Response shift in the assessment of anxiety, depression and perceived health in urologic cancer patients: an individual perspective.

The assessment of quality of life in cancer patients is hampered because patients may change their frames of reference during the course of the disease. The aim of this study was to test individual differences in these response shift effects. Urologic cancer patients (n= 275) were examined during the stay in the hospital (T1), 2 weeks later (T2) and 3 months later (T3). Furthermore, at T3 they were asked to retrospectively assess their situation at T1 (then-test). The difference between this retrospective assessment and the original assessment at T1 was used to determine the response shift effect (recalibration). Anxiety (Generalized Anxiety Disorder Questionnaire-2), depression (Patient Health Questionnaire-2) and health dissatisfaction (Questionnaire on Life Satisfaction) were obtained at all points in time. The effect sizes of the mean response shift effects (recalibration) ranged between 0.26 and 0.48. Nevertheless, a large proportion of the sample showed no response shift (22-38%) or even negative response shift effects (20-30%). There were significant correlations among the response shift measures of the domains (anxiety, depression and health dissatisfaction) with coefficients between 0.29 and 0.51. The results indicate that response shift should not only be assessed on the mean score level, since it is also a dimension of individual difference.

[Regional and individual factors of stress experience in Germany: results of a representative survey with the perceived stress questionnaire (PSQ)]. / Regionale und individuelle Faktoren von Stresserleben in Deutschland: Ergebnisse einer repräsentativen Befragung mit dem Perceived Stress Questionnaire (PSQ).

AIM: The aim of the present study was to define, besides prevalence data, regional and individual factors of stress experience in a representative sample of the German general population. METHODS: Regional factors were examined separately by federal state and the size of the political location. Individual factors were defined according to the severity of the stress experience as well as on the basis of central social factors such as family state, profession and earnings. The Perceived Stress Questionnaire (PSQ), a validated, self-evaluation process for recording a subjective representation of frequency estimates of stress experiences was used. Data acquisition was carried out by a market research institute in a multi-topic questionnaire (N=2,552). Households were selected by the random route procedure, target persons were also selected at random. RESULTS: The prevalence rate for an elevated stress experience was 14.5%, that for a very high stress experience 3.1% of the sample. People without education exhibited the highest rates of stress experience (36.8%), followed by the unemployed (30.6%). Individual and social factors that favour an increased stress experience are a subjectively poor state of health (OR: 3.42) or belonging to the lower social economic status (OR: 1.30). Furthermore, there are indications of regional factors such as size of the location as well as differences between the individual federal states. An east-west comparion did not show any significant differences with regard to stress experiences. CONCLUSION: In the light of the illness burden associated with chronic stress situations, preventative measures in cases of unemployment or low level of education should be given priority.

[Life satisfaction and subjective importance of life domains in schizophrenia patients: the role of partnership and parenthood]. / Lebenszufriedenheit und subjektive Relevanz von Lebensbereichen bei schizophren Erkrankten.

OBJECTIVE: The aim is to analyze determinants of subjective quality of life in schizophrenia patients. METHODS: Life satisfaction and subjective importance of life domains were assessed in 107 patients (FLZ (M)) and compared with the general population (n = 2974). RESULTS: Schizophrenia patients experience lower levels of life satisfaction as well as less meaningfulness in all life domains. According to the range-of-affect hypothesis, patients with low importance ratings judged their life satisfaction more homogenously. While the presence of a partnership increases life satisfaction, parenthood has only indirect influences on satisfaction. CONCLUSION: Psychiatrists should not only explore life satisfaction, but also the importance of different life domains and the patient's family relations. Supporting beneficial family relations can increase the quality of life in schizophrenia patients.

[Is health really the most important value? - Results of a representative survey of the German general population concerning the subjective meaning of health]. / Ist Gesundheit das höchste Gut? - Ergebnisse einer bevölkerungsrepräsentativen Umfrage zur subjektiven Bedeutung von Gesundheit.

INTRODUCTION: The aim of this study was to investigate which meaning is attributed to health by the general population. Furthermore, the relationship between health satisfaction and health importance was also analysed. METHOD: A sample of 4,808 representatively selected subjects from the general German population judged the importance and the satisfaction with several life domains, including health, using the questions on life satisfaction FLZ (M). Moreover, sociodemographic variables (sex, age, socioeconomic status) and psychological variables (self-esteem, resilience, anxiety and depression) were collected. RESULTS: Health is the most important life domain. The importance of health increases with increasing age. However, there are no sex differences and SES (socio-economic status) differences concerning the importance of health. Subjective satisfaction with health and health importance are only marginally correlated (r=0.08). High degrees of self-esteem and resilience are associated with a high importance of health. Anxiety and depression show only weak relationships to the importance of health. CONCLUSIONS: In the German general population health has a very high subjective significance. This is not only true for handicapped or ill people, but for all subsamples of the society. Therefore, a general plea for an understanding of the importance of health is not necessary, not even for subgroups. Preventive activity can be based on the general understanding of the meaning of health, but it should pursue specific health- related goals for target groups.

Fatigue assessment questionnaire: standardization of a cancer-specific instrument based on the general population.

OBJECTIVES: Fatigue has become a major issue of concern in the care of cancer patients, as it has been shown to compromise their quality of life in a significant and lasting way. However, there is a lack of economic and specific measures. The Fatigue Assessment Questionnaire (FAQ) has been developed based on thorough interviews and tested on a large mixed sample of cancer patients. The purposes of this paper are to test the psychometric properties of the FAQ and to provide norms for the German population. METHODS: The FAQ was administered to a representative sample of the German population (1,340 female and 1,101 male participants) along with standardized scales of depression, mood and life satisfaction. RESULTS: We could confirm that fatigue is multidimensional and can be measured by the scales of physical, affective and cognitive fatigue with good reliability and validity. The dependency of fatigue on sex and age makes it useful to have standard fatigue scores for oncological research as provided in this paper. CONCLUSION: The FAQ is a promising, differentiated, yet economic instrument for further use in oncological research.

[Severity of chronic back pain. Assessment with the Mainz Pain Staging System]. / Schmerzchronifizierung bei ambulanten Rückenschmerzpatienten. Anwendung des Mainzer Stadienmodells der Schmerzchronifizierung.

BACKGROUND: Among the possible reasons for low back pain, psychological factors are getting more attention. Early assessment of the stage of chronicity is important for successful therapy. The aim of the present study was to analyse the applicability of the Mainz Pain Staging System (MPSS) for chronic back pain outpatients. METHODS: Each of 679 back pain outpatients were assigned to one of the three MPSS stages of chronic back pain severity. Pain intensity and duration, anxiety and depression, pain sensation, impression of control and muscular capacity (isometric power of lumbal extensor), number of clinical consultations, hospitalisation, and days of work inability were also recorded. RESULTS: Males and females showed levels of chronic pain increasing with age. Patients with high MPSS levels showed significantly higher mean scores for anxiety, depression, number of consultations, hospitalisation, and days of inability to work. Furthermore, the same patients showed lower impressions of control and muscular capacity. CONCLUSIONS: The present study confirms the significance and usefulness of the MPSS applied to outpatients with back pain. To assess completely the stage of chronicity, psychological and physical/functional parameters should also be obtained.