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Lee JH, Lee YJ, Park SJ, Park YM, Lee CW, Hwang SW, Seo MS, Kim SH, Ahn HY, Hwang IC. Patient Acceptance of Death and Symptom Control/Quality of Care Among Terminal Cancer Patients Under Inpatient Hospice Care: A Multicenter Cross-Sectional Study. Am J Hosp Palliat Care 2025:10499091251318738. [PMID: 39888879 DOI: 10.1177/10499091251318738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2025] Open
Abstract
INTRODUCTION Patient attitude to death is associated with outcomes in hospice care settings. This Korean study investigated the association between terminal cancer patient death acceptance and symptom control and quality of care (QoC) as perceived by family caregivers (FCs). METHODS A multicenter cross-sectional survey was conducted in nine inpatient hospice care units, and the data of 108 dyads (terminal cancer patients who responded to the revised Death Attitude Profile and their primary FCs) were analyzed. Dyads were dichotomized into high and low groups by death-acceptance level. Multivariate regression models were used to examine the association between death acceptance and symptom severity/QoC as perceived by FCs. RESULTS Patients in the high acceptance group were younger, educated to a higher level, more religious, and had better-functioning families. Patients with severe shortness of breath were less likely to accept the inevitability of death. FCs of patients with high acceptance of death were more satisfied with QoC, particularly in domains of individualized care and family relationships. In addition, the positive association between patient acceptance and FC satisfaction with care was significant in dyads of young or female patients, patients with a low education level, and patients not cared for by a spouse. CONCLUSION Terminal cancer patient death acceptance is associated with symptom control and FC perceived QoC.
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Affiliation(s)
- Jae Hyuck Lee
- Department of Family Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Yoo Jeong Lee
- Department of Family Medicine, Korea University Guro Hospital, Seoul, Korea
| | - So Jung Park
- Department of Family Medicine, National Cancer Center, Goyang, Korea
| | - Young Min Park
- Department of Family Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Chung Woo Lee
- Department of Family Medicine, Veterans Health Service Medical Center, Seoul, Korea
| | - Sun Wook Hwang
- Department of Family Medicine, Eunpyeong St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Min Seok Seo
- Department of Family Medicine, Incheon St. Mary's Hospital, The Catholic University of Korea, Incheon, Korea
| | - Sun Hyun Kim
- Department of Family Medicine, International St. Mary's Hospital, Catholic Kwandong University, Incheon, Korea
| | - Hong Yup Ahn
- Department of Statistics, Dongguk University, Seoul, Korea
| | - In Cheol Hwang
- Department of Family Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
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Franzoi IG, Sauta MD, Bonafede M, Francioso G, De Luca A, Barbagli F, Granieri A. Psychological Distress in Patients With Asbestos-Related Diseases and Their Families: A Systematic Literature Review. Psychooncology 2025; 34:e70051. [PMID: 39776006 PMCID: PMC11707407 DOI: 10.1002/pon.70051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2024] [Revised: 11/08/2024] [Accepted: 12/09/2024] [Indexed: 01/11/2025]
Abstract
BACKGROUND Exposure to asbestos in the workplace is currently recognized as one of the leading causes of work-related deaths, with more than half of deaths attributable to cancer. AIMS The aim of this systematic literature review was to investigate the mental health and psychological distress of patients affected by asbestos-related diseases and their caregivers. METHODS The review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The studies were identified in October 2023 by searching four electronic databases: Scopus, Web of Science, PubMed and PsycInfo/PsycArtcicles. Risk of bias was assessed using the JBI checklist. RESULTS Fourteen articles were identified. The studies focused exclusively on the psychological distress of patients with malignant mesothelioma (MM) and their caregivers. MM appears to have traumatic effects on both patients and caregivers, who may experience anxiety and depression, an impoverished emotional life, somatization, social withdrawal, and a deterioration in their quality of life. In addition, a need for information about MM, its progression and associated care tasks was identified, and patients and caregivers reported frequently seeking information from online sources. CONCLUSIONS Our review has shown that there are still few studies addressing psychological distress in MM patients and their caregivers, and none addressing distress in the context of other asbestos-related diseases. The somatopsychic consequences of MM in patients and caregivers should encourage institutions and health professionals to develop assessment and intervention models that are tailored to the specific suffering and needs of MM patients and their caregivers and promote their residual vitality.
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Affiliation(s)
| | | | - Michela Bonafede
- Epidemiology and Hygiene DepartmentOccupational and Environmental MedicineItalian Workers' Compensation Authority (INAIL)RomeItaly
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Franzoi IG. Rediscovering one's own voice in a brief psychoanalytic group intervention aimed at malignant mesothelioma patients and their families. Front Psychol 2024; 15:1471057. [PMID: 39737233 PMCID: PMC11682879 DOI: 10.3389/fpsyg.2024.1471057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2024] [Accepted: 11/08/2024] [Indexed: 01/01/2025] Open
Abstract
Occupational and/or environmental exposure to asbestos can lead to clinical manifestation of a variety of diseases, including malignant mesothelioma (MM), a rare cancer with a particularly high incidence rate in areas with a long history of asbestos processing. This paper aims to describe brief psychoanalytic groups (BPGs), which is an intervention model aimed at MM patients and their families in the early stages of the disease, shortly after diagnosis. The BPG model comprises 12 weekly sessions of 1 h each, co-led by two psychoanalytically oriented psychotherapists who are trained in working with cancer patients and their families and in the specifics of the BPG setting. Reflections in this paper on the BPGs will attempt to trace the voice of the group in clinical material, paying attention to its horizontal unfolding as a melodic development over time and its vertical unfolding as a harmonic interweaving between the different individual voices, which, even when opposed to each other, can find a generative interlocking of meaning. In the BPG, then, it is possible to set in motion transformations that allow one to embrace the different and diverse affective colorations of experience, evolve toward a thinking that is capable of incorporating intense emotions related to death and grief, follow healthier paths of interaction on an intrapsychic and interpersonal level, and find traces of one's own vitality.
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Franzoi IG, Sauta MD, De Luca A, Barbagli F, Granieri A. Psychological Interventions for Mesothelioma Patients and Their Caregivers: A Systematic Literature Review. J Pain Symptom Manage 2024; 68:e347-e355. [PMID: 39029809 DOI: 10.1016/j.jpainsymman.2024.07.004] [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: 02/26/2024] [Revised: 06/06/2024] [Accepted: 07/05/2024] [Indexed: 07/21/2024]
Abstract
Malignant Mesothelioma (MM) has a striking impact on the somatopsychic balance of patients and their families, including physical, psychological, and interpersonal problems. The aim of this systematic literature review was to investigate what psychological interventions are offered to patients with MM and their caregivers worldwide. METHODS The review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The literature search led to the identification of 12 articles. Results were categorized into five categories. 1. Individual psychological support, 2. Group psychological support, 3. Cognitive-behavioral group psychotherapy, 4. Brief psychoanalytic groups, 5. Multifamily group. RESULTS The interventions differed in terms of form, duration and resources used. Most of them were group-based and psychoanalytically oriented, although individual and cognitive-behavioral interventions were also described. Despite the differences, the interventions appeared to be fundamental in facilitating the processing of mental pain and anger related to the diagnosis. CONCLUSION Our study has shown that there are still few psychological interventions available for MM patients and their caregivers. The somatopsychic consequences of MM in patients and caregivers should encourage institutions and healthcare professionals to develop assessment and intervention models that address the different dimensions of their suffering and promote their residual vitality.
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Sherborne V, Ejegi-Memeh S, Tod AM, Taylor B, Hargreaves S, Gardiner C. Living with mesothelioma: a systematic review of mental health and well-being impacts and interventions for patients and their informal carers. BMJ Open 2024; 14:e075071. [PMID: 38951010 PMCID: PMC11218022 DOI: 10.1136/bmjopen-2023-075071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 06/12/2024] [Indexed: 07/03/2024] Open
Abstract
OBJECTIVES Mesothelioma is an aggressive cancer predominantly affecting the lung and abdominal linings. It can have a unique impact on mental health and well-being (MHWB) due to its incurability, poor prognosis and asbestos-exposure causation. This review's aims were to identify/synthesise international evidence on mesothelioma's MHWB impacts; explore MHWB interventions used by patients and carers; and identify evidence of their effectiveness. DESIGN Systematic review. DATA SOURCES Databases, searched March 2022 and March 2024, were MEDLINE; CINAHL; PsycINFO; Cochrane Library; ASSIA. ELIGIBILITY CRITERIA We included study designs focusing on psychological impacts of living with mesothelioma and MHWB interventions used by patients and informal carers, published in English since January 2002. DATA EXTRACTION AND SYNTHESIS A team of reviewers screened included studies using standardised methods. Quality was assessed using validated tools: Mixed-Methods Appraisal tool for primary research and Joanna Briggs Institute Critical Appraisal Checklist for Systematic Reviews. RESULTS Forty-eight studies met the inclusion criteria: 20 qualitative, 16 quantitative, nine reviews, two mixed-methods, one combined systematic review/qualitative study. UK studies predominated. Many MHWB impacts were reported, including traumatic stress, depression, anxiety and guilt. These were influenced by mesothelioma's causation, communication issues and carer-patient relational interactions. Participants used wide-ranging MHWB interventions, including religious/spiritual practice; talking to mental-health professionals; meaning-making. Some strategies were presented as unhelpful, for example, denial. Participants reported lack of access to support. CONCLUSIONS Most qualitative studies were rated high quality. The quality of the quantitative studies and reviews varied. The sparse literature regarding MHWB in mesothelioma means more research is needed into impacts on patients and carers, including trauma. To enable access to evidence-based support, research is recommended concerning MHWB interventions' effectiveness in mesothelioma. PROSPERO REGISTRATION NUMBER CRD42022302187.
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Affiliation(s)
- Virginia Sherborne
- Mesothelioma UK Research Centre, Division of Nursing and Midwifery, The University of Sheffield, Sheffield, UK
| | - Stephanie Ejegi-Memeh
- Mesothelioma UK Research Centre, Division of Nursing and Midwifery, The University of Sheffield, Sheffield, UK
| | - Angela Mary Tod
- Mesothelioma UK Research Centre, Division of Nursing and Midwifery, The University of Sheffield, Sheffield, UK
| | - Bethany Taylor
- Mesothelioma UK Research Centre, Division of Nursing and Midwifery, The University of Sheffield, Sheffield, UK
| | - Sarah Hargreaves
- Mesothelioma UK Research Centre, Division of Nursing and Midwifery, The University of Sheffield, Sheffield, UK
| | - Clare Gardiner
- Mesothelioma UK Research Centre, Division of Nursing and Midwifery, The University of Sheffield, Sheffield, UK
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Bonafede M, Franzoi IG, Sauta MD, Marinaccio A, Mensi C, Rugarli S, Migliore E, Cozzi I, Cavone D, Vimercati L, Grosso F, Bertolotti M, Raimondi G, Innamorati M, Granieri A. Confirmatory validation of the Mesothelioma Psychological Distress Tool-Patients: A brief patient-reported outcome measure assessing psychological distress in malignant mesothelioma patients. Psychooncology 2024; 33:e6371. [PMID: 38942736 DOI: 10.1002/pon.6371] [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: 03/04/2024] [Revised: 06/14/2024] [Accepted: 06/20/2024] [Indexed: 06/30/2024]
Abstract
OBJECTIVE Psychological suffering in patients with Malignant Mesothelioma (MM) is different from the one experienced by patients with other cancers due to its occupational or environmental etiology and its peculiar symptomatology and prognosis (i.e., poor prognosis, reduced effectiveness of the therapies, poor quality of residual life, and advanced age at the time of diagnosis). Therefore, the Mesothelioma Psychological Distress Tool-Patients (MPDT-P) has been developed to evaluate the specific profile of psychological suffering in this population. This paper describes the item selection, factor analysis, and psychometric evaluation of the revised MPDT-P. METHODS The analyses of the current work aimed to confirm the factorial structure found in the first version of the MPDT-P. In the case of nonfit, it aimed to find an alternative structure and causes of nonfit in the model. The search for the fit of the factorial model was conducted using a Bayesian approach. RESULTS The two-factor model reported in the first version of the instrument did not fit the data. Confirmatory Bayesian analyses showed adequate fit for the three-factor solution. Based on the content of the items, we labeled the factors as dysfunctional emotions, claims for justice, and anxieties about the future. CONCLUSIONS Integrating the MPDT-P into clinical practice could help clinicians gain insight into the specific suffering related to MM and investigate potential differences related to different occupational and environmental exposure contexts.
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Affiliation(s)
- Michela Bonafede
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers' Compensation Authority (INAIL), Rome, Italy
| | | | | | - Alessandro Marinaccio
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers' Compensation Authority (INAIL), Rome, Italy
| | - Carolina Mensi
- COR Lombardy, Occupational Health Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico of Milan, Milan, Italy
| | - Sabrina Rugarli
- COR Lombardy, Occupational Health Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico of Milan, Milan, Italy
| | - Enrica Migliore
- COR Piedmont, Unit of Cancer Epidemiology, AOU Città della Salute e della Scienza di Torino, CPO Piedmont and University of Turin, Turin, Italy
| | - Ilaria Cozzi
- Department of Epidemiology, COR Lazio, Lazio Regional Health Service, Local Health Unit 1, Rome, Italy
| | - Domenica Cavone
- Department of Interdisciplinary Medicine, Section of Occupational Medicine "B. Ramazzini", Regional Operating Center of Puglia (COR Puglia), University of Bari, Bari, Italy
| | - Luigi Vimercati
- Department of Interdisciplinary Medicine, Section of Occupational Medicine "B. Ramazzini", Regional Operating Center of Puglia (COR Puglia), University of Bari, Bari, Italy
| | - Federica Grosso
- Mesothelioma and Rare Cancers Unit, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Marinella Bertolotti
- Research Training Innovation Infrastructure, Research and Innovation Department (DAIRI), AO SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Giulia Raimondi
- Department of Psychology, University of Turin, Turin, Italy
- Clinical Epidemiology Unit, Istituto Dermopatico dell'Immacolata, IDI-IRCCS, Rome, Italy
| | - Marco Innamorati
- Department of Human Sciences, European University of Rome, Roma, Italy
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Sherborne V, Wood E, Mayland CR, Gardiner C, Lusted C, Bibby A, Tod A, Taylor B, Ejegi-Memeh S. The mental health and well-being implications of a mesothelioma diagnosis: A mixed methods study. Eur J Oncol Nurs 2024; 70:102545. [PMID: 38522172 DOI: 10.1016/j.ejon.2024.102545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 02/21/2024] [Accepted: 03/03/2024] [Indexed: 03/26/2024]
Abstract
PURPOSE Mesothelioma is an incurable, asbestos-related cancer with a poor prognosis. There is scant evidence about the mental health and well-being impacts on patients and carers living with the illness. This study aimed to investigate mesothelioma's impact on mental health and well-being and the scale of mental health conditions in patients and informal carers. METHODS A mixed-methods design was used: a cross-sectional survey of mesothelioma patients and informal carers plus semi-structured interviews with patients and carers. The survey used validated scales collecting data on mental health aspects of mesothelioma: the EQ5D to assess health-related quality-of-life; the Hospital Anxiety and Depression scale; the PCL-5 to assess Posttraumatic Stress; and the Posttraumatic Growth Inventory. The datasets were integrated during analysis. RESULTS 96 useable survey responses were received. A clinical level of depression was reported by 29 participants (30.21%), of anxiety by 48 (50%), of posttraumatic distress disorder by 32 (33.33%), and of posttraumatic growth by 34 (35.42%). Carers had worse scores than patients. Three main themes were developed from interviews with 10 patients and 11 carers: 'Prognosis', 'Support from services', and 'Social connections and communication'. CONCLUSIONS Healthcare professionals delivering a mesothelioma diagnosis require regular training in communication skills plus updating in current treatment options, so they provide an appropriate mix of realism and hope. Better signposting to mental health support is needed for patients and carers. Our introduction of posttraumatic growth into the mesothelioma literature is novel. We recommend specialist nurses are trained to recognise, understand, and foster posttraumatic growth.
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Affiliation(s)
- Virginia Sherborne
- Mesothelioma UK Research Centre, School of Allied Health Professions, Nursing and Midwifery, University of Sheffield, Barber House Annexe, 3a Clarkehouse Road, Sheffield, S10 2LA, UK.
| | - Emily Wood
- Division of Population Health, School of Medicine and Population Health, The University of Sheffield, UK
| | - Catriona R Mayland
- Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield, UK
| | - Clare Gardiner
- Mesothelioma UK Research Centre, School of Allied Health Professions, Nursing and Midwifery, University of Sheffield, Barber House Annexe, 3a Clarkehouse Road, Sheffield, S10 2LA, UK
| | - Caitlin Lusted
- Mesothelioma UK Research Centre, School of Allied Health Professions, Nursing and Midwifery, University of Sheffield, Barber House Annexe, 3a Clarkehouse Road, Sheffield, S10 2LA, UK
| | - Anna Bibby
- Academic Respiratory Unit, University of Bristol and North Bristol NHS Trust, Bristol, UK
| | - Angela Tod
- Mesothelioma UK Research Centre, School of Allied Health Professions, Nursing and Midwifery, University of Sheffield, Barber House Annexe, 3a Clarkehouse Road, Sheffield, S10 2LA, UK
| | - Bethany Taylor
- Mesothelioma UK Research Centre, School of Allied Health Professions, Nursing and Midwifery, University of Sheffield, Barber House Annexe, 3a Clarkehouse Road, Sheffield, S10 2LA, UK
| | - Stephanie Ejegi-Memeh
- Mesothelioma UK Research Centre, School of Allied Health Professions, Nursing and Midwifery, University of Sheffield, Barber House Annexe, 3a Clarkehouse Road, Sheffield, S10 2LA, UK
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