Our aim is to explore the effectiveness of a mindfulness based intervention for smartphones designed to reduce pre-surgical distress. Mindfulness is defined as the ability to pay attention to the present moment with a curious, non-judgmental attitude. This team is experienced with mindfulness and has developed the app "En Calma en el Quirófano" ("Staying Calm in the OR") to reduce distress before surgery. Our study will focus on those patients with abdominal cancer, who have recently been diagnosed, and are waiting for a surgical intervention.
We expect anxiety and depression to be lower in the experimental arm.
In this randomized controlled trial, participants are assigned to the experimental group ("Stay calm in the operating room") or the control arm. The initial evaluation will be carried out before surgery (t0); post-treatment evaluation, at the time of hospital discharge (t1). The follow-up evaluation one month after discharge (t2).
At this time the total sample is 54 patients. There are 31 people who have completed surgery process: 16 in the experimental group and 15 in the control. The significant associations in the experimental group are: in T2, the less psychological health, social relations and environmental quality, the more depression and the less psychological health and social relations, the more anxiety.
These results obtained at the moment invite us to think that people who use the mindfulness-based app is a benefit for the patient who is going to be intervened by an oncological surgery.
Upper urinary tract urothelial carcinoma (UTUC) is too rare to guide the management. The combined therapeutic modalities with chemotherapy and radiotherapy can be considered in curative intention for patients with incomplete surgical resection or for those not medically fit for surgery.
The objective of the study is to determine the survival of non-metastatic upper urinary tract urothelial carcinoma underwent concurrent chemoradiotherapy.
This is a retrospective study. The subjects of this study were patients with non-metastatic UTUC underwent concurrent chemoradiotherapy of a medical center in southern Taiwan from January 2011 to August 2015.
The study included a total of 21 patients with non-metastatic UTUC underwent concurrent chemoradiotherapy. The median follow-up period was 3.5 years. A total of 10(47.6%) patients died. The median overall survival was 3.13 years, and the median recurrence-free survival was 1.22 years. The 3-year overall survival rate and 3-year recurrence-free survival rate were 57.58% and 21.05%, respectively.
In conclusion, for non-metastatic UTUCs, CCRT can be considered for patients with unfavorable prognostic factors or who are medically unfit for surgery.
Cancer is a global problem that has a huge impact on mental health of family-members. The purpose of this study was to explore experiences of informal Family Caregivers about aspects of care burden.
The purpose of this study was to explore the individual & social burden of informal family caregivers in cancer patients by means of a qualitative method.
A qualitative design and purposive sampling was used in the study. Data were collected using semi-structured interviews. The interviews were analyzed using content analysis.
Data analysis identified four categories including eight subcategories: 1.Impacting health of the caregiver (physical impacts; psycho-emotional stress) 2.Inability to effectively fulfill multiple roles (balancing caring roles and family responsibilities; impacts on employment and education) 3.Health system tensions (ignoring family members in the health structure; inadequate support for family-caregivers from health personnel) 4.Social challenges of cancer (economic burden; negative societal beliefs).
Healthcare professionals may need to provide specialized supports and counseling that address sources of burden. This highlights the benefit of training healthcare professionals to provide psychosocial support that is more sensitive to family-caregivers’ needs and circumstance.
Patients with esophageal cancer and a history of gastrectomy or concurrent gastric cancer undergo not only esophagectomy but also total gastrectomy. Quality of life (QOL) of these patients should be impaired immensely, but it’s difficult to know how they feel about their life after surgery.
The goal of this study is to evaluate the postoperative QOL and dysfunction of these patients using two postoperative questionnaires.
41 patients underwent concurrent esophagectomy and total gastrectomy. A jejunal pedicle with the subcutaneous supercharge technique was used for reconstruction. Patients were divided into two groups, including those undergoing concurrent esophagostomy and gastrectomy (Group 1), and those undergoing esophagectomy alone (Group 2, history of previous gastrectomy). Patients were analyzed by time interval, including patients within three years of surgery (Group A) and those more than three years after surgery (Group B).
Eighteen patients completed the questionnaires. The mean DAUGS20 score was 26.4±13.2. The DAUGS20 scores of groups 1 (N=7) and 2 (N=11) were 25.4±12.5 and 27±15.4 (p=0.58), respectively. Global health status scored by the EORTC QLQC-30 were 71.4±18.5 in group 1 and 67.4±22.8 in group 2 (p=0.85). DAUGS20 scores of group A (N=10) and B (N=8) were 28.1±12.4 and 23.3±14.4 (p=0.35). No significant differences were found between groups A and B regarding the QLQ-C30 scores.
DAUGS20 and QLQ-C30 scores showed no significant differences between groups 1 and 2 or groups A and B. These results suggest that postoperative QOL and dysfunction may be influenced more by current status than by surgical history and postoperative interval.
Diagnosis and treatment of a life-threatening illness, such as cancer, as a traumatic stressor has major influence on patients quality of life. Social support that patients receive from their loved ones helps to decrease overall levels of distress.
With this survey we wanted to investigate current quality of life level and satisfaction with social support our patients are receiving.
For conduction of this study we used two questionnaires: Multidimensional Scale of Perceived Social Support (MSPSS) and Quality of Life of Cancer Patients (QLQ-C30) together with demographical data of our patients.
Collected data were statistically analysed.The results show the current satisfaction with social support and quality of life of patients with cancer diagnosis who are receiving psychosocial treatment at University Hospital Center Zagreb.
There's the growing pool of literature on this topic, so the purpose of this poster is to spread the awareness of the factors that impact on psychosocial well-being of patients with cancer diagnosis.
Breast cancer is the most common cancer in women. In Tunisia, this crippling disease affects more and more young working women.
Evaluating the impact of psychosocial factors in the recovery of professional activity in patients with breast cancer.
We performed a prospective, descriptive study on patients with breast cancer who received treatment and follow up in the carcinologic unit all over the year 2016. Data were collected using a pre-established questionnaire.
We registered 30 cases. Our population was composed of 29 women and one man. Mean age of the patients was 43 + 7 years. Our patients worked in 61% of cases in the private sector; the average seniority was 12 + 7 years. Most of the patients were in stage 2 of the disease. During our study, 77% of the patients were in remission without metastases. The average work stoppage was 9 months +/-10. Professional resumption interested 26 patients. 17% consulted a psychologist. The main factors leading to work resumption was material need in 50% of cases and a search for psychological support in 42% of cases. One-third of our patients reported that they returned to work to forget their illness and 11% wanted to keep the social link. These patients might have a strong desire to return to normal life and overcome obstacles.
The professional reintegration of patients with breast cancer would be, according to our study, a therapeutic psychological support.
Head and neck cancers occur mostly in middle-aged men. If treatments are interrupted, the mortality rate will be increased. So we analyzed the data about survival and recurrence rate and identified high-risk patients of interrupted treatment to help people to complete their fully treatment and achieve optimal care outcomes.
The objective of the study is to determine the risk factors of interrupted treatment, recurrence and survival on patients with head and neck cancer.
This is a retrospective secondary data analysis study. The subjects of this study were patients with head and neck cancer registered in the cancer registration database of a medical center in southern Taiwan during January 2013 to December 2016. We collected and analyzed information from two delinking databases.
The study included a total of 544 patients with head and neck cancer. The rate of treatment interruption was 12.5%. The risk factors of interrupted treatment were stage 4 (OR: 1.9, p <0.05), age greater than 65 years (OR: 2.9, p< 0.05), and no radiation therapy (OR:8.9, p < 0.05). The major reasons of interrupted treatment were side effects (39.7%), and comorbidities (23.5%).The recurrence and survival rates of treatment interruption were 20.6% and 29.4%, respectively. The recurrence and survival rates of without interruption treatment were 14.1% and 64.7%, respectively.
In future, for the high-risk group of patients with interrupted treatment, medical staff should treat side effects or complications actively to reduce interrupted treatment, cancer recurrence, and increase the survival of patients with head and neck cancer.
Despite the remarkable progress made in the diagnosis and treatment of oncological conditions, cancer remains the second leading cause of death worldwide, according to data provided by the World Health Organization (WHO).
Increased incidence of psychiatric disorders in patients with malignancies has prompted field specialists to form multidisciplinary medical teams.
The case was selected from the patients admitted to the oncology department. The diagnosis of oncological and mental disorders was completed according to ICD-10 criteria (Mental and Behavioral Disease Classification).
The diagnosis of mental illness in oncological patients is frequently encountered, and the correlation between the two conditions may have a negative impact on clinical adherence with a significant decrease in survival. We present the case of a patient aged 45 years, in the rural area hospitalized for an oncological condition, in the genital sphere. After a medical and paraclinical examination, the patient is diagnosed with stage III B cervical cancer and the Oncology Committee agrees to recommend care for radiochemotherapy.
Psycho-oncology is an essential partner for the success of antineoplastic treatment.
Radiation treatment plays a vital role in curative and palliative cancer therapy. In elderly cancer patients (ECPs) who may have compromised organ function and/or co-morbidities, the measurement of quality of life (QoL) is increasingly being recognized as an important patient-reported outcome to determine the burden of cancer treatment in this population.
To investigate the effect of radiotherapy on QoL, functional outcomes of ECPs and identify the risk factors for low QoL.
Cross sectional study was performed on consecutively recruited patients from the Department of Radiation Oncology. The EORTC QLQ-C30 was administered to patients ≥65 years undergoing radiotherapy. It consists of 30 single questions, comprising five functioning scales (physical, role, cognitive, emotional, social), nine symptom items and a global quality of life scale.
A total of 48 patients answered the questionnaire, 65.1% males, mean age 73 years. Global health status/QoL score was 79.7%. Regarding the functional scales, lower scores were observed in physical (56%), social (58.3%), emotional (60.7%), and role functioning (61.5%), whereas cognitive functioning (71.5%) revealed higher score. Females had higher score in social functioning (63.2% vs 55.6%, p<0.05) and patients ≥75 years old scored in all functional scales lower compared to 65-75 years old patients (p<0.05).
All functioning scales of EORTC QLQ-C30 had scores above 50, suggesting thus, that radiotherapy may not have detrimental effects on QoL in most ECPs with solid tumors. However, measuring QoL in this population group is important for clinical decision-making and the evaluation of treatment outcomes.
One of the most common causes of pain are tumours. Clinical guidelines recommend the use of opioid drugs for treatment of tumoral pain. In addition, the presence of certain risk factors that may favour the harmful consumption of opioid drugs must be taken into account.
Main objective: to describe the prescription of opioid drugs in patients with head and neck cancer and pain in follow-up in Hospital Universitario La Paz.
- Secondary objectives: description of the characteristics of the sample. Study of the risk factors associated with the development of harmful use of opioid drugs in these patients.
Retrospective transversal descriptive observational study. Review of data from the medical records of patients cited in medical oncology consultations with head and neck tumours
The prevalence of opioid prescription in the studied sample is 24.5%. The most commonly used opioid is the fentanyl patch. Patients with chemotherapeutic and radiotherapeutic treatment have a higher prescription of opioids. There is an association between the prescription of opioids and the state of the oncological disease. The smoking and enolic habit are risk factors of dependence that are frequently found in patients with neoplasia of the head and neck.
The results about the prevalence of prescription of opioids in the sample of patients studied reflect a good practice of the use of these drugs in patients with head and neck tumours. The high prevalence of risk factors that are associated with the development of misuse, abuse and dependence of these drugs must be taken into account.
A novel psychosocial intervention, dignity therapy, designed initially to help terminally ill patients to process their most valuable memories or existential aspects, is nowadays studied for multiple indications, like alcoohol use disorders, affective disorders, or neurocognitive disorders. In oncologic patients the importance for dignity therapy can not be overemphasized in relation to their quality of life, starting from these patients’ essential need to embrace realistic expectations and to cope with the disease-related stressful situations.
To study the impact of dignity therapy over the quality of life in patients with oncologic diagnoses based on a literature search.
A literature review was performed using as paradigm “dignity therapy” and “quality of life” and “oncologic patients”. All papers published between 2015 and 2019, found in the main electronic databases (EMBASE, CINAHL, PubMed), were evaluated.
A number of 33 papers were included in the primary analysis, and only 12 remained after filtering out the results according to the inclusion and exclusion criteria. Quality of life increased as reported by good quality trials (n=2), in relation to the improvement of other secondary variables, like the will to live, anxiety, depression, overall perception of patients’ clinical status. Several study protocols have been identified with respect to this subject, so new results are expected in the future.
Dignity therapy may have a positive impact over quality of life in patients with oncologic diagnoses, but larger clinical trials are needed in order to support its recommendation on a wider scale.
Cancer is the second leading cause of the death worldwide – it has been responsible for approximately 9.6 million deaths in 2018. Psychological and existential distress affects up to 49% of cancer patients and is often experienced by the terminally ill. To ameliorate such suffering, psychologic and psychiatric support is often requested. Such a particular time of a patient’s life requires equally particular interventions, which mental health professionals may be ill equipped to provide.
We aim to review the recent advances in interventions on distress in terminally ill cancer patients.
We conducted a comprehensive non-systematic review on PubMed.
We identified pharmacologic and non-pharmacologic interventions. Regarding pharmacologic interventions, classic psychedelics have been recently revisited with favorable results in phase II clinical trials, suggesting decreased rates of psychologic distress following single dose administration integrated in psychotherapy. Several psychotherapeutic interventions in recent years have focused on the terminally ill patient, though effectiveness studies have relayed inconsistent results and little evidence to support their utility in clinical practice.
There are several interventions available for existential distress in the terminally ill patient, though effectiveness results are not promising. Classic psychedelics may be a useful tool to ameliorate psychologic suffering in advanced cancer. Further studies are necessary to develop more efficient strategies.
The recent research database study shows a big difference from 5up to 35% of comorbid PTSD incidence in cancer patients that depends on study design and instruments used.
It is well known that leucosis is one of the most malignant cancers with relatively low survival rate that makes it an extraordinary life threatening experience, that goes one even after successful surgical treatment because of the possible delayed relapses.
72 leucosis patients after transplantation treatment were enrolled in the study, including 37 with comorbid PTSD symptoms and 35 stress-resistant patients.
PTSD Trauma Screening Questionnaire and evaluation by psychiatrist were used to verify PPTSD diagnosis. Test battery included Ego-structure test, Hardiness Survey questionnaire , ICII test
The PTSD screening score became the dependent variable for MRA and other test results were considered as independent ones. The model we got could determine 76% of the variance of the dependent variable and predict the PTSD manifestation, there is a strong impact of the destructiveness Ego-test scores and Deficiency low profile with the , ego-syntone ICii types and Commitment low profile on PTSD comorbidity.
Therefore we can recommend the selected test-battery for the detection of the PTSD vulnerable patients in haemato oncology.
Oncohematological diseases were the fifth cancer-related cause of mortality in 2017.
Given the development of new therapeutics options, life expectancy and cronicity rates have increased. Quality of life in these patients has become a very important issue. QoL in this group is quite lower than in general population.
Among this group, those who go throught HSCT have more complicated situations; HSCT may have a deep emotional impact. 25-36% of HSCT patients have psychopathological disturbances, anxiety and depression symptoms are the most common. Anxiety and depression prior transplantation are associated with slower recovery from transplantation.
It is important to give an integrative support to patients and families, including psychological interventions.
Mindfulness-Based Intervention is a good option, given the nature of the process which sorrounds HSCT. Potential stressors and uncontrollable and unpredictable characteristics of the procedure require stress management, acceptance, compassion, self-care and emotion regulation habilities; all of them are trained in MBI.
To describe group differences between those who get emotional support and emotion regulation-MBI prior HSCT, and those who do not, in terms of sociodemographic and clinical data.
Retrospective, quasi-experimental study.
We will study differences between both groups: age, gender, diagnosis, disease stage, type of transplantation (autologous or allogeneic), marital and employment status.
We will expect to find some predictors variables of who engages in psychological intervention and who does not, in order to find new approaches to attend needs of every singular patient.
Caring emotional aspects of these patients could positively influence the course of disease, and help to increase QoL.
This article is devoted to discussing the results of a comprehensive study of the hospice workers activity providing palliative care to patients on the incurable stage of the disease. The relevance of this study is connected with the need to develop objective criteria for assessing professional success and creating programs of psychological support for hospice personnel.
Our research was focused on the current work of hospice medical staff and the factors that influence their motivation.
42 medical workers of hospice took part in the study. The respondents were offered to fill in a set of 6 techniques aimed at job satisfaction, professional burnout, personality traits and motivational structure. Statistic elaboration was carried out with the pack SPSS, version 17.
The data obtained confirm that job satisfaction of hospice employees is formed as a result of the interaction of the personal characteristics of the respondents and the organizational environment. Quick Cluster Analysis method was applied and the entire sample of respondents was split in two groups – “active, efficient” and “passive, executive”. The revealed differences between the two groups (significant level p<0.05) associated with different “sources” of job satisfaction of the sample as a whole - focus on comfort and creative implementation or their resistance to the occurrence of professional burnout.
The results of the study showed the possibility of separating two "quality" different groups of hospice workers, so psychological support for their work should be carried out in accordance with this specificity.
In line with self-regulation in health and illness theory (Leventhal et al., 2002), illness representation (especially in severe illnesses like oncology) moderates the relationship between symptoms and relationship to treatment as well as general well-being.
The aim was to reveal aspects of illness representation in oncological patients that are most closely related to subjective relationship to treatment (health anxiety, self-efficacy or helplessness regarding treatment).
40 oncological patients (10 males, 20-72 years old, mean age 50.49±13.75 years old, localizations included gastrointestinal tract and genitourinary system) first referred to chemotherapy filled Illness Perception Questionnaire revised (Moss-Morris et al., 2002) and Illness and Treatment Self-Regulation Questionnaire (Kovyazina et al., 2019). Disturbance of functioning was assessed in the interview as an opportunity to cope with job, home responsibilities or self-care (1-5-point Likert scale).
Health anxiety associated with diagnosis of oncology was unrelated to social functioning of patients but was higher in patients with more emotional representations of illness (β=.51, p<.01, ΔR2=24.9%). Helplessness regarding treatment was predicted by poorer functioning (β=-.42, p<.05, ΔR2=17.2%) but also by poorer personal control and understanding of illness (β=-.34 - -.33, p<.05, ΔR2=20.4%). Self-efficacy in treatment was related to treatment control (β=.38, p<.05, ΔR2=13.2%)
Psychological interventions aimed at emotional reactions to illness could be preventative for health anxiety regarding treatment of oncological illnesses while interventions aimed at better control and understanding could be helpful for optimism versus helplessness. Research is supported by the Russian Foundation for Basic Research, project No. 18-00-01228-komfi.
Emotional condition and representation of treatment are important factors of quality of life (Horne, 2002) and could influence the effectiveness and/or side effects of treatment. In Russia oncological patients ongoing radiotherapy receive no psychological consultation about it and their condition.
The aim was to reveal psychological factors that are important for quality of life, relationship to treatment and illness in oncological patients ongoing radiotherapy.
31 patients referred for the first time to radiotherapy treatment filled Illness Perception Questionnaire revised (Moss-Morris et al., 2002), Items of Hospital Anxiety and Depression Scale (Zigmond, Snaith, 1983) and were interviewed about their relationship to illness and treatment.
All patients attributed their illness to psychological reasons (stress, emotions etc.) while 67% considered psychological reasons as major reasons for illness and felt guilty or regretted for them. 60% of patients reported sleep disturbances and ruminations about illness. All patients had fears regarding radiotherapy and its side effects while 20.6% expected that their condition would become better with time without any intervention.
Results indicate need of oncological patients in psychoeducation regarding radiotherapy and its’ side effects as well as need for interventions concentrating on illness attributions and in some cases – necessity of treatment. Research is supported by the Russian Foundation for Basic Research, project No. 18-00-01228-komfi.
Standardized assessment of psychopathological symptoms is very important across countries and illness including severe somatic illnesses with high risk of comorbid depression and anxiety.
The aim was to validate Hospital Anxiety and Depression Scale and Illness and Treatment Self-Regulation Questionnaire in Azerbaijan females after surgery for breast cancer comparing to females with other severe somatic illnesses.
Items of Hospital Anxiety and Depression Scale (Zigmond, Snaith, 1983) and Illness and Treatment Self-Regulation Questionnaire (Kovyazina et al., 2019) were translated to Azerbaijan and back-translated, then discussed with 5 patients to reveal possible misunderstandings. 27 Azerbaijan females just after surgery for breast cancer and 27 females with other (not oncological) severe illnesses filled them and Quality of Life Enjoyment and Satisfaction Questionnaire (Ritsner et.al, 2005).
Cronbach’s alphas for all the scales in both samples varied .62-.93 and factor analysis supported factor validity of the scales. Females with breast cancer reported less helplessness and depression comparing to females with other severe illnesses (p<.01) as well as better quality of life in the social sphere (p<.05). Higher anxiety and depression were related to helplessness regarding treatment and poorer satisfaction with health, emotions and social sphere (r=.23-.58, p<.05).
Azerbaijan versions of Hospital Anxiety and Depression scale and Illness and Treatment Self-Regulation Questionnaire could be used with oncological patients for structural assessment of anxiety and depression. Research is supported by the Russian Foundation for Basic Research, project No. 18-00-01228-komfi.
Depression is wide-spread problem in patients with oncology. Prevention of depression in oncological patients includes support of subjective quality of life (especially emotional). According to the theory of self-regulation in health and illness (Leventhal et al., 2002), illness representation that could be modified using cognitive behavioral therapy is important factor of successful coping with illness.
The aim was to reveal components of illness representation that are related to quality of life in patients with oncology.
27 Azerbaijan females just after surgery for breast cancer and 27 females with other (not oncological) severe illnesses filled Illness Perception Questionnaire revised (Moss-Morris et al., 2002) and Quality of Life Enjoyment and Satisfaction Questionnaire (Ritsner et.al, 2005) in Azerbaijan.
Cronbach’s alphas varied .67-.91 for both groups and factor structure with some culture relevant exceptions was close to original structure of questionnaires. In females with breast cancer worries about illness consequences, higher emotional reaction to illness (r=.-.60 - .47, p<.01), lower personal control and poorer understanding of illness (r=.40-.44, p<.05) were related wo worse quality of life in social sphere and emotions but not in health or leisure time activity.
Emotional representation of illness, understanding, illness consequences and personal control could be a target for psychological interventions for females with breast cancer preventing possible depressive symptoms. Research is supported by the Russian Foundation for Basic Research, project No. 18-00-01228-komfi.