Cancer worry at higher-risk sample of hereditary cancer in Spain.

BACKGROUND: Few studies have examined the prevalence of cancer worry in the general and at-risk population. The objective of this study was to describe the prevalence of cancer worry in a sample of individuals at increased risk of developing hereditary cancer, determine differences in cancer worry by socio-demographic characteristics and assess the relationship between cancer worry and psychological distress. METHODS: A cross-sectional study was designed with 895 patients. The Cancer Worry Scale (CWS), Hospital Anxiety and Depression Scale (HADS) for psychological distress and sociodemographic characteristics were examined. The multiple linear regression model was developed to explore what variables were predicted for cancer worry. To identify variables associated with higher cancer worry scores, a logistic model was fitted. RESULTS: In the at-higher-risk sample of hereditary cancer, the mean of CWS was 10.20 (SD: 3.70). The significant predictors for cancer worry were gender, age, previous psychiatric treatment, patients affected by cancer and having children. In the sample, 38% of patients had higher scores on cancer worry, the variables associated were patients affected by cancer compared, women, widow/divorced participants, less than secondary school, patients with previous psychiatric treatment and patients less than 55 years old. Using the HADS cutoff score 29% of the sample showed significant psychological distress, more anxiety (35%) than depressive (22%) symptomatology. Psychological distress showed a higher variability (36%) on cancer worry. CONCLUSION: Findings highlighted distinctive profiles in socio-demographic characteristics according to the degree of cancer worry; therefore, genetic counseling should continue to be provided to address cancer worry and relieve psychological distress.

Comparison of the accuracy of the 7-item HADS Depression subscale and 14-item total HADS for screening for major depression: A systematic review and individual participant data meta-analysis.

The seven-item Hospital Anxiety and Depression Scale Depression subscale (HADS-D) and the total score of the 14-item HADS (HADS-T) are both used for major depression screening. Compared to the HADS-D, the HADS-T includes anxiety items and requires more time to complete. We compared the screening accuracy of the HADS-D and HADS-T for major depression detection. We conducted an individual participant data meta-analysis and fit bivariate random effects models to assess diagnostic accuracy among participants with both HADS-D and HADS-T scores. We identified optimal cutoffs, estimated sensitivity and specificity with 95% confidence intervals, and compared screening accuracy across paired cutoffs via two-stage and individual-level models. We used a 0.05 equivalence margin to assess equivalency in sensitivity and specificity. 20,700 participants (2,285 major depression cases) from 98 studies were included. Cutoffs of ≥7 for the HADS-D (sensitivity 0.79 [0.75, 0.83], specificity 0.78 [0.75, 0.80]) and ≥15 for the HADS-T (sensitivity 0.79 [0.76, 0.82], specificity 0.81 [0.78, 0.83]) minimized the distance to the top-left corner of the receiver operating characteristic curve. Across all sets of paired cutoffs evaluated, differences of sensitivity between HADS-T and HADS-D ranged from -0.05 to 0.01 (0.00 at paired optimal cutoffs), and differences of specificity were within 0.03 for all cutoffs (0.02-0.03). The pattern was similar among outpatients, although the HADS-T was slightly (not nonequivalently) more specific among inpatients. The accuracy of HADS-T was equivalent to the HADS-D for detecting major depression. In most settings, the shorter HADS-D would be preferred. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Comparison of psychological distress for breast, ovarian and colorectal cancer predisposition in a Spanish sample at high risk of hereditary cancer.

OBJECTIVES: Although future treatments may speciically target the tumour phenotype, other factors should be included to confirm the efficacy of treatment and prevention strategies. The objective of this study was to compare sociodemographic characteristics and psychological distress for breast, ovarian and colorectal cancer predisposition syndrome in a sample at high risk of hereditary cancer. METHODS: A cross-sectional study was designed with 799 patients. The nonparametric test, with Kruskal-Wallis test, was used to compare three genetic cancer syndromes, with significant differences in sample size. RESULTS: There were no differences in cancer hereditary syndromes related to sociodemographic characteristics except sex, as breast/ovarian cancer mainly affects women. No group differences were observed for cancer worry (P = 0.17). Breast/ovarian cancer syndrome showed significantly higher scores in cognitive distress compared to colorectal cancer (P = 0.01). CONCLUSION: The differences in the distribution of sociodemographic characteristics in these hereditary cancer syndromes can help to better plan resources for patient care in genetic counselling units.

Psychiatric symptoms in a Spanish sample with hereditary cancer risk.

OBJECTIVE: An integral part of the genetic counselling process is the assessment of psychiatric morbidity. The objectives of this study were first to assess psychometric properties of the General Health Questionnaire (GHQ-28items) in a Spanish sample at increased risk of hereditary cancer, and second evaluated the prevalence of psychiatric morbidity and the contribution of socio-demographic and clinical characteristics to predict distress. METHODS: A cross-sectional study was designed with 766 patients. Psychometric analysis with exploratory factor analysis was performed. The influences of socio-demographic characteristics were investigated by multiple linear regression analyses. RESULTS: Factor analysis supported the four-factor solution of the original GHQ-28; Depression and Social dysfunction scales were more stable than Anxiety and Somatic symptom scales. Psychiatric morbidity was detected in 212 (27.9%) patients. The variables predicting psychiatric morbidity were gender, age, patient affected by cancer, previous psychiatric treatment, and patients with relatives affected by cancer. The higher prevalence of psychiatric symptoms was in the age group from 41 to 59 years (16.73%), women (24.37%), patients affected by cancer (19.89%), patients without previous psychiatric treatment (20.82%), and patients with relatives affected by cancer (21.74%). CONCLUSION: Screening psychological distress should consider socio-demographic and clinical characteristics with reference to improve the quality of care. TRIAL REGISTRATION: Clinical trials identifier: NCT04428710.

Perfil de personalidad en pacientes con trasplante renal: el modelo alternativo de los cinco factores / Personality profile of kidney transplant patients: the alternative five factor model

Resumen Introducción: la investigación sobre rasgos de personalidad en pacientes con trasplante renal es limitada. El objetivo de este estudio fue describir el perfil de personalidad de pacientes con trasplante renal, utilizando el modelo alternativo de cinco factores (AFFM), y compararlo con población estándar española. Material y métodos: la personalidad fue evaluada mediante el Zuckerman-Kuhlman Personality Questionnaire (ZKPQ). Una muestra de 207 pacientes con trasplante renal se emparejó por edad y género con 207controles de la población estándar. El análisis de regresión logística permitió estudiar la aportación de cada dimensión del ZKPQ al perfil distintivo de los pacientes trasplantados. Resultados: aparecieron diferencias significativas en las dimensiones de Neuroticismo-Ansiedad (p=.001), Agresión-Hostilidad (p=.009) y Actividad (p=.001), con puntuaciones bajas en pacientes trasplantados en comparación con la población estándar. La sociabilidad (p=.024) fue significativamente mayor en pacientes trasplantados. En el análisis de regresión, las bajas puntuaciones en Neuroticismo-Ansiedad (p=.005) y Actividad (p=.001) fueron predictores significativos para caracterizar los rasgos de personalidad de pacientes trasplantados. Conclusiones: desde el AFFM, los pacientes con trasplante renal muestran un perfil diferente de personalidad comparado con la población estándar, con bajas puntuaciones en las dimensiones de Neuroticismo-Ansiedad y Actividad.

Abstract Background: There is limited research on personality traits that characterized kidney transplant patients. The aim of this study was to describe personality profile of kidney transplant patients using the Alternative Five Factor Model (AFFM), and compared it with the Spanish standard population. Method: Personality was assessed using the Zuckerman-Kuhlman Personality Questionnaire (ZKPQ). A sample of 207 kidney transplant patients was matched by age and gender with 207 standard range controls. A logistic regression analyses was utilized to study the contribution of each ZKPQ dimension to describe the distinctive transplant patient's profile. Results: Significant differences were showed in Neuroticism-Anxiety (p=.001), Aggression-Hostility (p=.009), and Activity (p=.001) dimensions, with lower scores on transplant patients compared with standard population. But Sociability (p=.024) was significantly higher on kidney transplant patients. In logistic regression analysis low scores on Neuroticism-Anxiety (p=.005) and Activity (p=.001) were the significant predictors to characterize personality traits of kidney transplant patients. Conclusions: Kidney transplant patients had a differential profile under the AFFM compared to standard range sample, with lower scores on Neuroticism-Anxiety and Activity dimensions.

Evaluación de la empatía en donante vivo de riñón / Evaluation of emphathy in living kidney donors

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Calidad de vida relacionada con la salud en el trasplante renal: seguimiento longitudinal a 2 años / Health related quality of life in renal transplantation: 2 years of longitudinal follow-up

Antecedentes y objetivo: La calidad de vida relacionada con la salud (CVRS) se considera una medida de resultado del trasplante renal. En este estudio se evaluaron los cambios en la CVRS y los síntomas específicos de la enfermedad renal, además de los efectos de variables sociodemográficas y clínicas en la CVRS percibida por el paciente. Pacientes y método: Se realizó un estudio longitudinal, con 5 momentos de evaluación durante 2 años después del trasplante. Para evaluar la CVRS se administró el Kidney Disease Quality of Life Questionnaire Short Form, y el Hospital Anxiety and Depression Scale para evaluar el malestar emocional. Resultados: A los 6 meses postrasplante, los pacientes tienen una CVRS similar a la población general. La dimensión de efectos de la enfermedad renal obtuvo un tamaño de efecto grande (η2=0,29), y un tamaño medio la dimensión de sobrecarga de la enfermedad renal (η2=0,12), la dimensión de actividad laboral (η2=0,12) y la dimensión de función sexual (η2=0,13). El malestar emocional, la hemoglobina y la creatinina influyeron significativamente en la CVRS percibida por el paciente. Conclusiones: Durante los 2 años posteriores al trasplante renal se observó una mejora de la CVRS en cuanto a aspectos generales y síntomas específicos de la enfermedad (AU)

Background and objective: Health related quality of life (HRQoL) is recognized as an outcome measure in kidney transplantation. In this study was assessed changes on HRQoL and kidney-specific symptoms, also was evaluated the effect of socio-demographic and clinical parameters on patient's perceived HRQoL. Patients and method: A longitudinal study was done, at 5 time-points over 2 years after transplantation. To evaluate HRQoL the Kidney Disease Quality of Life Questionnaire Short Form was administrated, and Hospital Anxiety and Depression Scale was used to assess psychological distress. Results: At 6-months after transplantation, patients had similar HRQoL scores compared to the general population. The improvement on effects of kidney disease domain could be considered as large (η2=0.29), and medium on burden of kidney disease domain (η2=0.12), work status domain (η2=0.12), and sexual function domain (η2=0.13). Psychological distress, depressive symptoms, haemoglobin, and serum creatinine had significant influence on patient's perceived HRQoL over 2 years after transplantation. Conclusions: An improvement of HRQoL was observed on general and specific-targeted symptoms over 2 years after renal transplantation (AU)

Health related quality of life in renal transplantation: 2 years of longitudinal follow-up. / Calidad de vida relacionada con la salud en el trasplante renal: seguimiento longitudinal a 2 años.

BACKGROUND AND OBJECTIVE: Health related quality of life (HRQoL) is recognized as an outcome measure in kidney transplantation. In this study was assessed changes on HRQoL and kidney-specific symptoms, also was evaluated the effect of socio-demographic and clinical parameters on patient's perceived HRQoL. PATIENTS AND METHOD: A longitudinal study was done, at 5 time-points over 2 years after transplantation. To evaluate HRQoL the Kidney Disease Quality of Life Questionnaire Short Form was administrated, and Hospital Anxiety and Depression Scale was used to assess psychological distress. RESULTS: At 6-months after transplantation, patients had similar HRQoL scores compared to the general population. The improvement on effects of kidney disease domain could be considered as large (η2=0.29), and medium on burden of kidney disease domain (η2=0.12), work status domain (η2=0.12), and sexual function domain (η2=0.13). Psychological distress, depressive symptoms, haemoglobin, and serum creatinine had significant influence on patient's perceived HRQoL over 2 years after transplantation. CONCLUSIONS: An improvement of HRQoL was observed on general and specific-targeted symptoms over 2 years after renal transplantation.

Alfabetización en salud y enfermedad renal crónica / Health literacy and chronic kidney disease

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Health-related behaviours after 1 year of renal transplantation.

Health-related behaviours and psychological distress were examined after kidney transplantation. Patients were evaluated at 1 month, 6 months and 1 year after transplantation. Participants completed the Healthy Behaviours Questionnaire and the Hospital Anxiety and Depression Scale. No significant differences in Healthy Behaviours Questionnaire's total score and psychological comorbidity were observed at three time points. However, there was an increase in drug-consumer habits ( p < 0.05) and a reduction in sedentary lifestyle ( p < 0.05) at 6 months and 1 year. Moreover, at 1 year, post-transplant had increased the harmful health habits ( p < 0.05). In regression analysis, anxiety symptoms were significant predictors of Healthy Behaviours Questionnaire change at a year post-transplantation.

Caregiver burden in end-of-life care: advanced cancer and final stage of dementia.

OBJECTIVE: Considering two advanced illnesses, cancer and end-stage dementia, the aim of this study was to describe the symptoms of caregiver psychological distress and burden. METHOD: In this cross-sectional study, regression analyses were calculated to explain the influence of psychological distress in caregiver burden. A t test was employed to compare differences between the symptoms of caregiver burden. RESULTS: The percentage of psychological distress was similar between caregivers of cancer patients (77.6%) and caregivers of dementia patients (72.4%). In the regression analysis, cancer caregiver distress accounted for 27.9% of the variance in symptoms of burden, while dementia caregiver distress accounted for 24.4% of the variance in symptoms of burden. No significant differences were revealed when comparing caregiver burden symptoms between caregivers of the two advanced illnesses (t = 0.06; p = 0.94). SIGNIFICANCE OF RESULTS: In end-of-life care for patients with dementia, due to significant levels of caregiver distress and burden symptoms, there is a need to support caregivers in the same way as is done for caregivers of cancer patients.

The influence of coping response and health-related quality of life on perceived social support during cancer treatment.

OBJECTIVE: In the biopsychosocial approach, perceived social support has served as a protective factor for psychological adjustment to cancer. This study aimed to determine the influence of different coping responses and health-related quality of life (HRQoL) domains on perceived social support during cancer treatment. METHOD: A cross-sectional analysis was carried out in a sample of 757 cancer outpatients. The Medical Outcomes Study Social Support Survey (MOS-SSS) was employed to assess perceived social support. The Mental Adjustment to Cancer (MAC) Scale measured coping response, and HRQoL was tested with the Medical Outcomes Study Short Form-36 (SF-36). Multivariate analyses were carried out to examine the extent to which coping and HRQoL were associated with perceived social support. RESULTS: Coping response explained only 2% of the variance in perceived social support, but Hopelessness had a significant influence on perceived social support (p ≤ 0.01). HRQoL, physical, and mental domains made a significant contribution toward perceived social support, accounting for around 10% of total variance. More than coping response, HRQoL's physical and mental domains had an important influence on perceived social support during cancer treatment. SIGNIFICANCE OF RESULTS: The findings of the current study report the importance of HRQoL domains in predicting perceived social support during cancer treatment, emphasizing the holistic and multidisciplinary approach to facilitate adjustment to cancer.

A propósito de un caso: supresión emocional en estado avanzado de la enfermedad / A case report: emotional suppression in advanced disease

INTRODUCCIÓN. La supresión emocional se ha definido como un mecanismo predictor de la respuesta de afrontamiento a enfermedades físicas, pudiendo bloquear en la persona el desarrollo de estrategias activas para el manejo de sus emociones. Se expone el caso de una mujer de 59 años que durante los últimos años presenta una clínica somatica difusa. Su historia vital de pérdidas significativas, y su tendencia a la supresión emocional como estrategia bàsica de afrontamiento, enmascararon un cuadro depresivo cronificado, dificultando la atención y tratamiento medico, así como retrasaron el diagnóstico certero de la enfermedad. Se plantea la importancia de evaluar con prontitud estas posibles dificultades emocionales, de manera que puedan rescatarse estrategias de afrontamiento positivas que permitan al paciente un adecuado manejo de la enfermedad y de conductas de búsqueda de salud (AU)

Emotional suppression has been defined as a mechanism that could be predictor of the coping response to physical illness, this response could block in the person a developing active strategies to manage their emotions. We described the case report of a 59 years-old woman, who showed at the last time diffuse somatic symptoms. Her psychobiography of significant personal losses, and her tendency to show emotional suppression as a basic coping style, masked a chronic depressive disease. These coping styles could be blocked the medical treatment and care of the patient, moreover than delayed the accurate diagnosis of the disease. It was highlight that the early assessment of these coping styles in front of emotional difficulties could be rescue positive coping responses, to allow the appropriate management of the disease and their health related behavior (AU)

La calidad de vida relacionada con la salud en el paciente trasplantado renal / Health related quality of life in the kidney transplant patient

Fundamento y objetivo: El trasplante es una modalidad de tratamiento eficaz para la insuficiencia renal terminal. El objetivo de este estudio fue comparar, al mes y 6 meses postrasplante, la percepción de la calidad de vida relacionada con la salud (CVRS) en pacientes con trasplante renal con valores de la población general. Pacientes y método: El Cuestionario de Calidad de Vida en Enfermedades Renales fue administrado al mes y 6 meses postrasplante. La comparación con la población general fue realizada con la parte genérica del cuestionario. Se compararon puntuaciones típicas estandarizadas. Resultados: Participaron 72 pacientes, con una mediana de edad de 57 años. A los 6 meses postrasplante, la CVRS en todas sus dimensiones muestra valores similares a los de la población general. Al comparar la CVRS al mes y 6 meses del trasplante, resultan significativas las diferencias en todos las dimensiones, excepto en Salud general y Rol emocional. Conclusiones: A los 6 meses del trasplante hay una mejoría en la CVRS que es semejante a la percibida en la población general (AU)

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[Health related quality of life and kidney transplantation: a comparison with population values at 6 months post-transplant]. / Calidad de vida relacionada con la salud y trasplante renal: comparación con los valores poblacionales a los 6 meses postrasplante.

BACKGROUND AND OBJECTIVE: Transplantation is an effective treatment for end stage renal failure. The aim of this study was to compare patient's perceived health related quality of life (HRQoL) with population values, at one moth and 6 moths of kidney post-transplantation. PATIENTS AND METHOD: The Questionnaire of Quality of Life in Kidney Disease was administered during the first month and also at the 6 months following transplantation. A comparison with the general population was done with the generic part of the questionnaire. In the statistical analyses, typical standardized scores were used. RESULTS: In this study 72 patients were included with a median age of 57 years. At the 6 month post-transplantation, the patient's HRQoL showed values that were similar to the general population. When we compared the HRQoL at the first month and at the 6 month post-transplantation, the differences of HRQoL were significant in all dimensions, except on the General health and Emotional role. CONCLUSIONS: At 6 moths after transplantation, there was an improvement in the perceived HRQoL that was similar to the general population.

Evaluación del sufrimiento en la demencia avanzada / Suffering assessment in the advanced dementia

Introducción: En el estadio de fin de vida de la demencia, las comorbilidades médicas se asocian a un grado elevado de sufrimiento en el paciente. Se trata de averiguar la relación entre los síntomas de falta de confortabilidad y el grado de sufrimiento del paciente, así como aclarar su relación con el malestar emocional y el grado de sobrecarga del cuidador. Material y métodos: Se incluyen pacientes con demencia avanzada según los criterios del Hospice Enrolment Criteria for End-stage Dementia patients. El sufrimiento del paciente se evaluó con la escala Mini-Suffering State Examination (MSSE). En los cuidadores se administró la escala de sobrecarga del cuidador de Zarit (ZR), y el cuestionario de salud general de Goldberg (GHQ-28). Se utilizan técnicas de tendencia central y análisis de correlaciones. Resultados: Se registraron datos de 71 pacientes. De la comorbilidad de síntomas asociados a la demencia avanzada, la neumonía (rho de Spearman: −0,29; p = 0,01) y la malnutrición (rho de Spearman: −0,25; p = 0,03), muestran asociaciones significativas con la puntuación total de la escala MSSE. No aparecen correlaciones significativas entre el sufrimiento del paciente y los síntomas psiquiátricos del cuidador (r: 0,11; p = 0,37) o grado de la sobrecarga (r: 0,13; p = 0,32). Conclusiones: La identificación de signos de sufrimiento en los pacientes con demencia avanzada viene reconocida por las afecciones concurrentes específicas como la neumonía y la malnutrición. El malestar emocional del cuidador no muestra relación con el sufrimiento del paciente medido por el MSSE (AU)

Introduction: At the end stage of life of dementia, medical comorbidities are associated with a high degree of patient suffering. The aim of this study was to assess the relationship between the lack of symptoms of discomfort and the level of patient suffering. The relationship with psychological distress and caregiver burden was also clarified. Material and methods: This study included patients with advanced dementia according to the criteria of the Hospice Enrolment Criteria for End-stage Dementia patients. Patient suffering was assessed with Mini-Suffering State Examination (MSSE). The caregivers were scored by Zarit caregiver burden scale (ZR), and the General Health Questionnaire of Goldberg (GHQ-28). Central tendency and correlation tests were used in the statistical analysis. Results: The study recorded data from 71 patients. In the comorbidity of medical symptoms associated with advanced dementia, pneumonia (Spearman’s rho: −0.29; P=.01), and malnutrition (Spearman’s rho: −0.25; P=.03), showed a significant association with the total scale score of MSSE. There were no significant correlations between patient suffering and caregiver psychological distress (r: 0.11; P=.37), or caregiver burden (r: 0.13; P=.32). Conclusions: The identification of suffering in patients with advanced dementia is recognised by specific symptoms, such as pneumonia and malnutrition. The caregiver’ psychological distress of the caregiver was shown to be unrelated to patient suffering as measured by MSSE (AU)

[Suffering assessment in the advanced dementia]. / Evaluación del sufrimiento en la demencia avanzada.

INTRODUCTION: At the end stage of life of dementia, medical comorbidities are associated with a high degree of patient suffering. The aim of this study was to assess the relationship between the lack of symptoms of discomfort and the level of patient suffering. The relationship with psychological distress and caregiver burden was also clarified. MATERIAL AND METHODS: This study included patients with advanced dementia according to the criteria of the Hospice Enrolment Criteria for End-stage Dementia patients. Patient suffering was assessed with Mini-Suffering State Examination (MSSE). The caregivers were scored by Zarit caregiver burden scale (ZR), and the General Health Questionnaire of Goldberg (GHQ-28). Central tendency and correlation tests were used in the statistical analysis. RESULTS: The study recorded data from 71 patients. In the comorbidity of medical symptoms associated with advanced dementia, pneumonia (Spearman's rho: -0.29; P=.01), and malnutrition (Spearman's rho: -0.25; P=.03), showed a significant association with the total scale score of MSSE. There were no significant correlations between patient suffering and caregiver psychological distress (r: 0.11; P=.37), or caregiver burden (r: 0.13; P=.32). CONCLUSIONS: The identification of suffering in patients with advanced dementia is recognised by specific symptoms, such as pneumonia and malnutrition. The caregiver' psychological distress of the caregiver was shown to be unrelated to patient suffering as measured by MSSE.