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1.
Ann Hematol ; 103(6): 2113-2121, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38578507

RESUMEN

Acquired aplastic anemia (AA) is a rare form of immune-mediated bone marrow failure, which can result in life-threatening infections or bleeding if left untreated. Treatment consists of either immune suppressive therapy (IST) or allogeneic stem cell transplantation (alloHSCT). While considerable research has been published regarding survival, response rate and toxicity of both treatments, knowledge on the impact on quality of life (QoL) is scarce. We used the recently developed AA-specific QoL questionnaire (QLQ-AA/PNH-54) to evaluate QoL in a single center cohort of AA patients who were successfully treated with IST. The 54 questions represent 12 different QoL domains. Results were analyzed for all patients and grouped based on hematologic response (complete response (CR) or partial response (PR)). Thirty-six successfully treated adult patients (15 in CR, 21 in PR) completed the questionnaire (median age 54 years, range 21-71; median time since last IST 5 years, range 0-41). Fatigue was experienced by 83% of patients. Even though total QoL scores did not significantly differ between patients with PR and CR (105 vs 92, p-value 0,17) there appeared to be a trend towards higher scores in patients with PR, especially in domains concerning psychological wellbeing. This trend was most clear in the domains fear of progression (2,12 in PR patients vs 1,73 in CR patients; p-value 0,08) and role functioning (2,22 vs 1,88; p-value 0,07). In conclusion, patients with AA continue to experience psychological and physical effects despite successful IST.


Asunto(s)
Anemia Aplásica , Calidad de Vida , Humanos , Anemia Aplásica/terapia , Adulto , Masculino , Persona de Mediana Edad , Femenino , Anciano , Encuestas y Cuestionarios , Adulto Joven , Inmunosupresores/uso terapéutico , Trasplante de Células Madre Hematopoyéticas
2.
Support Care Cancer ; 32(1): 80, 2024 Jan 04.
Artículo en Inglés | MEDLINE | ID: mdl-38175303

RESUMEN

PURPOSE: The purpose of this study was to systematically review the literature on the association between adverse childhood events (ACEs) and mental health problems in cancer survivors. METHODS: This review was conducted in line with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Four databases (PubMed, PsychINFO, Web of Science, and Cochrane) were searched on 27-08-2023. RESULTS: Of the 1413 references yielded by the literature search, 25 papers met inclusion criteria and were reviewed. Most studies were performed in the USA, most included breast cancer survivors, and the number of included participants ranged between 20 and 1343. ACEs were relatively prevalent, with self-report rates ranging between 40 and 95%. Having been exposed to ACEs was a risk factor for heightened levels of emotional distress, anxiety, depressive symptoms, and fatigue during cancer treatment. Results varied depending on the variables included, and per subscale, but were consistent across different cultures and heterogenous patient groups. CONCLUSION: The association between ACE and mental health outcomes was significant in most studies. In order to improve treatment for this vulnerable population, it may be necessary to screen for ACEs before cancer treatment and adjust treatment, for example, by means of trauma-informed care (TIC), which recognizes and responds to the impact of trauma on individuals seeking healthcare.


Asunto(s)
Supervivientes de Cáncer , Neoplasias , Niño , Humanos , Salud Mental , Sobrevivientes , Ansiedad , Trastornos de Ansiedad
3.
J Genet Couns ; 2023 Oct 25.
Artículo en Inglés | MEDLINE | ID: mdl-37876362

RESUMEN

Individuals with a germline CDKN2A pathogenic variant (PV) are at high risk of developing melanoma and pancreatic cancer and are therefore offered surveillance. The potential advantages and disadvantages associated with genetic testing and surveillance are discussed during medical counseling, although little is known about the associated psychosocial factors that are relevant to this population. This study sought to provide a qualitative exploration of psychosocial factors related to genetic testing and participation in skin and pancreatic surveillance in (potential) carriers of a CDKN2A PV. Fifteen individuals-both at-risk individuals and confirmed variant carriers-participated in one of the three online focus groups. Pre-defined discussion topics, including genetic testing, cancer surveillance, influence on lifestyle and family planning, were discussed. Patients reported that important reasons to engage in genetic testing included the possibility to participate in surveillance to gain control over their cancer risk and to get clarification on the potential carrier status of their children. We observed considerable differences in risk perception and experienced burden of surveillance. Knowledge of the PV has had a positive influence on lifestyle factors and altered attitudes toward life in some. Most participants were not aware of preimplantation genetic testing. This focus group study provided insight into a variety of psychosocial themes related to (potential) carriership of a CDKN2A PV. Future efforts should focus on identifying those who may benefit from additional psychosocial support, development of a centralized source of information, and assessing the knowledge, needs, and timing of counseling for family planning.

4.
Support Care Cancer ; 30(8): 6947-6953, 2022 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-35543818

RESUMEN

BACKGROUND: Chemotherapy-induced peripheral neuropathy (CIPN) is a common side effect of chemotherapy, especially after taxane-based therapy. This study aimed to examine the relationship between symptoms of anxiety and depression before the start of taxane-based chemotherapy and the development of CIPN in women with breast cancer. METHODS: In this prospective study, women with breast cancer receiving taxane-based (neo)adjuvant chemotherapy were recruited from four hospitals in the Netherlands. Patients completed questionnaires assessing anxiety and depressive symptoms before treatment and CIPN before treatment (T0), 6 weeks after start of treatment (T1), after the last cycle of chemotherapy (T2), and 6 months after the end of treatment (T3). Mixed model analyses were used to investigate whether medium/high levels of anxiety or depression at baseline are associated with the level of CIPN during and after treatment. RESULTS: Among the 61 participating women, 14 (23%) reported medium/high levels of anxiety and 29 (47.5%) reported medium/high levels of depressive symptoms at baseline. The group of women with medium/high baseline levels of anxiety showed a significantly higher increase in CIPN during and after chemotherapy than women with low baseline levels of anxiety (p < .001). No relationship between depressive symptoms at baseline and the development of CIPN was found. CONCLUSION: This study showed that baseline medium to high levels of anxiety but not depressive symptoms impacted the development of CIPN during and in the 6 months after treatment.


Asunto(s)
Antineoplásicos , Neoplasias de la Mama , Enfermedades del Sistema Nervioso Periférico , Antineoplásicos/efectos adversos , Ansiedad/inducido químicamente , Ansiedad/epidemiología , Neoplasias de la Mama/complicaciones , Neoplasias de la Mama/tratamiento farmacológico , Femenino , Humanos , Enfermedades del Sistema Nervioso Periférico/inducido químicamente , Enfermedades del Sistema Nervioso Periférico/tratamiento farmacológico , Enfermedades del Sistema Nervioso Periférico/epidemiología , Estudios Prospectivos , Taxoides
5.
J Clin Psychol Med Settings ; 27(1): 190-198, 2020 03.
Artículo en Inglés | MEDLINE | ID: mdl-31144221

RESUMEN

Disturbed sleep and (morbid) obesity are increasing health problems in industrial societies and play an important role in chronic illnesses. Conclusive evidence about their relationship is lacking. The aim of this study was to investigate the relationship between insomnia and obesity and if common associated factors such as psychological distress, self-control, attachment insecurity, and socioeconomic status are present to the same extent in both patient groups. The sample consisted of 177 patients referred to the Medical Psychology department of a general hospital (92 with morbid obesity and 85 with insomnia). Measures used were PSQI, HADS, BSCS, PSWQ, DERS, and ECR-M16. Results showed that morbid obesity and insomnia are largely unrelated health risks, with little overlap in associated factors and divided mainly by SES. This indicates that condition-oriented interventions rather than transdiagnostic interventions are likely to be more effective and that different population groups (high vs low SES) may benefit from different approaches.


Asunto(s)
Obesidad Mórbida/epidemiología , Trastornos del Inicio y del Mantenimiento del Sueño/epidemiología , Adolescente , Adulto , Anciano , Enfermedad Crónica , Comorbilidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Países Bajos/epidemiología , Obesidad Mórbida/psicología , Apego a Objetos , Autocontrol/psicología , Trastornos del Inicio y del Mantenimiento del Sueño/psicología , Factores Socioeconómicos , Estrés Psicológico/epidemiología , Estrés Psicológico/psicología , Adulto Joven
6.
J Clin Psychol Med Settings ; 21(1): 116-23, 2014 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-24492914

RESUMEN

This study examines whether patients self-reported attachment representations and levels of depression and anxiety influenced psychologists' evaluations of morbidly obese patients applying for bariatric surgery. A sample of 250 patients (mean age 44, 84 % female) who were referred for bariatric surgery completed questionnaires to measure adult attachment and levels of depression and anxiety. Psychologists rated patients' suitability for bariatric surgery using the Cleveland Clinic Behavioural Rating System (CCBRS), unaware of the results of the completed questionnaires. Attachment anxiety (OR = 2.50, p = .01) and attachment avoidance (OR = 3.13, p = .001) were found to be associated with less positive evaluations on the CCBRS by the psychologists, and symptoms of depression and anxiety mediated this association. This study strongly supports the notion that patients' attachment representations influence a psychologist's evaluation in an indirect way by influencing the symptoms of depression and anxiety patients report during an assessment interview. The clinical implications of these findings are discussed.


Asunto(s)
Trastornos de Ansiedad/psicología , Cirugía Bariátrica/psicología , Trastorno Depresivo/psicología , Obesidad Mórbida/psicología , Apego a Objetos , Adulto , Trastornos de Ansiedad/complicaciones , Trastorno Depresivo/complicaciones , Femenino , Humanos , Masculino , Persona de Mediana Edad , Obesidad Mórbida/complicaciones , Oportunidad Relativa , Encuestas y Cuestionarios
7.
Acta Oncol ; 52(1): 110-7, 2013 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-23113593

RESUMEN

BACKGROUND: The degree of trust in and satisfaction with the physician has been shown to have important implications for treatment outcomes. This study aims to examine individual differences in patients' trust, satisfaction and general distress from an attachment theoretical perspective. MATERIAL AND METHODS: One hundred and thirty recently diagnosed cancer patients of three medical hospitals were extensively interviewed by trained psychologists to assess attachment style. Patients completed standardized questionnaires three and nine months after diagnosis to assess trust, satisfaction and distress. t-tests and repeated measures ANOVAs were used to examine differences between securely and insecurely attached patients and changes over time. A mediation model based on a bootstrapping method was used to examine whether trust mediated between attachment and satisfaction, and attachment and distress. RESULTS: Insecurely attached patients (N = 45, 35%) reported less trust in and satisfaction with their physician, and reported more general distress than securely attached patients three and nine months after diagnosis (p < 0.05). Trust and distress levels did not change over time. Trust mediated between attachment and satisfaction, but not between attachment and distress. CONCLUSION: Insecurely attached patients trusted their physician less than securely attached patients, and in turn were less satisfied with their physician. Their higher levels of general distress were not related to their lower levels of trust. Attachment theory provides a framework to interpret differences in patients' trust, satisfaction and distress, and may help physicians respond in such a way that their patients feel secure, which in turn is expected to result in better health outcomes.


Asunto(s)
Neoplasias/psicología , Apego a Objetos , Relaciones Médico-Paciente , Confianza , Análisis de Varianza , Comorbilidad , Femenino , Estado de Salud , Humanos , Entrevista Psicológica , Masculino , Persona de Mediana Edad , Neoplasias/diagnóstico , Neoplasias/epidemiología , Países Bajos/epidemiología , Satisfacción del Paciente , Estrés Psicológico/psicología , Encuestas y Cuestionarios
8.
BMC Psychol ; 11(1): 248, 2023 Aug 25.
Artículo en Inglés | MEDLINE | ID: mdl-37626349

RESUMEN

BACKGROUND: Attachment avoidance and anxiety have been linked to overweight and poor health behaviours, yet the mechanisms that underpin the relationship between attachment and health behaviours are not fully understood. Self-esteem and self-efficacy have been found to differ between attachment styles, rendering these variables potential mediators of the relationship. This longitudinal study investigated the serial mediation between preoperative attachment and 2-year post-operative health behaviours through self-esteem and health self-efficacy. METHODS: Participants were 263 bariatric surgery patients (75.7% females, aged 47.7 ± 10.4 years, BMI 38.9 ± 3.6 kg/m2) assessed before the operation and again one and two years after the surgery. Patients completed the Experiences for Close Relationships Brief Scale, Rosenberg Self-esteem scale, Weight Efficacy Lifestyle Questionnaire, Bariatric Surgery Self-Management Questionnaire, Exercise Self-Efficacy Scale and the Exercise Behaviour Scale. RESULTS: Higher preoperative attachment anxiety and avoidance were associated with lower self-esteem one year after bariatric surgery and poorer health self-efficacy two years after the surgery. Self-esteem and health self-efficacy mediated the relationships between preoperative anxious and avoidant attachment and 2- year post-operative diet adherence and physical activity. CONCLUSIONS: Helping patients to feel more worthy and reinforcing their beliefs about their own competences could lead to higher engagement with healthy lifestyle and adherence to treatment protocols, ultimately helping patients to achieve their goals for bariatric surgery. CLINICAL TRIAL REGISTRATION: BARIA: Netherlands Trial Register: NL5837 (NTR5992) https://www.trialregister.nl/trial/5837 . Diabaria: ClinicalTrials.gov identifier (NCT number): NCT03330756.


Asunto(s)
Cirugía Bariátrica , Autoeficacia , Femenino , Humanos , Masculino , Conductas Relacionadas con la Salud , Estudios Longitudinales , Autoimagen , Adulto , Persona de Mediana Edad
9.
AIDS Care ; 24(12): 1535-42, 2012.
Artículo en Inglés | MEDLINE | ID: mdl-22530817

RESUMEN

The present study investigated the relationship between adult attachment style and depressive symptomatology in patients with HIV. Moreover, perceived social support was investigated as a potential mediator between adult attachment and depressive symptoms. A sample of 233 HIV-infected patients (90% male) completed questionnaires assessing adult attachment style (Relationship Questionnaire), depressive symptoms (Beck Depression Inventory), and perceived social support (Medical Outcomes Study Social Support Survey). After controlling for demographic and medical variables, an insecure adult attachment style was found to be strongly related with depressive symptoms. Half of the insecurely attached patients reported clinically elevated levels of distress, while one in nine securely attached patients reported elevated levels of distress (χ(2)=32.25, p=0.001). Moreover, the association between attachment style and depressive symptomatology was found to be partly mediated through perceived social support. This study strongly supports the notion that an insecure attachment style is a vulnerability factor for developing depressive symptoms that would warrant clinical attention when confronted with a chronic illness such as HIV. The clinical implications of these findings are discussed.


Asunto(s)
Depresión/psicología , Infecciones por VIH/psicología , Apego a Objetos , Apoyo Social , Adulto , Estudios de Cohortes , Depresión/etiología , Femenino , Infecciones por VIH/complicaciones , Humanos , Relaciones Interpersonales , Masculino , Persona de Mediana Edad , Países Bajos , Percepción , Inventario de Personalidad , Escalas de Valoración Psiquiátrica , Análisis de Regresión , Encuestas y Cuestionarios , Adulto Joven
10.
BMC Psychiatry ; 12: 227, 2012 Dec 14.
Artículo en Inglés | MEDLINE | ID: mdl-23237076

RESUMEN

BACKGROUND: Inflammatory Bowel Disease (IBD) patients report poorer quality of life (QoL) and more anxiety and depressive symptoms than controls from the general population. Cognitive behavioral therapy (CBT) is effective for anxiety and depression, but questionable in case of co-morbidity with IBD. Therefore, an adapted new CBT specifically designed for IBD patients was developed. The objective of this study is to evaluate the effectiveness of adapted CBT on QoL. METHODS/DESIGN: IBD patients with a poor level of mental QoL (score less than or equal to 23 on the mental health scale of SF-36) will be randomly assigned to the experimental (n = 40) or waiting-list control condition (n = 40). The experimental condition will then immediately start CBT. The waiting-list control condition will wait 3,5 months before CBT begins with pre- and post assessments. Both conditions will complete a baseline and follow-up assessment following CBT and a mid-treatment assessment. The primary outcome is IBD-specific QoL (IBDQ). Secondary outcomes are generic QoL (SF-36) and anxiety and depression complaints (HADS, CES-D). Additionally, we will examine the working mechanism of the psychological intervention by investigating the impact of the intervention on illness-related cognitions, attitudes, coping styles and their associations with outcome. Data will be analysed on an intention to treat (ITT) as well as treatment completer basis (greater than or equal to five sessions followed). DISCUSSION: If found effective, this IBD-specific CBT is a first step to enhance poor QoL in IBD patients and possibly, other gastroenterological diseases. By enhancing IBD patients' QoL, we may also improve their mental and physical health, and lower unnecessary health care consumption. TRIAL REGISTRATION NUMBER: NTR (TC = 1869).


Asunto(s)
Protocolos Clínicos/normas , Terapia Cognitivo-Conductual/métodos , Enfermedades Inflamatorias del Intestino/psicología , Enfermedades Inflamatorias del Intestino/terapia , Calidad de Vida/psicología , Adaptación Psicológica , Adulto , Ansiedad/terapia , Actitud Frente a la Salud , Cognición , Depresión/terapia , Humanos
11.
Psychol Health ; : 1-17, 2022 Dec 13.
Artículo en Inglés | MEDLINE | ID: mdl-36511583

RESUMEN

PURPOSE: Research investigating depressive symptoms among cancer patients rarely distinguish between core symptoms of depression (motivational and consummatory anhedonia, and negative affect). This distinction is important as these symptoms may show different trajectories during the course of the illness and require different treatment approaches. The aim of the present study is to investigate fluctuations in core depressive symptoms in patients with colorectal cancer (CRC). It is hypothesized that these core depressive symptoms fluctuate differently during the course of the illness and depend on the phase of the illness (diagnostic, treatment, recovery and palliative phase). METHOD: This study is based on data from the PROCORE study. PROCORE is a prospective, population-based study aimed to examine the longitudinal impact of CRC and its treatment on patient-reported outcomes. Eligible patients completed self-report questionnaires (i.e. Multifactorial Fatigue Index, Hospital Anxiety and Depression scale, EORTC-C30) after diagnosis, after surgery and at one and two years after diagnosis. RESULTS: In total, 539 patients participated of whom 68 have died until March 1ste 2021. Core depressive symptoms fluctuated differently during the course of the illness with higher levels of motivational anhedonia during treatment and palliative phase (P<.001), consummatory anhedonia at the palliative phase (p < .001) and negative affect at the diagnostic and palliative phase (P<.001). CONCLUSION: It is important to distinguish between different core depressive symptoms as they fluctuate differently during the course of an illness like CRC. The various depressive symptoms may require a different treatment approach at specific moments during the illness process.

12.
Cancers (Basel) ; 14(8)2022 Apr 16.
Artículo en Inglés | MEDLINE | ID: mdl-35454932

RESUMEN

The aim of this study is to provide a systematic overview of the scientific literature on sociodemographic, psychological and social determinants that may facilitate or hamper lifestyle change after the diagnosis cancer. Four databases (PubMed, PsychINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Web of Science) were searched for relevant papers up to October 2021. Of the 9586 references yielded by the literature search, 123 papers were included: 71 quantitative and 52 qualitative papers. Findings showed a large variety of determinants influencing lifestyle change after cancer diagnosis, with differences between lifestyle behaviors (physical activity, diet, smoking, alcohol, sun protection, and multiple lifestyle behaviors) and findings from quantitative vs. qualitative studies. Findings demonstrate the important role of oncology healthcare professionals in promoting healthy lifestyle changes in cancer survivors. In addition, findings inform researchers involved in the development of health promotion programs about the methods and strategies they can use to promote healthy lifestyle changes in cancer survivors. Favorable lifestyle changes are expected to have beneficial effects on cancer risk and overall health in cancer survivors.

13.
Respir Med Res ; 82: 100973, 2022 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-36403358

RESUMEN

BACKGROUND: We investigated whether COVID-19 leads to persistent impaired pulmonary function, fibrotic-like abnormalities or psychological symptoms 12 months after discharge and whether severely ill patients (ICU admission) recover differently than moderately ill patients. METHODS: This single-centre cohort study followed adult COVID-19 survivors for a period of one year after discharge. Patients underwent pulmonary function tests 6 weeks, 3 months and 12 months after discharge and were psychologically evaluated at 6 weeks and 12 months. Computed tomography (CT) was performed after 3 months and 12 months. RESULTS: 66 patients were analysed, their median age was 60.5 (IQR: 54-69) years, 46 (70%) patients were male. 38 (58%) patients had moderate disease and 28 (42%) patients had severe disease. Most patients had spirometric values within normal range after 12 months of follow-up. 12 (23%) patients still had an impaired lung diffusion after 12 months. Impaired pulmonary diffusion capacity was associated with residual CT abnormalities (OR 5.1,CI-95: 1.2-22.2), shortness of breath (OR 7.0, CI-95: 1.6-29.7) and with functional limitations (OR 5.8, CI-95: 1.4-23.8). Ground-glass opacities resolved in most patients during follow-up. Resorption of reticulation, bronchiectasis and curvilinear bands was rare and independent of disease severity. 81% of severely ill patients and 37% of moderately ill patients showed residual abnormalities after 12 months (OR 8.1, CI-95: 2.5-26.4). A minority of patients had symptoms of post-traumatic stress disorder, anxiety, depression and cognitive failure during follow-up. CONCLUSION: Some patients still had impaired lung diffusion 12 months after discharge and fibrotic-like residual abnormalities were notably prevalent, especially in severely ill patients.


Asunto(s)
COVID-19 , Adulto , Humanos , Masculino , Persona de Mediana Edad , Femenino , COVID-19/complicaciones , COVID-19/epidemiología , Estudios de Cohortes , Hospitalización , Alta del Paciente , Gravedad del Paciente , Progresión de la Enfermedad
14.
Patient Educ Couns ; 104(2): 427-431, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-32814682

RESUMEN

OBJECTIVE: Information about physicians' skills is increasingly available on the internet and consulted by patients. The impact of such information on patient expectations is largely unknown. The aim of the present study was to investigate whether information about the competence and empathic skills of a physician may impact pre-consultation trust and treatment outcome expectations in mild and severe medical conditions. METHODS: In this experimental web-based study, participants (n = 237) read vignettes describing competence and empathic skills (low versus high) of a fictive physician who would surgically remove a mole or melanoma (low versus high severity) following a 2 × 2 × 2 between-subjects design. Participants rated trust in the physician and treatment outcome expectations. RESULTS: High competence and empathy raised trust in the physician, regardless of condition severity. High competence and high empathy both also increased expected surgery success, while only high competence reduced expected side effects. CONCLUSION: Pre-consultation information highlighting a physician's competence and/or empathy may lead to higher trust in that physician, higher expected surgery success, and lower expected side effects. PRACTICE IMPLICATIONS: Physicians and hospital staff should be aware of the effects of written information available and might, for example, provide profiles on hospital websites emphasizing healthcare providers' competence and empathy.


Asunto(s)
Médicos , Confianza , Empatía , Humanos , Motivación , Relaciones Médico-Paciente , Derivación y Consulta , Resultado del Tratamiento
15.
Clin Psychol Psychother ; 16(1): 10-21, 2009.
Artículo en Inglés | MEDLINE | ID: mdl-19165809

RESUMEN

In accordance with attachment theory, the present study investigates whether internal working models of attachment mediated the association between childhood memories and satisfaction about life in adulthood. A convenient sample of 437 participants completed questionnaires assessing a broad range of childhood memories, working models of attachment and life satisfaction. After controlling for demographics, relational status and living condition, Baron and Kenny's mediation criteria were met for the association between memories about childhood, adult attachment and life satisfaction. That is, family warmth and harmony and parental support were associated with attachment security while parental rejection and adverse childhood events (e.g., abuse, parental psychopathology) were associated with an insecure attachment style. More securely attached individuals were in turn more satisfied about their current life than insecurely attached individuals. Sobel test confirmed these findings. These finding are in accordance with attachment theory and highlight the importance of this theory for understanding how early childhood experiences may impact adult life.


Asunto(s)
Adaptación Psicológica , Recuerdo Mental , Apego a Objetos , Relaciones Padres-Hijo , Satisfacción Personal , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Acontecimientos que Cambian la Vida , Masculino , Persona de Mediana Edad , Países Bajos
16.
Ann Behav Med ; 36(2): 141-8, 2008 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-18797979

RESUMEN

BACKGROUND: Previous studies offer a limited perspective on the dynamic course of distress in cancer patients and their partners, owing to a restricted number of assessment points and the absence of comparison controls drawn from the general population. PURPOSE: This study investigated the course of distress among breast cancer patients and their partners (N = 92 couples) in comparison to matched control couples (N = 64). Furthermore, the influence of neuroticism on distress was investigated. METHOD: The Hospital Anxiety and Depression Scale was administered nine times over a 12-month period, and neuroticism was assessed at the beginning of the study using the Eysenck Personality Questionnaire. RESULTS: Multilevel analyses revealed that patients were more distressed during the first 15 months after diagnosis than nonpatients. A significant portion of the distress that could not be explained by the cancer experience was explained by neuroticism. CONCLUSION: Differences in distress between patients and comparison-control women are relatively small and decreased over time, while distress in male partners was not elevated in comparison to their controls.


Asunto(s)
Adaptación Psicológica , Neoplasias de la Mama/psicología , Trastornos Neuróticos/complicaciones , Esposos/psicología , Estrés Psicológico/psicología , Adulto , Anciano , Neoplasias de la Mama/complicaciones , Estudios de Casos y Controles , Femenino , Humanos , Relaciones Interpersonales , Acontecimientos que Cambian la Vida , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Trastornos Neuróticos/psicología , Valores de Referencia , Apoyo Social , Estrés Psicológico/complicaciones , Factores de Tiempo
17.
Br J Health Psychol ; 13(Pt 4): 737-54, 2008 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-17999780

RESUMEN

OBJECTIVE: The aim of this study was to investigate whether a breast cancer diagnosis, personal assertiveness (i.e. frequency of assertive behaviour and tension associated with this behaviour), and partners' relationship-focused coping (i.e. active engagement and protective buffering) were sources of variation in patients' relationship satisfaction, cross-sectionally and over time. DESIGN AND METHOD: This longitudinal case-control study assessed the two dimensions of personal assertiveness and relationship satisfaction in both women with cancer (N=72) and comparison controls (N=62). In addition, patients completed a measure assessing their partners' active engagement and protective buffering. RESULTS: Cases (i.e. women with breast cancer) were not found to report more relationship problems than controls. Women with breast cancer who tended not to express their concerns and feelings and who experienced much tension when they did, reported relatively low marital satisfaction. Moreover, partners' protective buffering was associated with less relationship satisfaction in especially more assertive (i.e. high frequency of assertive behaviour and low tension) women with cancer, while active engagement was associated with more relationship satisfaction, regardless of the women's personal assertiveness. DISCUSSION: The results of the present study indicate that a breast cancer diagnosis by itself may not be a risk factor for relationship problems. However, in the context of an illness such as cancer, personal assertiveness, and a partner's relationship-focused coping strategies do seem to play a role in maintaining a satisfactory relationship with one's partner.


Asunto(s)
Adaptación Psicológica , Asertividad , Neoplasias de la Mama/psicología , Matrimonio/psicología , Satisfacción Personal , Apoyo Social , Adulto , Anciano , Neoplasias de la Mama/terapia , Estudios de Casos y Controles , Comunicación , Emociones , Femenino , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad
18.
Dement Geriatr Cogn Dis Extra ; 8(2): 290-305, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-30323830

RESUMEN

BACKGROUND: Diagnosing dementia in elderly immigrants is often difficult due to language and cultural barriers, low education, and illiteracy. We compared the diagnostic accuracy of the Rowland Universal Dementia Assessment Scale (RUDAS) to that of the Mini Mental State Examination (MMSE). METHODS: A total of 144 patients (42 with intact cognition, 44 with mild cognitive impairment [MCI], and 58 with dementia) were administered both instruments and were diagnosed by specialists blinded for MMSE and RUDAS results. RESULTS: Areas under the curve for discriminating intact cognition from MCI and dementia were comparable for RUDAS (0.81; 95% confidence interval 0.74-0.88) and MMSE (0.75; 95% confidence interval 0.69-0.85). Education and literacy were not correlated with the RUDAS but had a medium-large correlation with the MMSE (rho = 0.39). CONCLUSIONS: The study provides additional evidence for the usefulness of the RUDAS in a highly illiterate, culturally diverse geriatric outpatient population.

19.
Obes Surg ; 28(2): 415-420, 2018 02.
Artículo en Inglés | MEDLINE | ID: mdl-28798989

RESUMEN

BACKGROUND: Bariatric surgery is an effective intervention for the majority of patients with morbid obesity, but a significant minority fails to achieve substantial weight loss. In the search of possible predictors of weight loss following bariatric surgery, preoperative factors turn out to have limited predictive power. This study will examine the impact of two postoperative factors on weight loss: perceived social support and stressful life events. METHODS: From the entire 2013 cohort that underwent laparoscopic Roux-and-Y gastric bypass (LRYGB) in a general hospital in the Netherlands, a group of 56 non-responders and a matched group of 56 responders were selected, using an alterable weight loss (%AWL)-based percentile chart. Patients from both groups were interviewed by phone to collect data on demographics, medical complications and comorbidities, social support and stressful life events. A total of 61 patients completed the data collection (54% response rate). RESULTS: One-way ANOVA analysis showed that responders and non-responders differed with regard to perceived support (F(1) = 8.60, p = .005). In a model with place of birth, level of education and pre-surgery diabetes mellitus as covariates, perceived social support was able to classify 83.6% of patients correctly as either responder or non-responder (χ 2 = 28.26, p < .001). Stressful life events turned out to be unrelated to weight loss. CONCLUSIONS: Perceived social support differentiates responders from non-responders after LRYGB. When patients present themselves after LRYGB with sub-optimal weight loss, social support should be a focus of attention.


Asunto(s)
Obesidad Mórbida/diagnóstico , Obesidad Mórbida/psicología , Obesidad Mórbida/cirugía , Percepción , Apoyo Social , Adulto , Comorbilidad , Estudios Transversales , Femenino , Estudios de Seguimiento , Derivación Gástrica/efectos adversos , Derivación Gástrica/psicología , Derivación Gástrica/rehabilitación , Humanos , Laparoscopía/efectos adversos , Laparoscopía/psicología , Laparoscopía/rehabilitación , Masculino , Persona de Mediana Edad , Obesidad Mórbida/rehabilitación , Periodo Posoperatorio , Pronóstico , Estudios Retrospectivos , Factores de Tiempo , Resultado del Tratamiento , Pérdida de Peso
20.
Surg Obes Relat Dis ; 13(7): 1204-1210, 2017 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-28396129

RESUMEN

BACKGROUND: Numerous studies have demonstrated that bariatric surgery is an effective intervention for morbid obesity, but study samples are characterized by an underrepresentation of young adult patients. OBJECTIVES: The aim of this study was to evaluate weight loss, dietary adherence, and quality of life (QoL) in a multicenter, young adult sample, in the first 6 years after bariatric surgery. SETTING: Four general hospitals in the Netherlands. METHODS: A total of 184 young adult patients who underwent bariatric surgery between 6 and 74 months previously at the age of 18 to 24 years were included, interviewed by phone, and sent questionnaires assessing postoperative weight, QoL, and lifestyle behaviors including dietary adherence. Complete data were available for those 96 patients who returned the questionnaires. RESULTS: Mean percent weight loss was 30.2 (SD 10.7) for laparoscopic sleeve gastrectomy and 35.6 (SD 6.9) for laparoscopic Roux-en-Y gastric bypass. Adherence to postoperative dietary recommendations declined over the years (r = -.25, P = .02) and explained 8.3% of the variance in weight loss (r = .29, P = .005). QoL scores lagged behind national norms for young adults and were largely unrelated to weight loss. A quarter of patients (25%) turned out to be not in education, employment, or training and 38% had used mental healthcare services since surgery, which occurred independent of weight loss and concurred with poorer QoL. CONCLUSION: Young adult patients achieve weight loss comparable to adult patients after bariatric surgery. However, postoperative adherence to behavioral recommendations and psychosocial functioning clearly demonstrate room for improvement and require adjunctive interventions.


Asunto(s)
Cirugía Bariátrica , Laparoscopía , Obesidad Mórbida/cirugía , Calidad de Vida , Pérdida de Peso/fisiología , Adolescente , Estudios Transversales , Ejercicio Físico/fisiología , Humanos , Relaciones Interpersonales , Cumplimiento de la Medicación , Salud Mental , Países Bajos , Obesidad Mórbida/dietoterapia , Obesidad Mórbida/psicología , Satisfacción del Paciente , Cuidados Posoperatorios , Adulto Joven
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