Objectives: Psychosocial distress is common in cancer patients and survivors and encompasses a broad range of concerns and psychological symptoms. The aim of the current study was to identify subgroups of respondents who experience a specific constellation of distress symptoms.Methods: This study uses data from a large data base (n = 21 680) of cancer patients from diverse settings who provided data in the Questionnaire on Distress in Cancer Patients-Short Form (QSC-R10). Cluster analysis was applied to identify subgroups with a distinct constellation of distress symptoms. Results:The results showed five distinct clusters: minimally distressed patients (46.6% of the sample), highly distressed patients (12.7%), mainly physically distressed patients (15.2%), mainly psychologically distressed patients (15.6%), and mainly socially distressed patients (9.9%). These groups differed with regard to age, sex, cancer site, treatment setting, and disease progression. Conclusion:The results revealed large heterogeneity in the experience of distress.Distress clusters were associated with socio-demographic and clinical variables.These associations might aid a clinician to tailor interventions and to address specific types of distress. K E Y W O R D Scancer, cluster analysis, distress screening, oncology, psycho-oncology, psychosocial distress
Objective: Many distressed cancer patients do not want or, finally, do not use psychological support. This study aimed at identifying factors associated with the decline of psychological support during hospital stay. Methods:This cross-sectional study included inpatients with different cancer diagnoses. Distress was assessed using the short form of the Questionnaire on Stress in Cancer Patients-Revised (QSC-R10) and the Distress Thermometer (DT). Multivariable logistic regression was used to identify factors associated with decline.Results: Of 925 patients, 71.6% (n = 662) declined psychological support. Male sex (OR = 2.54, 95% CI = 1.69-3.80), low psychosocial distress (OR = 3.76, CI = 2.50-5.67), not feeling depressed (OR = 1.93, CI = 1.24-2.99), perceived overload (OR = 3.37, CI = 2.19-5.20), no previous psychological treatment (OR = 1.88, CI = 1.25-2.83), and feeling well informed about psychological support (OR = 1.66, CI = 1.11-2.46) were associated with decline. Among the patients who indicated clinical distress (46.2%), 53.9% declined psychological support. Male sex (OR = 2.96, CI = 1.71-5.12), not feeling depressed (OR = 1.87, CI = 1.12-3.14), perceived overload (OR = 5.37, CI = 3.07-9.37), agreeableness (OR = 0.70, CI = 0.51-0.95), and feeling well informed about psychological support (OR = 1.81, CI = 1.07-3.07) were uniquely associated with decline in this subgroup. Conclusions:Decline of psychological support is primarily due to psychological factors. Feeling well informed about support emerged as a relevant factor associated with decline. Thus, design of informational material and education about available psychological services seem crucial. ---This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
The emerging adulthood represents a vulnerable and critical turning point for the beginning of mental illnesses and is therefore of particular interest for the study of risk and resilience. The present survey investigated the impact of sex on the associations between resilience and the perception of social support and stress in students. The Resilience Scale was used to assess resilience. Stress perception and social support perception were measured using the Perceived Stress Scale and the Social Support Questionnaire FSozU k-22, respectively. Between the ages of 18 and 30, 503 subjects (59.6% female) were included into the study. We detected a significant effect of sex with markedly lower resilience and a more pronounced perception of stress and social support among females. Significant correlations between resilience, stress perception, and social support perception were found in both sexes with women showing a stronger interrelationship between stress perception and both resilience and social support perception. Mediation analysis revealed that the relationship between the perception of social support and stress was fully mediated by resilience among men and partly mediated by resilience among women. Of note, the mediation of resilience on the interrelationship between the perception of social support and stress was much stronger in women than in men. These findings suggest that sex-specific, customized interventions focusing on the strengthening of resilience and the claiming of social support are needed to promote mental health in emerging adults.
Objective: Precision cancer medicine (PCM) aims at identifying tumor-driving molecular characteristics to improve therapy. Despite early successes for some cancers, the approach faces manifold challenges. Patients undergoing extensive molecular diagnostics (MD) may hope for personal benefit, although chances are small. In order to offer suitable support to this group, health-care professionals need to gain insight into patients' experience. Thus, this study sought to explore the expectations of cancer patients undergoing MD of their tumor.Methods: In two German Comprehensive Cancer Centers, 30 patients with advanced-stage cancer who had exhausted conventional treatment and had consented to extensive, research-oriented MD (whole-genome sequencing n = 24, panel sequencing n = 6) participated in semi-structured interviews. Following thematic content analysis by Kuckartz, the interview transcripts were coded for expectations of MD participation and topics closely related. Moreover, patients completed questionnaires on their sociodemographic characteristics, medical history, and psychosocial distress.Results: Patients reported to be expecting (a) an improvement of their treatment, (b) a contribution to research, and/or (c) additional insight to their own cancer. Further, they described to feel individually appreciated and to have a reason to maintain hope for cure or recovery by participating in MD.Conclusions: Molecular diagnostics participation led patients to feel treated in a more "personalized" way, allowing them a greater sense of control in their situation of severe illness. Oncologists and psycho-oncologists need to ensure comprehensive information and empathetic support for patients undergoing extensive MD to balance their expectations and actual chances of clinical benefit. K E Y W O R D Scancer, oncology, hope, palliative care, precision medicine, psycho-oncology, qualitative research, whole-genome sequencing Ute Goerling and Peter Herschbach are joint senior authors.
Background: Patients with sarcoma are particularly vulnerable to psychosocial distress. The aim of this study was to collect preliminary data on the prevalence of psychosocial distress in such patients during follow-up care and identify risk factors associated with higher psychooncological stress levels. Patients and Methods: The study retrospectively enrolled 202 patients with bone or soft-tissue sarcomas who underwent routine psychosocial distress screening during their follow-up care. All patients were screened using an electronic cancer-specific questionnaire. Results: Females and patients who underwent radiotherapy were more distressed. Psychosocial distress levels were markedly higher in the early postoperative phase, but approximately one-third of patients showed high psychosocial distress levels even more than 2 years postoperatively. Conclusion: The results underscore the importance of routine psychosocial distress screenings in patients with sarcoma, which should be performed throughout the follow-up period.Approximately 30-66% of all patients with cancer suffer from psychosocial distress during the course of their disease, which constitutes a relevant clinical and economical problem (1-4). However, treatment of such patients is still mainly focused on biomedical aspects. Studies on psychosocial distress in patients with cancer have shown that the identification of distressed patients is a considerable challenge (5,6). This difficulty might be attributed to the weak correlation between objective disease characteristics/symptoms and the subjective perception of distress of patients with cancer (5-8). Additionally, many patients feel discomfort when talking about mental health issues, and approximately 25% speak about their mental concerns only when invited to do so (9). International guidelines suggest routine distress screening for all patients with cancer, and such screening is one of the certification requirements for cancer centres (7, 10). In this context, we implemented routine psychosocial distress screenings for all patients with cancer at our Orthopaedic University Department.Malignant tumours of the musculoskeletal system are rare, comprising only 1% of all malignant tumours (11). Despite improvements in therapy and increased survival rates, patients with musculoskeletal malignancies, such as softtissue sarcomas, are particularly vulnerable to psychosocial distress (12-15). In our experience, high distress levels occur not only at early stages of the disease but also during the follow-up period (even years after the operation) in some patients.Most studies on the prevalence of psychosocial distress in patients with extremity sarcomas use common screening instruments such as the Brief Symptom Inventory (BSI), the Hospital Anxiety and Depression Scale (HADS) or the Depression and Anxiety Stress Scale 21 (DASS 21) (14,(16)(17)(18)(19). These questionnaires, however, are not cancer-specific and mainly assess the prevalence of psychiatric disorders, especially anxiety and depression. In contrast, ca...
Purpose Despite promising achievements in precision cancer medicine (PCM), participating patients are still faced with manifold uncertainties, especially regarding a potential treatment benefit of molecular diagnostics (MD). Hence, MD poses considerable challenges for patient information and communication. To meet these challenges, healthcare professionals need to gain deeper insight into patients’ subjective experiences. Therefore, this qualitative study examined information aspects of MD programs in cancer patients. Methods In two German Comprehensive Cancer Centers, 30 cancer patients undergoing MD participated in semi-structured interviews on information transfer and information needs regarding MD. Additionally, patients provided sociodemographic and medical data and indicated their subjective level of information (visual analogue scale, VAS, 0–10). Results On average patients had high levels of information (mean = 7, median = 8); nevertheless 20% (n = 6) showed an information level below 5 points. Qualitative analysis revealed that patients show limited understanding of the complex background of MD and have uncertainties regarding their personal benefit. Further, patients described unmet information needs. Existential threat in awaiting the results was experienced as burdensome. To withstand the strains of their situation, patients emphasized the importance of trusting their physician. Conclusion The challenges in PCM consist in providing unambiguous information, especially concerning treatment benefit, and providing guidance and support. Therefore, psycho-oncology needs to develop guidelines for adequate patient communication in order to help healthcare providers and cancer patients to handle these challenges in the developing field of PCM.
Zusammenfassung Hintergrund Diese Studie untersucht aktuelle Bedürfnisse und Belastungen von ambulanten Krebspatienten im Rahmen der COVID-19-Pandemie. Material und Methoden Zwischen 11/2020 und 02/2021 wurden 122 ambulante Krebspatientinnen und -patienten des Comprehensive Cancer Center München in die Studie eingeschlossen und anhand eines standardisierten, halbstrukturierten Interviews zu Wissensstand und Informationsbedürfnissen in Bezug auf COVID-19, Risikowahrnehmung und Sorgen hinsichtlich der ambulanten Krebsbehandlung, COVID-19-spezifischen Belastungen sowie zum Vertrauen in das Gesundheitssystem und der Impfbereitschaft befragt. Zusätzlich wurde psychosozialer Distress anhand des Distress-Thermometers (DT) erhoben. Ergebnisse Über ein Drittel der Krebspatienten (34,2 %, n = 41/120) hatte noch Informationsbedarf hinsichtlich der Auswirkungen des Coronavirus auf ihre Erkrankung oder Behandlung. 17,2 % (n = 21/122) waren von Veränderungen der laufenden oder geplanten Krebstherapie betroffen. Bei n = 42/121 (34,7 %) der Patienten zeigte sich ein erhöhter psychosozialer Distress (DT ≥ 5). Die häufigste Corona-spezifische Belastung war die Angst vor einer Überlastung des Gesundheitssystems (77,9 %, n = 95/122), gefolgt von der Befürchtung, dass sich Angehörige noch größere Sorgen um die betroffenen Patienten machen (56,2 %, n = 68/121). 71,2 % (n = 74/104) der Patienten sind bereit, sich impfen zu lassen; 60 % (n = 18/30) der zum Zeitpunkt der Untersuchung Unentschlossenen oder Ablehner wünschen sich vor einer endgültigen Entscheidung für die Impfung ein Informationsgespräch mit ihrem Onkologen/ihrer Onkologin. Schlussfolgerung Corona-spezifische Belastungen von Krebspatienten betreffen insbesondere den Verlauf der Therapie, aber auch eine mögliche Überlastung des Gesundheitssystems. Onkologische Behandler-Teams sollten Fragen ihrer Patienten Raum geben, mögliche Unsicherheiten anerkennen, emotionale Unterstützung leisten und auf valide Informationsquellen aufmerksam machen.
Objective To improve allocation of psychosocial care and to provide patient‐oriented support offers, identification of determinants of elevated distress is needed. So far, there is a lack of evidence investigating the interplay between individual disposition and current clinical and psychosocial determinants of distress in the inpatient setting. Methods In this cross‐sectional study, we investigated 879 inpatients with different cancer sites treated in a German Comprehensive Cancer Center. Assessment of determinants of elevated distress included sociodemographic, clinical and psychosocial characteristics as well as dimensions of personality. Multiple linear regression was applied to identify determinants of psychosocial distress. Results Mean age of the patients was M = 61.9 (SD = 11.8), 48.1% were women. In the multiple linear regression model younger age (β = −0.061, p = 0.033), higher neuroticism (β = 0.178, p = <0.001), having metastases (β = 0.091, p = 0.002), being in a worse physical condition (β = 0.380, p = <0.001), depressive symptoms (β = 0.270, p = <0.001), not feeling well informed about psychological support (β = 0.054, p = 0.046) and previous uptake of psychological treatment (β = 0.067, p = 0.020) showed significant associations with higher psychosocial distress. The adjusted R2 of the overall model was 0.464. Conclusion Controlling for sociodemographic characteristics and dispositional vulnerability, that is neuroticism, current clinical and psychosocial characteristics were still associated with hospitalized patients' psychosocial distress. Psycho‐oncologists should address both, the more transient emotional responses, such as depressive symptoms, as well as more enduring patient characteristics, like neuroticism.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.