Predictive factors for psychological distress in ambulatory lung cancer patients

Akechi, Tatsuo; Kugaya, Akira; Okamura, Hitoshi; Nishiwaki, Yutaka; Yamawaki, Shigeto; Uchitomi, Yosuke

doi:10.1007/s005200050167

Cited by 57 publications

(48 citation statements)

References 23 publications

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“…It is possible, for instance, that lower levels of symptoms and distress resulted in higher perceived self-efficacy, or that other unmeasured factors led to both higher self-efficacy and lower levels of symptoms and distress. However, clinical observations suggest that feelings of helplessness and loss of control are a frequent problem for patients coping with cancer (Akechi et al, 1998;Uchitomi et al, 2003). The findings of this study suggest that clinicians interested in understanding how lung cancer patients adapt to their illness may benefit by attending to patients' perceptions of self-efficacy.…”

Section: Discussionmentioning

confidence: 81%

Self-efficacy for managing pain, symptoms, and function in patients with lung cancer and their informal caregivers: Associations with symptoms and distress

Porter

Keefe

Garst

et al. 2008

Pain

234

187

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This study examined self-efficacy for managing pain, symptoms, and function in patients with lung cancer and their caregivers, and associations between self-efficacy and patient and caregiver adjustment. 152 patients with early stage lung cancer completed measures of self-efficacy, pain, fatigue, quality of life, depression, and anxiety. Their caregivers completed a measure assessing their self-efficacy for helping the patient manage symptoms and measures of psychological distress and caregiver strain. Analyses indicated that, overall, patients and caregivers were relatively low in selfefficacy for managing pain, symptoms, and function, and that there were significant associations between self-efficacy and adjustment. Patients low in self-efficacy reported significantly higher levels of pain, fatigue, lung cancer symptoms, depression, and anxiety, and significantly worse physical and functional well being, as did patients whose caregivers were low in self-efficacy. When patients and caregivers both had low self-efficacy, patients reported higher levels of anxiety and poorer quality of life than when both were high in self-efficacy. There were also significant associations between patient and caregiver self-efficacy and caregiver adjustment, with lower levels of self-efficacy associated with higher levels of caregiver strain and psychological distress. These preliminary findings raise the possibility that patient and caregiver self-efficacy for managing pain, symptoms, and function may be important factors affecting adjustment, and that interventions targeted at increasing self-efficacy may be useful in this population.Self-efficacy, or the confidence in one's ability to perform a specific behavior or task (Bandura, 1997), is one factor that has been examined in relation to patient's adjustment to cancer. Selfefficacy for managing pain, symptoms, and function in particular may be critical to a patient's ability to manage the physical and psychological challenges of cancer. For several reasons, lung cancer provides a particularly good model in which to study self-efficacy for pain and symptom control. First, lung cancer is common, being the second leading site of cancer occurrence among both men and women with over 174,000 new cases projected for 2006 (American Cancer Society, 2006). Second, lung cancer poses significant challenges for patients and their caregivers including aggressive medical treatments and an uncertain prognosis. In Address correspondence to: Laura S. Porter, Ph.D., 2200 West Main St, Suite 340, Durham, NC 27705, USA, email: laura.porter@duke.edu, telephone: 919-416-3436, fax: 919-416-3458.. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovere...

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Section: Discussionmentioning

confidence: 81%

Self-efficacy for managing pain, symptoms, and function in patients with lung cancer and their informal caregivers: Associations with symptoms and distress

Porter

Keefe

Garst

et al. 2008

Pain

234

187

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“…Younger patients and women report higher levels of distress [7,11,14,15], and individuals with lung cancer, compared to individuals with other cancer diagnoses, also report higher levels of distress [15,17]. Approximately 43% of patients with lung cancer report clinically-significant levels of distress [15,18], compared to about 33% of patients with breast cancer and 32% of patients with colon cancer [15].…”

Section: Introductionmentioning

confidence: 99%

“…Distress has been defined as "a multifactorial, unpleasant experience of an emotional, psychological, social, or spiritual nature that interferes with the ability to cope with cancer, its physical symptoms, and its treatment" [1,2]. In the oncology context, distress is multifactorial, as numerous areas in a patient's life contribute to his or her experience of distress, including physical symptoms, disease severity, treatment [3,4]; physical activity level / performance status [5][6][7]; social support (for a review see [8]); and psychological factors such as optimism [9,10], coping style [11,12], and pre-morbid or current depression [13].…”

Section: Introductionmentioning

confidence: 99%

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Distress screening in a multidisciplinary lung cancer clinic: Prevalence and predictors of clinically significant distress

et al. 2007

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SummaryScreening for distress in cancer patients is recommended by the National Comprehensive Cancer Network, and a Distress Thermometer has previously been developed and empirically-validated for this purpose. The present study sought to determine the rates and predictors of distress in a sample of patients being seen in a multidisciplinary lung cancer clinic. Consecutive patients (N = 333) were recruited from an outpatient multidisciplinary lung cancer clinic to complete the Distress Thermometer, an associated Problem Symptom List, and two questions about interest in receiving help for symptoms. Over half (61.6%) of patients reported distress at a clinically significant level, and 22.5% of patients indicated interest in receiving help with their distress and/or symptoms. Problems in the areas of family relationships, emotional functioning, lack of information about diagnosis/treatment, physical functioning, and cognitive functioning were associated with higher reports of distress. Specific symptoms of depression, anxiety, pain and fatigue were most predictive of distress. Younger age was also associated with higher levels of distress. Distress was not associated with other clinical variables, including stage of illness or medical treatment approach. Similar results were obtained when individuals who had not yet received a definitive diagnosis of lung cancer (n = 134) were excluded from analyses; however, family problems and anxiety were no longer predictive of distress. Screening for distress in a multidisciplinary lung cancer clinic is feasible and a significant number of patients can be expected to meet clinical criteria for distress. Results also highlight younger age and specific physical and psychosocial symptoms as predictive of clinically-significant distress. Identification of the presence and predictors of distress are the first steps toward appropriate referral and treatment of symptoms and problems that contribute to cancer patients' distress.

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“…Support from a coresident may influence both the quality of life of cancer sufferers and their need for external services, including in-patient admission. Studies of particular patient groups from a range of settings have reported that cancer patients who live alone report more distress, poorer adjustment to diagnosis and have a poorer quality of life than those living with others (Forsberg and Cedermark, 1996;Akechi et al, 1998;Rustoen et al, 1999;Sollner et al, 1999;Sarna et al, 2002). Living arrangements may also influence chance of a home death, for which many people with cancer report a preference (Davison et al, 2001; Serra-Prat, Gallo and Picaza, 2001).…”

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confidence: 99%

Living arrangements and place of death of older people with cancer in England and Wales: a record linkage study

et al. 2004

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The main objectives of the study were to (1) see whether the household circumstances of people aged 50 years and over with cancer, and trends in these, differ from those of the rest of the population and (2) whether living arrangements and presence and health status of a primary coresident are associated with place of death among older people dying of cancer and those dying from other causes. The design included prospective record linkage study of people aged 50 years and over included in a 1% sample of the population of England and Wales (the Office for National Statistics Longitudinal Study). The main outcome measures comprised family and household type, and death at home. The household circumstances of older people with cancer were very similar to those of the rest of the population of the same age and both showed a large increase in living alone, and decrease in living with relatives, between 1981 and 1991. The primary coresident of cancer sufferers who did not live alone was in most cases a spouse, with much smaller proportions living with a child, sibling or other person. In all, 30% of spouse, and 23% of other, primary coresidents had a limiting long-term illness. Compared with people who lived alone in 1991, odds of a home death among those dying of cancer between 1991 and 1995 were highest for those who lived with a spouse who had no limiting long-term illness (odds ratio (OR) 2.52, 95% confidence interval (CI) 2.15 -2.97) and raised for those living with a spouse with a long-term illness (OR 2.14, CI 1.79 -2.56) and those living with someone else who was free of long-term illness (OR 2.13, CI 1.69 -2.68). Higher socioeconomic status, both individual and area, was positively associated with increased chance of a home death, while older age reduced the chance of dying at home. The changing living arrangements of older people have important implications for planning and provision of care and treatment for cancer sufferers.

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Predictive factors for psychological distress in ambulatory lung cancer patients

Cited by 57 publications

References 23 publications

Self-efficacy for managing pain, symptoms, and function in patients with lung cancer and their informal caregivers: Associations with symptoms and distress

Self-efficacy for managing pain, symptoms, and function in patients with lung cancer and their informal caregivers: Associations with symptoms and distress

Distress screening in a multidisciplinary lung cancer clinic: Prevalence and predictors of clinically significant distress

Living arrangements and place of death of older people with cancer in England and Wales: a record linkage study

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