Cancer patients' reluctance to discuss psychological distress with their physicians was not associated with underrecognition of depression by physicians: A preliminary study

2009 ◽  
Vol 7 (2) ◽  
pp. 229-233 ◽  
Author(s):  
Toru Okuyama ◽  
Chiharu Endo ◽  
Takashi Seto ◽  
Masashi Kato ◽  
Nobuhiko Seki ◽  
...  

ABSTRACTObjective:To investigate the association between cancer patients' reluctance for emotional disclosure to their physician and underrecognition of depression by physicians.Methods:Randomly selected ambulatory patients with lung cancer were evaluated by the Hospital Depression and Anxiety Scale (HADS), and those with scores over the validated cutoff value for adjustment disorder or major depressive disorder were included in this analysis. The data set included the responses to the 13-item questionnaire to assess four possible concerns of patients in relation to emotional disclosure to the treating physician (“no perceived need to disclose emotions,” “fear of the negative impact of emotional disclosure,” “negative attitude toward emotional disclosure,” “hesitation to disturb the physician with emotional disclosure”). The attending physicians rated the severity of depression in each patient using 3-point Likert scales (0 [absent] to 2 [clinical]). Depression was considered to be underrecognized when the patients had a HADS score above the cutoff value, but in whom the depression rating by the attending physician was 0.Results:The HADS score was over the cutoff value in the 60 patients. The mean age was 65.1 ± 10.0, and 82% had advanced cancer (Stage IIIb or IV or recurrence). Depression was underrecognized in 44 (73%) patients. None of the four factors related to reluctance for emotional disclosure was associated with the underrecognition of depression by the physicians. None of the demographic or cancer–related variables were associated with depression underrecognition by physicians.Significance of results:The results did not support the assumption that patients' reluctance for emotional disclosure is associated with the underrecognition of depression by physicians.

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ruofei Du ◽  
Xin Wang ◽  
Lixia Ma ◽  
Leon M. Larcher ◽  
Han Tang ◽  
...  

Abstract Background The adverse reactions (ADRs) of targeted therapy were closely associated with treatment response, clinical outcome, quality of life (QoL) of patients with cancer. However, few studies presented the correlation between ADRs of targeted therapy and treatment effects among cancer patients. This study was to explore the characteristics of ADRs with targeted therapy and the prognosis of cancer patients based on the clinical data. Methods A retrospective secondary data analysis was conducted within an ADR data set including 2703 patients with targeted therapy from three Henan medical centers of China between January 2018 and December 2019. The significance was evaluated with chi-square test between groups with or without ADRs. Univariate and multivariate logistic regression with backward stepwise method were applied to assess the difference of pathological characteristics in patients with cancer. Using the univariate Cox regression method, the actuarial probability of overall survival was performed to compare the clinical outcomes between these two groups. Results A total of 485 patients were enrolled in this study. Of all patients, 61.0% (n = 296) occurred ADRs including skin damage, fatigue, mucosal damage, hypertension and gastrointestinal discomfort as the top 5 complications during the target therapy. And 62.1% of ADRs were mild to moderate, more than half of the ADRs occurred within one month, 68.6% ADRs lasted more than one month. Older patients (P = 0.022) and patients with lower education level (P = 0.036), more than 2 comorbidities (P = 0.021), longer medication time (P = 0.022), drug combination (P = 0.033) and intravenous administration (P = 0.019) were more likely to have ADRs. Those with ADRs were more likely to stop taking (P = 0.000), change (P = 0.000), adjust (P = 0.000), or not take the medicine on time (P = 0.000). The number of patients with recurrence (P = 0.000) and metastasis (P = 0.006) were statistically significant difference between ADRs and non-ADRs group. And the patients were significantly poor prognosis in ADRs groups compared with non-ADRs group. Conclusion The high incidence of ADRs would affect the treatment and prognosis of patients with cancer. We should pay more attention to these ADRs and develop effective management strategies.


2021 ◽  
pp. 089443932098382
Author(s):  
Jildau Borwell ◽  
Jurjen Jansen ◽  
Wouter Stol

While criminality is digitizing, a theory-based understanding of the impact of cybercrime on victims is lacking. Therefore, this study addresses the psychological and financial impact of cybercrime on victims, applying the shattered assumptions theory (SAT) to predict that impact. A secondary analysis was performed on a representative data set of Dutch citizens ( N = 33,702), exploring the psychological and financial impact for different groups of cybercrime victims. The results showed a higher negative impact on emotional well-being for victims of person-centered cybercrime, victims for whom the offender was an acquaintance, and victims whose financial loss was not compensated and a lower negative impact on emotional well-being for victims with a higher income. The study led to novel scientific insights and showed the applicability of the SAT for developing hypotheses about cybercrime victimization impact. In this study, most hypotheses had to be rejected, leading to the conclusion that more work has to be done to test the applicability of the SAT in the field of cybercrime. Furthermore, policy implications were identified considering the prioritization of and approach to specific cybercrimes, treatment of victims, and financial loss compensation.


Author(s):  
Hiroyuki Kurosu ◽  
Yukiharu Todo ◽  
Ryutaro Yamada ◽  
Kaoru Minowa ◽  
Tomohiko Tsuruta ◽  
...  

Abstract Objective The aim of this study was to find a clinical marker for identifying refractory cancer cachexia. Methods We analyzed computed tomography imaging data, which included the third lumbar vertebra, from 94 patients who died of uterine cervix or corpus malignancy. The time between the date of examination and date of death was the most important attribute for this study, and the computed tomography images were classified into >3 months before death and ≤ 3 months before death. Psoas muscle mass index was defined as the left–right sum of the psoas muscle areas (cm2) at the level of third lumbar vertebra, divided by height squared (m2). Results A data set of 94 computed tomography images was obtained at baseline hospital visit, and a data set of 603 images was obtained at other times. One hundred (16.6%) of the 603 non-baseline images were scanned ≤3 months before death. Mean psoas muscle mass index change rates at >3 months before death and ≤3 months before death were −1.3 and −20.1%, respectively (P < 0.001). Receiver operating characteristic curve analysis yielded a cutoff value of −13.0%. The area under the curve reached a moderate accuracy level (0.777, 95% confidence interval 0.715–0.838). When we used the cutoff value to predict death within 3 months, sensitivity and specificity were 74.0 and 82.1%, respectively. Conclusions Measuring change in psoas muscle mass index might be useful for predicting cancer mortality within 3 months. It could become a potential tool for identifying refractory cancer cachexia.


2018 ◽  
Vol 10 (9) ◽  
pp. 136
Author(s):  
Rakibul Islam ◽  
Mohammad Emdad Hossain ◽  
Mohammad Nazmul Hoq ◽  
Md. Morshedul Alam

Working capital management plays centric role in enhancing operational efficiency and their ultimate profitability. Globally financial managers have been searching the proper way on how to utilize working capital components which prolong profitability. The purpose of this study is to assess the impact of working capital components on profitability indicators of selected pharmaceutical firms in Bangladesh. The paper used financial data of 9 pharmaceutical firms listed in Dhaka stock exchange (DSE) covered 2011-2015. Two methods were used in this study for analysis data set. Firstly, to measure the relationship between selected variables Pearson Correlation matrix was used. Secondly, multiple regression analysis was used to investigate the impact working capital components on profitability of selected pharmaceutical firms. The study also conducted Durbin Watson test to assess autocorrelation of selected variables. In this study the correlation matrix identified a negative correlation between working capital components and profitability, whereas regression analysis found number of days account receivable (AR) had significant positive and current ratio (CR) and debt ratio (DR) had appeared a significant negative impact on profitability.


2015 ◽  
Vol 6 (2) ◽  
pp. 399-410 ◽  
Author(s):  
R. Cremades ◽  
J. Wang ◽  
J. Morris

Abstract. The challenges China faces in terms of water availability in the agricultural sector are exacerbated by the sector's low irrigation efficiency. To increase irrigation efficiency, promoting modern irrigation technology has been emphasized by policy makers in the country. The overall goal of this paper is to understand the effect of governmental support and economic incentives on the adoption of modern irrigation technology in China, with a focus on household-based irrigation technology and community-based irrigation technology. Based on a unique data set collected at household and village levels from seven provinces, the results indicated that household-based irrigation technology has become noticeable in almost every Chinese village. In contrast, only about half of Chinese villages have adopted community-based irrigation technology. Despite the relatively high adoption level of household-based irrigation technology at the village level, its actual adoption in crop sown areas was not high, even lower for community-based irrigation technology. The econometric analysis results revealed that governmental support instruments like subsidies and extension services policies have played an important role in promoting the adoption of modern irrigation technology. Strikingly, the present irrigation pricing policy has played a significant but contradictory role in promoting the adoption of different types of modern irrigation technology. Irrigation pricing showed a positive impact on household-based irrigation technology, and a negative impact on community-based irrigation technology, possibly related to the substitution effect that is, the higher rate of adoption of household-based irrigation technology leads to lower incentives for investment in community-based irrigation technology. The paper finally concludes and discusses some policy implications.


Healthcare ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1422
Author(s):  
Evaldas Kazlauskas ◽  
Odeta Gelezelyte ◽  
Auguste Nomeikaite ◽  
Paulina Zelviene

Multiple empirical studies have revealed significant pandemic effects of COVID-19 on mental health in various populations. This study aimed to analyze the incidences of posttraumatic stress disorder (PTSD) and adjustment disorder (AjD) in national healthcare in 2018–2020 in one of the European countries—Lithuania—and estimate the effect of the COVID-19 pandemic on PTSD and AjD incidences in 2020. The national healthcare registry was used for estimations of diagnosis of PTSD, AjD, and major depressive disorder (MD). The study revealed that stress-related disorders PTSD and AjD are diagnosed rarely, resulting in a considerable gap between the expected prevalence and incidences of these diagnoses in healthcare in Lithuania. Moreover, a significant decline in mental disorders incidence in healthcare in 2020, in comparison to 2018 and 2019, was found, revealing that the COVID-19 pandemic had a negative impact on access to healthcare services and increased barriers for mental disorders treatment. The study indicates that major developments in building up knowledge about the effects of trauma and life stressors on mental health are needed in Lithuania and other countries to increase awareness about stress-related disorders and improve care for trauma survivors, in particular in the context of the pandemics or other large-scale disasters.


2021 ◽  
Author(s):  
George Antoniou ◽  
Scott Penfold

Abstract Inter-fractional anatomical variations in head and neck (H&N) cancer patients can lead to clinically significant dosimetric changes. Adaptive re-planning should thus commence to negate any potential over-dosage to organs-at-risk (OAR), as well as potential under-dosage to target lesions. The aim of this study is to explore the correlation between transit fluence, as measured at an electronic portal imaging device (EPID), and dose volume histogram (DVH) metrics to target and OAR structures in a simulated environment. Planning data of 8 patients that have previously undergone adaptive radiotherapy for head and neck cancer using volumetric modulated arc therapy (VMAT) at the Royal Adelaide Hospital were selected for this study. Through delivering the original treatment plan to both the planning and rescan CTs of these 8 patients, predicted electronic portal images (EPIs) and DVH metrics corresponding to each data set were extracted using a novel RayStation script. A weighted projection mask was developed for target and OAR structures through considering the intra-angle overlap between fluence and structure contours projected onto the EPIs. The correlation between change in transit fluence and planning target volume (PTV) D98 and spinal cord D0.03cc with and without the weighting mask applied was investigated. PTV D98 was strongly correlated with mean fluence percentage difference both with and without the weighting mask applied (RMask = 0.69, RNo Mask = 0.79, N = 14, p < 0.05), where spinal cord D0.03cc exhibited a weak correlation (RMask = 0.35, RNo Mask = 0.53, N = 7, p > 0.05) however this result was not statistically significant. The simulation toolkit developed in this work provided a useful means to investigate the relationship between change in transit fluence and change in key dosimetric parameters for head and neck cancer patients.


2021 ◽  
Vol 12 (4) ◽  
pp. 78-84
Author(s):  
M. Bakos ◽  
T. Jankovic ◽  
M. Vidiscak ◽  
S. Durdik

Introduction:Quality of life in cancer patients and probably also long term survival is negatively affected with fear of the recurrence of cancer and consequences of aggressive therapy. This is the reason for anxiety, depressions, and frustration which are accompanied by cognitive, emotional and behavioral disorders in their physical, relationship, sexual and social func- tioning. The aim of our study is to analyze the dynamics of evolution of the psychosocial loads and qualitative changes its symptomatology in cancer patients who survival 1-4 years after surgery. Material and methods:For assessment of psychosocial mor- bidity ́s in measure in surgery patients standardized question- naires of European Organization for Research and Treatment of Cancer- questionnaire EORTC QLQ-C30.3 (Quality of Life- C.30.3) and its module EORTC QLQ- BR23 were used. Results:The degree of psychosocial mortality in survival pa- tients one year after MRM in our group clearly demonstrated that these patients suffered because of consequences of psy- chosocial loads. It results from fear of recurrence of cancer and next functional, emotional, cognitive and social disorders with- out regard for surgery range. The degree of psychosocial loads in patients after MRM is still more than 4 years after end of treatment. Results show, that after the end of treatment there are many changes in their lives - anxiety and depressions can lead to psychical lability because of higher doubts, nervous- ness, irritability, helplessness and loneliness in their sufferers. Conclusion:Out-patient psychosocial interventions and pre- ventions because of negative impact of ongoing and changing psychosocial loads becomes necessary. It means that there is negative impact on quality of life; of long term cancer remis- sion and survival of patients after surgery.


2019 ◽  
Author(s):  
Jamal Kaid Mohammed Ali ◽  
S. Imtiaz Hasnain ◽  
M. Salim Beg

Overindulgence in social networking, in general, and texting, in particular, is much in practice. It is cutting across various population boundaries and has almost assumed an endemic proportion. Its consequential impact on the standard language has acquired greater importance. This paper aims to determine the perceptions and attitudes of English Second Language (ESL) learners at Aligarh Muslim University towards the consequences of texting on Standard English. The data were collected through a five-point scale questionnaire from ninety students who were enrolled at Aligarh Muslim University during the academic year 2010-2011. The respondents completed a 16-item questionnaire. The students from which the data were collected were grouped according to their levels. The results indicate the negative impact of this new usage of the language in breaking the rules of English language and influencing their literacy. Moreover, the questionnaire results from respondents' point of view show that regardless of their heavy use of texting, most respondents have a negative attitude towards texting and they viewed it as a threat to Standard English.


Author(s):  
Madeeha Malik ◽  
Iqra Parveen Kiyani ◽  
Shazana Rana ◽  
Azhar Hussain ◽  
Muhammad Bin Aslam Zahid

Introduction: Liver Cancer is aggressive cancer and patients are mostly screened and diagnosed when they become symptomatic at advanced. Disease severity, depression, fatigue, joint pain, and poor appetite have been reported as strong determinants of quality of life (QoL) among liver cancer patients. Aims: The objective of the study was to assess the quality of life and depression among liver cancer patients in Pakistan. Study Design:  A descriptive cross-sectional study design was used. Place and Duration of Study: The study was conducted in healthcare facilities of Islamabad and Rawalpindi, Pakistan between June 2020-December 2020. Methodology: Two pre-validated questionnaires i.e. EORTC QLQ-C30 and HADS were self-administered to a sample of 100 liver cancer patients selected using a convenience sampling technique for measuring QoL and depression, respectively. After data collection, data was cleaned, coded, and entered in SPSS. Results: The results highlighted that the lowest scores observed in the domain of symptom scale were: Nausea and Vomiting (23.72, ± 28.238), Dyspnea (25.27, ± 26.90), Constipation (26.03, ± 34.75) followed by Diarrhea (22.63, ± 28.42), whereas highest scores in the symptom scale were observed in the domain of fatigue (37.69, ± 20.06), pain (40.37, ± 18.44), insomnia (41.65, ± 32.37) and financial difficulties (60.33, ± 33.830). On the other hand, highest score on the functional scale was observed for physical functioning (64, ± 21.76) and the lowest score was observed in social functioning (53.19, ± 20.66). Conclusion: The present study concluded that liver cancer had a negative impact on risk factors/past medical history, co-morbidities, and poor socio-economic of life across all domains along with moderate depression in liver cancer patients. Illiteracy, advanced liver cancer stage, risk factors/past medical history, co-morbidities and poor socio-economic status negatively affected functional and symptom scale. Appropriate health educational and psychological interventional programs targeting patients should be initiated to improve awareness and reduce depression among liver cancer patients.


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