scholarly journals Perceptions of prognosis and goal of treatment in patients with malignant gliomas and their caregivers

2020 ◽  
Vol 7 (5) ◽  
pp. 490-497
Author(s):  
Deborah A Forst ◽  
Kit Quain ◽  
Sophia L Landay ◽  
Maya Anand ◽  
Emilia Kaslow-Zieve ◽  
...  
Keyword(s):  
Malignant Gliomas ◽  
Depression Scale ◽  
Primary Treatment ◽  
Treatment Goal ◽  
Anxiety And Depression ◽  
Newly Diagnosed ◽  
Hospital Anxiety ◽  
Treatment Perceptions ◽  
Multivariable Regression ◽  
A Prospective Study

Abstract Background Patients with malignant gliomas have a poor prognosis. However, little is known about patients’ and caregivers’ understanding of the prognosis and the primary treatment goal. Methods We conducted a prospective study in patients with newly diagnosed malignant gliomas (N = 72) and their caregivers (N = 55). At 12 weeks after diagnosis, we administered the Prognosis and Treatment Perceptions Questionnaire to assess understanding of prognosis and the Hospital Anxiety and Depression Scale to evaluate mood. We used multivariable regression analyses to explore associations between prognostic understanding and mood and McNemar tests to compare prognostic perceptions among patient-caregiver dyads (N = 48). Results A total of 87.1% (61/70) of patients and 79.6% (43/54) of caregivers reported that it was “very” or “extremely” important to know about the patient’s prognosis. The majority of patients (72.7%, [48/66]) reported that their cancer was curable. Patients who reported that their illness was incurable had greater depressive symptoms (B = 3.01, 95% CI, 0.89-5.14, P = .01). There was no association between caregivers’ prognostic understanding and mood. Among patient-caregiver dyads, patients were more likely than caregivers to report that their primary treatment goal was cure (43.8% [21/48] vs 25.0% [12/48], P = .04) and that the oncologist’s primary goal was cure (29.2% [14/48] vs 8.3% [4/48], P = .02). Conclusions Patients with malignant gliomas frequently hold inaccurate perceptions of the prognosis and treatment goal. Although caregivers more often report an accurate assessment of these metrics, many still report an overly optimistic perception of prognosis. Interventions are needed to enhance prognostic communication and to help patients cope with the associated distress.

The use of the Distress Thermometer and the Hospital Anxiety and Depression Scale for screening of anxiety and depression in Italian women newly diagnosed with breast cancer

2020 ◽  
Vol 28 (10) ◽  
pp. 4997-5004
Author(s):  
Cristina Civilotti ◽  
Daniela Acquadro Maran ◽  
Francesca Santagata ◽  
Antonella Varetto ◽  
Maria Rosa Stanizzo
Keyword(s):  
Breast Cancer ◽  
Depression Scale ◽  
Distress Thermometer ◽  
Anxiety And Depression ◽  
Newly Diagnosed ◽  
Hospital Anxiety ◽  
Italian Women

Is alexithymia a personality trait increasing the risk of depression? A prospective study evaluating alexithymia before, during and after a depressive episode

2008 ◽  
Vol 38 (12) ◽  
pp. 1717-1722 ◽  
Author(s):  
C. Marchesi ◽  
S. Bertoni ◽  
A. Cantoni ◽  
C. Maggini
Keyword(s):  
Prospective Study ◽  
Pregnant Women ◽  
Personality Trait ◽  
Depressive Episode ◽  
Depression Scale ◽  
Anxiety And Depression ◽  
Hospital Anxiety ◽  
State Dependent ◽  
A Prospective Study ◽  
Care Evaluation

BackgroundWhether alexithymia is a personality trait that increases the risk of major depression (MD) is still debated. In this prospective study, alexithymic levels were evaluated before, during and after a depressive episode.MethodThe alexithymic levels, the presence of MD and the severity of anxious-depressive symptoms were evaluated at intervals of about 1 month in pregnant women attending the Centers for Prenatal Care, using the Toronto Alexithymia Scale (TAS), the Primary Care Evaluation of Mental Disorders (PRIME-MD) and the Hospital Anxiety and Depression Scale (HADS).ResultsSixteen women affected by MD, 21 affected by subthreshold depression and 112 non-depressed women were included in the study. Women who developed depression, compared to non-depressed women, showed similar TAS and HADS scores during the pre-morbid phase, a significant increase in the scores during depression and a significant decrease after remission, whereas no change was observed in non-depressed women.ConclusionsOur data suggest that in pregnant women alexithymia does not represent a personality trait that increases the risk of developing a depressive episode, and they support the hypothesis that alexithymia is a state-dependent phenomenon in depressed pregnant women.

Course of distress, anxiety, and depression in hematological cancer patients: Association between gender and grade of neoplasm

2013 ◽  
Vol 13 (2) ◽  
pp. 115-123 ◽  
Author(s):  
Cristiane Decat Bergerot ◽  
Karen Lynn Clark ◽  
Alexandre Nonino ◽  
Sarah Waliany ◽  
Marco Murilo Buso ◽  
...  
Keyword(s):  
Significant Interaction ◽  
Depression Scale ◽  
Anxiety And Depression ◽  
Hospital Anxiety ◽  
Hematological Cancer ◽  
Physical Problems ◽  
Male Patients ◽  
A Prospective Study ◽  
The Impact ◽  
Over Time

AbstractObjective:The aim of our study was to explore the impact of gender and hematological cancer grade on distress, anxiety, and depression in patients receiving chemotherapy.Methods:A prospective study was done in a cohort of 104 patients with hematological cancer. We employed the (1) Distress Thermometer (DT) and the Problem List (PL) and (2) the Hospital Anxiety and Depression Scale (HADS) for assessments at baseline (T1), the halfway timepoint (T2), and completion of chemotherapy (T3).Results:The proportion of patients experiencing significant distress (DT ≥ 4) decreased from the first to the last timepoint; the proportion experiencing anxiety and depression (as assessed by HADS) also decreased. Specifically, 50% of participants reported significant distress levels, 47.1% anxiety, and 26% depression at T1. At T2, the proportion of patients experiencing distress was reduced by 60.8%, by 76% for anxiety, and by 48.5% for depression; at T3, the reduction was close to 80% for all assessments compared with T1. Emotional and physical problems were most commonly reported. Significant reductions were discovered for distress and problem-related distress levels over time, and a significant interaction was found between gender and practical and physical problems (p < 0.05).Significance of results:Our findings suggest that female patients reported more distress, anxiety, and depression than male patients. Gender differences were related to problem-related distress but not to grade of neoplasm. We observed that, over the course of chemotherapy, the distress levels of patients with hematological cancer decrease over time.

Prognostic awareness and illness understanding in patients with malignant glioma and their caregivers.

2018 ◽  
Vol 36 (34_suppl) ◽  
pp. 33-33
Author(s):  
Sophia Landay ◽  
Maya V. Anand ◽  
Katharine M. Quain ◽  
Areej El-Jawahri ◽  
Joseph Greer ◽  
...  
Keyword(s):  
Prospective Study ◽  
Malignant Glioma ◽  
Cancer Patients ◽  
Poor Prognosis ◽  
Malignant Gliomas ◽  
Treatment Goals ◽  
Newly Diagnosed ◽  
Communication Preferences ◽  
Treatment Perceptions ◽  
A Prospective Study

33 Background: Malignant gliomas (MG) are rapidly progressive, incurable tumors. Patients with glioblastoma, the most common MG, have a median survival of approximately 14 months when treated aggressively. Despite this poor prognosis, data is lacking on patients’ and caregivers’ (CGs’) understanding of patients’ prognosis and treatment goals and their communication preferences. We assessed prognostic awareness (PA) in patients with MG and their CGs three months following diagnosis. Methods: We conducted a prospective study in patients with newly diagnosed MG and their CGs. At three months post-diagnosis, we administered to patients and CGs the Prognosis and Treatment Perceptions Questionnaire, which assesses illness understanding, goals of treatment, and likelihood of cure. Results: At three months after diagnosis, 82.9% (68/82) of patients and 81.3% (52/64) of CGs reported that knowing prognosis is “extremely” or “very” important, yet only 42.6% (35/82) of patients and 60.9% (39/64) of CGs reported accurate PA, defined as responses of “unlikely,” “very unlikely,” or “no” chance of cure. 46.3% (38/82) of patients and 46.9% (30/64) of CGs reported that their oncologist’s primary goal was to “extend life as long as possible,” while 25.6% (21/82) of patients and 10.9% (7/64) of CGs stated that their oncologist’s goal was to cure their cancer. Patients’ primary goal was most frequently “to cure my cancer” [40.2% (33/82)], while CGs most often presumed that their loved ones’ treatment goal was to “extend life as long as possible” [43.8% (28/64)]. Conclusions: Patients with MG and their CGs report that PA is important, but most patients, and to a lesser degree their CGs, have inaccurate PA. Additionally, patients’ treatment goals differ from CGs’ perceptions of patients’ goals and oncologists’ presumed goals. Patients’ primary goal is often curative, while CGs frequently presume that their loved one’s goal is to prolong life without aiming for cure. Patients and CGs most often presume that their oncologists are primarily aiming to extend survival rather than cure their disease. Further investigation of interventions to improve conversations about prognosis among patients with MG, their CGs and their oncologists is warranted.

scholarly journals Web-Based Stress Management for Newly Diagnosed Patients With Cancer (STREAM): A Randomized, Wait-List Controlled Intervention Study

2018 ◽  
Vol 36 (8) ◽  
pp. 780-788 ◽  
Author(s):  
Corinne Urech ◽  
Astrid Grossert ◽  
Judith Alder ◽  
Sandra Scherer ◽  
Barbara Handschin ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Stress Management ◽  
Depression Scale ◽  
Anxiety And Depression ◽  
Newly Diagnosed ◽  
Hospital Anxiety ◽  
Web Based ◽  
Patients With Cancer ◽  
Chronic Illness Therapy

Purpose Being diagnosed with cancer causes major psychological distress; however, a majority of patients lack psychological support during this critical period. Internet interventions help patients overcome many barriers to seeking face-to-face support and may thus close this gap. We assessed feasibility and efficacy of Web-based stress management (STREAM [Stress-Aktiv-Mindern]) for newly diagnosed patients with cancer. Patients and Methods In a randomized controlled trial, patients with cancer who had started first-line treatment within the previous 12 weeks were randomly assigned to a therapist-guided Web-based intervention or a wait-list (control), stratified according to distress level (≥ 5 v < 5 on scale of 0 to 10). Primary efficacy end point was quality of life after the intervention (Functional Assessment of Chronic Illness Therapy–Fatigue). Secondary end points included distress (Distress Thermometer) and anxiety or depression (Hospital Anxiety and Depression Scale). Treatment effect was assessed with analyses of covariance, adjusted for baseline distress. Results A total of 222 of 229 screened patients applied online for participation. Between September 2014 and November 2016, 129 newly diagnosed patients with cancer, including 92 women treated for breast cancer, were randomly assigned to the intervention (n = 65) or control (n = 64) group. Adherence was good, with 80.0% of patients using ≥ six of eight modules. Psychologists spent 13.3 minutes per week (interquartile range, 9.5-17.9 minutes per week) per patient for online guidance. After the intervention, quality of life was significantly higher (Functional Assessment of Chronic Illness Therapy–Fatigue: mean, 8.59 points; 95% CI, 2.45 to 14.73 points; P = .007) and distress significantly lower (Distress Thermometer: mean, −0.85; 95% CI, −1.60 to −0.10; P = .03) in the intervention group as compared with the control. Changes in anxiety or depression were not significant in the intention-to-treat population (Hospital Anxiety and Depression Scale: mean, −1.28; 95% CI, −3.02 to 0.45; P = .15). Quality of life increased in the control group with the delayed intervention. Conclusion The Web-based stress management program STREAM is feasible and effective in improving quality of life.

Assessment of the impact of the Hospital Anxiety and Depression Scale on the initiation of treatment in newly diagnosed cancer patients in a safety-net hospital.

2017 ◽  
Vol 35 (31_suppl) ◽  
pp. 250-250
Author(s):  
Daulath Singh ◽  
Annapoorna Singh ◽  
Punita Grover ◽  
Mahathi Indaram ◽  
Nikki Malomo ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Poisson Regression ◽  
Treatment Initiation ◽  
Depression Scale ◽  
Anxiety And Depression ◽  
P Value ◽  
Newly Diagnosed ◽  
Hospital Anxiety ◽  
Poisson Regression Analysis ◽  
The Impact

250 Background: Distress is a universal symptom in oncologic patients which negatively impact the quality of life and survival. It interferes with the ability to cope with the diagnosis and is a risk factor for non-adherence with treatment. The Hospital Anxiety and Depression Scale (HADS), is used at our institution for distress screening. The aim of our study is to assess the impact of distress, measured by the HADS score, on initiation of treatment in newly diagnosed cancer patients. Methods: We conducted a retrospective chart review of patients with a new diagnosis of cancer, between March 1st, 2014 and December 31st, 2015; who had been evaluated for distress at their first oncology clinic visit. We included only patients who were treated with chemotherapy or chemoradiation, with curative intent. Poisson regression analysis was conducted to investigate the relationship between HADS to treatment initiation while including age, sex, race, insurance status, cancer type, and stage as covariates in the model. Results: A total of 101 patients met the inclusion criteria. The mean age was 54 years, 63% were female and 37% were male. The majority were Caucasians (53%), followed by African-Americans (36%). 56% of the population had Medicaid, and 26% had Medicare and private insurance. The most common cancers were – breast (30%), gastrointestinal (20%), gynecologic (15%) and lung (11%). 64% received chemotherapy and 36% were treated with chemoradiation. We grouped patients into 3 categories based on the HADS score – category 1 with score ≤7 (28%), category 2 with score 8-10 (17%) and category 3 with score ≥11 (55%). The median time to treatment initiation was 28 days. Multivariate Poisson regression analysis did not show any correlation between the HADS score and treatment initiation. Subscales analyses showed that higher depression scores correlate with a delay in treatment initiation (p-value 0.01), while the anxiety scores had no influence (p-value 0.57). Conclusions: In our study, the initial total HADS score did not affect the treatment initiation. Interestingly, depression had an influence on the initiation of treatment in newly diagnosed cancer patients.

Stehen kognitive Funktionen im Zusammenhang mit Angst, Depression und Posttraumatischer Belastungsstörung bei Brustkrebspatientinnen nach onkologischer Behandlung?

2009 ◽  
Vol 57 (1) ◽  
pp. 33-42 ◽  
Author(s):  
Lena Schirmer ◽  
Anja Mehnert ◽  
Angela Scherwath ◽  
Barbara Schleimer ◽  
Frank Schulz-Kindermann ◽  
...  
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Depression Scale ◽  
Anxiety And Depression ◽  
Hospital Anxiety ◽  
Kognitive Funktionen

Die in mehreren Studien gefundenen kognitiven Störungen bei Tumorpatienten nach Chemotherapie werden zumeist mit der Zytostatikaneurotoxizität assoziiert. In der vorliegenden Arbeit wird der Zusammenhang von Angst, Depression und Posttraumatischer Belastungsstörung mit der kognitiven Leistungsfähigkeit bei Frauen mit Mammakarzinom untersucht. Insgesamt wurden 76 Brustkrebspatientinnen fünf Jahre nach Abschluss der onkologischen Behandlung mit neuropsychologischen Testverfahren sowie mit der Hospital Anxiety and Depression Scale – Deutsche Version (HADS-D) und der Posttraumatic Stress Disorder Checklist – Civilian Version (PCL-C) untersucht: 23 nach Standard- und 24 nach Hochdosistherapie sowie 29 nach Brustoperation und Strahlentherapie als Vergleichsgruppe. Signifikante Zusammenhänge sind vor allem zwischen kognitiven Funktionen und Intrusionssymptomen einer Posttraumatischen Belastungsstörung (PTBS) festzustellen. Bei Patientinnen nach Standardtherapie weisen Intrusionen der PTBS einen moderaten Zusammenhang mit der globalen kognitiven Beeinträchtigung auf. Die Ergebnisse der Studie deuten auf multidimensionale Einfluss- und moderierende Faktoren bei der Entwicklung kognitiver Defizite bei Brustkrebspatientinnen nach onkologischer Therapie hin.

Hypochondrie in der Allgemeinbevölkerung:

Diagnostica ◽  
2003 ◽  
Vol 49 (1) ◽  
pp. 34-42 ◽  
Author(s):  
Andreas Hinz ◽  
Winfried Rief ◽  
Elmar Brähler
Keyword(s):  
Nottingham Health Profile ◽  
Depression Scale ◽  
Somatoforme Störungen ◽  
Anxiety And Depression ◽  
Multidimensional Fatigue Inventory ◽  
Health Profile ◽  
Hospital Anxiety ◽  
Gießener Beschwerdebogen

Zusammenfassung. Der Whiteley-Index ist ein Instrument zur Erfassung von Hypochondrie. Für diesen Fragebogen wurde eine Normierungs- und Validierungsstudie anhand einer bevölkerungsrepräsentativen Stichprobe (n = 1996) durchgeführt. Hypochondrie zeigt eine etwa lineare Altersabhängigkeit (r = .24). Frauen haben in allen Altersstufen höhere Hypochondrie-Ausprägungen als Männer. Für verschiedene Alters- und Geschlechtsgruppen werden Normwerte bereit gestellt. Die in der Literatur beschriebene dreidimensionale Struktur des Whiteley-Index (Krankheitsängste, somatische Beschwerden und Krankheitsüberzeugung) konnte mit gewissen Einschränkungen bestätigt werden. Validierungsuntersuchungen mit anderen Instrumenten (Hospital Anxiety and Depression Scale, Multidimensional Fatigue Inventory, Gießener Beschwerdebogen, Screening für Somatoforme Störungen und Nottingham Health Profile) zeigten, dass eine auf sieben Items reduzierte Kurzskala der Gesamtskala mit 14 Items ebenbürtig ist. Für differenzierte Analysen wird jedoch die Originalskala empfohlen. Durch die angegebenen Normwerte ist es künftig besser möglich, Patientengruppen verschiedener Alters- und Geschlechtsverteilungen untereinander oder auch mit Stichproben der Normalbevölkerung zu vergleichen.

Hospital Anxiety and Depression Scale

1983 ◽  
Author(s):  
A. S. Zigmond ◽  
R. P. Snaith
Keyword(s):  
Depression Scale ◽  
Anxiety And Depression ◽  
Hospital Anxiety
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