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Lv G, Qin R, Zhao X, Li G, Zhao D, Li P. Network structure and temporal stability of symptoms during perioperative period among gastrointestinal cancer patients. J Cancer Surviv 2025:10.1007/s11764-025-01773-w. [PMID: 40163221 DOI: 10.1007/s11764-025-01773-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2024] [Accepted: 02/24/2025] [Indexed: 04/02/2025]
Abstract
PURPOSE Symptom networks can provide empirical evidence for developing personalized and precise symptom management strategies. However, the network structure and temporal stability of perioperative symptoms among gastrointestinal cancer patients remain unknown. This study aims to explore the dynamic connections between symptoms and accurately identify core symptoms to support clinical decision-making. METHODS The measurement points included T0 (2 days before surgery), T1 (2 days after surgery), T2 (6 days after surgery), T3 (10 days after surgery), and T4 (14 days after surgery). Measurement tools included M.D. Anderson Symptoms Inventory-Gastrointestinal Cancer Module (MDASI-GI). A Multilevel Vector Autoregressive Model (mlVAR) was used to build the temporal and contemporaneous networks. RESULTS A total of 241 gastrointestinal cancer participants were recruited, primarily with colorectal cancer type. In the temporal network, sadness had the strongest predictive effect on appetite change, with a value of -0.231. Additionally, dry mouth was identified as the core symptom with the highest outward strength centrality (1.234) and positively predicted pain, sadness, difficulty swallowing, distress, and fatigue (EW = 0.157 ~ 0.230, Ps < 0.001). In the contemporaneous network, depression was a core symptom with the highest strength centrality (1.001). The strongest correlation was found between distress and sadness (EW = 0.645, Ps < 0.05), followed by dry mouth and difficulty swallowing (EW = 0.363, Ps < 0.05). At five time points, the core symptoms within the perioperative symptom network encompassed appetite loss (at T0, with a value of 0.943), distress (at T1, with a value of 1.225; at T2, with a value of 1.057; and at T3, with a value of 0.858), and sadness (at T4, with a value of 1.238). CONCLUSION There exist a prevalent occurrence of positive predictive and associative effects among symptoms. Moreover, emotional and gastrointestinal symptoms, particularly depression and dry mouth, hold significant positions in the perioperative symptom network and should be prioritized in symptom management strategies. IMPLICATIONS FOR CANCER SURVIVORS This study uncovers the underlying patterns of widespread positive predictive and associative effects among symptoms, and provides targeted clinical guidance for managing core symptoms such as dry mouth in perioperative care for cancer patients.
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Affiliation(s)
- Gaorong Lv
- School of Nursing and Rehabilitation, Shandong University, 44 Wenhua West Road, Jinan, Shandong, 250012, People's Republic of China
- School of Software, Shandong University, 1500 Shunhua Road, Jinan, Shandong, 250101, People's Republic of China
| | - Rui Qin
- School of Nursing and Rehabilitation, Shandong University, 44 Wenhua West Road, Jinan, Shandong, 250012, People's Republic of China
| | - Xiangyu Zhao
- School of Nursing and Rehabilitation, Shandong University, 44 Wenhua West Road, Jinan, Shandong, 250012, People's Republic of China
| | - Guopeng Li
- School of Nursing and Rehabilitation, Shandong University, 44 Wenhua West Road, Jinan, Shandong, 250012, People's Republic of China
| | - Di Zhao
- School of Nursing and Rehabilitation, Shandong University, 44 Wenhua West Road, Jinan, Shandong, 250012, People's Republic of China
| | - Ping Li
- School of Nursing and Rehabilitation, Shandong University, 44 Wenhua West Road, Jinan, Shandong, 250012, People's Republic of China.
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Shabanloei R, Ghasempour M, Zamanesazi R, Purabdollah M, Asghari-Jafarabadi M. Illness perception and resilience in patients with cancer: a cross-sectional study. BMC Psychol 2025; 13:276. [PMID: 40108658 PMCID: PMC11924744 DOI: 10.1186/s40359-025-02572-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2024] [Accepted: 03/06/2025] [Indexed: 03/22/2025] Open
Abstract
BACKGROUND Cancer is the second leading cause of death after cardiovascular diseases and is considered a debilitating and incurable condition. Following diagnosis, individuals often experience anxiety, depression, and diminished social energy. Therefore, identifying factors that influence the psychological state of these patients and intervening to improve their well-being is crucial. AIM This study aims to examine the relationship between illness perception and resilience in cancer patients visiting healthcare centers. METHODS The study was conducted in a cross-sectional design, involving 262 cancer patients selected through stratified random sampling from two public and two private oncology treatment centers in Tabriz, Iran. Data were collected using a demographic checklist, the Connor-Davidson Resilience Scale (CD-RISC), and the Revised Illness Perception Questionnaire (IPQ-R). Data analysis was conducted using IBM SPSS Statistics (V.20) at a significance level of 0.05. Statistical methods included descriptive statistics, one-way ANOVA, t-test, Pearson correlation, and multiple linear regression to examine relationships between demographic variables, illness perception, and resilience. RESULTS The majority of participants in the study were male (74%), married (72%), suffering from gastrointestinal cancers (62%), with an average age of 40.9 (SD: 11.9) years. The average overall resilience score was 60.1 (SD: 16.6). Pearson correlation results showed a significant positive correlation between overall resilience and the subscales of illness identity (r = 0.26, p < 0.001), consequences of illness (r = 0.20, p < 0.001), personal control (r = 0.47, p < 0.001), treatment control (r = 0.61, p < 0.001), and time line cyclical (r = 0.33, p < 0.001). Linear regression analysis revealed that illness Identity (B = 0.94, CI [0.43, 1.44], p < 0.001), personal control (B = 1.75, CI [1.30, 2.21], p < 0.001), treatment control (B = 2.37, CI [1.87, 2.88], p < 0.001), and time line cyclical (B = 0.30, CI [0.40, 1.01], p = 0.04) significantly predicted resilience. CONCLUSION The findings suggest that improving patients' understanding and control over their illness may enhance their psychological resilience. These results highlight the importance of patient education and psychological interventions in cancer care, aimed at strengthening personal control and resilience. Integrating these strategies into standard care has the potential to improve patients' ability to cope with the psychological challenges of cancer and ultimately lead to an enhanced quality of life.
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Affiliation(s)
- Reza Shabanloei
- Department of Medical Surgical Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, 51389-47977, Iran
| | - Mostafa Ghasempour
- Department of Medical Surgical Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, 51389-47977, Iran.
| | - Reza Zamanesazi
- Department of Medical Surgical Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, 51389-47977, Iran
| | - Majid Purabdollah
- Department of Nursing, Faculty of Nursing, Khoy University of Medical Sciences, Khoy, Iran
| | - Mohammad Asghari-Jafarabadi
- Cabrini Research, Cabrini Health, Malvern, VIC, 3144, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
- Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, VIC, 3168, Australia
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Garcia P, Block A, Mark S, Mackin L, Paul SM, Cooper BA, Conley YP, Hammer MJ, Levine JD, Miaskowski C. Higher Levels of Multiple Types of Stress Are Associated With Worse State Anxiety and Morning Fatigue Profiles in Patients Receiving Chemotherapy. Cancer Nurs 2025; 48:E75-E89. [PMID: 38259094 PMCID: PMC11263502 DOI: 10.1097/ncc.0000000000001304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
BACKGROUND Anxiety and fatigue are common problems in patients receiving chemotherapy. Unrelieved stress is a potential cause for the co-occurrence of these symptoms. OBJECTIVES The aims of this study were to identify subgroups of patients with distinct state anxiety and morning fatigue profiles and evaluate for differences among these subgroups in demographic and clinical characteristics, as well as measures of global, cancer-specific, and cumulative life stress and resilience and coping. METHODS Patients (n = 1335) completed measures of state anxiety and morning fatigue 6 times over 2 cycles of chemotherapy. All of the other measures were completed prior to the second or third cycle of chemotherapy. Latent profile analysis was used to identify the state anxiety and morning fatigue profiles. RESULTS Three distinct joint profiles were identified: Low Anxiety and Low Morning Fatigue (59%), Moderate Anxiety and Moderate Morning Fatigue (33.4%), and High Anxiety and High Morning Fatigue (7.6%). Patients in the 2 highest classes were younger, were less likely to be married/partnered, and had a higher comorbidity burden. All of the stress scores demonstrated a dose-response effect (ie, as anxiety and morning fatigue profiles worsened, stress increased). Patients in the 2 highest classes reported higher rates of emotional abuse, physical neglect, physical abuse, and sexual harassment. CONCLUSIONS More than 40% of these patients experienced moderate to high levels of both anxiety and morning fatigue. Higher levels of all 3 types of stress were associated with the 2 highest profiles. IMPLICATIONS FOR PRACTICE Clinicians need to perform comprehensive evaluations of patients' levels of stress and recommend referrals to psychosocial services.
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Affiliation(s)
- Philip Garcia
- Author Affiliations: School of Nursing, University of California, San Francisco (Mr Garcia, Ms Block, and Drs Mark, Mackin, Paul, Cooper, and Miaskowski); School of Nursing, University of Pittsburgh, Pennsylvania (Dr Conley); Dana Farber Cancer Institute, Boston, Massachusetts (Dr Hammer); School of Medicine, University of California, San Francisco (Drs Miaskowski and Levine)
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Allaire L, Block A, Paul SM, Hammer MJ, Conley YP, Cooper BA, Levine JD, Miaskowski C. Unrelieved Stress, Decreased Resilience, and Disengagement Coping Strategies Are Associated With Lower Levels of Hope in Patients With Cancer. Oncol Nurs Forum 2024; 52:23-40. [PMID: 39933108 PMCID: PMC12056870 DOI: 10.1188/25.onf.23-40] [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: 05/01/2024] [Accepted: 06/23/2024] [Indexed: 02/13/2025]
Abstract
OBJECTIVES To determine clinically meaningful cut points for the Herth Hope Index and evaluate for differences in demographic and clinical characteristics, as well as stress, resilience, and coping, between patients with lower versus higher levels of hope. SAMPLE & SETTING Outpatients with cancer receiving chemotherapy (N = 1,295). METHODS & VARIABLES Patients completed the Herth Hope Index, Multidimensional Quality of Life Scale-Patient Version, and stress, resilience, and coping measures prior to their second or third cycle of chemotherapy. RESULTS Optimal cut points for the Herth Hope Index were 40 or less (i.e., lower level of hope) and greater than 40 (i.e., higher level of hope). The Lower Hope group had a higher comorbidity burden and lower functional status. IMPLICATIONS FOR NURSING Clinicians can use this information to educate patients about interventions that can decrease stress and improve their coping abilities. Patients with cancer may benefit from having conversations with clinicians that authentically convey prognosis and provide a realistic sense of hope.
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Chen Y, Nam Ng MS, Wei X, Zhang L, Choi KC, Ma Y, Wang F, Han Chan CW. Medication perceptions mediate the association between illness perceptions and adherence to oral anticancer agents among patients with gastrointestinal tract cancer: A cross-sectional study. Eur J Oncol Nurs 2024; 76:102720. [PMID: 40185059 DOI: 10.1016/j.ejon.2024.102720] [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: 07/17/2024] [Revised: 10/22/2024] [Accepted: 10/26/2024] [Indexed: 04/07/2025]
Abstract
PURPOSE Patients with gastrointestinal tract cancer reported suboptimal adherence to oral anticancer agents, reducing the therapeutic benefit and increasing mortality risk. The Common-Sense Model of Self-Regulation highlights patients' perceptions of illness and treatment influence adherence. However, how these perceptions influence adherence remains unknown among this population. This study aimed to explore whether illness perceptions influence adherence via their effect on medication perceptions. METHODS A multi-center cross-sectional study design was conducted. Between July and August 2023, a questionnaire was administered to patients from four tertiary hospitals in Mainland China. Illness perceptions were assessed using the Brief Illness Perceptions Questionnaire. Medication perceptions were measured in medication belief and self-efficacy using the Belief about Medicines Questionnaire and Self-efficacy for Appropriate Medication Use Scale, respectively. Adherence was evaluated using the Morisky 4-item Medication Adherence Scale. Mediation analyses were conducted. RESULTS In total, 253 participants were recruited. Patients with worse negative illness perceptions reported higher concern, lower self-efficacy, and poorer adherence. Medication self-efficacy was positively associated with adherence, whereas the necessity and concern belief of taking oral anticancer agents were not. Illness perceptions, including the cognitive and emotional dimensions, had direct and indirect effects on adherence via its effects on medication self-efficacy. The indirect effect explained 26.63% of the total effect. CONCLUSIONS The association between illness perceptions and adherence is partially mediated by medication self-efficacy. Strategies to foster positive illness perceptions may contribute to better medication self-efficacy and adherence. Attention should be equally focused on both the emotional and cognitive dimensions of illness perceptions.
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Affiliation(s)
- Yongfeng Chen
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong; People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Marques Shek Nam Ng
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Xulian Wei
- People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - LiYuan Zhang
- People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Kai Chow Choi
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Yan Ma
- Shandong Cancer Hospital and Institute, Shandong First Medical University, Shandong Academy of Medical Sciences, Jinan, China
| | - Fang Wang
- First People's Hospital of Yunnan Province, Kunming, China
| | - Carmen Wing Han Chan
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong.
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Song N, Zhang X, Su J, Chen L, Jin Q, Liu C, Dai Z. Nature and Determinants of Fear of Cancer Recurrence After Endoscopic Submucosal Dissection for Early Gastric Cancer: A Cross-Sectional Study. Gastroenterol Nurs 2024; 47:358-367. [PMID: 39356122 DOI: 10.1097/sga.0000000000000812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 02/08/2024] [Indexed: 10/03/2024] Open
Abstract
Gastric cancer is one of the most prevalent tumors in China and other countries, with high morbidity and mortality. Fear of cancer recurrence is common among cancer survivors. Fear of cancer recurrence experiences and psychological interventions have been investigated in breast and other cancers. However, this phenomenon and associated factors have not been evaluated in early gastric cancer survivors in China. The objective of this study was to investigate the nature of fear of cancer recurrence and influencing factors in Chinese patients with early gastric cancer treated with endoscopic submucosal dissection. This cross-sectional study in two centers included 312 early gastric cancer patients who answered self-report questionnaires and were treated with endoscopic submucosal dissection between June 2022 and May 2023 to assess fear of cancer recurrence. Gender, family history of gastrointestinal tumor, tumor recurrence, Helicobacter pylori infection, disease perception, and self-perceived burden were significant factors influencing fear of cancer recurrence (p < .05). More than half of early gastric cancer patients have fear of cancer recurrence, and how to deal with it has become a key issue in the postoperative care of patients. Medical professionals should address these factors to reduce fear of cancer recurrence in at-risk patients.
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Affiliation(s)
- Nian Song
- Nian Song, MD, School of Nursing, Nanjing University of Chinese Medicine, Jiangsu, China
- Xiaotao Zhang, MD, Department of Digestive Endoscopy, the Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
- Jie Su, BD, Department of Digestive Endoscopy, the Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
- Lu Chen, BD, Department of Digestive Endoscopy, the Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
- Qianhong Jin, MD, School of Nursing, Nanjing University of Chinese Medicine, Jiangsu, China
- Chengcheng Liu, MD, School of Nursing, Nanjing University of Chinese Medicine, Jiangsu, China
- Zhengxiang Dai, MD, RN, Department of Hospital-Acquired Infection Control, the Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu, China
| | - Xiaotao Zhang
- Nian Song, MD, School of Nursing, Nanjing University of Chinese Medicine, Jiangsu, China
- Xiaotao Zhang, MD, Department of Digestive Endoscopy, the Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
- Jie Su, BD, Department of Digestive Endoscopy, the Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
- Lu Chen, BD, Department of Digestive Endoscopy, the Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
- Qianhong Jin, MD, School of Nursing, Nanjing University of Chinese Medicine, Jiangsu, China
- Chengcheng Liu, MD, School of Nursing, Nanjing University of Chinese Medicine, Jiangsu, China
- Zhengxiang Dai, MD, RN, Department of Hospital-Acquired Infection Control, the Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu, China
| | - Jie Su
- Nian Song, MD, School of Nursing, Nanjing University of Chinese Medicine, Jiangsu, China
- Xiaotao Zhang, MD, Department of Digestive Endoscopy, the Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
- Jie Su, BD, Department of Digestive Endoscopy, the Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
- Lu Chen, BD, Department of Digestive Endoscopy, the Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
- Qianhong Jin, MD, School of Nursing, Nanjing University of Chinese Medicine, Jiangsu, China
- Chengcheng Liu, MD, School of Nursing, Nanjing University of Chinese Medicine, Jiangsu, China
- Zhengxiang Dai, MD, RN, Department of Hospital-Acquired Infection Control, the Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu, China
| | - Lu Chen
- Nian Song, MD, School of Nursing, Nanjing University of Chinese Medicine, Jiangsu, China
- Xiaotao Zhang, MD, Department of Digestive Endoscopy, the Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
- Jie Su, BD, Department of Digestive Endoscopy, the Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
- Lu Chen, BD, Department of Digestive Endoscopy, the Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
- Qianhong Jin, MD, School of Nursing, Nanjing University of Chinese Medicine, Jiangsu, China
- Chengcheng Liu, MD, School of Nursing, Nanjing University of Chinese Medicine, Jiangsu, China
- Zhengxiang Dai, MD, RN, Department of Hospital-Acquired Infection Control, the Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu, China
| | - Qianhong Jin
- Nian Song, MD, School of Nursing, Nanjing University of Chinese Medicine, Jiangsu, China
- Xiaotao Zhang, MD, Department of Digestive Endoscopy, the Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
- Jie Su, BD, Department of Digestive Endoscopy, the Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
- Lu Chen, BD, Department of Digestive Endoscopy, the Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
- Qianhong Jin, MD, School of Nursing, Nanjing University of Chinese Medicine, Jiangsu, China
- Chengcheng Liu, MD, School of Nursing, Nanjing University of Chinese Medicine, Jiangsu, China
- Zhengxiang Dai, MD, RN, Department of Hospital-Acquired Infection Control, the Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu, China
| | - Chengcheng Liu
- Nian Song, MD, School of Nursing, Nanjing University of Chinese Medicine, Jiangsu, China
- Xiaotao Zhang, MD, Department of Digestive Endoscopy, the Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
- Jie Su, BD, Department of Digestive Endoscopy, the Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
- Lu Chen, BD, Department of Digestive Endoscopy, the Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
- Qianhong Jin, MD, School of Nursing, Nanjing University of Chinese Medicine, Jiangsu, China
- Chengcheng Liu, MD, School of Nursing, Nanjing University of Chinese Medicine, Jiangsu, China
- Zhengxiang Dai, MD, RN, Department of Hospital-Acquired Infection Control, the Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu, China
| | - Zhengxiang Dai
- Nian Song, MD, School of Nursing, Nanjing University of Chinese Medicine, Jiangsu, China
- Xiaotao Zhang, MD, Department of Digestive Endoscopy, the Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
- Jie Su, BD, Department of Digestive Endoscopy, the Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
- Lu Chen, BD, Department of Digestive Endoscopy, the Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
- Qianhong Jin, MD, School of Nursing, Nanjing University of Chinese Medicine, Jiangsu, China
- Chengcheng Liu, MD, School of Nursing, Nanjing University of Chinese Medicine, Jiangsu, China
- Zhengxiang Dai, MD, RN, Department of Hospital-Acquired Infection Control, the Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu, China
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Singh A, Rejeb A. Illness perception: A bibliometric study. Heliyon 2024; 10:e31805. [PMID: 38845980 PMCID: PMC11153196 DOI: 10.1016/j.heliyon.2024.e31805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 05/20/2024] [Accepted: 05/22/2024] [Indexed: 06/09/2024] Open
Abstract
Illness perception is a crucial area of study that has seen significant growth and development over the years. This study conducts a comprehensive bibliometric and network analysis of illness perception research, capturing its evolution from 1975 to 2023. Utilizing 1813 publications from the Scopus database, authored by 5428 researchers, we identify key scholars and influential articles in the field. Our analysis includes various bibliometric networks such as citation, co-citation, collaboration, and keyword co-occurrence networks, along with the presentation of intellectual structure maps. Major research areas include the role of illness perception in mental health conditions like depression, coping mechanisms, quality of life, and chronic illnesses like diabetes, as well as the influence of lay beliefs on health behaviors, and the impact of illness beliefs on conditions like Myocardial Infarction and stroke. The results show a growing academic interest in understanding how illness perceptions shape healthcare outcomes and behaviors.
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Affiliation(s)
- Arti Singh
- Jindal School of Psychology and Counseling, O.P Jindal Global University, Sonipat, Haryana-131029, India
| | - Abderahman Rejeb
- Faculty of Business Economics, Széchenyi István University, 9026 Győr, Hungary
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Zhang Y, Chen X, Li R, Wang Y, Sun Z, Li Q. Interventions strategies and their efficacy in illness perceptions in patients with cancer: A systematic review and meta-analysis. Eur J Oncol Nurs 2024; 70:102599. [PMID: 38810586 DOI: 10.1016/j.ejon.2024.102599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 04/20/2024] [Accepted: 04/25/2024] [Indexed: 05/31/2024]
Abstract
PURPOSES To identify intervention strategies for improving illness perception (IP) of cancer patients and/or family caregivers; and to examine the effects of IP interventions by meta-analysis. METHODS A systematic search was performed to identify literature that focused on improving the IP of cancer patients and/or family caregivers from the establishment of eight databases to August 2023. Manual screening was also applied. The IP intervention strategies for cancer populations were synthesized basing the CSM. Meta-analysis was conducted to assess the effects of IP interventions on health outcomes. Multiple subgroup analyses of the same intervention conditions were conducted to explore the optimal IP-focused intervention. RESULTS 18 studies were included. 11 studies were conducted in a meta-analysis. No studies on family caregivers' IP were identified. Compared to general care, subgroup analysis revealed that IP interventions had favorable effects on cancer patients' IP as well as quality of life and other outcomes. Six IP intervention strategies (information support, cognitive reframing, emotion adjustment, active coping, effective appraisal, and self-social identification) were generated. Meta-analysis showed that compared with theory-less studies (Z = 8.64, p < 0.01) and single delivery formats (Z = 3.66, p < 0.01), the theory-based interventions (Z = 10.86, p < 0.01) and mixed delivery formats (Z = 7.15, p < 0.01) had higher positive effects on IP outcomes. CONCLUSIONS The positive outcomes of IP intervention focusing on cancer patients were highlighted. IP traits and patients' and their caregivers' needs in coping with specific cancer types should be explored before the intervention design. More IP interventions targeting cancer dyads are warranted to develop in the future.
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Affiliation(s)
- Yi Zhang
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Xuan Chen
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Rongyu Li
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Ye Wang
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Zheng Sun
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Qiuping Li
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China; Affiliated Hospital of Jiangnan University, Wuxi, China.
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Liu P, Wu Q, Cheng Y, Zhuo Y, Li Z, Ye Q, Yang Q. Associations of illness perception and social support with fear of progression in young and middle-aged adults with digestive system cancer: A cross-sectional study. Eur J Oncol Nurs 2024; 70:102586. [PMID: 38657348 DOI: 10.1016/j.ejon.2024.102586] [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: 01/17/2024] [Revised: 03/27/2024] [Accepted: 03/31/2024] [Indexed: 04/26/2024]
Abstract
PURPOSE While Fear of progression (FoP) is a natural reaction in cancer, elevated FoP can impact life quality and social function. Our study aims to explore how illness perception, social support, and posttraumatic growth influence patients' FoP. METHODS This study enrolled 243 young and middle-aged adults with digestive system cancer at a hospital in Guangzhou from November 2022 to November 2023. In this study, the measurement instruments utilized included The Fear of Progression Questionnaire-Short Form, The Brief Illness Perception Questionnaire, The 12-item Perceived Social Support Scale, and The 21-item Posttraumatic Growth Inventory. Data was analyzed employing polynomial regression and response surface analyses. RESULTS The mean score of FoP was 35.45 ± 10.05, and 59.3% of the cancers (scores≥34) had clinically dysfunctional levels of FoP. Regarding congruence, patients' FoP was higher when the levels of illness perception and social support were both low or high than when the levels were both intermediate. Regarding incongruence, patients' FoP was lower when the level of illness perception was low and social support was high compared with when the level of illness perception was high and social support was low. Additionally, posttraumatic growth moderated the (in)congruence effect of illness perception-social support on the FoP of patients. CONCLUSIONS Low or high illness perception-social support congruence was detrimental to the FoP of patients. Low illness perception-high social support incongruence was beneficial to patients' FoP. Posttraumatic growth can be a positive factor for enhancing the impact of low illness perception-high social support incongruence on patients' FoP.
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Affiliation(s)
- Peng Liu
- School of Nursing, Jinan University, Guangzhou, Guangdong, China
| | - Qinyang Wu
- School of Nursing, Jinan University, Guangzhou, Guangdong, China
| | - Yingying Cheng
- School of Nursing, Jinan University, Guangzhou, Guangdong, China
| | - Yishang Zhuo
- School of Nursing, Jinan University, Guangzhou, Guangdong, China
| | - Zihan Li
- School of Nursing, Jinan University, Guangzhou, Guangdong, China
| | - Qiuyun Ye
- Tianhe Shipai Huashi Community Health Service Center, Guangdong, China.
| | - Qiaohong Yang
- School of Nursing, Jinan University, Guangzhou, Guangdong, China.
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Bahçecioğlu Turan G, Türkben Polat H. The effects of illness perception on death anxiety and satisfaction with life in patients with advanced gastrointestinal cancer. Palliat Support Care 2024; 22:360-366. [PMID: 37620999 DOI: 10.1017/s1478951523001244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
OBJECTIVES This study was conducted to determine the effects of illness perception on death anxiety and satisfaction with life in patients with advanced gastrointestinal cancer. METHODS This cross-sectional and correlational study was conducted with 125 patients with cancer who were admitted to the oncology clinic of a university hospital in the Central Anatolian Region of Turkey between March and December 2022 and who met the research criteria and accepted to participate in the study. The data were collected with "Patient descriptive information form," "Brief Illness Perception Questionnaire (BIPQ)," "Scale of Death Anxiety (SDA)," and "Satisfaction with Life Scale (SWLS)." RESULTS It was found that mean BIPQ score of the patients was 39.54 ± 12.82, the mean SDA score was 8.02 ± 3.16, and the mean SWLS score was 14.74 ± 5.19. BIPQ total score was found to affect SDA total score positively (β = .751) and SWLS total score negatively (β = - .591). SDA total score was found to affect SWLS total score negatively (β = -.216) (p < .05). SIGNIFICANCE OF RESULTS It was found that patients with advanced gastrointestinal cancer had moderate level of illness perception and life satisfaction, and high death anxiety. It was found that as illness perception of the patients increased, their death anxiety increased and satisfaction with life decreased. In addition, it was found that as the death anxiety of patients increased, their satisfaction with life decreased.
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Affiliation(s)
| | - Hilal Türkben Polat
- Department of Fundamentals of Nursing, Seydişehir Kamil Akkanat Faculty of Health Sciences, Necmettin Erbakan University, Konya, Turkey
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11
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Horwood M, Loades ME, Kosir U, Davis C. Illness Perceptions, Fear of Cancer Recurrence, and Mental Health in Teenage and Young Adult Cancer Survivors. JOURNAL OF PEDIATRIC HEMATOLOGY/ONCOLOGY NURSING 2024; 41:44-55. [PMID: 37956647 DOI: 10.1177/27527530231190378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
Background: The Common-Sense Model of illness self-regulation underpins illness-specific cognitions (including both illness perceptions and a fear of cancer recurrence; FCR). There is evidence in adults of associations between FCR, illness perceptions, and mental health in adult cancer survivors. However, there is limited empirical research examining these constructs within the developmentally distinct population of adolescent and young adult (AYA) survivors of cancer. The current study aimed to bridge that gap to inform potentially modifiable treatment targets in this population. Method: A cross-sectional, correlational design was used to examine the associations between illness perceptions, FCR, and mental health. A web-based survey was completed by a convenience sample of AYA survivors. Regression and mediation analyses were performed. Results: Overall, more negative illness perceptions were associated with more severe FCR and greater depressive and anxiety symptomatology. Higher FCR was predictive of worse overall mental health. More negative overall illness perceptions predicted the relationship between FCR-depression, mediating 24.1% of the variance. Contrastingly, overall illness perceptions did not predict or mediate the relationship between FCR-anxiety. However, the specific illness perceptions regarding timeline, personal control, and emotional representation, were predictive of the FCR-anxiety relationship. Discussion: Illness perceptions and FCR were predictive of mental health outcomes. Identifying and therapeutically targeting negative illness perceptions in those young adults who have survived adolescent cancer could therefore be a means of reducing anxiety and depressive symptomatology. Limitations and future directions are discussed.
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Affiliation(s)
| | | | - Urska Kosir
- Orthopedic Oncology - Sarcoma Team, McGill University Health Centre (Sarcoma Team), Montreal, Canada
| | - Cara Davis
- Department of Psychology, University of Bath, Bath, UK
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12
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Liu S, Huang R, Li A, Yu S, Yao S, Xu J, Tang L, Li W, Gan C, Cheng H. Effects of the CALM intervention on resilience in Chinese patients with early breast cancer: a randomized trial. J Cancer Res Clin Oncol 2023; 149:18005-18021. [PMID: 37980293 DOI: 10.1007/s00432-023-05498-0] [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: 10/05/2023] [Accepted: 10/30/2023] [Indexed: 11/20/2023]
Abstract
OBJECTIVE Resilience is an important regulating factor for anxiety and depression in breast cancer. The Managing Cancer and Living Meaningfully (CALM) intervention has been confirmed to improve anxiety and depression in patients, but the role of resilience is still unclear. This study explores this issue. METHODS In this study, a cohort of 124 patients diagnosed with breast cancer was recruited and randomly assigned to either the intervention group (IG) or the control group (CG). In addition, we enrolled a group of cancer-free women (regular control group) and assessed their resilience. All patients were evaluated using the Connor-Davidson Resilience Scale (CD-RISC), Hospital Anxiety and Depression Scale (HADS), Functional Assessment of Cancer Therapy (FACT-B) and Perceived Stress Scale (PSS) at different time points. The primary outcomes were resilience, quality of life, anxiety, depression, and perceived stress. A repeated measures ANOVA was used to compare the scores of the IG and CG groups. The relationship between resilience and quality of life was analyzed using Pearson's correlation test. The paired-sample t-test was used to compare the changes in each score at different time points. RESULTS The intervention group showed significant differences in resilience, adamancy, optimism, tenacity, anxiety, depression, perceived stress and QOL scores before and after 6, 12, and 24 weeks (F = 17.411, F = 226.55, F = 29.096, F = 50.67, F = 82.662, F = 105.39, F = 62.66, F = 72.43, F = 34.561, respectively; P < 0.001). Compared to the control group, the intervention group demonstrated significant improvement in resilience and quality of life (t = -11.517, p < 0.001; t = - 4.929, p < 0.001), as well as a significant reduction in anxiety, depression, and perceived stress scores (t = 5.891, p < 0.001; t = 2.654, p < 0.001; t = 4.932, p < 0.001). In the intervention group, a significant positive correlation was observed between resilience in breast cancer survivors and quality of life (QOL) scores. (before CALM treatment: r = 0.3204, P = 0.0111; after 6 weeks: r = 0.3619, P = 0.0038; after 12 weeks: r = 0.3355, P = 0.0077; after 24 weeks: r = 0.2801, P = 0.0274). CONCLUSIONS A positive impact of the CALM intervention can be seen in improved resilience and reduced anxiety and depression, supporting its use as an effective psychological management tool and intervention strategy in the early stages of long-term breast cancer recovery.
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Affiliation(s)
- Shaochun Liu
- Department of Oncology, the Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, Anhui, China
| | - Runze Huang
- Department of Oncology, the Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, Anhui, China
| | - Anlong Li
- Department of Oncology, the Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, Anhui, China
| | - Sheng Yu
- Department of Oncology, the Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, Anhui, China
| | - Senbang Yao
- Department of Oncology, the Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, Anhui, China
| | - Jian Xu
- Department of Oncology, the Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, Anhui, China
| | - Lingxue Tang
- Department of Oncology, the Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, Anhui, China
| | - Wen Li
- Department of Oncology, the Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, Anhui, China
| | - Chen Gan
- Department of Oncology, the Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, Anhui, China
| | - Huaidong Cheng
- Department of Oncology, the Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, Anhui, China.
- Shenzhen Clinical Medical School of Southern Medical University, Guangzhou, China.
- Department of Oncology, Shenzhen Hospital of Southern Medical University, Shenzhen, Guangdong, China.
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13
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Oppegaard KR, Mayo SJ, Armstrong TS, Kober KM, Anguera J, Hammer MJ, Levine JD, Conley YP, Paul S, Cooper B, Miaskowski C. Adverse Childhood Experiences and Higher Levels of Stress Are Associated With the Co-occurrence of Cancer-Related Cognitive Impairment and Anxiety. Semin Oncol Nurs 2023; 39:151513. [PMID: 37914659 DOI: 10.1016/j.soncn.2023.151513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 09/19/2023] [Accepted: 09/20/2023] [Indexed: 11/03/2023]
Abstract
OBJECTIVES We sought to identify subgroups of patients with distinct joint cancer-related cognitive impairment (CRCI) AND anxiety profiles and evaluate for differences in demographic and clinical characteristics, as well as levels of global stress, cancer-specific stress, cumulative life stress, and resilience. DATA SOURCES Patients (n = 1332) completed the Attentional Function Index and the Spielberger State Anxiety Inventory six times over two cycles of chemotherapy. Global, cancer-specific, and cumulative life stress and resilience were evaluated using Perceived Stress Scale, Impact of Event Scale-Revised, Life Stressor Checklist-Revised, and Connor-Davidson Resilience Scale, respectively. Latent profile analysis was used to identify subgroups of patients with distinct joint CRCI AND anxiety profiles. Differences were evaluated using parametric and nonparametric tests. RESULTS Three classes were identified (ie, No CRCI and Low Anxiety [57.3%], Moderate CRCI and Moderate Anxiety [34.5%], and High CRCI and High Anxiety [8.2%]). All of the stress measures showed a dose-response effect (ie, as the CRCI AND anxiety profile worsened, scores for all three types of stress increased). The two highest symptom classes reported higher occurrence rates for six specific stressors (eg, emotional abuse, physical abuse, sexual harassment). CONCLUSIONS Findings suggest that higher levels of co-occurring CRCI AND anxiety are associated with some common risk factors, as well as higher levels of stress and lower levels of resilience. Increased knowledge of modifiable risk factors and sources of stress associated with the co-occurrence of these two symptoms will assist clinicians to identify high-risk patients and implement individualized interventions.
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Affiliation(s)
- Kate R Oppegaard
- Department of Physiological Nursing, University of California San Francisco, San Francisco, CA
| | - Samantha J Mayo
- Lawrence S. Bloomberg School of Nursing, University of Toronto, Toronto, Canada
| | - Terri S Armstrong
- Neuro-Oncology Branch, Office of Patient-Centered Outcomes Research, Center for Cancer Research, National Cancer Institute, Bethesda, MD
| | - Kord M Kober
- Department of Physiological Nursing, University of California San Francisco, San Francisco, CA
| | - Joaquin Anguera
- Weill Institute for Neurosciences, Departments of Neurology and Psychiatry, University of California San Francisco, San Francisco, CA
| | - Marilyn J Hammer
- Director of Research and Evidence-based Practice, Dana-Farber Cancer Institute, Boston, MA
| | - Jon D Levine
- Department of Medicine, School of Medicine, University of California San Francisco, San Francisco, CA
| | - Yvette P Conley
- Department of Health Promotion and Development, School of Nursing, University of Pittsburg, Pittsburgh, PA
| | - Steven Paul
- Department of Physiological Nursing, University of California San Francisco, San Francisco, CA
| | - Bruce Cooper
- Department of Physiological Nursing, University of California, San Francisco, CA
| | - Christine Miaskowski
- Departments of Physiological Nursing and Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, CA.
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Sırlıer Emir B, Yıldız S, Kurt O, Emre E, Aydın S. Relationships between Anxiety, Depression, and Illness Perceptions in Lung and Breast Cancer Patients throughout the Cancer Continuum. Healthcare (Basel) 2023; 11:2794. [PMID: 37893868 PMCID: PMC10606067 DOI: 10.3390/healthcare11202794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 10/17/2023] [Accepted: 10/20/2023] [Indexed: 10/29/2023] Open
Abstract
Cancer is a devastating disease that has significant psychological and biological impacts. Generally, lung cancer primarily affects men while breast cancer primarily affects women. Thus, this study aimed to investigate the levels of anxiety and depression in patients with these prevalent cancer types, as well as their perceptions of the illness and any potential connections between them. The study included a total of 252 participants, consisting of 110 breast cancer patients, 112 lung cancer patients, and 30 healthy individuals as controls. The Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) were administered to assess mood, while the Illness Perception Questionnaire (IPQ) was used to evaluate cancer perceptions. Results revealed that both breast cancer and lung cancer patients had significantly higher BDI and BAI scores compared to the control group. Furthermore, the BDI and BAI scores were lower in breast cancer patients compared to lung cancer patients. The IPQ causal representation-immunity score was significantly higher in lung cancer patients than in breast cancer patients (p = 0.01). Positive correlations were found between BDI scores and BAI scores, as well as between BDI scores and certain subscale scores of the IPQ related to illness representation and causal representation. Additionally, a positive correlation was observed between BAI scores and the IPQ illness representation-timeline acute/chronic subscale, while a negative correlation was found between BAI scores and the IPQ causal representation-accident or chance scores. Overall, the study findings demonstrated that breast and lung cancer patients possess negative perceptions of their disease and experience high levels of anxiety and depression. To enhance the quality of life and promote resilience in these patients, it is recommended to incorporate psychological interventions that consider anxiety, depression, and disease perception.
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Affiliation(s)
- Burcu Sırlıer Emir
- Department of Psychiatry, Elazığ Fethi Sekin City Hospital, 23100 Elazığ, Turkey;
| | - Sevler Yıldız
- Department of Psychiatry, Elazığ Fethi Sekin City Hospital, 23100 Elazığ, Turkey;
| | - Osman Kurt
- Department of Public Health, Adıyaman Provincial Health Directorate, 02100 Adıyaman, Turkey;
| | - Elif Emre
- Department of Anatomy, Faculty of Medicine, University of Fırat, 23119 Elazığ, Turkey;
| | - Süleyman Aydın
- Department of Biochemistry, Faculty of Medicine, University of Fırat, 23119 Elazığ, Turkey;
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15
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Cai Y, Zhang Y, Cao W, Guo VY, Deng Y, Luo L, Shen J, Zhu Y, Chen X, Yang X, Hou F, Li J. Preliminary Validation of the Revised Illness Perception Questionnaire for Patients with Nasopharyngeal Carcinoma in China. Healthcare (Basel) 2023; 11:2469. [PMID: 37761666 PMCID: PMC10530590 DOI: 10.3390/healthcare11182469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 08/15/2023] [Accepted: 09/03/2023] [Indexed: 09/29/2023] Open
Abstract
Nasopharyngeal carcinoma is a common and highly malignant cancer in southern China. It is important to accurately assess the illness perception of nasopharyngeal carcinoma according to the common-sense model of self-regulation. The purpose was to validate the Chinese version of the Revised Illness Perception Questionnaire for patients with Nasopharyngeal carcinoma. A cross-sectional survey of 631 patients with Nasopharyngeal carcinoma was conducted in Guangzhou, China. The reliability of the scale was evaluated using Cronbach's alpha. The factor structure was assessed using exploratory factor analysis (EFA) of each dimension. The EFA revealed that the 29-item self-rated scale has a seven-factor structure consistent with the original scale and explained 67.3% of the variance after extraction and rotation. The scale showed satisfactory reliability. The item-total correlations ranged from -0.16 to 0.64 (p < 0.05). The item-subscale correlations ranged from 0.46 to 0.91 (p < 0.05). The item-other subscale correlations ranged from -0.38 to 0.51 and from -0.21 to 0.56 (p < 0.05). Significant correlations were found between the timeline (acute/chronic) (r = 0.224, r = 0.166), consequences (r = 0.415, r = 0.338), timeline cyclical (r = 0.366, r = 0.284), emotional representations (r = 0.497, r = 0.465), personal control (r = -0.122, r = -0.134), treatment control (r = -0.135, r = -0.148), and illness coherence (r = -0.261, r = -0.213) subscales, and depression, anxiety (p < 0.05). The scale revealed acceptable reliability, factorial validity, and construct validity. It could be used to assess the illness representations of Chinese patients with nasopharyngeal carcinoma.
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Affiliation(s)
- Yuqi Cai
- School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China (J.L.)
| | - Yuan Zhang
- Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou 510080, China
| | - Wangnan Cao
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing 100871, China
| | - Vivian Yawei Guo
- School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China (J.L.)
| | - Yang Deng
- School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China (J.L.)
| | - Liying Luo
- School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China (J.L.)
| | - Jianling Shen
- School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China (J.L.)
| | - Yang Zhu
- School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China (J.L.)
| | - Xiaoting Chen
- School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China (J.L.)
| | - Xiao Yang
- School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China (J.L.)
| | - Fengsu Hou
- Shenzhen Kangning Hospital/Shenzhen Mental Health Center, Shenzhen 518020, China
| | - Jinghua Li
- School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China (J.L.)
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16
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Valero-Cantero I, Casals C, Espinar-Toledo M, Barón-López FJ, Martínez-Valero FJ, Vázquez-Sánchez MÁ. Cancer Patients' Satisfaction with In-Home Palliative Care and Its Impact on Disease Symptoms. Healthcare (Basel) 2023; 11:healthcare11091272. [PMID: 37174814 PMCID: PMC10178555 DOI: 10.3390/healthcare11091272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 04/26/2023] [Accepted: 04/27/2023] [Indexed: 05/15/2023] Open
Abstract
The aim of the study was to determine whether the satisfaction of cancer patients with in-home palliative care is associated with the impact of disease symptoms and with self-perceived quality of life. This was a cross-sectional descriptive study, conducted in the primary health care sector in six clinical management units, where 72 patients were recruited over a period of six months. The severity of symptoms was determined by the Edmonton Symptom Assessment System (ESAS). Quality of life was evaluated with the EORTC QLQ-C30 (version 3) questionnaire, and patients' satisfaction with the care received was evaluated by the Client Satisfaction Questionnaire (CSQ-8). The patients' satisfaction with the health care received was represented by an average score of 6, on a scale of 1-10; thus, there is room for improvement in patient satisfaction. Moreover, it was found that more intense symptoms and lower quality of life are associated with lower satisfaction with health care received (p = 0.001). Similarly, when symptoms are more severe, the quality of life is lower (p < 0.001). The identification of fatigue, reduced well-being, pain, drowsiness, and depression as the symptoms experienced with the highest intensity by our patients provides valuable information for health care providers in developing individualized symptom management plans for patients with advanced cancer.
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Affiliation(s)
| | - Cristina Casals
- ExPhy Research Group, Department of Physical Education, Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Universidad de Cádiz, 11519 Puerto Real, Spain
| | - Milagrosa Espinar-Toledo
- Rincón de la Victoria Clinical Management Unit, Malaga-Guadalhorce Health District, 29730 Malaga, Spain
| | - Francisco Javier Barón-López
- Faculty of Health Sciences, Institute of Biomedical Research in Málaga (IBIMA), University of Malaga, 29016 Malaga, Spain
| | | | - María Ángeles Vázquez-Sánchez
- Department of Nursing, Faculty of Health Sciences, PASOS Research Group and UMA REDIAS Network of Law and Artificial Intelligence Applied to Health and Biotechnology, University of Malaga, 29071 Malaga, Spain
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17
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Brett J, Henshall C, Dawson P, Collins GP, Ehlers A, Mitchell-Floyd T, Aspinall A, Gilmour-Hamilton C, Robinson K, Watson E. Examining the levels of psychological support available to patients with haematological cancer in England: a mixed methods study. BMJ Open 2023; 13:e060106. [PMID: 36806143 PMCID: PMC9943904 DOI: 10.1136/bmjopen-2021-060106] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
Abstract
OBJECTIVES The psychological impact of a haematological malignancy is well documented. However, few studies have assessed the provision of psychological support to people with these diagnoses. This study explores the extent and nature of psychological support for people diagnosed with haematological cancer to inform future service provision. DESIGN This study consisted of an online survey with healthcare professionals (phase 1) and qualitative interviews with patients (phase 2) and key health professionals (phase 3). A descriptive analysis of survey data and thematic analysis of interviews were conducted. PARTICIPANTS Two hundred health professionals practising in England completed the survey. Twenty-five interviews were conducted with people diagnosed with haematological cancer in the past 3 years, and 10 with key health professionals, including haematologists, cancer nurse specialists and psychologists were conducted. PRIMARY OUTCOME MEASURES Level of psychological assessment undertaken with people with haematological cancer, and level and nature of psychological support provided. RESULTS Less than half (47.3%) of survey respondents strongly agreed/agreed that their patients were well supported in terms of their psychological well-being and approximately half (49.4%) reported providing routine assessment of psychological needs of patients, most commonly at the time of diagnosis or relapse. Patients described their need for psychological support, their experiences of support from health professionals and their experiences of support from psychological therapy services. There was considerable variation in the support patients described receiving. Barriers to providing psychological support reported by health professionals included time, skills, resources and patient barriers. Most doctors (85%) and 40% of nurse respondents reported receiving no training for assessing and managing psychological needs. CONCLUSIONS Psychological well-being should be routinely assessed, and person-centred support should be offered regularly throughout the haematological cancer journey. Greater provision of healthcare professional training in this area and better integration of psychological support services into the patient care pathway are required.
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Affiliation(s)
- Jo Brett
- Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Catherine Henshall
- Health and Life Sciences, Oxford Brookes University, Oxford, UK
- Research Delivery, Oxford Health NHS Foundation Trust, Oxford, UK
| | - Paul Dawson
- Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Graham P Collins
- Clinical Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Anke Ehlers
- Experimental Psychology, University of Oxford, Oxford, UK
| | - Tracy Mitchell-Floyd
- Clinical Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Anya Aspinall
- Clinical Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | | | - Kate Robinson
- Patient and Public Involvement, Oxford Brookes University, Oxford, UK
| | - Eila Watson
- Health and Life Sciences, Oxford Brookes University, Oxford, UK
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18
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Stacker T, Kober KM, Dunn L, Viele C, Paul SM, Hammer M, Conley YP, Levine JD, Miaskowski C. Associations Between Demographic, Clinical, and Symptom Characteristics and Stress in Oncology Patients Receiving Chemotherapy. Cancer Nurs 2023; 46:E62-E69. [PMID: 35671412 PMCID: PMC9437148 DOI: 10.1097/ncc.0000000000001069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Patients undergoing cancer treatment experience global stress and cancer-specific stress. Both types of stress are associated with a higher symptom burden. OBJECTIVE In this cross-sectional study, we used a comprehensive set of demographic, clinical, and symptom characteristics to evaluate their relative contribution to the severity of global and cancer-specific stress. METHODS Patients (N = 941) completed study questionnaires before their second or third cycle of chemotherapy. RESULTS Consistent with our a priori hypothesis, we found both common and distinct characteristics associated with higher levels of global stress and cancer-specific stress. A significant proportion of our patients had scores on the Impact of Event Scale-Revised suggestive of subsyndromal (29.4%) or probable (13.9%) posttraumatic stress disorder. Four of the 5 stepwise linear regression analyses for the various stress scales explained between 41.6% and 54.5% of the total variance. Compared with various demographic and clinical characteristics, many of the common symptoms associated with cancer and its treatments uniquely explained a higher percentage of the variance in the various stress scales. Symptoms of depression made the largest unique contribution to the percentage of total explained variance across all 5 scales. CONCLUSION Clinicians need to assess for global stress, cancer-specific stress, and depression in patients receiving chemotherapy. IMPLICATIONS FOR PRACTICE Patients may benefit from integrative interventions (eg, mindfulness-based stress reduction, cognitive behavioral therapy, acupuncture) that simultaneously address stress and symptoms commonly associated with cancer and its treatments.
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Affiliation(s)
- Tara Stacker
- Author Affiliations: School of Nursing, University of California (Ms Stacker and Viele, and Drs Kober, Paul, and Miaskowski), San Francisco; School of Medicine, Stanford University (Dr Dunn), California; Dana Farber Cancer Institute (Dr Hammer), Boston, Massachusetts; School of Nursing, University of Pittsburgh (Dr Conley), Pennsylvania; and School of Medicine, University of California (Drs Levine and Miaskowski), San Francisco
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19
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Maersk JL, Rosted E, Lindahl‐Jacobsen L. 'When I can ride my bike, I think, am I at all as sick as they say?' An exploration of how men with advanced lung cancer form illness perceptions in everyday life. Eur J Cancer Care (Engl) 2022; 31:e13751. [PMID: 36382401 PMCID: PMC9787393 DOI: 10.1111/ecc.13751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 09/29/2022] [Accepted: 10/09/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The purpose of this study was to explore how men with advanced lung cancer form perceptions of their illness in everyday life and how this influences perceptions about rehabilitation. METHODS Constructivist grounded theory principles guided the collection and analysis of data from in-depth interviews with 10 men with advanced lung cancer. RESULTS The findings show that the men's illness perception was fluid, contextual and formed by interrelated factors. Engaging in daily activities and maintaining everyday life was a strong influence on their illness perception. CONCLUSION In order to make rehabilitation relevant to men with lung cancer, consideration should be given to how the men's everyday lives may be incorporated into the service provision.
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Affiliation(s)
- Jesper Larsen Maersk
- Centre for Nutrition, Rehabilitation, and MidwiferyUniversity College AbsalonNaestvedDenmark
| | - Elizabeth Rosted
- Department of Oncology and Palliative CareZealand University HospitalRoskildeDenmark,Department of Regional Health ResearchUniversity of Southern DenmarkOdenseDenmark
| | - Line Lindahl‐Jacobsen
- Centre for Nutrition, Rehabilitation, and MidwiferyUniversity College AbsalonNaestvedDenmark
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20
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Michnevich T, Pan Y, Hendi A, Oechsle K, Stein A, Nestoriuc Y. Preventing adverse events of chemotherapy for gastrointestinal cancer by educating patients about the nocebo effect: a randomized-controlled trial. BMC Cancer 2022; 22:1008. [PMID: 36138381 PMCID: PMC9502603 DOI: 10.1186/s12885-022-10089-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 09/12/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adverse events of chemotherapy may be caused by pharmacodynamics or psychological factors such as negative expectations, which constitute nocebo effects. In a randomized controlled trial, we examined whether educating patients about the nocebo effect is efficacious in reducing the intensity of self-reported adverse events. METHODS In this proof-of-concept study, N = 100 outpatients (mean age: 60.2 years, 65% male, 54% UICC tumour stage IV) starting first-line, de novo chemotherapy for gastrointestinal cancers were randomized 1:1 to a nocebo education (n = 49) or an attention control group (n = 51). Our primary outcome was patient-rated intensity of four chemotherapy-specific and three non-specific adverse events (rated on 11-point Likert scales) at 10-days and 12-weeks after the first course of chemotherapy. Secondary outcomes included perceived control of adverse events and tendency to misattribute symptoms. RESULTS General linear models indicated that intensity of adverse events differed at 12-weeks after the first course of chemotherapy (mean difference: 4.04, 95% CI [0.72, 7.36], p = .02, d = 0.48), with lower levels in the nocebo education group. This was attributable to less non-specific adverse events (mean difference: 0.39, 95% CI [0.04, 0.73], p = .03, d = 0.44) and a trend towards less specific adverse events in the nocebo education group (mean difference: 0.36, 95% CI [- 0.02, 0.74], p = .07, d = 0.37). We found no difference in adverse events at 10-days follow-up, perceived control of adverse events, or tendency to misattribute non-specific symptoms to the chemotherapy. CONCLUSIONS This study provides first proof-of-concept evidence for the efficacy of a brief information session in preventing adverse events of chemotherapy. However, results regarding patient-reported outcomes cannot rule out response biases. Informing patients about the nocebo effect may be an innovative and clinically feasible intervention for reducing the burden of adverse events. TRIAL REGISTRATION Retrospectively registered on March 27, 2018 to the German Clinical Trial Register (ID: DRKS00009501).
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Affiliation(s)
- T Michnevich
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
- Department of Psychiatry and Psychotherapy, Charité - University Medicine Berlin, Berlin, Germany.
- Present address: Charité - University Medicine Berlin, Berlin, Germany.
| | - Y Pan
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A Hendi
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Oncology, Asklepios Clinic Barmbek, Hamburg, Germany
| | - K Oechsle
- Center of Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A Stein
- Center of Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Y Nestoriuc
- Department of Clinical Psychology, Helmut Schmidt University, University of the Federal Armed Forces Hamburg, Hamburg, Germany
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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21
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Valentine TR, Presley CJ, Carbone DP, Shields PG, Andersen BL. Illness perception profiles and psychological and physical symptoms in newly diagnosed advanced non-small cell lung cancer. Health Psychol 2022; 41:379-388. [PMID: 35604701 PMCID: PMC9817475 DOI: 10.1037/hea0001192] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Of all cancers, advanced nonsmall cell lung cancer (NSCLC) is associated with the highest burden on mental and physical health-related quality of life (HRQoL). Patients' subjective beliefs about their cancer (i.e., illness perceptions) may influence coping responses and treatment decisions and affect health. To identify cognitive and emotional perceptions and their association with patient characteristics and illness circumstances, the relationship between illness perception schemas and psychological and physical responses and symptoms were studied. METHOD Patients newly diagnosed with stage IV NSCLC (N = 186) enrolled in a prospective cohort study (NCT03199651) completed measures of illness perceptions; anxiety, depression, and physical symptoms; and health status. Latent profile analysis identified illness perception profiles. Hierarchical linear regressions tested profile assignment as a correlate of responses and symptoms. RESULTS A three-profile solution was optimal. Patients with a "struggling" profile (n = 83; 45%) reported the most negative perceptions; patients with a "coping" profile (n = 41; 22%) reported relatively positive perceptions; and patients with a "coping but concerned" profile (n = 62; 33%) endorsed high illness concern but relatively positive perceptions otherwise. Patients with a "struggling" profile reported the highest levels of anxiety and depression symptoms, overall physical symptoms, cough, dyspnea, and pain, and the poorest self-rated health. CONCLUSIONS New data add to the clinical portrayal of patients coping with NSCLC since the availability of new therapies and survival improvements. Other disease groups have reported a predominance of positive perceptions, rather than ones of significant cognitive and emotional struggles found here. Illness perception data may provide content-rich resources for intervention tailoring. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Thomas R. Valentine
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI
| | - Carolyn J. Presley
- Department of Internal Medicine, Division of Medical Oncology, The Ohio State University Comprehensive Cancer Center, Columbus, OH
| | - David P. Carbone
- Department of Internal Medicine, Division of Medical Oncology, The Ohio State University Comprehensive Cancer Center, Columbus, OH
| | - Peter G. Shields
- Department of Internal Medicine, Division of Medical Oncology, The Ohio State University Comprehensive Cancer Center, Columbus, OH
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22
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Tian X, Tang L, Yi LJ, Qin XP, Chen GH, Jiménez-Herrera MF. Mindfulness Affects the Level of Psychological Distress in Patients With Lung Cancer via Illness Perception and Perceived Stress: A Cross-Sectional Survey Study. Front Psychol 2022; 13:857659. [PMID: 35465528 PMCID: PMC9022206 DOI: 10.3389/fpsyg.2022.857659] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 03/03/2022] [Indexed: 11/17/2022] Open
Abstract
Purpose The aims of the study were first to investigate the association between illness perception and psychological distress and second to determine whether mindfulness affects psychological distress via illness perception and perceived stress in patients with lung cancer. Methods Among 300 patients with lung cancer who participated in this cross-sectional study, 295 patients made valid responses to distress thermometer (DT), the Five Facet Mindfulness Questionnaire (FFMQ), the Brief Illness Perception Questionnaire (B-IPQ), and the Perceived Stress Scale (PSS) between January and July 2021. The possible pathways of mindfulness affecting psychological distress were analyzed based on the structural equation modeling analysis. Results A total of 24.4% patients with lung cancer had DT > 4. Illness perception (β = 0.17, p = 0.002) and perceived stress (β = 0.23, p < 0.001) had a direct effect on psychological distress. Mindfulness had a direct effect on illness perception (β = -0.16, p = 0.006) and mindfulness indirectly influenced psychological distress (β = -0.04, p = 0.009) through affecting illness perception alone or simultaneously affecting both the illness perception and perceived stress in patients with lung cancer. Conclusion Lung cancer suffered from varying levels of psychological distress. Mindfulness may alleviate psychological distress by reducing the level of illness perception and perceived stress. We suggest developing a comprehensive factor model to clarify potential mechanisms of mindfulness on psychological distress due to the very low effect of mindfulness on psychological distress via illness perception and perceived stress.
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Affiliation(s)
- Xu Tian
- Department of Nursing, Universitat Rovira i Virgili, Tarragona, Spain
| | - Ling Tang
- Chongqing University Cancer Hospital, Chongqing, China
| | - Li-Juan Yi
- Department of Nursing, Universitat Rovira i Virgili, Tarragona, Spain
| | - Xiao-Pei Qin
- Department of Rehabilitation Medicine, Jiaozuo People’s Hospital, Jiaozuo, China
| | - Gui-Hua Chen
- Department of Nursing, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
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23
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Valero-Cantero I, Casals C, Carrión-Velasco Y, Barón-López FJ, Martínez-Valero FJ, Vázquez-Sánchez MÁ. The influence of symptom severity of palliative care patients on their family caregivers. BMC Palliat Care 2022; 21:27. [PMID: 35227246 PMCID: PMC8886938 DOI: 10.1186/s12904-022-00918-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 02/14/2022] [Indexed: 11/17/2022] Open
Abstract
Background This study anlyzed whether family caregivers of patients with advanced cancer suffer impaired sleep quality, increased strain, reduced quality of life or increased care burden due to the presence and heightened intensity of symptoms in the person being cared for. Method A total of 41 patient-caregiver dyads (41 caregivers and 41 patients with advanced cancer) were recruited at six primary care centres in this cross-sectional study. Data were obtained over a seven-month period. Caregiver’s quality of sleep (Pittsburgh Sleep Quality Index), caregiver’s quality of life (Quality of Life Family Version), caregiver strain (Caregiver Strain Index), patients’ symptoms and their intensity (Edmonton Symptom Assessment System), and sociodemographic, clinical and care-related data variables were assessed. The associations were determined using non-parametric Spearman correlation. Results Total Edmonton Symptom Assessment System was significantly related to overall score of the Pittsburgh Sleep Quality Index (r = 0.365, p = 0.028), the Caregiver Strain Index (r = 0.45, p = 0.005) and total Quality of Life Family Version (r = 0.432, p = 0.009), but not to the duration of daily care (r = -0.152, p = 0.377). Conclusions Family caregivers for patients with advanced cancer suffer negative consequences from the presence and intensity of these patients’ symptoms. Therefore, optimising the control of symptoms would benefit not only the patients but also their caregivers. Thus, interventions should be designed to improve the outcomes of patient-caregiver dyads in such cases.
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24
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Yang L, Chen X, Liu Z, Sun W, Yu D, Tang H, Zhang Z. The Impact of Illness Perceptions on Depressive Symptoms Among Benign Prostatic Hyperplasia Patients with Lower Urinary Tract Symptom. Int J Gen Med 2021; 14:9297-9306. [PMID: 34887677 PMCID: PMC8651631 DOI: 10.2147/ijgm.s342512] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 11/08/2021] [Indexed: 11/23/2022] Open
Abstract
Objective This study aimed at exploring whether illness perceptions may mediate the relationship between depressive symptoms and lower urinary tract symptoms (LUTS) among benign prostatic hyperplasia (BPH) patients. Methods The Patient Health Questionnaire (PHQ-9) for depression, the International Prostate Symptom Score (IPSS) for the severity of LUTS and the brief Illness Perception Questionnaire (B-IPQ) for illness perceptions (IPs) were used among the 157 BPH patients with LUTS. Pearson’s correlation test and hierarchical regression analyses were used to assess the correlations between LUTS, depressive symptoms and IPs. Results Our study found that the severity of LUTS was associated with depressive symptoms and subscales of illness perception; meanwhile, IPs were associated with the level of education. A positive relationship was found between the scores of PHQ9 and the B-IPQ subscales of illness consequences, identity, timeline, concern and emotion; thus, a negative correlation was found between scores of PHQ9 and the B-IPQ subscales of illness coherence, personal control and treatment control. The hierarchical regression analysis showed IPSS and the B-IPQ subscales of illness consequences, concern and emotion were significantly associated with depression, and explained 85.1% of the variance in depressive symptoms (R2 = 0.851, p < 0.05). Conclusion The relationship between LUTS and depressive symptoms may be mediated by the negative IPs, including consequences, concern and emotions. Clinicians should not only focus on the LUTS but also on the IPs to improve depressive symptoms among BPH patients.
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Affiliation(s)
- Linlin Yang
- Department of Geriatrics Cardiology, The First Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China.,Department of General Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China
| | - Xin Chen
- Department of Urology, The Second Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China
| | - Zhiqi Liu
- Department of Urology, The Second Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China
| | - Wei Sun
- Department of Urology, The Second Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China
| | - Dexin Yu
- Department of Urology, The Second Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China
| | - Haiqin Tang
- Department of Geriatrics Cardiology, The First Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China.,Department of General Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China
| | - Zhiqiang Zhang
- Department of Urology, The Second Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China
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Associations between perceived stress and quality of life in gynaecologic cancer patient-family caregiver dyads. Eur J Oncol Nurs 2021; 55:102060. [PMID: 34763206 DOI: 10.1016/j.ejon.2021.102060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 10/17/2021] [Accepted: 10/17/2021] [Indexed: 11/21/2022]
Abstract
PURPOSE This study aims to explore the level of stress perceived and quality of life (QOL) by gynaecologic cancer (GC) patients and family caregivers' dyads. METHODS In this cross-sectional study, 86 dyads were recruited from the gynaecological oncology department of a general hospital in Taichung City, Taiwan. The patients and family caregivers completed a sociodemographic information sheet, the Perceived Stress Scale, and the Taiwanese version of World Health Organization Quality of Life-BREF questionnaire. Data were analysed using descriptive statistics and Pearson's correlations. This study used the actor-partner interdependence model (APIM) with distinguishable dyads to examine the effect of patients' and caregivers' perceived stress on QOL in patient-caregiver dyads. RESULTS GC patients' and caregivers' level of QOL was influenced by their own stress level (actor effect). Caregivers' stress was statistically negatively associated with the patients' QOL (partner effect); however, there were no partner effect from GC patients to caregivers. Both patients and family caregivers with higher perceived stress had poorer QOL. Therefore, we identified that stress has some level of actor and partner effects on QOL in GC patient-family caregiver dyads. CONCLUSIONS Family caregivers' stress displayed both actor and partner effects within the first year of the cancer diagnosis; therefore, patient-and caregiver-based interventions, such as stress reduction strategies, should be developed to enhance patients' and caregivers' QOL and stress management ability.
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Pranggono EH, Tiara MR, Pamungkas TC, Syafriati E, Mutyara K, Wisaksana R. Medical students' positive perception towards vaccination is strongly correlated to protective diphtheria antibody after Td vaccination. Brain Behav Immun Health 2021; 18:100362. [PMID: 34704079 PMCID: PMC8526771 DOI: 10.1016/j.bbih.2021.100362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 08/30/2021] [Accepted: 09/30/2021] [Indexed: 11/15/2022] Open
Abstract
Negative perception towards vaccination is one of the reasons for low coverage of diphtheria immunization in Indonesia. Perception, which is difficult to change, is related to stress level, possibly influences outcome of diseases, and also vaccination. This study aims to identify the correlation between perception of diphtheria vaccination and antibody response after vaccination. This study used secondary data from two unpublished studies on 30 medical interns in Hasan Sadikin Hospital, Bandung, West Java, after diphtheria outbreak, from June to July 2019. Antibody level after diphtheria emergency vaccination was measured using ELISA and perception towards vaccination was measured using a questionnaire. Perception towards vaccination was expressed as perception score and was divided into 4 components: perceived threat, benefit, barrier, and cues to action. Higher perception score indicated more positive perception towards vaccination. Diphtheria antibody level was grouped into reliable protection (≥0,10 IU/mL) or unreliable protection (<0,10 IU/mL). Statistical correlation analysis was done with GraphPad Prism version 7.0. Most of our subjects were female. Median age was 22 (20-24) years old. Median time elapsed between vaccination date and measurement of antibody level was 18 (6-18) months. Median antibody level was 0,28 (0,09-3,47) IU/mL. Twenty-three subjects (82,1%) had reliable protection. Subjects with reliable protection had more positive perception compared to unreliable protection (perception score 80,6 ± 5,4 vs 69,0 ± 1,8, p = 0,0001). Subjects with reliable protection had less perceived barrier for vaccination (15,6 ± 2,1 vs 13,0 ± 1,8, p = 0,0083). Perception score showed strong, positive correlation to reliable protection against diphtheria (R = 0,705, p < 0,001). Perceived barrier and threat showed positive correlation to reliable protection (R = 0,489, p = 0,008 and R = 0,402, p = 0,034). In conclusion, perception towards diphtheria vaccination is strongly correlated to protective antibody. Improving perception of vaccination are needed to overcome vaccine hesitancy.
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Affiliation(s)
- Emmy Hermiyanti Pranggono
- Department of Internal Medicine, Hasan Sadikin General Hospital/Universitas Padjadjaran, Jl. Pasteur No. 38 Bandung, West Java, Indonesia
| | - Marita Restie Tiara
- Department of Internal Medicine, Hasan Sadikin General Hospital/Universitas Padjadjaran, Jl. Pasteur No. 38 Bandung, West Java, Indonesia
| | - Tohari Catur Pamungkas
- Faculty of Medicine, Universitas Padjadjaran, Jl. Eyckman No. 38 Bandung, West Java, Indonesia
| | - Esti Syafriati
- Department of Internal Medicine, Al-Ihsan General Hospital, Jl. Kiastramanggala Bale Endah, Bandung, West Java, Indonesia
| | - Kuswandewi Mutyara
- Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Jl. Eyckman No. 38, Bandung, West Java, Indonesia
| | - Rudi Wisaksana
- Department of Internal Medicine, Hasan Sadikin General Hospital/Universitas Padjadjaran, Jl. Pasteur No. 38 Bandung, West Java, Indonesia
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The Role of Disease Acceptance, Life Satisfaction, and Stress Perception on the Quality of Life Among Patients With Multiple Sclerosis: A Descriptive and Correlational Study. Rehabil Nurs 2021; 46:205-213. [PMID: 32932423 DOI: 10.1097/rnj.0000000000000288] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of this study was to evaluate the relationship between illness acceptance, life satisfaction, stress intensity, and their impact on the quality of life (QOL) in patients with multiple sclerosis (MS). DESIGN Descriptive and correlational study. METHODS A group of 100 patients with MS responded to the Expanded Disability Status Scale, the World Health Organization Quality of Life Brief (WHOQOL-BREF) Scale, the Acceptance of Illness Scale (AIS), the Perceived Stress Scale (PSS-10), the Satisfaction With Life Scale (SWLS), and a sociodemographic questionnaire. FINDINGS A significant relationship was shown between the mean scores of AIS, SWLS, PSS-10, and WHOQOL-BREF; however, there was no relationship between the mean scores of AIS, SWLS, PSS-10, WHOQOL-BREF and the Expanded Disability Status Scale. CONCLUSION Quality of life in patients with MS is positively affected by higher level of disease acceptance and life satisfaction as well as a lower level of perceived stress. CLINICAL RELEVANCE Rehabilitation nurses should consider the patient's disease acceptance, QOL, perceived stress, disability level, and satisfaction of life in planning and implementing a comprehensive rehabilitation plan.
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28
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Amaral-Prado HM, Borghi F, Mello TMVF, Grassi-Kassisse DM. The impact of confinement in the psychosocial behaviour due COVID-19 among members of a Brazilian university. Int J Soc Psychiatry 2021; 67:720-727. [PMID: 33161815 PMCID: PMC7653368 DOI: 10.1177/0020764020971318] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND The current situation due COVID-19 may cause an eminent impact on mental health because the confinement restrictions. AIMS The aim of this study was to analyze and compare perceived stress, resilience, depression symptoms and coping strategies on the members of University of Campinas, in Brazil, before and during the outbreak of the COVID-19. METHODS Volunteers over 18 years of both sexes, members of the University of Campinas (Unicamp) in Brazil answered instruments related to perceived stress, depression, resilience and coping strategies during final exams at the end of semester during 2018 to 2020. RESULTS We obtained 1,135 responses (893 before COVID-19 and 242 during COVID-19). The volunteers did not show significant differences for perceived stress, depressive signs and resilience before and during the pandemic. In both periods, men exhibited lower scores for perceived stress and depression and higher scores for resilience when compared to women. Undergraduate and graduate students exhibited higher perceived stress scores, more pronounced depressive signs and lower resilience, and employees and professors presented lower scores for perceived stress, depressive signs and greater resilience. CONCLUSIONS These first months of confinement did not directly affect the scores of perceived stress, depression and resilience, however, each subgroup adapted to the new routine by changing the coping strategy used. This study suggests the importance of monitoring the mental health of member in the university, especially in times of epidemic, in the search for policies that aim to improve the resilience of the population and seek positive and effective coping strategies within the university environment.
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Affiliation(s)
- Heloísa Monteiro Amaral-Prado
- LABEEST - Laboratory of Stress Study, Department of Structural and Functional Biology, Institute of Biology, University of Campinas - UNICAMP, Campinas, São Paulo, Brazil
| | - Filipy Borghi
- LABEEST - Laboratory of Stress Study, Department of Structural and Functional Biology, Institute of Biology, University of Campinas - UNICAMP, Campinas, São Paulo, Brazil
| | - Tânia Maron Vichi Freire Mello
- Department of Medical Psychology and Psychiatry, School of Medical Sciences, University of Campinas - UNICAMP, Campinas, São Paulo, Brazil
| | - Dora Maria Grassi-Kassisse
- LABEEST - Laboratory of Stress Study, Department of Structural and Functional Biology, Institute of Biology, University of Campinas - UNICAMP, Campinas, São Paulo, Brazil
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Ting RSK, Aw Yong YY, Tan MM, Yap CK. Cultural Responses to Covid-19 Pandemic: Religions, Illness Perception, and Perceived Stress. Front Psychol 2021; 12:634863. [PMID: 34421700 PMCID: PMC8375556 DOI: 10.3389/fpsyg.2021.634863] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 06/16/2021] [Indexed: 11/15/2022] Open
Abstract
Many psychological researchers have proven the deteriorating effects of the coronavirus disease 2019 (Covid-19) pandemic on public mental health. In Malaysia, various Covid-19 clusters were associated with religious gatherings. From a cultural psychology perspective, how ethno-religious groups respond to this crisis originating from their unique rationality and ecological systems. Therefore, this study aimed to explore the illness perceptions of major religious groups (Christian, Muslim, and Buddhist) in Malaysia toward the Covid-19 pandemic, their stress levels, and the relationship between illness perception, stress, and forms of religious expression during the lockdown period. Through an online survey method, 608 Malaysian religious believers were included in this mixed-method empirical study, which adapted standardized instruments [Duke University Religion Index (DUREL), Brief Illness Perception Questionnaire (BIPQ), and Perceived Stress Scale (PSS)]. Statistical analysis showed that all three groups reported moderate levels of stress in average without any significant difference after controlling for age. Both internal and external forms of religious expression had a significant negative relationship with stress levels. Personal control, comprehension, and emotions domains of illness perception accounted for a significant variance in the stress level. Furthermore, religious expression significantly moderated the relationship between some illness perception domains and stress. Qualitative coding revealed that most participants perceived human behavior and attitudes, sociopolitical, and sociological factors as causal factors to the current pandemic. These findings confirmed the relationship between religious expression, illness belief, and stress regulation during the pandemic lockdown. Incidental findings of age as a potential protective factor for Malaysian believers warrants further study. In the conclusion, implications for public health policymakers and religious communities on pandemic prevention and well-being promotion were discussed.
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Affiliation(s)
- Rachel Sing-Kiat Ting
- Department of Psychology, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Malaysia
| | - Yue-Yun Aw Yong
- Department of Psychology, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Malaysia
| | - Min-Min Tan
- South East Asia Community Observatory, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Segamat, Malaysia
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30
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Mazor M, Wisnivesky JP, Goel M, Harris YT, Lin JJ. Racial and ethnic disparities in post-traumatic stress and illness coherence in breast cancer survivors with comorbid diabetes. Psychooncology 2021; 30:1789-1798. [PMID: 34109695 DOI: 10.1002/pon.5747] [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: 03/08/2021] [Revised: 04/26/2021] [Accepted: 06/07/2021] [Indexed: 11/09/2022]
Abstract
CONTEXT Breast cancer survivors (BCS) with comorbid diabetes mellitus (DM) and of racial and ethnic minority status are at higher risk of cancer-related post-traumatic stress (PTS) and severe illness beliefs. These affective and cognitive outcomes influence self-management and treatment adherence in patients with chronic conditions, yet little is known regarding the interplay of these processes in diverse BCS with comorbid DM. OBJECTIVES The purposes of this study were to (1) describe racial and ethnic differences in cancer-related PTS and illness perceptions; and (2) examine the relationship between PTS and illness perceptions in BCS with comorbid DM. METHODS Female BCS with DM completed measures of cancer related stress (Impact of Events Scale-Revised) and cancer and DM illness perception (Illness Perception Questionnaire-Revised). Logistic regression analyses were used to assess the association between PTS, race and illness perceptions. RESULTS Of the 135 BCS with comorbid DM, the mean (standard deviation) age was 65.3 (7.1) years, 38% were Black, 31% Non-Hispanic White (NHW), 13% Hispanic/Latina, and 18% were "other." Minority women were more likely to report cancer-related PTS (p < 0.01). In adjusted analyses, PTS was associated with chronicity (odds ratio [OR] = 9.79, p = 0.005), time-cycle (OR = 6.71, p = 0.001), negative consequences (OR = 3.95, p = 0.018), and negative emotional impact (OR = 12.63, p < 0.001) of cancer. CONCLUSION Minority BCS with comorbid DM report higher rates of cancer-related PTS and lower cancer illness coherence relative to NHW survivors. Cancer-related PTS influences cancer and DM illness perceptions. Culturally sensitive care is needed to improve these outcomes in minority BCS. KEY MESSAGE This article presents findings from a cross sectional cohort of an understudied population of racially and ethnically diverse BCS with comorbid diabetes. The results indicate that the occurrence of PTS is significantly higher in racial and ethnic minority women and is strongly associated with more severe illness perceptions.
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Affiliation(s)
- Melissa Mazor
- Division of Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Juan P Wisnivesky
- Division of Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Mita Goel
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Yael Tobi Harris
- Division of Endocrinology, Diabetes & Metabolism, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Great Neck, New York, USA
| | - Jenny J Lin
- Division of Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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Pasternak A, Poraj-Weder M, Schier K. Polish Adaptation and Validation of the Revised Illness Perception Questionnaire (IPQ-R) in Cancer Patients. Front Psychol 2021; 12:612609. [PMID: 34054639 PMCID: PMC8155706 DOI: 10.3389/fpsyg.2021.612609] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 04/16/2021] [Indexed: 12/03/2022] Open
Abstract
The article presents findings from three studies designed to validate and culturally adapt the Polish version of the Revised Illness Perception Questionnaire (IPQ-R), a measure of the cognitive and emotional components of illness representations among oncology patients. The tool is conceptually based on Leventhal’s Self-Regulatory Model (Leventhal et al., 1984, 2001). The results of the study 1 (n = 40) show that it can be successfully used in a Polish cultural context as a reliable equivalent to its original English version (Moss-Morris et al., 2002). Analyses conducted in Study 2 (n = 318) provided good evidence for construct and criterion validity as well as the internal reliability of the IPQ-R subscales. Study 3 (n = 54) revealed that the IPQ-R subscales present good test–retest reliability. Overall, the results show that the Polish version of the IPQ-R provides a comprehensive and psychometrically acceptable assessment of the representation of cancer and can be reliably used in studies involving Polish oncology patients.
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Affiliation(s)
- Aneta Pasternak
- Institute of Pedagogy and Psychology, Warsaw Management University, Warsaw, Poland
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Sahni PS, Singh K, Sharma N, Garg R. Yoga an effective strategy for self-management of stress-related problems and wellbeing during COVID19 lockdown: A cross-sectional study. PLoS One 2021; 16:e0245214. [PMID: 33566848 PMCID: PMC7875402 DOI: 10.1371/journal.pone.0245214] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 12/23/2020] [Indexed: 12/27/2022] Open
Abstract
This cross-sectional research aims to study the effect of yoga practice on the illness perception, and wellbeing of healthy adults during 4-10 weeks of lockdown due to COVID19 outbreak. A total of 668 adults (64.7% males, M = 28.12 years, SD = 9.09 years) participated in the online survey. The participants were grouped as; yoga practitioners, other spiritual practitioners, and non-practitioners based on their responses to daily practices that they follow. Yoga practitioners were further examined based on the duration of practice as; long-term, mid-term and beginners. Multivariate analysis indicates that yoga practitioners had significantly lower depression, anxiety, & stress (DASS), and higher general wellbeing (SWGB) as well as higher peace of mind (POMS) than the other two groups. The results further revealed that the yoga practitioners significantly differed in the perception of personal control, illness concern and emotional impact of COVID19. However, there was no significant difference found for the measure of resilience (BRS) in this study. Yoga practitioners also significantly differed in the cognitive reappraisal strategy for regulating their emotions than the other two groups. Interestingly, it was found that beginners -those who had started practicing yoga only during the lockdown period reported no significant difference for general wellbeing and peace of mind when compared to the mid- term practitioner. Evidence supports that yoga was found as an effective self- management strategy to cope with stress, anxiety and depression, and maintain wellbeing during COVID19 lockdown.
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Affiliation(s)
- Pooja Swami Sahni
- National Resource Centre for Value Education in Engineering, Indian Institute of Technology Delhi, Noida, India
| | - Kamlesh Singh
- National Resource Centre for Value Education in Engineering, Indian Institute of Technology Delhi, Noida, India
- Department of Humanities and Social Sciences, Indian Institute of Technology Delhi, New Delhi, India
| | - Nitesh Sharma
- National Resource Centre for Value Education in Engineering, Indian Institute of Technology Delhi, Noida, India
| | - Rahul Garg
- National Resource Centre for Value Education in Engineering, Indian Institute of Technology Delhi, Noida, India
- Department of Computer Science and Engineering, Indian Institute of Technology Delhi, New Delhi, India
- Amar Nath and Shahsi Khosla School of Information Technology, Indian Institute of Technology Delhi, New Delhi, India
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Valero-Cantero I, Wärnberg J, Carrión-Velasco Y, Martínez-Valero FJ, Casals C, Vázquez-Sánchez MÁ. Predictors of sleep disturbances in caregivers of patients with advanced cancer receiving home palliative care: A descriptive cross-sectional study. Eur J Oncol Nurs 2021; 51:101907. [PMID: 33636585 DOI: 10.1016/j.ejon.2021.101907] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 01/30/2021] [Accepted: 02/02/2021] [Indexed: 01/07/2023]
Abstract
PURPOSE To evaluate the quality of sleep in caregivers of patients with advanced cancer receiving home palliative care, basing the analysis on subjective and objective measures, and to develop a predictive model of sleep disturbances among this population. METHOD A descriptive cross-sectional study was conducted in six clinical management units within primary healthcare centres. Data were obtained during a period of six months, from a sample population of 41 caregivers. The Pittsburgh Sleep Quality Index (PSQI) and a 7-day accelerometry evaluation were performed to assess sleep quality. Daytime sleepiness, caregiver strain and quality of life were also evaluated. RESULTS According to the PSQI, 90.2% of participants had poor sleep quality. The average duration of night-time sleep, measured by accelerometry and the PSQI, was 6 h. Taking PSQI as the dependent variable, the study model predicted 40.7% of the variability (p < 0.01). The variables "Caregiver strain" and "Daily hours dedicated to care" produced the following results: B coefficient 0.645; p = 0.001; and B coefficient 0.230; p = 0.010, respectively. CONCLUSIONS The caregivers presented significant health-related alterations, including sleep disturbances, which were directly related to two variables: the index of caregiver strain and the number of hours per day dedicated to providing care.
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Affiliation(s)
- Inmaculada Valero-Cantero
- Nurse Case Manager, Puerta Blanca Clinical Management Unit, Malaga-Guadalhorce Health District, Malaga, Spain.
| | - Julia Wärnberg
- Professor at the Department of Nursing, Faculty of Health Sciences, University of Malaga and Malaga Biomedical Research Institute (IBIMA), Malaga, Spain; CIBER Fisiopatología de La Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
| | - Yolanda Carrión-Velasco
- Nurse Case Manager, Tiro Pichón Clinical Management Unit, Malaga-Guadalhorce Health District, Malaga, Spain.
| | | | - Cristina Casals
- Professor at the Department of Physical Education, MOVE-IT Research Group, University of Cadiz, Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerta del Mar University Hospital, Cadiz, Spain.
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Lin ECL, Weintraub MJ, Miklowitz DJ, Chen PS, Lee SK, Chen HC, Lu RB. The associations between illness perceptions and social rhythm stability on mood symptoms among patients with bipolar disorder. J Affect Disord 2020; 273:517-523. [PMID: 32560948 PMCID: PMC9012307 DOI: 10.1016/j.jad.2020.05.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 04/01/2020] [Accepted: 05/10/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND The association between illness perceptions and the effectiveness of patients' illness-management strategies has been supported across a range of medical and psychiatric disorders. Few studies have examined these variables or their association in bipolar disorder (BD). This study examined the main and interactive associations between illness perceptions and one important illness management strategy - social rhythms stability on mood symptom severity in adults with BD. METHODS A cross-sectional study with 131 patients with BD in Taiwan was conducted using clinician- and patient-rated mood symptoms, self-reported illness perceptions, and a measure of daily and nightly social rhythms. RESULTS Illness perceptions were associated with mood symptom severity, but social rhythms were not. Unfavorable illness perceptions (e.g., beliefs of experiencing more BD symptoms, having stronger emotional responses to the illness) were associated with more severe mood symptoms. Favorable illness perceptions (e.g., beliefs of being able to understand and control the illness) were associated with less severe mood symptoms, with personal control as the strongest correlate of mood symptom severity. Finally, social rhythm stability moderated the relationship between unfavorable illness perceptions and clinician-rated manic symptoms. LIMITATIONS The cross-sectional design limits our ability to make causal conclusions. Also, the effects pertain to patients in remission and may not generalize to more severely ill or hospitalized bipolar patients. CONCLUSIONS This study indicates that in patients with BD, illness perceptions are associated with symptom severity. Interventions to enhance favorable IPs and reduce unfavorable IPs may improve mood outcomes, particularly when patients have adopted regular social rhythms.
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Affiliation(s)
- Esther Ching-Lan Lin
- Department of Nursing, College of Medicine, National Cheng Kung University and Hospital, Taiwan.
| | - Marc J Weintraub
- Department of Psychiatry and Behavioral Sciences, UCLA Semel Institute, University of California, Los Angeles, CA, USA
| | - David J Miklowitz
- Department of Psychiatry and Behavioral Sciences, UCLA Semel Institute, University of California, Los Angeles, CA, USA
| | - Po-See Chen
- Department of Psychiatry, College of Medicine, National Cheng Kung University and Hospital, Taiwan
| | - Shih-Kai Lee
- Department of Nursing, Tsaotun Psychiatric Center, Ministry of Health and Welfare, Tsaotun Township, Nantou County 542, Taiwan
| | - Hsin-Chi Chen
- Department of Nursing, National Cheng Kung University and Hospital, Taiwan
| | - Ru-Band Lu
- Department of Psychiatry, College of Medicine, National Cheng Kung University and Hospital, Taiwan
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Andersen BL, Valentine TR, Lo SB, Carbone DP, Presley CJ, Shields PG. Newly diagnosed patients with advanced non-small cell lung cancer: A clinical description of those with moderate to severe depressive symptoms. Lung Cancer 2020; 145:195-204. [PMID: 31806360 PMCID: PMC7239743 DOI: 10.1016/j.lungcan.2019.11.015] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 11/19/2019] [Accepted: 11/20/2019] [Indexed: 12/11/2022]
Abstract
OBJECTIVES The aims of this observational study were to 1) accrue newly diagnosed patients with advanced-stage non-small cell lung cancer (NSCLC) awaiting the start of first-line treatment and identify those with moderate to severe depressive symptoms and, 2) provide a clinical description of the multiple, co-occurring psychological and behavioral difficulties and physical symptoms that potentially exacerbate and maintain depressive symptoms. MATERIALS AND METHODS Patients with stage IV NSCLC (N = 186) were enrolled in an observational study (ClinicalTrials.gov Identifier: NCT03199651) and completed the American Society of Clinical Oncology-recommended screening measure for depression (Patient Health Questionnaire-9 [PHQ-9]). Individuals with none/mild (n = 119; 64 %), moderate (n = 52; 28 %), and severe (n = 15; 8 %) depressive symptoms were identified. Patients also completed measures of hopelessness, generalized anxiety disorder (GAD) symptoms, stress, illness perceptions, functional status, and symptoms. RESULTS Patients with severe depressive symptoms reported concomitant feelings of hopelessness (elevating risk for suicidal behavior), anxiety symptoms suggestive of GAD, and traumatic, cancer-specific stress. They perceived lung cancer as consequential for their lives and not controllable with treatment. Pain and multiple severe symptoms were present along with substantial functional impairment. Patients with moderate depressive symptoms had generally lower levels of disturbance, though still substantial. The most salient differences were low GAD symptom severity and fewer functional impairments for those with moderate symptoms. CONCLUSIONS Depressive symptoms of moderate to severe levels co-occur in a matrix of clinical levels of anxiety symptoms, traumatic stress, impaired functional status, and pain and other physical symptoms. All of the latter factors have been shown, individually and collectively, to contribute to the maintenance or exacerbation of depressive symptoms. As life-extending targeted and immunotherapy use expands, prompt identification of patients with moderate to severe depressive symptoms, referral for evaluation, and psychological/behavioral treatment are key to maximizing treatment outcomes and quality of life for individuals with advanced NSCLC.
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Affiliation(s)
- B L Andersen
- Department of Psychology, The Ohio State University, United States.
| | - T R Valentine
- Department of Psychology, The Ohio State University, United States
| | - S B Lo
- Department of Psychology, The Ohio State University, United States
| | - D P Carbone
- Department of Internal Medicine, Division of Medical Oncology, The Ohio State University Comprehensive Cancer Center and The James Cancer Hospital/Solove Research Institute, United States
| | - C J Presley
- Department of Internal Medicine, Division of Medical Oncology, The Ohio State University Comprehensive Cancer Center and The James Cancer Hospital/Solove Research Institute, United States
| | - P G Shields
- Department of Internal Medicine, Division of Medical Oncology, The Ohio State University Comprehensive Cancer Center and The James Cancer Hospital/Solove Research Institute, United States
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Sundelin R, Bergsten C, Tornvall P, Lyngå P. Self-rated stress and experience in patients with Takotsubo syndrome: a mixed methods study. Eur J Cardiovasc Nurs 2020; 19:740-747. [PMID: 32491953 PMCID: PMC7817986 DOI: 10.1177/1474515120919387] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND A relation to stress and stressful triggers is often, but not always, described in patients with Takotsubo syndrome. Few studies have focused on patients' self-rated stress in combination with qualitative experiences of stress in Takotsubo syndrome. AIMS The aim of this study was to describe stress before and after the onset of Takotsubo syndrome. METHODS Twenty patients were recruited from five major hospitals in Stockholm, Sweden between December 2014 and November 2018. A mixed methods design was used containing the validated questionnaire, perceived stress scale (PSS-14) filled in at baseline and at a 6 and 12-month follow-up, respectively. Qualitative interviews were made at the 6-month follow-up. RESULTS Self-rated stress, measured by the perceived stress scale, showed stress levels above the cut-off value of 25, at the onset of Takotsubo syndrome (median 30.5). Stress had decreased significantly at the 12-month follow-up (median 20.5, P = 0.039) but remained high in one third of the patients. Qualitative interviews confirmed a high long-term stress and half of the patients had an acute stress trigger before the onset of Takotsubo syndrome. The qualitative interviews showed that the patients had reflected on and tried to find ways to deal with stress, but for many this was not successful. CONCLUSION Patients with Takotsubo syndrome reported long-term stress sometimes with an acute stress trigger before the onset of Takotsubo syndrome. Stress decreased over time but remained high for a considerable number of patients. Despite reflection over stress and attempts to deal with stress many were still affected after 6 months. New treatment options are needed for patients with Takotsubo syndrome.
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Affiliation(s)
- Runa Sundelin
- Karolinska Institutet, Department of Clinical Science and Education, Södersjukhuset and Cardiology Unit, Sweden
| | - Chatarina Bergsten
- Karolinska Institutet, Department of Clinical Science and Education, Södersjukhuset and Cardiology Unit, Sweden
| | - Per Tornvall
- Karolinska Institutet, Department of Clinical Science and Education, Södersjukhuset and Cardiology Unit, Sweden
| | - Patrik Lyngå
- Karolinska Institutet, Department of Clinical Science and Education, Södersjukhuset and Cardiology Unit, Sweden
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Valero-Cantero I, Martínez-Valero FJ, Espinar-Toledo M, Casals C, Barón-López FJ, Vázquez-Sánchez MÁ. Complementary music therapy for cancer patients in at-home palliative care and their caregivers: protocol for a multicentre randomised controlled trial. BMC Palliat Care 2020; 19:61. [PMID: 32359361 PMCID: PMC7196216 DOI: 10.1186/s12904-020-00570-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Accepted: 04/27/2020] [Indexed: 12/20/2022] Open
Abstract
Background Patients with advanced cancer, receiving at-home palliative care, are subject to numerous symptoms that are changeable and often require attention, a stressful situation that also impacts on the family caregiver. It has been suggested that music therapy may benefit both the patient and the caregiver. We propose a study to analyse the efficacy and cost utility of a music intervention programme, applied as complementary therapy, for cancer patients in palliative care and for their at-home caregivers, compared to usual treatment. Method A randomised, double-blind, multicentre clinical trial will be performed in cancer patients in at-home palliative care and their family caregivers. The study population will include two samples of 40 patients and two samples of 41 caregivers. Participants will be randomly assigned either to the intervention group or to the control group. The intervention group will receive a seven-day programme including music sessions, while the control group will receive seven sessions of (spoken word) therapeutic education. In this study, the primary outcome measure is the assessment of patients’ symptoms, according to the Edmonton Symptom Assessment System, and of the overload experienced by family caregivers, measured by the Caregiver Strain Index. The secondary outcomes considered will be the participants’ health-related quality of life, their satisfaction with the intervention, and an economic valuation. Discussion This study is expected to enhance our understanding of the efficacy and cost-utility of music therapy for cancer patients in palliative care and for their family caregivers. The results of this project are expected to be applicable and transferrable to usual clinical practice for patients in home palliative care and for their caregivers. The approach described can be incorporated as an additional therapeutic resource within comprehensive palliative care. To our knowledge, no previous high quality studies, based on a double-blind clinical trial, have been undertaken to evaluate the cost-effectiveness of music therapy. The cost-effectiveness of the project will provide information to support decision making, thereby improving the management of health resources and their use within the health system. Trial registration The COMTHECARE study is registered at Clinical Trials.gov, NCT04052074. Registered 9 August, 2019.
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Affiliation(s)
| | | | - Milagrosa Espinar-Toledo
- "Rincón de la Victoria" Clinical Management Unit, Malaga-Guadalhorce Health District, Malaga, Spain
| | - Cristina Casals
- MOVE-IT Research group and Department of Physical Education, Faculty of Education Sciences. Biomedical Research and Innovation Institute of Cadiz (INiBICA) Research Unit, Puerta del Mar University Hospital, University of Cadiz, Cádiz, Spain.
| | - Francisco Javier Barón-López
- Department of Preventive Medicine, Public Health and Science History. Institute of Biomedical Research in Malaga (IBIMA), University of Malaga, Malaga, Spain
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