Prevalence of distress, its associated factors and referral to support services in people with cancer.
TL;DR: In this paper, the authors investigated the factors associated with increasing levels of clinically significant distress in people diagnosed with cancer and found that emotional problems such as depression, sadness, worry and a lack of control over treatment decisions were the most prevalent problems for people with clinically significant stress.
Abstract: Aims and objectives To (i) characterise prevalence of distress amongst people diagnosed with cancer, (ii) determine factors associated with increasing distress, (iii) describe reported problems for those with clinically significant distress and (iv) investigate the factors associated with referral to support services. Background International studies report a high prevalence of clinically significant distress in people with cancer. Australian studies are notably lacking. Additionally, clinicians still do not fully understand the factors associated with cancer-related distress. Design Period prevalence study. Methods Distress screening data were analysed for 1,071 people accessing the Cancer Council Western Australia information and support line between 01/01/2016-31/12/2018. These data included people's demographics, cancer diagnoses, level of distress, reported problems and the service to which they were referred. Distress and reported problems were measured using the National Comprehensive Cancer Network Distress Thermometer and Problem List. A partial proportional logistic regression model was constructed to determine which factors were associated with increasing levels of distress. Standard binary logistic regression models were used to investigate factors associated with referral to support services. The STROBE checklist was followed. Results Prevalence of clinically significant distress was high. Self-reported depression, sadness, worry and a lack of control over treatment decisions were significantly associated with increasing distress. Emotional problems were the most prevalent problems for people with clinically significant distress. Most people were referred to emotional health services, with depression, fatigue, living regionally and higher socioeconomic status associated with referral. Conclusions Emotional problems such as depression, sadness and worry are associated with increasing levels of distress. Relevance to clinical practice Not all factors associated with referral to support services were those associated with increasing levels of distress. This suggests that other factors may be more influential to referral decisions.
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TL;DR: In this article, a systematic review was conducted to analyse the effectiveness of virtual reality intervention as an aid for treatment-related anxiety and fatigue in cancer patients undergoing chemotherapy, including three randomised, controlled and three crossover studies with an overall sample size of 453 patients.
15 citations
TL;DR: In this article , the authors evaluated the effectiveness of virtual reality therapy in improving the mental state and quality of sleep, as well as increasing the physical activity (PA) of patients diagnosed with breast cancer.
Abstract: Breast cancer is becoming an important issue due to its various consequences and epidemiology. Studies are showing that it extremely impacts the mental health as well as the physical activity of the patients. In addition to the most common symptom, which is fatigue, patients also have problems with the quality of sleep. Therefore, this study aimed to evaluate the effectiveness of virtual reality (VR) therapy in improving the mental state and quality of sleep, as well as increasing the physical activity (PA) of patients diagnosed with breast cancer. The study was conducted in a hospital’s Breast Unit and included patients at the time of diagnosis of malignant breast cancer. A total of 16 subjects randomly divided into experimental (n = 9), and control (n = 7) groups were measured with the Beck Depression Scale, Mental Adjustment to Cancer Scale, International Physical Activity Questionnaire, and Pittsburgh Sleep Quality Index at two timepoints. The experimental intervention consisted of a 2-week (8 sessions) Virtual Therapeutic Garden (VRTierOne) procedure performed daily for about 15 min. Significant differences were identified between groups in the interactions between the main factors seen in the destructive style of the Mini-Mac scale: F(1.14) = 4.82, p = 0.04, and between multiple experiments: F(1.14)= 5.54, p = 0.03 showing a significant reduction in the destructive style of coping with the disease in the study group after therapy (32.44 vs. 28.33, p = 0.003). The level of main effects [study] for the constructive style is F(1.14) = 3.93, p = 0.06 with a significant increase in constructive style in the study group (43.33 vs. 45.33, p = 0.044). Significant differences in levels of depression between multiple experiments: F(1.14) = 5.04, p = 0.04, show a significant reduction in the severity of depressive symptoms was found in the experimental group after therapy (13.33 vs. 8.11, p = 0.02). However, the analysis did not show significant differences between group analyses (p = 0.25). It seems that VR reduces the severity of depressive symptoms and reduces the destructive style and can be an effective option in improving the mental state of patients diagnosed with breast cancer.
1 citations
TL;DR: The authors conducted a systematic literature review to assess the met and unmet post-treatment information needs of cancer survivors living in rural communities in Australia, to inform the improvement of survivors' transition from treatment in major cities to community care.
Abstract: To conduct a systematic literature review to critically assess the met and unmet post‐treatment information needs of cancer survivors living in rural communities in Australia, to inform the improvement of survivors' transition from treatment in major cities to community care.
08 Apr 2022
TL;DR: The study shows evidence for appropriateness and high acceptability to clinicians and completers of an existing, frequently used screening instrument in oncological populations, the Distress Thermometer and Problem List (DT and PL), although the effectiveness of the PL may be lower compared to the DT and needs adaptation to better meet the burn survivors’ situation.
Abstract: Burn survivors may benefit from screening for a broad area of problems to improve communication and inform referral needs. Therefore, the aim of this study was to investigate clinical utility aspects such as appropriateness and acceptability to clinicians and completers of an existing, frequently used screening instrument in oncological populations, the Distress Thermometer and Problem List (DT and PL). Methods: Paediatric and adult patients visiting the outpatient clinic after admission to the burn centre were invited to complete the instrument. The DT and (problem domains of) the PL were related and compared to the need to discuss the reported problems. Results: A total of 160 patients were invited to complete the DT and PL, of which 139 agreed. The study shows evidence for appropriateness and high acceptability to clinicians and completers, although the effectiveness of the PL may be lower compared to the DT and needs adaptation to better meet the burn survivors’ situation. Discussion: The use of a screening instrument in the outpatient clinic environment has shown to be appropriate and acceptable and informs clinical practice to identify supportive needs in patients with burns. However, the PL needs to be adapted to the situation of the burn survivors.
02 Mar 2023
TL;DR: In this paper , the psychosocial experiences of 125 rural people accessing cancer services through three health services in rural NSW were evaluated and the findings of this study suggest that cancer patient and carer populations experience concerning levels of psychological distress and barriers to accessing quality healthcare.
Abstract: Abstract Purpose: An increasing body of evidence indicates that people with cancer experience psychosocial concerns across the entirety of their cancer experience from pre-diagnosis to survivorship. These concerns have not just a deleterious effect on their medical journey, but impact more broadly across well-being and, importantly, the well-being of the people that love and care for them. Whilst most oncology research focuses on patients, the role and experiences of families and carers is increasingly recognised as a core component of health service delivery. Methods: This paper outlines an evaluation of the psychosocial experiences of 125 rural people accessing cancer services through three health services in rural NSW. Results: Despite an increasing and improved focus on rural heath equity, and the funding of high-quality rural cancer services over the past decade, the findings of this study suggest that cancer patient and carer populations in rural NSW experience concerning levels of psychological distress and barriers to accessing quality healthcare. Conclusions: The combination of high psychological need for patients and carers with insufficiency and inaccessibility of psychosocial support services have substantial implications for service provision and the psychological wellbeing of those they service. Under-detection of psychosocial need and a lack of support services poses a significant challenge for rural people with cancer and for those that care for them; this must be an urgent priority for quality improvement and equitable health care provision.
References
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TL;DR: The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) initiative developed recommendations on what should be included in an accurate and complete report of an observational study, resulting in a checklist of 22 items (the STROBE statement) that relate to the title, abstract, introduction, methods, results, and discussion sections of articles.
Abstract: Much biomedical research is observational. The reporting of such research is often inadequate, which hampers the assessment of its strengths and weaknesses and of a study's generalisability. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Initiative developed recommendations on what should be included in an accurate and complete report of an observational study. We defined the scope of the recommendations to cover three main study designs: cohort, case-control, and cross-sectional studies. We convened a 2-day workshop in September 2004, with methodologists, researchers, and journal editors to draft a checklist of items. This list was subsequently revised during several meetings of the coordinating group and in e-mail discussions with the larger group of STROBE contributors, taking into account empirical evidence and methodological considerations. The workshop and the subsequent iterative process of consultation and revision resulted in a checklist of 22 items (the STROBE Statement) that relate to the title, abstract, introduction, methods, results, and discussion sections of articles. 18 items are common to all three study designs and four are specific for cohort, case-control, or cross-sectional studies. A detailed Explanation and Elaboration document is published separately and is freely available on the Web sites of PLoS Medicine, Annals of Internal Medicine, and Epidemiology. We hope that the STROBE Statement will contribute to improving the quality of reporting of observational studies.
15,454 citations
TL;DR: The goal of this project was to determine the prevalence of psychological distress among a large sample of cancer patients and variations in distress among 14 cancer diagnoses.
Abstract: Purpose:
The goal of this project was to determine the prevalence of psychological distress among a large sample of cancer patients (n=4496). In addition, variations in distress among 14 cancer diagnoses were examined.
Patients and methods:
The sample was extracted from a database that consists of 9000 patients who completed the Brief Symptom Inventory as a component of comprehensive cancer care. Relevant data points for each case included age, diagnosis, gender, insurance status, marital status, race and zip code. Simple frequencies, percentages, measures of central tendency and variability were calculated. In addition, a univariate and multiple regression analysis was used to examine the relationships of these relevant variables to psychological distress.
Results:
The overall prevalence rate of distress for this sample was 35.1%. The rate varied form 43.4% for lung cancer to 29.6% for gynecological cancers. While some rates were significantly different, diagnoses with a poorer prognosis and greater patient burden produced similar rates of distress. Pancreatic cancer patients produced the highest mean scores for symptoms such as anxiety and depression, while Hodgkin's patients exhibited the highest mean scores for hostility
Conclusions:
These results offer vital support for the need to identify high-risk patients through psychosocial screening in order to provide early intervention. To simply perceive cancer patients as a homogeneous group is an erroneous assumption. Failure to detect and treat elevated levels of distress jeopardizes the outcomes of cancer therapies, decreases patients' quality of life, and increases health care costs. Copyright © 2001 John Wiley & Sons, Ltd.
2,378 citations
TL;DR: The prevalence of depression in cancer patients throughout the course of cancer is reviewed, finding that depression is highly associated with oropharyngeal, pancreatic, breast, and lung cancers and a less high prevalence is reported in patients with other cancers.
Abstract: Depression is the psychiatric syndrome that has received the most attention in individuals with cancer. The study of depression has been a challenge because symptoms occur on a broad spectrum that ranges from sadness to major affective disorder and because mood change is often difficult to evaluate when a patient is confronted by repeated threats to life, is receiving cancer treatments, is fatigued, or is experiencing pain. Although many research groups have assessed depression in cancer patients since the 1960s, the reported prevalence (major depression, 0%-38%; depression spectrum syndromes, 0%-58%) varies significantly because of varying conceptualizations of depression, different criteria used to define depression, differences in methodological approaches to the measurement of depression, and different populations studied. Depression is highly associated with oropharyngeal (22%-57%), pancreatic (33%-50%), breast (1.5%-46%), and lung (11%-44%) cancers. A less high prevalence of depression is reported in patients with other cancers, such as colon (13%-25%), gynecological (12%-23%), and lymphoma (8%-19%). This report reviews the prevalence of depression in cancer patients throughout the course of cancer.
1,309 citations
TL;DR: Given that levels of anxiety and depression varied widely by cancer type, gender, and age, these results inform which cancer patients are most likely in need of psychosocial support.
896 citations
TL;DR: Screening for depression should be routinely conducted in the cancer treatment setting and research is needed on whether the treatment of depression could, beyond enhancing quality of life, extend survival of depressed cancer patients.
Abstract: BackgroundThe goal of the present study was to analyze associations between depression and mortality of cancer patients and to test whether these associations would vary by study characteristics.MethodMeta-analysis was used for integrating the results of 105 samples derived from 76 prospective studies.ResultsDepression diagnosis and higher levels of depressive symptoms predicted elevated mortality. This was true in studies that assessed depression before cancer diagnosis as well as in studies that assessed depression following cancer diagnosis. Associations between depression and mortality persisted after controlling for confounding medical variables. The depression–mortality association was weaker in studies that had longer intervals between assessments of depression and mortality, in younger samples and in studies that used the Beck Depression Inventory as compared with other depression scales.ConclusionsScreening for depression should be routinely conducted in the cancer treatment setting. Referrals to mental health specialists should be considered. Research is needed on whether the treatment of depression could, beyond enhancing quality of life, extend survival of depressed cancer patients.
827 citations