Abstract:Older cancer patients' sense of control orientation over the course of illness and the cause of illness predicted the levels of depressive symptomatology.
“…For example, results for chance sleep locus of control indicate the importance of discussing personal sense of control over sleep and correcting the misconception that healthy sleep is out of one’s control. This is consistent with many behavioral medicine interventions that highlight the importance of sense of control in achieving better health (Mystakidou, Tsilika, Parpa, & Galanos, 2015; Nuccitelli et al, 2017). Further, there is very little knowledge regarding what components of CBT-I are best delivered in-person or via an Internet intervention.…”
Online CBT-I may reduce the enormous public health burden of insomnia by changing underlying cognitive variables that lead to long-term changes in sleep outcomes.
“…For example, results for chance sleep locus of control indicate the importance of discussing personal sense of control over sleep and correcting the misconception that healthy sleep is out of one’s control. This is consistent with many behavioral medicine interventions that highlight the importance of sense of control in achieving better health (Mystakidou, Tsilika, Parpa, & Galanos, 2015; Nuccitelli et al, 2017). Further, there is very little knowledge regarding what components of CBT-I are best delivered in-person or via an Internet intervention.…”
Online CBT-I may reduce the enormous public health burden of insomnia by changing underlying cognitive variables that lead to long-term changes in sleep outcomes.
“…Some have demonstrated that patients with high external LOC have poor coping skills and may experience increased rates of depression (14, 23, 27). Other studies have shown that an elevated external LOC can allow patients to better adapt to their illness because they are able to separate themselves from their illness and see it as being the responsibility of their physician (a powerful other) (12).…”
Section: Discussionmentioning
confidence: 99%
“…Some studies suggest that high external LOC may be associated with decreased quality of life and mental well-being while others demonstrate improved outcomes (3, 11–13) . Prior research in cancer patients suggest that a high external LOC may be related to increased rates of depression (14). The primary objective of our study was to evaluate the manner in which LOC impacts QOL and mental well-being of patients with advanced stage cancer who had been referred to a cancer center’s supportive care clinic.…”
Purpose
To evaluate if Locus of Control (LOC) predicts various quality of life (QOL) and mental well-being measures among terminally ill cancer patients at the time of palliative care consult.
Methods
Multi-site analysis of patients with advanced cancer being seen as new patients in a Palliative and Supportive Care outpatient clinic. Patients completed the following surveys: Locus of Control Scale (LOC), Functional Assessment of Chronic Illness Therapy-General (FACT-G), Functional Assessment of Chronic Illness Therapy–Spiritual (FACIT-Sp), Hospital Anxiety Depression Scale (HADS), and Herth Hope Index (HHI).
Regression models were created to examine the effect of LOC upon QOL, symptoms, and other measures of mental well-being. These models adjusted for the effect of age, gender, race, partnership status, education, and months since diagnosis as potential confounders.
Results
This study enrolled 100 patients. After adjusting for site, race and partnership status, higher levels of LOC Chance predicted decreased QOL (FACT-G) (p< 0.01). Higher levels of LOC Chance also correlated with increased depression and anxiety (p≤0.01) and decreased meaning/peace and faith (p≤0.01). Additionally, higher levels of LOC Chance predicted decreased hope (HHI) (p≤0.001).
Conclusions
Terminally ill cancer patients with a high LOC chance may be at risk for decreased physical and mental well-being at the end of life. Efforts should be made to identify these patients and design interventions to increase their feeling of control over the situation in order to improve physical and mental well-being at the end of life.
“…The present study has some limitations. First, our subjects may have been lacking one or more factors that were previously shown to affect the association between depressive symptoms and age, including comorbidities, 19,29 poor cognitive function, 18,19,29,49e53 other somatic symptoms, 7,19,37 social factors, such as caring for young children, career or economic stresses, 54,55 social support factors, 7,29 locus of control, 56 and Charlson comorbidity scores. 29 We especially should have assessed cognitive function, which has been shown to be associated with depression 18,19,49,50 and is prevalent in cancer patients.…”
The finding that depressive symptoms in cancer patients decreased with age was concordant with our first hypothesis, but the second hypothesis was not supported. Younger cancer patients were vulnerable to depressive symptoms and should be monitored carefully. Further studies using more representative samples are needed to examine in detail the association between depressive symptoms and age in older cancer patients.
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