of which 2080 women were diagnosed with BC and their follow-up year ranges were from 4–24 years. NEs were significantly (p < 0.0001) associated with a higher incidence of BC with RR = 1.59, 95% CI:1.15–2.19, with other high-risk factors including, geographical distribution, emotion types, standard diagnosis of NEs, and follow-up duration. This study suggests that NEs significantly increase the risk for the incidence of BC, which can be supportive of the prognosis of the disease.
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Affiliation(s)
- Cong Xu
- School of Chinese Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong; (C.X.); (K.G.); (Y.C.)
| | - Kumar Ganesan
- School of Chinese Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong; (C.X.); (K.G.); (Y.C.)
| | - Xiaoyan Liu
- Department of Breast Surgery, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou 510405, China; (X.L.); (D.L.)
| | - Qiaobo Ye
- School of Basic Medical Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China;
| | - Yuenshan Cheung
- School of Chinese Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong; (C.X.); (K.G.); (Y.C.)
- Department of Breast Surgery, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou 510405, China; (X.L.); (D.L.)
| | - Dan Liu
- Department of Breast Surgery, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou 510405, China; (X.L.); (D.L.)
| | - Shaowen Zhong
- Department of Breast Surgery, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou 510405, China; (X.L.); (D.L.)
- Correspondence: (S.Z.); (J.C.); Tel.: +852-39-17-6479 (J.C.)
| | - Jianping Chen
- School of Chinese Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong; (C.X.); (K.G.); (Y.C.)
- Department of Breast Surgery, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou 510405, China; (X.L.); (D.L.)
- School of Basic Medical Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China;
- Shenzhen Institute of Research and Innovation, The University of Hong Kong, Shenzhen 518057, China
- Correspondence: (S.Z.); (J.C.); Tel.: +852-39-17-6479 (J.C.)
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Baussard L, Proust-Lima C, Philipps V, Portales F, Ychou M, Mazard T, Cousson-Gélie F. Determinants of Distinct Trajectories of Fatigue in Patients Undergoing Chemotherapy for a Metastatic Colorectal Cancer: 6-Month Follow-up Using Growth Mixture Modeling. J Pain Symptom Manage 2022; 63:140-150. [PMID: 34161813 DOI: 10.1016/j.jpainsymman.2021.06.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 05/11/2021] [Accepted: 06/14/2021] [Indexed: 12/21/2022]
Abstract
OBJECTIVES This longitudinal prospective and observational study was designed to identify fatigue trajectories during a 6-month period of chemotherapy in patients with metastatic colorectal cancer, and examine the psychosocial factors predicting these trajectories. Associations between fatigue and survival were also investigated. METHODS A total of 169 patients (Mage = 64.36 years, SD = 10.5) reported their fatigue levels every 2 weeks for 6 months. Psychological variables (anxiety, depression, internal control, and coping) were assessed at baseline. A Growth Mixture Model was used to identify latent trajectories of fatigue, and a multinomial logistic regression tested covariate predictors of patients' trajectories. RESULTS Four clinically distinct fatigue trajectories were identified: intense fatigue (6.51%), moderate fatigue (48.52%), no fatigue (33%), and increasing fatigue (11.83%). Fatigue severity was directly associated with overall survival. High depression levels were associated with fatigue severity over time for intense (OR = 1.80 [1.32-2.47]) and for moderate (OR = 1.58 [1.25-2.00]) fatigue, compared to patients reporting no fatigue. Patients who did not report fatigue were better adjusted, and had more resources, such as better internal control over the disease and less emotion-focused coping (guilt and avoidance), than those who reported intense (ORcontrol = 0.77 [0.65-0.92]) or moderate (ORcontrol = 0.89 [0.79-0.99] and ORcoping = 1.13 [1.02-1.24]) fatigue. CONCLUSION Fatigue trajectories differed considerably across patients with metastatic colorectal cancer. This first longitudinal study on colorectal cancer patients involving transactional variables suggests that psychosocial interventions should target these specific outcomes, in order to help patients manage their fatigue.
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Affiliation(s)
- Louise Baussard
- University of Nîmes (L.B.), APSY-V Research Laboratory, Nîmes, France.
| | | | | | - Fabienne Portales
- Digestive Oncology Department (F.P., M.Y., T.M.), Montpellier Cancer Institute, Montpellier, France
| | - Marc Ychou
- Digestive Oncology Department (F.P., M.Y., T.M.), Montpellier Cancer Institute, Montpellier, France
| | - Thibault Mazard
- Digestive Oncology Department (F.P., M.Y., T.M.), Montpellier Cancer Institute, Montpellier, France
| | - Florence Cousson-Gélie
- University Paul Valéry Montpellier 3 (F.C.G.), University Montpellier, Montpellier, France; Epidaure Prevention Department (F.C.G.), Montpellier Cancer Institute, Montpellier, France
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Samami E, Elyasi F, Mousavinasab SN, Shojaee L, Zaboli E, Shahhosseini Z. The effect of a supportive program on coping strategies and stress in women diagnosed with breast cancer: A randomized controlled clinical trial. Nurs Open 2021; 8:1157-1167. [PMID: 34482657 PMCID: PMC8046153 DOI: 10.1002/nop2.728] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 10/07/2020] [Accepted: 11/05/2020] [Indexed: 12/31/2022] Open
Abstract
AIM To investigate the effect of a supportive program on coping strategies and stress in women with breast cancer. DESIGN A randomized, two-armed, controlled trial. METHODS Sixty women were randomly allocated to intervention group (N = 30) and control group (N = 30). The interventions were held in six sessions, weekly from August 2018-March 2019 It was consisting of education regarding breast cancer; progressive muscle relaxation; stress management; emotional coping; and problem-solving strategies. RESULTS At baseline, there was no difference between the two groups regarding the mean score of coping strategies and stress. Supportive program group participants experienced a significantly higher increase on their problem-oriented coping strategies score in comparison with the control group. At the same time, scores in emotion-oriented coping strategies and stress decreased significantly in the intervention group compared with the control group. Result of this study can be used to develop relevant interventions targeting coping strategies to reduce stress among women with breast cancer.
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Affiliation(s)
- Elahe Samami
- Student Research Committee, Mazandaran University of Medical SciencesSariIran
| | - Forouzan Elyasi
- School of MedicineSexual and Reproductive Health Research Center, Psychiatry and Behavioral Sciences Research Center, Addiction InstituteMazandaran University of Medical SciencesSariIran
| | | | - Leila Shojaee
- Department of SurgerySchool of MedicineGastrointestinal Cancer Research CenterMazandaran University of Medical SciencesSariIran
| | - Ehsan Zaboli
- Department of Hematology & OncologySchool of MedicineGastrointestinal Cancer Research CenterMazandaran University of Medical SciencesSariIran
| | - Zohreh Shahhosseini
- Sexual and Reproductive Health Research CenterMazandaran University of Medical SciencesSariIran
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Coping Strategies-Oriented Interventions in Breast Cancer Women: A Systematic Scoping Review of the Quantitative Evidence. IRANIAN JOURNAL OF PSYCHIATRY AND BEHAVIORAL SCIENCES 2020. [DOI: 10.5812/ijpbs.99884] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Context: Coping strategies can predict breast cancer patients’ emotional well-being. Objectives: The aim of this systematic scoping review was to investigate the effect of coping strategies-oriented interventions on coping skills in breast cancer women. Data Sources: A systematic scoping review was conducted using a broad search across PubMed, Scopus, Springer, Elsevier, Cochrane Library, Science Direct, Web of Science, Magiran, Scientific Information Database, and Google scholar from 2009 - 2018. Study Selection: Clinical or quasi-experimental trials using interventions and control groups on the coping strategies-oriented interventions in breast cancer women in English or Persian were included. Data Extraction: Two independent researchers selected the final papers. In the case of a disagreement, the third researcher made the final decision. The quality of the included studies was assessed using the Jadad scale. Results: The coping strategies-oriented interventions were classified into four main categories: psychological interventions, such as cognitive-behavioral therapy, mindfulness, coping therapy, self-management, and psychoeducation; spiritual-religious interventions; social interventions, such as family therapy; and complementary interventions, such as acupuncture. Most interventions improved the coping skills of the studied women. Based on the Jadad scale, only two studies had good quality. Conclusions: Considering that most interventions improved the coping skills of breast cancer women, it is suggested that healthcare providers be proficient in examination techniques that maximize the patient’s coping skills. However, there remains a need for further culture-based research to adopt the best interventions and make changes in policy.
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O'Hea E, Kroll-Desrosiers A, Cutillo AS, Michalak HR, Barton BA, Harralson T, Carmack C, McMahon C, Boudreaux ED. Impact of the mental health and dynamic referral for oncology (MHADRO) program on oncology patient outcomes, health care utilization, and health provider behaviors: A multi-site randomized control trial. PATIENT EDUCATION AND COUNSELING 2020; 103:607-616. [PMID: 31753521 PMCID: PMC7061075 DOI: 10.1016/j.pec.2019.10.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 10/11/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE The MHADRO assesses psychosocial and medical needs, provides tailored feedback reports, and connects patients to mental health providers. This study examined the MHADRO's effect on patient outcomes, health care utilization, and oncology provider documentation and behaviors. METHODS 836 patients were part of a multi-site RCT and assessments were conducted at baseline, 2, 6 and 12 months. RESULTS The intervention group engaged in less emergency calls to providers. There were no differences in psychosocial outcomes at follow up assessments. Providers of patients in the intervention group were more likely to: document psychosocial symptoms and history; refer to psychosocial services; encourage support groups; seek psychological evaluations during visits. Patients who agreed to a mental health referral had decreased hospitalizations, increased mental health care interactions, and stronger ratings of counseling potential benefits. This group also reported increased psychosocial distress at all follow-up assessments. CONCLUSION The MHADRO may increase access to mental health care, lessen utilization, and improve providers' management of psychosocial needs, but does not appear to impact overall functioning over time. PRACTICE IMPLICATIONS Providers are encouraged to consider incorporating programs, like the MHADRO, into patient care as they may have the potential to impact screening and management of patients' psychosocial needs.
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Affiliation(s)
- Erin O'Hea
- University of Massachusetts Medical School, Worcester, MA, and Department of Psychology, Stonehill University, Easton, MA, 320 Washington Street, Shields Science Center 212, Easton, MA, USA.
| | - Aimee Kroll-Desrosiers
- Biostatistician, Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - Alexandra S Cutillo
- Medical/Clinical Psychology Doctoral Program, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Hannah R Michalak
- Yale University Alzheimer's Disease Research Unit, One Church Street, Suite 600, New Haven, CT, 06510, United States
| | - Bruce A Barton
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | | | | | - Cori McMahon
- Anderson at Cooper Cancer Center, Camden, NJ, USA
| | - Edwin D Boudreaux
- Departments of Emergency Medicine, Psychiatry, and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
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Lingens SP, Schilling G, Harms J, Schulz H, Bleich C. Observational non-randomised controlled evaluation of the effectiveness of cancer counselling centres: a study protocol. BMJ Open 2019; 9:e032889. [PMID: 31806615 PMCID: PMC6924776 DOI: 10.1136/bmjopen-2019-032889] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
INTRODUCTION In recent years, medical treatment for cancer has improved, thereby increasing the life expectancy of patients with cancer. Hence, the focus in healthcare shifted towards analysing treatments that offer to decrease distress and improve the quality of life of patients with cancer. The psychological burden of patients with cancer originates from all kinds of psychosocial challenges related to diagnosis and treatment. Cancer counselling centres (CCounCs) try to address these concerns. However, the current literature lacks research on the effectiveness of CCounCs. This study aims to assess the effectiveness of CCounCs with regard to distress and other relevant psychosocial variables (quality of life, anxietyand so on). METHODS AND ANALYSIS This prospective observational study with a non-randomised control group has three measurement points: before the first counselling session (baseline, t0) and at 2 weeks and 3 months after baseline (t1, t2). Patients and their relatives who seek counselling between December 2018 and November 2020 and have sufficient German language skills will be included. The control group will be recruited at clinics and oncological outpatient centres in Hamburg. Propensity scoring will be applied to adjust for differences between the control and intervention groups at baseline. Sociodemographic data, medical data and counselling concerns are measured at baseline. Distress (distress thermometer), quality of life (Short Form-8 Health Survey, European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire-Core 30), anxiety (Generalized AnxietyDisorder-7), depression (Patient HealthQuestionnaire-9) and further psychosocial variables are assessed at all time points. With a total of 787 participants, differences between the intervention and control groups of a small effect size (f=0.10) can be detected with a power of 80%. ETHICS AND DISSEMINATION The study was registered prior to data collection with the German Registration of Clinical Trials in September 2018. Ethical approval was received by the local psychological ethical committee of the Center for Psychosocial Medicine at the University Medical Centre Hamburg-Eppendorf in August 2018. The results will be published in peer-reviewed journals. TRIAL REGISTRATION NUMBER DRKS00015516; Pre-results.
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Affiliation(s)
- Solveigh Paola Lingens
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Julia Harms
- Department of Psychology, University of Osnabruck, Osnabruck, Germany
| | - Holger Schulz
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christiane Bleich
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Kroenke CH. A conceptual model of social networks and mechanisms of cancer mortality, and potential strategies to improve survival. Transl Behav Med 2018; 8:629-642. [PMID: 30016520 PMCID: PMC6065533 DOI: 10.1093/tbm/ibx061] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Women with larger personal social networks have better breast cancer survival and a lower risk of mortality. However, little work has examined the mechanisms through which social networks influence breast cancer outcomes and cancer outcomes more generally, potentially limiting the development of feasible, clinically effective interventions. In fact, much of the emphasis in cancer research regarding the influence of social relationships on cancer outcomes has focused on the benefits of the provision of social support to patients, especially through peer support groups, and only more recently through patient navigation. Though critically important, there are other ways through which social relationships might influence outcomes, around which interventions might be developed. In addition to social support, these include social resources, social norms, social contagion, social roles, and social burdens and obligations. This narrative review addresses how social networks may influence cancer outcomes and discusses potential strategies for improving outcomes given these relationships. The paper (a) describes background and limitations of previous research, (b) outlines terms and provides a conceptual model that describes interrelationships between social networks and relevant variables and their hypothesized influence on cancer outcomes, (c) clarifies social and psychosocial mechanisms through which social networks affect downstream factors, (d) describes downstream behavioral, treatment, and physiological factors through which these subsequently influence recurrence and mortality, and (e) describes needed research and potential opportunities to enhance translation. Though most literature in this area pertains to breast cancer, this review has substantial relevance for cancer outcomes generally. Further clarification and research regarding potential mechanisms are needed to translate epidemiological findings on social networks into clinical and community strategies to improve cancer outcomes.
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Affiliation(s)
- Candyce H Kroenke
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
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Xiao F, Song X, Chen Q, Dai Y, Xu R, Qiu C, Guo Q. Effectiveness of Psychological Interventions on Depression in Patients After Breast Cancer Surgery: A Meta-analysis of Randomized Controlled Trials. Clin Breast Cancer 2017; 17:171-179. [DOI: 10.1016/j.clbc.2016.11.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2016] [Revised: 11/10/2016] [Accepted: 11/15/2016] [Indexed: 10/20/2022]
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Brandão T, Tavares R, Schulz MS, Matos PM. Measuring emotion regulation and emotional expression in breast cancer patients: A systematic review. Clin Psychol Rev 2016; 43:114-27. [DOI: 10.1016/j.cpr.2015.10.002] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Revised: 08/25/2015] [Accepted: 10/16/2015] [Indexed: 01/17/2023]
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Victoria Cerezo M, Ortiz-Tallo M, Cardenal V, De La Torre-Luque A. Positive psychology group intervention for breast cancer patients: a randomised trial. Psychol Rep 2014; 115:44-64. [PMID: 25153949 DOI: 10.2466/15.20.pr0.115c17z7] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study assessed the effects of a psychological group intervention based on positive psychology in women with breast cancer. 175 women were randomly assigned either to an experimental group, receiving the 14-session intervention (n = 87), or to a wait list group (n = 88) that did not receive any type of intervention. For treatment, a group intervention was applied, based on improving psychological strengths and enhancing positive psychology-based styles of coping. Strength-related outcomes, self-esteem, well-being, and happiness were assessed before and after the intervention. The experimental group showed higher scores on all of the study variables after the intervention. Participants reported improved self-esteem, emotional intelligence-related abilities, resilience, and optimism, as well as positive affectivity, well-being, and happiness. The results show a beneficial effect of this psychological intervention based on positive psychology on female breast cancer patients' psychological health.
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Kipling M, Ralph JEM, Callanan K. Psychological impact of male breast disorders: literature review and survey results. ACTA ACUST UNITED AC 2014; 9:29-33. [PMID: 24803884 DOI: 10.1159/000358751] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Referrals of men to breast assessment clinics are increasing. While most of the men will have benign disease, some of them will have breast cancer. Whichever pathology they have, men should be offered a service tailored to their needs, rather than being 'shoehorned' into a service designed to care for women. This paper explores the psychological impact on men of their condition and of attending a breast assessment clinic. METHODS The literature regarding male experience of breast problems is reviewed, and screening for psychological morbidity is discussed. Results of a survey regarding an all-male breast assessment clinic are reported, with a plan for future research. RESULTS Many of the 78 men surveyed described negative feelings relating to their condition although they did not want to be seen in an all-male breast assessment clinic if that meant a longer wait. Men reported feelings of anxiety, embarrassment, emasculation and even depression regarding their condition. CONCLUSIONS Men are distressed by gynaecomastia and need psychological support for any breast-related presentation. More formalised research into this area is needed, although the men's distress does not translate into the desire to attend an all-male assessment clinic if this means a longer wait before being seen.
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Affiliation(s)
- Mike Kipling
- Breast Unit, University Hospital of North Durham (UHND), Durham, UK
| | - Jane E M Ralph
- Breast Unit, University Hospital of North Durham (UHND), Durham, UK
| | - Keith Callanan
- Breast Unit, University Hospital of North Durham (UHND), Durham, UK
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Matsuda A, Yamaoka K, Tango T, Matsuda T, Nishimoto H. Effectiveness of psychoeducational support on quality of life in early-stage breast cancer patients: a systematic review and meta-analysis of randomized controlled trials. Qual Life Res 2014; 23:21-30. [PMID: 23881515 PMCID: PMC3929036 DOI: 10.1007/s11136-013-0460-3] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2013] [Indexed: 01/08/2023]
Abstract
PURPOSE Most breast cancer patients receive psychosocial support interventions. However, the effectiveness of these interventions has not yet been clarified. Quality of life (QOL) was an important construct that should be considered when assessing these interventions. The purpose was to evaluate the effectiveness of psychosocial and especially psychoeducational support interventions for early-stage breast cancer patients since the follow-up was bound up to 6 months after finishing the intervention. METHODS We conducted a systematic review and meta-analysis to identify randomized controlled trials with early-stage breast cancer patients receiving psychosocial (psychoeducational and other) support in which QOL was measured as a treatment outcome. We compared mean differences at less than 6 months post-intervention with a control group. The primary outcome was Global Health Status/QOL scale (Global QOL), and secondary outcomes were the subscales of QOL. RESULTS No significant effect was observed for Global QOL; however, individuals receiving psychosocial support scored higher on the Breast Cancer Symptoms subscale. For psychoeducational support in the psychosocial support, significant effect was observed on the Emotional subscale. CONCLUSIONS Our analysis strengthens the evidence of the effectiveness of psychosocial support in improving breast cancer symptoms and psychoeducational support in improving emotional well-being within 6 months post-intervention.
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Affiliation(s)
- Ayako Matsuda
- Surveillance Division, Center for Cancer Control and Information Services, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan,
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Social networks, social support mechanisms, and quality of life after breast cancer diagnosis. Breast Cancer Res Treat 2013; 139:515-27. [PMID: 23657404 DOI: 10.1007/s10549-013-2477-2] [Citation(s) in RCA: 115] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2012] [Accepted: 03/06/2013] [Indexed: 10/26/2022]
Abstract
We examined mechanisms through which social relationships influence quality of life (QOL) in breast cancer survivors. This study included 3,139 women from the Pathways Study who were diagnosed with breast cancer from 2006 to 2011 and provided data on social networks (the presence of a spouse or intimate partner, religious/social ties, volunteering, and numbers of close friends and relatives), social support (tangible support, emotional/informational support, affection, positive social interaction), and QOL, measured by the FACT-B, approximately 2 months post diagnosis. We used logistic models to evaluate associations between social network size, social support, and lower versus higher than median QOL scores. We further stratified by stage at diagnosis and treatment. In multivariate-adjusted analyses, women who were characterized as socially isolated had significantly lower FACT-B (OR = 2.18, 95 % CI: 1.72-2.77), physical well-being (WB) (OR = 1.61, 95 % CI: 1.27-2.03), functional WB (OR = 2.08, 95 % CI: 1.65-2.63), social WB (OR = 3.46, 95 % CI: 2.73-4.39), and emotional WB (OR = 1.67, 95 % CI: 1.33-2.11) scores and higher breast cancer symptoms (OR = 1.48, 95 % CI: 1.18-1.87) compared with socially integrated women. Each social network member independently predicted higher QOL. Simultaneous adjustment for social networks and social support partially attenuated associations between social networks and QOL. The strongest mediator and type of social support that was most predictive of QOL outcomes was "positive social interaction." However, each type of support was important depending on outcome, stage, and treatment status. Larger social networks and greater social support were related to higher QOL after a diagnosis of breast cancer. Effective social support interventions need to evolve beyond social-emotional interventions and need to account for disease severity and treatment status.
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Kroenke CH, Quesenberry C, Kwan ML, Sweeney C, Castillo A, Caan BJ. Social networks, social support, and burden in relationships, and mortality after breast cancer diagnosis in the Life After Breast Cancer Epidemiology (LACE) study. Breast Cancer Res Treat 2012; 137:261-71. [PMID: 23143212 DOI: 10.1007/s10549-012-2253-8] [Citation(s) in RCA: 99] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2012] [Accepted: 09/11/2012] [Indexed: 11/25/2022]
Abstract
Larger social networks have been associated with lower breast cancer mortality. The authors evaluated how levels of social support and burden influenced this association. We included 2,264 women from the Life After Cancer Epidemiology study who were diagnosed with early-stage, invasive breast cancer between 1997 and 2000, and provided data on social networks (spouse or intimate partner, religious/social ties, volunteering, time socializing with friends, and number of first-degree female relatives), social support, and caregiving. 401 died during a median follow-up of 10.8 years follow-up with 215 from breast cancer. We used delayed entry Cox proportional hazards regression to evaluate associations. In multivariate-adjusted analyses, social isolation was unrelated to recurrence or breast cancer-specific mortality. However, socially isolated women had higher all-cause mortality (HR = 1.34, 95 % CI: 1.03-1.73) and mortality from other causes (HR = 1.79, 95 % CI: 1.19-2.68). Levels of social support and burden modified associations. Among those with low, but not high, levels of social support from friends and family, lack of religious/social participation (HR = 1.58, 95 % CI: 1.07-2.36, p = 0.02, p interaction = 0.01) and lack of volunteering (HR = 1.78, 95 % CI: 1.15-2.77, p = 0.01, p interaction = 0.01) predicted higher all-cause mortality. In cross-classification analyses, only women with both small networks and low levels of support (HR = 1.61, 95 % CI: 1.10-2.38) had a significantly higher risk of mortality than women with large networks and high levels of support; women with small networks and high levels of support had no higher risk of mortality (HR = 1.13, 95 % CI: 0.74-1.72). Social networks were also more important for caregivers versus noncaregivers. Larger social networks predicted better prognosis after breast cancer, but associations depended on the quality and burden of family relationships.
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Affiliation(s)
- Candyce H Kroenke
- Division of Research, Kaiser Permanente, 2101 Webster, 20th Floor, Oakland, CA 94612, USA.
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