Prospective study of predictors for anxiety, depression, and somatization in a sample of 1807 cancer patients.

In cancer patients, psychological distress, which encompasses anxiety, depression, and somatization, arises from the complex interplay of emotional and behavioral reactions to the diagnosis and treatment, significantly influencing their functionality and quality of life. The aim was to investigate factors associated with psychological distress in cancer patients. This prospective and multicenter study, conducted by the Spanish Society of Medical Oncology (SEOM), included two cohorts of patients with cancer (localized resected or advanced unresectable). They completed surveys assessing psychological distress (BSI-18) before and after cancer treatment and coping (MINI-MAC) and spirituality (FACIT-sp) prior to therapy. A multivariable logistic regression analysis and a Structural Equation Modeling (SEM) were conducted. Between 2019 and 2022, 1807 patients were evaluated, mostly women (54%), average age 64 years. The most frequent cancers were colorectal (30%), breast (25%) and lung (18%). Men had lower levels of anxiety and depression (OR 0.66, 95% CI 0.52-0.84; OR 0.72, 95% CI 0.56-0.93). Colorectal cancer patients experienced less anxiety (OR 0.63, 95% CI 0.43-0.92), depression (OR 0.55, 95% CI 0.37-0.81), and somatization (OR 0.59, 95% CI 0.42-0.83). Patients with localized cancer and spiritual beliefs had reduced psychological distress, whereas those with anxious preoccupation had higher level. SEM revealed a relationship between psychological distress and coping strategies, emphasizing how baseline anxious preoccupation exacerbates post-treatment distress. This study suggests that age, sex, extension and location of cancer, coping and spirituality influence psychological distress in cancer patients.

Evaluación del Miedo a la Recurrencia del cáncer en español: el Cuestionario de Miedo a la Recurrencia del Cáncer y Escala General del Miedo a la Recurrencia del Cáncer: un estudio piloto / Assessment of fear of cancer recurrence in Spanish: Fear of Recurrence Questionnaire and he General Scale of Fear of Cancer Recurrence: A pilot study

El objetivo de este estudio es la elaboración de un cuestionario de evaluación del miedo a la recurrencia del cáncer en español. Método: se presenta un estudio piloto de diseño correlacional trasversal elaborado en dos fases: 1) creación del cuestionario del miedo a la recurrencia del cáncer (CMRC) y de la Escala General del Miedo a la Recurrencia del Cáncer (EGMRC); 2) evaluación de sus propiedades psicométricas. Resultados: para la elaboración de los cuestionarios se utilizó el acuerdo entre expertos medido por la V de Aiken. El CMRC queda finalmente configurado con 8 ítems que se responden con una escala tipo Likert de 0-4 y un Alfa de Cronbach de 0,85. La EGMRC de una sola pregunta que se responde con una escala de 0-100 correlaciona hasta un 0,84 con el CMRC. Se utilizó una muestra de 50 mujeres supervivientes de cáncer ginecológico seleccionadas en el Hospital Universitario Clínico San Carlos de Madrid. Ambas escalas correlacionan con el nivel de ansiedad de las pacientes y la función emocional de calidad de vida. No se hallan correlaciones con los niveles de depresión. Conclusiones: El CMRC y la EGMRC son dos instrumentos que pueden ser válidos para la evaluación del miedo a la recurrencia del cáncer en pacientes supervivientes de cáncer ginecológico (AU)

The objective of this study is the elaboration of a questionnaire for the evaluation of the fear of recurrence of cancer in Spanish. Method: A pilot study with a cross-sectional correlational design is presented, elaborated in two phases: 1) creation of the Fear Cancer recurrence Questionnaire (CMRC) and the General Scale of Fear of Cancer Recurrence (EGMRC); 2) evaluation of their psychometric properties. Results: for the elaboration of the questionnaires, the agreement between experts was used, measured by Aiken’s V. The CMRC questionnaire is finally configured with 8 items that are answered with a Likert-type scale of 0-4 and a Cronbach’s Alpha of 0.851. The EGMRC consists of a single question that is answered with a scale of 0-100 correlates up to 0.84 with the CMRC. A sample of 50 female survivors of gynecological cancer selected from the Hospital Universitario Clínico San Carlos in Madrid was used. Both scales correlate with the level of anxiety of the patients and the emotional function of quality of life. No correlations with levels of depression were found. Conclusions: The CMRC and the EGMRC are two instruments that may be valid for the evaluation of FCR in Spanish for survivors of gynecological cancer (AU)

Psychological distress and resilience in patients with advanced cancer during the Covid-19 pandemic: the mediating role of spirituality.

BACKGROUND: The purpose of this study was to investigate the sociodemographic factors related to psychological distress, spirituality, and resilience, and to examine the mediating role of spirituality with respect to psychological distress and resilience in patients with advanced, unresectable cancer during the Covid-19 pandemic. METHODS: A prospective, cross-sectional design was adopted. Data were collected from 636 participants with advanced cancer at 15 tertiary hospitals in Spain between February 2019 and December 2021. Participants completed self-report measures: Brief Resilient Coping Scale (BRCS), Brief Symptom Inventory (BSI-18), and Spiritual well-being (FACIT-Sp). Hierarchical linear regression models were used to explore the mediating role of spirituality. RESULTS: Spirituality was significantly different according to the person's age and marital status. Psychological distress accounted for 12% of the variance in resilience (ß = - 0.32, p < 0.001) and spirituality, another 15% (ß =0.48, p < 0.001). Spirituality acted as a partial mediator in the relationship between psychological distress and resilience in individuals with advanced cancer. CONCLUSIONS: Both psychological distress and spirituality played a role in resilience in cases of advanced cancer. Spirituality can help promote subjective well-being and increased resilience in these subjects.

Breast cancer patient experiences through a journey map: A qualitative study.

BACKGROUND: Breast cancer is one of the most prevalent diseases in women. Prevention and treatments have lowered mortality; nevertheless, the impact of the diagnosis and treatment continue to impact all aspects of patients' lives (physical, emotional, cognitive, social, and spiritual). OBJECTIVE: This study seeks to explore the experiences of the different stages women with breast cancer go through by means of a patient journey. METHODS: This is a qualitative study in which 21 women with breast cancer or survivors were interviewed. Participants were recruited at 9 large hospitals in Spain and intentional sampling methods were applied. Data were collected using a semi-structured interview that was elaborated with the help of medical oncologists, nurses, and psycho-oncologists. Data were processed by adopting a thematic analysis approach. RESULTS: The diagnosis and treatment of breast cancer entails a radical change in patients' day-to-day that linger in the mid-term. Seven stages have been defined that correspond to the different medical processes: diagnosis/unmasking stage, surgery/cleaning out, chemotherapy/loss of identity, radiotherapy/transition to normality, follow-up care/the "new" day-to-day, relapse/starting over, and metastatic/time-limited chronic breast cancer. The most relevant aspects of each are highlighted, as are the various cross-sectional aspects that manifest throughout the entire patient journey. CONCLUSIONS: Comprehending patients' experiences in depth facilitates the detection of situations of risk and helps to identify key moments when more precise information should be offered. Similarly, preparing the women for the process they must confront and for the sequelae of medical treatments would contribute to decreasing their uncertainty and concern, and to improving their quality-of-life.

Multidimensional scale of perceived social support (mspss) in cancer patients: psychometric properties and measurement invariance / Escala Multidimensional de Apoyo Social Percibido (MSPSS) en pacientes con cáncer: propiedades psicométricas e invariancia de medida

BACKGROUND: The aim of this study was to evaluate the psychometric properties, convergent validity, and factorial invariance of the Multidimensional Scale of Perceived Social Support (MSPSS) in cancer patients. METHOD: Confirmatory factor analysis (CFA) was conducted to explore the scale's dimensionality and test for strong measurement invariance across sex and age in a cross-sectional, multicenter, prospective study. Patients completed the MSPSS and Satisfaction with Life Scale (SWLS). RESULTS: A total of 925 consecutive patients were recruited in 13 hospitals between July 2015 and December 2018. The CFA indicated that the original three-factor model was replicated in patients with cancer. The results of the multi-group CFA revealed a strong invariance according to sex and age. The Spanish version of the MSPSS had high estimated reliability with values exceeding .90. The simple sum of the items of each scale was a good indicator of oncology patients' perceived social support. The three MSPSS subscales correlated significantly with the SWLS. Women scored higher on social support by friends than men. CONCLUSION: The Spanish version of the MSPSS proved to be a valid, reliable instrument to assess perceived social support in cancer patients

ANTECEDENTES: el objetivo de este estudio fue evaluar las propiedades psicométricas, la validez convergente y la invariancia factorial de la Escala Multidimensional de Apoyo Social Percibido (MSPSS) en pacientes con cáncer. MÉTODO: el análisis factorial confirmatorio (CFA) se realizó para explorar la dimensionalidad de la escala y la invariancia de medición por sexo y edad en un estudio prospectivo, transversal y multicéntrico. Los pacientes completaron el MSPSS y la Escala de Satisfacción con la Vida (SWLS). RESULTADOS: un total de 925 pacientes consecutivos fueron reclutados en 13 hospitales entre julio de 2015 y diciembre de 2018. El CFA indicó que el modelo original de tres factores fue replicado en pacientes con cáncer. Los resultados del CFA multigrupo revelaron invariancia fuerte según el sexo y la edad. La versión en español del MSPSS tenía una alta fiabilidad estimada, con valores superiores a 0,90. La suma simple de los ítems de cada escala fue un buen indicador del apoyo social percibido de los pacientes oncológicos. Las tres subescalas MSPSS se correlacionaron significativamente con el SWLS. CONCLUSIÓN: la versión en español del MSPSS demostró ser un instrumento válido y confiable para evaluar el apoyo social percibido en pacientes con cáncer

Multidimensional Scale of Perceived Social Support (MSPSS) in cancer patients: psychometric properties and measurement invariance.

BACKGROUND: The aim of this study was to evaluate the psychometric properties, convergent validity, and factorial invariance of the Multidimensional Scale of Perceived Social Support (MSPSS) in cancer patients. METHOD: Confirmatory factor analysis (CFA) was conducted to explore the scale's dimensionality and test for strong measurement invariance across sex and age in a cross-sectional, multicenter, prospective study. Patients completed the MSPSS and Satisfaction with Life Scale (SWLS). RESULTS: A total of 925 consecutive patients were recruited in 13 hospitals between July 2015 and December 2018. The CFA indicated that the original three-factor model was replicated in patients with cancer. The results of the multi-group CFA revealed a strong invariance according to sex and age. The Spanish version of the MSPSS had high estimated reliability with values exceeding .90. The simple sum of the items of each scale was a good indicator of oncology patients' perceived social support. The three MSPSS subscales correlated significantly with the SWLS. Women scored higher on social support by friends than men. CONCLUSION: The Spanish version of the MSPSS proved to be a valid, reliable instrument to assess perceived social support in cancer patients.

Ascertaining breast cancer patient experiences through a journey map: A qualitative study protocol.

BACKGROUND: The current cancer care system must be improved if we are to have in-depth knowledge about breast cancer patients' experiences throughout all the stages of their disease. AIM: This study seeks to describe breast cancer patients' experience over the course of the various stages of illness by means of a journey model. METHODS: This is a qualitative descriptive study. Individual, semi-structured interviews will be administered to women with breast cancer and breast cancer survivors. Patients will be recruited from nine large hospitals in Spain and intentional sampling will be used. Data will be collected by means of a semi-structured interview that was elaborated with the help of medical oncologists, nurses, and psycho-oncologists. Data will be processed adopting a thematic analysis approach. DISCUSSION: The outcomes of this study will afford new insights into breast cancer patients' experiences, providing guidance to improve the care given to these individuals. This protocol aims to describe the journey of patients with breast cancer through the healthcare system to establish baseline data that will serve as the basis for the development and implementation of a patient-centered, evidence-based clinical pathway.