Assessment of psychological distress and its associated factors among patients with cancer undergoing chemotherapy in rural Bangladesh.

Background: Psychological distress may worsen during cancer treatment and affect well-being. Information on the prevalence of distress and its associated variables in cancer patients undergoing chemotherapy in rural Bangladesh has not been thoroughly explored. To address this, we aimed to assess psychological distress and its associated factors in patients with cancer undergoing chemotherapy. Methods: This cross-sectional study was conducted at a tertiary care hospital in rural Bangladesh. Only adult patients with cancer who were receiving chemotherapy were enrolled in this study. The validated Depression Anxiety Stress Scale was used to assess psychological distress. Frequency and percentages were used in descriptive analysis, and logistic regression analysis was performed to investigate potential associated factors for depression, anxiety, and stress. Results: Participants comprised 415 patients with a mean age of 46.3 years. The prevalence of depression, anxiety, and stress was 61.5%, 55.4%, and 22.0%, respectively. In the multivariate logistic regression analysis, patients with more than five family members and smokeless tobacco users had a significant association with depression, anxiety, and stress. In contrast, participants aged >60 years had a protective association with depression. Conclusions: Our findings show that patients with cancer receiving chemotherapy experience a high prevalence of depression and anxiety and that the use of smokeless tobacco and having six or more family members are associated with psychological distress. These findings will aid health professionals and policymakers in establishing and implementing improved care programs to ensure the greater mental health of cancer survivors, particularly in resource-limited settings.

A scoping review of cognitive assessment tools and domains for chemotherapy-induced cognitive impairments in cancer survivors.

Backgrounds: Cancer survivors suffer from specific symptoms known as chemotherapy-induced cognitive impairments (CICIs). CICIs are difficult to capture with existing assessments such as the brief screening test for dementia. Although recommended neuropsychological tests (NPTs) exist, international consensus and shared cognitive domains of assessment tools are unknown. The aim of this scoping review was as follows: (1) to identify studies that assess CICIs in cancer survivors; (2) to identify shared cognitive assessment tools and domains by mapping the domains reported in studies using the International Classification of Functioning, Disability and Health (ICF) framework. Methods: The study followed the recommendations made by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. We searched the following three databases through October 2021: PubMed, CINAHL, and Web of Science. Prospective longitudinal or cross-sectional studies were selected to determine CICI-specific assessment tools for adult cancer survivors. Results: Sixty-four prospective studies (36 longitudinal studies and 28 cross-sectional studies) were included after checking for eligibility. The NPTs were divided into seven main cognitive domains. The specific mental functions were often used in the order of memory, attention, higher-level cognitive functions, and psychomotor functions. Perceptual functions were used less frequently. In some ICF domains, shared NPTs were not clearly identified. In some different domains, the same NPTs were used, such as the trail making test and the verbal fluency test. When the association between the publishing year and the amount of NPT use was examined, it was found that the amount of tool use tended to decline over the publication years. The Functional Assessment of Cancer Therapy-Cognitive function (FACT-Cog) was a shared consensus tool among the patient-reported outcomes (PROs). Conclusion: Chemotherapy-induced cognitive impairments are currently gaining interest. Shared ICF domains such as memory and attention were identified for NPTs. There was a gap between the publicly recommended tools and the tools actually used in the studies. For PROs, a clearly shared tool, FACT-Cog, was identified. Mapping the domains reported in studies using the ICF can help in the process of reviewing consensus on which NPTs may be used to target cognitive domains. Systematic review registration: https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000053710, identifier UMIN000047104.

Association Between Subjective Voice Assessment and Psychological Distress After Thyroidectomy.

PURPOSE: This study aimed to determine the association between postoperative subjective voice function and psychological distress in patients without laryngeal nerve injury after thyroidectomy. DESIGN: A prospective cohort study. METHODS: We investigated the factors associated with subjective voice function in patients who underwent thyroidectomy without laryngeal nerve injury between October 2018 and July 2020. The Voice Handicap Index was used to assess subjective voice function, the GRBAS (grade, roughness, breathiness, asthenia, strain) scale to assess objective voice, and the Hospital Anxiety and Depression Scale to assess psychological distress. FINDINGS: Among 39 patients who underwent thyroidectomy, 32 had no postoperative laryngeal nerve injury. Postoperative Voice Handicap Index was significantly associated with Hospital Anxiety and Depression Scale-Anxiety score after surgery (rs = 0.448, P = .010). CONCLUSIONS: In this study, an association was observed between subjective voice function and anxiety following surgery. The finding suggested that nurses and medical practitioners need to consider postoperative anxiety when evaluating patients' voice function after thyroidectomy.

Validation of the Japanese Version of the Functional Assessment of Cancer Therapy-Cognitive Function Version 3.

CONTEXT: Cancer therapy-induced cognitive impairment adversely affects the quality of life of patients with cancer but cannot be detected by neuropsychological tests. OBJECTIVES: This study aimed to validate a Japanese version of the Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog) version 3, which is a self-report measure of the cognitive concerns of patients with cancer. METHODS: The FACT-Cog was translated into Japanese and pilot tested with five patients with breast cancer and five patients with hematologic malignancy. Study participants were recruited in Hiroshima University Hospital and Kagawa Breast Clinic in Hiroshima, Japan. Patients with breast cancer (N = 236) responded to the resultant assessment and Functional Assessment of Cancer Therapy-General version 4. The internal consistency and concurrent and construct validity of the FACT-Cog were examined. RESULTS: The Cronbach's alphas of the four FACT-Cog subscales, namely, CogPCI, CogOth, CogPCA, and CogQOL, were 0.95, 0.73, 0.93, and 0.88, respectively. The item-to-domain correlations ranged from 0.211 to 0.920. Most of the FACT-Cog subscales were significantly correlated with other subscale and total scores (r = 0.133-0.425). Structural equation modeling was barely acceptable (χ2 = 1361.8, df = 489, P < 0.001; goodness of fit index = 0.731, adjusted goodness of fit index = 0.691, comparative fit index = 0.848, root-mean-square error of approximation = 0.087). CONCLUSION: The Japanese version of the FACT-Cog is a valid and reliable self-report measure of the cognitive function of patients with breast cancer. Its utility to clinicians and researchers in measuring the cognitive concerns of patients with cancer in Japan will serve as a further test of its validity.

Clinical usefulness of the Frontal Assessment Battery at bedside (FAB) for elderly cancer patients.

BACKGROUND: The number of elderly cancer patients has been rising in recent years, and decreases in cognitive function are reportedly seen in 25-50% of these patients. However, no validated and practical tests are available for the assessment of cognitive function in cancer patients. Age and the effects of cancer treatment have been pointed out as possible causes of these decreases in cognitive function; in both instances, a strong possibility of a decrease in frontal lobe function exists. METHODS: We administered the Frontal Assessment Battery at bedside (FAB), the Mini-Mental State Examination (MMSE), the Barthel Index, and the Instrumental Activities of Daily Living (IADL) to 54 cancer patients who were 65 years of age or older and assessed the clinical usefulness of the FAB. RESULTS: The results showed that the FAB scores were significantly correlated with the MMSE and IADL scores and were unaffected by the number of years of education. Moreover, when the subjects were divided into two groups according to whether their total FAB score was less than 16 points or 16 points or more, significant differences in the total MMSE scores and the total IADL scores were observed. CONCLUSIONS: Based on these findings and because the FAB sensitively detected decreases in cognitive function, accurately reflected the status of everyday life, and could be performed conveniently and in a short time, we concluded that the FAB may be very useful clinically as a means of evaluating the cognitive function of elderly cancer patients.

Importance of rehabilitation in cancer treatment and palliative medicine.

Although rehabilitation for cancer patients is being practiced in clinical settings, it has not been very well recognized in cancer care. However, interest has been turning to cancer rehabilitation in recent years in association with advances in palliative care and the increasing numbers of patients who survive for long periods, while enduring symptoms caused by cancer or adverse effects associated with treatment. The fact that cancer patient rehabilitation fees were newly established in the 2010 revision of the Japanese medical service fees has propelled interest in this topic. Rehabilitation can be applied throughout the entire phase from the time of diagnosis to the terminal stage, and it is an approach that can involve psychosocial aspects as well as physical aspects. Although its effectiveness has not been adequately demonstrated, especially in the area of palliative medicine, rehabilitation for cancer patients is expected to be an important means of supporting the hopes of patients and their families, and attempting to maintain and improve patients' quality of life.

Factors affecting the sense of burden felt by family members caring for patients with mental illness.

The purpose of this study was to identify factors that affect the sense of burden felt by family members caring for patients with mental illness at home in Japan. This study was conducted by using the cross-sectional method, and a questionnaire was delivered to 30 patients and 30 family caregivers. A multiple regression analysis was conducted, with sense of burden as the dependent variable and variables showing a significant correlation in the univariate analysis as the independent variables. The results of the study revealed that patients' satisfaction with daily life and ability to perform tasks had a strong impact on the sense of burden felt by the caregivers. These results suggest that providing support that enhances the quality of life of the patients with mental illness may indirectly help reduce the sense of burden felt by family members caring for them.

Assessment of degree of satisfaction of cancer patients and their families with rehabilitation and factors associated with it--results of a Japanese population.

PURPOSE: To evaluate the effectiveness of rehabilitation from the standpoint of both cancer patients and their families and their degree of satisfaction with it and to assess factors associated with their degree of satisfaction. METHOD: The subjects were 23 inpatients for whom rehabilitation had been prescribed during the period of the survey, and their families. Degree of satisfaction with rehabilitation and associated factors were assessed using questionnaires by both patients and their families twice: Before and 2 weeks after the start of rehabilitation. RESULTS: The mean scores for degree of patient satisfaction and degree of family satisfaction were 8.6 and 7.7 (0-10), respectively. Awareness of rehabilitation (after rehabilitation), willingness for rehabilitation (before and after rehabilitation), emotional state (before and after), effectiveness of rehabilitation, and communication with staff were significantly correlated with degree of patient satisfaction. Emotional state of the patient (before), change in emotional state of the patient, family awareness of rehabilitation (after), change in emotional state of the family, and communication with staff were significantly correlated with degree of family satisfaction. CONCLUSIONS: The results indicated that both the cancer patients and their families were satisfied with rehabilitation. They also suggested a need to understand and provide care for the emotional state of patients and their families in order to increase their degree of satisfaction, and a need for adequate explanation and active involvement to increase awareness and willingness in regard to rehabilitation.

Endometrial carcinoma in adenomyosis: assessment of myometrial invasion on T2-weighted spin-echo and gadolinium-enhanced T1-weighted images.

OBJECTIVE: The aim of our study was to compare T2-weighted and contrast-enhanced dynamic T1-weighted images with histologic findings in assessing the depth of myometrial invasion by endometrial carcinoma in adenomyosis. MATERIALS AND METHODS: We retrospectively reviewed the MRIs of 11 patients who had a total of 12 lesions of endometrial carcinoma within adenomyosis. T2-weighted and contrast-enhanced dynamic T1-weighted images were compared with the histologic findings separately. We assessed the extent of myometrial invasion by endometrial carcinomas. The depth of myometrial invasion seen on MRI was classified as stage S (superficial invasion), stage D (deep invasion), or undetectable. The staging accuracies of each sequence were assessed. The tumor-myometrium contrast-to-noise ratios were calculated for each sequence. RESULTS: The histologic specimens revealed that myometrial invasion was deep in seven of 12 lesions and superficial in five. On T2-weighted images the depth of invasion was underestimated in two lesions and impossible to determine in five lesions. On dynamic T1-weighted images the depth of invasion was overestimated in one lesion and underestimated in one lesion. The staging accuracy on dynamic T1-weighted images (83%) was significantly higher than that on T2-weighted images (42%). The contrast-to-noise ratio was significantly higher on dynamic T1-weighted studies during the early phase (mean +/- SD, 2.68 +/- 0.94) than it was on T2-weighted studies (1.74 +/- 1.05) and during the delayed phase (2.01 +/- 0.86). CONCLUSION: When adenomyosis coexists with endometrial cancer at the same site on T2-weighted images, contrast-enhanced dynamic T1-weighted imaging improves the accuracy of staging.