scholarly journals Suicidal ideation, distress, and related factors in a population of cancer patients treated in a general acute hospital

2021 ◽  
Author(s):  
Bianca Senf ◽  
Bernd Bender ◽  
Jens Fettel
Keyword(s):  
Suicidal Ideation ◽  
Cancer Patients ◽  
Associated Factors ◽  
Rating Scale ◽  
Daily Life ◽  
Assessment Instrument ◽  
Screening Tools ◽  
Care Hospital ◽  
Distress Screening ◽  
Primary Care Hospital

Abstract Purpose Suicidality and suicidal ideation (SI) in oncology has long been an underestimated danger. Although there are cancer-specific distress screening tools available, none of these specifically incorporates items for SI. We examined the prevalence of SI in cancer patients, investigated the relation between SI and distress, and tried to identify additional associated factors. Methods A cross-sectional study with patients treated for cancer in a primary care hospital was conducted. Psychosocial distress and SI in 226 patients was assessed. An expert rating scale (PO-Bado-SF) and a self-assessment instrument (QSC-R23) were used to measure distress. SI was assessed with item 9 of the PHQ-9. Data was descriptively analyzed, and correlations and group comparisons between clinically distressed and non-distressed patients were calculated. Results SI was reported by 15% of patients. Classified as clinically distressed were 24.8% (QSC-R23) to 36.7% (PO-Bado-SF). SI was correlated with externally (rτ = 0.19, p < 0.001) and self-rated distress (rτ = 0.31, p < 0.001). Symptoms sufficiently severe for at least a medium major depressive episode were recorded in 23.5% of patients (PHQ-9). Factors associated with SI were feeling bad about oneself, feeling down, depressed, and hopeless, deficits in activities of daily life, psycho-somatic afflictions, social restrictions, and restrictions in daily life. Being in a steady relationship seemed to have a protective effect. Conclusions SI is common in cancer patients. Distress and associated factors are increased in patients with SI. A distress screening with the ability to assess SI could be an important step in prevention, but more research is necessary.

scholarly journals Predictors of Suicidal Ideation and Attempt among Patients with Major Depressive Disorder at a Tertiary Care Hospital, Puducherry

2021 ◽  
Vol 12 (01) ◽  
pp. 122-128
Author(s):  
Ralte Lalthankimi ◽  
Padmavathi Nagarajan ◽  
Vikas Menon ◽  
Jeby Jose Olickal
Keyword(s):  
Major Depressive Disorder ◽  
Suicidal Ideation ◽  
Depressive Disorder ◽  
Rating Scale ◽  
Tertiary Care ◽  
Severe Depression ◽  
Care Hospital ◽  
Suicidal Behaviors ◽  
Major Depressive ◽  
Severity Of Depression

Abstract Objectives Mental disorders have a large impact on death by suicide. Hence, this study aims to determine the prevalence of suicidal behaviors among major depressive disorder (MDD) patients and the associated factors. Materials and Methods This cross-sectional analytical study was conducted among individuals aged 18 to 65 years, diagnosed with MDD in the Psychiatry Outpatient Department of a Tertiary Care Center, Puducherry during March to October 2019. Severity of depression was assessed using Hamilton Depression Rating Scale and Columbia-Suicide Severity Rating Scale was used to find the suicidal behaviors. Results For 166 participants in the study, mean (standard deviation) age was 40 (11) years and majority were females (76%). More than one-third (37%) had severe or very severe depression, and the prevalence of suicidal ideation, plan, and attempts were 83, 24, and 35%, respectively. After adjusting the covariates, the severity of depression and unemployment were significantly associated with suicidal attempts (adjusted prevalence ratios [aPR] = 11.4 and 1.9), and very severe depression was associated with suicidal ideation (aPR = 1.6). Among 140 individuals with suicidal ideation, 45 (32%) had an ideation frequency of 2 to 3 times/week, 69 (50%) had ideation for 1 hour, 36 (26%) could control ideation with little difficulty, and 12% had suicidal ideation mostly to end or stop their pain. Conclusion Suicidal ideation and attempts were significantly high in MDD patients, and the severity of depression was significantly associated with it. Early identification of high-risk suicidal behavior and implementation of effective preventive interventions are necessary to reduce death by suicide in these groups.

scholarly journals 479. Associated Factors for Extended-Spectrum β-Lactamase Infection Among Patients with Solid or Hematological Malignancy

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S234-S235
Author(s):  
Alvaro J Martinez-Valencia ◽  
Brian J Gomez Martinez ◽  
Anita Montañez Ayala ◽  
Katherine Garcia ◽  
Ricardo Sánchez Pedraza ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Associated Factors ◽  
Conditional Logistic Regression ◽  
Charlson Index ◽  
Care Hospital ◽  
Esbl Producer ◽  
Patients With Cancer ◽  
Extended Spectrum ◽  
Admission Data ◽  
Oncologic Patients

Abstract Background Cancer patients are susceptible to infections due to immunodeficiency, frequent invasive interventions-devices, chemotherapy and antibiotics exposure. Infections caused by extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae increase morbidity and mortality. The objective was to identify clinical factors associated with ESBL in infected patients with cancer at the Instituto Nacional de Cancerología. Methods A case–control study was conducted from 2013 to 2015. Cases were infected patients with ESBL-producer Enterobacteriaceae. Controls (matched for date and ward) with non-ESBL-producer Enterobacteriaceae were included. Data were extracted from electronic medical records at index culture: clinical and admission data, Charlson index, immunosuppressive, radio and chemotherapy, neutropenia, invasive devices, surgical procedures and antimicrobial therapy. Microorganisms were identified by the automatized system. Conditional logistic regression and backward stepwise was used to identify predictors of ESBL isolation. Results A total of 265 patients with ESBL producer Enterobacteriaceae and 445 non-ESBL producers were identified, mean age 59, 61% male, 48% admitted as outpatients, 73% with solid tumors, 38% with Charlson index ≥4. E.coli and Klebsiella spp. represented 90% of microorganisms. Factor associated with ESBL producer Enterobacteriaceae were hospitalization ≥7 days (OR: 1,59; CI 1.11–2,29), hospitalization the previous year (OR: 4.02; CI 2,68–6,02), immunosuppressive therapy (OR: 2.07; CI 1,05–4.05), Β-lactam therapy the last month (OR: 1.54; CI 1.05–2.26), invasive devices (OR: 1.58; CI 1.10–2.27), active neoplasia (OR: 2,22; CI1.05–4.68), neutropenia (OR: 2.03; CI:1.26–3.27) and absence of chemotherapy during last 3 months (OR: 1.91; CI1.29–2.82). Discriminatory capacity was acceptable (AUC: 0.71). Conclusion The presence of ESBL-producer Enterobacteriaceae in oncologic patients is associated with health care, hospital admission and length of stay, invasive devices and exposure to antibiotics. The magnitude of associated factors are weak and do not completely allow the identification of cancer patients infected with ESBL-producer Enterobacteriaceae. Disclosures All authors: No reported disclosures.

The Commission on Cancer Psychosocial Distress Screening Standard: The first year in review.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 198-198 ◽  
Author(s):  
Nina S. Miller ◽  
Ryan M. McCabe ◽  
Allison Knutson
Keyword(s):  
Cancer Patients ◽  
Treatment Plan ◽  
Psychosocial Care ◽  
Psychosocial Distress ◽  
Screening Tools ◽  
Institute Of Medicine ◽  
Distress Screening ◽  
Patient Centered ◽  
Screening Process ◽  
Cancer Program

198 Background: In response to recommendations from the 2007 Institute of Medicine report, Cancer Care for the Whole Patient, the American College of Surgeons’ Commission on Cancer developed a set of Continuum of Care standards, including a patient-centered standard regarding the delivery of psychosocial distress screening to all cancer patients. According to Cancer Program Standards 2012: Ensuring Patient-Centered Care, the accredited cancer program must implement a process to integrate and monitor on-site psychosocial distress screening and referral for the provision of psychosocial care. Patients experience psychological, social, financial, and behavioral issues that can interfere with their treatment plan and adversely affect outcomes. Screening processes result in the identification of distressed cancer patients and assessment and referral pathways to ensure appropriate psychosocial care provision can be obtained. The standard was established in 2012 with a 2015 implementation period allowing programs time to develop a screening, assessment, and referral process tailored to their patient population. Methods: Programs submit documentation to describe their process for delivery of care through an electronic activity report. Documentation of this standard includes the timing for delivery of the psychosocial distress screening tool; methodology; the specific tools selected with preference to validated and reliable screening tools; and a process for assessment, referral and documentation. This presentation will summarize the program submissions for 2015 and include an analysis of the details of the standard compliance as reported by accredited programs. Results: This analysis will include responses from all Commission on Cancer accredited programs reporting on this standard. The analysis will provide information about the trends in the timing, methods, and tools used by programs implementing a psychosocial distress screening process. Conclusions: This analysis will inform future decisions about standardization of a screening process and the feasibility of pooling data across centers.

scholarly journals Factors Associated with Suicidal Ideation, and Attempt Among Cancer Patients in Ayder Comprehensive Specialized Hospital: Cross-Sectional, Mekelle, Ethiopia

2020 ◽  
Vol 13 (1) ◽  
pp. 365-372
Author(s):  
Tesfalem Araya ◽  
Weyni Gidey
Keyword(s):  
Social Support ◽  
Suicidal Ideation ◽  
Cancer Patients ◽  
Associated Factors ◽  
Performance Status ◽  
Depression And Anxiety ◽  
Cross Sectional ◽  
Factors Associated ◽  
Specialized Hospital ◽  
The World

Background: Cancer patients are at high risk for suicide, particularly, when they are informed about the cancer diagnosis. However, there is a limited study in Ethiopia therefore, assessing suicidal ideation, attempt, and its associated factors are needed for intervention. Methods: An institutional-based cross-sectional study was conducted from March to June 2019 at Ayder comprehensive specialized hospital with a total of 297 participants. Suicide module of the World Mental Health (WMH) survey initiative version adopted from the World Health Organization (WHO) and used to assess suicidal ideation and attempt. Binary logistic regression analysis employed to identify factors associated with suicidal ideation and attempt. Odds ratio with 95% CI and P-value <0.05 was applied to identify significantly associated factors. Results: The lifetime prevalence of suicidal ideation and the attempt was found to be 27.9% [95%CI (22.3, 31.6)] and 8.4% [95%CI (5.2, 10.3)] respectively. Being female [AOR= 2.23, 95%CI (1.27, 3.92)], stage IV cancer [AOR=2.08, 95%CI(1.47, 3.81)], having depression and anxiety [AOR=2.31, 95%CI(1.24,4.32)], poor social support [AOR=3.70, 95%CI(2.01,6.78)], and level 4 performance status [AOR=3.73, 95%CI(1.71, 8.13)] were the factors associated with lifetime suicidal ideation. While being in level 4, performance status was also significantly associated with suicidal attempt. Conclusion: Both suicidal ideation and attempt among cancer patients are high. The suicidal ideation had a statistical association with sex, stage of cancer, having depression and anxiety, social support, and level of performance. Therefore, health education for early screening and treatment for depression and anxiety, and giving social support are crucial for the reduction of suicide.

scholarly journals Neonatal pneumonia in a rural primary care hospital in Bangladesh: prevalence, validation of clinical features and their outcome

2016 ◽  
Vol 4 (2) ◽  
pp. 74-78
Author(s):  
Md Nazim Uzzaman ◽  
Md Al Fazal Khan ◽  
Tahmeed Ahmed ◽  
Mohammad Habibur Rahman Sarker ◽  
Sultana Yeasmin ◽  
...  
Keyword(s):  
Primary Care ◽  
Regression Analysis ◽  
Chest Wall ◽  
Associated Factors ◽  
Clinical Signs ◽  
Care Hospital ◽  
Rural Primary Care ◽  
Resource Limited ◽  
Primary Care Hospital ◽  
Adventitious Sound

Objective: To explore prevalence, validity of associated factors and their outcome of pneumonia in neonates.Methods: We retrospectively enrolled neonates admitted to a rural hospital in Bangladesh from January 2012-December 2014. Those with pneumonia constituted cases (n=142) and randomly selected three folds of cases from those without pneumonia formed the controls (n=426). Pneumonia was diagnosed by hospital physicians based on respiratory difficulty and/or abnormal auscultatory findings in lungs.Result: The deaths were significantly higher among the cases than the controls (p=0.025). In logistic regression analysis, fast breathing, lower chest wall in-drawing, adventitious sound and cough were independently associated with neonatal pneumonia (for all, p<0.01). However, best of all, sensitivity of fast breathing and lower chest wall in-drawing was 94% and 76% and specificity 81% and 82% respectively.Conclusion: The results underscore the importance of adherence to WHO defined clinical signs in diagnosing pneumonia in neonates especially in resource limited settings.Bangladesh Crit Care J September 2016; 4 (2): 74-78

Distress management in a community oncology center.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 107-107
Author(s):  
Lori Watts ◽  
Nicolas Camilo ◽  
Nicole Thurston ◽  
Michele Betts ◽  
Dan Sayam Zuckerman
Keyword(s):  
Social Workers ◽  
Cancer Patients ◽  
Nurse Practitioners ◽  
Sleep Problems ◽  
Psychosocial Care ◽  
Screening Tools ◽  
Distress Screening ◽  
Medical Provider ◽  
Care Clinic

107 Background: NCCN and the Institute of Medicine recommend distress screening for all cancer patients. Surveys have found that 20% to 47% of newly diagnosed and recurrent cancer patients experience significant levels of distress. Less than half of distressed patients with cancer are actually identified and referred for psychosocial help. The development of screening tools, processes, appropriate timing, and systems for follow up on concerns is an ongoing challenge for many cancer programs. Mountain States Tumor Institute p,iloted a distress screen process as part of our work with NCCCP. Methods: From October 24, 2011, to April 30, 2012, 133 patients completed distress screens. Most frequently reported concerns included fatigue (50%), sleep changes (32%), and anxiety/worry (31%). 51% of patients reported three or more concerns. 90% of all patients reporting anxiety also reported fatigue or sleep problems. All patients who reported concerns were offered social work and other supports. Screens were reviewed by social workers and discussed at weekly multidisciplinary psychosocial care rounds by social workers, psychiatrist, nurse practitioners, and chaplains. A variety of interventions were used to respond to distress including symptom management, education and referrals to on-site social workers, chaplains, supportive care clinic, integrative medicine and psychiatry. Results: A task was created in Mosaiq Electronic Medical Record to cue Health Information Specialists to schedule patients for distress screening as close as possible to 45 days from first chemotherapy treatment. Patients completed screens before seeing their medical provider. The majority of patients screened received one or more interventions in follow-up. Conclusions: EMRs can be effective tools to cue scheduled screening of patient distress. The use of multidisciplinary psychosocial care rounds can effectively help clinics plan interventions to alleviate patient distress. The use of rounds can ensure staff from different disciplines are not duplicating efforts and can help determine appropriate timing of various psychosocial interventions. Project funded with Federal funds from the NCI, Contract No HHSN261200800001E.

Correlates of distress for cancer patients: Results from multi-institution use of holistic patient-reported screening tool.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 11587-11587
Author(s):  
Christine B. Weldon ◽  
James I. Gerhart ◽  
Frank J. Penedo ◽  
Paramjeet Khosla ◽  
Betty Roggenkamp ◽  
...  
Keyword(s):  
Supportive Care ◽  
Physical Function ◽  
Cancer Patients ◽  
Screening Tool ◽  
Screening Tools ◽  
Distress Screening ◽  
Age Related ◽  
Distress Score ◽  
Patient Reported ◽  
Chi Squared

11587 Background: The Commission on Cancer (CoC) Standard 3.2 requires distress screening and indicated action for cancer patients. NCCN and ASCO supportive care and age-related guidelines include patient reported concerns beyond distress. This study compares PHQ4 scores to other patient reported concerns. Methods: The Coleman Supportive Oncology Collaborative aggregated “best of” screening tools to assess patient reported needs and concerns aligned with CoC, NCCN and ASCO guidance. This supportive care screening tool was implemented at 8 sites from July 2015 thru July 2018. Analysis used chi squared test. Results: Most patients, 86% (10,635/12,295), reported one plus concerns and/or above threshold scores on PHQ4, PROMIS Pain, Fatigue or Physical Function. A chi squared comparison of patients with at least mild distress on PHQ4 to patients with no distress resulted in p values < .0001 for every screening category. Conclusions: Patients with a PHQ4 distress score of mild, moderate or severe also reported statistically significant levels of practical, family, physical, nutrition and treatment concerns. These patients also scored threshold levels for PROMIS Pain, Fatigue, and Physical Function. Screening only for distress without screening for other patient concerns may direct patients to services that do not address or focus on the underlying cause of the distress. [Table: see text]

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