Write to recover: The impact of group led creative writing on behavioral health outcomes in cancer patients.

11536 Background: The diagnosis of cancer can adversely affect mental wellbeing. In addition to treating cancer, the emotional wellbeing of patients must simultaneously be addressed. A previous pilot exploring the feasibility of creative writing workshop (CWW) in cancer patients showed apositive effect on patients’ mental health. Methods: To longitudinally evaluate the efficacy of CWW on mood, we conducted a phase II study with cancer patients (any stage, any cancer type); randomized 2:1 to CWW vs. active control (AC). Patients in the CWW arm attended at least 4, 1.5-hour bi-monthly CWW x 8 wks, whereas AC patients completed independent writing at home with the help of a book (bi-monthly x 8wks). We used validated tools, [Emotional Thermometer Scales (ETS), PHQ-9, GAD-7] to assess changes in overall mood, depression, and anxiety. Primary end point: a) ETS scores before and after intervention b) Changes in depression and anxiety based on PHQ-9 and GAD-7 scores. We present results from ETS scores. Descriptive statistics were generated for these quantitative scales measured in each group, pre and post intervention. Comparisons between groups (gp) were made using Wilcoxon Rank-sum tests. All tests were two sided and the statistical significance level used was 0.05. Results: Amongst evaluable patients, N of 50 (demographics in table below), twenty-six patients in the CWW gp attended at least one class and 19 attended at least 4 classes. Patients in CWW showed significant mood improvement vs. AC when comparing the final overall ETS (p=0.0063). Three of the five sub-scale ETS scores were significantly lower for the CWW vs. AC gp: anxiety (p=0.0027), depression (p=0.0009), and anger (p=0.0027). Conclusions: Group led CWW have a positive effect on mood. Our results suggest potential therapeutic benefit of this intervention on the emotional wellbeing of cancer patients. Larger studies are needed to evaluate the effect of CWW in cancer patients. Clinical trial information: NCT03536702. [Table: see text]

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Comparative study of prevalence and costs of depression and anxiety among elderly cancer patients.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.6595 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. 6595-6595

Author(s):

Stacey DaCosta Byfield ◽

Kae Tanudtanud ◽

John Rich Barrientos ◽

Kiesha Mae Lasquite ◽

Kierstin Catlett

Keyword(s):

Cancer Patients ◽

Healthcare Spending ◽

Healthcare Services ◽

Medical Professional ◽

Cancer Type ◽

Depression And Anxiety ◽

Cancer Breast ◽

Pharmacy Claims ◽

Cost Categories ◽

The Impact

6595 Background: Depression and anxiety are common among cancer patients and can worsen outcomes. We studied the occurrence of depression and anxiety in three common cancers to investigate whether healthcare costs were greater for cancer patients with two mental health disorders (MHD), depression and anxiety, compared to patients without MHD. Methods: This retrospective analysis used deidentified medical and pharmacy claims from a large national U.S. health insurer. Patients were Medicare Advantage enrollees ≥65 years diagnosed with breast, colorectal, or prostate cancer and continuously enrolled from 1/2018–12/2019. We determined statistically whether the annual prevalence of the two MHDs varied by cancer types. Total costs and costs exclusive of MHD-related expenses in five sub-categories were compared: inpatient, emergency room, non-inpatient medical, professional, and pharmacy. Costs from 2019 claims were presented as per-patient per-month (PPPM). Direct depression- and anxiety-related costs were from claims with depression/anxiety diagnoses or drugs. The impact of MHDs on 2019 healthcare spending was examined using multiple linear regression, controlling for demographic and clinical characteristics. LASSO was used for variable selection. Mann-Whitney U tests compared differences in costs by service types between patients with and without MHDs. Results: Of 19,304 study patients, 8,916 (46%) had coexisting depression or anxiety: (i) 4% depression only; (ii) 27% anxiety only; (iii) 7% depression and anxiety; and (iv) 8% were on antidepressant without MHDs diagnoses. There were significant differences in the rates of MHDs between the three cancer groups, with the highest frequency in breast cancer ( breast vs colorectal. 56% vs 49%, p < 0.0005 ; breast vs prostate. 56% vs 38%, p < 0.0005; colorectal vs prostate. 49% vs 38%, p < 0.0005). After excluding the MHDs-related costs (PPPM mean = $44), the monthly spending was 54% higher for patients with MHDs ($2,184 MHDs vs. $1,406 non-MHDs). After adjusting for covariates, the PPPM costs were 23%–58% higher for the MHD-cohort vs. the non-MHD cohort for each cancer type ( non-MHD vs. with depression only, CI 13%–34%, p < 0.0001; non-MHD vs. with anxiety only, CI 40%-52%, p < 0.0001; non-MHD vs. with depression and anxiety, CI 48%-70%, p < 0.0001; non-MHD vs. with antidepressant only, CI 28%-45%, p < 0.0001). Higher costs in MHD-cohort were observed in all cost categories (p < 0.0001). Conclusions: We found high prevalence of MHDs in patients diagnosed with cancer. Analyses showed that total spending was significantly higher in individuals with cancer and MHD for all cost categories. Explanations for higher costs are unclear, as costs remain high even after adjusting for MHD-related care costs. Research on specific healthcare services driving higher costs and the risk factors for depression and anxiety is needed to address broader MHDs to improve cancer care.

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Effect of creative writing on mood in cancer patients.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.31_suppl.178 ◽

2017 ◽

Vol 35 (31_suppl) ◽

pp. 178-178

Author(s):

Muhammad Azam Hussain ◽

Junjia Zhu ◽

Joseph Drabick ◽

Aditya Joshi ◽

Erika Saunders ◽

...

Keyword(s):

Mental Health ◽

Creative Writing ◽

Cancer Patients ◽

Statistical Significance ◽

Standard Of Care ◽

Continuous Variables ◽

Psychological Benefits ◽

Post Intervention ◽

Five Dimensions ◽

Wide Range

178 Background: Patients with cancer may have significant mental health comorbidity. Creative writing has a substantial history in providing a wide range of psychological benefits for cancer patients. Methods: We conducted a pilot study to determine feasibility whether cancer patients can be enrolled, randomized and retained for four weeks for creative writing classes (Feasibility was defined as 50% of our enrolled patients on intervention arm (IA) could attend at least 2 classes). We anticipated enrolling 45 patients over the period of 2 months with randomization into 2 arms: IA and standard of care (SOC). “Write from the Heart”, a series of creative writing workshops (CWW) were conducted on IA. Subjects in IA had four, 2-hour weekly CWW whereas SOC arm did not receive any sessions. We used validated Emotional Thermometer Scales (ETS), ranging from 0 (best)-10 (worst), to predict changes in parameters reflecting patient’s mental health pre and post intervention. ETS has five dimensions (distress, anxiety, depression, anger and need help), which are all continuous variables. Results: Total of 16 patients were accrued -11 in IA and 5 in SOC. 7 out of 11 (63%) patients enrolled in IA attended at least 75% of classes. Comparisons were made using two-sample T-tests. Although sample size was small, analysis showed intriguing results. IA did show a decreasing pattern on Total Emotion Score (TES). For each visit, post-class scores were lower than pre-class scores. SOC versus IA and IA intragroup analysis (Paired T-test) did not reveal any statistical significance. Conclusions: We observed that it is feasible for cancer patients to attend focused workshops geared towards mental health wellbeing. Although not statistically significant, IA showed trend towards mood improvement. A second study is planned with a single arm for all cancer patients. In addition to using emotional thermometers, we will include questionnaires to evaluate mental health symptoms effectively. Further prospective clinical studies should be conducted to evaluate effect of this intervention in cancer patients. Clinical trial information: Study 00006541. [Table: see text]

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The Impact of Religious Practices on Depression and Anxiety Among Moroccan Cancer Patients

10.21203/rs.3.rs-669324/v1 ◽

2021 ◽

Author(s):

Elkhalloufi Fahd ◽

Saber boutayeb ◽

Youssef Lamrani Alaoui ◽

Mounia Eljaouhari ◽

Hassan Errihani ◽

...

Keyword(s):

Cancer Patients ◽

Statistical Significance ◽

Religious Practices ◽

Current Evidence ◽

Depression And Anxiety ◽

Chi Square ◽

Chi Square Test ◽

The Impact ◽

Predictors Of Depression

Abstract Background: Many researchers have associated between religiosity with a lower level in depression and anxiety among patients with chronic diseases and especially in cancer patients.The aim of this study is to examine the association between spirituality and depression among Moroccan cancer patients. Another aim resides in to examining the association between spirituality and anxiety among Moroccan cancer patients.Methods: 1054 cases were included. Cancer profile, socio demographic and spiritual characteristics were considered. The data were firstly analyzed using the validated HADS scale arabic version. The statistical significance was tested using Chi-square test. The Odds ratios were also computed for the likelihood of being in depression and/or anxiety.Results: The results obtained revealed that the performance of religious practices such as reading Quran, doing Roquia , and the consideration of cancer as a divine test are factors that significantly decrease the risk of having depression and/or anxiety. However women wearing the “hijab” have three times higher chances of having anxiety compared to other women that do not wear the “hijab”. Patients considering cancer as a divine punishment have significantly higher odds of having anxiety and/or depression. Regarding charity, pilgrimage, visit of “marabouts”, use of medicinal plants and fasting are found to be insignificant predictors of depression and anxiety.Conclusions: The current evidence indicates that religiosity is important to patients facing cancer. Religiosity is not just protective in nature, but it can also be therapeutic. Praying, reading or listening to the Quran, as well as considering cancer as a divine test have been shown to reduce the level of depression and anxiety . In conclusion, the spiritual aspect plays an important role in the quality of life of cancer patients.

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PITX2 DNA-Methylation: Predictive versus Prognostic Value for Anthracycline-Based Chemotherapy in Triple-Negative Breast Cancer Patients

Breast Care ◽

10.1159/000510468 ◽

2020 ◽

pp. 1-9

Author(s):

Rudolf Napieralski ◽

Gabriele Schricker ◽

Gert Auer ◽

Michaela Aubele ◽

Jonathan Perkins ◽

...

Keyword(s):

Breast Cancer ◽

Dna Methylation ◽

Cancer Patients ◽

Triple Negative Breast Cancer ◽

Predictive Value ◽

Untreated Patient ◽

Triple Negative ◽

Statistical Significance ◽

Breast Cancer Patients ◽

The Impact

Background: PITX2 DNA methylation has been shown to predict outcomes in high-risk breast cancer patients after anthracycline-based chemotherapy. To determine its prognostic versus predictive value, the impact of PITX2 DNA methylation on outcomes was studied in an untreated cohort vs. an anthracycline-treated triple-negative breast cancer (TNBC) cohort. Material and Methods: The percent DNA methylation ratio (PMR) of paired-like homeodomain transcription factor 2 (PITX2) was determined by a validated methylation-specific real-time PCR test. Patient samples of routinely collected archived formalin-fixed paraffin-embedded (FFPE) tissue and clinical data from 144 TNBC patients of 2 independent cohorts (i.e., 66 untreated patients and 78 patients treated with anthracycline-based chemotherapy) were analyzed. Results: The risk of 5- and 10-year overall survival (OS) increased continuously with rising PITX2 DNA methylation in the anthracycline-treated population, but it increased only slightly during 10-year follow-up time in the untreated patient population. PITX2 DNA methylation with a PMR cutoff of 2 did not show significance for poor vs. good outcomes (OS) in the untreated patient cohort (HR = 1.55; p = 0.259). In contrast, the PITX2 PMR cutoff of 2 identified patients with poor (PMR >2) vs. good (PMR ≤2) outcomes (OS) with statistical significance in the anthracycline-treated cohort (HR = 3.96; p = 0.011). The results in the subgroup of patients who did receive anthracyclines only (no taxanes) confirmed this finding (HR = 5.71; p = 0.014). Conclusion: In this hypothesis-generating study PITX2 DNA methylation demonstrated predominantly predictive value in anthracycline treatment in TNBC patients. The risk of poor outcome (OS) correlates with increasing PITX2 DNA methylation.

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Prevalence of Depression and Anxiety amongst Cancer Patients in a Hospital Setting: A Cross-Sectional Study

Psychiatry Journal ◽

10.1155/2016/3964806 ◽

2016 ◽

Vol 2016 ◽

pp. 1-6 ◽

Cited By ~ 5

Author(s):

Anish Khalil ◽

Muhammad Faheem ◽

Ammad Fahim ◽

Haran Innocent ◽

Zainab Mansoor ◽

...

Keyword(s):

Cancer Patients ◽

Tertiary Care ◽

Hospital Setting ◽

Depression Scale ◽

Cross Sectional Study ◽

Mental Wellbeing ◽

Anxiety And Depression ◽

Depression And Anxiety ◽

Sectional Study ◽

Cross Sectional

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.

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Impact of cancer on the risk of unplanned 30-day readmissions.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.6581 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. 6581-6581

Author(s):

Alexander Qian ◽

Edmund Qiao ◽

Vinit Nalawade ◽

Nikhil V. Kotha ◽

Rohith S. Voora ◽

...

Keyword(s):

Cancer Patients ◽

Cancer Diagnosis ◽

Hospital Admissions ◽

Reference Group ◽

Cancer Site ◽

Cancer Type ◽

Logistic Regression Models ◽

Increased Risk ◽

Initial Hospitalization ◽

The Impact

6581 Background: Hospital readmission are associated with unfavorable patient outcomes and increased costs to the healthcare system. Devising interventions to reduce risks of readmission requires understanding patients at highest risk. Cancer patients represent a unique population with distinct risk factors. The purpose of this study was to define the impact of a cancer diagnosis on the risks of unplanned 30-day readmissions. Methods: We identified non-procedural hospital admissions between January through November 2017 from the National Readmission Database (NRD). We included patients with and without a cancer diagnosis who were admitted for non-procedural causes. We evaluated the impact of cancer on the risk of 30-day unplanned readmissions using multivariable mixed-effects logistic regression models. Results: Out of 18,996,625 weighted admissions, 1,685,099 (8.9%) had record of a cancer diagnosis. A cancer diagnosis was associated with an increased risk of readmission compared to non-cancer patients (23.5% vs. 13.6%, p < 0.001). However, among readmissions, cancer patients were less likely to have a preventable readmission (6.5% vs. 12.1%, p < 0.001). When considering the 10 most common causes of initial hospitalization, cancer was associated with an increased risk of readmission for each of these 10 causes (OR range 1.1-2.7, all p < 0.05) compared to non-cancer patients admitted for the same causes. Compared to patients aged 45-64, a younger age was associated with increased risk for cancer patients (OR 1.29, 95%CI [1.24-1.34]) but decreased risk for non-cancer patients (OR 0.65, 95%CI [0.64-0.66]). Among cancer patients, cancer site was the most robust individual predictor for readmission with liver (OR 1.47, 95%CI [1.39-1.55]), pancreas (OR 1.36, 95%CI [1.29-1.44]), and non-Hodgkin’s lymphoma (OR 1.35, 95%CI [1.29-1.42]) having the highest risk compared to the reference group of prostate cancer patients. Conclusions: Cancer patients have a higher risk of 30-day readmission, with increased risks among younger cancer patients, and with individual risks varying by cancer type. Future risk stratification approaches should consider cancer patients as an independent group with unique risks of readmission.

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The Impact of The Covid-19 Pandemic on Investor Risk Tendency: The Case of Turkey

10.53350/pjmhs211593046 ◽

2021 ◽

Vol 15 (9) ◽

pp. 3046-3049

Author(s):

Abdulkadir Kaya

Keyword(s):

Risk Perceptions ◽

Time Series Data ◽

Statistical Significance ◽

Series Data ◽

Causality Test ◽

Significance Level ◽

Risk Appetite ◽

Central Registry ◽

The Face ◽

The Impact

Introduction and Aim: It is an important issue that what kind of changes occur in the risks that people face in the face of emerging problems and the role of people in possible pandemics in the last twenty years and in the future. The solution of the problems that arise in the control and management of these risks attracts the attention of many researchers. In this study, the causality effect of the COVID-19 pandemic on risk appetites representing the attitudes and behaviors of securities investors. Materials and Methods: In the study; To represent the pandemic, weekly time series data of the number of COVID-19 cases (COVID) and the Risk Appetite index (RISK) announced by the Central Registry Agency for the period 30.03.2019-30.08.2021 were used. In order to determine the causality relationship, the Hatemi-J Causality test was performed. Results: It was determined that the negative shocks of the COVID variable were a cause of the positive shocks of the RISK variable at a statistical significance level of 1%. Conclusion and Suggestions: The effect of the pandemic process on the investment decisions of the investors is reduced, with the expectation that the economy and financial markets will improve, positively affecting the behavior and risk perceptions of the investors, and this expectation causes the investment behavior and risk appetite to increase. can be expressed. Keywords: COVID-19, Risk appetite, Pandemic, Hatemi-J

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Mood disorders and outcomes in lung cancer patients undergoing surgery: a brief summery

Future Oncology ◽

10.2217/fon-2018-0835 ◽

2020 ◽

Author(s):

Maria Salvina Signorelli ◽

Teresa Surace ◽

Marcello Migliore ◽

Eugenio Aguglia

Keyword(s):

Lung Cancer ◽

Cancer Patients ◽

Mood Disorders ◽

Psychiatric Symptoms ◽

Depression And Anxiety ◽

Lung Cancer Patients ◽

Patients With Cancer ◽

Treatment Of Depression ◽

The Impact

Cancer is a leading cause of death worldwide. Literature reports depression and anxiety are the most common psychiatric symptoms in cancer patients. Notably, lung cancer is associated with major depressive disorder in 5–13% of cases. The present article aims to give an overview regarding the impact of mood disorders on the outcomes of patients affected by lung cancer. Our review showed that pharmacological treatment and psychotherapy can be useful to improve the quality of life of patients with lung cancer. Moreover, the treatment of depression and anxiety can be associated with a reduced mortality. In conclusion, it is important to consider psychiatric care as important as other adjuvant oncologic therapies in patients with cancer.

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Cognitive impairment after cytotoxic chemotherapy

Neuro-Oncology Practice ◽

10.1093/nop/npz052 ◽

2019 ◽

Vol 7 (1) ◽

pp. 11-21 ◽

Cited By ~ 2

Author(s):

Petra Huehnchen ◽

Antonia van Kampen ◽

Wolfgang Boehmerle ◽

Matthias Endres

Keyword(s):

Breast Cancer ◽

Colon Cancer ◽

Cognitive Impairment ◽

Cancer Patients ◽

Cytotoxic Chemotherapy ◽

Cytotoxic Drugs ◽

Cytotoxic Agents ◽

Cancer Type ◽

Breast Cancer Patients ◽

The Impact

Abstract Background Neurotoxicity is a frequent side effect of cytotoxic chemotherapy and affects a large number of patients. Despite the high medical need, few research efforts have addressed the impact of cytotoxic agents on cognition (ie, postchemotherapy cognitive impairment; PCCI). One unsolved question is whether individual cytotoxic drugs have differential effects on cognition. We thus examine the current state of research regarding PCCI. Neurological symptoms after targeted therapies and immunotherapies are not part of this review. Methods A literature search was conducted in the PubMed database, and 1215 articles were reviewed for predefined inclusion and exclusion criteria. Thirty articles were included in the systematic review. Results Twenty-five of the included studies report significant cognitive impairment. Of these, 21 studies investigated patients with breast cancer. Patients mainly received combinations of 5-fluorouracil, epirubicin, cyclophosphamide, doxorubicin, and taxanes (FEC/FEC-T). Five studies found no significant cognitive impairment in chemotherapy patients. Of these, 2 studies investigated patients with colon cancer receiving 5-fluorouracil and oxaliplatin (FOLFOX). Independent risk factors for PCCI were patient age, mood alterations, cognitive reserve, and the presence of apolipoprotein E e4 alleles. Conclusions There is evidence that certain chemotherapy regimens cause PCCI more frequently than others as evidenced by 21 out of 23 studies in breast cancer patients (mainly FEC-T), whereas 2 out of 3 studies with colon cancer patients (FOLFOX) did not observe significant changes. Further studies are needed defining patient cohorts by treatment protocol in addition to cancer type to elucidate the effects of individual cytotoxic drugs on cognitive functions.

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Science fiction prototyping’s features and impact on college students’ perceptions of writing

Scientific Study of Literature ◽

10.1075/ssol.20002.nic ◽

2020 ◽

Vol 10 (1) ◽

pp. 128-164

Author(s):

Justin Nicholes

Keyword(s):

College Students ◽

Creative Writing ◽

Science Fiction ◽

Science Writing ◽

Post Intervention ◽

Stem Majors ◽

Emotional Tone ◽

Mathematics Majors ◽

English Majors ◽

The Impact

Abstract The present study develops an applied literariness study by exploring both the features, and the impact, of science fiction prototyping (SFP) on college students’ perceptions of disciplinary, or field-specific, writing. College students (N = 83), who were English (n = 35) or STEM (science, technology, engineering, mathematics) majors (n = 48), composed micro-science fiction prototyping (µSFP), a genre that blends creative and science writing. Linguistic Inquiry and Word Count (LIWC2015) analysis demonstrated that, aside from a more positive average emotional tone, µSFP written fell psycho-linguistically between personal and science writing. English and STEM majors’ µSFP stories were similar in terms of analytical levels, clout, authenticity, emotional tone, and use of words. Mann-Whitney U tests indicated that, while English majors evaluated creative writing as significantly more relevant to their future career goals pre-intervention than did STEM majors (p = .04, r = .23), this difference vanished post-intervention. Additionally, while STEM majors evaluated science writing as significantly more worth their time to study (p = .042, r = .22) and relevant to their major (p = .01, r = .28) pre-intervention than did English majors, these differences disappeared post-intervention. Wilcoxon signed-ranks tests indicated that, while English majors’ ownership and evaluation of science and creative writing did not change, STEM majors’ evaluations of creative writing as relevant to their majors and future careers were significantly higher post-intervention (p = .015, r = .35)

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