Patients' Desire for Psychological Support When Receiving a Cancer Diagnostic.

BACKGROUND: Factors related to the desire of receiving psychological help in cancer patients are not well known. The aim of this study is to assess the prevalence of patients who would ask for psychological assistance in the first weeks following diagnosis, and to identify their psychosocial and disease-related profile. METHOD: This cross-sectional study assessed 229 consecutive cancer outpatients at a visit with their oncologist to be informed about the treatment they will receive. Disease-related and medical characteristics were assessed, and patients were asked about their mood states, levels of self-efficacy, and difficulties coping with the disease. Finally, patients were asked about their desire to receive psychological assistance. RESULTS: Only 20% of patients expressed a desire for psychological help. These patients were lower in age and had previous history of mood disorders and reported higher discouragement and coping difficulties. These variables explained 30.6% of variance. CONCLUSIONS: Although psycho-oncologists can provide helpful interventions, the percentage of patients interested in receiving psychological assistance in this study is low. Although further studies are needed, results from this study suggest methods that could easily be used by oncologists and nurses to identify patients who would like to receive psychological support.

Adapted ice cream as a nutritional supplement in cancer patients: impact on quality of life and nutritional status.

AIMS: The aim of this study was to assess the impact of adapted ice cream as a dietary supplement on the quality of life (QLQ) of malnourished patients with cancer. MATERIAL AND METHODS: We present an exploratory prospective observational study comparing two patterns of nutrition in cancer patients admitted during the study period who presented malnutrition disorders: adapted ice cream (Group I: 39 patients) and nutritional supplements (Group II: 31 patients). Patients were selected from two different hospitals from the same Oncologic Institute. QLQ was evaluated with the Hospital Anxiety and Depression Scale (HADS) and QLQ of the European Organization for Research and Treatment of Cancer (EORTC QLQ C30). Nutrition was determined by the PG-SGA test. RESULTS: HADS showed significant differences in anxiety (p = 0.023) and depression (p = 0.011) at the end of the study only in Group I. QLQ-C30 revealed statistically significant differences in baseline measures of global dimension between the two groups (Group I: 40.64-56.36 CI; Group II: 25.70-43.11 CI; p = 0.017). Differences were also present in the social dimension (Group I: 77.42-93.51 CI; Group II: 55.85-82.85 CI; p = 0.039). Statistically significant differences were observed between the two groups at the end of the study in the global scale: Group I had 49.36-63.88 CI and Group II had 33.05-51.88 CI (p = 0.016), and in the fatigue scale: Group I had 36.19-53.83 CI and Group II had mean = 65.87, 52.50-79.23 CI (p = 0.007). CONCLUSIONS: The administration of ice cream could cover, in part, the social aspect of food and improve QLQ in malnourished cancer patients. These results are encouraging and deserve further confirmation.

Evidence-based consensus recommendations to improve the quality of life in prostate cancer treatment.

INTRODUCTION: Prostate cancer (PC) is one of the tumours with the highest incidence in recent years. PC therapies have several adverse effects. A panel consensus recommendation has been made to prevent or ameliorate complications in PC treatment to improve quality of life. MATERIAL AND METHODS: Fifteen specialists have met to analyse the different toxicities associated with PC treatment. Each medical specialist performed a National Library of Medicine PubMed search citations searching about these secondary effects and his specialty from 1999 to 2009 to propose measures for their prevention/amelioration. RESULTS: Surgery is associated with incontinence and impotence. Radiotherapy can produce acute, late urological and gastrointestinal toxicity. Brachytherapy can produce acute urinary retention. Chemotherapy is associated with haematotoxicity, peripheral neuropathy and diarrhoea, and hormone therapy can produce osteoporosis, metabolic syndrome, cognitive and muscular alterations, cardiotoxicity, etc. CONCLUSIONS: Improvement in surgical techniques and technology (IMRT/IGRT) can prevent surgical and radiotherapeutic toxicity, respectively. Brachytherapy toxicity can be prevented with precise techniques to preserve the urethra. Chemotherapy toxicity can be prevented with personalized schedules of treatment and close follow-up of iatrogenia and hormone therapy toxicity can be prevented with close follow-up of possible secondary effects.

Mindfulness para la reducción del malestar emocional en pacientes oncológicos. Estudio comparativo con una intervención psicoeducativa estándar / No disponible

Objetivo: Comparar la efectividad de una intervención de Mindfulness (MBSR) versus una intervención psicoeducativa estándar en pacientes oncológicos. Método: La intervención MBSR (grupo experimental) consistió en 10 sesiones semanales de 2,5 horas cada una de ellas y el paciente debía practicar Mindfulness diariamente y durante 45 minutos en su casa y la intervención psicoeducativa (grupo control) consistió en 8 sesiones semanales de 2,5 horas. Participaron 20 y 17 personas, respectivamente. Se recogieron datos basales y se administraron (pretest-postest) los siguientes cuestionarios a los participantes de ambos grupos: STAI (ansiedad-estado y ansiedad-rasgo), BDI (depresión) y EORT-QLQ C-30 (calidad de vida). Resultados: En el grupo experimental resultaron diferencias estadísticamente significativas indicativas de mejoría en todas las medidas (depresión, ansiedad-estado, ansiedad-rasgo y calidad de vida) mientras que en el grupo de control sólo aparecieron en la variable ansiedad-estado. Conclusiones: Los datos de esta investigación indican que el MBSR produce una mejoría importante en el malestar emocional y en la calidad de vida, superior a la que puede lograrse con una intervención psicoeducativa. No obstante, no puede afirmarse que el MBSR deba ser la técnica de elección para todos los casos, pues no está claro que pueda ser seguida por cualquier tipo de paciente, al requerir una alta implicación por parte del mismo (AU)

Purpose: To compare the effectiveness of a Mindfulness-Based Stress Reduction (MBSR) intervention versus a psychoeducational standard intervention in oncological patients. Method: MBSR intervention was applied following a 2’5 h-session schedule, across 10 weekly sessions. Patients (n= 20) had to practice mindfulness daily at home during 45 minutes. In the psychoeducational group (n=17) a schedule of 8 weeekly sessions of 2’5 h each was applied. Following a pre-post design, the following questionnaires were applied to both groups of patients: STAI (to assess both state and trait anxiety), BDI (Depression) and EORTC-QLQ-C-30 (quality of life). Results: In the MBSR group, scores in anxiety and depression decreased at post-treatment assessment whereas quality of life scores increased. These differences reached statistical significance. In the psychoeducational group only state anxiety scores decreased at post-treatment, with the difference reaching statistical significance. Conclusions: MBSR produces higher improvements in emotional states and quality of life than those obtained following a psychoeducational standard procedure. However, itcannot be stated that MBSR must be always the intervention to be applied in all cases, since it is not clear that all patients could follow theguidelines, tasks and exercices required by this technique (AU)

Factores predictores de solicitud de ayuda psicológica en los meses inmediatos al diagnóstico oncológico / No disponible

Objetivo: Determinar la prevalencia de pacientes que, tras conocer el diagnóstico oncológico y el tratamiento prescrito, desearían recibir atención psicooncológica, e identificar las características sociodemográficas, biomédicas y psicológicas de los mismos, con la finalidad de establecer un posible perfil del demandante. Método: Se evaluaron 236 pacientes oncológicos atendidos en el Consorci Sanitari de Terrassa, mediante un cuestionario que recogía información sociodemográfica, datos clínicos y aspectos psicológicos (estado de ánimo, dificultad para afrontar e historia previa de ansiedad o depresión) asociados a las necesidades percibidas tras el diagnóstico, y que administraba el propio oncólogo en los meses inmediatos a la comunicación de la enfermedad. Resultados: Un 24% de los pacientes formularon deseo de atención psicooncológica. Se observó que los pacientes más jóvenes, que presentaban alguna alteración emocional, o que no se encontraban preparados para abordar sin mucho esfuerzo la situación, eran los que expresaban mayor interés junto con los pacientes sin antecedentes de diagnóstico y/o tratamiento psiquiátrico y/o psicofarmacológico. No se encontraron diferencias estadísticamente significativas respecto al género, nivel educativo, pronóstico, el hecho de vivir sólo, tipo de tumor, tiempo transcurrido desde el diagnóstico o grado de diseminación del tumor. Conclusiones: Se confirma que los pacientes que presentan malestar emocional, pero sin antecedentes de trastorno psicológico, son los que principalmente desean ayuda psicológica así como que las variables clínicas y sociodemográficas no tienen una clara relación con este deseo. Se advierte la necesidad de definir con más precisión qué se entiende por "ayuda psicológica" para que el paciente pueda valorar mejor si lo que se le ofrece puede serle útil para responder a sus necesidades (AU)

Purpose: To state the rate of patients who would ask for psychological assistance, once they have known their diagnosis and treatment assigned. To find the profile of these patients considering their demographic, clinical and psychosocial features. Method: A sample of 236 patients assisted at Consorci Sanitari de Terrassa (CST) was assessed using a questionnaire which asked for demographic and social features, as well as for some psychological variables (mood states, coping problems, previous anxiety or depression disorders) during the months which followed the diagnosis. Results: 24% of patients were interested in receiving psychological assistance. These patients were younger, expressed mood alterations and coping difficulties, and did not have previous anxiety or depression disorders. There were no differences between patients who asked for psychological assistance and those who do not, in gender, educational level, social relationships, diagnostic, or prognosis. Months from the knowledge of diagnosis were also unrelated with desire of receiving psychological assistance. Conclusions: A definition of what does mean "psychological assistance" is needed in order to understand why only 22% of patients ask for this resource. Sociodemographic and clinical variables were unrelated with desire of receiving psychological assistance. Younger patients with psychological distress and without previous history of emotional disturbance are more prone to ask for psychological assistance (AU)