ABSTRACT
Objectives (a) to evaluate and compare the psychological treatment needs of patients with cancer and non-cancer, who are going to undergo scheduled thoracic surgery, and (b) evaluate and compare the diagnostic accuracy of the screening tests of psychological treatment needs for cancer and non-cancer patients. Method The need for psychological treatment was evaluated in a total of 169 patients prior to thoracic surgery, through a clinical interview. The screening tests used were: the physician's judgment (yes/no), the Hospital Anxiety and Depression Scale (HADS) and, the single-item interview to assess depression Do you feel depressed? (DEPQ). Results The number of patients who needed psychological treatment in the total sample was 47 (27.81%), in non-cancer-patients: 22 (30.99%) and in cancer patients: 25 (25.51%). The participants with treatment needs were more often young women with primary education levels, with more fears and concerns regarding their disease. With respect to the screening tests, the HADS-T (cut-off point ≥13) obtained a sensitivity (SE) of 0.75 and Specificity (SP) of 0.81 in the total sample. In patients with cancer, the HADS total score (cut-off point ≥10) obtained an SE=0.84 and SP=0.80, and, in non-cancer patients, the HADS total score (cut-off point ≥13) showed an SE=0.59 and SP=0.84. The DEPQ and the physician's judgment did not achieve adequate levels of precision. Conclusions A high percentage of patients have psychological treatment needs before performing thoracic surgery, which are similar for cancer and non-cancer patients. Preoperative detection of patients who need psychological intervention is feasible with a simple screening test: HADS, which achieves greater precision in cancer patients (AU)
Objetivos Evaluar y comparar: a) las necesidades de tratamiento psicológico de pacientes con cáncer y sin cáncer, que van a someterse a una cirugía torácica programada, y b) la precisión diagnóstica de las pruebas de detección de necesidades psicológicas para pacientes con y sin cáncer. Métodos Se evaluó la necesidad de tratamiento psicológico en un total de 169 pacientes antes de la cirugía torácica, a través de una entrevista clínica. Las pruebas de cribado fueron: el criterio médico (sí/no), la Escala de Ansiedad y Depresión Hospitalaria (HADS) y la entrevista de un solo ítem de depresión «¿Se siente deprimido?» (DEPQ). Resultados El número de pacientes que necesitaron tratamiento psicológico fue en el total 47 (27,81%), en pacientes sin cáncer: 22 (30,99%) y con cáncer: 25 (25,51%). Las participantes con necesidades de tratamiento eran con mayor frecuencia mujeres jóvenes con niveles de educación primaria y más temores con respecto a su enfermedad. Con respecto a las pruebas de detección, el HADS total (corte ≥ 13) obtuvo una sensibilidad (S)=0,75/especificidad (E)=0,81 en la muestra total. En pacientes con cáncer el HADS total (corte ≥ 10): S=0,84/E=0,80 y en pacientes sin cáncer, la HADS total (corte ≥ 13): S=0,59/E=0,84. DEPQ y juicio médico obtuvieron bajos niveles de precisión. Conclusiones Un alto porcentaje de pacientes antes de realizar una cirugía torácica tiene necesidades de tratamiento psicológico, similares para pacientes con y sin cáncer. La HADS total es un buen método de cribado de necesidades psicológicas, especialmente en pacientes con cáncer (AU)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Thoracic Surgical Procedures , Stress, Psychological , Preoperative Care , Surgical Clearance , Anxiety/psychology , Socioeconomic FactorsABSTRACT
OBJECTIVES: To study depression, anxiety, maladjustment and coping in caregivers of patients in vegetative state (VS) or minimally conscious state (MCS). MATERIALS AND METHODS: Fifty-three caregivers of 43 patients with VS or MCS were assessed using Beck Anxiety Inventory, Beck Depression Inventory, maladjustment scale and Brief Coping Orientation of Problems Experienced (COPE-28). RESULTS: There were 15 clinical cases (cut-off ≥ 21) of anxiety (28.30%); 16 cases (cut-off ≥ 21) of depression (30.20%); and 45 cases (cut-off ≥ 12) of maladjustment (84.8%). Active and problem-focused (Active coping, Instrumental support, Planning and Acceptance) were the most frequently used coping strategies. Acceptance predicted the absence of depression (p = 0.000, Cohen's d = 1.08) and anxiety (p = 0.000, Cohen's d = 1.08). Denial was associated with depression (p = 0.000, Cohen's d = 1.65) and anxiety (p = 0.000, Cohen's d = 1.23). Self-blame was associated with greater anxiety (p = 0.001, Cohen's d = 1.06) and depression (p = 0.001, Cohen's d = 1.07). Emotion-focused coping was associated with anxiety (p = 0.000, Cohen's d = 1.29) and depression (p = 0.001, Cohen's d = 1.11). CONCLUSIONS: Caregivers of patients with VS or MCS presented high levels of distress. Psychological support for caregivers of patients with VS or MCS is necessary. The most frequently used coping strategies were Active and Problem-focused. Acceptance was highly protective, but Denial, Self-blame and Emotion-focused strategies were very negative.
Subject(s)
Adaptation, Psychological , Anxiety , Caregivers/psychology , Consciousness Disorders/psychology , Depression , Adult , Aged , Anxiety/epidemiology , Depression/epidemiology , Female , Humans , Male , Middle Aged , Quality of Life , Social Support , Spain/epidemiology , Stress, Psychological , Surveys and QuestionnairesABSTRACT
OBJECTIVES: To study the relationship between coping strategies and prolonged grief disorder (PGD) in caregivers of patients with disorders of consciousness: vegetative state (VS) or minimally conscious state (MCS). MATERIALS AND METHODS: Fifty-three caregivers of 43 patients with VS or MCS were assessed using PG-12 and Brief COPE-28. Mean differences for each coping strategy between caregivers of patients with/without PGD were compared using Bonferroni-adjusted t-tests, and the size effect was calculated (Cohen's d). RESULTS: The frequency of PGD was very high (n = 32; 60.40%). The most common coping strategies were problem-focused: active coping (mean = 6.41; SD = 1.02), Instrumental support (mean = 6.41; SD = 1.06), Planning (mean = 6.32; SD = 1.01) and Acceptance (mean = 6.20; SD = 1.29). Acceptance predicted a lower presence of PGD (P = 0.001; Cohen's d = 1.02), while Denial (P = 0.003; Cohen's d = 0.98) and Self-blame (P = 0.004, Cohen's d = 0.91) increased the presence of PGD. CONCLUSIONS: The caregivers of patients with VS or MCS show a high risk of PGD. Problem-focused coping strategies are the most used. Acceptance is highly protective of PGD, and Denial and Self-blame are associated with an increased presence of PGD. PGD in caregivers of patients in VS or MCS should be evaluated, Acceptance and problem-focused strategies should be promoted, and Denial and Self-blame should be diminished.
Subject(s)
Adaptation, Psychological , Caregivers/psychology , Grief , Persistent Vegetative State/psychology , Persistent Vegetative State/therapy , Adolescent , Adult , Aged , Depressive Disorder/etiology , Female , Hospitalization , Humans , Male , Middle Aged , Risk Factors , Self-Assessment , Stress, Psychological/etiology , Surveys and Questionnaires , Young AdultABSTRACT
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