Depression and Anxiety in Patients With Cancer: A Cross-Sectional Study

ObjectivesDepression and anxiety persist in cancer patients, creating an additional burden during treatment and making it more challenging in terms of management and control. Studies on the prevalence of depression and anxiety among cancer patients in the Middle East are limited and include many limitations such as their small sample sizes and restriction to a specific type of cancer in specific clinical settings. This study aimed to describe the prevalence and risk factors of depression and anxiety among cancer patients in the inpatient and outpatient settings.Materials and MethodsA total of 1,011 patients (399 inpatients and 612 outpatients) formed the study sample. Patients’ psychological status was assessed using the Hospital Anxiety and Depression Scale (HADS), the Patient Health Questionnaire (PHQ-9), and the Generalized Anxiety Disorder 7-item (GAD-7) scale. The prevalence rate of depressive and anxious symptomatology was estimated by dividing the number of patients who exceeded the borderline score: 10 or more for each subscale of the HADS scale, 15 or more for the GAD-7 scale, and 15 or more in the PHQ-9 by the total number of the patients. Risk factors were identified using logistic regression.ResultsThe prevalence of depressive and anxious symptomatology among all patients was 23.4% and 19.1–19.9%, respectively. Depressive symptomatology was more prevalent across patients who were hospitalized (37.1%) compared with patients in the outpatient setting (14.5%) (p < 0.001). Similarly, anxious symptomatology was more prevalent in the inpatient setting (p < 0.001). In the inpatient setting, depressive symptomatology was more prevalent among patients with bladder cancer, while severe anxious symptomatology was more prevalent across patients with lung cancer. In the outpatient setting, depressive and anxious symptomatology was more prevalent among breast and prostate cancer patients, respectively. Despite that, around 42.7% and 24.8% of the patients, respectively, reported that they feel anxious and depressed, and only 15.5% of them were using medications to manage their conditions.ConclusionOur study findings demonstrated a higher prevalence of depressive and anxious symptomatology in the inpatient setting and advanced disease stages. In addition, the underutilization of antidepressant therapy was observed. There is a need to consider mental disorders as part of the treatment protocol for cancer patients. Enhanced clinical monitoring and treatment of depression and anxiety of cancer patients are required.

Download Full-text

Cardiovascular risk factors during cancer treatment: prevalence, incidence and prognostic relevance

European Heart Journal ◽

10.1093/ehjci/ehaa946.3251 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

J Caro Codon ◽

T Lopez-Fernandez ◽

C Alvarez-Ortega ◽

P Zamora Aunon ◽

I Rodriguez Rodriguez ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Cardiovascular Risk ◽

Cancer Therapy ◽

Cancer Patients ◽

Individual Risk ◽

Funding Source ◽

Number Of Patients ◽

All Cause Mortality

Abstract Background The actual usefulness of CV risk factor assessment in the prognostic evaluation of cancer patients treated with cardiotoxic treatment remains largely unknown. Design Prospective multicenter study in patients scheduled to receive anticancer therapy related with moderate/high cardiotoxic risk. Methods A total of 1324 patients underwent follow-up in a dedicated cardio-oncology clinic from April 2012 to October 2017. Special care was given to the identification and control of CV risk factors. Clinical data, blood samples and echocardiographic parameters were prospectively collected according to protocol, at baseline before cancer therapy and then at 3 weeks, 3 months, 6 months, 1 year, 1.5 years and 2 years after initiation of cancer therapy. Results At baseline, 893 patients (67.4%) presented at least 1 risk factor, with a significant number of patients newly diagnosed during follow-up. Individual risk factors were not related with worse prognosis during a 2-year follow-up. However, a higher Systemic Coronary Risk Estimation (SCORE) was significantly associated with higher rates of severe cardiotoxicity and all-cause mortality [HR 1.79 (95% CI 1.16–2.76) for SCORE 5–9 and HR 4.90 (95% CI 2.44–9.82) for SCORE ≥10 when compared with patients with lower SCORE (0–4)]. Conclusions This large cohort of patients treated with a potentially cardiotoxic regimen showed a significant prevalence of CV risk factors at baseline and significant incidence during follow-up. Baseline cardiovascular risk assessment using SCORE predicted severe cardiotoxicity and all-cause mortality. Therefore, its use should be recommended in the evaluation of cancer patients. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): This study was partially funded by the Fondo Investigaciones Sanitarias (Spain), Centro de Investigaciόn Biomédica en Red Cardiovascular CIBER-CV (Spain)

Download Full-text

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.

Download Full-text

Contemporary use of inpatient antineoplastic (IP) treatment (Rx): Who is getting care and why?

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.15_suppl.e18015 ◽

2019 ◽

Vol 37 (15_suppl) ◽

pp. e18015-e18015

Author(s):

Hilal Hachem ◽

David Levitz ◽

Danai Dima ◽

Joshua R. Dower ◽

Rabiah B. Fresco ◽

...

Keyword(s):

Outpatient Setting ◽

Index Admission ◽

Intravesical Therapy ◽

Inpatient Setting ◽

Disease Characteristics ◽

Medication Delivery ◽

Number Of Patients ◽

High Acuity ◽

Inpatient Management ◽

To Receive

e18015 Background: The steady trend towards outpatient antineoplastic medication delivery has been spurred by improvements in supportive care, innovations in drug delivery, and financial considerations. Despite these trends, a significant number of patients (pts) continue to receive IP Rx for both hematological (HM) and solid cancers (ST). The purpose of this study is to describe a single center’s experience with IP Rx between 01/01/2015 and 12/31/2017. Methods: All pts ( > 18yo) who received IP Rx for a cancer diagnosis, exclusive of stem cell transplantation, were identified from hospital pharmacy records. Patient and disease characteristics were collected at the index (initial) admission. All pts were followed for 1 year after index admission for 30-day readmission and subsequent admissions for IP Rx. Reasons for IP Rx included: urgent/emergent initiation of Rx; high acuity inpatient management for ST (e.g., intraperitoneal, intra-arterial, intravesical therapy) or complex HM regimen; ongoing Rx; palliation. Results: A total of 266 index admissions were identified with 66.2% of pts having a HM (n = 176) and 33.8% having a ST (n = 90). IP Rx was classified as urgent for 48.1% of pts (n = 128); 70.3% (n = 90) of these admissions were new diagnoses of which 91.4% (n = 86) were HM. High acuity IP management was required for 37.5% of pts (n = 100) (47% for ST (n = 47) and 53% for HM (n = 53)). The remaining index admissions were classified as ongoing Rx for 4.5% of pts (n = 12) and palliation for 9.8% (n = 26). Pts with ST required intensive care significantly more often than pts with HM (57.8% vs. 15.9%, p < 0.001) but with no difference in inpatient mortality (4.4% vs. 5.7%, p = 0.891). The 30-day readmission rate was 32.2% for ST and 25.6% for HM (p = 0.515). After the index admission, 10% of ST pts and 60.2% of HM pts had at least 1 subsequent admission for IP Rx (p < 0.001). Conclusions: In this 3-year retrospective review, the vast majority of pts receiving IP Rx required either urgent initiation of care or high acuity care, currently only available in the inpatient setting. While there is little evidence of routine IP Rx or opportunity, at present, to transition further care to the outpatient setting, the high rates of 30-day readmission warrant further evaluation.

Download Full-text

Prevalence of depression among relatives of cancer patients in Jordan: A cross-sectional survey

Palliative & Supportive Care ◽

10.1017/s1478951510000519 ◽

2011 ◽

Vol 9 (1) ◽

pp. 25-29 ◽

Cited By ~ 5

Author(s):

Nizar M. Mhaidat ◽

Suleiman A. Ai-Sweedan ◽

Karem H. Alzoubi ◽

Sayer I. Alazzam ◽

Mohammed N. Banihani ◽

...

Keyword(s):

Cancer Patients ◽

Depression Scale ◽

Chronically Ill ◽

University Hospital ◽

Psychological Status ◽

Disease Stage ◽

Psychological State ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Prevalence Of Depression

AbstractObjective:Depression is common among chronically ill patients and their relatives. In this article, we investigated the prevalence of depression among relatives of cancer patients in Jordan, and studied the relation between several socio-demographic, disease- and treatment-related factors, together with the occurrence of depression among those relatives.Method:A cross-sectional survey study was conducted at a major university hospital in Jordan. Relatives of cancer patients were interviewed for socio-demographic information, and medical records were checked for information about disease and treatment of patient. Psychological status of the relative was assessed using the Hospital Anxiety & Depression Scale (HADS).Results:The prevalence of depression in our sample was 81.9%. Age and degree of relatedness were significantly correlated with the occurrence of depression among relatives of cancer patients. Significant correlations were also detected between depression among patient's relatives and the stage of the disease. Positive predictive factors for depression included relatives being middle aged, close relatedness, patients being in advanced disease stage, and on chemotherapy or undergoing surgery for cancer treatment.Significance of results:Depression is prevalent among relatives of cancer patients. Therefore, more attention is needed to detect changes in the psychological state of vulnerable relatives of cancer patients, in an effort to reduce the occurrence of depression.

Download Full-text

Screening for depression and anxiety in cancer patients using the Hospital Anxiety and Depression Scale

General Hospital Psychiatry ◽

10.1016/0163-8343(93)90099-a ◽

1993 ◽

Vol 15 (2) ◽

pp. 69-74 ◽

Cited By ~ 209

Author(s):

Brendan T. Carroll ◽

Roger G. Kathol ◽

Russell Noyes ◽

Tina G. Wald ◽

Gerald H. Clamon

Keyword(s):

Cancer Patients ◽

Depression Scale ◽

Anxiety And Depression ◽

Depression And Anxiety ◽

Hospital Anxiety

Download Full-text

Age Paradox: Depressive Symptomatology For Older Men and Women in Taiwan

10.21203/rs.3.rs-605253/v1 ◽

2021 ◽

Author(s):

Ching-Ju Chiu ◽

Chun-Yu Tsai ◽

Tsung-Yu Tsai

Keyword(s):

Risk Factors ◽

Older Adults ◽

Depressive Symptoms ◽

Social Participation ◽

Protective Factor ◽

Depressive Symptomatology ◽

Depression Scale ◽

Advanced Age ◽

Men And Women ◽

Factors Associated

Abstract Background: To discern if prevalence of depressive symptoms in adults aged 65 and above in Taiwan changed during the past decade and to identify if protective and risk factors of depressive symptomatology differ by gender. Method: Data of nationally representative older adults (65+) interviewed from the 2005, 2009 and 2013 National Health Interview Survey (NHIS) in Taiwan was analyzed (n=8,832). The Center for Epidemiologic Studies Depression Scale (CES-D) was used for the measurement of depressive symptomatology. Results: Age adjusted prevalence rate of depressive symptomatology among older adults in Taiwan reduced from 20.6% to 13.3% (X2=-7.5, p<.05) in the community. The most significant factors associated with higher depressive symptomatology in both gender was too much carbohydrates intake, which was significantly associated with 8.8 (95%CI=5.1-15.2) and 7.9 (95%CI=5.2-11.8) times depressive symptomatology in men and women respectively. Factors associated with lower depressive symptomatology in both gender include advanced age (over the age of 85), exercise and social participation. The advanced age for men and women reduced about 63% (AOR over the age of 85=0.4, 95%CI=0.2-0.9) and 62% (AOR over the age of 85=0.4, 95%CI=0.2-0.8) of depressive symptomatology for men and women respectively; Exercise reduced about 50% (AOR exercise=0.5, 95%CI=0.3-0.6) and 58% (AOR exercise=0.5, 95%CI=0.3-0.6) of depressive symptomatology for men and women respectively; social participation reduced about 55% (AOR social participation=0.5, 95%CI=0.3-0.7) and 36% (AOR social participation=0.6, 95%CI=0.5-0.9) of depressive symptomatology for men and women respectively.Conclusions: For adults aged over 65, advanced age, which is 85+ for men and 75+ for women, is a significant protective factor guarding against depressive symptoms. Carbohydrates, cognitive disorder, heart disease and falls were associated with higher depressive symptomatology in both gender. The pulmonary disease, underweight and educational level were risk factors for men; metabolic disease and milk intake were risks for women. Common factors associated with lower depressive symptomatology in both gender includes advanced age, exercise and social participation. Tea and coffee intake and married status were associated with lower depressive symptomatology for women.

Download Full-text

Cognitive impairment is differentially associated with depression and anxiety at six-months post-stroke

10.1101/2020.09.24.20200972 ◽

2020 ◽

Author(s):

Owen A Williams ◽

Nele Demeyere

Keyword(s):

Cognitive Impairment ◽

Spatial Attention ◽

Depressive Symptomatology ◽

Depression Scale ◽

Anxiety Symptoms ◽

Cognitive Domain ◽

Stroke Severity ◽

Depression And Anxiety ◽

Post Stroke ◽

Post Stroke Depression

Objective: This study investigated the associations between general cognitive impairment and domain specific cognitive impairment with post-stroke depression and anxiety at six-months post-stroke. Methods: Participants were a subset of 437 stroke patients from the OCS-CARE study who were followed up at a 6 months post-stroke assessment. Depression and anxiety symptoms were assessed by the Hospital Anxiety and Depression Scale sub-scales. General cognitive impairment was assessed using the Montreal Cognitive Assessment and stroke-specific cognitive domain impairments was assessed using the Oxford Cognitive Screen. Multivariable linear regression was used to examine the associations between cognition and depression/anxiety symptoms, controlling for acute stroke severity and ADL impairment, age, sex, education, and co-occurring post-stroke depression/anxiety. Results: Six-month post-stroke depression was associated with six-month impairment on the MoCA (beta [b] =0.96, standard error [SE] =0.31, p=0.006), and all individual domains assessed by the OCS including spatial attention (b=0.67, SE=0.33, p =0.041), executive function (b=1.37, SE=0.47, p=0.004), language processing (b=0.87, SE=0.38, p=0.028), memory (b=0.76, SE=0.37, p=0.040), number processing (b=1.13, SE=0.40, p=0.005), and praxis (b=1.16, SE =0.49, p=0.028). Post-stroke anxiety was associated with impairment on the MoCA (b=1.47, SE=0.42, p=0.001), and spatial attention (b=1.25, SE=0.45, p=0.006), but these associations did not remain significant after controlling for co-occurring post-stroke depression. Conclusion: The different profiles of associations between cognitive impairment and post-stroke depression and anxiety suggest that cognitive impairment is highly related to depressive symptomatology, but associations observed between cognitive impairment and anxiety may actually be the result of co-morbid post stroke depression.

Download Full-text

Relationship between malnutrition and the presence of symptoms of anxiety and depression in hospitalized cancer patients

Supportive Care in Cancer ◽

10.1007/s00520-021-06532-y ◽

2021 ◽

Author(s):

Francisco José Sánchez-Torralvo ◽

Victoria Contreras-Bolívar ◽

María Ruiz-Vico ◽

José Abuín-Fernández ◽

Inmaculada González-Almendros ◽

...

Keyword(s):

Cancer Patients ◽

Nutritional Assessment ◽

Depressive Symptomatology ◽

Depression Scale ◽

Cross Sectional Study ◽

Anxiety And Depression ◽

Average Score ◽

Cross Sectional ◽

Patients With Cancer ◽

Depression Symptomatology

Abstract Background Anxiety and depression are a common issue in patients with cancer, yet understudied among hospitalized patients. The aim of this study was to estimate the prevalence of anxiety and depression symptomatology in cancer inpatients and its relationship with malnutrition. Methods Cross-sectional study in hospitalized cancer patients. A nutritional assessment was done using the Global Leadership Initiative on Malnutrition (GLIM) criteria to diagnose malnutrition. Data regarding anxiety and depression symptomatology was obtained with the Hospital Anxiety and Depression Scale (HADS). Results A total of 282 inpatients were assessed. GLIM criteria found 20% (66) of well-nourished and 80% (216) with malnutrition. HADS presented an average score of 8.3 ± 4.4 with respect to anxiety and an average score of 7.7 ± 4.6 with respect to depression. Up to 54% of the patients showed a possible presence of anxiety, and 45.3% of them showed a possible presence of depression. In malnourished patients, HADS score was non-significantly higher with respect to anxiety (8.5 ± 4.3 in malnourished vs 7.1 ± 4.6 in well-nourished; p = 0.06) and was significantly higher with respect to depression (8.2 ± 4.6 in malnourished vs 5.3 ± 4.0 in well-nourished; p < 0.001). After controlling for potential confounders, malnourished patients were 1.98 times more likely to present anxious symptomatology (95% CI 1.01–3.98; p = 0.049) and 6.29 times more likely to present depressive symptomatology (95% CI 1.73–20.47; p = 0.005). Conclusions The presence of anxiety and depression symptomatology in oncological inpatients is high. There is an association between malnutrition and presenting anxious and depressive symptomatology in hospitalized cancer patients.

Download Full-text

Incidence, Treatment, and Consequences of Chemotherapy-Induced Febrile Neutropenia in Inpatient and Outpatient Settings

Blood ◽

10.1182/blood.v120.21.4232.4232 ◽

2012 ◽

Vol 120 (21) ◽

pp. 4232-4232 ◽

Cited By ~ 1

Author(s):

Derek Weycker ◽

Richard Barron ◽

Alex Kartashov ◽

Jason C. Legg ◽

Gary H. Lyman

Keyword(s):

Length Of Stay ◽

Cancer Patients ◽

Research Funding ◽

Hospital Length ◽

Outpatient Setting ◽

Hospital Length Of Stay ◽

Inpatient Setting ◽

Outpatient Management ◽

Myelosuppressive Chemotherapy ◽

Study Population

Abstract Abstract 4232 Background: Febrile neutropenia (FN) is a life-threatening side effect of myelosuppressive chemotherapy. The incidence and consequences of FN requiring inpatient care have been evaluated using healthcare claims or hospital administrative databases (Kuderer et al, Cancer 2006; Caggiano et al, Cancer 2005; Lyman et al, Eur J Cancer 1998). These sources did not include absolute neutrophil counts (ANC) and body temperature; thus the accuracy of case-ascertainment methods and findings is unknown. Moreover, none of these studies considered FN managed in the outpatient setting. Because some of these limitations may be overcome using electronic health records (EHR), a new study was undertaken. Methods: Data were obtained from Humedica's National EHR-Derived Longitudinal Patient-Level Database (2007–2010), which includes comprehensive point-of-care information from EHR and administrative data stores across the continuum of care for ∼5 million patients. The study population included adult patients who initiated 1 or more new courses of myelosuppressive chemotherapy for the treatment of a solid tumor or non-Hodgkin's lymphoma (NHL). For each patient, each chemotherapy course and each cycle within each course was identified. FN was identified on a cycle-specific basis based on ANC <1.0 × 109/L and evidence of infection or fever (ie, temperature ≥38.3°C, diagnosis, or antibiotic use); inpatient diagnosis of neutropenia, fever, or infection; outpatient diagnosis of neutropenia and antibiotic use; or mention of FN in physician notes. Episodes of FN were categorized as inpatient or outpatient based on initial locus of care. Consequences of FN included hospital length of stay and mortality (inpatient cases only) and number of FN-related outpatient management visits. Means, percentages, and corresponding 95% confidence intervals (CIs) are reported below. Results: The study population included 2131 patients who received 2323 courses and 8999 cycles of chemotherapy. About 50% of patients were aged ≥65 years, and more patients were female (59.7%). The most common cancers were breast (23.0%), lung (19.9%), genitourinary (17.5%), NHL (10.7%), and colorectal (10.4%). The most common chemotherapy regimens were docetaxel/cyclophosphamide (TC; 33.9% of breast cancer patients); paclitaxel/carboplatin (PC; 42.9% of lung cancer and 51.1% of genitourinary cancer patients); cyclophosphamide/doxorubicin/vincristine/prednisone (CHOP; 42.0% of NHL patients); and fluorouracil/leucovorin/oxaliplatin (FOLFOX; 60.5% of colorectal cancer patients). Among the 2131 patients in the study population, 401 patients experienced a total of 458 FN events, which occurred most frequently (41.0%) in cycle 1. Among the 2323 chemotherapy courses identified, the FN risk was 16.8% (95% CI: 15.3, 18.4). FN risk was highest in cycle 1 (8.1%; 95% CI: 7.1, 9.3) and cycle 2 (4.9%; 95% CI: 3.9, 6.0). Among the 8999 cycles of chemotherapy, 83.2% of FN events were initially treated in the inpatient setting and 16.8% were initially treated in the outpatient setting. Of events initially treated in the outpatient setting, 3.9% required subsequent hospitalization. Among FN events initially treated in the inpatient setting, mean hospital length of stay was 8.4 (95% CI: 7.7, 9.1) days, and inpatient mortality was 8.1% (95% CI: 5.8, 11.1). Among FN events initially treated in the outpatient setting, the mean total number of FN-related outpatient management visits was 2.6 (95% CI: 2.1, 3.1); most encounters were in the physician's office (69.2%) or emergency department (26.9%). Conclusions: Nearly 1 in 5 patients receiving myelosuppressive chemotherapy experienced FN. Most FN events (83.8%) required hospitalization either for initial treatment or subsequent to outpatient treatment, and mean hospital length of stay was greater than 8 days. Outpatient care alone was used to successfully treat 16.2% of FN events. Outpatient FN events required 2.6 outpatient management visits, most of which were in the physician's office. Disclosures: Weycker: Amgen Inc: Research Funding. Barron:Amgen Inc.: Employment, Equity Ownership. Kartashov:Amgen Inc.: Research Funding. Legg:Amgen Inc. : Employment, Equity Ownership. Lyman:Amgen Inc: Research Funding.

Download Full-text

Relationship of Depression and Anxiety to Cancer Patients' Medical Decision-Making

Psychological Reports ◽

10.2466/pr0.2003.93.2.323 ◽

2003 ◽

Vol 93 (2) ◽

pp. 323-334 ◽

Cited By ~ 5

Author(s):

Suni Petersen ◽

Elisabeth Sherman-Slate ◽

Jamie L. Straub ◽

Robert C. Schwartz ◽

Hanna Frost ◽

...

Keyword(s):

Decision Making ◽

Cancer Patients ◽

Information Seeking ◽

Medical Decision Making ◽

Depression Scale ◽

Cancer Prognosis ◽

Medical Decision ◽

Anxiety And Depression ◽

Depression And Anxiety ◽

Rural And Urban

The purpose of this study was to examine the relation of depression and anxiety to cancer patients' medical decision-making. Participants were 79 rural and urban cancer patients undergoing chemotherapy. The four decisional styles of the Decisional Processing Model were the independent variables. Dependent variables were anxiety and depression, measured by Spielberger's State-Trait Anxiety and the Center for Disease Control Depression Scale, respectively. Consistent with the Decisional Processing Model, analysis suggested that patients make medical decisions by information seeking, information processing, advice following, or ruminating. Decisional style did not vary according to type or stage of cancer, prognosis, time elapsed since initial diagnosis, or whether cancer was initial or recurrent. Decisional style did not systematically vary with depression and anxiety suggesting how a person makes decisions is a stable personality trait. Thus, decision-making may follow a cognitive schema. It is likely that patients' decisional styles help to manage anxiety and depression when confronted with life-threatening illness. Implications for informed consent and patients' involvement in decision-making are discussed.

Download Full-text