Objective According to the Common‐Sense Model of Self‐Regulation, when faced with a health threat, we make cognitive and emotional assumptions about the illness. The aims of this study were to (a) examine the role of sociodemographic and disease‐specific factors on illness perception and perceived stress and (b) test the association between perceived stress and illness perception in participants diagnosed with gastrointestinal cancer. Methods Participants completed a battery of questionnaires including a Sociodemographic and Disease‐Specific Questionnaire, the Illness Perception Questionnaire, Brief Version (Brief‐IPQ), and the Perceived Stress Scale (PSS‐14). Descriptive statistics, Pearson correlations, analysis of variance (ANOVA), and linear regression were performed to test the hypotheses. Results Of the 627 participants, the mean age was 62 years (SD = 11); the majority were male (63.3%) and Caucasian (90.9%). Younger (F3,625 = 5.80, P < .01) and divorced or never married participants reported higher levels of perceived stress when compared with older and married participants (F4,618 = 3.52, P < .01). Younger participants (18‐74 years old) reported more negative illness perceptions than older participants (75 years and older) (F3,511 = 4.08, P < .01). A weak, positive relationship between perceived stress and illness perceptions was observed (r = 0.22, P < .01), and illness perceptions predicted 36.1% of the variance of perceived stress. Conclusions Our findings suggest that participants who negatively perceived their illness experienced greater levels of perceived stress. Interventions that aim to adjust patients' illness perceptions in order to facilitate a reduction of stress and improvement in quality of life are needed.
Objective Cancer caregivers are at increased risk for cardiovascular disease (CVD) and mortality. The aims of this study were to examine psychosocial and behavioral predictors of metabolic syndrome, an intermediate endpoint of CVD. Methods Cancer caregivers were administered a battery of questionnaires assessing sociodemographic characteristics, depressive symptoms, perceived stress, caregiver quality of life, sleep, physical activity, alcohol and tobacco use, social support, relationship quality, and loneliness. Metabolic syndrome was defined using the American Heart Association guidelines and the National Cholesterol Education Program's Adult Treatment Panel (ATP) III, which includes the presence of at least three of the following abnormalities: blood pressure, glucose, abdominal girth, high‐density lipoprotein (HDL), and triglycerides. Results Of the 104 caregivers, 77% were female, 94% were Caucasian, and the mean age was 59.5 (SD = 12.8). Of the 104 caregivers, 35.6% reported depressive symptoms in the clinical range of the Center for Epidemiologic Studies‐Depression (CES‐D) and 69.2% reported Perceived Stress Scale scores at least one standard deviation above the general population norms. A total of 16.3% of caregivers currently used tobacco, 28.8% consumed alcohol, and 26.7% were overweight (BMI = 25‐29.9) and 48.5% were obese (BMI ≥ 30). Forty‐nine percent of the caregivers met the criteria for metabolic syndrome. After age, gender, and race were adjusted, the following remained as significant predictors of metabolic syndrome: low levels of caregiver quality of life (Odds Ratio (OR) = 1.067; 95% CI, 1.019‐1.117; P = .006), high levels of hostility (OR = 1.142; 95% CI, 1.030‐1.267; P = .012), and current alcohol use (OR = 4.193; 95% CI, 1.174‐14.978; P = .027). Conclusion Development of interventions to reduce the risk of metabolic syndrome in cancer caregivers is recommended.
Background The objectives of this study were to examine benefits and consequences of the COVID‐19 pandemic for patients diagnosed with cancer and their family caregivers. Methods A 23‐item questionnaire assessing COVID‐19‐related issues, the Patient Health Questionnaire‐2, Generalized Anxiety Disorder‐2, Pittsburgh Sleep Quality Index, and the Perceived Stress Scale (PSS)‐4 were administered to patients diagnosed with cancer and their family caregivers. Results Of the 161 patients and 78 caregivers who participated, 38.1% and 32.8 were male, 95% and 84.6% Caucasian, and the mean age was 66 and 64.6 years, respectively. A total of 16.5% and 15.2% reported depressive symptoms, 18.4% and 19% reported anxiety; 35.5% and 26.6% reported poor sleep quality, and 66% and 63.3% scored one standard deviation above the norms for the PSS, respectively. Predictors of poorer patient‐ and caregiver‐reported outcomes included greater loneliness, worry about self or family being infected by the COVID‐19, and worsening relationships with family. The fear of COVID‐19 led to 20.8% of patients and 24.4% of family caregivers cancelling medical appointments, procedures, and treatments. A total of 52.5% of patients and 53.2% caregivers reported that the pandemic led to benefit finding but these changes were not associated with any of the measured patient‐ or caregiver‐related outcomes. Conclusions Psychological functioning for patients and caregivers was similar to that of pre‐pandemic levels, however the decrease in health care utilization secondary to fear of COVID‐19 was notable. While there were many negative effects of the pandemic, the majority of patients and caregivers reported some benefit to the pandemic.
e23128 Background: The aims of this study were to examine the associations between depression and complications, health care utilization and costs in patients with cancer. Methods: Patients diagnosed with cancer were administered a battery of questionnaires, including the Center for Epidemiological Studies-Depression (CES-D) Scale. Health care utilization and costs for patients was collected for one year after the administration of the CES-D. Descriptive statistics, Chi-square and ANOVA, and ordered restricted inference analyses were performed. Results: Of the 100 patients, the mean age was 64.0 years (SD = 10.3), the majority of patients were male (51%), Caucasian (89%), diagnosed with hepatocellular or cholangiocarcinoma (47%) and stage III and IV cancer (60%), and 34% of patients had clinical levels of depressive symptoms (CES-D > 16). No demographic or disease specific variables were associated with depressive symptoms or outcomes. Surgical patients with clinical levels of depression had a greater number of complications [Chi-square = 4.4, p = 0.036] and a greater severity of complications using Clavien-Dindo classification [Chi-square = 4.5, p = 0.033]. Patients undergoing chemotherapy, who reported depressive symptoms in the clinical range, were more likely to require medical intervention for chemotherapy side effects [Chi-square = 4.2, p = 0.04]. Patients with clinical levels of depressive symptoms also had a greater number of emergency room visits [F(1,99) = 8.4, p = 0.005]. Patients who reported clinical levels of depressive symptoms had significantly higher median costs associated with the loss of work force productivity (Median = $7154 versus $2104; p = 0.015), hospital costs (Median = $29,917 versus $8292, p = 0.019), and cost per registration (Median = $3324 versus $1247, p = 0.017) but lower physician costs (Median = $6171 versus $10,821; p = 0.026) than patients with non-clinical levels of depressive symptoms. Conclusions: Depressive symptoms are associated with increased complications and health care utilization and costs. There is an urgent need for effective and scalable interventions to reduce depressive symptoms in patients diagnosed with cancer to improve quality of life and reduce health care utilization and costs.
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