BackgroundBRCA1 and BRCA2 mutations are associated with a higher risk of breast and ovarian tumors. This study evaluated the emotional states of women 1 month after having received the results of the genetic test and assessed eventual associations with the type of outcome, personal/familiar disease history and major socio-demographic variables.MethodsThe study, an observational retrospective one, involved 91 women, evaluated 1 month after receiving their results. Patients were administered the Hospital Anxiety and Depression Scale, the Profile of Mood States and emotional Thermometers.ResultsAnxiety was significantly higher than depression (p < 0.001), and 21.3% and 21.3% of the sample were, respectively, possible and probable cases for anxiety, whereas 13.5% and 10.1% were possible and probable cases for depression. Within the six mood states, Confusion-Bewilderment (M = 48.5) was the lowest, whereas Fatigue-Inertia (M = 52.3) was the highest. Differences were recorded within the ten assessed emotions too. Being a proband/nonproband and being or not a cancer patient were associated with many tested variables.ConclusionThe psycho-emotional screening of women undertaking genetic counseling is relevant and should cover a large range of dimensions.
Despite the discussed limitations, PFS-R seems a valid and reliable multidimensional fatigue measure also adequate in Italian oncological settings.
Aims and background In cancer patients, fatigue interferes with the individual's functioning and quality of life (QoL). We investigated the association between fatigue and the main QoL dimensions and mood states as well as the main sociodemographic and clinical variables. Methods A total of 105 inpatients undergoing chemotherapy were administered the Revised Piper Fatigue Scale and the EORTC QLQ-C30 and POMS questionnaires, along with a form for collecting personal and clinical data. Results Compared with patients reporting lower fatigue levels, patients with higher levels showed worse functioning (P <0.001) in every QoL domain (i.e., physical, role, emotional, social, cognitive functioning, pain, and general health) as well as in the assessed mood states (depression-dejection, tension-anxiety, confusion-bewilderment). Moreover, both QoL and mood states in the subgroup reporting intermediate fatigue levels were worse than those of the subgroup with lower fatigue levels (P <0.02), except for emotional functioning, general health and QoL, and tension-anxiety. In addition, fatigue was significantly associated with gender, age, education, performance status, but not with marital status, survival rate of cancer type, and current chemotherapy cycle. Conclusions The associations observed between fatigue, the main QoL domains, and negative mood states call for further active interventions to prevent and reduce fatigue.
In cancer patients, depression causes suffering during the whole disease trajectory and it also influences the personal perception of well-being as well as treatment adherence. Consequently, its better definition is needed for planning more tailored supportive programmes. This study was aimed to provide information on depressive state intensity and prevalence in an heterogeneous sample of cancer inpatients. In addition, associations were studied between depressive state and different socio-demographic and clinical factors. A total of 1,147 consecutive adult cancer inpatients completed the Center for Epidemiologic Studies Scale on Depression together with a form for collecting socio-demographic and clinical data. The mean score of depression was 16.9 (SD = 9.3). There were differences in depression intensity associated with gender (p < .001), age (p = .001) and cancer type (p < .001), but not with education level (p = .282) or marital status (p = .436). Of the entire sample 13.9% had depressive states; this percentage raised to 26.2% if a less stringent criterion was used. These data reinforce the importance of a clinical and research focus on depression in oncology. As differences according to gender, age and diagnosis exist in depression prevalence and intensity, tailored supportive intervention should be planned and verified for effectiveness and efficacy.
Currently, 5-10% of all breast cancers are estimated to be hereditary, and a proportion of them are attributable to mutations in several highly penetrant susceptibility genes, including BRCA1/2 [1-3]. Availability of genetic testing for BRCA1/2 gene mutations has stimulated the need to thoroughly analyze the psychological impact of the genetic information in families with hereditary breast and/or ovarian cancers. In particular, the individual increased risk for these tumors and the possibility of transmission of the predisposing mutation to the offspring suggested that disclosure of a BRCA1/2 genetic test results could be an emotionally relevant event, associated with different coping behaviors.With the aim of surveying the actual need for psychological support in individuals with familial predisposition to breast/ovarian cancer, we have investigated the major emotional states and coping strategies of subjects getting the results of BRCA1/2 genetic test. We chose the profile of emotional states as a dependent variable as it was considered a more comprehensive measure than the "emotional distress" (i.e., it records states of anger and confusion, beyond anxiety and depression) commonly employed in oncological settings, whereas coping strategies are indirect indicators of resourceful adjustment.The enrolled sample included 91 subjects (93.1% females) with a median age of 50 years (range, 21-74 years). The majority of our sample was married (70.8%), had at least one child (67.8%), and a postcompulsory education level (above 8 years of schooling, 55.8%). Regarding genetic status, 78.7% of participants were probands (i.e., patients with breast or ovarian cancer who initiated a counseling process for their family) whereas 21.3% were non-probands (i.e., relatives of a proband); of whom, 19.8% had the genetic diagnosis of carrier, 68.1% of non-carrier, and 11.1% carried an unclassified variant. Among the probands (N=71), 63.6% were under treatment whereas 36.4% were cancer survivors (i.e., at least 5 years since cancer diagnosis).
Psychological distress includes all negative subjective experiences elicited by a disease and its treatments. Since psychological distress in oncology is associated with negative outcomes, its detection and description are helpful for designing tailored supportive interventions. This study used the Hospital Anxiety and Depression Scale (HADS) to assess the intensity and prevalence of psychological distress (i.e., anxiety and depression) in cancer inpatients and examined the relationships between these variables and sociodemographic and clinical factors. An existing dataset of HADS results, from 2021 consecutive adult cancer inpatients at a single hospital, was analyzed. Only those questionnaires with complete responses were used. The intensity of anxiety and depression was determined from HADS sub-scores. The prevalence of anxiety and depression was calculated using, as case-finding criteria, cut-offs of ≥ 10 and ≥ 8, respectively. The mean HADS scores describing intensity were 7.3 for anxiety (n = 1,990) and 5.8 (n = 1,970) for depression. The prevalence rates for anxiety and depression were 26.6 and 28.6%, respectively. Among the 1,916 patients who completed both subscales, 17.2% had both anxiety and depression, 21.0% had either anxiety or depression, and 61.7% had neither. Gender, age, occupational status, and cancer diagnosis were associated with anxiety intensity or prevalence, while age, occupational status, and cancer diagnosis were associated with depression intensity or prevalence. Anxiety intensity was affected by the interaction effect between gender and diagnosis. Our study showed anxiety and depression being distinct entities, with more intense anxiety overall. From a research perspective, it reaffirms the usefulness for assessing both intensity and prevalence concurrently to gain a more detailed description of anxiety and depression.
Even though this was a clinical and not a research activity, it still offers important descriptive data.
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