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Martinez-Calderon J, Cano-García FJ, García-Muñoz C, Rufo-Barbero C, Matias-Soto J, Infante-Cano M. How can clinicians enhance self-efficacy beliefs in osteoarthritis? An overview of systematic reviews with meta-analysis. Clin Rheumatol 2024; 43:1435-1446. [PMID: 38517651 DOI: 10.1007/s10067-024-06943-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 03/12/2024] [Accepted: 03/14/2024] [Indexed: 03/24/2024]
Abstract
This overview of reviews aimed to synthesize the effectiveness of non-pharmacological approaches to enhance self-efficacy in people with osteoarthritis. The CINAHL, Embase, PsycINFO, PubMed, SPORTDiscus, and the Cochrane Library databases were searched from inception to December 2023. We considered systematic reviews with meta-analysis of randomized clinical trials evaluating any non-pharmacological intervention. We used AMSTAR 2 to assess the methodological quality of reviews. The overlap between reviews was calculated. We included eight systematic reviews with meta-analysis evaluating 30 different clinical trials. Overall, mind-body exercises, psychological interventions, and self-management strategies may improve arthritis self-efficacy. Specifically, the meta-analyses showed tai chi exercises, coping skills training, and the arthritis self-management program are more effective than controls to enhance arthritis self-efficacy in people with hip and/or knee osteoarthritis. In addition, inconsistent results were detected across meta-analyses regarding the effectiveness of multidisciplinary interventions. Finally, the degree of overlap between all reviews was moderate (CCA = 6%) and many included reviews reported most of the items of AMSTAR 2. Tai chi exercises, coping skills training, and the arthritis self-management program may be beneficial for enhancing arthritis self-efficacy. Open Science Framework Registration: https://doi.org/10.17605/OSF.IO/VX2T6 .
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Affiliation(s)
- Javier Martinez-Calderon
- Departamento de Fisioterapia, Instituto de Biomedicina de Sevilla (IBiS), Universidad de Sevilla, Seville, Spain
- CTS 1110: Understanding Movement and Self in Health From Science (UMSS) Research Group, Andalusia, Spain
| | - Francisco Javier Cano-García
- Departamento de Personalidad Evaluación y Tratamiento Psicológicos, Universidad de Sevilla, 41018, Seville, Spain
| | - Cristina García-Muñoz
- CTS 1110: Understanding Movement and Self in Health From Science (UMSS) Research Group, Andalusia, Spain
- Departamento de Ciencias de La Salud y Biomédicas, Universidad Loyola de Andalucía, Seville, Spain
| | - Carmen Rufo-Barbero
- Departamento de Personalidad Evaluación y Tratamiento Psicológicos, Universidad de Sevilla, 41018, Seville, Spain
| | - Javier Matias-Soto
- CTS 1110: Understanding Movement and Self in Health From Science (UMSS) Research Group, Andalusia, Spain.
- Department of Physical Therapy, Faculty of Health Sciences, Universidad de Malaga, Malaga, Spain.
| | - Marta Infante-Cano
- CTS 1110: Understanding Movement and Self in Health From Science (UMSS) Research Group, Andalusia, Spain
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Martinez-Calderon J, García-Muñoz C, Cano-García FJ, Heredia-Rizo AM. Spiritual well-being, faith, meaning in life, peace, and purpose in life for cancer-related fatigue: systematic review with meta-analysis and meta-regressions. J Cancer Surviv 2024:10.1007/s11764-024-01579-2. [PMID: 38632174 DOI: 10.1007/s11764-024-01579-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 03/28/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND Cancer-related fatigue is associated with spiritual distress. Spiritual well-being, characterized by the presence of factors such as meaning in life or purpose in life, seems to play an important role in the management of symptoms of cancer. Currently, the number of studies evaluating the association between cancer-related fatigue and spiritual well-being is increasing and no systematic review has been conducted. AIM To summarize the association between cancer-related fatigue and spiritual well-being, faith, meaning in life, peace, and purpose in life. DESIGN A systematic review with meta-analysis. DATA SOURCES The CINAHL, Embase, PsycINFO, and PubMed databases were searched from inception to 9 October 2023. We considered studies evaluating the cross-sectional or longitudinal association between cancer-related fatigue and the spiritual factors above mentioned. The Joanna Briggs Institute Checklist for Analytical Cross-Sectional Studies and the Quality in Prognosis Studies tool assessed the methodological quality of cross-sectional and longitudinal studies, respectively. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system rated the certainty of evidence. Meta-analyses, meta-regressions, subgroup meta-analyses, and sensitivity analyses were conducted. RESULTS A total of 13 studies were included and no longitudinal findings were found. One meta-analysis showed that cancer-related fatigue may be negatively correlated with spiritual well-being (r = - 0.37 (95%CI - 0.44 to - 0.28) p < 0.01). In addition, another meta-analysis found the correlation between cancer-related fatigue and faith was not statistically significant (r = - 0.25 (95%CI - 0.66 to 0.28) p = 0.36). CONCLUSIONS Cancer-related fatigue may be correlated with spiritual well-being. However, the certainty of evidence was very low across the meta-analyzed outcomes. IMPLICATIONS FOR CANCER SURVIVORS A negative correlation was observed between spiritual well-being and cancer-related fatigue.
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Affiliation(s)
- Javier Martinez-Calderon
- Instituto de Biomedicina de Sevilla, IBiS, Departamento de Fisioterapia, Universidad de Sevilla, Seville, Spain
- CTS 1110: Understanding Movement and Self in Health From Science (UMSS) Research Group, Andalusia, Spain
| | - Cristina García-Muñoz
- CTS 1110: Understanding Movement and Self in Health From Science (UMSS) Research Group, Andalusia, Spain.
- Departamento de Ciencias de La Salud y Biomédicas, Universidad Loyola de Andalucía, Avda. de Las Universidades S/N, 41704 Seville, Seville, Spain.
| | - Francisco Javier Cano-García
- Departamento de Personalidad, Evaluación y Tratamiento Psicológicos, Universidad de Sevilla, 41018, Seville, Spain
| | - Alberto Marcos Heredia-Rizo
- Instituto de Biomedicina de Sevilla, IBiS, Departamento de Fisioterapia, Universidad de Sevilla, Seville, Spain
- CTS 1110: Understanding Movement and Self in Health From Science (UMSS) Research Group, Andalusia, Spain
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Martinez-Calderon J, García-Muñoz C, Heredia-Rizo AM, Cano-García FJ. The prevalence of anxiety and depression in cancer around the world: An overview of systematic reviews evaluating 128 meta-analyses. J Affect Disord 2024; 351:701-719. [PMID: 38311072 DOI: 10.1016/j.jad.2024.01.259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 01/25/2024] [Accepted: 01/28/2024] [Indexed: 02/06/2024]
Abstract
BACKGROUND This overview of systematic reviews with meta-analysis summarized the prevalence of anxiety and depression in different types of tumors around the world. METHODS The quality of reviews was assessed. The degree of overlap between reviews was calculated. The regional prevalence of anxiety and depression was shown in the main text based on the World Health Organization regions. RESULTS Twenty-five reviews including 128 meta-analyses of interest were selected. The pooled prevalence of anxiety in breast tumors was in Africa (19 %), the Americas (38 %), Eastern Mediterranean (56 %), Europe (38 %), South-East Asia (42 %), and Western Pacific (26 %). The pooled prevalence of depression in breast tumors was in Africa (40 %), the Americas (23-25 %), Eastern Mediterranean (49-51 %), Europe (27-29 %), South-East Asia (23-33 %), Western Pacific (29 %). The pooled prevalence of depression in digestive tumors was in the Americas (4-44 %), Eastern Mediterranean (42 %), Europe (20-27 %), South-East Asia (66 %), and Western Pacific (24-40 %). The pooled national prevalence of anxiety and depression was mainly evaluated in China and Iran. LIMITATIONS Important methodological issues were identified. For example, no reviews judged the certainty of evidence. CONCLUSIONS The Eastern Mediterranean region showed the highest prevalence of anxiety and depression for breast tumors. The South-East Asian region showed the highest prevalence of depression for digestive tumors. In these regions, many countries are considered low-income and middle-income countries. Further research funding would help increase the investigation on this topic, which may allow the development of preventive strategies that reduce the prevalence of anxiety and depression.
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Affiliation(s)
- Javier Martinez-Calderon
- Instituto de Biomedicina de Sevilla, IBiS, Departamento de Fisioterapia, Universidad de Sevilla, Sevilla, Spain; CTS 1110: Understanding Movement and Self in health from Science (UMSS) Research Group, Andalusia, Spain
| | - Cristina García-Muñoz
- CTS 1110: Understanding Movement and Self in health from Science (UMSS) Research Group, Andalusia, Spain; Departamento Ciencias de la Salud y Biomédicas, Universidad Loyola de Andalucía, Sevilla, Spain.
| | - Alberto Marcos Heredia-Rizo
- Instituto de Biomedicina de Sevilla, IBiS, Departamento de Fisioterapia, Universidad de Sevilla, Sevilla, Spain; CTS 1110: Understanding Movement and Self in health from Science (UMSS) Research Group, Andalusia, Spain
| | - Francisco Javier Cano-García
- Departamento de Personalidad, Evaluación y Tratamiento Psicológicos, Universidad de Sevilla, 41018 Sevilla, Spain
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Martínez-García I, De Witte H, García-Martínez J, Cano-García FJ. A systematic review and a comprehensive approach to PhD students' wellbeing. Appl Psychol Health Well Being 2024. [PMID: 38606943 DOI: 10.1111/aphw.12541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 03/13/2024] [Indexed: 04/13/2024]
Abstract
The pursuit of a doctoral degree is a challenging process that can have a negative impact on the wellbeing of PhD students. Therefore, the aim here is to offer a systematic review of the current state of the literature on wellbeing among PhD students and the variables it involves in order to build an integrative model that will enrich future research. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology for systematic reviews has been used to lay out the process in a flow diagram. We systematically review studies up to 2021 (N = 38) published on the Web of Science and SCOPUS databases. The results show the current state of the literature on wellbeing in PhD students, the characteristics of the studies (location, study design, and sample), how the literature defines the concept, the variables involved, the study limitations, and future perspectives to improve the quality of life of doctoral students. Finally, a comprehensive approach to the topic is presented in an integrative model that encompasses all variables identified in the literature and offers a guide for future research.
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Affiliation(s)
- Inmaculada Martínez-García
- Departamento de Personalidad, Evaluación y Tratamiento Psicológicos, Universidad de Sevilla, Seville, Spain
- Departamento de Didáctica y Organización Escolar, Universidad de Málaga, Málaga, Spain
| | - Hans De Witte
- O2L, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
- Optentia Research Unit, North-West University, Vaal Triangle, Potchefstroom, South Africa
| | - Jesús García-Martínez
- Departamento de Personalidad, Evaluación y Tratamiento Psicológicos, Universidad de Sevilla, Seville, Spain
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Martinez-Calderon J, García-Muñoz C, Cano-García FJ, Heredia-Rizo AM. Correction to: Psychological and spiritual interventions to enhance meaning in adults diagnosed with cancer: a systematic review with meta‑analysis and meta‑regression. Support Care Cancer 2023; 31:588. [PMID: 37733129 DOI: 10.1007/s00520-023-08055-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Affiliation(s)
- Javier Martinez-Calderon
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, C/Avicena S/N, Seville, Spain
- CTS 1110: Uncertainty, Mindfulness, Self, and Spirituality (UMMS) Research Group, Andalusia, Spain
| | - Cristina García-Muñoz
- CTS 1110: Uncertainty, Mindfulness, Self, and Spirituality (UMMS) Research Group, Andalusia, Spain.
- Universidad Loyola de Andalucía, Avda. de Las Universidades S/N, 41704, Seville, Seville, Spain.
| | - Francisco Javier Cano-García
- Departamento de Personalidad, Evaluación y Tratamiento Psicológicos, Universidad de Sevilla, 41018, Seville, Spain
| | - Alberto Marcos Heredia-Rizo
- CTS 1110: Uncertainty, Mindfulness, Self, and Spirituality (UMMS) Research Group, Andalusia, Spain
- Instituto de Biomedicina de Sevilla, IBiS, Departamento de Fisioterapia, Universidad de Sevilla, Seville, Spain
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Varo C, Aires-González MDM, García-Jiménez M, Trigo ME, Cano-García FJ. Effective Coping with Academic Stress Is a Matter of Personality Types: Revisiting the Person-Centred Approach. Behav Sci (Basel) 2023; 13:687. [PMID: 37622827 PMCID: PMC10451618 DOI: 10.3390/bs13080687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 08/14/2023] [Accepted: 08/16/2023] [Indexed: 08/26/2023] Open
Abstract
Recent literature provides alarming data on the increase in university academic stress. The role of personality in understanding and addressing this problem is well established. However, this evidence could be improved by adopting a person-centred approach (e.g., types), as opposed to the usual variable-centred approach (e.g., traits), and considering the role of gender. Our aim was to explore how personality types and gender relate to coping strategies and perceived coping efficacy for academic stress. A total of 810 university psychology students completed the NEO-FFI Inventory and the Coping Strategies Inventory. Post hoc tests for MANOVA and ANOVA were performed. Types and gender were used as predictors and coping strategies, and perceived coping efficacy as criteria. There was no type-gender interaction. Types combining low neuroticism-high conscientiousness (e.g., entrepreneur) chose the most adaptive coping strategies and showed the highest levels of perceived coping efficacy, while high neuroticism-low conscientiousness types (e.g., insecure) opted for maladaptive coping strategies and presented the lowest perceived coping efficacy. Gender was not associated with perceived coping efficacy but with use (e.g., women prefer emotional expression). The personality typology provided useful information on individual differences in coping with academic stress, which can help guide specific strategies to manage it.
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Affiliation(s)
- Cristina Varo
- Department of Personality, Assessment, and Psychological Treatments, Universidad de Sevilla, 41018 Seville, Spain; (C.V.); (M.d.M.A.-G.)
| | - María del Mar Aires-González
- Department of Personality, Assessment, and Psychological Treatments, Universidad de Sevilla, 41018 Seville, Spain; (C.V.); (M.d.M.A.-G.)
| | - María García-Jiménez
- Department of Experimental Psychology, Universidad de Sevilla, 41018 Seville, Spain; (M.G.-J.); (M.E.T.)
| | - María Eva Trigo
- Department of Experimental Psychology, Universidad de Sevilla, 41018 Seville, Spain; (M.G.-J.); (M.E.T.)
| | - Francisco Javier Cano-García
- Department of Personality, Assessment, and Psychological Treatments, Universidad de Sevilla, 41018 Seville, Spain; (C.V.); (M.d.M.A.-G.)
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Martinez-Calderon J, García-Muñoz C, Cano-García FJ, Heredia-Rizo AM. Psychological and spiritual interventions to enhance meaning in adults diagnosed with cancer: a systematic review with meta-analysis and meta-regression. Support Care Cancer 2023; 31:523. [PMID: 37584817 DOI: 10.1007/s00520-023-07986-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 08/07/2023] [Indexed: 08/17/2023]
Abstract
OBJECTIVE To summarize the evidence on the effectiveness that psychological and/or spiritual interventions may have to change the levels of meaning, measured with the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale (FACIT-Sp), in adults diagnosed with cancer. METHODS Systematic review with meta-analysis and meta-regression. CINAHL (via EBSCOhost), Embase, PubMed, PsycINFO (via ProQuest), and the Cochrane Library were searched from inception to 21st October 2022. Manual searches were conducted. Only randomized clinical trials (RCTs) were included. The risk of bias was assessed with the Cochrane Risk of Bias tool 2. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach was used to judge the certainty of the evidence. RESULTS Eight RCTs were included (N = 1682). Although some individual studies showed positive effects to enhance meaning using mindfulness or dignity therapy, the overall and individual meta-analyses showed a lack of effect of psychological and spiritual interventions in comparison to comparator interventions (MD (95%CI) = -0.19 (-0.45 to 0.06), p = 0.11, Tau2 = 0.0015, I2 = 2%). Publication bias was undetected (Egger's test = 0.35). Furthermore, no RCTs were judged to have a low risk of bias and the overall certainty of the evidence was judged as low. Meta-regression and subgroups meta-analyses also found possible sources of heterogeneity such as some cancer characteristics, the educational stage, or the religious affiliation. CONCLUSIONS Despite some RCTs may show promising results following mindfulness or dignity therapy, no effects were observed in the meta-analysis. Moreover, important methodological and clinical concerns precluded us to make sound clinical recommendations with the available evidence. OPEN SCIENCE FRAMEWORK DOI REGISTRATION: https://doi.org/10.17605/OSF.IO/4YMTK .
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Affiliation(s)
- Javier Martinez-Calderon
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, c/Avicena s/n, Sevilla, Spain
- CTS 1110: Uncertainty, Mindfulness, Self, and Spirituality (UMMS) Research Group, Andalusia, Spain
| | - Cristina García-Muñoz
- CTS 1110: Uncertainty, Mindfulness, Self, and Spirituality (UMMS) Research Group, Andalusia, Spain.
- Universidad Loyola de Andalucía, Avda. de las Universidades s/n, 41704 Sevilla, Sevilla, Spain.
| | - Francisco Javier Cano-García
- Departamento de Personalidad, Evaluación y Tratamiento Psicológicos, Universidad de Sevilla, 41018, Sevilla, Spain
| | - Alberto Marcos Heredia-Rizo
- CTS 1110: Uncertainty, Mindfulness, Self, and Spirituality (UMMS) Research Group, Andalusia, Spain
- Instituto de Biomedicina de Sevilla, IBiS, Departamento de Fisioterapia, Universidad de Sevilla, Sevilla, Spain
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Martinez-Calderon J, Casuso-Holgado MJ, Cano-García FJ, Heredia-Rizo AM. Integrative model for self-perception of well-being in cancer. Disabil Rehabil 2023:1-8. [PMID: 37303159 DOI: 10.1080/09638288.2023.2222645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 05/31/2023] [Accepted: 06/02/2023] [Indexed: 06/13/2023]
Abstract
PURPOSE Continual illness uncertainty can affect how people perceive and interpret their well-being. Some cognitive and spiritual factors may be involved in the management of disruptive thoughts and emotions that can emerge during the experience of cancer. MATERIAL AND METHODS An evidence-based integrative model was developed to evaluate and show the role that mindfulness, acceptance, self-efficacy, uncertainty, meaning, and purpose in life play in the self-perception of well-being in individuals with cancer. This evidence-based integrative model was conducted using relevant and selected studies. RESULTS An integrative model for self-perception of well-being has been proposed. This model integrates evidence-based findings and provides clear principles for clinicians and researchers. This integrative model proposes that mindfulness, acceptance, self-efficacy perception, and uncertainty can predict how people with cancer perceive their well-being. The model also posits that meaning and purpose in life can act as mediators or moderators of this prediction. CONCLUSIONS This integrative model involves the multidimensionality of human beings and facilitates the understanding of some key factors for the design of therapeutic approaches such as Acceptance & Commitment Therapy or Meaning-Centered Psychotherapy.IMPLICATIONS FOR REHABILITATIONMindfulness, acceptance, self-efficacy, uncertainty, meaning, and purpose in life can be highly relevant for clinical oncology.An integrative model is proposed to understand the combined influence of these factors on patients with cancer.This model may favor a better integration of well-known interventions, such as Mindfulness-based approaches, Acceptance and Commitment Therapy (ACT), and Meaning-Centered Psychotherapy (MCP).
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Affiliation(s)
- Javier Martinez-Calderon
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, Sevilla, Spain
- Uncertainty, Mindfulness, Self, Spirituality (UMSS) Research Group, Sevilla, Spain
| | - María Jesús Casuso-Holgado
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, Sevilla, Spain
- Uncertainty, Mindfulness, Self, Spirituality (UMSS) Research Group, Sevilla, Spain
| | | | - Alberto Marcos Heredia-Rizo
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, Sevilla, Spain
- Uncertainty, Mindfulness, Self, Spirituality (UMSS) Research Group, Sevilla, Spain
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Martinez-Calderon J, García-Muñoz C, Heredia-Rizo AM, Cano-García FJ. Meaning and purpose in life, happiness, and life satisfaction in cancer: Systematic review with meta-analysis. Psychooncology 2023. [PMID: 37095608 DOI: 10.1002/pon.6135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 03/29/2023] [Accepted: 04/03/2023] [Indexed: 04/26/2023]
Abstract
OBJECTIVE To summarize current evidence on the potential cross-sectional and longitudinal association between meaning or purpose in life and subjective happiness or life satisfaction among cancer patients. METHODS A systematic review with meta-analysis and meta-regression was conducted. CINAHL (via EBSCOhost), Embase, PubMed, and PsycINFO (via ProQuest) were searched from inception to 31 December 2022. In addition, manual searches were performed. The risk of bias in cross-sectional and longitudinal studies was assessed using the Joanna Briggs Institute Checklist for Analytical Cross-Sectional Studies and the Quality in Prognosis Studies tool, respectively. Certainty in the evidence was judged using the Grading of Recommendations, Assessment, Development, and Evaluations approach. Meta-regressions and sensitivity analyses were performed to explore potential sources of heterogeneity. RESULTS We included 13 cross-sectional studies, comprising 12 different samples, and a longitudinal study. A total of 4968 individuals with cancer were interviewed across included studies. Certainty in the evidence was judged as very low for all outcomes, which was associated to serious concerns on risk of bias and imprecision of the results, and very serious concerns on indirectness of evidence. The assessed studies showed a marked heterogeneity in terms of participants' clinical (i.e., disease stage) and sociodemographic factors. A lack of reporting of these clinical and sociodemographic aspects were also evident among included studies. CONCLUSIONS The wide number of methodological flaws detected in this systematic review preclude to make any clinical recommendation. More rigorous high-quality observational studies should guide future research on this topic.
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Affiliation(s)
- Javier Martinez-Calderon
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, Sevilla, Spain
- Uncertainty, Mindfulness, Self, Spirituality (UMSS) Research Group, Sevilla, Spain
| | - Cristina García-Muñoz
- Uncertainty, Mindfulness, Self, Spirituality (UMSS) Research Group, Sevilla, Spain
- Department of Nursing and Physiotherapy, University of Cadiz, Cadiz, Spain
| | - Alberto Marcos Heredia-Rizo
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, Sevilla, Spain
- Uncertainty, Mindfulness, Self, Spirituality (UMSS) Research Group, Sevilla, Spain
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López-Jiménez CM, Cano-García FJ, Sanduvete-Chaves S, Chacón-Moscoso S. Profile of Mood States Factor Structure Does Not Accurately Account for Patients with Chronic Pain. Pain Med 2021; 22:2604-2614. [PMID: 33822193 PMCID: PMC8789763 DOI: 10.1093/pm/pnab127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The need for measuring emotional functioning in patients with chronic pain was recognized decades ago. The Initiative on Methods, Measures, and Pain Assessment in Clinical Trials (IMMPACT) proposed the Profile of Mood States for this purpose. However, to date, its factor structure has not been confirmed in these patients. METHODS We set out to use confirmatory factor analysis to test the theoretical structure of seven factors: Tension-Anxiety, Depression-Dejection, Anger-Hostility, Vigor-Activity, Fatigue-Inertia, Confusion-Bewilderment, and Friendliness. PARTICIPANTS The sample consisted of 588 Spanish adult patients with chronic pain. RESULTS The original structure could not be verified according to the obtained fit indices (e.g., root-mean-square error of approximation = 0.11). For this reason, we carried out a second study that relied on exploratory factor analysis to evaluate the structure in half of the cases and confirmatory factor analysis to validate it in the other half. The factor structure detected in the exploratory factor analysis was not satisfactory, nor could it be validated with confirmatory factor analysis (e.g., normed fit index between 0.54 and 0.56). CONCLUSIONS The factor structure of the Profile of Mood States could not be satisfactorily confirmed. Consequently, other mood measures and shorter, optimized versions of the POMS are discussed as possible alternatives.
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Affiliation(s)
- Celia María López-Jiménez
- Departamento de Personalidad, Evaluación y Tratamiento Psicológicos, Universidad de Sevilla, Seville, Spain
| | | | - Susana Sanduvete-Chaves
- Departamento de Psicología Experimental, Facultad de Psicología, Universidad de Sevilla, Seville, Spain
| | - Salvador Chacón-Moscoso
- Departamento de Psicología Experimental, Facultad de Psicología, Universidad de Sevilla, Seville, Spain.,Universidad Autónoma de Chile, Santiago, Chile
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Cano-García FJ, Muñoz-Navarro R, Sesé Abad A, Moretti LS, Medrano LA, Ruiz-Rodríguez P, González-Blanch C, Moriana JA, Cano-Vindel A. Latent structure and factor invariance of somatic symptoms in the patient health questionnaire (PHQ-15). J Affect Disord 2020; 261:21-29. [PMID: 31600584 DOI: 10.1016/j.jad.2019.09.077] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 09/03/2019] [Accepted: 09/30/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Somatic symptoms are highly prevalent in primary care although insufficiently understood. The Patient Health Questionnaire (PHQ-15) is a valuable screening test but it has not yet been possible to unequivocally demonstrate its latent structure and measurement invariance. METHODS A total of 1,255 patients from 28 primary care centres suffering symptoms of anxiety, depression or somatisation participated in a clinical trial. They completed the PHQ-15 at baseline and 374 retook it at three months. Exploratory structural equation modelling (ESEM) was used to compare three models: 1) a single global factor for somatisation, 2) four specific correlated factors, and 3) a bifactor model integrating the first two models. RESULTS A multi-group invariance analysis of the best-fit model was performed: the bifactor model (χ2=25.17, df=23, p = 0.34, RMSEA=0.009, CFI=1.00, TLI=0.999). Strict invariance was good for both gender (RMSEA = 0.046, CFI = 0.973, TLI = 0.963) and age (RMSEA = 0.048, CFI = 0.964, TLI = 0.962). Configural and metric invariance were confirmed for moment of assessment, but scalar invariance was not. LIMITATIONS The two main limitations were the sample (primary care patients with emotional disorders), which was not representative of the general population, and the utilisation of ESEM (vs. confirmatory factor analysis), which did not allow a second-order factor model to be tested. CONCLUSIONS PHQ-15 showed a bifactor structure, providing both a single global measure of somatisation and specific measures of pain, gastrointestinal, cardiopulmonary and fatigue factors. Its factor invariance with regard to both gender and age was confirmed.
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Affiliation(s)
- Francisco Javier Cano-García
- Department of Personality, Assessment and Psychological Treatments, School of Psychology, Universidad de Sevilla, Spain.
| | - Roger Muñoz-Navarro
- Department of Basic Psychology, School of Psychology, Universidad de Valencia, Spain
| | - Albert Sesé Abad
- Department of Psychology, School of Psychology, Universitat de les Illes Balears, Palma, Spain
| | | | | | - Paloma Ruiz-Rodríguez
- Castilla La Nueva Primary Care Centre, Health Service of Madrid, Fuenlabrada, Madrid, Spain
| | - César González-Blanch
- Mental Health Centre, Marqués de Valdecilla University Hospital - IDIVAL, Santander, Cantabria, Spain
| | - Juan A Moriana
- Department of Psychology, Universidad de Córdoba/Maimónides Institute for Research in Biomedicine of Cordoba (IMIBIC)/Reina Sofía University Hospital, Córdoba, Spain
| | - Antonio Cano-Vindel
- Department of Experimental Psychology, School of Psychology, Universidad Complutense de Madrid, Madrid, Spain
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Abstract
To determine whether hypnosis is more effective than conventional interviewing to find traumatic life events in patients with fibromyalgia, we carried out a within-subject experimental design with complete intragroup counterbalancing. Thirty-two women under care in a public primary care center gave 2 identical interviews, with an interval of 3 months, in which the occurrence of traumatic life events was explored, once in a state of wakefulness and once in a state of hypnosis. The state of consciousness was evaluated using 3 measures: bispectral index, skin conductance level, and pain intensity. In the hypnotic state, the patients expressed 9.8 times more traumatic life events than in the waking state, a statistically significant difference with a large effect size.
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Affiliation(s)
| | - José Sánchez-Blanco
- b South Seville Area Health Authority , Andalusian Health Service , Seville , Spain
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Alcocer-Gómez E, Cano-García FJ, Cordero MD. Effect of coenzyme Q10 evaluated by 1990 and 2010 ACR Diagnostic Criteria for Fibromyalgia and SCL-90-R: Four case reports and literature review. Nutrition 2013; 29:1422-5. [DOI: 10.1016/j.nut.2013.05.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2013] [Revised: 04/15/2013] [Accepted: 05/12/2013] [Indexed: 01/07/2023]
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Cordero MD, Cano-García FJ, Alcocer-Gómez E, De Miguel M, Sánchez-Alcázar JA. Oxidative stress correlates with headache symptoms in fibromyalgia: coenzyme Q₁₀ effect on clinical improvement. PLoS One 2012; 7:e35677. [PMID: 22532869 PMCID: PMC3330812 DOI: 10.1371/journal.pone.0035677] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2011] [Accepted: 03/21/2012] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Fibromyalgia (FM) is a chronic pain syndrome with unknown etiology and a wide spectrum of symptoms such as allodynia, debilitating fatigue, joint stiffness and migraine. Recent studies have shown some evidences demonstrating that oxidative stress is associated to clinical symptoms in FM of fibromyalgia. We examined oxidative stress and bioenergetic status in blood mononuclear cells (BMCs) and its association to headache symptoms in FM patients. The effects of oral coenzyme Q(10) (CoQ(10)) supplementation on biochemical markers and clinical improvement were also evaluated. METHODS We studied 20 FM patients and 15 healthy controls. Clinical parameters were evaluated using the Fibromyalgia Impact Questionnaire (FIQ), visual analogues scales (VAS), and the Headache Impact Test (HIT-6). Oxidative stress was determined by measuring CoQ(10), catalase and lipid peroxidation (LPO) levels in BMCs. Bioenergetic status was assessed by measuring ATP levels in BMCs. RESULTS We found decreased CoQ(10), catalase and ATP levels in BMCs from FM patients as compared to normal control (P < 0.05 and P < 0.001, respectively) We also found increased level of LPO in BMCs from FM patients as compared to normal control (P < 0.001). Significant negative correlations between CoQ(10) or catalase levels in BMCs and headache parameters were observed (r = -0.59, P < 0.05; r = -0.68, P < 0.05, respectively). Furthermore, LPO levels showed a significant positive correlation with HIT-6 (r = 0.33, P<0.05). Oral CoQ(10) supplementation restored biochemical parameters and induced a significant improvement in clinical and headache symptoms (P < 0.001). DISCUSSION The results of this study suggest a role for mitochondrial dysfunction and oxidative stress in the headache symptoms associated with FM. CoQ10 supplementation should be examined in a larger placebo controlled trial as a possible treatment in FM.
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Affiliation(s)
- Mario D Cordero
- Centro Andaluz de Biología del Desarrollo, Universidad Pablo de Olavide-CSIC-Junta de Andalucía and Centro de Investigación Biomédica en Red de Enfermedades Raras, ISCIII, Sevilla, Spain.
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Cordero MD, Alcocer-Gómez E, Cano-García FJ, de Miguel M, Campa F, Bonal P, Fernández AMM. The Effect of Coenzyme Q10on Symptoms of Mother and Son with Fibromyalgia Syndrome. ACTA ACUST UNITED AC 2011. [DOI: 10.3109/10582452.2011.558990] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Cordero MD, Alcocer-Gómez E, Cano-García FJ, de Miguel M, Sánchez-Alcázar JA, Moreno Fernández AM. [Low levels of serotonin in serum correlates with severity of fibromyalgia]. Med Clin (Barc) 2010; 135:644-6. [PMID: 20591450 DOI: 10.1016/j.medcli.2010.05.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2010] [Revised: 05/06/2010] [Accepted: 05/06/2010] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Fibromyalgia (FM) is a chronic pain syndrome of unknown etiology, which affects predominantly women. Among the alterations that have been implicated in the pathophysiology of FM, there have been postulated disturbances in serotonin levels and metabolism, and their implication in symptoms. The aim of the present study was to assess the correlation levels between low levels of serotonin and severity of symptoms in FM. PATIENTS AND METHODS We determined serotonin levels using an ELISA kit in serum from 38 FM patients and 25 healthy individual. Results were correlated with symptoms regarding pain, depression, impact of disease (FIQ) and age. RESULTS Serotonin levels were decreased by 45% compared to healthy individual. An important correlation was observed between serotonin levels and predetermined parameters of pain, depression, FIQ and age. CONCLUSION Serotonin levels are correlated with severity of FM. In addition, there is an interesting correlation between serotonin levels and age of patients.
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Affiliation(s)
- Mario David Cordero
- Centro Andaluz de Biología del Desarrollo (CABD), Universidad Pablo de Olavide-CSIC y Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), ISCIII, Sevilla, España.
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Cano-García FJ, Rodríguez-Franco L. [The validity of the International Headache Society criteria and the modifications put forward in 2002 in the diagnosis of migraine and tension type headaches]. Rev Neurol 2003; 36:710-4. [PMID: 12717646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
INTRODUCTION The diagnosis of migraine (M) and tension type headaches (TH) is clinical; it is therefore important to refine the diagnostic criteria. The International Headache Society (IHS) set out the currently used criteria in 1988; 14 years later it has just put forward a number of modifications. AIMS Our aim was to test the comprehensiveness, sensitivity and specificity of both the current and the newly proposed diagnostic criteria in Primary Health Care (PHC), where patients must be screened properly before referral to Neurology services. PATIENTS AND METHODS 74 cases of M and 44 of TH attended in two PHC centres in Seville, in the course of a study about the psychological aspects of headaches. The doctors used a semi structured clinical interview based on the IHS criteria to carry out diagnoses. RESULTS The comprehensiveness of the system was 100%; sensitivity and specificity of the diagnostic criteria were, generally speaking, appropriate and one point highlighted was the intensity of the pain and the fact that it was aggravated by physical activity. Discriminating analysis correctly classified 94.1% of the cases according to the 1988 IHS criteria and 90.7% according to the IHS proposals from 2002, although in the latter case an extra criterion was included in the discrimination. DISCUSSION As shown by different studies, diagnosis carried out by professionals who are well trained in the use of the current IHS criteria is perfectly valid. The present proposals for modification seem to reorganise the classification more efficiently, since they include chronic migraine and also divide episodic TH into infrequent and frequent bouts. These new proposals are now beginning their test period in different fields of application.
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Affiliation(s)
- F J Cano-García
- Departamento de Personalidad, Evaluación y Tratamiento Psicológicos, Universidad de Sevilla, Sevilla, España.
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