[Frequency of depression and anxiety in a group of 623 patients with cancer]. / Estado emocional de pacientes oncológicos: evaluación de la ansiedad y la depresión en función de variables clínicas y sociodemográficas.

BACKGROUND: Patients with life threatening diseases may experience anxiety and depression. AIM: To analyze anxiety and depression in Chilean patients with cancer. MATERIAL AND METHODS: The Hospital Anxiety and Depression Scale (HADS) was applied to 623 ambulatory and hospitalized patients with cancer (70% women). RESULTS: A low frequency of clinical anxiety (11,7%) and depression (5,3%) was observed. Depression was more common in women, in patients with mid-level education, in unemployed patients and in older people. Anxiety was more common in young and unemployed patients. CONCLUSIONS: The frequency of depression and anxiety was low in this group of cancer patients. Women, educated, uneomployed, and older subjects are risk groups for depression. Young and unemployed subjects experience more anxiety.

Estado emocional de pacientes oncológicos: evaluación de la ansiedad y la depresión en función de variables clínicas y sociodemográficas / Frequency of depression and anxiety in a group of 623 patients with cancer

Background: Patients with life threatening diseases may experience anxiety and depression. Aim: To analyze anxiety and depression in Chilean patients with cancer. Material and Methods: The Hospital Anxiety and Depression Scale (HADS) was applied to 623 ambulatory and hospitalized patients with cancer (70% women). Results: A low frequency of clinical anxiety (11,7%) and depression (5,3%) was observed. Depression was more common in women, in patients with mid-level education, in unemployed patients and in older people. Anxiety was more common in young and unemployed patients. Conclusions: The frequency of depression and anxiety was low in this group of cancer patients. Women, educated, uneomployed, and older subjects are risk groups for depression. Young and unemployed subjects experience more anxiety.

La Activación Conductual (AC) en mujeres con cáncer de mama durante la quimioterapia: análisis de la evolución de casos / Behavioral Activation Therapy (AC) in women with breast cancer undergoing chemotherapy: case evolution análisis

OBJETIVO: Valorar la utilidad de la Activación Conductual para el afrontamiento del cáncer. MÉTODO: 18 pacientes con cáncer de mama de reciente diagnóstico siguieron 6 sesiones protocolarizadas dirigidas a recuperar actividades relevantes, eliminar conductas de enfermedad y modificar patrón de evitación experiencial. El análisis funcional determinó objetivos concretos de intervención y la estimación del cambio clínico en cada caso. Se evaluó el cambio pre-post-seguimiento (trimestral). RESULTADOS: Se observa recuperación de las actividades, en particular, domésticas (p = 0,005) y ocio (p = 0,05). Es escasa la presencia de patrones de evitación, aunque se logra su reconocimiento. Las conductas de enfermedad se reconocen y reducen (p = 0,03). No hay casos de ansiedad ni depresión (HAD), pero sí sintomatología que mejora durante la intervención. CONCLUSIONES: La orientación de los pacientes oncológicos hacia el mantenimiento de actividades de la vida cotidiana relevantes durante la quimioterapia, parece mejorar el afrontamiento de la enfermedad

OBJECTIVE: To assess the utility of Behavioral Activation for coping with cancer. METHOD: 18 patients with recently diagnosed breast cancer followed 6 protocoled sessions, aimed to recover relevant activities, eliminate illness behavior and to modify experiential avoidance patterns. Functional analysis determined concrete intervention objectives and the estimation of clinically significant change for each case. Pre-post and three months follow up changes were assessed. RESULTS: Activity recovery is observed specifically related to of daily living (p = .005) and leisure activities (p = .05). The presence of avoidance patterns is scarce, although recognizable. Illness behaviors are recognized and reduced (p = .03). There were no cases of anxiety and depression (HAD), although some symptomatology is detected, it evolves favorably during the intervention. CONCLUSIONS: The guidance of oncologic patients towards maintaining relevant activities of daily living during chemotherapy, seems to improve the coping with the disease

Assessment of the Hospital Anxiety and Depression Scale for cancer patients.

BACKGROUND: Depression and anxiety are common in patients with cancer. AIM: To adapt and validate the Hospital Anxiety and Depression Scale (HADS) for adult Chilean cancer patients, and to provide information about their prevalence of anxiety and depression. MATERIAL AND METHODS: Two hundred fifteen patients with cancer answered an adapted version of HADS for Chilean population. The language adjustment of the scale was carried out with the opinions of 10 expert linguists and with a pilot study on 17 cancer patients. The Depression and Anxiety subscales of the DASS-21 were also applied to verify the convergent validity of HADS: Results: The confirmatory factor analysis indicated that the data fits the model of two correlated factors (anxiety and depression), χ2 = 98.608; df = 76;p < 0.05; χ2/df= 1.23, RMSEA = 0.037; CFI = 0.99; TLI = .98. Reliability analysis showed an adequate internal consistency of both subscales (.76 for anxiety and .84 for depression) and the general scale (.87). Correlations between HADS and DASS-21 scores were significant for both anxiety (r =.514, p < 0.001) and depression (r = 0.600, p < 0.001). Prevalence rates were approximately 30% for depression (actual = 12%, possible = 22.8%) and approximately 20% for anxiety (actual = 7%, possible = 8.4%). CONCLUSIONS: We conclude that HADS is a reliable and valid instrument for screening clinically relevant anxiety and depression symptoms in Chilean cancer patients.

Assessment of the Hospital Anxiety and Depression Scale for cancer patients / Adaptación y validación de la Escala de Ansiedad y Depresión Hospitalaria en pacientes chilenos con cáncer

Background: Depression and anxiety are common in patients with cancer. Aim: To adapt and validate the Hospital Anxiety and Depression Scale (HADS) for adult Chilean cancer patients, and to provide information about their prevalence of anxiety and depression. Material and Methods: Two hundred fifteen patients with cancer answered an adapted version of HADS for Chilean population. The language adjustment of the scale was carried out with the opinions of 10 expert linguists and with a pilot study on 17 cancer patients. The Depression and Anxiety subscales of the DASS-21 were also applied to verify the convergent validity of HADS: Results: The confirmatory factor analysis indicated that the data fits the model of two correlated factors (anxiety and depression), χ2 = 98.608; df = 76;p < 0.05; χ2/df= 1.23, RMSEA = 0.037; CFI = 0.99; TLI = .98. Reliability analysis showed an adequate internal consistency of both subscales (.76 for anxiety and .84 for depression) and the general scale (.87). Correlations between HADS and DASS-21 scores were significant for both anxiety (r =.514, p < 0.001) and depression (r = 0.600, p < 0.001). Prevalence rates were approximately 30% for depression (actual = 12%, possible = 22.8%) and approximately 20% for anxiety (actual = 7%, possible = 8.4%). Conclusions: We conclude that HADS is a reliable and valid instrument for screening clinically relevant anxiety and depression symptoms in Chilean cancer patients.

Objetivo: Adaptar y validar la Escala Hospitalaria de Ansiedad y Depresión (HAD) a población adulta oncológica chilena y aportar información sobre la prevalencia de ansiedad y depresión en la muestra. Método: Participantes: 215 pacientes oncológicos. Instrumentos: Protocolo de datos sociodemográficos y clínicos; HAD y el DASS-21, utilizada como Gold Standar para comprobar la validez de convergencia de la escala. Procedimiento: adaptación lingüística de la escala mediante juicio de expertos lingüistas (n = 10) y pilotaje con 17 pacientes oncológicos. Resultados: El análisis factorial confirmatorio indica que la escala se ajusta al modelo de dos factores correlacionados (ansiedad y depresión) (χ2 = 98,608; gl = 76; p < 0,05; χ2/gl = 1.23; RMSEA = 0,037; CFI = 0,99; TLI = 0,98). Los análisis de confiabilidad ponen de manifiesto una adecuada consistencia interna tanto de las subescalas que la componen (0,76 para ansiedad y 0,84 para depresión) como de la escala general (0,87). Las correlaciones entre las puntuaciones del HAD y el DASS-21 fueron positivas y significativas tanto para ansiedad (r = 0,514, p < 0,001) como para depresión (r = 0,600, p < 0,001). Se señalan cifras de prevalencia en torno al 30% para depresión (caso = 12%; posible = 22,8%) y al 20% para ansiedad (caso = 7%; posible = 8,4%). Conclusiones: El HADS es un instrumento válido y confiable para el screnning de síntomas de ansiedad y depresión de relevancia clínica en pacientes oncológicos chilenos.

La intervención psicológica en pacientes oncológicos: una revisión de la literatura (2000-2014) / Psychological intervention in oncological patients: a review (2000-2014)

Objetivo: Valorar la utilidad de las distintas intervenciones psicológicas en relación al estado emocional, físico, funcionalidad y la calidad de vida de los pacientes oncológicos en las diferentes fases de la enfermedad. Método: Se realizó una búsqueda bibliográfica en las bases de datos Medline y CancerLit, entre el año 2000 y 2014. Resultados: Un total de 122 estudios experimentales se describen agrupados según las fases de la enfermedad y los tipos de intervención psicológica aplicados. Se discute acerca de sus garantías metodológicas y se analizan las medidas y valoraciones de eficacia terapéutica para identificar las intervenciones con mejores pronósticos. Conclusiones: En general, los trabajos revisados han logrado resultados favorables en relación a la mejora del estado emocional, físico, funcional y la calidad de vida de los pacientes. No obstante, sus limitaciones metodológicas (uso de muestras pequeñas, dificultades de generalización, ausencia de grupo control, etc.) y, en ocasiones, resultados contradictorios señalan cautela a la hora de concluir sobre la efectividad o no de la intervención psicológica en cáncer y los beneficios de su aplicación

Objective: The aim of this work has been to assess the use of the different psychological interventions related to the emotional, physical, functional state and quality of life of cancer patients in the different phases of the illness. Method: For this purpose, a bibliographic search between the years 2000 and 2014 in Medline and CancerLit databases was conducted. Results: A total of 122 experimental studies are described grouped according to the illness phases and the kind of psychological intervention employed. It is discussed about the methodological guaranties and the measures and the assessments of therapeutic efficiency to identify the interventions with the best prognostic. Conclusions: In general, the studies reviewed have achieved favorable results in relation to the improvement of the emotional, physical, functional state and the quality of life the patients. Nevertheless, their methodological limitations (little samples, difficulties of generalization, control group absence, etc.) and, sometimes, contradictory results suggest to be cautious when concluding about the effectiveness or not of the psychological intervention in cancer and the benefits of its application

Terapia de activación conductual en pacientes con cáncer / Behavioral activation treatment for cancer patients

Objetivo: Valorar la eficacia de la Terapia de Activación Conductual con pacientes con cáncer de pulmón y cáncer de mama durante el tratamiento oncológico. Procedimiento: Se establecen como criterio de resultado: frecuencia e intensidad de síntomas de enfermedad y/o trata-miento; afectación de la autonomía personal, actividad doméstica, laboral, ocio, relaciones familiares y sociales y alteraciones emocionales. Los datos se recogen mediante escalas estandarizadas (IK, HAD, QLQ-C30), autoinforme y entrevista clínica en cada sesión de tratamiento y en un seguimiento de tres meses. Se empleó un grupo control que ocupó el mismo número de sesiones en la evaluación de la calidad de vida. El total de participantes con cáncer de mama fueron 54 (G.C.: N = 29 / G.E.: N = 25) y con cáncer de pulmón 84 (G.C.: N = 37 / G.E.: N = 47). Resultados: Los análisis de comparación inter e intra grupos indican que entre los pacientes con cáncer de pulmón, el G.E. presenta significativamente menos pérdida de apetito, dificultades para dormir, ansiedad, depresión y mayor recuperación de actividades cotidianas y de ocio. Entre los pacientes con cáncer de mama no hay diferencias entre grupos pero el efecto tiempo resultó significativo en la evolución negativa del cansancio y la fatiga. Conclusiones: los pacientes que, durante el tratamiento con quimioterapia, mantienen sus actividades cotidianas y de ocio no presentan alteraciones emocionales. La activación conductual puede contribuir a mejorar la calidad de vida y prevenir alteraciones emocionales (AU)

Aim: In this research was evaluated the efficacy of the behavioural activation therapy in patients suffering lung cancer and breast cancer along the oncologic treatment. Measures: The variables used as outcome criterion were: frequency and intensity of the illness symptoms and/o medical treatment; affectation of personal autonomy, daily life activity, leisure, work activity, family and social relationships and emotional disturbances. Data were collected through standardized scales (IK, HAD, QLQ-C30), self-report and clinical interview in each of the treatment sessions and three months follow-up. The control group underwent the same number of sessions of assessment. The total number of participants with breast cancer was 54 (control group 29 and experimental group 25) and lung cancer 84 (control group 37 and experimental group 47. Results: The subjects of the experimental group of lung cancer showed a higher recovery of daily life activities and leisure and less difficulty sleeping, anxiety, depression and less loss of appetite. In the breast cancer no differences were found between groups but the effect of time was significant in the variables tiredness and fatigue. Conclusions: The patients that, during chemotherapy treatment, maintain their daily activities and leisure activities do not show emotional disturbances. The behavioural activation can contribute to improving the quality of life and prevent emotional disturbances in cancer (AU)