scholarly journals Validation of the PHQ-9 depression scale in Ethiopian cancer patients attending the oncology clinic at Tikur Anbessa specialized hospital

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Mikyas Degefa ◽  
Benyam Dubale ◽  
Fikirte Bayouh ◽  
Biniyam Ayele ◽  
Yared Zewde

Abstract Background Although depression is highly prevalent among cancer patients, it is often underdiagnosed and poorly managed particularly in developing nations. These shortcomings can have substantial adverse effects not only on the disease prognosis but also on patients’ quality of life. The Patient Health Questionnaire-9 is a widely used depression screening tool but it has not been validated among patients with chronic illnesses such as cancer in Ethiopia. We aim to validate the PHQ-9 among Ethiopian cancer patients in an outpatient setting. Methods A cross-sectional study was conducted among cancer patients attending the oncology clinic at Tikur Anbessa Specialized Hospital (TASH). We assessed criterion validity and performance of the PHQ-9 test against the gold standard Mini-International Neuropsychiatric Interview (MINI) diagnostic tool among patients with cancer. The MINI was administered by psychiatric nurses who were blind to the initial PHQ-9 screening tool. Results A total of 163 patients completed the 2 stages of a diagnostic interview in the study. The majority (64%) of the participants were women, the mean age was 46 (13.5) years. Using the gold standard MINI test the prevalence of Major Depressive Episode (MDE) was 15%. The internal consistency (Cronbach’s α) for PHQ-9 was 0.78 suggesting good (acceptable) internal consistency for the reliability of the test scores. When the total PHQ-9 score was used to identify cases of MDE, the Area under the Curve (AUC) was 0.93 (95% confidence interval [CI], 0.88–0.97) on Receiver Operating Characteristic (ROC) analysis. This shows evidence for the excellent discriminating power of the PHQ-9 between cases and non-cases of MDE. At cutoff point ≥4, the PHQ-9 had a sensitivity of 88% and specificity of 78.1% on the ROC curve to detect MDE. Conclusion PHQ-9 is a reliable and valid instrument to detect MDE among individuals with chronic conditions such as cancer patients in outpatient settings and it can be used in resource-limited settings for early diagnosis and proper therapy of such patients.

2021 ◽  
Author(s):  
Eyerusalem Worku ◽  
Hayat Aragaw ◽  
Damitie Kebede

Abstract Background Cancer is one of the leading causes of death in the world and it is considered that every fourth person dies of it. Under-nutrition is most commonly seen in cancer patients with some types of solid tumors, various chronic diseases, as well as in older persons and young children. This can result in longer hospital stay, reduced response to therapies, increased complications to therapy and surgery proceedings, poor survival and higher care costs. This study aimed to assess the prevalence and factors associated with under-nutrition on cancer patients attending Tikur Anbessa Specialized Hospital, Ethiopia.Methods Cross-sectional study was conducted from September to October 2018 among 347 cancer patients in Tikur Anbessa Specialized hospital Addis Ababa, Ethiopia. All cancer patients 18–65 years of age who were on the 2nd cycle and above treatment phase were included. Quantitative data was collected using questionnaires and the Patient Generated-Subjective Global Assessment (PG-SGA) score. Data was entered into Epi-Info version 7 and exported and analyzed by SPSS version 20. Both bivariate and multivariate logistic regression analyses were employed to identify the associated factors. Variables with 𝑃 value of less than 0.05 were considered as significant predictors.Results The prevalence of under-nutrition according to PG-SGA score result 202 (63.1%) and 88(27.5%) of the participants were moderately and severely undernourished, respectively. BMI of the participants also showed that 206 (64.4%) and 89 (27.8%) were normal and underweight, respectively. Two hundred seventy-six (86.3%) of the patients needed critical nutrition intervention. Performance status of ≥ 2 [AOR = 7.9, 95% CI (3.05, 20.48)] and cancer stage II, III & IV [AOR = 3.47, 95% CI (1.25, 9.58)], [AOR = 3.81, 95% CI (1.17, 12.31)] and [AOR = 6.11, 95% CI (1.48, 25.14)] were significantly associated with malnutrition on cancer patients at a P-value < 0.05.Conclusion The prevalence of under-nutrition is prevalent in the study area. Performance status of ≥ 2 and cancer stages were important factors associated with malnutrition in cancer patients. Screening and evaluation of nutritional status of the patients and planning nutritional therapy such as dietary supplements or enteral nutrition to counteract malnutrition on cancer patients should be implemented.


BMC Cancer ◽  
2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Junren Kang ◽  
Hailong Li ◽  
Xiaodong Shi ◽  
Enling Ma ◽  
Wei Chen

Abstract Background Malnutrition is common in cancer patients. The NUTRISCORE is a newly developed cancer-specific nutritional screening tool and was validated by comparison with the Patient-Generated Subjective Global Assessment (PG-SGA) and Malnutrition Screening Tool (MST) in Spain. We aimed to evaluate the performance of the NUTRISCORE, MST, and PG-SGA in estimating the risk of malnutrition in Chinese cancer patients. Methods Data from an open parallel and multicenter cross-sectional study in 29 clinical teaching hospitals in 14 Chinese cities were used. Cancer patients were assessed for malnutrition using the PG-SGA, NUTRISCORE, and MST. The sensitivity, specificity, and areas under the receiver operating characteristic curve were estimated for the NUTRISCORE and MST using the PG-SGA as a reference. Results A total of 1000 cancer patients were included. The mean age was 55.9 (19 to 92 years), and 47.5% were male. Of these patients, 450 (45.0%) had PG-SGA B and C, 29 (2.9%) had a NUTRISCORE ≥5, and 367 (36.7%) had an MST ≥ 2. Using the PG-SGA as a reference, the sensitivity, specificity, and area under the curve values of the NUTRISCORE were found to be 6.2, 99.8%, and 0.53, respectively. The sensitivity, specificity, and area under the curve values of the MST were 50.9, 74.9%, and 0.63, respectively. The kappa index between the NUTRISCORE and PG-SGA was 0.066, and that between the MST and PG-SGA was 0.262 (P < 0.05). Conclusions The NUTRISCORE had an extremely low sensitivity in cancer patients in China compared with the MST when the PG-SGA was used as a reference.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mulugeta Wassie ◽  
Beletech Fentie ◽  
Tseganesh Asefa

Abstract Background The discrepancy in cervical cancer incidence between women with HIV and women without HIV is highest in low and middle-income countries. In Africa, cervical cancer is the most common cause of cancer death. As a result, HIV-infected women are 6 times more likely to develop cervical cancer than uninfected women. In addition, HIV is associated with several triggering factors for cervical cancer, including multiple sexual partners, early sexual debut, economic status and substance use. Objective To assess the prevalence and associated factors of HIV among cervical cancer patients at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. Methods A cross sectional study was conducted among 1057 cervical cancer patients registered from January 1, 2014 to December 31, 2018 at Oncology Center of Tikur Anbessa Specialized Hospital. A structured English version checklist was used to collect the data from patient charts. The pre coded data were entered in to EPI-data version 3.1 then exported to STATA version 14.0 for analysis. Both bivariable and multivariable regression analysis were carried out. Variables with p value < 0.05 in multivariable logistic regression were consider as significant predictors of the outcome variable. Result The prevalence of HIV among cervical cancer patients was 18.35%. HIV among cervical cancer patients was significantly associated with age group 30–39 [AOR = 2.83; 95%CI (1.27, 6.22)] and 40–49 [AOR = 2.39; 95%CI (1.07, 5.32)], employed [AOR = 2.23; 95%CI (1.46, 3.41)] and substance users [AOR = 3.92; 95%CI (2.04, 6.28)]. Conclusion This study revealed that about 18% of cervical cancer patients were HIV seropositive. HIV seropositivity was significantly increased with 30–49 age group, employed and substance users. Authors recommended that it is better to screen all HIV seropositive patients for cervical cancer and give greater attention for women with cervical cancer in the age groups of 30–49 years, employed and substance users.


BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Edgeit Abebe ◽  
Tesfaye Tollesa ◽  
Mathewos Assefa ◽  
Zelalem Tilahun ◽  
Yohannes Dinku ◽  
...  

Abstract Background Breast cancer is the second leading cause of cancer in the world. It is the commonest type of cancer in Ethiopia. Cognitive problems are common among breast cancer patients. The study aimed to assess cognitive functioning and its associated factors among breast cancer patients at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia 2020. Methods Institution-based comparative cross-sectional study was conducted. Study subjects were 117 breast cancer patients on chemotherapy and 117 women without breast cancer who volunteered for the study. Data was collected from May–June 2020. The Mini-mental status exam (MMSE) was used to assess cognitive functioning. Data were entered into Epi Data version 4.6.0.2 and analyzed using STATA version 14 software. Univariable and multivariable linear regression model was fitted to identify factors associated with cognitive functioning. A two-tailed p-value less than 0.05 was used to declare statistical significance. Results Among the total breast cancer patients 41.9% were diagnosed with earlier sage of the diseases (stage I and II), while the rest 58.1% were diagnosed with stage III and stage IV breast cancer. A significant difference in the MMSE score was observed among breast cancer patients and controls (19.76 ± 5.29, 25.18 ± 4.68 p <  0.0001) respectively. In multivariable linear regression analysis being non-breast cancer (Adjusted beta coefficient (Adj.β.coff). = 3.34, 95% CI (1.92–4.76) p <  0.001), hemoglobin gm/dl (Adj.β.coff =0.34, 95% CI (0.04–0.63) p = 0.02), and primary education (Adj.β.coff =2.98 95%CI (1.16–4.96) p = 0.001) secondary level and more education (Adj.β.coff = 5.47, 95%CI (3.51–7.28) p < 0.001) were significantly associated with MMSE cognitive score. Conclusion Breast cancer patients had lower mean MMSE scores when compared to non-breast cancer women. Higher hemoglobin level and higher level of education increase the MMSE cognitive score. Clinicians should incorporate routine screening of cognitive functioning for breast cancer patients and further study is required to evaluate cognitive impairment among breast cancer patients in Ethiopia.


2021 ◽  
Author(s):  
Eyerusalem Worku ◽  
Hayat Aragaw ◽  
Damitie Kebede

Abstract Background Cancer is one of the leading causes of death in the world and it is considered that every fourth person dies of it. Under-nutrition is most commonly seen in cancer patients with some types of solid tumors, various chronic diseases, as well as in older persons and young children. This can result in longer hospital stay, reduced response to therapies, increased complications to therapy and surgery proceedings, poor survival and higher care costs. This study aimed to assess the prevalence and factors associated with under-nutrition on cancer patients attending Tikur Anbessa Specialized Hospital, Ethiopia. Methods Cross-sectional study was conducted from September to October 2018 among 347 cancer patients in Tikur Anbessa Specialized hospital Addis Ababa, Ethiopia. All cancer patients 18–65 years of age who were on the 2nd cycle and above treatment phase were included. Quantitative data was collected using questionnaires and the Patient Generated-Subjective Global Assessment (PG-SGA) score. Data was entered into Epi-Info version 7 and exported and analyzed by SPSS version 20. Both bivariate and multivariate logistic regression analyses were employed to identify the associated factors. Variables with 𝑃 value of less than 0.05 were considered as significant predictors. Results The prevalence of under-nutrition according to PG-SGA score result 202 (63.1%) and 88(27.5%) of the participants were moderately and severely undernourished, respectively. BMI of the participants also showed that 206 (64.4%) and 89 (27.8%) were normal and underweight, respectively. Two hundred seventy-six (86.3%) of the patients needed critical nutrition intervention. Performance status of ≥ 2 [AOR = 7.9, 95% CI (3.05, 20.48)] and cancer stage II, III & IV [AOR = 3.47, 95% CI (1.25, 9.58)], [AOR = 3.81, 95% CI (1.17, 12.31)] and [AOR = 6.11, 95% CI (1.48, 25.14)] were significantly associated with malnutrition on cancer patients at a P-value < 0.05. Conclusion The prevalence of under-nutrition is prevalent in the study area. Performance status of ≥ 2 and cancer stages were important factors associated with malnutrition in cancer patients. Screening and evaluation of nutritional status of the patients and planning nutritional therapy such as dietary supplements or enteral nutrition to counteract malnutrition on cancer patients should be implemented.


2021 ◽  
Author(s):  
Edgeit Abebe ◽  
Tesfaye Tollesa ◽  
Mathewos Assefa ◽  
Zelalem Tilahun ◽  
Yohannes Dinku ◽  
...  

Abstract Background: Breast cancer is the second leading cause of cancer in the world. It is the commonest type of cancer in Ethiopia. Cognitive problems are common among breast cancer patients especially if they are treated with chemotherapy. The study aimed to assess cognitive functioning and its associated factors among breast cancer patients at Tikur Anbessa Specialized Hospital, Ethiopia 2020.Methods: Institution-based comparative cross-sectional study was conducted. Study subjects were 117 breast cancer patients on chemotherapy and 117 women without breast cancer who volunteered for the study. Data was collected from May - June 2020. The Mini-mental status exam was used to assess cognitive functioning. Data was entered into Epi Data version 4.6.0.2 and analyzed using STATA software version 14. Univariable and multivariable linear regression model was fitted to identify factors associated with cognitive functioning. A two-tailed p-value lower than 0.05 was used to declare statistical significance.Results: Significant difference in the MMSE score was observed among breast cancer patients and controls (19.76 ±5.29, 25.18±4.68 p< 0.0001) respectively. In multivariable linear regression analysis being non-breast cancer (controls) (std.β 3.34, 95% CI [1.92 4.76] p<0.001), hemoglobin gm/dl (std. β 0.34, 95 % CI [0.04 0.63] p=0.02), and primary education (Adj. β 2.98 95 %CI [1.16 4.96] p=0.001) secondary level and more education (std. β 5.47, 95 %CI [3.51 7.28] p<0.001) were significantly associated with MMSE cognitive score. Conclusion: Breast cancer patients had lower mean MMSE scores when compared to non-breast cancer controls. Hemoglobin level, breast cancer status, and educational level are significant predictors of the MMSE cognitive score. Clinicians should incorporate routine screening of cognitive functioning for breast cancer patients and further study is required to evaluate cognitive impairment among breast cancer patients in Ethiopia.


2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Anish Khalil ◽  
Muhammad Faheem ◽  
Ammad Fahim ◽  
Haran Innocent ◽  
Zainab Mansoor ◽  
...  

Background. The biomedical care for cancer has not been complemented by psychosocial progressions in cancer care.Objectives. To find the prevalence of anxiety and depression amongst cancer patients in a hospital setting.Design and Setting. This cross-sectional study was conducted at the tertiary care hospitals Shifa International Hospital Islamabad and Nuclear Medicine, Oncology, and Radiotherapy Institute [NORI].Patients and Methods. 300 patients were interviewed from both the outpatient and inpatient department using The Aga Khan University Anxiety and Depression Scale (AKUADS).Main Outcome Measures. Using a score of 20 and above on the AKUADS, 146 (48.7%) patients were suffering from anxiety and depression.Results. When cross tabulation was done between different factors and the cancer patients with anxiety and depression, the following factors were found out to be significant with associatedpvalue < 0.05: education of the patient, presence of cancer in the family, the severity of pain, and the patient’s awareness of his anxiety and depression. Out of 143 (47.7%) uneducated patients, 85 (59.4%) were depressed, hence making it the highest educational category suffering from depression and anxiety.Conclusion. The prevalence of anxiety and depression amongst cancer patients was high showing that importance should be given to screening and counseling cancer patients for anxiety and depression, to help them cope with cancer as a disease and its impact on their mental wellbeing.Limitations. The frequency of female patients in our research was higher than those of male patients.


2016 ◽  
Vol 56 (3) ◽  
pp. 149
Author(s):  
Ferriandis Harsono ◽  
Purboyo Solek ◽  
Kusnandi Rusmil

Background Developmental and behavioral problems are among the most common conditions of childhood. These problems affect 12−16% of children in the United States and 13−18% of children in Indonesia. Early detection of developmental deficits among children requires clinicians to screen with accurate tools. Cognitive function screening in children has been increasingly used in many clinical and educational settings. The School-Years Screening Test for Evaluation of Mental Status-Revised (SYSTEMS-R) is becoming a widely-used, reliable, and valid cognitive screening tool for children aged 4−15 years. Prior to our study, there was no Indonesian language version of the SYSTEMS-R.Objective To determine the reliability of the Indonesian translation of the SYSTEMS-R.Methods A cross-sectional study was conducted in children aged 4−15 years who understood the Indonesian language and did not have neurologic or communication impairments. Data were analysed to determine reliability (internal consistency and inter-rater reliability) of the Indonesian version of SYSTEMS-R. Internal consistency was determined using Cronbach’s alpha formula. Internal consistency is a reflection of inter-item correlation and item-to-total correlation. Inter-rater reliability was determined using the Bland-Altman method.Results This study was conducted on 133 children aged 4−15 years in a kindergarten, elementary, junior high, and senior high school in Bandung. The Indonesian version of SYSTEMS-R had significant internal consistency (Cron bach’s alpha 0.936−0.941), and the scores obtained by two raters had good agreement (difference within mean + 1.96 SD).Conclusion The Indonesian version of SYSTEMS-R is reliable for use as a cognitive screening tool for Indonesian children. [Paediatr Indones. 2016;56:149-54.].


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