Psychological symptoms of illness and emotional distress in advanced cancer cachexia

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Koji Amano ◽  
Jane Hopkinson ◽  
Vickie Baracos
Keyword(s):  
Advanced Cancer ◽  
Emotional Distress ◽  
Cancer Cachexia ◽  
Psychological Symptoms

Lifestyle Interference And Emotional Distress In Family Caregivers Of Advanced Cancer Patients

2002 ◽  
Author(s):  
Jill I. Cameron ◽  
Renee-Louise Tranche ◽  
Angela M. Cheung ◽  
Donna E. Stewart
Keyword(s):  
Cancer Patients ◽  
Family Caregivers ◽  
Advanced Cancer ◽  
Emotional Distress ◽  
Advanced Cancer Patients

scholarly journals Family caregiver emotional distress in advanced cancer: the DME-C scale psychometric properties

2020 ◽  
pp. bmjspcare-2020-002608
Author(s):  
Joaquín T Limonero ◽  
Jorge Maté-Méndez ◽  
María José Gómez-Romero ◽  
Dolors Mateo-Ortega ◽  
Jesús González-Barboteo ◽  
...  
Keyword(s):  
Psychometric Properties ◽  
End Of Life ◽  
Family Caregivers ◽  
Advanced Cancer ◽  
Emotional Distress ◽  
Family Caregiver ◽  
Screening Tools ◽  
Anxiety And Depression ◽  
The Family ◽  
End Stage

BackgroundFamily caregivers of patients with advanced illness at end of life often report high levels of emotional distress. To address this emotional distress is necessary to have adequate and reliable screening tools.AimThis study analyses the psychometric properties and clinical utility of the Family Caregiver Emotional Detection Scale for caregivers of patients with end-stage cancer (DME-C, Spanish acronym) who are receiving palliative care (PC).DesignMulticentre, cross-sectional study.Settings/participantsFamily caregivers of patients with advanced cancer at end of life receiving palliative treatment were interviewed to explore their emotional distress through the DME-C scale and other instruments measuring anxiety and depression (Hospital Anxiety and Depression Scale (HADS)), distress thermometer (DT) and overload (B), as well as a clinical psychological assessment (CPA).Results138 family caregivers, 85 (61.6%) female and 53 (38.4%) male, with an average age of 59.69±13.3 participated in the study. The reliability of the scale, as measured by Cronbach’s alpha, was 0.76, and its stability over time was 0.734. Positive, significant correlations were found between the DME-C and the scores for anxiety and depression registered on the HADS scale, as well as with the total result of this latter scale and the results for B, the DT and the CPA. A statistical analysis of the receiver-operating characteristic curves showed that the scale has a sensitivity and specificity of 75%, and that the cut-off point for the detection of emotional distress was a score ≥11. Fifty-four per cent of the caregivers displayed emotional distress according to this scale.ConclusionsThe DME-C displays good psychometric properties. It is simple, short, reliable and easy to administer. We believe that the instrument is useful for the detection of emotional distress in the family caregivers of hospitalised patients suffering from end-stage illnesses and receiving PC.

scholarly journals Emotional Distress in Cancer Patients During the First Wave of the COVID-19 Pandemic

2021 ◽  
Vol 12 ◽  
Author(s):  
Patricia Toquero ◽  
Carmen Blanco Fernández ◽  
María Pilar López Martí ◽  
Berta Hernández Marín ◽  
E. Beatriz Vera Cea ◽  
...  
Keyword(s):  
Mental Health ◽  
Cancer Patients ◽  
Emotional Distress ◽  
Mental Health Problems ◽  
Psychological Symptoms ◽  
Univariate Analysis ◽  
Depression Scale ◽  
Tumor Type ◽  
Prevention Measures ◽  
Psychological Symptomatology

Background: The COVID-19 pandemic has caused mental health problems worldwide. The psychopathological implications of COVID-19 in cancer patients have rarely been addressed. Considering the increased vulnerability of oncology patients, this issue needs to be addressed to improve the long-term mental health status of these patients.Methods: We conducted a prospective study in outpatients under active cancer treatment during the first wave of the COVID-19 pandemic. A semi-structured 24-question survey was designed to measure baseline sociodemographic, psychosocial and COVID-19 exposure characteristics. The Hospital Anxiety and Depression Scale was used to measure psychological symptoms. A descriptive and analytical univariate analysis of the variables studied was performed. We used the Z-score to compare different populations (experimental and historical control cohort).Results: 104 patients were included, the majority of which were women (64.4%), were above 65 years of age (57.7%), had either lung and breast cancer (56.7%), had advanced disease (64%) and were undergoing chemotherapy (63.5%). 51% of them expressed greater fear of cancer than of COVID-19 infection or both.In relation to HADS, 52.8% of emotional distress, 42.3% of anxiety and 58.6% of depression rates were detected. The main factors related with higher rates of psychological symptomatology were history of previous psychotropic drug consumption and the adoption of additional infection prevention measures because they considered themselves at risk of severe COVID-19 infection (p = 0.008; p = 0.003 for emotional distress, p = 0.026; p = 0.004 for anxiety, and p = 0.013; p = 0.008 for depression). Tumor type, stage, oncologic treatment or rescheduling of cancer treatments were not related to higher levels of psychological symptomatology.Comparison of our results with another population of similar characteristics was not significant (Z score = −1.88; p = 0.060).Conclusions: We detected high rates of emotional distress during the first wave of the COVID-19 pandemic among cancer patients in active treatment (52.8%). This was higher and clinically relevant than observed in a comparable population (42.5%), although not significant. Cancer itself is the main factor of concern for cancer patients, above and beyond the emotional distress generated by COVID-19 pandemic.

scholarly journals A pilot randomised controlled trial to reduce suffering and emotional distress in patients with advanced cancer

2013 ◽  
Vol 148 (1) ◽  
pp. 141-145 ◽  
Author(s):  
Mari Lloyd-Williams ◽  
Mark Cobb ◽  
Christina O'Connor ◽  
Laurie Dunn ◽  
Chris Shiels
Keyword(s):  
Randomised Controlled Trial ◽  
Advanced Cancer ◽  
Emotional Distress ◽  
Controlled Trial ◽  
Pilot Randomised Controlled Trial ◽  
Randomised Controlled

Emotional stress in the aetiology of cancer

1972 ◽  
Vol 61 (02) ◽  
pp. 87-98
Author(s):  
James Hamilton
Keyword(s):  
General Practice ◽  
Psychological Stress ◽  
Emotional Distress ◽  
Emotional Stress ◽  
Malignant Disease ◽  
Psychological Symptoms ◽  
Scientific Study ◽  
Psychosomatic Disease

Summary1 This paper is based on a study of sixteen patients suffering from various forms of cancer. These patients were found in general practice.2 In these patients the malignant disease was found in breasts, stomach, colon, rectum, uterus, larynx and lungs.3 It was found that these sixteen patients had histories of both somatic and psychological illnesses for varying periods before the presence of cancer was detected. None had a clean bill of health before the onset of cancer.4 A study and assessment of the personalities of the patients were made. These referred to the periods before and during the development of cancer.5 The presence of psychological symptoms resulting from emotional stress previous to the development of cancer was noted in all cases.6 It was noted that in many patients, the symptoms of cancer developed gradually and were aggravated during periods of severe emotional distress.7 The psychological stress produced symptoms predominantly related to fear, anxiety, apprehension, grief and depression, anger and resentment.8 The hypothesis that, from a study of these sixteen patients, cancer may have the characteristics of a psychosomatic disease, was explored.9 It would appear from the evidence of these cases that a more detailed scientific study of cancer cases would be profitable, to asses with greater precision the hypothesis that unpleasant emotional stress plays a part in the aetiology of at least some forms of cancer.

Outcomes of prognostic disclosure: Effects on advanced cancer patients’ prognostic understanding, mental health, and relationship with their oncologist.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 9519-9519 ◽  
Author(s):  
Andrea Catherine Enzinger ◽  
Baohui Zhang ◽  
Tracy A. Balboni ◽  
Deborah Schrag ◽  
Holly Gwen Prigerson
Keyword(s):  
Psychological Distress ◽  
Life Expectancy ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Psychological Symptoms ◽  
Substantial Improvement ◽  
Wilcoxon Test ◽  
Advanced Cancer Patients ◽  
Incurable Cancer ◽  
Symptoms Of Depression

9519 Background: Many oncologists are reluctant to discuss life expectancy with advanced cancer patients. We examined the frequency of prognostic disclosure and its impact on patients’ prognostic understanding, the patient-doctor relationship, and psychological distress. Methods: Coping with Cancer was an NCI-funded, multi-site prospective cohort of 726 patients with advanced incurable cancer, enrolled 2002-2008. At baseline, patients were asked if their oncologist had ever discussed prognosis, and if so what estimate was communicated. Patients also estimated their prognosis. The therapeutic alliance scale measured patient-doctor relationship, and the McGill QOL instrument assessed symptoms of depression and anxiety. Multivariable analyses (MVA) assessed relationships between prognostic disclosure and psychological symptoms, controlling for confounds. Results: Among this cohort of terminally ill patients (median survival 4mos), most (72%) wanted to be told their life expectancy. Only 19.8% (104/525) of patients had received a prognostic estimate from their oncologist (median estimate 6mos; IQR 6-15mos). When queried about factors informing their prognostic understanding, 85.9% of patients cited personal or religious beliefs; only 11.7% cited a physician’s estimate. Of the 299 patients willing to estimate their life expectancy, patients who had been previously informed of their prognosis were substantially more realistic in their own estimate (median 12mos v 48mos, Wilcoxon test p<0.001). Moreover, patients’ and oncologists’ prognostic estimates were significantly correlated (ρ=0.49, p<0.001). Prognostic disclosure was not associated with poor patient-doctor relationship rating (Fisher’s Exact, p=0.625), nor was it associated with depressive symptoms (β 0.06, p=0.242) or anxiety (β 0.06, p=0.234) in MVA. Conclusions: Few advanced cancer patients are informed of their life expectancy, although most want this information. Prognostic disclosure is associated with substantial improvement in patients’ prognostic understanding, without compromising the patient-doctor relationship or increasing psychological distress.

A systematic and interdisciplinary approach to the measurement of outcomes over the disease trajectory in a unique specialized cachexia clinic.

2014 ◽  
Vol 32 (31_suppl) ◽  
pp. 25-25
Author(s):  
Jonathan di Tomasso ◽  
Lorella Ciutto ◽  
Sabrina Cesare ◽  
Irina Uscatescu ◽  
Kevin Yu-Chueh ◽  
...  
Keyword(s):  
Functional Status ◽  
Advanced Cancer ◽  
Cancer Cachexia ◽  
Handgrip Strength ◽  
Locally Advanced ◽  
Interdisciplinary Approach ◽  
Assessment System ◽  
Positive Trend ◽  
Over Time

25 Background: Cancer cachexia affects 60-80% of advanced cancer patients and leads to weight loss, worsening functional status, and increased mortality. Thus, specialized clinics are needed to measure nutritional and functional trajectories over time in this population. Recently, the McGill University Health Centre has developed a systematic, standardized and interdisciplinary approach for the profiling and management of cancer cachexia. Methods: Patients with advanced cancer were recruited and categorized as cachetic. The following information was collected at baseline and at three follow-up visits: hand grip strength measured by Jamar dynamometer, the Edmonton Symptom Assessment System (ESAS) and the abridged Patient Generated Subjective Global Assessment (aPG-SGA) questionnaires. Results: Fifty-nine patients were eligible for this study yet only 24 completed 3 follow-ups and were included. There were 15 men and 9 women, mean age 65.7 years. Five patients had locally advanced disease and 19 had metastatic disease. The table contains results for handgrip strength, ESAS and aPG-SGA scores. Conclusions: Following baseline assessment and treatment, patients were noted to have a significant improvement in the aPG-SGA total score. Handgrip strength was maintained throughout the follow up period. ESAS appetite and fatigue exhibited a positive trend but did not achieve significance over time. This work suggests the benefits of an interdisciplinary cachexia clinic for the maintenance of nutritional and functional status in patients with cancer cachexia as well as possible improvements in quality of life. [Table: see text]

Symptom burden in hospitalized patients with advanced cancer.

2015 ◽  
Vol 33 (29_suppl) ◽  
pp. 100-100 ◽  
Author(s):  
Samantha M.C. Moran ◽  
Areej El-Jawahri ◽  
William F. Pirl ◽  
Lara Traeger ◽  
Pallavi Kumar ◽  
...  
Keyword(s):  
Advanced Cancer ◽  
Hospital Admissions ◽  
Psychological Symptoms ◽  
Massachusetts General Hospital ◽  
Symptom Burden ◽  
Hematologic Malignancies ◽  
Psychological Needs ◽  
Physical Symptoms ◽  
Hospitalized Patients ◽  
Assessment System

100 Background: Patients with advanced cancer experience high rates of both physical and psychological morbidity, but data describing patients’ symptoms during hospital admissions are lacking. We sought to describe symptom burden in hospitalized patients with incurable solid and hematologic malignancies. Methods: We prospectively enrolled patients with incurable cancers admitted to the Massachusetts General Hospital from 9/1/2014 through 5/1/2015. Within the first week of their admission, we assessed physical and psychological symptoms using the Edmonton Symptom Assessment System-revised (ESAS-r). Beginning 11/15/2015, we also administered the Patient Health Questionnaire 4 (PHQ-4), scored categorically. Results: We enrolled 457 of 547 (84%) eligible patients. Participants (mean age=63.8 years; n=231, 51% female) had the following malignancies: gastrointestinal (n=149, 33%), lung (n=77, 17%), genitourinary (n=52, 11%), breast (n=33, 7%), hematologic (n=24, 5%), and other solid tumors (n=122, 27%). Using the ESAS-r, tiredness, drowsiness, anorexia, and pain were the most common severe symptoms. Using the PHQ-4, approximately one-third of participants screened positive for depression (91/271, 34%) and anxiety (86/273, 32%). Conclusions: Hospitalized patients with incurable solid and hematologic malignancies experience substantial physical and psychological symptoms. Most patients reported at least moderate tiredness, drowsiness, anorexia and pain. Additionally, a concerning proportion reported depression and anxiety. Our data demonstrate the need for efforts to alleviate the physical symptoms experienced by this population, while also seeking to understand and address their psychological needs. [Table: see text]

Advanced cancer patients’ changes in terminal illness understanding (TIU) and their psychological well-being.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 11617-11617
Author(s):  
Login S. George ◽  
Megan Johnson Shen ◽  
Paul K. Maciejewski ◽  
Andrew S. Epstein ◽  
Holly Gwen Prigerson
Keyword(s):  
Life Expectancy ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Psychological Symptoms ◽  
Treatment Decision ◽  
Well Being ◽  
Advanced Cancer Patients ◽  
Psychological Well Being ◽  
Change Scores

11617 Background: Although accurate TIU is necessary for informed treatment decision-making, clinicians worry that patients’ recognition of the terminal nature of their illness may lower psychological well-being. This study examines if such recognition is associated with lowered psychological well-being, that persists over time. Methods: Data came from 87 advanced cancer patients, with a life expectancy of less than 6 months. Patients were assessed pre and post an oncology visit to discuss cancer restaging scan results, and again one month later (follow-up). TIU was assessed at pre and post as the sum of four indicator variables — understanding of terminal nature of illness, curability, stage, and life-expectancy — and a TIU change score was computed (post minus pre). Psychological well-being (psychological symptoms subscale, McGill questionnaire) was assessed at pre, post, and follow-up, and two change scores were computed (post minus pre; follow-up minus post). Results: Changes toward more accurate TIU was associated with a corresponding decline in psychological well-being ( r = -0.33, p < .01), but thereafter was associated with subsequent improvements in psychological well-being ( r = .40, p < .001). This pattern persisted even after adjustment for relevant demographic factors, prognostic discussion, scan results, and physical well-being change. TIU change scores ranged from positive to negative, with some participants showing improvements in TIU ( n = 19), some showing decrements in TIU ( n = 14), and others showing stable TIU ( n = 54). Among patients with improved TIU, psychological well-being initially decreased, but subsequently recovered [7.03 (2.23) to 6.30 (1.80), to 7.63 (2.08)]; the stable TIU group showed relatively unchanged well-being [7.34 (2.37) to 7.45 (2.32), to 7.36 (2.66)], and the less accurate TIU group showed an initial improvement followed by a subsequent decline [6.30 (2.62) to 7.36 (2.04), to 5.63 (3.40)]. Conclusions: Improved TIU may be associated with initial decrements in psychological well-being, followed by patients rebounding to baseline levels. Concerns about psychological harm may not need to be a deterrent to having prognostic discussions with patients.

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