RESUMO
INTRODUCTION AND AIM: Employment of mindfulness-based programs and techniques in the treatment of cancer patients have spread exponentially in the past decade. A large number of studies have proved the effectiveness of the program in the reduction of stress symptoms, depression and anxiety, and the improvement of sleep and mood patterns. The present study was done at Firebird Foundation and examines the effectiveness of the complex, MBCR (mindfulness-based cancer recovery)-based psycho-social intervention in the treatment of cancer patients. METHOD: The experimental group consisted of 101 people with various types and states of cancer. The control group consisted of 72 adjusted people. We did measurements (PPS, HADS, FACT-G, POMS-SF, Freiburg Adaptation Questionnaire) before the intervention (T1), right after the 8-week intervention (T2), and 6 months after the intervention (T3). RESULTS: The experimental group showed significant improvement in the measured psychological variables, and in few aspects of life quality between T1 and T2. There was a decrease in levels of observed stress and depression, and an escalation in optimism and vitality. We found a decrease in depressive and minimizing coping scores as well. There was a significant improvement in two dimensions of quality of life, and all these positive changes remained present by the end of the follow-up period (T3). In the control group, we only found a significant increase in minimizing coping scores at the time of T3 measurements. This is the first impact assessment study done on cancer patients using MBCR techniques in Hungary. CONCLUSIONS: The MBCR program is a very effective psychosocial intervention among cancer patients; it has a long term significant impact on mood and quality of life. Orv Hetil. 2017; 158(33): 1293-1301.
Assuntos
Atenção Plena/métodos , Neoplasias/reabilitação , Psicoterapia de Grupo/métodos , Sobreviventes/psicologia , Adaptação Psicológica , Feminino , Humanos , Hungria , Masculino , Neoplasias/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Espiritualidade , Resultado do TratamentoRESUMO
The development of a recommendation was intended for the follow-up of breast cancer patients treated with curative intent in Hungary. Follow-up includes the permanent contact with and health education of the patient, the surveillance and control of the adverse effects of oncological therapies or radiotherapy, the screening of metachron cancers, and the comprehensive (physical, psychological and social) rehabilitation of the patient. The early detection of local/regional tumor relapse is essential with careful follow-up, but there is no need for screening of distant metastases by means of imaging studies or tumor marker tests. If adjuvant endocrine therapy is needed, optimal adherence should be ensured with supportive therapy. In rare cases, special issues such as breast cancer risk/genetic mutation, pregnancy are raised, which should be thoughtfully discussed in view of recent advances in oncology. Follow-up is generally practised by the oncologist, however, in some cases the social worker, the physiotherapist, the psychooncologist, or in special cases, the lymphoedema expert is to be involved. The follow-up approach should be comprehensive and holistic.
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Neoplasias da Mama/terapia , Assistência ao Paciente , Psico-Oncologia , Neoplasias da Mama/psicologia , Humanos , Hungria , Recidiva Local de Neoplasia/prevenção & controleRESUMO
INTRODUCTION: Psychosocial status of cancer patients is still understudied in Hungary. AIM: The aim of the authors was to obtain current information on the mental and social status of this patient group. METHOD: Altogether, 1070 cancer patients with a wide range of cancer types were included in the study (30.0% male; age: 55.9 ± 11.0 years). RESULTS: A large part of the patients had serious financial difficulties and 41.3% of them were struggling with at least one more comorbid chronic disease. Further, 52.2% of the patients reported at least moderate anxiety or depression, while the occurrence of suicidal thoughts was almost three times higher among them than in the Hungarian normal population (13.0% vs. 4.6%). Level of perceived social support was also lower than the population standards and 61.6% of the patients reported willingness to benefit from professional psychological support. Quality of social life of the patients deteriorated with time after cancer diagnosis. A positive phenomenon, however, was that the primary coping style reported was active problem solving. CONCLUSIONS: The authors conclude that it is necessary to screen cancer patients for psychosocial difficulties and to establish conditions for their adequate mental and social care in Hungary.
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Ansiedade/etiologia , Depressão/etiologia , Neoplasias/psicologia , Resolução de Problemas , Qualidade de Vida , Apoio Social , Adaptação Psicológica , Adulto , Idoso , Doença Crônica/epidemiologia , Comorbidade , Feminino , Humanos , Hungria/epidemiologia , Masculino , Pessoa de Meia-Idade , Neoplasias/complicações , Neoplasias/economia , Neoplasias/epidemiologia , Estresse Psicológico/etiologia , Estresse Psicológico/terapia , Ideação Suicida , Fatores de TempoRESUMO
PURPOSE: The aim of the present study was to explore potential differences in the sociodemographic (with a special focus on gender differences) and psychological predictors of quality of life in individuals diagnosed with cancer. METHODS: A cross-sectional, observational study was carried out involving individuals struggling with different forms of cancer (N = 430). Linear regression was used to investigate the concurrent predictive role of the independent variables, stratified by gender, for each of the five cancer-specific quality of life domains and overall quality of life. RESULTS: Sociodemographic characteristics had only a negligible to small role in predicting quality of life in both men and women. In contrast, the psychological variables explained a significantly larger portion of the variance in both genders. There were no statistically significant gender differences regarding the raw quality of life domain scores; however, their predictors were markedly different in the two groups. CONCLUSION: The results of the present study indicate that it is imperative to take gender differences into consideration when planning psychosocial interventions also focusing on strengths, resources, and coping strategies. Considering the consistently emerging importance of family support in patients' quality of life, offering psychological interventions to caregivers/family members seems warranted to empower them to provide support to patients throughout the illness trajectory.
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Neoplasias , Qualidade de Vida , Humanos , Masculino , Feminino , Qualidade de Vida/psicologia , Estudos Transversais , Adaptação Psicológica , Fatores Sexuais , Neoplasias/terapia , Neoplasias/psicologiaRESUMO
GOAL: To follow up Hungarian gastrointestinal cancer patients who were treated at St. Laszlo Hospital (Budapest) between the years of 2001-2006. We focused on the impact of the illness, quality of life, emotional health, and factors contributing to meaning in life. METHODS: Out of the 240 questionnaires that were sent out in 2010, altogether 64 were returned (refusal rate: 72.3%) of which 40 filled-in questionnaires were interpretable. Mean age of the respondents (33% males) was 66.9+/-8.3 years. The following measure instruments were used: 1.) Ad hoc questions referring to the illness experience; 2.) Hospital Anxiety and Depression Scale (during the illness in a retrospective way and at present); 3.) WHO Well-being Index (WBI-5); 4.) general evaluation of quality of life on a 7-point Likert-scale (during the illness in a retrospective way and at present); 5.) Personal Meaning Profile (PMP). RESULTS: Our respondents reported significantly better quality of life at present when compared to the time of illness (p<0.001). Level of depression and anxiety were also significantly lower at the time of participation (p<0.001 and p=0.009, respectively). Self-acceptance, good interpersonal relationships, and sense of achievement proved to be the most important factors contributing to a sense of meaning in life. As a result of their illness, our respondents considered themselves as more patient, opener persons with elevated health consciousness. CONCLUSIONS: Quality of life of the respondents 4-9 years after treatment seemed to be adequate as perceived by the participants who showed low level of depression and anxiety. The illness itself has brought positive changes for the participants in their attitudes towards life and their surroundings. In spite of this fact, the perceived threat of the recurrence of cancer remains constant in their everyday life.
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Ansiedade/etiologia , Depressão/etiologia , Neoplasias/psicologia , Qualidade de Vida , Sobreviventes/psicologia , Sobreviventes/estatística & dados numéricos , Logro , Idoso , Ansiedade/epidemiologia , Atitude , Depressão/epidemiologia , Feminino , Humanos , Hungria/epidemiologia , Relações Interpessoais , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Inquéritos e QuestionáriosRESUMO
Form C of the Multidimensional Health Locus of Control Scales (MHLC-C) was designed to investigate health-related control beliefs of persons with an existing medical condition. The aim of the present study was to examine the psychometric properties of this instrument in a culture characterized by external control beliefs and learned helplessness-contrary to the societal context of original test development. Altogether, 374 Hungarian patients with cancer, irritable bowel syndrome, diabetes, and cardiovascular and musculoskeletal disorders were enrolled in the study. Besides the MHLC-C, instruments measuring general control beliefs, anxiety, depression, self-efficacy, and health behaviors were also administered to evaluate the validity of the scale. Both exploratory and confirmatory factor analytic techniques were used to investigate the factor structure of the scale. Our results showed that the Hungarian adaptation of the instrument had a slightly different structure than the one originally hypothesized: in the present sample, a three-factor structure emerged where the items of the Doctors and the Others subscales loaded onto a single common component. Internal reliability of all three subscales was adequate (alphas between .71 and .79). Data concerning the instrument's validity were comparable with previous results from Western countries. These findings may suggest that health locus of control can be construed very similarly to Western countries even in a post-communist society-regardless of the potential differences in general control beliefs.