The relation between the experience of time and psychological distress in patients with hematological malignancies

2006 ◽  
Vol 4 (4) ◽  
pp. 357-363 ◽  
Author(s):  
MARC WITTMANN ◽  
TANJA VOLLMER ◽  
CLAUDIA SCHWEIGER ◽  
WOLFGANG HIDDEMANN
Keyword(s):  
Quality Of Life ◽  
Psychological Distress ◽  
Hematological Malignancies ◽  
Well Being ◽  
Anxiety And Depression ◽  
Life Threatening Illness ◽  
Experience Of Time ◽  
Spiritual Well Being ◽  
Life Threatening

Objective: The experience of time is strongly related to our momentary mood states. Patients with a life-threatening illness experience an extreme change in mood and suffer from psychological distress that can develop into clinically relevant psychiatric disorders, like anxiety and depression. The aim of this study was to investigate the associations among the subjective perception of time, psychological distress, and quality of life in patients with hematological malignancies.Methods: Eighty-eight inpatients with hematological malignancies rated how fast time passes subjectively on a visual analog scale and prospectively estimated a time span of 13 min. The Hospital Anxiety and Depression Scale (HADS) self-report measures of health-related quality of life (FACT-G) and spiritual well-being (FACIT-Sp) were employed to assess psychological distress and quality of life.Results: Those patients who reported a lower quality of life, less spiritual well-being, and more anxiety experienced a slower passage of subjective time and overestimated the 13-min time interval.Significance of results: Our interpretation of the results is that patients with a life-threatening illness who show symptoms of psychological distress draw attention away from meaningful thoughts and actions and, thus, experience time as passing more slowly. An altered sense of time can be a sign of mental suffering, which should be addressed within psycho-oncological interventions. As this is the first study to demonstrate this relation in cancer patients, further research is needed to investigate the experience of time and its relation to meaning as an issue in clinical diagnostics.

The meaning of dignity in psychosocial care

2018 ◽  
Author(s):  
Susan McClement ◽  
Genevieve Thompson
Keyword(s):  
Psychosocial Care ◽  
Holistic Approach ◽  
Well Being ◽  
Physical Symptoms ◽  
Clinical Encounters ◽  
Life Threatening Illness ◽  
Whole Person ◽  
Spiritual Well Being ◽  
Life Threatening

Individuals living with life-limiting illness experience a myriad of physical, psychosocial and existential challenges. Psychosocial care is an holistic approach that aims to mitigate the distress engendered by these challenges. One important facet of such care includes tending to patient dignity. This chapter discusses what dignity is, why it is important, and how dignity conserving care can be weaved into daily clinical encounters. Palliative care is a type of health care for individuals facing life-threatening illness and their families that involves ongoing evaluation and management of a person’s pain and other physical symptoms. It also involves the provision of psychosocial care—care that attends to a person’s emotional, social, and spiritual well-being. This whole-person approach to the care of individuals is concerned with addressing a range of needs that can improve quality of life.

scholarly journals Association between spiritual well-being, quality of life, anxiety and depression in patients with gynaecological cancer in China

Medicine ◽  
2021 ◽  
Vol 100 (1) ◽  
pp. e24264
Author(s):  
Jing Chen ◽  
Huaxuan You ◽  
Yan Liu ◽  
Qian Kong ◽  
Anjiang Lei ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Well Being ◽  
Gynaecological Cancer ◽  
Anxiety And Depression ◽  
Spiritual Well Being

scholarly journals Efficacy of Meaning-Centered Psychotherapy in adult patients with advanced cancer: A systematic review and meta-analysis

2021 ◽  
Vol 18 (2) ◽  
pp. 227-244
Author(s):  
Natalia Dietrich ◽  
Andrés Estradé ◽  
Juan Antonio Cruzado
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Clinical Trials ◽  
Psychological Distress ◽  
Advanced Cancer ◽  
Meta Analysis ◽  
Well Being ◽  
Adult Patients ◽  
Spiritual Well Being

Objective: We conducted a PRISMA-compliant systematic review of clinical trials, and a meta-analysis of randomised clinical trials (RCTs) of manualised Meaning-Centered Psychotherapy (MCP) interventions for adult advanced cancer patients. We searched seven databases for trials published in English and Spanish, until March 27, 2021. Results: Seven trials were included in the systematic review, and four in the meta-analysis. The systematic review favoured the effectiveness of MCP for the improvement of spiritual well-being, quality of life (QoL), sense of meaning and psychological distress, although inconsistencies between the trials were found. In pre-post meta-analytic estimates, MCP had a superior therapeutic effect than control conditions for spiritual well-being (d=0.52, p<0.001), QoL (d=0.60, p<0.001), anxiety symptoms (d=-0.47, p<0.001), depressive symptoms (d=-0.50, p<0.001) and desire for hastened death (d=-0.28, p<0.001). No differences were observed in between-group comparisons. MCP was not associated with an increased risk of abandonment at post-treatment (OR=0.86, p=0.57). Conclusion: Manualised MCP interventions are a promising treatment for the improvement of spiritual well-being and quality of life and the reduction of psychological distress in adult patients with advanced cancer. The evidence base is still in an emerging state and should be expanded by higher methodological quality studies.

Dignity therapy, psycho-spiritual well-being and quality of life in the terminally ill: systematic review and meta-analysis

2021 ◽  
pp. bmjspcare-2021-003180
Author(s):  
Ruishuang Zheng ◽  
Qiaohong Guo ◽  
Zhiqian Chen ◽  
Yingchun Zeng
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Terminally Ill ◽  
Well Being ◽  
Cochrane Library ◽  
Anxiety And Depression ◽  
Terminally Ill Patients ◽  
Dignity Therapy ◽  
Spiritual Well Being

ObjectivesDignity therapy (DT) is a brief, individualised psychotherapy that aims to alleviate psychosocial and spiritual distress in the final stages of life. It is unknown yet whether DT can enhance sense of dignity and improve psychological and spiritual well-being as well as quality of life of terminally ill patients.MethodsWe searched PubMed, EMBASE, CINAHL plus, ProQuest Health & Medical Complete, PsycINFO and the Cochrane Library, as well as Chinese databases including Weipu Data, Wanfang Data and China National Knowledge Infrastructure from inception to 30 April 2021, for randomised controlled trials (RCTs) assessing the effects of DT on dignity, psycho-spiritual well-being and quality of life of terminally ill patients receiving palliative care.ResultsWe identified 507 unique records, and included 9 RCTs (871 participants). Comparator was standard palliative care. DT did not improve terminally ill patients’ sense of dignity (p=0.90), hope (p=0.15), spiritual well-being (p=0.99) and quality of life (p=0.23). However, DT reduced anxiety and depression after intervention (standardised mean difference, SMD=−1.13, 95% CI (−2.21 to –0.04), p=0.04; SMD=−1.22, 95% CI (−2.25 to –0.18), p=0.02, respectively) and at 4 weeks post-intervention (SMD=−0.89, 95% CI (−1.71 to –0.07), p=0.03; SMD=−1.26, 95% CI (−2.38 to –0.14), p=0.03, respectively).ConclusionDT can be offered as a psychological intervention for terminally ill patients to reduce their anxiety and depression. More studies are needed to further evaluate the effects of DT on terminally ill patients’ dignity, spiritual well-being and quality of life.

Faktor yang Memengaruhi Kualitas Hidup Pasien dengan Penyakit Jantung Koroner

1970 ◽  
Vol 4 (2) ◽  
Author(s):  
Aan Nuraeni ◽  
Ristina Mirwanti ◽  
Anastasia Anna ◽  
Ayu Prawesti ◽  
Etika Emaliyawati
Keyword(s):  
Quality Of Life ◽  
Heart Disease ◽  
Cardiac Rehabilitation ◽  
Beck Depression Inventory ◽  
Well Being ◽  
Anxiety Scale ◽  
Seattle Angina Questionnaire ◽  
Spiritual Well Being ◽  
Anxiety Depression

Prevalensi Penyakit Jantung Koroner (PJK) terus mengalami peningkatan setiap tahunnya dan menjadi masalah kesehatan utama di masyarakat saat ini. PJK berdampak terhadap berbagai aspek kehidupan penderitanya baik fisik, psikososial maupun spiritual yang berpengaruh terhadap kualitas hidup pasien. Isu kualitas hidup dan faktor-faktor yang berhubungan didalamnya belum tergambar jelas di Indonesia. Tujuan dari penelitian ini adalah mengidentifikasi faktor yang memengaruhi kualitas hidup pada pasien PJK yang sedang menjalani rawat jalan. Faktor-faktor yang diteliti dalam penelitian ini meliputi jenis kelamin, tingkat penghasilan, revaskularisasi jantung, rehabilitasi jantung, kecemasan, depresi dan kesejahteraan spiritual. Kecemasan diukur dengan Zung Self-rating Anxiety Scale, depresi diukur dengan Beck Depression Inventory II, kesejahteraan spiritual diukur dengan kuesioner Spirituality Index of Well-Beingdan kualitas hidup diukur menggunakan Seattle Angina Questionnaire. Penelitian ini menggunakan rancangan kuantitatif deskriptif dan analitik multivariatedengan regresi logistic. Diteliti pada 100 responden yang diambil secara randomdalam kurun waktu 1 bulan di Poli Jantung. Hasil penelitian menunjukkan faktor yang memengaruhi kualitas hidup pada pasien PJK adalah cemas (p) 0,002; Odd Ratio(OR) 4,736 (95% confidence interval(CI), 1,749 – 12,827); depresi (p) 0,003; OR 5,450 ( 95% CI, 1,794 – 16,562); dan revaskularisasi (p) 0,033; OR 3,232 (95% CI, 1,096 – 9,528). Depresi menjadi faktor yang paling berpengaruh terhadap kualitas hidup pasien PJK. Faktor yang memengaruhi kualitas hidup pada pasien PJK meliputi depresi, cemas dan revaskularisasi. Dari ketiga variabel tersebut depresi merupakan variabel yang paling signifikan berpengaruh, sehingga manajemen untuk mencegah depresi perlu mendapatkan perhatian lebih baik lagi dalam discharge planningataupun rehabilitasi jantung.Kata kunci: Cemas, depresi, faktor yang memengaruhi, kualitas hidup, spiritual.Factors Influenced the Quality of Life among Patients Diagnosed with Coronary Heart Disease AbstractCoronary Heart Disease (CHD) has affected multidimensional aspects of human live nowadays. Yet, quality of life and factors associated with quality of life among people who live with heart disease has not been explored in Indonesia. This study aimed to identify factors influenced the quality of life among people with CHD received outpatient services. Those factors are gender, income, revascularization, cardiac rehabilitation, anxiety, depression and spiritual well-being. Zung Self-rating Anxiety Scale was used to measure anxiety where depression level measured using Beck Depression Inventory II. Spirituality index was used to measure spiritual well-being. The quality of life level was measured using the Seattle Angina Questionnaire. This study used quantitative descriptive with multivariate analysis using logistic regression. 100 respondents were randomly selected from the Cardiac Outpatient Unit. Findings indicated factors influenced the quality of life of CHD patients using a significance of ƿ-value < 0.005 were: anxiety (ƿ=0,002, OR = 4,736, 95% CI, 1,749 – 12,827); depression (ƿ=0,003; OR=5,450, 95% CI, 1,794 – 16,562); and revascularizations (ƿ=0,033; OR=3,232, 95% CI, 1,096 – 9,528). Depression was considered as the most significant factor; therefore, managing depression is a priority in the discharge planning or cardiac rehabilitation programme. Keywords: Anxiety, depression, quality of life, spiritual, well-being.

scholarly journals More comprehensively measuring quality of life in life-threatening illness: the McGill Quality of Life Questionnaire – Expanded

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
S. Robin Cohen ◽  
Lara B. Russell ◽  
Anne Leis ◽  
Javad Shahidi ◽  
Pat Porterfield ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Second Order ◽  
Model Fit ◽  
Life Questionnaire ◽  
Quality Of Life Questionnaire ◽  
Healthcare Environment ◽  
Life Threatening Illness ◽  
Life Threatening ◽  
Order Factor

Abstract Background Domains other than those commonly measured (physical, psychological, social, and sometimes existential/spiritual) are important to the quality of life of people with life-threatening illness. The McGill Quality of Life Questionnaire (MQOL) – Revised measures the four common domains. The aim of this study was to create a psychometrically sound instrument, MQOL – Expanded, to comprehensively measure quality of life by adding to MQOL-Revised the domains of cognition, healthcare, environment, (feeling like a) burden, and possibly, finance. Methods Confirmatory factor analyses were conducted on three datasets to ascertain whether seven new items belonged with existing MQOL-Revised domains, whether good model fit was obtained with their addition as five separate domains to MQOL-Revised, and whether a second-order factor representing overall quality of life was present. People with life-threatening illnesses (mainly cancer) or aged > 80 were recruited from 15 healthcare sites in seven Canadian provinces. Settings included: palliative home care and inpatient units; acute care units; oncology outpatient clinics. Results Good model fit was obtained when adding each of the five domains separately to MQOL-Revised and for the nine correlated domains. Fit was acceptable for a second-order factor model. The financial domain was removed because of low importance. The resulting MQOL-Expanded is a 21-item instrument with eight domains (fit of eight correlated domains: Comparative Fit Index = .96; Root Mean Square Error of Approximation = .033). Conclusions MQOL-Expanded builds on MQOL-Revised to more comprehensively measure the quality of life of people with life-threatening illness. Our analyses provide validity evidence for the MQOL-Expanded domain and summary scores; the need for further validation research is discussed. Use of MQOL-Expanded will enable a more holistic understanding of the quality of life of people with a life-threatening illness and the impact of treatments and interventions upon it. It will allow for a better understanding of less commonly assessed but important life domains (cognition, healthcare, environment, feeling like a burden) and their relationship to the more commonly assessed domains (physical, psychological, social, existential/spiritual).

The effectiveness of hope-fostering interventions in palliative care: A systematic review and meta-analysis

2021 ◽  
pp. 026921632199472
Author(s):  
Natalia Salamanca-Balen ◽  
Thomas V Merluzzi ◽  
Man Chen
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Palliative Care ◽  
Meta Analysis ◽  
Symptom Burden ◽  
Well Being ◽  
Medium Effect ◽  
Spiritual Well Being ◽  
Quasi Experimental

Background: The concept of hope is an important theme in chronic illness and palliative care and has been associated with increased psycho-spiritual well-being and quality of life. Psycho-spiritual interventions have been described in this population, but no systematic review of hope-enhancing interventions or hopelessness-reducing interventions has been conducted for persons with palliative care diseases. Aim: To describe and assess the effectiveness of interventions in palliative care that measure hope and/or hopelessness as an outcome. Design: This systematic review and meta-analysis was pre-registered (Prospero ID: CRD42019119956). Data sources: Electronic databases, journals, and references were searched. We used the Cochrane criteria to assess the risk of bias within studies. Results: Thirty-five studies (24 randomized controlled trials, 5 quasi-experimental, 6 pre-post studies) involving a total of 3296 palliative care patients were included. Compared with usual/standard cancer care alone, interventions significantly increased hope levels at a medium effect size ( g = 0.61, 95% confidence interval (CI) = 0.28–0.93) but did not significantly reduce hopelessness ( g = −0.08, 95% CI = −0.18 to 0.02). It was found that interventions significantly increase spirituality ( g = 0.70, 95% CI = 0.02–1.37) and decrease depression ( g = −0.29, 95% CI = −0.51 to −0.07), but had no significant effect over anxiety, quality of life, and symptom burden. Overall, quality of evidence across the included studies was rated as low. Conclusions: Evidence suggests that interventions can be effective in increasing hope in palliative care patients.

Current measures of distress may not account for what's most important in existential care interventions: Results of the outlook trial

2020 ◽  
Vol 18 (6) ◽  
pp. 648-657
Author(s):  
Karen E. Steinhauser ◽  
Karen M. Stechuchak ◽  
Katherine Ramos ◽  
Joseph Winger ◽  
James A. Tulsky ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Early Stage ◽  
Well Being ◽  
Primary Analysis ◽  
Significant Difference ◽  
Spiritual Well Being ◽  
Screening For Distress ◽  
Secondary Outcomes ◽  
Stage Renal Disease

AbstractObjectiveCompare the efficacy of two interventions addressing emotional and existential well-being in early life-limiting illness.MethodPrimary trial analysis (n = 135) included patients with advanced cancer, congestive heart failure, or end-stage renal disease; Arm 1 received the Outlook intervention, addressing issues of life completion and preparation, and Arm 2 received relaxation meditation (RM). Primary outcomes at five weeks (primary endpoint) and seven weeks (secondary): completion and preparation (QUAL-E); secondary outcomes: anxiety (POMS) quality of life (FACT-G) and spiritual well-being (FACIT-Sp) subscales of faith, meaning, and peace.ResultsAverage age was 62; 56% were post-high school-educated, 54% were married, 52% white, 44% female, and 70% had a cancer diagnosis. At baseline, participants demonstrated low levels of anxiety (<5 on POMS subscale) and depression (<10 on CESD) relative to population norms. Results of the primary analysis revealed no significant differences in mean Preparation by treatment arm at five weeks (14.4 Outlook vs. 14.8 RM; between-group difference −0.4 [95% CI, −1.6, 0.8], p = 0.49) or seven weeks (15.2 vs.15.4; between-group difference −0.2 [95% CI, −1.5, 1.0], p = 0.73). There were also no significant differences in mean Life Completion by treatment arm between five weeks (26.6 Outlook vs. 26.3 RM; between-group difference 0.2 [95% CI, −1.2, 1.7], p = 0.76) or seven weeks (26.5 vs. 27.5; between-group difference −1.0 [95% CI, −2.7, 0.7], p = 0.23). Compared to RM, Outlook participants did not have significant differences over time in the secondary outcomes of overall quality of life, anxiety, depression, FACT-G subscales, and FACIT-Sp subscales.DiscussionIn early-stage life-limiting illness, Outlook did not demonstrate a significant difference in primary or secondary outcomes relative to RM. Results underscore the importance of pre-screening for distress. Qualitatively, Outlook participants were able to express suppressed emotions, place illness context, reflect on adaptations, and strengthen identity. Screening for distress and identifying specified measures of distress, beyond anxiety and depression, is essential in our ability to adequately assess the multi-dimensional mechanisms that decrease existential suffering.

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