Predictors of anxiety and depression risk among individuals with lung cancer.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e23136-e23136
Author(s):  
Kevin Stein ◽  
Shauna McManus ◽  
Pierre M. Gardan ◽  
Julie S. Olson ◽  
Melissa F. Miller ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Health Care ◽  
Symptom Burden ◽  
Health Care Team ◽  
Care Team ◽  
Anxiety And Depression ◽  
Team Communication ◽  
Cancer Support ◽  
Depression Risk ◽  
Clinically Significant

e23136 Background: Lung cancer (LC) patients can face long-term symptom burden, quality of life concerns, and enduring distress. This study explored predictors of psychosocial distress among a community-based sample of LC survivors. Methods: 208 individuals with LC enrolled in Cancer Support Community’s Cancer Experience Registry, provided demographic/clinical background, and reported cancer-related distress using CancerSupportSource, a 25-item tool measuring level of concern ( 0-4) over 5 domains: emotional well-being (including 2-item depression and 2-item anxiety risk screening subscales), symptom burden and impact, body image and healthy lifestyle, health care team communication (HCTC), and relationships and intimacy. Using logistic regression, we estimate which domains influence anxiety and depression risk, controlling for significant demographic/clinical variables. Results: Participants were 68% female, 83% non-Hispanic White; mean ( SD) age = 61 (11) years; mean ( SD) years since diagnosis = 3.1 (4.5); 86% non-small cell lung cancer (NSCLC); 43% ever diagnosed as metastatic. 52% underwent surgery; 76% received chemotherapy, 65% radiation. 53% were at risk for clinically significant anxiety; 42% for clinically significant depression. Concerns about relationships and intimacy were associated with greater odds of anxiety risk ( OR= 1.70; p< .01); a positive interaction suggested that anxiety risk among individuals with NSCLC varied by HCTC concerns, with greater concerns being associated with higher risk ( p< .05). Concerns about symptom burden and impact ( OR= 1.21; p< .01) and HCTC ( OR= 1.57; p< .05) were significantly associated with greater odds of depression risk; these associations did not vary by LC type. Conclusions: Concerns around health care team communication, relationships and intimacy, and symptom burden and impact are important considerations in understanding risk for anxiety and depression among lung cancer patients and survivors. Additionally, type of lung cancer (NSCLC) can moderate the degree to which concerns about HCTC are associated with risk. Findings highlight the need for constructive patient-provider communication, particularly around relationships and intimacy and symptom burden. Clinical trial information: NCT02333604.

Predictors of distress among individuals with gastric cancer.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 96-96
Author(s):  
Julie Olson ◽  
Shauna McManus ◽  
Melissa F. Miller ◽  
Eva Yuen ◽  
Crystal S. Denlinger ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Symptom Burden ◽  
Anxiety And Depression ◽  
Bivariate Analysis ◽  
Healthcare Team ◽  
Team Communication ◽  
Persistent Symptoms ◽  
Cancer Support ◽  
Depression Risk ◽  
Clinically Significant

96 Background: With improving survival, gastric cancer patients face long-term quality of life concerns, including management of persistent symptoms and maintenance of social activity. We examined psychosocial distress and areas of concern in a national sample of gastric patients. Methods: Using data from the Cancer Support Community’s Cancer Experience Registry, our sample included 72 patients with a primary diagnosis of stomach (54%), esophageal (36%), or GIST (11%) cancer. Participants reported cancer-related distress using CancerSupportSource®, a 25-item tool with a 2-item anxiety risk subscale, 2-item depression risk subscale, and four additional subscales measuring symptom burden, body/healthy lifestyle, healthcare team communication, and relationship concerns. We used logistic regression to estimate which of these subscales influence risk for clinically significant anxiety and depression controlling for demographic/clinical variables that were associated with anxiety and depression risk in bivariate analysis. Results: Our sample was 62% female, 80% White, and averaged 58 years of age ( SD = 13). 24% were diagnosed less than one year before participating. 33% were ever diagnosed as metastatic. 42% had received surgery. 60% were at risk for clinically significant anxiety and 50% for clinically significant depression. In regression models, relationship concerns were significantly associated with greater risk for anxiety ( OR = 1.5; p < .05) and depression ( OR = 1.7; p < .05). Greater concern with healthcare team communication was associated with anxiety risk in bivariate analysis ( r = .41, p < .01), but the association was only a trend in the multivariate model ( OR = 1.4; p = .06). Similarly symptom burden concern was associated with depression risk in bivariate analysis ( r = .57, p < .01) but only a trend in multivariate analysis ( OR = 1.2; p = .06). Conclusions: Relationship concerns predicted risk for clinically significant anxiety and depression among stomach, esophageal, and GIST patients. Healthcare team communication and symptom burden concerns were also associated with anxiety and depression risk. Results highlight the need for constructive patient-provider communication, particularly around relationships and symptoms. Clinical trial information: NCT02333604.

Evaluation of interprofessional health care team communication simulation in geriatric palliative care

2018 ◽  
Vol 40 (1) ◽  
pp. 30-42 ◽  
Author(s):  
Zvi D. Gellis ◽  
Eunhae Kim ◽  
Diane Hadley ◽  
Lora Packel ◽  
Cathy Poon ◽  
...  
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Health Care Team ◽  
Care Team ◽  
Team Communication ◽  
Communication Simulation

Provider-patient communication about cost of care: Results from a national patient education program.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 9578-9578 ◽  
Author(s):  
Ivy A. Ahmed ◽  
Allison Harvey ◽  
Marni Amsellem ◽  
Thomas J. Smith
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Cancer Care ◽  
Health Care Team ◽  
Cost Of Care ◽  
Care Team ◽  
Cancer Support ◽  
Support Organizations ◽  
National Patient ◽  
The Cost

9578 Background: A 2010 NIH study indicates direct cancer care expenditures will reach $158 billion in the U.S. by 2020, impacting millions of Americans. The cost of insurance for a family of 4 has increased from $6000 (2000) to over $16,000 (2011). Medical debt is a significant cause of personal bankruptcy, even if insured. The financial realities posed by costs associated with cancer care greatly complicate a cancer diagnosis. The most recent American College of Physicians Ethics Manual recommends all parties must interact honestly, openly, and fairly. (Snyder L, et al. Ann Int Med 2012, p86) This analysis explores the occurrence and value of patient-provider communication surrounding costs associated with care in a national survey of those affected by cancer. Methods: From 2011-12, 505 individuals attending Frankly Speaking About Cancer: Coping with the Cost of Care workshops completed a survey assessing experiences about the costs of cancer care. This is a Cancer Support Community national evidence-based educational program. All attendees (n=708) were eligible to complete survey. Results: Most attendees (71.3%) responded. The majority (62.4%) were people with cancer/survivors; the remainder included spouses/partners, family members, and 8.7% were health care professionals. Most (80.8%) were Caucasian, and averaged 57.2 years. Of those with cancer, 89.9% were insured at diagnosis. 59.4% reported no one on their health care team initiated a discussion about the financial aspects of their care. Included in this figure, 22.7% actively sought information from health care team, and 36.7% received no information about cost. When topic was initiated, it was by social workers (16.2%), physicians (12.3%), nurses (6.3%) or financial specialists (8.2%). When information was provided, 72.1% found it somewhat or very useful. Also, regardless of provider discussion, respondents independently sought resources for managing costs, such as other patients (44.2%), the Internet (41.5%), and patient support organizations (38.1%). Conclusions: Patients want financial information but do not receive it. These data highlight the need and value of providers initiating a dialogue about the cost of cancer care with patients.

Cancer-related distress and cost of care concerns among gastric cancer patients.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e15583-e15583 ◽  
Author(s):  
Linda S. House ◽  
Melissa F Miller ◽  
Alexandra K Zaleta ◽  
Jamese Johnson ◽  
Crystal Shereen Denlinger ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Health Care ◽  
At Risk ◽  
Emotional Distress ◽  
Financial Burden ◽  
Health Care Team ◽  
Physical Symptoms ◽  
Cost Of Care ◽  
Care Team ◽  
Clinically Significant

e15583 Background: Individuals with gastric cancer (GC) are at risk for significant physical, psychological, and financial burden related to their illness and cost of care. This study characterizes cancer-related distress and concerns among survivors of GC and related cancers and the support survivors receive from their health care team for these concerns. Methods: Of 110 GC survivors enrolled in the Cancer Support Community’s online Cancer Experience Registry, 30 (43% stomach, 37% esophageal, 20% GIST) rated their level of concern (0 = not at all; 4 = very seriously) about psychological, emotional, physical and practical concerns (27 items). Risk for clinically significant distress was identified via a 4-item subscale (α = 0.86, cutoff score = 6.) Participants also completed the Impact of Events (IES) intrusion subscale and questions about their healthcare team’s involvement in addressing concerns. Results: Participant median age was 61 years; median time since diagnosis was 3 years. 23% experienced recurrence; 37% had metastatic disease.The highest ranked concerns (rated moderately to very seriously) included: eating and nutrition (62%); fatigue (62%); health insurance or money worries (59%); worry about the future (59%); feeling sad or depressed (50%); changes or disruptions to work, school, or home life (48%); sleep problems (48%); and worry about family (48%). Half of respondents (50%) were at risk for clinically significant emotional distress; 39% reported intrusive thoughts about the cost of cancer care. Fewer than half indicated their health care team asked about emotional distress (43%), lifestyle (43%), work (40%), finances (37%), or family (33%). Participants wished for more help with emotions related to cancer (57%), long-term side effects (55%), and financial advice/assistance (52%). Conclusions: Substantial proportions of gastric cancer survivors express concern about physical symptoms, emotional distress, and financial burden, yet many report they are not counseled about these concerns. Efforts are needed to reduce distress and the financial burden associated with gastric cancer to reduce their potential impact on quality of life, treatment adherence, and other illness outcomes.

Cancer-related distress and unmet needs among newly diagnosed and longer-term cancer survivors from a community-based distress screening program.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 220-220 ◽  
Author(s):  
Joanne S. Buzaglo ◽  
Melissa F Miller ◽  
Victoria Kennedy ◽  
Margaret Longacre ◽  
Mitch Golant ◽  
...  
Keyword(s):  
Health Care ◽  
Cancer Survivors ◽  
Screening Tool ◽  
Unmet Needs ◽  
Health Care Team ◽  
Care Team ◽  
First Year ◽  
Newly Diagnosed ◽  
Distress Screening ◽  
Cancer Support

220 Background: As survival rates increase among cancer patients, quality of life needs become more salient. Cancer Support Source (CSS) is a distress screening, referral and follow up program that uses a validated distress screening tool and referral algorithm to link cancer patients to resources tailored to their needs. The objective of this study was to describe psychosocial concerns and unmet needs at different times since cancer diagnosis. Methods: English speaking cancer survivors (n = 905) across 26 affiliates of a nationwide cancer support organization participated in the CSS program by first completing a screening tool, including a 4 item depression subscale. Participants rated the level of concern (0 to 4) about 15 items and identified the help they wanted for each item (talk with a member of your health care team and/or connect you with online resources). We used regression analysis, adjusting for age, to examine differences by time since diagnosis ( < 1 y; ≥ 1 y) in level of distress; type of concerns (rated ≥ 2); and items selected to talk with the health care team. Results: The sample was 78% female, 10% Latino, 9% Black, and median age 57 y. 41% were breast cancer survivors, 6% lung, and 6% colorectal. More than half were within 1 y of their diagnosis (61%, n = 507); 39% ≥ 1 y (n = 331). Those newly diagnosed ( < 1 y) had significantly higher levels of distress (p = 0.011); increased risk for depression (p = 0.007); and more likely to be concerned about changes in work, school, or home life; body image; feeling nervous or afraid; worry about the future; and making a treatment decision (p < 0.05). Among those who indicated that an item was a concern, newly diagnosed patients were significantly more likely to want to talk to their health care team about pain; financial worries; exercising; feeling lonely or isolated; feeling nervous or afraid; and worry about the future (p < 0.05). Conclusions: These findings suggest that patients are more distressed and more likely to want to talk about their psychosocial needs within the first year of a cancer diagnosis. Future research should evaluate efforts to provide tailored resources within the first year of a diagnosis when distress levels are highest.

Cancer-related distress and unmet needs among members of a metastatic breast cancer registry.

2014 ◽  
Vol 32 (26_suppl) ◽  
pp. 118-118
Author(s):  
Joanne S. Buzaglo ◽  
Melissa F Miller ◽  
Anne Morris ◽  
Allison Harvey ◽  
Mitch Golant
Keyword(s):  
Breast Cancer ◽  
Health Care ◽  
Metastatic Breast Cancer ◽  
Metastatic Breast ◽  
Health Care Team ◽  
Cost Of Care ◽  
Care Team ◽  
Comprehensive Cancer Center ◽  
Community Based ◽  
Cancer Support

118 Background: An estimated 155,000 people are living with metastatic breast cancer (MBC) in the US. Emotional distress among people living with MBC is common; yet, little is known about the patient experience and distress screening. Methods: Since March 2013, the Cancer Support Community has registered 909 people living with MBC to the Cancer Experience Registry, an online initiative that is designed to raise awareness about the psychosocial impact of cancer. 599 registrants responded to questions about cancer related distress. This sample was 99% female, 91% Caucasian, and 69% with a college degree and median age 56. Median time since MBC diagnosis was 3 years. Results: The top sources of distress (% rated seriously or very seriously concerned) were: (1) worry about the future (44%); (2) fatigue (39%); (3) health insurance or money worries (38%). 49% reported fatigue was ‘quite a bit’ or ‘very much’ disruptive in their life and 46% reported intrusive ideation about the financial cost of care. Factors that were independently associated with greater overall distress included younger age (p<0.001), higher comorbidity (p<0.001), lower income (p=0.001). 43% of respondents were never asked about distress by their health care team. Those who received all or part of their treatment in an academic or comprehensive cancer center were significantly more likely to be asked about distress versus those receiving treatment anywhere else (65% vs. 50%, p=0.002). Among those who were asked about distress (n=340), 62% received referrals to manage distress within their health care system, and 19% at a community-based organization; 47% reported their health care team helped coordinated distress-related care. 20% of those asked about distress never received referrals for managing it. Conclusions: These findings support the need for integrated supportive care services and better side-effect management. Disturbingly, 20% of patients who asked for referrals never received them and only 19% of patients were referred to community-based organizations for treating their distress where these services are often provided at low or no-cost. There is an on-going need for coordinated care that integrates programs and services across health care systems.

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